microsoft word dimkafinal3.docx disability, participation and apparel throughout the life course jessica dimka department of anthropology, temple university author contact: jessica.dimka@temple.edu allison kabel department of health sciences, university of missouri author contact: kabela@health.missouri.edu kerri mcbee-black department of textile and apparel management, university of missouri author contact: jmcbeeblackk@missouri.edu abstract there are a growing number of people living with disabilities (plwd) throughout the life course and across the disability spectrum. while much attention has been paid to environmental barriers to social participation for plwd, apparel-related barriers have been largely overlooked. we conducted an online survey of 110 plwd to identify challenges to finding appropriate clothing and related concerns regarding social participation for members of different adult age categories. survey results included (1) difficulties finding or purchasing appropriate clothing and some apparel-related barriers to participation were more frequently reported by respondents in older age groups and (2) the increase in complications were not simply directly associated with aging. keywords: disability; aging; apparel; participation anthropology & aging, vol 38, no 1 (2017), pp. 17-29 issn 2374-2267 (online) doi 10.5195/aa.2017.146 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 17 disability, participation and apparel throughout the life course jessica dimka department of anthropology, temple university author contact: jessica.dimka@temple.edu allison kabel department of health sciences, university of missouri author contact: kabela@health.missouri.edu kerri mcbee-black department of textile and apparel management, university of missouri author contact: jmcbeeblackk@missouri.edu over 16% of americans 21 to 64 years old and nearly half of people aged 65 and older are living with disabilities (brault 2012). further, the age structure of the united states’ population is changing, with the proportion of the population aged 65 or older estimated to nearly double between 2012 and 2050 (ortman, velkoff, and hogan 2014). from a strictly biomedical perspective, both disability and aging have significant impacts on individualand population-level health and health care. however, neither disability nor aging are solely biological or biomedical characteristics or processes, as both are also strongly influenced by environmental and sociocultural factors. one such factor is clothing or apparel, which can affect, for example, expression or understanding of personal identity, mobility, social engagement, and treatment of or stigma against individuals in professional and personal arenas. therefore, the interactions of age, disability and apparel are of particular interest to anthropologists and social scientists, as well as to health sciences researchers and health care providers. the purpose of this study is to document the relationships among age, social participation and apparel for persons living with disabilities (plwd). specifically, we focus on how apparel can impact functioning and participation through the particular interactions of age and inadequate access to or availability of appropriate clothing. in the following sections, we first review literature on disability and social participation and anthropological perspectives on aging, disability and clothing. we then present survey results demonstrating that the interaction of these variables can be both a straightforward linear process of disability-related apparel concerns changing with older age, as well as a more complex issue in which personal and social desires and needs can factor into apparel and disability issues at any age. disability assessment and impacts on social participation different policy and research perspectives on disabilities have emphasized either individual limitations typically caused by disease or trauma that require medical care or intervention, or societal attitudes and anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 18 environmental barriers that exacerbate impairments. the world health organization, in creating the international classification of functioning, disability and health (icf), recognized that an alternative model, which incorporates both these ideas as well as external environmental and internal personal factors, provides a more nuanced way of understanding disability. according to the icf model, it is possible for all individuals, at different times, to experience some degree of temporary or permanent disability either because of health-related issues or because of the environment in which they live (world health organization 2002). previous research has shown that apparel-related barriers can cause significant complications for plwd, but also that these barriers transcend different clinical categories of disability and are often influenced by social attitudes and features of the built environment. these findings suggest that identifying and addressing clothing-related concerns may be best served with the icf framework. the icf assesses health and disability at the level of the individual and of the population, and strategies for this assessment focus on functioning rather than disability, regardless of the particular reason for impairments in an individual’s functioning. in addition to body functions and structures, the classification framework also considers required or desired activities or tasks, and participation or involvement in life situations and events. assessments of individuals or populations thus identify impairments to body functions or structures, limitations to the ability to execute activities, and restrictions preventing participation. together with the physical and social environment, these different aspects all contribute to what is commonly known as “disability” (world health organization 2002). apparel-related concerns intersect all three components of the icf framework. for example, clothing might need to be modified to allow access to iv ports or catheters necessitated by impairments in body function, or might interfere with the ability to use assistive devices and thus a person’s ability to execute different activities (banks 2001; garner and douglas 1991; nessley and king 1980; wang et al. 2014; white and dallas 1977). further, clothing can increase feelings of stigma that influence the desire or ability to engage in social participation (carroll and gross 2010; carroll and kincade 2007; freeman, kaiser, and wingate 1985; wingate, kaiser, and freeman 1986). for many plwd, “…dressing in patient clothing can be a metaphor for illness or other health problems” (topo and iltanen-tähkävuori 2010, 1685). social participation has been linked to a higher quality of life for people with disabilities throughout the life course (jaeger, röjvik, and berglund 2015; mikula et al. 2015), and physical as well as social environments are known to influence participation (hammel et al. 2008). however, aging with disabilities has been associated with social disengagement (kubina et al. 2013) and an increase in participation barriers that older adults must navigate (johnson, brown, and knaster 2010). strategies for coping with these barriers may become more difficult with age (johnson, brown, and knaster 2010). for example, twigg (2013) found that older adult women struggled to express themselves through clothing, as “the body could no longer perform in relation to dress in the ways it had in the past” (2013, 150). this struggle was due to the interplay between aging bodies and the “institutional biases” of the fashion industry, resulting in a lack of suitable apparel designed for and marketed toward older consumers (2013, 145). anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 19 anthropological perspectives on aging, disability and clothing anthropological works reveal several points of intersection between aging, disability and apparel, including the dual role of social and physical or biological factors; the importance of identity and independence, particularly in light of the transient nature of health and ability across the life span; and issues of stigma and social participation. first, as indicated above, different conceptual models frame disability as either a biomedical impairment, a consequence of the social or built environment, or as with the icf, both. battles (2011) argues that one contribution of anthropology to disability studies has been a critique of the social model of disability, refining it to recognize the importance of the physical experiences of plwd. an emphasis on the intersection of biology and culture highlights the possibilities of research integrating anthropological subfields to improve knowledge of disability across cultures and over time (battles 2011; sofaer 2006). similarly, anthropologists have demonstrated the cultural values and assumptions, as well as the interactions between individuals and their environmental contexts, associated with aging, despite its common treatment in other fields as a culture-free biomedical process (lamb 2014; perkinson and solimeo 2014). anthropologists (e.g. hansen 2004) also have discussed the embodied nature of clothing and the simultaneous individual and collective roles of such material items, coined the “social skin” by turner (1993 [1980]). for example, the physical act of touching or holding apparel and accessories has even aided in recall of memories for people with dementia (buse and twigg 2015). a second cross-cutting theme in anthropological research emphasizes personhood or identity and, in some cases, retention or loss of that identity as individuals transition to different age groups or health and ability statuses. for example, lamb (2014) critiqued the “successful aging” model frequently espoused in the united states, which encourages independence and staying active, and presents an ideal vision of maintaining the self of a person’s earlier years. this model, however, can be counterproductive by not encouraging individuals to accept the various changes that come with aging (lamb 2014). clothing choices are one way that identities may be maintained and expressed among individuals as they age. research has shown, for example, that clothing has social and aesthetic significance for people with dementia, and selection of apparel consistent with styles preferred in the past may be one way for caretakers to cope with caring for elderly relatives (buse and twigg 2015). at all ages, disability can threaten perceived values of independence and identity, especially because individuals may easily become disabled at any time (ginsburg and rapp 2013; reid-cunningham 2009). sociocultural processes, historical context, and individual experiences all contribute to one’s sense of self and how that identity is expressed through clothing (twigg 2009). in some cases, individuals may actively embrace related changes, while for others, new apparel choices or needs may be resisted or rejected. for example, stalp et al. (2009) explored the activities of members of the red hat society, considering factors such as stigma associated with age and feminist issues of cultural norms about appropriate appearance and behavior in public, particularly for older women. these women dress in vibrant colors, may engage in loud, attention-grabbing behavior during group meetings, and aim to celebrate the aging process (stalp et al. 2009). in their research on dress among individuals with dementia, buse and twigg (2015) note that while some clothing preferences and personal styles persisted into older age, it is also not uncommon for styles to change over time, which may cause conflict between the person and their caretaker, especially if the clothing choices are seen as inappropriate or indicative of the person’s health condition. apparel issues related to stigma and social participation form another theoretical intersection among anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 20 anthropological works. in ethnographic interviews addressing opinions about the successful aging model described above, some individuals expressed discomfort with and a desire to be separated from others who might be perceived as unsuccessfully aging such as residents of nursing homes who may be noticeable through the use of wheelchairs or wearing of particular types of clothing such as bed clothes (lamb 2014). conversely, for the members of the red hat society, choice of apparel encourages social participation and challenges stigmas about gender and age (stalp et al. 2009). disability studies similarly show that negative perceptions, potentially produced by the knowledge that anyone may become disabled, produce stigma and marginalization (reid-cunningham 2009). these barriers to social participation can be exacerbated or concealed by available clothing choices. in the work presented here, we conducted a survey particularly focused on apparel-related barriers to social participation, but responses reflect many of the above themes. methods as part of a larger research project on clothing-related barriers (irb protocol # 1210290), we conducted a survey aimed at plwd and/or parents or caretakers of plwd. the survey, hosted through qualtrics.com, was distributed via social media platforms such as facebook and faculty webpages. it was launched in march, 2014, and remained open until may, 2014. respondents who completed the survey and provided sufficient contact information received an electronic gift card. no follow-up obligations were required of the participants. all respondents were asked 37 questions, with up to 19 follow-up questions depending on their answers. questions included, for example, whether individuals with disabilities experienced difficulty finding clothing with appropriate sizes and fit or that suited needs associated with the disability but also met standards of style and comfort, and whether respondents ever declined to participate in social activities, were concerned about employment prospects, or felt embarrassment due to the clothing available to them. the results of the survey were explored to determine whether there were any age-related trends or whether particular concerns were more common with certain age groups. in this paper, we focus on respondents who are plwd and may also be caretakers; we exclude participants who identified solely as caretakers. at this stage, only descriptive results are presented to indicate areas of concern that should be investigated with larger sample sizes and in more detail. exemplary responses to open-ended questions are also included to illustrate the findings. results at the time the survey was closed, a total of 240 surveys had been initiated. however, surveys that were incomplete or likely products of spamming were excluded from further analyses. of the remaining surveys in the sample, 110 were completed by participants who identified as plwd. table 1 indicates the age group and sex reported by these respondents. data on ethnicity and nature of disability were also collected but the analyses presented here pool all responses together for each age group to increase sample size. the majority of respondents in all age groups reported mobility-related challenges and white or european ancestry. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 21 table 1. reported demographic data of plwd survey participants age group male female other total 18-24 5 3 0 8 25-35 15 16 0 31 36-49 13 23 0 36 50-64 8 21 1 30 65+ 1 4 0 5 total 42 67 1 110 the results reported here are drawn from the subset of the questions for which patterns or relationships with age could be discerned. table 2 includes the full text of those questions and the possible responses, as well as the abbreviation used for each question throughout the rest of this paper. the two trends that became apparent were difficulties associated with increasing age and particular concerns associated with younger or intermediate age groups. table 2. questions from survey demonstrating age-related trends question possible responses abbreviation have you encountered difficulty in finding appropriately sized clothing for yourself or the person for whom you provide care? never, rarely, sometimes, routinely size have you encountered difficulty finding clothes that function to suit your needs but also meet (in terms of style, comfort, etc.) your standard of acceptability? never, rarely, sometimes, routinely standards have you encountered difficulty in finding clothes with the appropriate fit (length, girth, overall fit)? never, rarely, sometimes, routinely fit has your disability ever caused you (or your child/care recipient) to feel reluctant to try on clothes in a retail dressing room? never, rarely, sometimes, routinely dressing room reluctance does your disability make it difficult for you (or your child/care recipient) to try on clothes in a retail dressing room? yes, no dressing room difficulty have you ever declined to participate in an activity, event or experience because you lacked or are unable to wear the required appropriate/acceptable clothing? for example, have you chosen not to attend a wedding or other formal occasion due to a lack of suitable formal attire or shoes/footwear? never, rarely, sometimes, routinely participate are you able to find suitable swimwear for you or your child/care recipient? yes, no, i do not attempt to find swimwear swimwear do you have difficulty finding appropriate workout wear/athletic clothes? yes, no, i do not attempt to find this type of apparel exercise have you ever been concerned about barriers to employment due to required clothing? never, rarely, sometimes, routinely employment anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 22 has the lack of appropriate clothing ever caused you or your child/care recipient to miss out on something? never, rarely, sometimes, routinely miss out have apparel-related issues ever caused you embarrassment or humiliation? never, rarely, sometimes, routinely embarrassment have apparel or clothing issues sometimes or routinely become a barrier in any of the following? romantic relationships, obtaining education or training, transportation (public or private), spending leisure time the way you would like romantic, education, transportation, leisure trends with increasing age several questions demonstrated trends where difficulty with apparel increased or generally increased with age. for example, older respondents were more likely to respond “sometimes” or “routinely” (vs. “never” or “rarely”) to statements that they experienced difficulty finding clothes with appropriate size or fit or that met their standards (figure 1). figure 1. proportion of age group reporting “sometimes” or “routinely” to indicated questions despite varying degrees of reported difficulty, many of the specific complaints are similar across the age spectrum and reflect the need for clothing and apparel that both accommodate disability-related needs and are stylish and age-appropriate. for example, disabilities often result in atypical body sizes or proportions, leading to difficulty with finding appropriately fitting apparel items (garner and douglas 1991; wang et al. 2014). representative comments demonstrate these difficulties are shared and persistent across different age groups (table 3). another common problem for members of multiple age groups is difficulty with finding 0 0.2 0.4 0.6 0.8 1 size fit standards 18-24 25-35 36-49 50-64 65+ anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 23 appropriate shoes, as indicated by the example responses in table 4. table 3. representative comments regarding difficulty with clothing for atypical body sizes and shapes age group representative comments 18-24 “i’m small and wear a girls size 12/14 in clothes so it can be hard to find professional or age appropriate looking clothes sometimes.” 25-35 “pants are the hardest… i’m only 3f 7i and 30 years old. my rear end is bigger [than] what my leg length is!” “i’m 6’5 in a wheelchair, wide hips but skinny legs. never have the right fit with pants.” 36-49 “my arms & legs are very skinny due to loss of muscle tone so shirts & pants look very baggy on me.” “…i have the size body of an adult but the height of a small child…” 50-64 “i am only 4 ft 4. all petite sizes must be hemmed for me. i cannot find pants (waist to hip measurement is too long). i have a barrel chest so need larger but shorter sizes.” table 4. representative comments regarding difficulty with shoes age group representative comments 18-24 “shoes are hard to find due to them being hard to put on my prosthetic foot.” 25-35 “trouble finding shoes that fit my small feet that look professional and appropriate for a 30 year old. i also wear braces, so that makes it difficult too.” 36-49 “finding stylish shoes that i can walk in. tennis shoes are best, but they aren’t great for work or dressing up.” 50-64 “shoes that are wide enough to use with my brace for my right foot “shoe size is preschool, finding adult styled shoes is nearly impossible.” older respondents also reported increased difficulty using dressing rooms (38% in youngest age class and steadily increasing to 100% in the oldest), as well as increased reluctance to do so (25% in youngest, up to 100% in oldest). answers to open-ended questions suggested these issues were frequently related to wheelchairs, braces, and other devices, which also produce issues with finding appropriate or desired clothing beyond dressing room concerns (table 5). as mentioned above, the majority of respondents identified as having a mobility-related disability. however, reported difficulties also included perceptions of stigma from appearance or the presence of caregiver assistants in the room. one respondent wrote “people stare. it is hard enough to see me and how much something needs to be altered.” anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 24 table 5. representative comments regarding wheelchair-related apparel and/or dressing room concerns age group representative comments 25-35 “sometimes there are no dressing rooms large enough for a wheelchair and a caregiver whom i rely on for dressing assistance.” 36-49 “sizing, professional looking clothing that does not bunch up while sitting in a wheelchair all day, coats, sweaters, jackets, [blazers] that are not [too] long that i end up sitting on it and choking myself.” “…i also have used a wheelchair my whole life so my thighs are thicker and my calves are skinny…” “i never try on clothes in a dressing room. not enough room inside for me & my helper & too time consuming. there’s no way to transfer me in/out of my wheelchair to try on jeans/dresses/shorts with a lift being available.” 65+ “getting pants that come up higher in the back. getting dress jackets that aren’t too long for a person in wheelchair.” “i use a scooter, space in the changing area. few stores today have sales people available to get more. i cannot stand without my crutches.” survey responses also demonstrate how clothing-related concerns can contribute to loss of social engagement and physical activity among older plwd. members of older age groups reported being more likely to decline to participate in social activities (the “participate” question) because of clothing barriers. while only 13% of respondents aged 18-24 report this is sometimes or routinely a problem, 40% of respondents in both the 50-64 and 65+ age classes selected that response. similar proportions for the different age groups indicated that clothing issues sometimes or routinely prevented them from spending leisure time as they would prefer. as above, however, additional details provided – in this case, the types of activities often cancelled or avoided – are similar across the age spectrum, with frequent examples including swimming events, graduation or wedding ceremonies and parties, sporting or exercise activities, and church services. one participant noted that the decision not to attend a wedding resulted in resentment and strain in a friendship, demonstrating how apparel-related decisions to participate can have long-lasting implications for social relationships. conversely, the loss of social engagement due to disability can lead to changes in clothing choices and worsening emotions or health, as with one participant who described the frustration of being homebound and constantly wearing sleepand loungewear. additionally, a few questions showed declining trends with age, most notably the swimwear, exercise and transportation questions (figure 2). upon further examination, however, there is a corresponding general increase in the proportion of each age category who stated they do not attempt to find swimwear or athletic apparel, which likely explains decreasing complaints about these apparel items. these findings raise concerns regarding health impacts and other benefits associated with physical activity or exercise among both elderly individuals and plwd. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 25 figure 2. proportion of age group reporting apparel-related concerns to indicated questions important concerns for intermediate age groups rather than a relatively straightforward increase in difficulty with age, other responses demonstrate more problems associated with activities and concerns most likely to be undertaken by members of intermediate age groups. as indicated by figure 3, these groups tend to be more likely than members of the youngest adult age class (e.g. university students) or the oldest age class (e.g. post-retirement) to “sometimes” or “routinely” experience apparel-related issues that raise concerns about employment or education barriers and romantic relationships, or cause them embarrassment or to miss out on something. some of these responses therefore may reflect the “stage of life” individuals are in, such as more employment-related concerns for adults in prime or middle adulthood. overall minimal barriers reported in education-related activities, however, could reflect the resources available to schools that are legally required to meet the needs of individuals with disabilities. 0 0.2 0.4 0.6 0.8 1 swimwear exercise transportation 18-24 25-35 36-49 50-64 65+ anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 26 figure 3. proportion of age group reporting “sometimes” or “routinely” to indicated questions discussion two broad results emerged from a variety of questions addressing apparel-related barriers to everyday life. these results included (1) difficulties finding or purchasing appropriate clothing and some apparel-related barriers to participation were more frequently reported by respondents in older age groups and (2) the increase in complications were not simply directly associated with aging. rather, particular concerns are reported to be more relevant to younger and intermediate age groups, likely due to the shifting priorities of older adults as well as the lack of desirable clothing designed and marketed toward older consumers especially. an interesting and unexpected trend associated with the first theme is that, while the proportion of respondents indicating particular barriers varied by age, the nature of complaints often was similar across all age groups. for example, respondents often mentioned difficulty finding suitable shoes, navigating fitting rooms, or finding age-appropriate clothing. while it is important to remember that the underlying needs (such as what qualifies as age-appropriate for different groups) may vary, the general themes were often consistent. further, participants noted that these difficulties led to decreased social engagement, which could contribute to additional health or quality of life issues. this is consistent with the existing research on participation and disability (jaeger, röjvik, and berglund 2015; mikula et al. 2015). thus, these findings support the argument that clothing belongs among the external or human environmental factors to consider when assessing the level of impairment or functioning in individuals according to icf methods. further, these findings contribute to anthropological research about the nuances of independence among plwd and/or aging individuals by documenting the existence of and attitude about barriers to independence. 0 0.1 0.2 0.3 0.4 0.5 18-24 25-35 36-49 50-64 65+ anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 27 the second important result to take from this survey is the recognition that age-related changes in clothing needs and the disablement process cannot simply be assumed as a linear progression in difficulty with older age. age cohorts reflected common culturally and generationally ingrained life course expectations (becker 1994). for example, the age groups used in this study likely correspond with early adulthood or college-aged adults, intermediate groups whose members might be more likely to have stable employment or family responsibilities, and retirement-age and older individuals. specific needs and activities require or even demand participation in professional or personal arenas that cause apparel-related challenges for younger age groups but may be less of a consideration for older groups, such as employment obligations or pursuing romantic relationships. however, the “causal” direction in the relationship between age and participation in these types of activities, and how clothing challenges intersect that relationship, is unclear. for example, do older adults actually experience less difficulty with certain clothing-related barriers to social participation, as reported in many of the related survey questions? do they have fewer social or professional obligations, or feel less social pressure to dress in a specific manner? perhaps the clothing on offer for older consumers with disabilities is less desirable and presents no added benefit or improvement over items they already own, as suggested by twigg (2013). one question in particular (the “participate” question) suggested that members of older age groups are more likely to decline opportunities for activities, events and experiences and so may not even attempt to search for suitable clothing, explaining the low responses to other questions related to social engagement. thus, one avenue of further research is to expand these questions to address why respondents reported particular difficulties, rather than ask about the presence or severity of the difficulties as was done in this stage. further research will be required to address these questions more comprehensively. further, several participants made a point to specify their issues with finding clothing were not necessarily related to disability but characterized the difficulties instead as a matter of personal style. as suggested by previous anthropological research, clothing and how it is used to express identity, can be influenced by multiple factors including historical context, personal preferences and even emotional and practical concerns of caretakers. future research will be required to tease apart how stylistic choices are made independently or in conjunction with needs related to impairment or age. in addition to these contextual issues, an important limitation of this study is the overall sample size, as well as the relative sample size of different groups. the oldest and youngest age categories in particular were under-represented among respondents. results, therefore, are preliminary and represent possible trends that need to be explored further. nonetheless, collapsing the age groups into fewer, larger sets typically still demonstrate similar patterns. conclusion a variety of factors are likely to contribute to the number, as well as the age profile, of people classified as living with disabilities now and in the future, including changes in diagnostic criteria, injuries suffered by military personnel, continued modifications of the built environment in accordance with the americans with disabilities act, changes in services associated with health care reform, and an aging population. therefore, it is important for clinicians, occupational therapists, clothing designers and manufacturers, researchers and policymakers to be aware of the varied ways that clothing-related issues can affect both the functioning and anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.146 http://anthro-age.pitt.edu dimka, kabel & mcbee-black | 28 quality of life for plwd of all ages. importantly, although the reported severity and frequency of these issues vary by age, results from this survey study demonstrate that participants raise repeated and common concerns with clothing availability and design and how clothing influences social engagement. these results suggest that actions to alleviate barriers both within and across different age groups may be reasonably accomplished. in particular, disregarding specific disability categories and instead focusing on how clothing items more generally affect structure, functioning and social participation – an approach advocated by the icf – provides a productive framework for 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persons confined to wheelchairs.” journal of rehabilitation 46, no. 2 (1980): 63-67. ortman, jennifer m., victoria a. velkoff, and howard hogan. an aging nation: the older population in the united states. washington, d.c.: u.s. census bureau, 2014, https://www.census.gov/prod/2014pubs/p25-1140.pdf perkinson, margaret a., and samantha l. solimeo. “aging in cultural context and as narrative process: conceptual foundations of the anthropology of aging as reflected in the works of margaret clark and sharon kaufman.” the gerontologist 54, no. 1 (2014): 101-107. doi:10.1093/geront/gnt128 reid-cunningham, allison ruby. “anthropological theories of disability.” journal of human behavior in the social environment 19 (2009): 99-111. doi: 10.1080/10911350802631644 sofaer, joanna r. the body as material culture: a theoretical osteoarchaeology. cambridge: cambridge university press, 2006. stalp, marybeth, rachel williams, annette lynch, and m. elise radina. “conspicuously consuming: the red hat society and midlife women’s identity.” journal of contemporary ethnography 38, no. 2 (2009): 225-253. doi: 10.1177/0891241608316997 topo, päivi, and sonja iltanen-tähkävuori. “scripting patienthood with patient clothing.” social science & medicine 70, no. 11 (2010): 1682–1689. doi:10.1016/j.socscimed.2010.01.050. turner, t. “the social skin.” in reading the social body, edited by c.b burroughs and j. ehrenreich, 15-39. iowa city: university of iowa press, 1993[1980]. twigg, julia. “dress and the narration of life: women’s reflections on clothing and age.” in auto/biography yearbook 2009, bsa auto/biography study group, edited by a.c. sparkes, 1-18. nottingham: russell press, 2009. twigg, julia. fashion and age: dress, the body and later life. bloomsbury: london, 2013. wang, yunyi, daiwei wu, mengmeng zhao, and jun li. “evaluation on an ergonomic design of functional clothing for wheelchair users.” applied ergonomics 45, no. 3 (2014): 550-555. doi:10.1016/j.apergo.2013.07.010 white, louise wendt, and merry jo dallas. “clothing adaptations: the occupational therapist and the clothing designer collaborate.” the american journal of occupational therapy 31, no. 2 (1977): 90-94. wingate, stacy b., susan b. kaiser, and carla m. freeman. “salience of disability cues in functional clothing: a multidimensional approach.” clothing and textiles research journal 4, no. 2 (1986): 37-47. doi: 10.1177/0887302x8600400206. world health organization. towards a common language for functioning, disability and health: icf, the international classification of functioning, disability and health, 2002, http://www.who.int/classifications/icf/en/ microsoft word jayaramanfinal3.docx book review review of fienup-riordan, ann (editor), rearden, alice (translator). do not live without an elder: the subsistence way of life in southwest alaska (bilingual edition). university of alaska press. 2016. isbn: 9781602232976, 400 pages, price: $39.95 (paper) nirmala jayaraman b.a. anthropology, union college anthropology & aging, vol 38, no 1 (2017), pp. 80-81 issn 2374-2267 (online) doi 10.5195/aa.2017.160 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.160 http://anthro-age.pitt.edu jayaraman | book review 80 book review review of fienup-riordan, ann (editor), rearden, alice (translator). do not live without an elder: the subsistence way of life in southwest alaska (bilingual edition). university of alaska press. 2016. isbn: 9781602232976, 400 pages, price: $39.95 (paper) nirmala jayaraman union college, b.a. anthropology anthropologist ann fienup-riordan and translator alice rearden were set on a mission to facilitate cultural knowledge about the yukon-kuskokwim delta region in alaska from its elders to its youngest generation (p.4). their edited volume, “do not live without an elder: the subsistence way of life in southwest alaska” (2016), offers stories in both english and in the central alaskan yup’ik language that is learned by children in this community (p.26). what unfolds in theses stories are lessons and directions on how to handle risk and continue traditions of yup’ik society, so that the next generation will preserve their identity and pass on their advice to future generations as well (p.24). by interviewing a council of six elderly men, who represent their community, on topics that range from hunting, fishing, farming, traveling, harvesting, and adapting to new technology, fienup-riordan and rearden hope their ethnography is also used as an example of how the contemporary world can continue respecting native american populations and processes upheld by tribal councils in their homeland (p.32). with that in mind, the authors’ intended audience is both the youth within the native alaska communities and us, non-native people, who stand to benefit from listening to communities different from our own. by reading these six personal tellings of history, gerontologists will learn how they can study the active involvement of the elderly within the communities that they care about. they will also be given a realistic depiction of limited memories, personal conflict and the unresolved tension that remain among people. one may argue that it might be hard to change and implement policy concerning aging populations by having its’ analysts read ethnographic projects that interview six elders at at time. some may even argue that, however insightful it might be for communities, reading oral histories is a slow process with a small sample size. other readers will even have their own reservations about how elderly women are not part of the six people selected to share their advice and insight and that the section entitled “all women” consists of only four sentences in the whole book (p.232). however, i would argue that fienup-riordan and rearden are sensitive to these struggles as they include stories and observations made by these six leaders about other communities where one of the elders expresses, “since i didn’t fully understand what they [people of yukon and hooper bay area] said, i don’t really want to talk about something that i don’t fully understand like you. [laughs]” (p.268). what is insightful about this comment is that the elders are aware of the gaps between generations and people of different cultures (p.336). what leaves me optimistic about the authors’ approach is how they capture both the elders’ and ethnographers’ willingness to overcome communication anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.160 http://anthro-age.pitt.edu jayaraman | book review 81 barriers in order to keep the context behind these stories from becoming obsolete. not knowing, and therefore, not psychologically registering, the historical significance behind certain words and rituals will make it difficult for the next generation to decide what everyday practices and habits from their culture they would like to keep, adjust to, or change for the next generation of active listeners (p.334). in her report of the 2014 lindau nobel laureate meeting’s conference, concerning the topic of aging, lorna stewart included an insightful observation made by a neurologist who was also in attendance. this physician, who focuses on dementia care research, reflected, “we should consider a balance between adding years to life and adding life to years” (stewart 2014). i agree that it is important to add life to one’s years and not just years to one’s life (stewart 2014). i would also argue that preserving stories, oral histories, and ethnographic interviews of elders within one’s culture is important for this very same reason. this book serves as a wonderful example of how we can add life to an older adult’s years through the act of storytelling because it models how we can provide company and conversation. furthermore, by keeping their memories alive through storytelling we are not only adding life to their years, we are also adding a renewed sense of life to our years as well. the elders within a community can breathe life into the next generation by providing perspectives enhanced by time, relationship and place. bibliography fienup-riordan, ann (editor) and rearden, alice (translator). 2016. do not live without an elder: the subsistence way of life in southwest alaska (bilingual edition). university of alaska press: fairbanks, alaska. stewart, lorna. "gerontology: will you still need me, will you still feed me?." nature 514, no. 7522 (2014): s14-s15. microsoft word adventuremoorex.doc a spirit of adventure in retirement: japanese baby boomers and the ethos of interdependence katrina louise moore school of social sciences, the university of new south wales sydney, australia author contact: katrina.moore@unsw.edu.au abstract self-reliance has arisen as a key ethic in relation to older persons in japan. one part of a larger social trend affecting mature societies around the world is the rising emphasis on elders overcoming dependence in favor of a new ethic of independence. this analysis of older persons in japan opens a window into the gender dynamics of older-person households, and into the discourses about the lack of an independent autonomous identity in old age aside from that in the workplace. drawing on fieldwork with retirees, i illuminate retired couples’ experiences of and attitudes about retirement, considering the interpersonal dimensions of interdependence and the ways the ethos of self-reliance influences retirees’ lives. in particular, i analyse how the men seek to embody interdependence in relationships with their wives. how do they adjust in relation to their wives’ expectations, and how do they—and their identities—change after they leave the workforce? central to this process is an expansion in men’s acts of thoughtfulness in relation to their wives. keywords: japan, retirement, self-reliance, autonomy, interdependence, responsibility, gender, culture anthropology & aging, vol 38, no 2 (2017), pp. 10-28 issn 2374-2267 (online) doi 10.5195/aa.2017.159 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 10 a spirit of adventure in retirement: japanese baby boomers and the ethos of interdependence katrina louise moore school of social sciences, the university of new south wales sydney, australia author contact: katrina.moore@unsw.edu.au introduction in a radio interview on nhk, japan’s national broadcasting service, a market researcher, tsuchinaga toshihiko, spoke with the nhk anchorman, noguchi hiroyasu, about the retirement of japan’s dankai no sedai (baby boomer generation), those born between 1946 and 1950 (noguchi 2005). as they discussed the lives of retired salaried workers and their wives, tsuchinaga said, ‘if you compare retirement with getting off a train, the wives stepped off their train ten years ago when they finished childrearing. they’ve since made friends, been on trips, taken lessons to increase their cultural knowledge, and some have even opened their own businesses. women today are very versatile and independent… in contrast, male retirees …have simply worked. they have constantly acted on behalf of corporations, but they don’t know how to do things for themselves.’ then tsuchinaga spoke directly to the male baby boomers listening to the program: ‘retirees out there, please remember, when creating your post-retirement life, a spirit of adventure is what matters! (bōken no kokoro de yarimashō!) it can even be fun to learn cooking in a class, if you do it with the right attitude!’ this narrative about retirement appeared regularly in the japanese media when i was doing my fieldwork. in it, a central trope is the capable, self-reliant wife. she leads a versatile life filled with hobbies, self-cultivation activities and new ventures. she is enterprising, swift, and responsive. the other, and contrasting, central trope is of the retired baby boomer husband (salaryman), now in his mid60s, a lifelong company man who does not know how to construct his own lifestyle in retirement. he is at a loss without the structure provided by his job and company. he found comfort in his job, though he may have felt shackled by it. what is his next move? research into many cultures acknowledges that, for married couples, retirement brings enormous adjustment and transition (gradman 1994 104-107; lynch and danely 2013). the literature on ageing clearly documents the strain on mental health for older couples of spending much more time together. they must find a new balance between togetherness and separateness. married women can experience mental strain when the husband is home more often (oda 2009). the incidence of mature-age divorce (jukunen rikon) has signaled that couples sometimes part ways once the husbands get their retirement pensions (alexy 2007). i open this paper asking whether dedication to work is a liability for men. this question has vexed writers for some time. the gift of mass longevity raises questions about how people configure their later life-course (plath 1980). in the 1980s, david plath speculated that mass longevity would augur the birth of the 4generation ie (family), whether or not the generations lived under the same roof, and the attendant family interactions and obligations. consociates, that is, friends, lovers, kinswomen and colleagues, empaneled to be a special jury to examine and confirm the course of one’s growth and becoming (1980:8) anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 11 would emerge to comment on the development of the person.1 today in japan, the 4-generation family has emerged due to the rise in the number of centenarians, but the number of multi-generational households has fallen the single-person household is most prevalent (mackie 2014: 217). in 1980, 70% of senior citizens lived with their children, 18% with their spouses, and 4% alone, but by 2010, the relative figures were 42%, 40%, and 5%. in urban areas, more older persons live in couple-only households, making those relationships important to the experience of later life. furthermore, women are outliving men. as leonie stickland notes, the issue of ageing alone happily, healthily, and actively is one of great interest and concern for partnerless older japanese women, whether widowed, divorced, or lifetime singles (stickland 2015:36).2 the concept of productive ageing explains how older persons can remain involved in and contribute to society. rejecting the theory that disengagement from social life is a necessary aspect of ageing, productive ageing advocates seek to identify social participation opportunities for elders (hughes and heycox 2010:.76). american gerontologist, richard butler, originated the term in the 1980s and says the concept extends well beyond formal work: even a bedridden person can be ‘productive’ and ‘helpful to caregivers’. the key principle of productive ageing is to remain constructive in the larger society and immediate environment for as long as possible (butler in ilc 2011: 68). this approach has long existed in japan, where a retiree’s productive activity continued in a modified role after retirement. this may explain why the number of seniors working in japan is the highest in the world. as oecd data show, in japan, 76% of people over age 60 continue to be in employment (oecd 2016). in nearly 90% of cases, people aged 65 and over are rehired into new jobs, experiencing a 50-70% reduction in their salaries from before they retired (bungei shunju 2006: 104). far more elders are employed in japan than in france and germany. 77.5% of companies hired seniors age 65 and above (jilpt 2016:49). similarly, the human capital index quantifies how countries are developing and deploying their human capital. among 124 countries, japan ranks no. 5, but no. 1 for people 65 and over (world economic forum 2017).3 the ethos of productive ageing has shaped other societies with ageing populations such as the united states (lamb 2013: dumit 2012). this notion points to a broadened meaning of health among older persons and reflects the increased longevity and affluence of populations in the industrialised world. health care industry activities have expanded in recent years to encompass more than managing chronic disease and terminal illness and now include the enhancement of life and health. mature citizens in japan and other industrialised nations are encouraged to consume their way to wellness by striving to forestall the effects of biological ageing. in the rest of this paper, i explore the search for a valuable retirement among white-collar workers. i argue that it is expected that a person contribute meaningfully to others’ lives. for salarymen, it requires shifting from being a provider to being a fellow traveler in life. as emma cook argues, masculinity is linked to labour, family, and particular types of responsibility (2016:3). postwar ideas of manhood positioned men as hard workers, breadwinners, and heads of households (daikokubashira) responsible for families. with retirement, the nature of responsibility shifts. my thesis is that to be thoughtful toward the other is to be responsible toward the other, and to be responsible toward the other is to practice interdependence. all of this, moreover, is encapsulated in activities that the state labels as exercising independence in japan. i argue that the retirees’ search for meaningful hobbies and the self they engage in reflect more than simply the trend toward being productive; they also wish to embody independence in later life, and to have good marital relations in retirement. for older persons, it is important to find a social purpose after retirement, to have a meaningful channel of social contact with anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 12 people other than one’s immediate kin, and to continue to work (traphagan 2006). what follows is a discussion of how retirees adjust to retirement. i focus on the experiences of men who built their careers in a historical era where attachment to the corporation was valued. i analyse how they seek to embody independence in relationships with their wives. i explore the agency of the everyday: the ways in which men and women engage in practices of mutual aid, self-care and selfreliance. a second focus is thoughtfulness. my ethnographic findings show that indeed men are able to adjust in retirement. though media portrayals claim they cannot, i later provide micro sociological examples of men exercising thoughtfulness toward their wives in the years following retirement. i show how their efforts to be considerate of the other, and to minimize dependence, become intertwined. thus i contribute to the scholarship about productive ageing written in terms of the local idiom of ikigai (that which makes life worth living) in old age (mathews 2003; hashimoto 2000). to that discussion i contribute insights into the expansion of thoughtfulness that is involved in negotiating new life transitions. i show how elders remain in constructive relationships by being considerate, collaborative, and mindful about managing dependence. the crux, then, is to remain in constructive relationship: to be in relationship without being a burden (see traphagan 2006). first, however, i provide background on two values that prevail in the lives of senior citizens. other important issues that are not addressed in the paper include intergenerational family dependence relationships with grandchildren. although each of the men studied had grandchildren, i have decided to focus on their marital relationships because childrearing was not a central part of their adult lives. urgency of the ethos of self-reliance the expectation that elders participate in society stems from a rising ethos of self-reliance (jiritsu) in japan and other asian countries. writing about urban china, anna boermel (2010) asserts that finding a “new, dependable structure after retirement” is central to leading a meaningful and fulfilling life at an advanced age. there are many forms of self-reliance, for example, financial, physical, and emotional. given how central the concept of self-reliance is to this article, i provide a short history and definition of the concept. it becomes clear that elders have long aspired to the ideal. self-reliance involved social withdrawal and isolation; one transcended attachment to earthly realms and to the everyday world. the ideal has strong affinities to the buddhist concept of non-attachment and world renouncement (scheid 1997: 97). more recently, the self-reliance debate for elders has involved not being so dependent on others that one becomes a nuisance to them. i asked a retired salaried worker, satsumi, what she thought about the state’s discourse about independence. smiling a bit she said, she felt it was a slogan the government introduces to cut costs. of course, she said, all people want to be independent. and it would be ideal if the government introduced programs to support elders to stay independent. but she felt that the discourse of independence was driven by a wish to cut costs. she also said there might be people who don’t want to be independent. what is clear is that the discourse on the moral value or benefits of not being overly dependent has permeated the lives of citizens in japan, influencing their decisions to live in ways that are both creative and responsible and hence place little burden on the smooth functioning of family and society. for elders in japan, independence extends beyond taking responsibility for physical wellbeing to, in some cases, trying not to rely on people, including children. i discovered that elders are being taught to believe it is an act of consideration toward their younger kin to avoid being overly dependent on them. this perception that being overly reliant is problematic is quite pronounced in japanese society. historically, parent-child relations were constructed such that elders would return to their second childhood after anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 13 reaching 60 and could legitimately depend on their adult children for their care. today, a person who draws clearer boundaries between parent and child is praised. taking initiative in finding a nursing home or at least accepting to go into a nursing home, taking initiative in taking care of one’s belongings without leave them for family to sort out, and being responsible for progressing health goals all come under the umbrella of self-reliance. the counter-example is someone who depends on others to amend situations and find solutions. as the japanese live longer and family formation patterns have shifted, living arrangements for senior citizens have also changed. far more people over 65 are living in couple-only households or on their own. in surveys, older persons state that they prefer to live alone rather than with their children (kurokawa and campbell 2016), and that they prefer to engage the assistance of care robots rather than rely unduly on their children or on migrant carers (robertson 2014). the longevity and wellbeing of older men and women is raised in advice columns in popular magazines, and in other sites of public culture. this is the context in which older persons are enjoined to live creatively and sustain well-being. responsibility more recently, the idea of economic self-reliance has been discussed in deregulating neoliberal economies (seike 2015). this is especially relevant in japan, as its social security system shoulders large payments to elders for health insurance and pensions. the aging of the population, coupled with the low birthrate, has increased the number of retirees per capita—and the pressures on the social security system. cook describes a veritable moral panic about what young people are doing—or not doing— with their lives by not reproducing children to support the social security system (2016:6.). the young men cook analysed in her ethnography sought to create meaningful individualised lifestyles and to pursue aspirations according to their own values, which included work that was individually meaningful. following cook, i argue that men negotiate new masculine roles as they move through the life-course (ibid). for retirees, likewise, finding a source of meaning in retirement has been very important. the concept of responsibility (sekinin) has emerged as related to self-reliance. norms of personal responsibility and self-reliance suffuse contemporary japanese commentaries on personhood, which historically has been understood as embedded in social relationships. a person is constituted through her relationships with others. here i turn to the seminal work of historian carol gluck who, casting a gaze over the late 20th-century usage of the term sekinin/responsibility, notes that in japan in around 2000 and elsewhere, responsibility became a ubiquitous term, manifesting in phrases such as corporate, social, and environmental responsibility, as well as product responsibility (liability). though the term sekinin was used variously, its meaning held a clearly distinguishable valence: [r]anther than responsibility of office, role, or the individual, it was responsibility toward rather than for something (2009:101, italics in original). responsibility for the self was being reoriented toward the individual. for example, medical responsibility meant that physicians were required to tell patients the truth about their illness. responsibility was more often understood as accountability: public institutions were responsible to explain their actions to the people. and individual patients were gradually seen as being more responsible for their own well-being. at the same time, the notion of responsibility became less anchored in a sense of belonging to a community or vocation. as people became less concerned with discharging the obligations associated with such a status, the notion that arose was of responsibility anchored in principles of the person belonging to society, and thus being an accountable self. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore |14 what developed, in other words, was a heightened emphasis on the responsibility that individuals and institutions have to embody. people were enjoined to be choice-making, self-regulating members of a society. patients were held responsible for some of their diseases; by redefining diabetes as a lifestyle disease (seikatsu shukan byô), the medical establishment could make patients with adult-onset diabetes responsible for their disease. men who were let go from their jobs were told they were responsible for having chosen to work for those companies in the first place (gluck 2009:103). and following the big bang of financial deregulation in 1998, investors were told they were responsible for their investment choices. the 1990s was a time, then, when the state told people that they were responsible for all the actions they took, and the resulting outcomes. hence, the notion of responsibility in the office or position was not eroded completely, but it was joined by the new subjective feeling of responsibility associated with the modern self, and the notion of responsibility outward toward society. the support of strong individuals (tsuyoi kojin) was introduced by prime minister junichiro koizumi (2001-2005), and it was subsequently passed on to the shinzo abe cabinet (2006-2007; 2012-2017). the value was self-responsibility in the name of greater freedom. does this indicate a rise in the idea of the individual accountable for the self in society, and a gradual decline in the notion of individuals embedded in, and thus able to depend on, members of the community for their own wellbeing? i would argue that interdependence remains vitally important in japan. however, this is not to deny the importance of elders taking more initiative for their own wellbeing. the act of seeking help from others is seen as something to be actively avoided for as long as possible. reaching out for help has a new meaning of risk: that the elder is in danger of needing nursing care. local governments have promoted volunteering, as a means of ensuring that the senior population remains active (nakano 2009). they consider senior citizens’ participation volunteering work an important factor in reducing the risk of ill health associated with sedentary lifestyles in old age, and indirectly reducing the burden on the long-term care and national health insurance systems. by framing social participation in the language of individual initiative (jihatsuteki ishi), these governments are asking individuals to be proactive in constructing their retirement not only to remain healthy in later life but also to help shoulder the burden of an ageing society. overall, the twin values of self-reliance and responsibility have become a powerful prism for exploring shifting attitudes about old age, which emphasise living in a sustainable and hence responsible fashion. discourses about men’s self-reliance in retirement the sources of men’s dependence on women have occupied thinkers for some time. two theorists offer analyses that are relevant to my discussion of the retirees. taga futoshi (2006: 154-158) observes a shift in men’s sense of self upon retirement. their sense of self as a husband who is in a relationship with a wife, as opposed to a husband as a breadwinner, becomes amplified in retirement, as husbands lose other aspects of their identity as employees. without those other aspects of their identity, men can become more fixated on the couple relationship than before. they may assert their authority as husbands in the household to compensate for its loss in other domains. tanaka toshiyuki (2009) sees another source of difficulty in retirement: men become isolated from local social networks, and generally have fewer local networks than women. communication with anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 15 their wives becomes more important to them. they turn to their wives for companionship but women claim they have little to talk about together. i opened this paper by asking whether dedication to work is a liability. specifically, does it encroach on interdependence? the sociologist amano masako (1998;80),a strong advocate of balancing autonomy and interdependence, particularly among middle-aged and older couples, amano (1998:80) problematizes men’s self-reliance, or lack thereof, by saying the man only knows his corporate role and relies on his educational qualifications and work achievements to provide a source of identity and meaning. such a person does not show self-reliance even if he is financially independent because he defines his sense of self using criteria provided by corporations, e.g. his success in reaching the company’s sales goals. he is at risk of depending on his wife to have a “life” beyond work. amano says men need to develop their lives in three domains: of the self, community, and the family. these domains correspond to the sources of men’s dependence on women as identified by taga: over-identification with their careers, their limited household skills, and isolation from community networks. with the self, amano encourages men to develop a source of personal worth as a human being independently of their job tasks. for the community, it is to have local networks of friends, and neighbors. with the family, it is to contribute equally to household responsibilities, which include housework and childcare. all of these actions, especially relying less on their identity as a worker, contribute to men’s independence. yamato reiko (1996: 361) discovered that the more men take part in community activities while they are still working, the smoother their transition out of a work-focused identity. in her more recent analyses of elder dependence, amano (2014) articulates a new view. she summarizes some of the key findings from her in-depth study of japanese films dealing with the subject of older persons. to demand independence of older persons, she says, is to impose upon them the expectations of the strong; more important are sensitivity and imagination about ageing,. in other words, she is encouraging people to rely on each other, rather than pursue complete self-reliance. lamb (2013: 176) also argues that to become dependent in late life and to receive seva – respectful service and care is not a failure in personhood, but an appropriate, normal, and valued part of the life course. lamb, analysing how her indian informants approached the ageing process, states that americans may learn from them and begin to incorporate visions of appropriate dependence and meaningful decline into understandings of successful ageing (2013;185). she also sees value in developing visions of human interdependency and not seeing decline as failure. not all forms of debility signal a failure to age well. i now turn to the analysis of my research with retirees. methodology i have carried out fieldwork in japan on ageing during the past fourteen years, concentrating on urban-dwelling elders. in this article, i offer insights from interviews i conducted with retirees in saitama japan. the interviews touch on the issues of dependence and relationships in retirement. after retirement, the retirees had joined an english conversation class in the public citizens’ hall in saitama city, where i volunteered as an assistant instructor for eighteen months. my retiree informants come from diverse educational backgrounds and professions. they ranged in age from 60 to 75, and all have considered themselves suitable participants in a study of retirement and formal lifelong learning in classes (such as language and theatre classes), as well as informal circles such as hiking and walking. the interviews focus on their experience of ageing; attitudes to living a meaningful life as they grow older; daily life practices and social relations; and retirement experiences. i take a narrative analysis approach anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 16 in analysing taped and transcribed interviews and fieldwork notes. my research examines the emotions and affects that people experience when they transition into retirement. this article focuses primarily on men who retired from full-time career jobs, rather than self-employed men. the men i came to know entered the workforce in the 1960s and retired after 2000. they belong to a generation of men who worked extremely long hours and took few holidays. the japanese style of management required hard work, a great deal of unpaid overtime without pay and deference to immediate superiors. few of the men could remember eating dinner with their families except occasionally on sundays. anne allison (1994: 21-29) vividly captures the ways in which corporate entertainment can absorb workers’ time and affect, expanding the realm of work both temporally and spatially; in the process, the distinctions between work and play become blurred and the family recedes into the background. one salaryman i interviewed described this life: to tell you the truth, there was a part of me that was working because i really enjoyed it… the entertaining was crazy (mucha kucha) but great. i’d come home in the company car about 12 or 1 every morning. when i got home i’d plop down on the futon and sleep. i’d wake up later that morning and go right back to work. the salaryman who dedicated all his waking hours to work ended up spending little time at home with his family, but my informants considered this model of fatherhood to be normal. within this model of masculinity, which gave primacy to work, ties with children were neglected and they became accustomed to an absentee father. men poured their energies into work rather than their community networks. their sense of reward as husbands and fathers came from their financial support for their families, and as social beings from the camaraderie they enjoyed with their colleagues. personal stories of three retirees i now explore the subjectivities of three retirees, looking at how they negotiated shared domestic life with their wives, and what they expected after retirement. i focus in depth on a man i will call hayashi kenji whom i came to know well during my fieldwork, interviewing both him and his wife on a multiple occasions. i also look at two other retirees, murase makoto and kondo takashi. murase makoto mr. murase is 64 and lives with his wife, their second daughter, and her family. on finishing high school he began to work for a small firm in saitama, and eventually became president. over lunch one day, i asked him to explain his transition to retirement: for about three months after i retired, i was lying around at home. i felt satisfied that i had fulfilled my duty as a man, having worked for nearly 40 years. but then i began to think i had to do something. he went on to explain how a new schedule gradually unfolded around learning activities: this was just part of it: anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 17 on sundays i go to dance class, mondays to golf lessons, wednesdays to english language class… on tuesdays and thursdays i play golf with my elementary school friends. the people he had met at the english conversation class had not become close friends, but they did serve a key purpose for him: you see how at the english class most of the people come dressed up? they don’t show up in the gear they had on at home. it means they’re trying to present a nice appearance to the opposite sex. i had the choice of joining another english class where all the students were men in their 60s and 70s, but i chose this one because of the mix of men and women. when people stop caring about how the opposite sex sees them, it’s the true mark of aging. for makoto, mingling with women motivated him, and some other classmates, to consider the interests of others when selecting clothes to wear to class. leaving the house regularly gave him scope for freedom in being whom he wishes. he felt that having interactions with others helped guard against the onset of dementia. at home, he was respectful of the kitchen as his wife’s space, and rarely entered it. hayashi kenji another member of the english language class, whom i call mr. hayashi, was 67 when i interviewed him, and had worked as an architect for a large construction firm for nearly 40 years. he lived in a single-generation household. one spring day he invited me to his home to meet his wife, keiko, knowing i was interested in the impact retirement had on other members of a retiree’s household. as i chatted with keiko in the hayashis’ living room, i remarked to her that kenji was a very conscientious participant in the language class. she replied: before he retired, i encouraged him to get to know people in our local community; i knew it would be hard for him to keep in touch with his colleagues from the company. i think it’s very good for him to be going to these classes rather than stay at home all the time. when he goes out he gets stimulation and learns things he didn’t know before. in contrast to makoto, kenji enrolled in class a few weeks after he retired. but there is more to the comparison than their different degrees of initiative in seeking out learning opportunities: their home environments also helped shape their movement into the world outside the home. while both men described going to class as a good way to meet people, makoto described home as a place where he is made to feel at home by a wife who loves to cook for family members. makoto had entered his wife’s family as an adopted son (muko yôshi) and had worked for the family firm; hence he had a different schedule from the other two men, and more autonomy in managing his work-life balance. he could be more significantly involved in his children’s lives than kenji and mr. kondo, as they both worked for large corporations that dictated their working hours. “my wife likes it that i go out and do things, but she also likes me to be at home.” i asked makoto if he did any housework: anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 18 oh no. home is my wife’s domain. she won’t let me into the kitchen, except to get beer out of the refrigerator. my daughters claim my wife rules my life and it’s probably true that i live in the palm of her hand. my situation is like being on a piece of flat land surrounded by mountains. if i go too far in any direction, i hit a wall. even when i’m traveling on a golfing trip, i realize that i haven’t left my wife. mrs. murase, who enjoyed doting on her husband when he was at home, was quite different from keiko. keiko had no wish to do so: kenji said keiko preferred he be out of the house. several times during the months i knew kenji i had heard him state quite emphatically that he was making an effort to not disturb his wife’s life rhythm. when i met with keiko, she noted that when he retired one of the hardest things for her was that suddenly there were two of them in the house. she said, it’s probably true of many salaryman households where husbands leave early in the morning and come home late at night, but the woman is at home like the lord of her palace. this goes on for decades. then suddenly, it’s as if somebody begins to invade this space. keiko’s eyes narrowed as she said this. for a moment, the interview setting became tense, and kenji intervened, with a smile: “there’s this troublesome presence in your midst now, isn’t there? it’s become totally different.” keiko broke into a laugh and replied, “you make it sound harsh! but yes, having to share this space has been rather trying. it’s that i get distracted.” she went on to say that she could no longer concentrate on her painting and reading at home if he was there. kenji initially perceived the home as a space of creative relaxation. he expected he could pursue hobbies he had previously only dreamed about pursuing. keiko’s expectation that he leave the home regularly so that she could keep her ‘peace’ led him to revise his perception of home away from relaxation to a place which had a rhythm and life style he needed to respect. his wife’s organization of her home life impacted how he devised a schedule. kenji’s entry into centers of learning fulfilled a range of functions; among them, acquiring new knowledge and skills, and creating social links with neighbours. it also enabled keiko to retain the space of the home as hers for significant portions of the day. retirement forced the two to negotiate the use of the space in their home, and he responded by developing new pursuits outside. kondo toshi the third retiree, toshi kondo, like makoto joined the english language class a few months after he retired. toshi was 61 and lived with his wife and wife’s frail mother who was in her 90s and cared for by mrs. kondo. the kondos had two children in their with their own homes. i asked toshi whether his corporation had helped him make the transition into retirement. he brushed the question off, stating, “i’m very cool about things like that. i think it’s up to the individual.” although his firm had just begun to offer such guidance and services, he did not make use of them. toshi dismissed the idea of using any services offered to help men adjust to retirement. “i knew others who did, but i am not a nureochiba (wet fallen leaves).” takashi’s pride demanded that he show he was unperturbed and in charge even when in most need of support. toshi’s tone of voice suggested that only people without shame would seek such help after retirement. the citizens’ hall was a palatable source of social support where he could reconstitute himself without turning to his old employer for help. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 19 as we talked after class one day, toshi described himself as a typical salaryman: there was never a day i returned home from work before 10 pm. on weekends i would go on golfing trips with clients of my company. for six years, i lived as a tanshin funin [in a posting apart from his family] in southern japan. men of my generation – we were workaholics. toshi claimed with pride that he had no regrets about a lifestyle that had been devoted to work. the only problem was that late nights and living as a bachelor led to health troubles, namely high blood pressure and obesity: “i had a heart attack at 58. that’s why i took early retirement at 59.” toshi noted that the transition to retired life was easy at first: regaining his health became an allconsuming concern. i went walking every day to lose weight. about 9 months later, my health indicators were great. but my wife was not so happy about my retirement. she said she was sick of having to look at my face every day. i asked toshi about the source of his wife’s irritation: did he wish she would cook three meals a day for him? i had heard women members of the english class grumble about having to do so. no, he said, “i learned to cook during my six years of living on my own. these days i get my own breakfast and lunch, and i clean up after my wife cooks. it’s not that.” he continued, since our kids entered university, my wife has been an active member of the local tennis club. she’s formed a social life around the club and spends a lot of her time training. she likes for me to be active as well. i didn’t think i was being a burden (meiwaku) on anyone, but my wife became frustrated when i suggested we spend more time together after i retired. it was actually the kondos’ daughter who sought to remedy the situation between her parents and suggested that her father attend a class: that’s how i began to take chinese language classes about nine months after my retirement. six months after that i joined the english class. at $20 per month, they’re much more affordable than going out drinking or playing golf, he said, somewhat ruefully. i sensed he would have liked to have saved up more money for his retirement. in a follow-up interview, i met with toshi again. he told me he invited his wife to go to a hot springs resort; this was the kondos’ first trip as a couple in the 18 months since he had retired. he said, my wife was concerned that i would break her rhythm. she was concerned i would ask her to take care of me. but i’m keeping up my walking, and she’s keeping up her tennis life, and she’s very happy. he added: these days, i wake up earlier and earlier. i get up around 5 and have my breakfast by 6. i get my own breakfast, so i don’t put any burden on her for getting meals. i get my own lunch. i help clean up in the kitchen. i now help with preparing food and cleaning up. i don’t expect my wife to cook me three meals a day. he had also developed an interest in the nearby city of kamakura, and went there about once a month to visit friends. in the past year he had read about 20 books on kamakura; he took particular interest in its history before the heian period around the time of the life of buddhist scholar, shotoku taishi. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 20 women’s self-reliance i remembered kenji saying that he was trying not to disturb his wife’s life rhythm, but it was toshi’s comments that brought them into high relief. “after i stopped working i thought it would be nice to spend time with my wife, but she said she didn’t want to change her schedule to accommodate my retirement.” the theme of women’s angst about having their schedules disrupted emerges in the popular press. it is encapsulated in the words of a woman in her late 50s who eyes her husband’s impending retirement with considerable gloom: i want to continue all my learning activities but i worry that my husband will demand i change my schedule. he’ll ask, ‘when are you coming home? when’s dinner?’ it will drive me nuts. even now, whenever my husband is in the house, i can’t conduct life at my own pace…with his retirement, i’m afraid it will disturb my use of my time (nakamura and inokuma 2005:23). schedules provide a sense of comfort and continuity, a roadmap as to where people will go, and what activities they will pursue (dillard 2013). dillard writes that schedules provide a sense of order in a shifting world. to have such schedules disrupted is a problem. some women are in ambivalent relationships with their husbands in the domestic domain. some resist men’s expectations that they will put aside their own interests to attend to them. while many women may wish to be a good wife and friend to their husbands, they increasingly value their autonomy to design their life as they would like. hayashi keiko i saw these issues in action one day when kenji invited me to meet his wife, keiko, without him. i interviewed her in their living room, and she explained her experience of her husband’s retirement: i got used to being on my own. he was never home early in any case. he was out drinking with his colleagues after work rather than working in the office. so women like me did everything by ourselves and took care of the children by ourselves. pausing a moment, she added, ‘i learned self-reliance (jiritsu). i don’t mean isolation (koritsu), i mean self-reliance.’ as she emphasized this distinction, i heard a certain confidence in her voice, based on her experience. perhaps she was proud that she had turned isolation and aloneness into a source of strength, transforming it into independence. this involved developing skills in creating networks with other mothers and members of the local community. most importantly, it involved having an independent opinion. as she used the word jiritsu, i could see that she situated it less in a paradigm of active ageing or retirement, but rather in a longer genealogy of growing as an artist, mother and housewife who was responsible for singlehandedly raising their children while the husband was at work. she had cultivated her own opinion and own way of life. for her, self-reliance was not a new phenomenon. gender sociologist taga futoshi (2005) argues that wives, regardless of whether or not they work outside the house, are equipped with skills in running a household. this is because of responsibilities entrusted to women in line with gender expectations that prevailed in their life course. as their children needed less of their time, women were catapulted into a period of soul-searching and then adopting new pursuits. they sensed that they had finally earned the right to put themselves first. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 21 women frequently refer to this process as creating a world of one’s own (jibun jishin no sekai o tsukuru). the word sekai can be interpreted in multiple ways as a world of hobbies, learning, volunteering, or part-time work; these new activities invariably involve a new set of human connections. this world is often marked as distinct from family and home. creating a world of one’s own has interesting parallels with men’s experience of retirement in that both involve a process of establishing a new identity. loss in retirement hayashi kenji some elders such as kenji experienced the discourse of developing responsibility in later life to be prescriptive. on another day, i interviewed kenji on his own. over a bowl of ramen noodles that he had prepared, kenji and i spoke about his life. i asked him how his career had interfaced with his family life. i saw my role was to work and earn money to support a household. i saw my wife’s role was to take that income and raise the children and do the housework. keiko did all of the childrearing. that’s what i thought married life was: a division of labor. in any event, i was too busy with my work to think about my kids; 100% of my self-identity revolved around work. by providing for his family, he saw himself “guarding the house” albeit in a subordinate role (goldstein-gidoni 2012:xxiv). when kenji retired, he said, he tried to come up with activities he could engage in with keiko. he invited her on trips to thank her for their many years of marriage. he was surprised when she said no. he resolved instead to pursue his hobbies at home. during his entire working life, he had been so busy that he rarely had time to enjoy hobbies he had developed as a teenager, such as building miniature trains and creating maps. but he confronted another obstacle: keiko had become so accustomed to having the house to herself that she was irritated at his company. kenji sighed, as if this weighed heavily on him. home was not a comfortable space for him to settle into. he began to set up his schedule in a way that let him leave the house regularly. this was the best favour he could do for his wife, he said, a bit despondently: to be out of the house as often as possible. kenji got up from the table where we had been eating lunch and walked to a calendar on the far wall where he and keiko kept a record of when they would be out of the house. he talked about their situation: i know people who still cram their schedules even after they’ve retired. they’re obsessed with filling up their days. it’s called the datebook syndrome. when i meet them they say i’m busy, i’m busy. i think they’re afraid they will fade out of existence if they don’t participate in all these activities. so long as they have a place to go – to teach here, take painting there, or do haiku – they seem satisfied. i wonder why? you’re finally retired! why do you pack your schedule like that? anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 22 the mild-mannered man retorted, with feeling, “it’s the first time we are liberated from a busyness where schedules are packed. why try to reproduce that? i say, give me at least the freedom to use my time at a leisurely place.” kenji was speaking primarily about his friends, but his observations also seemed to point to his own predicament where he could not relax at home because keiko expected that he would leave regularly. kenji noted that he tried to create variety in his schedule by going to exhibitions and other public events. the way kenji spoke of retirement, it was clear that he had lost many things that had provided a sense of identity. he no longer had an identity that he could anchor to a corporation; the retiree became, in the words of a woman in the english conversation class, just a person (tada no hito), a deflated entity, stripped of his title and the corporate prestige that had been associated with it. also, kenji no longer had workmates with whom he could share the travails of work. he had lost a place of belonging. but perhaps most challenging, the loss of space of being and belonging was in some sense a highly literal problem in that home was a place where he was not comfortable settling in. kenji began looking for companionship through his high school reunions and met friends with whom he began traveling. he showed me pictures of a trip he had recently made to machu picchu in peru. he had invited keiko to join him, but he said she refused: “she gets irritable sitting in a cramped space for many hours.” in fact,” he observed, “she does travel. last year she went to the netherlands on a painting trip with her friends, which also involved sitting in a plane for hours.” kenji seemed bemused as he noted this. kenji had initially felt ambivalent about adopting a lifestyle of active ageing when he felt the value of rest at home, which has resonances with the earlier ethos of respectable elderhood: withdrawal and retreat from the everyday world as a form of transcendence and self-reliance. cramming his schedule incessantly with mundane activities in order to remain busy felt for him like an antithesis to the life of non-attachment in retirement. as the minister-philosopher henri nouwen (1994) observes, people often fill their days busily because they feel that if they stop doing so, then they will feel the loneliness in their own souls. staying busy is one way to quell the feeling of loneliness. yet in feeling that loneliness, do people develop a feeling of hospitality and compassion? perhaps kenji’s willingness to be busy in a lonely fashion was an expression of compassion towards his wife. kenji did not philosophize about the value of loneliness, as he was more concerned to spend time with his wife, but it is possible that in retirement, the pain of loneliness he felt had expanded his capacity for affection for others. besides, he lived in a social milieu where the value of remaining independent was prevalent. it became compelling for him to pursue such a lifestyle. adjustments in kenji’s expectations to round out this ethnographic section, i will explore kenji’s situation. his case brings together many of the themes in this paper about autonomy and interdependence, including the unnoticed capabilities of retirees, and the dynamics influencing their lives. indeed, elders are capable of adjustment and change following their initial difficulties in retirement. a year after our earlier interview, kenji and i met up again. it was clear that he had slowly modified his desires for togetherness. he reported a new source of fulfillment in watching keiko enjoy her own lifestyle: my whole way of thinking has turned around completely. these days i feel happy when keiko is happy or is enjoying herself. i feel i’ve changed in this regard. she has her own life, her friends, and anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 23 hobbies. i try my best to not disrupt her lifestyle. i make my own food. i shop for groceries. when there’s laundry to be done, i do it, and i run the bath. kenji seemed very content in his marriage, even if it failed to entirely match his initial expectations of retired life. surprisingly, the couple had discovered a new shared hobby: home decoration. he noted: i am happy that keiko shares a certain esthetic taste with me. it’s fun when one’s sense matches the other’s. take for example this room [that we decorated together] – i have a certain liking for minimalist décor and she also likes it, so that’s great. imagine if she liked clutter, it would be oppressive and hard for me to be in this room. but … we have a common taste in interior décor, and we bring our hands together and say ‘yatta’ (yay) – do a high five. that is important. kenji had discovered a new way of being together with his wife by finding a point of similarity in their aesthetic tastes and interests. it was a small example of how thoughtful, critical reflection on the likes and dislikes underlying his wife’s personality could have new effects on their marriage. i don’t know how my wife feels about me, but i respect her and ‘take a back seat to her.’ she has unique ideas and an engaging set of friends, and i feel excited about that. during my working life, i hadn’t really noticed this. but in my retirement, i can see this part of her personality more clearly. this new relationship was distinct from the settled home life and constant companionship he had initially expected. his comment reveals a new sense of contentment in discovering a new shared life rhythm. in kenji, we also see compassion for keiko, rooted in his own experience of dislocation and a newfound capacity for concern developed in retirement. we discern the practice of thoughtfulness (omoiyari) in him for the first time in decades; a greater appreciation for her feelings. kenji saw keiko as a separate person with unique interests.. no longer did he see her as just ‘his wife’ and consider only what she would do or be for him. now he saw her as keiko. while kenji’s story is perhaps unusual, his experience is not unique. several other retirees described how they discovered new aspects of their wives’ personalities once they left the workplace. familial cohesion engendered through creative uses of material artifacts that help inhabitants balance autonomy and interdependence is a key theme in the literature (daniels 2009). inge daniels (2009) observes that it is important for people who cohabit to be able to read the atmosphere and create smooth human relations. she studies the activities and material artifacts in the home through which individuals generate a feeling of homeliness or participate in creating “social heat” between themselves. she contends that people need to balance togetherness with distance, and these artifacts help to do that. for kenji, discovering a shared taste and interest in home decoration activities was one way he and keiko could live together joyfully in the home after keiko’s initial period of difficulty in adjusting to kenji’s presence there. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 24 conclusion: retirees…remember, when creating your post-retirement life, a spirit of adventure is what matters! within gender studies as developed by amano masako, there was significant discussion of the concept of self-reliance, particularly as it related to men nearing retirement. amano discusses why such self-reliance is necessary and elaborates on the ideal type of personhood arising from it. she adds that the practice of independence extends beyond individual accomplishment toward interpersonal relationships of mutual support (sasaeai). she endorses what carol gluck calls a “relational theory of responsibility”, which stresses that persons are social beings who are “responsible always – and only – in relation to others” (gluck 2009: 103). she identifies a relationship of mutual support between autonomous individuals as a condition for such self-reliance. self-reliance thus requires a degree of autonomy so that husbands do not “lean” on their wives. my aim here has been to outline the concept of independence that has arisen in relation to older persons in japan, and ‘what is at stake’ for local scholars and policy makers. in emphasizing the urgency of independence, we gain a window into a society grappling with a large ageing population, as well as the gender dynamics of older-person households. we see a difference in focus between gender studies scholars and policy makers. the former see the basis for achieving greater independence as fundamentally about managing one’s inevitable relationships of interdependence. the question is how to be in a relationship without being a burden; it is how to relate, or as amano masako puts it, how to support. for policy makers, the focus on independence is to let elders remain independent from both nursing care and reliance on the state. governments want to reduce seniors’ need for nursing care. thus, they frame independence in terms of reducing the risk of requiring nursing care by observing dietary practices and engaging in ‘muscle-development’ programs in order to sustain health and mobility; the ultimate aim is to avoid becoming bedridden. both valences of independence are important for understanding the experience of elders in japan. the concept of omoiyari is helpful here in demonstrating that even when trying to be independent, this wish is often framed in the context of being mindful of the impact of these decisions on others. to be a valued member of society, it is expected that a person contribute meaningfully to others’ lives. with the rising ethos of self-responsibility, the actions of being proactive and taking initiative to do things that promote one’s own wellbeing and the wellbeing of others are given renewed affirmation. as the case of redefining diabetes as a lifestyle disease (seikatsu shukan byô) attests, there has been a shift away from defining illnesses as an inevitable problem of ageing, to seeing them as an outcome of lifestyle practices under individual control. in practical terms, this can involve joining an exercise class, participating in a learning activity, or acting on the advice of family members who are concerned about the retiree’s wellbeing. although the discourse of developing independence in later life may appear onerous, it can bring a breath of fresh air into the lives of retirees insofar as it spurs them into new relational worlds. retirement is a richly debated period of life in contemporary japan. along with the life stage of old age, it summons up highly contrasting images. both concepts have become rich sites for commentators to intervene with ideas on what this period in life portends. there is a cultural expectation that men and women undergo a transformation from a state of loss to a state of clarity. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu retirees are in a transitional phase, neither anchored in the corporation nor fully settled into new moore | 25 spheres of social action. often the strain of retirement plays out in the domestic setting. balancing togetherness and separateness becomes a key concern. directives given to retirees on how to live their second life vary, but they emphasize the need for the retiree to stay connected with society at large by participating in activities that engender new social networks. if they fail to do so, they may see that their personhood is slowly fading and their marriage becoming less amicable. retirees discover that living with a spirit of adventure enables them to feel a new sense of belonging again. acknowledgements i would like to thank tanya jakimow, andrew metcalfe, david miller, yoshiko tada, the anonymous reviewers, and editors for comments on earlier drafts of this article. my research was supported by grants from the wenner gren foundation, japan foundation, and the university of new south wales. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 26 references alexy, a. (2007). deferred benefits, romance, and the specter of later-life divorce. in peter backhaus, ed. deutsche institute ed. japanstudien. munich: verlag. allison, a. (1994). nightwork: sexuality, pleasure, and corporate masculinity in a tokyo hostess club. chicago: university of chicago press. amano, m., ed. (1998). otoko no jiritsu to sono jōken o meguru kenkyū: dankai sedai o chūshin ni [research on men’s self-reliance and conditions associated with self-reliance: focus on baby boomers]. tokyo: tokyo josei zaidan. amano, m. (2014). oigai no jidai: nihon eiga kara mita kôreisha [an era worth ageing in: elders portrayed in japanese film.] tokyo: iwanami shoten. boermel, anna. (2010). “no wasting” and “empty nesters”: “old age” in beijing. oxford development studies. 34:4, 401-418. bungei shunju. (2006). “10-nengo no dankai: nihon no ronten henshûbu”. [baby boomers: ten years on, from the editors of ‘debates defining japan’.] tokyo: bungei shunju. campbell, r., and kurokawa, y. (2016). ichiban mirai no idea book: futsu no koreisha no minasan ga kangaemashita [the idea book for the best future: ideas conceptualized by ordinary seniors]. tokyo: dai nihon insatsu gaisha. cook, e. (2016). reconstructing adult masculinities: part-time work in contemporary japan. abingdon: routledge. danely, j., and lynch, c. (2013). transitions and transformations: paradigms, perspectives, and possibilities. in caitlin lynch and jason danely, eds., transitions and transformations: cultural perspectives on aging and the life course (pp.3-20) new york: berghan. daniels, i. (2015). feeling at home in contemporary japan: space, atmosphere, and intimacy. emotion, space, and society, 15: 47-55. dillard, a. (2013). the writing life. new york: harper perennial. dumit, j. (2012). drugs for life: how pharmaceutical companies define our health. durham and london: duke university press. gluck, c. (2009). sekinin/responsibility in modern japan. in anna tsing and carol gluck, eds. words in motion: toward a global lexicon. durham, nc: duke university press. goldstein-gidoni, o. (2012). housewives of japan: an ethnography of real lives and consumerized domesticity. new york: palgrave macmillan. gradman, t. j. (1994). masculine identity from work to retirement. in e. thompson, ed, older men’s lives, 104-121. thousand oaks, ca: sage. hashimoto, a. (1996.) the gift of generations: japanese and american perspectives on aging and the social contract. cambridge, uk: cambridge university press. hughes, m. and heycox, k. (2010). older people, ageing, and social work: knowledge and practice. sydney: allen and unwin. international longevity center. (2011). productive aging 2011. tokyo: international longevity center japan. lamb, s. (2013). “personhood, appropriate dependence, and the rise of eldercare institutions in india.” in caitlin lynch and jason danely, eds., transitions and transformations: cultural perspectives on aging and the life course (pp.171-187) new york: berghan. mathews, gordon. 2003. “can a real man live for his family?” in james roberson and nobuko suzuki, eds. men and masculinities in contemporary japan. london: routledge. nakamura, t., and inokuma, h. (2005). ‘teinengo no fuan: 520-nin chôsa’ [anxiety after retirement: survey of 520 respondents]. shûkan asahi 110(8), 22-27. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 27 nakano, l. (2009). community volunteers in japan: everyday stories of social change. london: routledge. noguchi, h. (2005, august 25). ‘dankai no sedai wa nani iro desuka’. nhk radio dai-ichi hôsô: iki iki hottorain. nouwen, h. (1994). the wounded healer: ministry in contemporary society. new york: random house. oda, a. (2009). autonomy, reciprocity, and communication in older spouse relationships. in maren godzik, ed., altern in japan: japanstudien 21: 25-53. munich: verlag. oecd. (2016). health statistics. geneva: oecd. www.stats.oecd.org accessed february 1, 2017. plath, d. (1980). long engagements: maturity in modern japan. stanford, ca: stanford university press. robertson, j. (2014). “human rights vs robot rights: forecast from japan.” critical asian studies. 46(4):571-598. scheid, b. (1992). the old tree in bloom. in susanne formanek and sepp linhart (eds.), japanese biographies: life histories, life cycles, lifestages. vienna: verlag. seike, a. (2015). japan’s demographic collapse and the vanishing provinces. in yoichi funabashi and barak kushner, eds, examining japan's lost decades. london: routledge. stickland, l. (2014). accommodating japan’s ageing sexual minorities: ‘the family of friends’ concept in lgbqti seniors’ residential care. in tomoko aoyama, laura dales, and romit dasgupta, eds., configurations of family in contemporary japan. london: routledge. taga, f. (2006). ‘otokorashisa no shakaigaku: yuragu otoko no raifu kōsu’[sociology of masculinity: changing men’s lifecourse]. tokyo: sekai shisōsha. tanaka, t. (2009). danseigaku no shintenkai [a new turn in masculinity studies]. tokyo: seikyûsha. traphagan, j. (2006). being a good rojin: senility, power, and self-actualization in japan. in annette leibing and lawrence cohen, eds., thinking about dementia: culture, loss, and the anthropology of senility. new brunswick, nj: rutgers university press. world economic forum. (2016). human capital report 2016. http://reports.weforum.org/human-capital-report-2016/economies/#economy=jpn accessed march 8, 2016. yamato, r. (1996). ‘chukônen dansei ni okeru sapôto nettowâku to ‘musubitsuki shikô’ yakuwari to no kankei’ [the relationship between support networks and ‘connectedness-oriented’ roles in late middle-aged japanese men: from the viewpoint of gender roles]. shakaigaku hyôron, 47(3), 350-365. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.159 http://anthro-age.pitt.edu moore | 28 notes 1 historically, the ie was governed by the rule of primogeniture (white 2014). while the oldest son would continue the family line. daughters and second sons would leave the family (white 2014: 242). 2 nonetheless, the japanese cohabit with family members far more than people elsewhere. in the netherlands, for example, 36.1% of elders live on their own, 59% live as couples, and 0.8% live with their families. in denmark, the respective figures are 46%, 48%, and under 1%. in the united kingdom, they are 34.1%, 53.4%, and 1.9% (oecd 2016). but one pattern is clear: mass longevity has brought discussions about how to configure life after age 65. 3 of japanese males aged 60 to 64, 76.3% were employed, compared to 50.8% in germany and 20.3% in france. of japanese women 60 to 64, 44.6% were employed compared with 32.9% in germany and 15.9% in france. the numbers are similar for persons aged 65-69. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.214-215 issn 2374-2267 (online) doi 10.5195/aa.2015.117 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review aging in rural places: policies, programs, and professional practice. k.m. hash, e.t. jurkowski, j.a. krout, eds. new york, ny: spring publishing company. 2015. isbn: 978-0-8261-9809-9. 308 pp. $70.00 (paper) t. thao pham, msw, phd department of social work, california university of pennsylvania http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.117 http://anthro-age.pitt.edu book review aging in rural places: policies, programs, and professional practice. k.m. hash, e.t. jurkowski, j.a. krout, eds. new york, ny: spring publishing company. 2015. isbn: 978-0-8261-9809-9. 308 pp. $70.00 (paper) t. thao pham, msw, phd department of social work, california university of pennsylvania the most challenging aspect of learning, teaching, and working with rural older americans is the dearth of literature on policies and practice with this population. ironically, the lack of research on rural older americans mirrors the scant resources and services available to the population. frustrated by this scholarly scarcity, hash, jurkowski, and krout compile a collection of essays for aging in rural places: policies, programs, and professional practice to fill “a critical need for a book that not only describes rural areas, their older residents, and their unique issues, but also discusses challenges faced by, and the best practices for, the health and human service professionals who work with, or aspire to work with, this population (xxiii).” aging in rural places contains 13 chapters, organized into five parts: introduction, health and human service needs of rural older adults, providing health and human services to rural older adults, competent practice in rural areas, and conclusion and future directions. the book begins and ends with discussions about the conceptualization of rurality and the need for accuracy in order to conduct more research. the introduction poses the questions: what is rural? who are the rural older adults? despite asking these important questions, hash, jurkowski, and krout have found the answers elusive as national, state, and local governments define and delineate ‘rurality’ and the rural population differently, which, consequently, pose more challenges than solutions for health and human service providers working with rural aging americans. the strength of this book comes from its multidisciplinary perspective and the breadth of topics related to policy and practice with rural older adults. ‘rural’ for hash, jurkoski, and krout encompasses a myriad of physical, mental, and cultural elements. the overarching themes indicate the need to pull knowledge and resources from multiple disciplines when working in rural environments, and particularly, with rural elderly. accordingly, the book has contributions from various health and human service fields to properly assess needs, resources, and effective service delivery. using vignettes and case studies to illustrate problems facing this population, the book highlights important policies, research findings, and current practices. the book serves as a good foundation for health and human service professionals and students, particularly social workers, who are interested in aging rural elders in the united states. students will find the discussions of rurality, the disparity of resources and social services, and the roles of health care professionals beneficial. on the other hand, advanced practioners and scholars may find some sections repetitive and lacking depth. for example, the chapter on health and wellness barely touches upon mental health and does not mention the topic of suicide among us rural elderly. additionally, the international perspective could use more research on aging pham | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.117 http://anthro-age.pitt.edu 215 215 from various parts of the world besides the handful mentioned (bangladesh, canada, and colombia) in the book. to the editors’ credit, the book makes a strong case for further research on rurality and the complexity of growing old in rural america. given the scarcity of current research in rural american studies and gerontology, aging in rural places is great introductory text that intersects these two fields. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.220-221 issn 2374-2267 (online) doi 10.5195/aa.2015.114 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review aging, media, and culture. c. lee harrington, denise d. bielby and anthony r. bardo, eds. lanham, md: lexington books. 2014. isbn: 978-0-7391-8363-2/978-0-7391-8364-9, 266 pp. price: $95.00 (hard copy) $81.00 (electronic) ruth n. grendell, dnsc, rn point loma nazarene university phoenix university http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.114 http://anthro-age.pitt.edu book review aging, media, and culture. c. lee harrington, denise d. bielby and anthony r. bardo, eds. lanham, md: lexington books. 2014. isbn: 978-0-7391-8363-2/978-0-7391-8364-9, 266 pp. price: $95.00 (hard copy) $81.00 (electronic) ruth n. grendell, dnsc, rn point loma nazarene university phoenix university sixteen of the 22 contributing authors have professional degrees in sociology, gerontology, communication, marketing, and hold leadership positions in academia, and/or in clinical practice and have conducted research related to gerontological and communication issues. six authors are graduate students and are participating in research on media, policy, and culture; family ideologies; the role of music in quality of life; educational games; and gender, aging, and retirement. the purpose of the collection of writings is to bridge the gap between the general theorybased gerontological research that focuses on adjustments to the aging processes and neglects the studies on the mediating influence of media on the everyday lives of aging persons throughout their life journeys. the major topics of the text are centered upon the social identities of the largest global aging population, the baby boomers, which differ from the perspectives of previous aging generations. the authors suggest that the two disciplines of inquiry on aging and the communication studies on the influence of media and culture could benefit from collaborative efforts in exploring the world views of the aging population as individuals, as groups, and as consumers in the 21st century. the strengths of the text are in the pairing of chapters within each major category on aging and the influence of media that include: advertising and marketing, age identities, celebrity, music, fandom, gender and sexuality, and social/new media. the following exemplars of the topics indicate the breadth of the text discussions. in chapter 2 the authors discuss the underrepresentation of older adults in advertising, or depicted as the celebrity senior spokesperson for a product; and women are often portrayed in stereotypical cultural aging schemas. in contrast, in chapter 3, the aging consumer is described as the “new old or forever young” consumer who is interested in travel, novel living environments, and cosmetic products or procedures to enhance a youthful appearance. the aging individual’s cognitive age is an additional demographic used for marketing purposes. “youthful aging” is discussed as a by-product of emotional engagement with the lives of celebrities, and the music of the times. fandom can continue or fade throughout the life time. gender and sexuality are highlighted in films including age differences among the partners, and expanding the sexuality role of the older woman. sexualizing the third age defines “sex as health” and the media frequently promotes therapies to enhance a healthy sex life. the authors provide unique perspectives of aging across the life span, and support their comments with communication research findings, and their personal perspectives as they enter grendell | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.114 http://anthro-age.pitt.edu 221 221 the aging population themselves. the values of the text to the field of gerontology and communication studies are revealed within a different knowledge base of the aging process in today’s environment, along with suggested tools to use in developing theory and future research. although there is no mention of using the text as a potential resource in the classroom, the content could be an excellent platform for group discussions and recommendations for innovative methods for research, interventions and development of policies on aging issues. in addition, the text would be a valuable resource for studying the lives of future aging generations that are greatly influenced by the media and virtual realities. microsoft word dalstromx.docx book review review of ageing in the contexts of migration. ute karl and sandra torres (editors). routledge. isbn 9780415738064, 204 pp. price $116.00 (hardback). matthew dalstrom saint anthony college of nursing anthropology & aging, vol 38, no 2 (2017), pp. 44-45 issn 2374-2267 (online) doi 10.5195/aa.2017.182 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.182 http://anthro-age.pitt.edu dalstrom | book review 44 book review review of ageing in the contexts of migration. ute karl and sandra torres (editors). routledge. isbn 9780415738064, 204 pp. price $116.00 (hardback). matthew dalstrom saint anthony college of nursing ageing in the contexts of migration, edited by ute karl and sandra torres is a collection of short essays that explore the ways that migration and gerontology research intersect and inform each other. as globalization and government policies allow and enable more people to migrate and as those migrant communities age, the editors argue that it is increasing important to think about how aging influences migration and vice versa. at first glance, neither one of those topics appear to appear to be novel, but the editors point out in the introduction that research on “older migrants has been relegated to the periphery of both, migration scholarship and gerontology” (1). thus, this edited collection represents an attempt to shed some light on the how migration shapes ageing as a process, ageing as a stage in the life course, and how migration impacts elder care. to that end, the book is divided into three sections, “elderly care regimes and migration regimes,” "aging in the context of migration," and "elderly care in the context of migration." primarily the book focuses on migration and aging in europe with just one chapter addressing issues in the us. the majority of chapters, focus on a single country and provide national demographic data to highlight the number of migrants (both elderly and/or engaged in elder care) and the state policies and/or cultural beliefs that shape their experience. the first collection of essays explores how national policies, population dynamics, and cultural beliefs interact with and influence migration practices and the aging process. for instance, in chapter two, perekbiatas and slany discuss how higher wages and the limited amount of elder care staff in germany, has resulted in an influx of polish elder care workers. the irony though, is that the loss of those workers has put a tremendous strain on the polish elder care system which relies heavily on children to take care of their parents. therefore, children find themselves taking care of the elderly in germany and sending money back to poland to have others take care of their parents. through highlighting this dynamic, the authors illustrate that studies of migration and aging should not be geographically bound, but be understood within the context of globalization. while interesting, the argument that context (in terms of the individual and society) along with culture have to be understood and taken into account to understand the aging experience and to improve it, should not be new to anthropologists. the field of anthropology has long argued that a holistic and ethnographically rich approach enables a much more nuanced understanding and it is refreshing to read a collection of essays that emphasis that point. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.182 http://anthro-age.pitt.edu dalstrom | book review 45 section two illustrates the different questions and contributions that studying migration and aging can illuminate. the chapters deal with a wide array of topics from intergenerational migrant relationships, return migration, labor relationships after retirement, and how stereotypes faced in a host country can strength ties to the origin community. the final section centers on the elder care system and the issues that arise when people migrate to work in that sector. the last section fits together better than the previous two because it is thematically organized around a more defined topic and the sequencing of chapters flow better. for example, chapter 11 begins with a literature review of migrant care worker policies, jobs, and working conditions. the subsequent chapters then go onto discuss the implications of regulation (or lack thereof) on the practice, how stereotypes of the “other” inform policy and care decisions, and the vulnerability of migrants engaged in the practice. within the current context of increasing immigration and refugee resettlement in europe, this book is a timely reminder that migrants age and their experiences of aging are different than the rest of the population. moreover, it pushes the reader to think about how context shapes the migrant experience and how policy needs to be address those differences within the community. it is important to note, however that the book is an overview and does not go into very much depth about any one particular issue. nevertheless, it would be useful for those interested in the perspective that gerontology and migration studies have on the intersection of aging and migration. anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp. 88-89 issn 2374-2267 (online) doi 10.5195/aa.2019.221 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of hoffman, jaco and katrien pype, eds. ageing in sub-saharan africa: spaces and practices of care. bristol, uk: policy press. 2016. pp (+ xi) 210. price: $115.00 (hardcover). casey golomski university of new hampshire http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ golomski | book review | 88 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.221 http://anthro-age.pitt.edu book review review of hoffman, jaco and katrien pype, eds. ageing in sub-saharan africa: spaces and practices of care. bristol, uk: policy press. 2016. pp (+ xi) 210. price: $115.00 (hardcover). casey golomski university of new hampshire this european and african researcher-based volume presents ethnographic case studies of ageing and care in diverse rural and urban settings across sub-saharan africa. cases from ghana, south africa, the democratic republic of congo, malawi, and tanzania are represented, the last being the geographical focus of three content chapters out of the seven total. the editors, a social gerontologist (hoffman) and an anthropologist (pype), thematically organize their interrogations of care through notions of space and place-making, and practice or agency. for the authors, space or place-making is highlighted in older adults’ mobilities surrounding ‘home’-based care and its absence (in neglect, abuse, or unavailability), which compels these elderly to move or be moved by others. depending on cultural and socioeconomic contexts, ‘home’ here is defined by its constituent members who, as the content chapters show, are different kinds of kin and, increasingly, non-kin (‘strangers’) in institutionalized care, ngos, and urban neighborhood community networks. these urban spaces enable new configurations of agerelated identity and offer a space-related vantage point on movement between city and countryside, as well as internationally. drawing from decades of his path-breaking research, sjaak van der geest (chapter 1) critiques current ghanaian state policies that rely on unrealistic culturalist models of familial care for older adults. katrien pype (chapter 2) gives a voice to older adults in retirement homes in kinshasa. these homes enable women without family to embody cultural models of immobility and inauspiciousness and condense a lifetime of actual care-related movement among kin. many reside there due to intergenerational in-law avoidance taboos or because they lack kin and economic resources. here, in what is commonly considered a space of inertia in a western understanding, these older adults can move about, sell wares – featured nicely in a photo of one woman’s hand-made dolls (44) – receive evangelist groups, and become media spectacles for charitable politicians. peter van eeuwijk (chapter 3) explores elder-to-elder care, as an unconventional, but accepted care practice in tanzania and documents a range of mostly urban caregiving sites like clubs, associational and self-help groups, ngos, and nursing environments. brigit obrist (chapter 4) contrasts rural and urban sites in tanzania through an “embodiment perspective” (96) in many detailed, lengthy quotes. she highlights older adult care recipients’ selfdescribed maladies and movements into different sites deemed ‘home’, so caregivers can address their physical and emotional needs. practice, as inspired by sherry ortner, is the term the editors use to describe care as it emerges among everyday actions and sociocultural ideologies. their ethnographic cases highlight new or increasing practices of able-bodied older adults caring for frail older adults, rather than golomski | book review | 89 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.221 http://anthro-age.pitt.edu reproducing standard sociocultural models and practices of intergenerational care. they also reiterate the significance of non-kin or ‘strangers’’ care practices and draw attention to the way caregivers and care recipients emphasize bodily dimensions of care practices. caregivers’ physical interventions enable frail older adults to survive, and frail older adults materially and socially cultivate ties with caregivers as well as prepare for their funerals. josien de klerk (chapter 6) describes the maladies of neglected older adults including tophista, a rural haya tanzanian woman, whose life and wellbeing deteriorated as her intergenerational relations waned. her grandson gradually withdrew physical care and social interaction, and tophista, incontinent, infected with chigoe, and stressed, attempted suicide before eventually passing away in a locked room. mutual dislike and stinginess in dividing her land in customary tenure systems evidenced to others, interviewed by de klerk and her research assistant, that tophista had not properly cultivated care relationships in late life and thus partly contributed to her own demise. emily freeman (chapter 5) shows how care practices inform reported embodied age-related identities in malawi. older adults who were unable to care for themselves saw themselves losing basic physical autonomy and material ownership, which socially defined adulthood. the inability to continue these practices rendered older adults, in many interviewees’ words, “child-like” (131). jaco hoffman (chapter 7) contrasts discourses of care ideals and practicalities among resource-constrained rural south african multi-generational kin networks, to show how such ideals change and are morally renegotiated. he envisions increasing acceptance of institutionalized elder care despite its financial challenges to these kin networks. the volume is a unique interdisciplinary blend of anthropology and policy studies. the majority of the chapters are substantively ethnographic. the introduction and the conclusion are different in tone and format, representing a policy studies approach. the concluding chapter by andries baart, systematically analyzes “discursive formations” (185) about age-related care that emerge from the chapters in a four-page-long table and a graph of four overarching discourses about age-related care. by gathering these insights from the volume in a tool which might be used by policymakers in designing more responsive care communities, baart responds to the aim of the volume put forward in the introduction: to “examine the extent to which present discourses and policy agendas are reflective of emergent insights on the realities of care” (5), as well as to contribute to making them more reflective. current interests in care in anthropology and allied fields make this volume timely, and equally relvant for ethnographers of ageing in africa. 404 not found 125-855-1-pb book review review of holland, janet and rosalind edwards, eds. understanding families over time: research and policy. palgrave macmillan: hampshire, england: 2014. pp. 205. richard zimmer sonoma state university anthropology & aging, vol 40, no 1 (2019), pp. 94-95 issn 2374-2267 (online) doi 10.5195/aa.2019.125 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.125 http://anthro-age.pitt.edu zimmer book review | 94 book review review of holland, janet and rosalind edwards, eds. understanding families over time: research and policy. palgrave macmillan: hampshire, england: 2014. pp. 205. richard zimmer sonoma state university janet holland and rosalind edwards have put together an excellent rich collection of essays about the state of familial relations in the united kingdom. they, and various other authors, have focused on qualitative longitudinal research (qlr), drawn from a series of continuing research efforts in different parts of england and northern ireland, especially the timescape project. this volume is part of a series issued by palgrave macmillan that examines changes in all aspects of family and personal life in the uk. the research addresses changes in ages in mother and father roles and the changes in reciprocal roles of grandparents, parents, grandchildren, and great grandchildren. each of the essays sets their findings in the context of political and economic changes going on in the uk, especially noting the ways in which government policy and social support institutions affect personal and familial choice. the authors embody their findings by presenting case studies/vignettes of their informants. sheena mcgrellis and janet holland present a good example of how both economic and political factors affect one person's career and family prospects. "maeve", a middle-class woman, left northern ireland with her long-term partner to further their prospects and then returned during hard times: "'it's just the way things are at the moment, isn't it, the recession...when we left, everything was fine, and when we came back this had all happened and we were like, what is going on, awful, all this bad news, left, right, and center” (2014, 58). it took them several months to adjust to the new conditions and readjust their lives. maeve and her partner were lucky because of their training and background. lower class young men, especially ones who started families early, however, found their lives interrupted, postponed, and diverted by the recession of 2008 and the cameron administration's austerity policies. bren neale and carmen lau clayton present "darren," aged 21, having to deal with new circumstances: "one grandmother in the sample offered to become the primary caregiver once the grandchild was born...'oh my mum...she was like "if you can't look after him, i'll take him on as my own but he'll still be calling you mum and dad' [sic] and all this'" (2014, 76). many young fathers in the studies were willing to "step up" to the new roles they had, including more housework, but they still relied to a great deal on their parents, and, often, on the new mother's parents to provide care giving and financial support. nevertheless, women continue to experience the most conflict and adjustment in terms of managing family and work roles. rachel thomson presents "deborah," a middle-class woman as she adjusts to her pregnancy and new motherhood. as many women find, a woman, becoming pregnant, especially when anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.125 http://anthro-age.pitt.edu zimmer book review | 95 she is visibly so, changes a "gender-neutral" workplace into a gendered workplace: she is obviously a woman, a person who is becoming a mother, and will have to adjust, as will the workplace, to her new status and condition. she has to decide how much time to take off, how much time to work at some point after the child is born, and how to change her role vis-a-vis her mother. this latter point is a good example of her shifts: “deborah's university education and career success created a gulf between mother and daughter. the arrival of a granddaughter has made this a little easier” (2014, 117). thomson notes that deborah's mother has been re-examining her own past to see that women could and can have greater independence juggling family and career. as a consequence of their children's new parenthood, many grandparents now faced new demands. many younger ones were willing to take on a greater role in their adult children's, grandchildren's, and great grandchildren's lives. this was especially true of lower class elders. but some people resented being put into this new role when they were "too young" themselves. nick emmel and kahryn hughes offer us the case of "ruth": "her experience of grandmothering, her feeling that she is the wrong age---expressed through the accounts of the way she feels some of her neighbours judge her and people in the street think about her—is, we suggest, the lack of harmony between societal symbol and her reality” (2014, 170) at the same time, many children of parents experiencing challenges and changes find that they, too, have to adapt to the needs of their parents and grandparents. they play a greater role in housework and care giving. what is particularly interesting is that they have hopes for their parents' own development and see themselves as playing a constructive role in their lives as they all age. rosalind edwards, susie weller, and sarah baker present "rooney," age 16: " ...[he] talked about his family sticking with and up for each other... (2014: 44.)" edwards et al. see this family solidarity and set of expectations contrary to the media-prevalent narrative of intergenerational warfare and resentment of the upcoming generation often found in the uk and the us. they say that the resentment, in particular, is only experienced by a minority of people. "[i]nter-generational and intra-generational conflict and solidarity are far from the simplistic divisions that intergenerationalists would lead us to believe” (2014, 44). the authors of the various articles and the editors intend that the case studies and their conclusions provide the basis for policy considerations and social service practice. throughout the book, it is clear that economic policy affects family structure and disrupts adjustment patterns. it changes opportunities for all involved. oftentimes agencies can and do adversely affect families, as when "geoff" and "margaret" got a "midnight drop" by social services of their three granddaughters because mom was a "chronic heroin user." nick emmel and kahryn hughes note that there was no warning of the drop and no follow-up in terms of social supports (2014, 167;172.) in their conclusions, janet holland and rosalind edwards argue that policy and future research should help the choices parents, grandparents, and growing children should make, not work against them. they further contend that qualitative research should continue to enhance this policy debate as well as understand from a larger perspective what changes families are experiencing (2014, 190-191.) their conclusions and methodologies are also useful for students of family structure and policy in other countries. microsoft word howellfinalbr.docx book review barbara ehrenreich. natural causes: an epidemic of wellness, the certainty of dying, and killing ourselves to live longer. twelve: hatchett book group. 2018. pp. 234. price: $18.00. britteny m. howell university of alaska anchorage anthropology & aging, vol 40, no 1 (2019), pp. 96-98 issn 2374-2267 (online) doi 10.5195/aa.2019.216 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.216 http://anthro-age.pitt.edu howell | book review 96 book review review of holland, janet and rosalind edwards, eds. understanding families over time: research and policy. palgrave macmillan: hampshire, england: 2014. pp. 205. britteny m. howell university of alaska anchorage keywords: mortality, fitness, successful aging, longevity, immunity, macrophage barbara ehrenreich is known for making us question the way american society works. her classic work “nickel and dimed” (2001) demonstrated the power of ethnographic methodologies as she embedded herself in the unskilled labor force to reveal harsh truths about the status and opportunities afforded (or not) to the working poor. since then, she has written several other books that similarly aim to demonstrate the incongruity of various aspects of our culture to her readers, from the outdated notion of the american dream to the supposed “power” of positive thinking. in her latest work, natural causes, ehrenreich continues this tradition of public anthropology as she aims her sights on the medical establishment. the field of anthropology is no stranger to taking a critical eye to the western biomedical system, and to her credit, ehrenreich references a number of anthropological works in her book. her first two chapters skewer the medical establishment for dressing up their screenings and annual examination procedures as “rituals of humiliation” that do not actually locate treatable conditions early enough (despite the fact that the author herself is a breast cancer survivor, presumably a beneficiary of the mammogram to which she directs much of her ire). ehrenreich argues that most preventative screenings are costly, degrading, and create unnecessary worry through false positives. she draws on the anthropological stylings of the nacirema (and cites this foundational work directly) to demonstrate the absurdity of many biomedical procedures by describing them in detail from an etic perspective. for example, she describes the gynecological exam as a form of sexual harassment “disguised as a professional, scientifically justified procedure” that causes trauma in female patients. she argues that many of the behaviors we have come to accept in the examination room are considered rude and/or violent outside of the clinic walls. in these first chapters, ehrenreich asks the reader to question everything they know about preventative screenings, which is uncomfortable at times. the book takes several hard left turns, from arguing in chapter three that very little about biomedicine is truly rooted in scientific evidence, to the ludicrous pursuit of extreme athleticism in chapter four, to the illogicality of the mindfulness movement in chapter five. chapter five strays from the topic at hand toward anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.216 http://anthro-age.pitt.edu howell | book review 97 describing autism spectrum disorders (asds) and learning disabilities as being related to decreasing attention span stemming from the reliance on screen time. she even puts the term “spectrum” in quotation marks (p. 73), as if to suggest that autism is not actually a spectrum of related conditions. her assertion that autism and related diagnoses are a result of an overreliance on technology are spurious at best, using cherry-picked data, as she does throughout much of the book. chapters eight and nine were particularly interesting, however, because she uses her phd research to show that some immune cells, called macrophages, play an active role in cancer and other cell death. these immune cells have been shown to encourage and pave the way for cancer cells to invade new areas of the body. this research that our own immune systems might be slowly killing us is likely to be new to most readers, even if these chapters did not seem to fit neatly in the middle of the book. most damaging, however, is that the overall tone of the book suggests that since the medical establishment has much to be desired in terms of effectively using evidence-based science and focusing on patientcentered outcomes, the medical system is therefore so flawed as to be harmful. in fact, chapter one opens with a personal treatise on why she now rebuffs all screening recommendations and shuns regular checkups with her doctor, stating that she is now “old enough to die” (at 76 years old). ehrenreich’s writing suggests she is attempting to grapple with her own mortality but she does so in a way that articulates deep distrust of the medical establishment. this produced very mixed feelings for me reading this book; as a medical anthropologist i enjoy critiquing our medical system as much as the next anthropologist, but as a gerontologist i must also work within the field of public health. i had to truly question what i thought i knew about preventative screenings and their effectiveness throughout the book, which details the history of medical “science” and shows that much of it is not based on science at all. ehrenreich rightly rejects the way americans link health and wellness to morality and virtue. she argues that economic class is written on the body as a space of demonstrating wealth through our physical appearance and the performance of fitness behaviors. yes, agreed. however, she needed to take one step further from her own narrow point of view and acknowledge that one of the biggest factors of poor health in america is a lack of access to medical care, especially in communities of color. choosing to shun an excess of preventative screenings and lab tests is not a luxury afforded to everyone. i read the book with interest as a scientist, but was simultaneously concerned with the messaging to a general audience readership, to which this book was aimed. overall, it seemed her assertion was that getting check-ups, exercising, and eating and sleeping right is much more trouble than its worth, merely adding “years of toil” and disability to the lives of older adults who want nothing more than to just sit around all day. my reading of the public health literature and my own work on healthy aging lead me to a very different conclusion than ehrenreich’s: that such preventative lifestyle behaviors can contribute to making your last years of life as disability-free as possible, rather than contributing to a longer life of disability and pain, as ehrenreich seems to believe. although this book may discourage the casual reader from visiting their physician regularly, as i read the book i found myself planning how i could use the text anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.216 http://anthro-age.pitt.edu howell | book review 98 to spark lively discussions in my senior (or graduate-level) public health and gerontology courses. once students have a firm grasp of the evidence-based research literature, they may quite enjoy debating the points from ehrenreich’s book in a classroom setting where the discussion can be framed in terms of the role that preventative screenings and lifestyle behaviors have on public health. microsoft word lindenbergbrf .docx book  review     powell,  j.l.  global  aging,  china  and  urbanization.  new  york,  ny:  nova  science  publishers.  2013.  isbn:   978-­‐‑1-­‐‑6280-­‐‑8463-­‐‑4.  51  pp.  $52.00  (ebook).     m j.  lindenberg,  phd   leyden  academy  on  vitality  and  ageing                                                     anthropology & aging, vol 37, no 1 (2016), pp.55-56 issn 2374-2267 (online) doi 10.5195/aa.2016.152         this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.152    http://anthro-­‐‑age.pitt.edu         lindenberg  |  book  review  55   book  review   powell,  j.l.  global  aging,  china  and  urbanization.  new  york,  ny:  nova  science  publishers.  2013.  isbn:  978-­‐‑1-­‐‑ 6280-­‐‑8463-­‐‑4.  51  pp.  $52.00  (ebook).     m j.  lindenberg,  phd   leyden  academy  on  vitality  and  ageing     jason  powell’s  book  global  aging,  china  and  urbanization  comes  at  the  right  time:  a  time  in  which   aging  has  indeed  become  a  global  phenomena;  a  time  at  which  urbanization  is  a  worldwide  process  of   phenomenal  importance;  and  a  time  at  which  china  has  become  of  increasing  political,  economic  and  social   relevance  worldwide.  the  goals  he  sets  for  this  book  are  quite  ambitious  –  especially  considering  the  size   of  this  book  with  a  mere  51  pages  –  as  he  endeavors  to  expose  “the  nature  and  extent  of  global  aging  in   contemporary  society”  and  “the  implications  of  urbanization  for  chinese  older  people”  (preface).  his  third,   and  last,  goal  is  to  moreover  “illuminate  a  perceptual  framework  to  examine  rapid  social  change”  (preface).   the   book   falls   into   two   main   parts.   the   first   part,   chapter   2,   discusses   global   aging   in   three   continents:  north  america,  europe  and  asia.  it  describes  the  processes  and  implications  of  aging  primarily   focusing  on  demographic  trends,  retirement  schemes  and  financial  consequences.  this  chapter  is  rich  with   statistical  data  and  includes  an  illustrative  discussion  of  current  and  prospective  trends  in  demographic   ratios  and  financial  burdens.   the  second  part  of  the  book,  chapter  3,  focuses  on  china  and  highlights  two  trends  that  have  come   about   simultaneously   in   china:   urbanization   and   aging.   powell   convincingly   shows   by   ample   (and   interesting,  quite  unique)  statistical  data  how  aging  is  concentrated  in  chinese  cities  such  as  shanghai  and   beijing.  as  a  result,  these  parallel  trends  of  aging  and  urbanization  have  become  interwoven.  urban  aging   in  china  has  become  a  development  that  has  its  challenges.  on  the  one  hand  what  immediately  comes  to   mind  are  images  of  chinese  elders  exercising,  dancing  and  discussing  in  the  street,  but  on  the  other  hand   the  precariousness  of  filial  and  pension  arrangements  also  emerge  leaving  china  with  many  of  uncertainties   that  touch  upon  the  global  processes  powell  describes  in  chapter  2.  in  this  chapter,  he  delves  more  deeply   into  the  idea  that  the  way  aging  is  portrayed,  or  is  imagined,  has  important  implications  for  the  way  social   policy  and  economic  policy  are  shaped.  in  this  context,  he  discusses  two  main  discourses:  the  neoliberal   economic  discourse  and  the  social  discourse  around  aging  in  china,  while  relating  these  to  larger  (global)   trends.  he  makes  some  sidesteps  to  social  theoretical  propositions  from  butler  and  foucault  to  situate  these   discursive  frameworks.  powell  argues  that  one  of  the  key  issues  is  that  in  north-­‐‑american  and  european   contexts  aging  is  often  referred  to  as  a  biomedical  idiom  in  which  deterioration,  decline  and  decay  are   primary  epistemes.  such  an  approach,  he  contends,  neglects  the  complexity  and  social-­‐‑construction  of  the   aging  process.  in  his  conclusion  he  therefore  makes  a  case  against  any  such  (negative)  stereotyping  and   simplification  and  argues  instead  to  look  at  age  and  aging  as  a  social  construct.   the  first  part  of  this  book  gives  a  broad  overview  of  what  one  could  see  as  global  aging,  although   the  selection  of  continents  and  the  actual  concept  of  “global”  remains  somewhat  unclear,  especially  given   the  intricacies  powell  himself  points  at  in  his  chapters.  chapter  2  does  point  to  global  processes  and  global   parallels  in  aging,  which  are  often  not  discussed  in  other  books  because  the  call  for  detail  and  the  urge  to   do  justice  to  uniqueness  is  so  strong.  the  second  part,  chapter  3,  provides  an  introduction  to  aging  and   urbanization  in  china.  it  is  an  accessible  outline  that  gives  the  reader  an  important,  but  brief,  idea  of  the   state  of  affairs  in  china.  theoretically,  the  whole  book  is  a  little  underdeveloped,  and  his  third  goal  to   approach  a  perceptual  framework  remains  a  little  hidden,  but  this  seems  inescapable  given  the  moderate           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.152    http://anthro-­‐‑age.pitt.edu         lindenberg  |  book  review  56     size  of  this  book.  all  in  all,  the  book  gives  a  good  overall  view  on  many  important  issues  in  aging  nowadays:   global  processes,  demographic  changes,  and  economic  consequences.  nevertheless,  perhaps  his  ambitious     goals  were  a  little  too  ambitious  for  the  size  of  this  book.  likely,  many  anthropologists  would  look  forward   to  a  next  book  in  which  powell  will  take  his  own  words  of  avoiding  stereotyping  and  simplification  further   and  expose  the  actual  narratives  and  nuances  of  the  social  construct  of  aging.                           microsoft word wagnerbrfdec.docx book  review     greenberg,  michael,  r.    protecting  seniors  against  environmental  disasters:    from  hazards  and   vulnerability  to  prevention  and  resilience.  new  york,  ny:  routledge.  2014.  isbn  978-­‐‑0-­‐‑415-­‐‑84201-­‐‑3,  210   pp.    price  $145  (hardcover)     jennifer  a.  wagner,  mph,  lnha   gerontology  program,  bowling  green  state  university                                                       anthropology & aging, vol 37, no 1 (2016), pp.61-62 issn 2374-2267 (online) doi 10.5195/aa.2016.155           this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.155      http://anthro-­‐‑age.pitt.edu       wagner  |  book  review  61   book  review   g greenberg,  michael,  r.    protecting  seniors  against  environmental  disasters:    from  hazards  and  vulnerability  to   prevention  and  resilience.  new  york,  ny:  routledge.  2014.  isbn  978-­‐‑0-­‐‑415-­‐‑84201-­‐‑3,  210  pp.    price  $145   (hardcover)     jennifer  a.  wagner,  mph,  lnha   gerontology  program,  bowling  green  state  university     my  first  thought  while  reading  greenberg’s  book  was  that  we  finally  have  a  text  that  demonstrates   the  struggles  older  adults  face  during  a  disaster.    this  book  is  a  must  read  for  those  who  work  in  public   health  and  formulate  disaster  mitigation  and  emergency  response  plans.    it  is  also  a  must  read  for  all  who   work  with  older  adults.    it  would  be  an  excellent  text  for  students  pursuing  careers  as  health  care  executives.   this  book  is  backed  by  a  foundation  of  research  and  historical  accounts  of  past  disasters.    what   makes  this  an  enjoyable  text  for  me  is  the  application  of  the  material  presented  by  the  author’s  use  of  case   studies  and  lessons  learned.    in  the  preface  of  the  book,  greenberg  shares  a  personal  story  of  his  parents  as   they  grew  older  and  their  fears  of  potentially  facing  yet  another  natural  disaster  in  their  lifetime  both  while   living  in  their  home  and  later  in  assisted  living.    despite  the  resilience  of  baby  boomers  (see  chapter  2  for   more  about  boomers)  surviving  events  such  as  the  great  depression,  hurricanes,  and  blizzards,  being  cut   off  from  the  external  world  was  of  great  concern  as  his  parents  aged.       chapter   3   provides   a   risk   assessment   of   events   such   as   tornadoes,   power   outages,   terrorism,   flooding,  wildfires,  and  more.    greenberg  discusses  the  impact  of  such  events  on  older  adults  which  can   vary  greatly  based  on  their  mobility,  access  to  resources,  and  the  condition  of  their  home.       chapter   4   provides   an   overview   of   the   local,   state,   and   federal   government’s   role   in   a   disaster.     greenberg  provides  a  summary  of  data  on  disasters  and  relief  efforts  from  1950-­‐‑1979.    what  caught  my   attention   in   this   chapter   was   the   section   on   nursing   homes.     as   the   author   notes,   most   healthcare   organizations,  due  to  a  variety  of  regulatory  and  accreditation  requirements  have  disaster  and  evacuation   plans.    he  also  notes  that  such  organizations  are  exempt  from  evacuation  and  have  the  option  to  shelter  in   place.    the  author  notes  the  tough  decision  by  executives  to  shelter  or  evacuate,  understanding  that  the   mortality  of  compromised  individuals  increases  during  an  evacuation.    the  author  shares  lessons  learned   from  hurricane  katrina  and  how  lives  may  have  been  saved  by  having  stronger  shelter  in  place  plans.     chapter   5   discusses   risk   management   for   not-­‐‑for-­‐‑profit   and   for-­‐‑profit   organizations.   greenberg   highlights  planning  for  senior  housing  and  other  agencies  from  a  variety  of  perspectives  such  as  first-­‐‑ responders,   financial   and   city   planners,   and   other   stakeholders.     the   author   provides   a   valuable   table   demonstrating  the  critical  elements  of  a  disaster  plan  and  provides  discussion  on  lessons  learned.       chapter  6  shares  the  risk  management  needs  of  seniors,  family,  and  friends.    greenberg  cites  renya   and  brainerd’s  decision  making  model  in  determining  older  adults’  reactions  to  disaster  and  predictions   for  their  action  in  a  crisis.    according  to  greenberg,  despite  potential  physical  and  cognitive  declines,  seniors   are   the   most   resilient,   most   optimistic,   and   feel   less   threatened   regarding   their   survival.     the   author   discusses  post  event  stress  which  is  not  so  much  a  factor  of  grief  and  loss  as  one  would  expect,  but  that  of   struggle  and  confusion  with  paperwork  and  eligibility  requirements  to  submit  insurance  claims,  receive   assistance,  the  laws  behind  what  disasters  qualify  for  governmental  assistance,  and  trying  to  make  sense  of   it  all.    when  they  cannot,  distrust  grows  and  seniors  are  less  likely  to  seek  assistance.    while  not  all  older   adults  are  frail,  the  author  notes  in  this  chapter  that  older  adults  who  are  able  are  more  likely  to  assist  in   prevention  and  recovery  efforts.           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.155      http://anthro-­‐‑age.pitt.edu                             wagner  |  book  review  62     chapter  7  provides  experiences  and  lessons  learned  from  tropical  storms  in  new  jersey.    chapter  eight   provides  recommendations  for  future  disaster  prevention  and  resilience.  the  recommendations  include   sheltering   and   post   event   recovery,   mitigating   and   improving   the   resilience   of   the   medical   system,   communication  with  seniors,  improving  infrastructure,  and  increasing  community  development  projects   resilience  by  evaluating  hazard  event  mitigation  before  building.   this   text   provides   an   excellent   overview   of   the   needs   of   older   adults   in   all   home   and   care   environments  during  a  disaster  and  offers  much  to  consider  for  all  professionals  who  work  with  older   adults.       portfolio reducing falls in older adults a qualitative exploration of an intergenerational tai chi class thomas miller new mexico state university author contact: thomascmiller@outlook.com mary alice scott department of anthropology, new mexico state university author contact: mscott2@nmsu.edu anthropology & aging, vol 38, no 2 (2017), pp. 29-37 issn 2374-2267 (online) doi 10.5195/aa.2017.141 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 29 reducing falls in older adults a qualitative exploration of an intergenerational tai chi class thomas miller new mexico state university author contact: thomascmiller@outlook.com mary alice scott department of anthropology, new mexico state university author contact: mscott2@nmsu.edu falls in the older adult population are a critical public health concern, particularly in new mexico where mortality due to falls is three times higher than the national average. following national center for injury prevention and control recommendations (ncipc 2008), an interdisciplinary team of researchers at new mexico state university's falls research and healthy aging laboratory has implemented a tai chi-based intervention to reduce this disproportionately high rate of falls-related mortality. the lab includes kinesiologists, physical therapists, and a medical anthropologist as well as their undergraduate and graduate students. during the spring semester of 2015, the lab began offering a tai chi course at a local community center as part of a pilot study evaluating the effectiveness of this intervention strategy for a u.s-mexico border population. the team conducted a qualitative analysis of participants’ experiences of the tai chi intervention. the 15-week program included two hour-long classes per week. the intervention paired kinesiology student-instructors with older adult participants in the class, creating intergenerational dyads that supported participants physically, socially, and mentally. our interviews suggest that participation in the class improved participants' confidence in performing activities of daily life. additionally, working one-on-one with university students enhanced the instructional experience and motivated participants to continue attending class. the research team conducted short interviews with nine participants (approximately 1/3 of the class) at the beginning, middle, and end of the course to document their experiences with the class. most participants articulated the physical benefits they gained from the class including increased body awareness, sustained engagement in low impact exercise, and improved balance. arnold (nb: all names used are pseudonyms) who has taken several tai chi courses, stated “you have to keep doing this; i have experienced no falls since february 2014. even when stumbling i am able to recover beautifully.” hayleigh described why she continues to participate: “for my wellbeing, and for being more active and mobile. by coming in and doing the exercise that we are set up to do, it allows us to open up the aching muscles and bones.” many individuals expressed a desire to participate in future opportunities to reduce their fall risk and maintain regular physical activity. http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 30 in addition to their positive experience with the actual physical activity taught in the class, participants also discussed their positive experience working with undergraduate students as their teachers. three interviewees compared this class to other exercise classes, noting that in other classes instructors often moved too quickly and did not provide sufficient guidance or one-on-one assistance. interviewees appreciated the individualized instruction by students. bridgette stated that without one-on-one instruction she felt “like an octopus," and noted, "it's helpful to have someone direct my arms the way they need to be." arnold appreciated the personalized exercise plans that students provided. these plans drew on students’ emerging expertise in kinesiology as they progressed in their undergraduate training. finally, bernice felt that the class was “a wonderful learning experience.” working with the students was particularly important for her: “you know, they learn, we learn, we all learn together. it creates a really nice environment as opposed to going to a gym – not a fun experience in a gym.” bridgette, arnold, and bernice appreciated the intergenerational experience of working with students who took the time necessary to teach the exercises, gaining access to academic knowledge to support ongoing exercise outside of the class, and learning alongside the student-teachers. there is substantial evidence that the physical activity that is part of participation in tai chi classes reduce falls risk (li et al. 2004), but we know less about how the specific qualitative experience influences sustained and effective participation. our research participants suggest that certain methods of instruction function better than others. in particular, participants enjoyed the mutual teachinglearning relationships they developed with undergraduate students. this intergenerational practice which cook and bailey (2013) define as "a practice that brings people together in purposeful, mutually beneficial activities which promote greater understanding and respect between generations" draws on the strengths of both the young people and the older adults involved. the undergraduate students bring their developing skills as teachers, while older adults bring their experiences of physical activity, falls, and preventive practices. intergenerational relationships may support greater efficacy of exercise programs among older adults, echoing other research that has identified positive effects of intergenerational relationships in other community settings (springate 2008; underwood and dorfman 2006). all participants experienced improved physical ability, including greater strength, increased flexibility, and heightened bodily awareness. however, participants also emphasized their interactions with the student-teachers in the class. we suggest that these relationships, even if temporary, contribute to reducing falls risks as participants gain strength, flexibility, and confidence. the intergenerational relationships that developed during the class increased participants' willingness to engage in activities that pushed the boundaries of older adults' perceived physical limits. through focused, individualized practice, participants built motivation to continue engaging in physical activity, particularly future classes involving undergraduate students as teachers. http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 31 references cook, glenda and catherine bailey. 2013. 'older care home residents’ views of intergenerational practice. journal of intergenerational relationships 11(4): 410-424. doi:10.1080/15350770.2013.837802 li, f., p. harmer, k. fisher, and e. mcauley. 2004. tai chi: improving functional balance and predicting subsequent falls in older persons. medicine & science in sports & exercise 36(12): 2046-2052. http://www.ncbi.nlm.nih.gov/pubmed/15570138 national center for injury prevention and control (ncipc). 2008. preventing falls: how to develop communitybased fall prevention programs for older adults. atlanta, ga: centers for disease control and prevention. springate, iain, mary atkinson, and kerry martin. 2008. intergenerational practice: a review of the literature (lga research report f/sr262). slough: national foundation for educational research. https://www.nfer.ac.uk/publications/lig01/lig01.pdf, accessed on july 26. underwood, heather l. and lorraine t. dorfman. 2006. a view from the other side: elders’ reactions to intergenerational service-learning. journal of intergenerational relationships 4(2): 43-60. doi:10.1300/j194v04n02_04 http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 32 photo by morgan taylor http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 33 photo by morgan taylor http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 34 photo by morgan taylor http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 35 photo by morgan taylor http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 36 photo by morgan taylor http://anthro-age.pitt.edu/ anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.141 http://anthro-age.pitt.edu miller & scott | 37 photo by morgan taylor http://anthro-age.pitt.edu/ portfolio reducing falls in older adults a qualitative exploration of an intergenerational tai chi class miller & scott | 29 reducing falls in older adults a qualitative exploration of an intergenerational tai chi class anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 121-123 issn 2374-2267 (online) doi 10.5195/aa.2015.109 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. response 1 to “toward a gerontoludic manifesto” caitrin lynch1 & maruta z. vitols2 1 anthropology, olin college of engineering contact: caitrin.lynch@olin.edu 2 media studies, olin college of engineering contact: maruta.vitols@olin.edu abstract responses to commentary, “toward a gerontoludic manifesto,” by bob de schutter and vero vanden abeele in anthropology & aging vol36, no.2, the special issue on “aging the technoscape,” followed by a reply by the commentary authors. http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.109 http://anthro-age.pitt.edu response 1 to “toward a gerontoludic manifesto” caitrin lynch1 & maruta z. vitols2 1 anthropology, olin college of engineering contact: caitrin.lynch@olin.edu 2 media studies, olin college of engineering contact: maruta.vitols@olin.edu “[w]hen i play my gameboy outside of my home i see people looking at me; they think that i have gone crazy” [a 62-year-old female participant in a study, quoted in “towards a gerontoludic manifesto”] this quote, included in bob de schutter and vero vanden abeele’s call to action, reveals a sense of stigma and embarrassment that some older adults feel when ‘outing’ themselves as avid video game players. by highlighting the social judgment felt by many older adults, the authors lay the groundwork for critical gaming scholars to develop a ‘gerontoludic’ approach to how older adults engage with video games. while their manifesto provides a useful strategy for embarking on this academic journey, they acknowledge that their essay marks only the first steps towards developing a deeper comprehension of gerontoludology. though we learned much from this manifesto, we are taking this opportunity to point out the work that remains to be done, both in terms of content and methodology. first, by acknowledging the heterogeneity of games and gaming experiences for older adults, we will necessarily reframe their gaming encounters to emphasize a continuum of engagement. de schutter and vanden abeele explicitly want to move beyond dichotomies in their three “adages” (playfulness over usefulness, growth over decline, heterogeneity over stereotyping). however, in the discussion of each, they sometimes reproduce the very dichotomies they criticize. for example, in their arguments about playfulness over usefulness, they advocate for an understanding of play in and of itself as valuable and worthy of examination (i.e., one should value games that are entertaining). the authors seem to imply that games are either playful or useful. yet, can’t a game be both playful and simultaneously serve a useful purpose? perhaps gaming is sometimes useful, sometimes playful, and, most often, a little bit of both along a spectrum of feeling and thought. likewise, some games might develop growth, while still productively acknowledging that aging can be accompanied by meaningful experiences of decline. taking anthropologist sarah lamb’s discussion of “meaningful decline” to its extreme interpretation, we could imagine residents of “old age homes” in india playing online games that focus on hindu notions of samsara (the cycle of birth and death) (lamb 2014). reframing aging experiences along a continuum will enable us to better see the variety of perspectives and meanings, and to imagine optimum design opportunities. lynch & vitols | response 1 to “toward a gerontoludic manifesto” anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.109 http://anthro-age.pitt.edu 122 second, while de schutter and colleagues have mentioned it elsewhere (de schutter, brown, and nap 2015), the manifesto overlooks the importance of gaming as self-expression. video games are a vehicle for creativity. the generative qualities of video games, such as football manager (where players create and manage their own soccer teams), allow participants to mobilize their imaginations, unique perspectives, and experiential wisdom to express their individual worldviews. while much current research is devoted to investigating how video games may nurture creativity in children and young adults, the role of and need for gaming as self-expression in an older population is largely neglected, and should be included as a fundamental aspect of any gerontoludic practice. third, video games offer older adults an opportunity for community. massive multiplayer online games (mmogs), in particular, supply a virtual space for older adults to engage in communal activities, including but not limited to chatting, flirting, forming friendships, and exploring different identities through role playing. games such as world of warcraft allow players to live in virtual communities, gaining the kind of social interaction they may otherwise lack in their non-digital lives. additionally, mmogs permit older adults, who may be disabled or unable to engage in some activities due to changing health conditions, to enjoy pursuits online that would otherwise be impossible in the “real world” (cf. evett et al. 2011). any gerontoludic approach must consider how video games foster community and sociality. finally, in terms of methodology, de schutter and vanden abeele’s manifesto does not distinguish between games for older adults and games for an unspecified age group. however, the authors primarily mention games specifically designed with an older population in mind (whether created to provide health benefits or for parody purposes). we suggest widening what we consider the allowable and “useful” experiences of gaming for older adults to include an expanded menu of gaming. in this manner, we may gain a new understanding of whether older adults find self-expression and communion in their gaming experiences. such insights will, in turn, be the fodder for designers and developers to adopt creative new approaches. this manifesto is an especially welcome addition to discussions among professionals who specialize in design for older adults. design for aging is a field of research and practice that has become increasingly robust in terms of a nuanced sensitivity toward the opportunities presented by our changing global demographics. josé colucci, from the design firm ideo, offers the following six principles for design for aging.1 these criteria for guiding the work of people who create products and services for older adults are also aptly suited for those who aspire to generate enabling, fun, and meaningful gaming experiences for the same population: 1. respect the individual 2. ease the transition 3. do not help more than is required 4. promote empathy 5. encourage fresh thinking 6. promote connection these principles urge designers to be sensitive to the range of ways of aging rather than assume a universality of experiences, to avoid over-designing or over-interpreting the role of the designer, and to think beyond the obvious.2 videogame designers would do well to abide by lynch & vitols | response 1 to “toward a gerontoludic manifesto” anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.109 http://anthro-age.pitt.edu 123 123 these principles, as they create worlds and experiences that are sensitive to the diversity of aging experiences. moreover, their gameplay would be less likely to marginalize older adults with underlying assumptions about that audience as feeble, on the one hand, or heroically ablebodied, on the other (cf. lamb 2014 and vitols and lynch 2015). de schutter and vanden abeele’s manifesto is the beginning of an expansion of critical academic studies of aging and game design that also offers the technology industry constructive guidelines on how to approach this new market. as professors in an engineering school, we train students in theories and practices for better design in aging and video gaming, and we join de schutter and vanden abeele in a desire to create a world where there is no stigma in playing a gameboy for a 62-year-old woman, or for people of any age or demographic background. a first step is to expose our students to the diversity of experiences and aspirations of gamers, and to the diversity of available gaming opportunities. notes 1. as presented in lynch’s engineering for humanity class at olin college, february 2015. quoted with permission. 2. see ideo’s collection of design concepts about aging (which includes some of colucci’s own work) at http://www.designs-on.com/issue/aging/ references de schutter, bob, julie a. brown, and henk herman nap 2015 digital games in the lives of older adults. in aging and the digital life course, david prendergast and chiara garattini eds. pp.236-256. new york: berghahn. evett, lindsay, allan ridley, liz keating, patrick merritt, nick shopland, and david brown 2011 designing serious games for people with disabilities: game, set and match to the wii[tm]. international journal of game-based learning 1(4):11-19. lamb, sarah 2014 permanent personhood or meaningful decline? toward a critical anthropology of successful aging. journal of aging studies 29 (2104):41–52. vitols, maruta z., and caitrin lynch 2015 back in the saddle again: ethics, visibility, and aging on screen. anthropology & aging 36(1):11-19. http://www.designs-on.com/issue/aging/ http://dx.doi.org/10.4018/ijgbl.2011100102 http://anthro-age.pitt.edu/ojs/index.php/anthro-age/article/view/85 anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 206-211 issn 2374-2267 (online) doi 10.5195/aa.2015.111 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. longing glances photographs from the series “far from home” bes young artist bio: bes young holds a ba from amherst college and an m.f.a. in photography from the belfast school of art. while still a freshman at amherst, young took an advanced seminar in “psychology of aging,” a course that would propel her to turn her camera towards the lives of older adults. she won a 2010 100 projects for peace grant to photograph senior homes in turkey and the united states, and in 2011, she traveled to japan with the support of a henry luce scholarship. in 2013, young was the recipient of the oxfam photography prize for women for her photographic work in sri lanka. she continues to explore memory, identity, narrative, culture and aging in her photography, more of which can be viewed at her website: http:/www.besyoungphotography.com/index/ keywords: aging, home, japan, dementia, built environment, technology, narrative. http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx https://www.amherst.edu/news/news_releases/2011/03/node/301083 http://www.ideastap.com/ideasmag/all-articles/exposure-oxfam-photography-prize-for-women-bes-young-sri-lanka http://www.ideastap.com/ideasmag/all-articles/exposure-oxfam-photography-prize-for-women-bes-young-sri-lanka http://www.besyoungphotography.com/index/ anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.111 http://anthro-age.pitt.edu longing glances photographs from the series “far from home” bes young the shift from institution to home-like environment for dementia care is often cast as a shift away from the marks of an institution: surveillance, power, and control, with the model’s success measured in decreased bpsd’s, which are behavioral and psychological symptoms of dementia such as aggression and agitation. in my position as a henry luce scholar at kwansei gakuin university from 2011-2012, i photographed group homes for dementia care throughout japan with an interest in exploring the tension between institutional control and these new homelike designs. i found the home-like environment to be not necessarily a shift away but rather a reimagining of the ways in which the body can be regulated and controlled via the environment, decreasing feelings of visibility which can lead to bpsd’s and providing flexibility for new and individualized approaches to governmentality. group homes are small home-like environments for residential dementia care which house anywhere from eight to fifteen residents. in japan, these homes are designed to house nine residents at a time. although some buildings may house more than one group home unit, each unit of nine residents is designed to feel like its own complete entity where continuity is maintained by a small, consistent group of staff. this portfolio is drawn from my stay with pokka pokka no ie, a group home for dementia care in kanegasaki, japan. pokka pokka is onomatopoeia in japanese meaning warmth, often used for "warmth of heart." the name pokka pokka no ie implies something along the lines of "warm home." although a mixed-gender facility, at the time of my visit the group home was at full capacity with an entirely female population. each resident in pokka pokka no ie has an individual bedroom. these bedrooms contain personal items, either curated by family members or the resident herself. not all residents enjoy these solitary bedrooms, however. in the past, the staff of pokka pokka no ie had difficulty with one resident nearly every night. her single bedroom was at the end of one of the two long hallways connected to the central living space. this resident refused to go to sleep and often made loud noises from her bed or got up to wander in the night. eventually, the staff decided that she was lonely, or potentially scared, sleeping by herself in this private bedroom. since then, they have encouraged her to sleep on a traditional japanese futon in a semi-private, elevated living space attached to the kitchen and dining area. the variety of private, public, and semiprivate spaces in group homes provides flexibility to the staff for effective management of behavioral symptoms. young | longing glances anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195// aa.2015.111 http://anthro-age.pitt.edu 207 207 pokka pokka no ie is also designed in such a way to include many large windows looking out onto the group home’s garden areas and local paddy fields. large windows also line one wall of each hallway, which lead to the residents’ bedrooms. the natural light decreases the need for harsh, institutional lighting, and the views provide a point of interest for residents – watching wildlife or looking at the plants outside. one such window looks out onto the front garden and serves another purpose as well. m. san grows strawberries and other small plants in the front garden. she is able to go outside and tend to the garden while a staff member can watch through this large window from inside. the outside garden is visible for a member of staff working in the combined kitchen and dining area space. while i was at pokka pokka no ie, m. san asked me to join her in picking strawberries. she was unprompted by staff to do so and did not need to ask permission. she simply invited me to join her, and we went outside into the unfenced garden. the unobtrusive form of surveillance the large front window provides allowed m. san a sense of independence while still allowing the staff to monitor her whereabouts. the design of pokka pokka no ie, however, is not entirely conducive to this form of unobtrusive surveillance. part of the move towards a more home-like care environment is the removal of the nurse’s station or staff desk from a position of surveillance or, in some instances, a removal of the desk altogether (in which case, staff are encouraged to complete paperwork while seated with the residents rather than behind a desk). pokka pokka no ie still has a staff desk, but it is located off to the side of the main kitchen and dining room area. this way the desk can remain as unobtrusive to the home-environment as possible. this comes at a cost, however. when i asked hareko-san, the manager of pokka pokka no ie, if there were anything she would change about the design of pokka pokka no ie, she explained that the location of the staff desk was such that the route to one exit door was not visible from it. this makes monitoring the residents very difficult, particularly during the night when only one staff member is on duty. since they have a policy of leaving doors unlocked (both a fire safety issue and a therapeutic decision to create a less restrictive environment), this out-of-view door provides a potential safety concern. a resident could slip outside unnoticed by staff. this is an example of where the effort to create a more home-like environment comes in direct conflict with surveillance needs. pokka pokka no ie has solved this problem by installing a motion detector near this door. the detector beeps when someone walks nearby. modern technology is assisting in regulating dementia care residents in less obtrusive ways. this also serves as a lesson, however, that an objective of the home-like environment is still governmentality. each beep is a reminder that this is not actually home. beds in pokka pokka no ie still have safety railings on them. many rooms contain commode chairs. there is a sterile nature to even the most decorated of rooms. despite attempts to make the facility more home-like, a group home still must regulate residents, ensure safety, and provide care through means of surveillance and design. the effects of these new forms of governmentality are present, embodied in longing glances and wistful statements, even if bpsd scales no longer fully apply for their measurement. these photos attempt to make visible new tensions that must be considered in the evaluation of dementia care environments. one afternoon, a resident of pokka pokka no ie saw a leaf decorating the dining table and it reminded her of a fan she had in her room. a staff member went to retrieve it and the next half hour was spent by the staff and other residents in the kitchen and dining area appreciating and discussing the fan holding it up to the light, asking how it was made, commenting on its beauty. young | longing glances anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.111 http://anthro-age.pitt.edu 208 the staff of pokka pokka no ie saw everything, even an offhand comment, as an opportunity for making the day a little more special. my time spent in pokka pokka no ie indicated that the success of a home-like living environment lay not in the design alone, but in the staff’s engagement with the design and willingness to help residents to do the same. but when i asked hareko-san the most difficult part of her job as manager of pokka pokka no ie her face immediately saddened, and she said, “all they want is to go home.” thus, even with home-like considerations made in the design of care homes, the desire to ‘go home’ still persists in those with dementia. young | longing glances anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195// aa.2015.111 http://anthro-age.pitt.edu 209 209 a resident sits in pokka pokka no ie’s combined kitchen and living area young | longing glances anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.111 http://anthro-age.pitt.edu 210 the door that cannot be seen from the staff desk young | longing glances anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195// aa.2015.111 http://anthro-age.pitt.edu 211 211 m. san looking out of a large window onto a garden area microsoft word danelyfinal3.docx book review review of świtek, beata. reluctant intimacies: japanese eldercare in indonesian hands. berghan books. 2016. isbn 978-1-78533-269-2 pp.242 price $90.00 jason danely oxford brookes university (senior lecturer in anthropology) anthropology & aging, vol 38, no 1 (2017), pp. 82-84 issn 2374-2267 (online) doi 10.5195/aa.2017.165 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.165 http://anthro-age.pitt.edu danely | book review 82 book review review of świtek, beata. reluctant intimacies: japanese eldercare in indonesian hands. berghan books. 2016. isbn 978-1-78533-269-2 pp.242 price $90.00 jason danely oxford brookes university while foreign migrant labor is a common feature of paid eldercare around the world (parreñas 2015), japan remains exceptional among highly developed countries for its reluctance to accept foreign eldercare workers, even though this sector dangerously under-resourced. japan's population is the oldest in the world, with the proportion of the population aged 65 and older making up around 27 percent of the overall population. despite japan's huge investments in media-friendly social robot carers (robertson 2014), care of the elderly still remains dependent upon human labor. by 2025, when the post-war baby-boom generation enters their mid-70s, the japanese ministry of health labour and welfare estimates a shortfall of 380,000 eldercare staff in japan. immigration, even if it were to start in earnest today, would still not make up these numbers in the next eight years. and yet the small numbers of foreign trainees working towards professional caregiver qualifications that will earn them the ability to stay and work in japan have received a lot of attention in the media, where they are simultaneously commended for coming to japan’s aid in a time of crisis and held up as examples of the many obstacles that immigrants continue to face. beata świtek’s ethnography of the first cohort of indonesian care work trainees brought to japan under the economic partnership agreement (epa) helps us peel away the many layers of representation that circulate in debates about aging, immigration and care by taking the us into the rooms of the nursing homes where encounters between trainees, japanese staff members, and residents bring “national imaginations and public discourses" (4) to the level of personal relationships and everyday practices used in "constructing, recognising and denying the viability of certain kinds of person" (4). the parallels between these indonesian caregivers and the older residents is clear, and świtek illustrates these two groups often strike up friendly alliances. but this is only one example of the many ways new relationships might emerge as rapidly aging, globally embedded societies bring about new sites of “multicultural coexistence” (4) which destabilize taken for granted assumptions and uncover anxieties about cultural identity. świtek shows that what is at stake for the japanese people in opening the possibility of more immigrant labor is both their contention of cultural-ethnic uniqueness and their claim to be an international economic power. as i read świtek's book, the word "relcutant" kept resurfacing. it is the ideal term for the kind of awkward, ambivalent ‘intimate encounters’ (to borrow faier's (2009) phrase) that are neither complete embrace nor total refusal. they are encounters where a distance is maintained, shaped and reshaped in ways that reflect both desires and discomfort. as an excellent ethnographer, świtek never lets this uncomfortable action too far out of her sight, recognizing them as sites where the universal human tendency to create categories of difference is ‘ruefully’ revealed (81). the notion of ‘reluctant intimacies’ allows świtek to address three main areas of contention: the bodily intimacy between caregivers and the elderly; the interpersonal intimacy between the trainees and japanese staff; and finally the national intimacy between anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.165 http://anthro-age.pitt.edu danely | book review 83 asian neighbors brought about mainly though economic interests and globalization. świtek’s ethnography shows how these three sites interpenetrate each other, and how this can explain many of the seeming contradictions in policies, attitudes, and practices across each. świtek was able to shadow several of these workers in care home placements across japan and to conduct interviews and observation. she would also travel to indonesia to meet the families of the migrants. the epa agreement itself reflects the reluctant intimacies and dependencies across asia. chapter 1 begins by describing the recruitment of indonesian candidates through the epa, many of whom were highly educated and experienced in caregiving and viewed the chance to work in japan as not only a chance to earn money and support family through remittances, but also to chase a japanese ‘dream’ of the good life. świtek follows the candidates to japan, tracking their hopes and disenchantments as they are given a six month crash-course in language and then dispersed to care homes where they must master a demanding schedule of menial tasks. as they bore the weight of their decision and tried to forge a life of success and dignity, they faced institutional and interpersonal obstacles and uncertainties. in chapter 2, świtek describes how, at times, the indonesian candidates’ novelty was an asset, at other times, a sign of their unsuitability. świtek examines the implications for these perceptions in terms of theories of care as well as the semiotics of “essentializing” or “stereotypical imaginations” (96). by grounding these concepts in ethnographic descriptions, świtek moves us beyond a simple notion of workplace discrimination, showing instead the ways candidates sought ways to accommodate japanese ways of life and even find friendship. at the same time, she is clear that the constant awareness of being a disruptive presence in the workplace (added to the already stressful conditions of care work), were not always easy to cope with. in many ways, by helping us see the japanese eldercare system through the eyes of the indonesian trainees, ‘circulating’ (33) through the dispersed care homes they were dispatched to on arrival, świtek is able to reveal much more about care institutions and immigrants’ experience than a typical 'nursing home ethnography' based in only one site. this is most clear in chapter 3, where she moves from staff coworkers to employers and broader institutional accommodation for the epa candidates. this includes everything from cultural orientation manuals to welcome ceremonies with staff and residents presenting flowers to their new trainee (133). one institution even chose to strike all pork products from its menus as a sign of respect for islamic dietary restrictions. these gestures, and other ways employers invested in the candidates, engendered, on the one hand, the feeling of a close familial bond, and on the other, a way for employers to exert more influence on candidates’ private lives. in the absence of the usual employeremployee relationship, świtek shows how employers’ position of responsibility for their epa candidates is one of both beneficence and control, but that intimacy provides further chances for personal relationships to form. chapter 4 returns to the topic of the representation of the indonesian candidates in the context of national discourses about immigration, internationalization and japan’s aging society. świtek covers an impressive range of sources, from policy and history to images in popular media. the picture that she paints is one of a japan that is reluctantly reflecting on its own long held ideology of cultural homogeneity as it finds itself caught up in a world of new pressures from inside and out. świtek acknowledges that immigrant labor will not become a panacea to japan’s eldercare worker shortage and she gives us little reason to believe politics around the issue are going to radically shift in the near future. nonetheless, świtek encourages us to also consider the potential of epa programs to provide new opportunities for not only beneficial anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.165 http://anthro-age.pitt.edu danely | book review 84 employment paths for immigrants, but also for introducing intercultural engagements that could have positive effects for dissolving reductive perceptions of foreigners and that might produce a more lively environment for care home residents and staff alike. reluctant intimacies does not shy away from the complexity of both the macro-level economic and political circumstances surrounding the epa, or the micro-level practices in the care homes, but masterfully weaves together the tense strands of mobility, economy, culture and care in a way that is clear, smart, and compelling. while much of the book will be of particular interest to japan specialists, świtek’s main contributions are to our understanding of intimacy, familiarity and cultural imaginations in an aging society, and she frames these concepts with brief but effective references throughout. for this reason, and for its sensitive ethnographic descriptions, reluctant intimacies would be appropriate for use in undergraduate or graduate courses, and should be seen as a model for anthropologists writing on the complexities of care and immigration. bibliography faier, lieba. 2009. intimate encounters: filipina women and the remaking of rural japan. university of california press. parreñas, rhacel salazar. 2015. servants of globalization: migration and domestic work, second edition. stanford university press. robertson, jennifer. 2014. “human rights vs. robot rights: forecasts from japan.” critical asian studies 46 (4): 571–98. doi:10.1080/14672715.2014.960707. microsoft word kesterkebrf.docx book  review     sprott,  richard  l.  (volume  editor),  antonucci,  toni  c.  (series  editor).  annual  review  of  gerontology  and   geriatrics:  genetics.  new  york,  ny:  springer  publishing  company.  2014.  isbn978-­‐‑0-­‐‑8261-­‐‑9965-­‐‑2        294pp  $119  (hardcover).     matt  j.  kesterke   department  of  anthropology,  university  of  pittsburgh                                                     anthropology & aging, vol 37, no 1 (2016), pp.49-50 issn 2374-2267 (online) doi 10.5195/aa.2016.149           this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.149      http://anthro-­‐‑age.pitt.edu       kesterke  |  book  review  49   book  review     sprott,  richard  l.  (volume  editor),  antonucci,  toni  c.  (series  editor).  annual  review  of  gerontology  and   geriatrics:  genetics.  new  york,  ny:  springer  publishing  company.  2014.  isbn978-­‐‑0-­‐‑8261-­‐‑9965-­‐‑2        294pp  $119  (hardcover).     matt  j.  kesterke   department  of  anthropology,  university  of  pittsburgh       in   his   time   with   the   national   institute   on   aging,   the   international   biogerontology   resource   institute,  and  ellison  medical  foundation,  dr.  richard  l.  sprott  has  become  an  esteemed  researcher  in  the   biology  of  aging.  in  this  volume,  he  has  assembled  27  researchers  focusing  on  the  genetics  of  aging.  the  ten   chapters  review  an  array  of  topics  regarding  the  genetics  of  longevity  and  disease  processes  associated  with   aging.  for  biologists  and  those  with  a  background  in  genetics,  this  volume  provides  an  informative  review   of  contemporary  studies  revolving  around  the  biology  of  aging.  for  non-­‐‑geneticists,  the  chapters  provide  a   somewhat  jargon-­‐‑heavy  primer  to  genetic  aging.  many  of  the  genetic  processes  correlated  to  longevity,   however,   will   reappear   throughout   this   book   and   allow   those   without   biological   research   leanings   to   appreciate   the   spectrum   of   physiological   and   genetic   pathways   associated   with   aging.   dr.   sprott   has   assembled  a  review  of  substantial  use  to  researchers,  anthropologists,  and  clinicians  alike.   the  first  chapter  reviews  foundations  of  aging  at  the  cellular  level  using  the  lens  of  contemporary   genetic   research   on   organisms   ranging   from   yeast   to   mammals.     key   questions   revolve   around   the   difference  between  adult  and  embryonic  stem  cells,  and  differential  preservation  of  both  during  aging.  the   authors   focus   on   longevity   pathways   that   are   critical   to   cell   regeneration   and   repair,   cellular   reprogramming,  and  metabolic  enzymes  essential  to  life  span  and  morbidity  studies.  the  second  chapter   deals  with  longevity  regulators  that  are  common  across  phylogeny,  responsible  for  both  development  and   inhibiting  longevity.  termed  ‘antagonistic  pleiotropy’  due  to  their  dual  functions  both  in  early  development   and  in  aging,  these  genetic  processes  are  beneficial  during  development  for  their  contributions  to  rapid  cell   proliferation  and  growth,  yet  detrimental  later  in  life  as  they  affect  tumor  growth  and  other  diseases  of   aging.     chapter  3  begins  to  look  at  environmental  factors  related  to  longevity,  focusing  on  the  role  of  oxygen.   despite  being  essential  to  the  survival  of  all  mammals,  the  metabolism  of  oxygen  leads  to  the  release  of   highly   reactive   oxygen   species,   which   in   turn   lead   to   the   alteration   of   cell   structure   during   aging.   environmental  oxygen  level  is  therefore  a  natural  avenue  of  research,  and  this  chapter  centers  on  hypoxia-­‐‑ inducible  factor  (hif),  a  transcription  factor  responsible  for  cellular  response  to  low  oxygen,  that  has  been   extensively  studied  in  animal  models  and  linked  to  vascular  health  and  overall  longevity.  however,  hif   may  prove  to  be  a  double-­‐‑edged  sword,  as  cancer  cells  can  “hijack”  it,  detrimentally  affecting  long-­‐‑term   health.  hif  has  also  been  linked  to  diseases  of  the  brain  (e.g.,  parkinson’s,  alzheimer’s),  which  can  actually   worsen  in  hypoxic  conditions.  the  chapter  authors  rightfully  call  for  further  research  and  standardization   on  the  topic,  and  this  call  is  mirrored  in  chapter  4,  which  reviews  the  intersection  of  dietary  changes,  gene   mutations,  and  medical  intervention  and  their  effect  on  longevity.  at  the  crux  of  this  chapter  is  the  question   of  exactly  how  these  interventions  increase  longevity:  by  extending  lifespan,  or  by  postponing  diseases  of   aging?  is  longevity  as  “simple”  as  a  decrease  in  early  life  hazards?  this  also  chapter  provides  a  fantastic  set   of   guidelines   for   evaluating   longevity   data   with   a   critical   eye   towards   statistical   power   and   over-­‐‑ assumptions.             anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.149      http://anthro-­‐‑age.pitt.edu       kesterke  |  book  review  50     chapter  5  takes  a  departure  from  the  nuances  of  genetics  to  look  at  primate  models  of  aging.  as  the   longest-­‐‑lived  of  the  primate  species,  humans  face  neurological  degradation  that  other  primates  do  not.  it  is   interesting  that  human-­‐‑like  patterns  of  neurodegradation  are  only  apparent  in  more  distant  primate  species,   and  not  our  closest  genetic  relatives  (bonobos  or  chimpanzees),  therefore  providing  a  promising  research   direction.  chapter  6  continues  the  theme  of  effective  study  models,  focusing  instead  on  exceptionally  old-­‐‑ aged  humans.  conserved  pathways  may  be  related  to  longevity  in  all  species,  and  therefore  selected  for  by   natural  selection.  genes  for  specific  diseases,  such  as  alzheimer’s,  metabolic  syndromes,  and  cancer  should   be  studied  in  centenarians  to  help  tease  out  precisely  how  extremely  old  individuals  are  protected  from  such   maladies.       the  role  of  genes  in  the  effective  health-­‐‑span  is  further  evaluated  in  chapter  7,  which  focuses  on   subjective  (e.g.,  self-­‐‑rated  health)  and  objective  (blood  pressure)  health  markers  and  their  relationship  to   stress  and  frailty.  using  a  wealth  of  data  from  numerous  genetic  and  sibling  studies,  this  chapter  highlights   the  complex  role  of  gene-­‐‑environment  interactions  on  successful  aging.  this  theme  is  continued  in  chapter   8,  which  demonstrates  the  extreme  complexities  of  genetic  and  environmental  interactions  found  even  in  a   “simpler”  mouse  model.  using  end-­‐‑of-­‐‑life  as  a  single  phenotypic  marker  for  longevity,  the  authors  use  mice   and   popular   candidate   genes   to   evaluate   the   causative   factors   behind   gerontological   phenotypes,   concluding   that   there   are   no   “best”   group,   environment,   or   level   of   variable   that   can   single-­‐‑handedly   answer  the  complex  processes  of  aging.     the   final   two   chapters   highlight   the   recurring   theme   of   complexity   of   the   aging   process   using   broader  and  more  theoretical  evaluations.  focusing  on  molecular  networks,  chapter  9  discusses  the  aging   process   across   numerous   genetic   pathways   before   moving   on   to   more   overarching   metabolic   and   physiological  processes  (and  corresponding  failures  thereof)  associated  with  longevity.  what  develops  is  a   cogent  call  for  future  research  on  these  networks,  not  only  in  how  they  shape  the  aging  process,  but  also   how  the  aging  process  in  turn  shapes  them.  the  final  chapter  of  the  volume  uses  the  notion  of  “nature  and   nurture”   as   an   explanatory   mechanism   for   the   complex   aging   process,   but   also   summons   the   oft-­‐‑ overlooked  element  of  “chance”  to  the  grand  scheme  of  evolutionary  processes  that  have  shaped  aging  and   longevity.  the  authors  demonstrate  that,  between  different  species,  variations  in  lifespan  and  health-­‐‑span   are  largely  governed  by  genotypes;  however,  within  the  same  species,  variations  in  these  processes  are   shaped  by  stochastic  events.  these  events,  the  author  argues,  likely  evolved  as  a  response  to  unpredictable   environments  during  growth  and  development  that  resulted  in  detrimental  effects  later  in  life  (antagonistic   pleiotropy).     overall,  dr.  sprott  has  assembled  an  admirable  compilation  of  genetic  studies  of  health  and  aging.   while  the  biological  data  is  dense  at  times,  especially  for  non-­‐‑biologists,  this  volume  represents  a  necessary   and   valuable   tool   for   researchers   looking   for   a   stepping-­‐‑stone   towards   future   research   regarding   the   complex  processes  of  genetic  aging.                     microsoft word portfolioramosbonilla.docx curriculum vitae: a photographic essay of elderly urban workers from peru gabriela ramos bonilla and erika jaclyn tirado ratto the photographs were taken by erick nazario and nicola espinosa. pontificia universidad católica del perú author contact: tirador.e@pucp.pe ramosbonilla@gmail.com anthropology & aging, vol 39, no 1 (2018), pp. 105-111 issn 2374-2267 (online) doi 10.5195/aa.%y.204 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 105 curriculum vitae: a photographic essay of elderly urban workers from peru gabriela ramos bonilla and erika jaclyn tirado ratto the photographs were taken by erick nazario and nicola espinosa. pontificia universidad católica del perú author contact: tirador.e@pucp.pe ramosbonilla@gmail.com introduction title: curriculum vitae: a photographic essay of elderly urban workers from peru “curriculum vitae” is a photographic project that was part of an anthropological study about elderly workers’ trajectories, routines and motivations to continue working beyond the retirement age. this study was undertaken in lima, the city with the most aged population of peru. a qualitative methodology was used based on in-depth interviews and photographs. the visual registry sought to capture the environments and work dynamics of the cases portrayed. the sample was composed by equal numbers of men and women working in diverse occupations between 61 and 89 years old. also, half of the sample was part of a pension scheme and the other did not receive any kind of pension income. it can be strange to think of elderly workers because, in popular imaginary, “work” and “old age” seem to be two incompatible elements, as this stage of life is usually considered as a moment of inactivity, dependence and economic unproductivity (bolles, 1981). contrary to these preconceptions, peruvian reality shows that more than half of the country's older adults (58%) continue working over the “state pension age” until quite advanced ages (inei, 2017; oecd; 2014). previous research about the peruvian elderly workers’ situation has been done but is still an issue that remains largely unexplored. national statistics and current research show it to be a social problem that deserves to be taken into account, especially focusing on the population living in poverty. the evidence shows that only 37.6% of people over 60 years old are part of the pension system, with a minimum fraction of 6% being poor and 1% being extremely poor. the proportion of men with a retirement pension is almost the double (49.2%) than that of women (26.9%), while more than half the total of older adults continue working. faced with this scenario, national public policy has not shown a clear position regarding the situation of the elderly workers, although the need of universal non-contributive pensions has been widely discussed. and, while this type of pension scheme has not yet been achieved, the discussion has led to the creation of the national program of economic assistance “pension 65”, designed to provide government economic transfers of only $77 american dollars every two months to the elderly population in extreme poverty condition (inei, 2017, olivera and clausen, 2014; ramos, 2009). anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 106 all the mentioned studies conclude that the elderly are forced to continue working because of their economic needs, but they also mention briefly that there could be other non-economic motivations, although without deepening into them. apart from the reasons mentioned there are the facts of being accustomed to a certain job routine or lifestyle, the desire of keeping in touch with spaces or people linked to their work activities, and continue learning or being perceived as an active member of their communities. in addition, work was emphasized by many people as a source of identity, wellbeing and fulfillment (helpage, 2012, paz, 2010, montes de oca and montoya, 2009, escobar, 2012). additionally, there are a few qualitative studies that approach the subjective meanings of work by analyzing aged workers in different contexts, such as rural and urban areas, or informal or formal labor markets. in all of these studies, several reasons or motivations to continue working were found besides economic need, including the desire to maintain a valuable social status, decision power or to maintain healthy (nué, 2000; reynolds, 2012; miralles, 2011; parry and taylor, 2007). the “successful and active aging” analytical framework has been used by some of these research to highlight the capacity of older adults in contributing to their families, and societies, through work. by doing so, they have sought to confront the prejudices that understand old age as a life stage of inactivity and dependence (miralles, 2011). however, although this paradigm seems to have positive effects, there are those who consider that it could be problematic due to potentially hidden coercive discourses, which would force people to remain active as a condition to be considered valuable and successful (lamb, 2013). taking this into consideration, those who choose to retire or are not able to engage in a remunerated activity, due to sickness or physical dependency, may be experiencing distress and pressure. throughout this study we have been able to verify what different researchers had previously mentioned. the variability of work experiences in old age and access to the pension system are the product of social inequalities and disadvantages accumulated throughout life (helpage, 2012, paz, 2010, eclac, 2002; montes de oca, 1999). in this sense, particular work trajectories and working conditions in old age are the result of having access to basic and higher education, the socioeconomic status, the place of birth (rural or urban) and the gender, as well as the economic and political context. all this is reflected in the number of hours worked per day, the type of space in which they work and the presence or absence of support to carry it out. for example, cases that have had trajectories marked by poverty, lack of access to education and that have exercised informal jobs throughout their lives, must now continue working more than 10 hours a day and in precarious situations, while retired professionals usually work less than 9 hours in safe and comfortable spaces such as their homes or institutions, surrounded by colleagues or family members. likewise, this study focuses particularly in the analysis of the motivations to continue working during old age despite an ageist labor market. after categorizing the various answers, numerous reasons were found and those were classified in economic and non-economic. first, there were economic motivations that focus in the survival needs of those who did not have a retirement pension or had to support the younger members of their families. additionally, older adults who have retirement pensions also had economic motivations to continue working because they intended to increase their income to keep a desired lifestyle. second, non-economic motivations were anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 107 also found. older adults keep working in order to bond and serve others. working was understood as an activity that provides meaning to life, a constitutive part of personal identity and an important way to continue learning and growing as a person. likewise, older adults wanted to keep working to achieve or to maintain a better state of health. finally, people wanted their work to transcend themselves in order to continue a family or cultural legacy. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 108 anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 109 anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 110 anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/a%y.204 http://anthro-age.pitt.edu ramos bonilla & tirado ratto | 111 references bolles, richard nelson (1981). “the three boxes of life and how to get out of them. an introduction to life/work planning”. berkley: ten speed press. eclac (2002). “los adultos mayores en américa latina y el caribe” (older adults in latin america and the caribbean). santiago de chile: eclac escobar, silvia (2014). “trabajando por la vida. los adultos mayores en el mundo rural de bolivia” (working to live. older adults in bolivia’s rural world). bolivia: cedla, helpage international helpage (2012). “los adultos mayores en el mundo del trabajo urbano” (older adults in the urban work world). bolivia: cedla, helpage international inei (2017). “situación de la población adulta mayor” (the situation of older adult population). technical report n°3september 2017. lima: inei lamb, sarah (2013). “permanent personhood or meaningful decline? toward a critical anthropology of successful aging”. in journal of aging studies. n°29. p. 4152 miralles, ivana (2011). “envejecimiento productivo. las contribuciones de las personas mayores desde la cotidianidad” (productive aging. the daily contribution of older adults). in trabajo y sociedad. n° 16. vol. xv montes de oca, v. and montoya, j. (2009). “situación laboral de la pam en el estado de méxico” (the work situation of older adults in the state of mexico). in papeles de población. n°59 nué, angélica (2000). “percepciones y autopercepciones de ancianos en la comunidad de santa cruz de andamarca” (perceptions and autoperceptions of the elderly in the community of santa cruz andamarca). in anthropologica. n° 18. pp. 153173 parry, jane and taylor, rebecca (2007). “orientation, opportunity and autonomy: why people work after state pension age in three areas of england”. in ageing and society. issue 04. pp. 579598 paz, jorge (2010). “envejecimiento y empleo en a1mérica latina y el caribe” (aging and employment in latin america and the caribbean). ginebra: ilo olivera, j. and clausen, j. (2014). “las características del adulto mayor peruano y las políticas de protección social” (the characteristics of the peruvian older adult and the policies of social protection). in economía. vol. xxxvii. n°73. pp. 75113 ramos, miguel (2009). “las pam y su contribución a la lucha contra la pobreza” (the older adults and their contribution to poverty reduction). lima: unfpa, mindes reynolds, et al (2012). “otherwise it would be nothing but cruises”. in international journal of ageing and later life. vol. 7. n°1. pp. 79-106 jt_interview a conversation with dr. janelle s. taylor, president of aage levi mitzen george mason university author contact: lmitzen@masonlive.gmu.edu anthropology & aging, vol 40, no 1 (2019), pp. 1-4 issn 2374-2267 (online) doi 10.5195/aa.2019.213 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.213 http://anthro-age.pitt.edu 1 a conversation with dr. janelle s. taylor, president of aage levi mitzen george mason university author contact: lmitzen@masonlive.gmu.edu i had the opportunity to sit down with dr. janelle s. taylor in january 2019 to discuss her career, current work, prospects for aage, and the possible trajectory of anthropology. dr. taylor is a professor of anthropology at the university of washington, the current president of aage, and an esteemed researcher, with publications covering the politics of reproductive medicine to the intersections of kinship and healthcare. this interview was done in observance of the 40th anniversary of aage, founded in 1979. it also served as a learning experience for myself and an opportunity to document the insight of someone progressing the field of anthropology into the expanding intellectual horizon. we began by discussing the ways individuals become anthropologists, with two noted means being through an anthropological education and the later recognition of the value of an anthropological perspective via work. dr. taylor’s described her own route to anthropology as “circuitous.” earning a b.a. in chinese language & literature, this served to further her fascination with the diverse ways people come to understand and relate to the world they exist within. however, as she progressed through her undergraduate, her attention began to shift to the types of questions being asked by anthropologists: larger questions of how the story that is human experience is told. it was this, the types of questions asked in the field of anthropology, that drove her to enter graduate school as a student of the discipline. from there we went on to talk about dr. taylor’s background in medical anthropology and how it has informed her work. her background in medical anthropology extends prior to what she termed the current “boom period” of medical anthropology when it had not yet experienced the popularity it enjoys today. yet she said that many medical anthropologists have resisted being classified as belonging to a distinct field of anthropology, with separate training and methods: “and i think that’s because really what we have to offer as anthropologists is insight into how health, and medicine, and aging are part of social life more broadly.” in relation to her own work, dr. taylor spoke about how this insight translates to some overarching themes: from one point of view, you can say that the topics i have studied over the years – reproductive technology, medical education, and aging -are very different, but i think that they all concern how individuals are produced socially. so for example you can look at reproductive medicine and technology in terms of questions about how the unborn is socially produced as a person, a child, a citizen, a consumer, etc. you can look at medical education in terms of how experts of various stripes are produced socially through systems of education and institutional arrangements around labor and so forth. i think relate to how the anthropology of aging looks at situations where older adults are being produced socially as particular kinds of individuals, as some of the health impacts that come with aging and disability complicate their capacity to perform individual autonomy. the fundamental relationality of individual people also becomes more obvious as they become older, for example in the importance of struggles and efforts around family, and inheritance, and more generally the concern for legacy. this led to me asking dr. taylor about the project she is currently working on: an nia grant for a cross-disciplinary study titled “health outcomes for patients with dementia without family caregivers.” this study builds on survey data collected through the longitudinal “adult changes in thought (act)” mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.213 http://anthro-age.pitt.edu 2 study, conducted by the kaiser permanente washington health research institute, which explores the development of dementia in patients 65 years and older. while the act study focuses on bio-medical questions (i.e., risk factors in terms of biomarkers and family genetic history), dr. taylor sets out to understand how dementia exists socially. her study explores how the availability of social support, or lack thereof, affects the health outcomes of patients with dementia as evidenced in patients’ health records postdiagnosis. while the relation of family support to health outcomes may seem obvious, dr. taylor noticed a lack of research on how the absence of familial social support manifests in the care of patients with dementia. speaking about her own experience with the subject via previous research, “i heard stories about people who were being cared for by people that they had met pretty randomly. where the grocery store clerk, for example, becomes the durable power of attorney.” stories like this shocked and intrigued dr. taylor, “is someone so alone that they don’t have anyone but the grocery store clerk? and what happens if the grocery store clerk doesn’t go above and beyond their job to find out about this person? then what?” through working on this study, dr. taylor has begun to uncover additional questions she may want to investigate in future research. “for better or for worse, i’m one of those people who tends to be working on something and then get interested in something else through that process, and it leads me into new topics that i don’t know much about”, describing the process as “always becoming ignorant over and over again.” her current work has turned her interest to the question of guardianship, specifically in cases where a patient lacks family. she said, one of the things that happens is the state becomes involved and appoints someone to be their legal guardian, or financial guardian, there are a variety of different types of guardianships. and that’s a very interesting topic to me and, again, there is very little social science research on that topic as far as i have been able to find. so, getting back to the question of how people are produced socially, what happens when it is someone appointed as a representative of the state rather than family, and friends, and people who’ve known you, that takes on the task of sustaining relational personhood? personally, i hope she goes on to develop this “keen curiosity” into full-fledged research on the subject. off of the topic of research, i turned my attention to dr. taylor’s role as the new president of aage to discuss the value of the professional organization and what plans she may have. dr. taylor spoke about how the construction of scholarly communities is essential to ensure that the full potential of their work is realized, just like i think individuals, in general, are sustained through social relations, the same is true of scholars and our work. no individual scholar can really thrive and do their best work unless they’re supported and sustained by an active, lively, welcoming scholarly community. i feel like i have been fortunate to benefit from that all along, even as i have bounced around different topics… connecting with other scholars and learning what other people are doing and are interested in, benefiting from their experience and insight and advice, is just valuable no matter what field you’re in. and in my view it is part of good citizenship, to do your bit to contribute to these thriving communities. as president of aage, dr. taylor is in a position to be familiar with the significance of doing “your bit” to help further the scholarly community. in her view, her role is to maintain the work done by her predecessors while fostering the growth of the organization. one way dr. taylor wishes to do this is to increase student membership and involvement, mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.213 http://anthro-age.pitt.edu 3 so we have a new person in the position of student liaison and a new membership director and we are going to be working together to figure out what would be helpful and cool and interesting to do from the point of view of students. and that’s part of how you have a thriving community: is when there is always new people joining and stretching it in different directions. so working on that is going to be a priority. in addition to supporting the future cohort of anthropologists through aage, dr. taylor wishes to strengthen the organization’s international presence, “jason danely has done a lot in that regard. i have a slightly different configuration of international connections with scholars interested in aging, so i will try to draw on those to add some new things to the organization.” both of these tactics will facilitate aage’s role in emboldening newcomers to the field of anthropology as well as broaden the perspectives present in the discipline. in discussing her aspirations for aage, dr. taylor mentioned aging and anthropology, the flagship journal of aage, as one of the organization's strengths. i agreed and mentioned that i am particularly fond of the fact that the journal is online and open access, making it more accessible to a larger and more general audience. i believe this is critical in the evolution of scholarly work if it is to work against the academic elitism and quietism risked by confining it strictly to universities. i asked dr. taylor if she could speak more on the issue of accessibility of scholarly work. she began by stating that she believes there are at least two dimensions in making scholarly writing more accessible: how it is published and how it is written. “so how we publish: i think open access is a great thing in terms of making work available to people who maybe don’t have an affiliation with a university so there is no ready way for them to get around a paywalls, for example.” however, dr. taylor also acknowledged some of the challenges facing a non-profit model of published scholarly work: “it does raise questions of what is the financial model that is going to support the work of doing scholarly work and publishing it. and that is a big question that a lot of scholarly associations, as well as publishing houses, are struggling with at the moment.” dr. taylor then went on to detail how scholarly work may be written in a way that is more accessible, including the pros and cons of doing this. i think that if you’re interested in public anthropology as a goal, which i think a lot of people are, it’s not enough to just want everyone to listen to us [laughs]. we have to actually be willing to write in a way that is accessible to people who not only might be outside of universities and not have subscriptions and all that, but might not take for granted all the jargon we learn in the course of our training. you learn specialized terms, that’s one of the tools of our trade, and there’s value in the specialized scholarly discussions that help develop sophisticated takes on things. but the jargon, the specialized language, can also exclude a lot of people, and if you rely on those terms to do a lot of the intellectual work in your writing, then that will limit where your arguments will be able to travel and who they will be able to engage. so i think there is a lot to learn about how to translate scholarly work into accessible terms without giving up the sophistication that these specialized discussions do provide... that’s a challenge that i think we don’t always train people in. dr. taylor mentioned the open access news source the conversation as a potential example of how scholarly work may be made more accessible, “[the conversation] works with researchers to kind of help them develop arguments that are formatted and written in such a way that they’re very accessible and then they make these articles available for free to anyone who wants to republish them. so they actually have mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.213 http://anthro-age.pitt.edu 4 done a lot of interesting work and i think that it's an interesting model to look at in how to write in a public way.” however, dr. taylor made it clear that this critique did not mean there is no value in more scholarly work. “i’m not trying to bash scholarly work at all… there is definitely also a place for specialized scholarly discussions that aren't specifically geared toward broader public audiences. i wouldn’t want to throw the baby out with the bathwater.” as we neared the end of our discussion, i asked dr. taylor if there was any advice she would give to individuals like myself: those just now entering the field of anthropology as graduate students and/or young professionals. she said that it should be made known that academia, and the jobs tied to the institution of academia, are changing rapidly, so, the kind of job i have, which i love [laughs], there are less and less of these jobs out there. as you may know, there are many more shorter term, more precarious kinds of positions being created in universities, and that's kind of a big, complex phenomenon that i think anthropologists as a profession are aware of and trying to work on. as such, we, as the future of anthropology, will need to adapt to a rapidly changing job market that, while full of opportunities, is not as rooted in academia as it once was. while this can be beneficial in providing a wider range of career choices, this may mean “... a little leg work and little asking around to find connections to people who have found their way into meaningful employment that uses their research skills.” while the uncertainty that accompanies change can be frightening, i believe the future of anthropology remains quite bright. the work of dr. taylor and professional organizations such as aage demonstrate the immense amount of practical value contained in the work anthropologists produce. thus, it is just a matter of finding novel ways of taking this valuable knowledge and translating it to the demands of modernity. through conversations such as the one i had with dr. taylor, we may discuss both the opportunities as well as challenges present in anthropology, with the goal of overcoming these challenges in the pursuit of knowledge and the betterment of humanity. microsoft word carriex.doc graduate student commentary carrie h. ryan department of social anthropology, university of oxford author contact: carrie.h.ryan@gmail.com anthropology & aging, vol 38, no 2 (2017), pp. 38-43 issn 2374-2267 (online) doi 10.5195/aa.2017.185 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.185 http://anthro-age.pitt.edu ryan | 38 graduate student commentary carrie h. ryan department of social anthropology, university of oxford author contact: carrie.h.ryan@gmail.com the editors of anthropology & aging approached me some time ago to see if i might be interested in developing a section within the journal for graduate research. i immediately agreed. rarely do journals create focused space for graduate work, and it seemed to me advantageous to do so on primarily two accounts: first, to investigate trending themes and issues in current aging research to see if and how new fieldwork might tell us something about this socio-political time; and second, to capture works and ideas still in progress, and thus to reveal educational trajectories, ever messy and knotty, in a publishing world that values polished products. it occurred to me later that this section might be an interesting space for a third reason, too: to discuss the methodological issues and queries that arise when studying aging as a graduate student. how do anthropology graduate students study aging, and how does their place within the life course impact their research methods and theory-building? additionally, fieldwork shapes the anthropologist, and the graduate’s first field particularly so. anthropology certainly impacts our approach to aging, but how does studying aging impact our approach to anthropology? i offer myself as a first case study for reflection. * * * i remember reading renato rosaldo’s (1993) ‘grief and a headhunter’s rage: on the cultural force of emotions’ for the first time and feeling, quite sharply, how inadequate my fieldwork would inevitably be as a young anthropologist. the reflexive turn in anthropology saddled me with the impression that all fieldwork knowledge is partial in its relational production (clifford and marcus 1986), but rosaldo’s analysis suggested that ethnography was also a craft that can be honed and refined through lived experience. his article showcases the transformations in his perceptions of ilongot headhunting throughout his life course. at first, he distrusted the ilongot when they said they headhunted to ‘carry’ and ‘throw away’ anger after a loss, and instead sought out a ‘deeper’ explanation for their actions through exchange theory. but when rosaldo’s wife died in a tragic accident, he felt the rage in grief firsthand. he could newly see that the ilongot’s explanation did not need a ‘deeper’ theoretical container; grief was grief and anger was anger, and these emotions, rosaldo now believed, could propel one to act in ways previously unthinkable. he concludes that it is crucial to have experienced the brute pain of bereavement personally before studying it in others. he also warns against the impulse to explain away confusion through grand, poetic theory. i was twenty-four when i embarked on my fieldwork to study the political economy of aging and dying in los angeles. i situated my research in a continuing care retirement community where i lived and worked for a year and half. ‘this all feels a bit… precocious,’ i wrote in the first line of my fieldwork journal. though my youth was marked both by my grandfather’s slow death from parkinson’s and my first job in my teens working at a nursing home, i still felt that my experience with death, and life in general, made me unfit for the journey i was about to undergo. and in many ways, i was. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.185 http://anthro-age.pitt.edu ryan | 39 i recall the first time in fieldwork i was slapped out of a wrong interpretation i had made. a resident, susan, had just lost her best friend after having endured three deaths that week within the retirement community. i went to her room to check on her. we sat down over tea and first discussed how salty the chicken kiev was that day in the dining room, and then we launched into how she was doing after all her losses. i kept saying how sorry i was and how difficult this must have been for her. i knew i was grieving painfully for having lost three residents, some of the first deaths i experienced there of people who i had really grown to know. after i continued to project deep sadness onto her, susan said defiantly, ‘you can’t know!’ she placed down her teacup and leaned towards me with urgency. ‘i’ve seen young people die in my years way before their time. this is hard, these deaths, but it is not tragic. they died old – that was a blessing.’ her correction embarrassed me, and made me feel the danger of my presumption about her psychological state of grief. confused on how to recover, and ruminating over her words, i kept quiet, stained red from blushing. susan noticed i needed help to find my feet after such a disorienting interaction, and offered, ‘you’ll know better when you’re my age.’ it was her attempt to console me, but for the anthropologist trying to understand local concepts of death and grief, it was a troublesome remark. was susan suggesting that i would never know what it means to endure everyday deaths at a retirement community until i had a shared experience in a lifetime of differentiated grief? i have waffled back and forth wondering whether aging is a process of knowing better or knowing differently. i have also thought about this in the realm of anthropology: does an anthropologist throughout their career, after multiple sites of fieldwork and their own personal experience in the world, develop more precise disciplinary tools? in one way, life and fieldwork throw up unexpectedly new horizons throughout the life course. the world’s unending difference and change can destabilize and induce dizzying wonder in anyone at any point, and therefore, macclancy (1988) notes, even previous experience in the field does not make you more fit for another field. nevertheless, to rosaldo’s argument, sensibilities can be sharpened, and a life course only expands the context in which to situate ideas and to notice patterns. de certeau (1984: 82) likens this sensitized navigation to the greek concept of mētis, a skilled knowledge born out of historical memory, a product of the ‘experience of the old man’ as opposed to the ‘thoughtlessness of youth’. without mētis, what can young anthropologists contribute? * * * as a graduate student now writing up, i think constantly about what i have come to know about aging and dying through fieldwork and what still, and may always, evade me. i feel my youth acutely: not only in the immense gaps in understanding aging and dying (what is it like to live in frail skin and to encounter last breaths?), but also in how limited my anthropological sensibility is at such an early moment in the academy (it is at once disheartening and encouraging to remember just how many books i have yet to read). this makes the doctoral journey all the more painful. even though graduate student’s stint in the field positions, legitimatizes, and demands them to write about the people they studied, pollard (2009) notes that many of them reported feeling ‘ashamed’, ‘regretful’, ‘embarrassed’, and ‘unprepared’ while doing so. these feelings overwhelmed me during the transition from field to home. in the field, i was the novice asking nurses how they could tell when an elder was about to die and questioning elders about their constant loss of friends. at home, i was the one being asked questions about aging and dying, about elders, and about caregiving. i have often wondered: who am i, a young twenty-something, to say anything about aging and dying, and to receive an advanced degree for having done so? i have noticed as i have emerged from the field that people frequently mistake my own partial fieldwork education for expertise. upon hearing about my fieldwork, people of all ages launch into their own stories anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.185 http://anthro-age.pitt.edu ryan |40 of their grandparents or their parents, sick or aging, dealing with alzheimer’s, dementia, bladder problems, sleeplessness, and hospice. i have learned a lot in these waterfall confessions, but have been worried about the kind of self-story i tell that begets them: is simply pronouncing ‘aging and dying’ in everyday conversation enough to launch such intimate discourse, or are there politics to saying ‘i study aging and dying’ that lend a veneer of expertise to a realm that, by its nature, narrows the possibility of deep knowing? amongst my generational peers, i function as an explorer and witness to an aging and dying realm unfamiliar, largely unknown, and seemingly faraway to them. i seem to them to have unusually pierced the generational enclaves by inserting myself as a young person in a world created for the old. few of my friends have ever set foot in a retirement community or a nursing home. if they did, it was only to see grandma at christmas or right before she was about to die. ‘what’s it really like in there?’ friends have asked with great intrigue. mostly the curiosity is comparative. ‘this place (oxford university) must seem… besides the point to you, having lived there (the retirement community), you know?’ i never know how to handle these sorts of questions, imagining, as i do, that they see me having a kind of metric for judgment about what really counts and what is really meaningful. i have come to realize that people think that the end of life is real-er than any other point, and that it provokes a kind of acute existential grappling so rarely incited. i have also been mistaken by peers as having expert insight into the realm of grief. a robust percentage of the people i met during fieldwork have since died. i have received more calls to funerals than i have wedding invitations, an unlikely inversion for someone in their late twenties. since, for many of my young friends, death still remains largely an anomalous event, they seek me out to understand what being around death regularly does to you, asking questions of me as one would to a religious teacher or a counselor. ‘what does it mean that we’re mortal?’ and ‘when a friend’s loved one dies, what are you supposed to say and to do for them?’ i’ve been asked to interpret dreams about graves and to calm fears about potential terminal illnesses. friends wonder if i believe in ghosts, what the appropriate amount of tears looks like for ‘good grief’, and if i would personally take advantage of a law like death with dignity. sometimes i wonder if all those deathbeds left a mark on me that people can now pick up on. of course, my experience fascinates and resonates more deeply amongst the young than it does the old. the first conference i went to at the end of my fieldwork joined aging professionals together to discuss how to solve some of the globes ‘most pressing concerns’ around the increasing elder demographic. i was put into a group with many professionals, all thirty years my senior, who believed that the only way to ‘control the aging tide’ was to make individuals ‘advance plan’ for their aging and dying trajectories. when i protested that this was neoliberal code to shift the responsibility for health from the state to the individual, and that this induced more precarity instead of abetting it, one of the older group members said, ‘when you’re our age, and you’ve been in this profession for as long as we have, you’ll see why you’re wrong.’ i was stuck in a difficult position: my political and anthropological analysis was just unusual enough to their professional ethos to seem irrelevant and biting enough to seem presumptuous. as many of them were older men, i had a feeling that my youth and gender contributed to their easy dismissal of me, too. it is always a difficult tight-rope to walk when disrupting popular ideas, even more so when you are, as a young person, disrupting an older person’s ideas about aging that you have yet to personally undergo. it was in this context that i could see that claiming privileged insight because of elderhood is also a claim to a particular kind of authority, a way in which to legitimate a particular methodology for the production of knowledge. such insight is not simply hard-won knowledge born from lived experience, but often involves anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.185 http://anthro-age.pitt.edu ryan | 41 political, economic and social beliefs hardened, by will, into ‘facts’. while my young peers have inappropriately slotted me as expert, elders have also undermined me because of my youth. both approaches, in my estimation, are wrong. the interesting question for me is not who knows better about the world, but how different perspectives illuminate the world newly and richly to us. * * * if fieldwork is a rite of passage, then writing up is the time you spend discovering how the rite of passage transformed you. i began to lose sight of what i had learned in the field near the end of it, and much of what initially disturbed me about the retirement community had, by that point, left its mark on me enough that i could no longer remember how i had started out so differently. it took leaving the field and returning back home to help me identify my learning arc. my clarity was aided by a significant displacement: in the span of thirty days, i transitioned out of one generational enclave into another, moving out of a los angeles continuing care retirement community and into an oxford college. at the beginning of march 2016, my next-door neighbors were 92 and 87 years old. the sounds outside of my room then were of walkers creaking by, nurses pounding on doors to deliver medicines, and neighbors gossiping about a resident falling, cracking a hip and landing himself in the hospital. but by the end of the month, my neighbors were 18 and 20 years old. the noises in the halls had radically changed: they were of lady gaga songs, whispers of who was ‘trying it on’ with whom at the ‘bop’, and of free-form running of young legs, late for class. the comparisons between the two worlds helped me draw conclusions i was unable to in the field: after dining with undergraduates who slurped up their food in a quiet hurry, i learned that part of the reason meals at the retirement community were foundational to its community-formation was because they joined people together ritually over long durations. in part due to slow chewing, the extended cadence of meals at the retirement community also had to do with how meals were understood in the context of daily routines. for undergraduates, meals were what fueled them to attend to activities throughout the day and were, in large part, a utilitarian consumption; for the elders, the daily meals were themselves activities and were, for many residents, the main structure of their day. undergraduates could quickly take care of their needs and almost forget about them, but elders were asked to labor over the maintenance of their bodies. indeed, many of the elders i lived with saw the maintenance of life itself as their central project. one resident’s regular retort when asked what he was going to do that day was, ‘just keep myself alive!’ the sharp juxtaposition between my time in the retirement community and then in the oxford generated an embodied form of knowing. for months i pushed wheelchairs in the retirement community, balanced leaning elders on my elbows, and learned how to be affected by the dying. my fieldwork, tactile and emotional, called me into being as a caregiver. i learned how to respond quickly to a falling elder. i understood the sensation of a touch that told me feverish or not. i appreciated my legs’ will to speed amidst an ocean of walkers and wheelchairs. i learned how my gut, and my shoulders, and the ligaments in my knee carry my grief. i understood how anxiety means constant attentiveness, how it can spread like contagion. i perceived how a soft but present touch on the shoulder could ease my presence into a blind woman’s realm. i calculated the right pitch and tone and volume for each of the hard of hearing. the first weekend back in oxford i stepped out of my room to the main streets to find breakfast. i saw an older couple inching their way slowly on the sidewalk to the bus stop, both balancing on skinny canes that were precariously meeting a rainy ground. my impulses lunged towards them, to stand near in case of a anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.185 http://anthro-age.pitt.edu ryan | 42 fall, but a big, double-decker bus whirled by and slapped me out of the task. these were not elders under my care and this was a street with different rules, i realized. as the steeple’s bells clang loudly and hints of british accents resounded all around me, i remember feeling how far away i was from the palm-treed californian retirement community i had for two years called home. in my first months back at oxford from the field, i mourned the touch in care. months of computer typing, singularly in my room or amidst dusty books, placed me squarely within the world of objects. the people i had known were now memories, unlocked through mental acts of recall. instead of responding to them in real time, i had the stories of them react to theories and ideas. the world i was sunk into was now in mp3 clips and .jpgs. a professor once joked to me that the only reason academics have bodies is to get them from one library, meeting, and laboratory to another. i was quickly sensing what he meant. though this shift in embodied existence was painful, it was also illuminating. nurses at the retirement community would often lament the fact that i had not yet had my own children. ‘you learn about how to care by being responsible for another,’ one nurse told me as she was teaching me how to feed a resident. but it was because i did not have any dependents while writing up in university that i could feel the loss of my fieldwork embodiment so intensely. when i was caregiving in the retirement community, my body calibrated with the needs of others; writing up, my body seems only to respond to its own needs. it was the absence my body felt because of its new isolation that clarified for me how caregiving intimately connects bodies together. though rosaldo thinks resonance leads to deeper understanding, i have learned about how gaps and differences can sharpen our ability to perceive, too. as a young person, my capacity to resonate with elders is highly limited, but anthropology argues that it is not sameness, but difference that drives the field forward. different seers produce different insights, and because of this, all eyes have something valuable and worthwhile to say. * * * on my last day of fieldwork, when the retirement community threw a party for me, a resident whispered in my ear, ‘go and do what you’ve learned here.’ she had said in a short dictum what several of my teachers – nurses, residents, death midwives and death workers – had been trying to tell me throughout my research: that what i was seeing and learning on an everyday basis during fieldwork should not be content to file, but rather catalysts to transform my being in the world. ‘it is sad, but it is also good you have learned about dying so young,’ a resident once said to me. ‘you will live your life differently now.’ it has been a bewildering project discerning what it is i actually learned in the retirement community and how, then, i should now live. bewildering because i discover each day what it was i learned there as my memories get refracted, sharpened, and illuminated anew by the fresh contexts i bring them into. bewildering also because, though moveable, these boundaries also highlight how much i do not know still, and how limited my knowledge will always be. elders in the retirement community would, like susan, confess that experience made their reflections about aging and dying intricate, but would also testify to the extent to which aging and dying continued to disorient and mystify them. though i often attribute my own ignorance around aging and dying issues to my youth, the elders i lived with encouraged me to see that claiming any expertise around aging and dying would be obtuse. these are processes not to be known fully, but to be partially apprehended, and particularly so. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.185 http://anthro-age.pitt.edu ryan | 43 writing up has been a process of transforming inadequate knowledge into partial knowledge, of figuring out how my own experience can be made into a time worth saying something about. it is an artful dance that must be learned, trying to find integrity throughout this process. i cannot ever fully know what it means to be old, but the curiosity and desire to attune and to attend are fed by my confusion. studying aging and dying leaves me thirsty to draw near and, to ask questions. anthropology has helped me navigate being young while studying old age and death, but studying old age and death as a young person has also helped me generate an anthropological sensibility i can be proud of. references clifford, j., & marcus, g. e. (eds.). (1986). writing culture: the poetics and politics of ethnography. berkeley: university of california press. de certeau, m. (1988). the practice of everyday life. london: university of california press. guyer, j. i. (2013). “the quickening of the unknown”: epistemologies of surprise in anthropology (the munro lecture, 2013). hau: journal of ethnographic theory, 3(3), 283. doi:10.14318/hau3.3.012 jackson, m. (2013). lifeworlds : essays in existential anthropology. chicago: the university of chicago. macclancy, j. (1988). ‘going nowhere: from melanesia to the mediterranean’ jaso xix (3) michaelmas: 233-240. miller, d. (2017). anthropology is the discipline but the goal is ethnography. hau: journal of ethnographic theory, 7(1), 27-31. doi:10.14318/hau7.1.006 pollard, a. (2009). ‘field of screams: difficulty and ethnographic fieldwork,’ anthropology matters 11(2), 1-24. rosaldo, r. (1993). ‘grief and a headhunter’s rage: on the cultural force of emotions,’ in culture and truth: the remaking of social analysis. boston: beacon press. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.212-213 issn 2374-2267 (online) doi 10.5195/aa.2015.118 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review aging, the individual, and society, 10th edition. susan m. hillier and georgia m. barrow. cengage learning. 2015. isbn: 1-285-74661-9, 496 pp. college bookstorewholesale $182.50, student list price $245.95 rachel sona reed, ma freelance writer and editor http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.118 http://anthro-age.pitt.edu book review aging, the individual, and society, 10th edition. susan m. hillier and georgia m. barrow. cengage learning. 2015. isbn: 1-285-74661-9, 496 pp. college bookstorewholesale $182.50, student list price $245.95 rachel sona reed, ma freelance writer and editor the instructor’s edition of aging, the individual, and society provides a comprehensive introduction to the multidisciplinary field of aging studies, particularly for college students interested in pursuing gerontology. instructors of advanced high school courses may also find this text appropriate. situating gerontology among psychology, biology, and sociology, the textbook considers all lenses to be critical to understanding aging in social context. on balance, it owes much of its theoretical underpinnings to sociology, as it “uses a social problems approach” to examine how social forces impact older adults (31). the text introduces topics as diverse as mental disorders and socio-economic inequality in its 15 chapters. aging, the individual, and society surveys its vast subject area to perfunctory satisfaction, with ample citation of key texts for those overachievers who wish to delve deeper into the many topics considered. the learning objectives within each chapter are limited to the necessarily truncated treatment of complex topics. one hopes that this text would be used in concert with a few of the primary sources it dutifully cites. by privileging regurgitation of its presented subject matter, the textbook implicitly trusts the instructor to expand students’ horizons with regard to alternate sources and critical thinking. to its credit, aging, the individual, and society doesn’t masquerade as anything other than what it is, while simultaneously making valiant attempts to assist instructors in their aforementioned horizon-broadening pursuits. the back matter includes an extensive bibliography, topic index, as well as internet resources for further research. designed to assist the instructor in constructing lessons plans, each chapter includes a summary, key learning concepts, learning objectives, discussion questions, fieldwork suggestions, and internet-based research activities. keywords and vocabulary terms are presented in bold, which will delight anyone nostalgic for their elementary school textbooks. public policy is a dominant theme, the authors often positioning gerontologists as agents of social change. “the need to address the issues of an aging nation is upon us” they importune (31). this rallying cry can be read as an assurance to gerontology students that they’ve chosen the right field, not like those misguided suckers in [insert esoteric field here] who won’t be able to find a job once they graduate. the authors of this textbook have at once more idealistic and more pragmatic aims for their readers. reed | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.118 http://anthro-age.pitt.edu 213 213 “policy has the unfortunate pattern of following far behind demographic changes, regardless of how certain those looming changes are,” they caution (413). but do not mistake this lament for the book’s attitude toward its subject. optimism prevails! with a robust new cohort of gerontologist, the authors believe that real social change is actually possible. their unwavering hope that the power of shifting social attitudes will influence public policy comes in the form of chapter 14 (on death and dying), which is immediately followed by the capstone chapter on “politics, policies, and programs.” if dismantling ageism it the endgame, this introduction focuses on broad trends in dominant u.s. cultural groups while paying lip service to difference. the textbook assumes a middle-class, straight, white, american reader, and takes its primary subjects to be of similar ilk. there are diversions from these unmarked categories, often to reductive effect, which reinforces the mainstream’s dominant cultural status. perhaps the idea is to ease the mainstream reader into the strange new world of cultural relativism. attempts are made to be inclusive, to varying rates of success. a chapter devoted to ethnic “others” (non-white americans) calls for “correcting inequalities for ethnic minorities and women,” and a few additional considerations of marginalized communities pop up (377). there’s a notable western bias in its brief historical overview of social attitudes toward aging and the authors routinely simplify the complexities of cultural shifts. arguably, the strategy of eschewing the cross-cultural for the familiarity of the united states is a wise one. already unwieldy in scope, to expand it would have weakened this already strained overview of critical aging issues. in short, this is an approachable, engaging text with the potential to enlighten many students, even those for whom this course fulfills an obscure requirement. the authors are banking on rallying some of those initially disinterested students to the cause, and they may well succeed. after all, the book has an abundance of pictures. final note: this reviewer is ill-equipped to judge the text on its pedagogical merits, as she is not an educator, much less a professor of gerontology. rather, she comes at this text from the perspective of a former student of anthropology and current non-profit professional immersed in the aging field. gerontology professors would do well to take the above review with a grain of salt. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.224-225 issn 2374-2267 (online) doi 10.5195/aa.2015.115 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review unforgotten: love and the culture of dementia care in india (life course, culture and aging: global transformations). bianca brijnath. oxford, ny: berghahn books, 2014. isbn-10: 1782383549, 240 pp. price $95.00 (hardcover) nirmala jayaraman, ba anthropology, union college http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.115 http://anthro-age.pitt.edu book review unforgotten: love and the culture of dementia care in india (life course, culture and aging: global transformations). bianca brijnath. oxford, ny: berghahn books, 2014. isbn-10: 1782383549, 240 pp. price $95.00 (hardcover) nirmala jayaraman, ba anthropology, union college in “unforgotten: love and the culture of dementia care in india”, bianca brijnath writes, ‘i am explicitly concerned with the transformative processes that illness and degeneration create and how this transformation occurs in contemporary urban india, which has undergone substantial economic, social and material changes in the last decade” (p.9). indeed, brijnath fulfills her objective to explore these perspectives among physicians and patients’ families through the lens of cultural anthropology. she holistically shows how the diagnosis and undetermined cure for dementia impacts patients’ everyday life outside the medical setting. brijnath’s writing style is so fluid and readable that her book will appeal to academics, medical students, and the general public. however, her intended audience may choose to read authors she has referenced to truly maximize their experience of reading her work. she cites sarah lamb’s ethnographies of elder care in india as a source of inspiration saying, “lamb (2009) also observed in her later study that while the wicked spectre of modernity continued to loom over the gerontological and media landscape in india, its shadow had diminished and that in actual practice older people and their carers enuciated far more ambiguous and complex understands of ageing and care” (p.8). what brijnath does to further contribute to the field of aging studies in india is that she is not afraid to challenge lamb’s findings and provide a picture of how these social trends are changing saying, “the social ties that bound lamb’s (2000) mangaldihi villagers endures but has thinned. that dialogue between india and abroad is occurring at all levels and the conversations are more ambiguous and less certain” (p.191). brijnath’s critical lens of her own literature review foreshadows how honest she will be when it comes to assessing her own understanding of her fieldwork. her most brilliant point emerges when she notices that “inconsistent stories” from informants about alzheimer’s disease and age related dementia reflect the devastation brought on by “the contrariness of the disease itself” which still has no biomedical or therapeutic cure (p.138). the strengths from brijnath’s arguments come from her ability to evoke feeling and memory from her readers. in one chapter she asks, “can you smell the writing?”, suggesting that she hopes to engage readers’ understandings of memory through their sense of smell and taste (p.33). in her book, elders long to savor their human existence and still possess the power to jayaraman | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.115 http://anthro-age.pitt.edu 225 225 value, and be valued, as they experience their culture through their senses (p.135). by gently asking readers to consider how they use their senses to connect with their environment, brijnath shows how vulnerable patients are when they lose their relationships and memories due to social isolation and aging (p.101). she further explores how in an age of medical pluralism, patients’ families turn to alternative herbal medicines instead of biomedicine because they fear the side effects of the latter (p.77). brijnath also acquiesces that there is ultimately “no language for emotion” that can convey the feelings internalized by patients and their families (p.98). although love serves as a major theme for this book, it is difficult to discuss it as a cultural phenomenon. perhaps the best way to understand love for this ethnography is to define it as “seva”, the responsibility to care for one’s elders (p.189). brijnath focuses on how love and social relationships motivate people to care for older family members beyond what is expected of them in contemporary society (pp.184-185). to clarify, studying expressions of love and care is not a weakness in the research, but readers may be able to understand brijnath’s ideas best in terms of the negotiations and limits of agency and power (p. 27). for example, in her formal and informal interviews, brijnath observes that women caregivers and elderly women patients are at risk of being neglected and even abused if public and health policies are not enforced to protect them (p.167). by attending to the conflict between acts of service and positions of power, brijnath identifies patterns between informal and formal expressions of social control (p.114). this tension relates to earlier work concerning the differences between “de facto power”, expressed in private domestic spaces by women, and “de jure power”, expressed in public settings and supported more readily by a legal authority (1983 cool and mccabe). ultimately, her findings contribute to the field where researchers continue to write about social actors transitioning between roles within their culture. bibliography cool, linda and justine mccabe 1983 the “scheming hag” and the “dear old thing”: the anthropology of aging women. http://faculty.usfsp.edu/jsokolov/cool.htm accessed: july 1, 2015 http://faculty.usfsp.edu/jsokolov/cool.htm microsoft word ikelsx.docx book review review of aging in world history. david g. troyansky. routledge. 2016. isbn 978-0-415-77906-7 (hbk). $155. (also available in paperback and as an ebook). charlotte ikels case western reserve university (professor of anthropology emerita) anthropology & aging, vol 38, no 2 (2017), pp. 46-47 issn 2374-2267 (online) doi 10.5195/aa.2017.163 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.163 http://anthro-age.pitt.edu ikels | book review 46 book review review of aging in world history. david g. troyansky. routledge. 2016. isbn 978-0-415-77906-7 (hbk). $155. (also available in paperback and as an ebook). charlotte ikels case western reserve university (professor of anthropology emerita) this work is the latest publication in routledge’s themes in world history series. as such it is not intended as a textbook but as a means of allowing students to dig deeper into the featured theme. the author, david g. troyansky, a specialist in french history, is professor of history at brooklyn college. his publications on aging, primarily in france, extend back to 1982. early in his career troyansky worked in a seminar with philippe aries, the french historian well-known for his encyclopedic works on childhood (centuries of childhood 1962) and on death (the hour of our death 1981) albeit primarily in western europe. troyansky’s similarly encyclopedic aging in world history continues this focus on one phase of the life course, but extends its scope well beyond western europe to include the middle east, asia, and beyond. troyansky examines both the population level (changing demography and its impact on state and society) and the individual level (personal experiences) of aging. exercising the historian’s craft, the author draws on a great variety of written and representational sources for his data. these sources include religious and philosophical texts, laws and regulations, census and statistical reports, the observations of contemporary writers, diaries, works of fiction, and popular and artistic representation, such as cartoons, drawings, and paintings. troyansky acknowledges the limitations of his data, e.g., that surviving diaries are not representative, that emphases in writing change over time even if the actual situations of older people do not, that neither laws nor moral texts should be assumed to describe reality. of particular interest to anthropologists of aging is troyansky’s use of ethnographic and comparative research when writing about the present and the near-present. he emphasizes that there should be more of these kinds of works! the book’s thirteen chapters are grouped under five sections: i theoretical concerns, “natural” aging, and classical prescriptions and representations; ii medieval to early modern transformations; iii transitions to modernity; iv modernity and old age, and v globalizing, medicalizing, and disciplining old age. while any chapter in the book is a great resource for the teacher or student writing a research paper or studying for a doctoral exam, anthropologists will probably find chapters 9, 11, 12, and 13 most directly relevant for their own purposes. chapter 9 old age in the context of colonialism, imperialism and decolonization investigates the impact of these eras on the elderly among both the settlers and the local indigenous populations in central america, africa, and asia. chapter 11 aging in a global context considers the impact of different rates of population aging on the status of older people and the resources available to them. while the early western european experience of the late 19th and 20th centuries saw the growth of the economy precede the aging of the population, in most of the rest of the world these processes occurred simultaneously or the growth in the economy lagged anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.163 http://anthro-age.pitt.edu ikels | book review 47 behind the aging of the population. under these circumstances troyansky asks how useful the programs and policies developed in the west will be to meeting the needs of societies whose experiences and resources are quite different. chapter 12 aging, medicalization, and the discipline of gerontology provides a review of medical takes on aging from antiquity to the present, from the egyptians and the incas to today’s geriatricians. troyansky emphasizes the multidisciplinarity of gerontology and helps the reader get oriented by introducing the content of several of the leading handbooks in the field. like the previous chapter, chapter 13 aging in present and future also provides a review – in this case of the main themes that have interested social scientists and policymakers working in the field including pension reform, retirement, the reconfiguration of the lifecourse, gender and ethnic differences in the experience of aging, etc. these two final chapters provide the reader with a comprehensive overview of the scholarly work in the field of gerontology. aging in world history is a dense book, packed with information, and rich in references. as such it is likely too much for the uninitiated reader taking an introductory course on aging though the instructor of that course will find it invaluable. anthropology & aging quarterly 2013: 34 (2) 156 guest editors’ introduction to the group submission: “silver linings” lindsay dubois, phd and liesl gambold, phd department of sociology and social anthropology dalhousie university  jean-marie guyau (1854-88), once a lecturer in philosophy at the lycée condorcet in paris, spent the better part of his short career writing a book on the theory of time. in it he notes the impatience of youth, their lives lived bulging at the seams, while old age “by contrast, is more like the unchanging scenery of the classical theatre, a simple place, sometimes a true unity of time, place and action that concentrates everything round one dominant activity and expunges the rest” (cf draaisma 2004: 207). guyau was illustrating the narrowing of life in the autumn years; the dispensing with, perhaps, things one has come to realize are unnecessary, but also the resignation that ones brightest, beautiful and bold years have long since passed.  one comes, then, to expect very little in old age, or from the elderly. the collection of papers here highlights an alternative stage in which people are not only exhibiting powerful and colorful agency in their later years, but also are doing so with little regard for the diminutive expectations the world holds for them. what is it that inspires seniors to challenge the standard tropes of senior citizenship?  these papers aspire to focus our attention on the ways in which older people depart from the socially defined roles of later life. we expect youth to cross boundaries, take risks, challenge themselves and the cultural institutions around them, not the aged. certainly the public eye is drawn more to youth movements and actions. however, with the world poised, in the next two decades, to experience its largest increase in the elderly population, how we treat aging and the decisions and actions of the elderly will be critical. aging is framed by a common terrain of shifting physical health (itself a very individual experience) while marked by class, gender, race and place. still, many seniors creatively navigate the ‘third age.’ some find that their time, no longer tied so strictly to work and family, becomes truly their own and they turn to rejuvenating old interests or forging new ones. others resist being moved, literally and figuratively, to the margins of society and strive to make their voices and opinions heard. as seniors see their social and political influence diminish in youth-obsessed cultures some find new strength and meaning in lives that include activism, migration, a new physicality, renegotiating their identity and carving out a new cultural and physical presence in their communities. such analyses demand attention to the gendered dimensions of later life and we consider them here.  this group of articles looks at these issues in a variety of contemporary contexts. robbinsruszkowski examines universities of the third age as sites which offer alternatives to dominant discourses about aging in contemporary poland. the argentine elders dubois describes engage in political activism in attempts to alter policies with respect to retirees, but also as an end in itself. gambold´s study of older women who retire abroad to mexico and france shows how these women use international retirement as a way to live old age differently. the articles thus describe older people actively engaged in redefining what it means to be old. references draaisma, douwe 2004. why life speeds up as you get older: how memory shapes our past. cambridge university press. cambridge. anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp. 90-92 issn 2374-2267 (online) doi 10.5195/aa.2019.222 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of bribiescas, richard g. how men age: what evolution reveals about male health and mortality. princeton, n.j: princeton university press. 2016. pp 192. price: $24,95 (hardcover); $17,95 (paperback). richard zimmer sonoma state university http://www.library.pitt.edu/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ zimmer | book review | 90 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.222 http://anthro-age.pitt.edu book review review of bribiescas, richard g. how men age: what evolution reveals about male health and mortality. princeton, n.j: princeton university press. 2016. pp 192. price: $24,95 (hardcover); $17,95 (paperback). richard zimmer sonoma state university richard bribiescas, professor of anthropology and ecology and of evolutionary biology at yale university, has written a witty, and provocative book about how men (and, in a similar vein, women) age. bribiescas takes the courage of opening the age old box of pandora in marrying anthropology with evolutionary biology. he does so, however, to map the human reproductive ecology of gendered ageing trajectories: he contends each gender has evolved differently as to their sexuality, particularly from the teen years onwards. whereas men have evolved to be stronger and to take risks at a younger age, women have evolved to be ready for reproduction around this same moment in maturation. their ageing trajectory, however inscripted by socio-cultural practices, is still more tightly bound to their biological fertility than men’s. although men, who survive the risky behavior they engage in in their earlier readiness for reproduction, will be able to keep on reproducing much longer than women, the concomitant physiological changes are likely to produce medical conditions that impact men's health, which can cause men to die earlier than women. while, today, medical and social interventions can help people from both sexes to live longer, bribiescas argues we cannot escape our sexual evolutionary past. pithily, he quotes peter ellison: “‘evolution does not select for health’” (106). the author makes his evolutionary argument compelling by comparing human, primate and higher animal patterns of reproduction and their consequences for natural selection. in his words: "[the challenges] for women ... include childbirth and lactation. for men, it has been competition with other males and evolving ways to be attractive mates” (5). bribiescas argues, today, each sex shows tradeoffs in terms of these designated reproductive roles. men "need to make decisions how to allocate calories and other resources to promote reproductive success” (5). following this line of thought, men have developed stronger upper body strength and have also developed faster energy burning rates (55-56). recently, shortly after the publication of this book, manu goyal and colleagues find that, as they age, men's brains deteriorate faster than women's. their research shows that, whereas women's brains were 3.8 years younger than their chronological age, men's brains were 2.4 years older. furthermore, age-related stressors seem to impact women's brains far more than men’s (goyal et al. 2019: 3251 e.s.). further neurological research is needed to determine what aspects of this phenomenon can be brought back to brain metabolism. following bribiescas' argument on the evolutionary basis of sex-differential energy usage, a causal relation between this factor and the unequal pace of decline appears ever more likely. zimmer | book review | 91 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.222 http://anthro-age.pitt.edu in their teen years, thus, in part because of heightened testosterone production, males’ risky behaviors can lead to premature death and accidents, which explains the earlier bump in male mortality. older men who survive risky behaviors, despite losing bodily strength, have developed more skills that allow them to survive and succeed. women use calories in their younger years for reproduction – not for challenging behavior – but are more likely to die in this period due to the vicissitudes of childbirth. once they have passed their reproductive years, they are still likely to live longer than men. furthermore, women and men face different risks for later mortality because of the hormonal changes involved in their different ways of sexual reproduction. bribiescas reviews established and more recent work in medical and evolutionary anthropology on how boys and men are more fragile than women. he equally situates hormonal differences in a comparative cultural perspective: women have "robust" immune systems, more so than men (120). moreover, men who increase their testosterone levels because of real and perceived erectile dysfunction may possibly put themselves at risk for prostate cancer (118). on the flip side, men who not just father children, but who are involved in their care, may experience lower levels of testosterone, higher levels of estradiol – the 'female’ hormone – and more robust immune systems. too much estradiol, however, can lead towards those health and mortality conditions to which women are susceptible. as an anthropologist, bribiescas also takes into account the impact of social factors on the way men and women play out their sexual and reproductive roles, and the effects thereof on health and mortality. bribiescas uses many examples from his own and other’s fieldwork to illustrate this. he, for example, reviews the "grandmother hypothesis" proposed by kristen hawkes. to put it briefly, hawkes states that women can be supported in their reproductive years in terms of child bearing and child care, by having their mothers participate in taking care of their children. this social situation, would allow a child bearing woman to have more children, who are equally more likely to survive (82 e.s.). on the flip side, the author reminds, men can continue to father children way past the age that women can reproduce, although their sperm may not be as strong and they may not find younger women who agree to have their children. as a rule, men tend to live longer in pair bonded relationships, in part because they are likely to indulge in less risky behavior (see chapter 5). in addition, they, too, may be involved in raising their grandchildren. as a bonus, those older men who take care of children and those who have daughters taking care of them live longer, as do post-reproductive women (102). bribiescas’ publication raises many questions for future study, questions way beyond the above-mentioned differences in brain aging. he notes, for example, the lack of research on gay populations, both male and female, and raises the intriguing question as to whether pair bonding among gay men would affect their mortality in the same way as it does with straight men (127 e.s.). or, in a similar vein: does engaging in warfare at an earlier age and surviving into old age "...have potential fitness benefits" (127)? bribiescas’ most important argument is that men (and women) cannot escape the aging effects of their evolutionary and gendered bodily material, effects which are determined by the physiological differences in reproduction and their concomitant medical conditions. this book is easily accessible for the educated and knowledgeable reader. it can be used in gerontology, physical and socio-cultural anthropology and biology classes for both undergraduate zimmer | book review | 92 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.222 http://anthro-age.pitt.edu and graduate students. it also provides food for thought for classes in gender studies as well as in physicians’ and nurses’ training. references goyal, manu et al. “persistent metabolic youth in the aging female brain.” proceedings of the national academy of sciences 116 (8): 3251-3255. https://doi.org/10.1073/pnas.1815917116. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.125-126 issn 2374-2267 (online) doi 10.5195/aa.2015.112 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. reply to responses bob de schutter1 & vero vanden abeele2 1 miami university contact: b@bobdeschutter.be 2 ku leuven, e-media lab, belgium contact: vero.vandenabeele@kuleuven.be abstract responses to commentary, “toward a gerontoludic manifesto,” by bob de schutter and vero vanden abeele in anthropology & aging vol36, no.2, the special issue on “aging the technoscape,” followed by a reply by the commentary authors. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.112 http://anthro-age.pitt.edu reply to responses bob de schutter1 & vero vanden abeele2 1 miami university 2 ku leuven, e-media lab, belgium we thoroughly enjoyed reading the critical and thoughtful responses to our manifesto. we are humbled by the authors’ kind words, and appreciate their valuable insights. their comments elevate the manuscript by introducing it to broader application domain and igniting an interesting debate. we find ourselves mostly in agreement with caitrin lynch and maruta z. vitols’s erudite exposition. although our previous work has addressed both key issues (i.e., gaming as selfexpression and gaming as community1), nonetheless, we had not considered including these in the manifesto. perhaps we were so eager to argue against ageist game design, that we neglected other, more positive design considerations (such as the divergent aesthetic outcomes of games for older adults). the combative voice of the manifesto is a response to the ageism that we perceive in the field of games and ageing, and as such this is also present in the dichotomous character of the adages. we argue that presenting the adages as contradictions is a necessity to make the manifesto’s statement bolder. admittedly, it also strips it from its sensitivity. as the field of gerontoludology develops, more nuanced approaches will surely arise, in particular in relation to the inherent usefulness of play. rubinstein and brazda’s comments provide an interesting expansion as well. one of us is currently running an “adult gamers club” which can best be depicted as a biweekly lan party for retirees. while our research has confirmed that the majority of older players play their games in a solitary setting (e.g., de schutter 2011), the adult gamers club demonstrates that games with a strong social component can be very successful. for example, diablo iii – a dungeon crawler in which a party of 4 fantasy heroes levels up, defeats monsters and collects loot – was a huge hit with the club thanks to the multiplayer possibilities. the potential of massive multiplayer online role-playing games for older adults is a vastly interesting yet underexplored terrain for game researchers, and not just because of interface complexities that they may be present – diablo iii actually has a simpler interface compared to a typical mmorpg, which also contributes to its appeal with the club. in conclusion, it is delightful to see that the manifesto has already been the topic of discussion in the very issue in which it has been published. we look forward to further discussion and extensions, as the manifesto is a living document that can and should grow. we hope that it may contribute towards a new age for the older players of digital games. bob de schutter vero vanden abeele de schutter & vanden abeele | reply to responses anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.109 http://anthro-age.pitt.edu 126 notes 1. for example, de schutter & vanden abeele (2008, 2010) addresses ‘connectedness’ and “contribution” as themes for digital games aimed at older players. references de schutter, b. and vero vanden abeele 2008 meaningful play in elderly life. in proceedings of the annual meeting of the international communication association. quebec, montreal, canada. de schutter, b. and v. vanden abeele 2010 designing meaningful play within the psycho-social context of older adults. in proceedings of the 3rd international conference on fun and games. pp. 84–93. fun and games ’10. new york, ny, usa: acm. de schutter, bob 2011 never too old to play: the appeal of digital games to an older audience. games and culture: a journal of interactive media 6(2):155–70. microsoft word editorwelcomex.docx the editor’s note cortney hughes rinker department of anthropology, george mason university author contact: chughe13@gmu.edu anthropology & aging, vol 38, no 2 (2017), pp. 1-3 issn 2374-2267 (online) doi 10.5195/aa.2017.183 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.183 http://anthro-age.pitt.edu hughes rinker | note 1 the editor’s note cortney hughes rinker department of anthropology, george mason university author contact: chughe13@gmu.edu research has shown that overall the world population is becoming older. an aging population is also accompanied by other demographic trends. people are living longer lives than in the past and fertility rates are declining in some places. in the united states, the population over 65-years-old will grow to 19% in 2030, up from 13% in 2009. the age group of 85+ will increase by 350% between 2000 and 2050 (wiener and tilly 2002). this trend is not unique to the united states. other countries, like japan, have seen an even more rapidly aging population. other regions and countries are also seeing an aging population, but not at such a fast pace. for instance, while the population in the middle east and north africa is also becoming older, it is still relatively young when compared to other regions. the percentage of the population over 65 in the mena is about 5%, but the range varies depending on country with some, like lebanon, having a higher percentage and others, like the united arab emirates, having a lower percentage of older adults (10% and 2% respectively). while fertility rates have declined worldwide with aging populations, they have remained somewhat steady in the middle east and north africa and are not decreasing as quickly as in some other places (hajjar et al. 2013). aging raises a number of theoretical and empirical questions about culture, infrastructure, the body, experience, identity, memory, medicine, health, ethics, social services, and policy, as well as other topics that are prime for anthropological investigation. this is an exciting time for anthropologists who work on issues related to aging and the life course in both academia and applied settings, or a combination of the two. these demographic trends open up new topics and spaces for anthropological study and encourage us to re-think older ones in light of changing populations and their unique needs. they present the opportunity for anthropologists to further explore issues such as: age-related illnesses and health care, the development and application of different types of technologies in caring for older adults, gender and sexuality in aging, identity formation over the life course, aging-in-place, and the emotional and psychological aspects of aging. with multiple opportunities for anthropologists today, i am honored to be the new co-editor of anthropology & aging and look forward to working with philip kao and the editorial board in developing issues that showcase the creativity and rigor of anthropological research on aging. i want to take the time to introduce myself to our readers. i am assistant professor in the department of sociology and anthropology at george mason university (fairfax, va), where i am also a faculty affiliate of women and gender studies and a member of the steering committee for the ali vural ak center for global islamic studies. i earned my bs in anthropology from iowa state university (with a minor in psychology) and my ma and phd in sociocultural anthropology from the university of california, irvine. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.183 http://anthro-age.pitt.edu hughes rinker | note 2 my earlier ethnographic research in rabat, morocco (2005-09) examined the diverse dynamics that came into play in working-class women’s reproductive decisions and practices. in my book islam, development, and urban women’s reproductive practices (routledge 2013), i analyze the impacts of the reorientation of development initiatives in morocco from primarily economic to social development on women’s reproductive lives. i look at how a neoliberal rhetoric of self-governance, active participation, and responsibility—core components of this new social development initiative—shapes the ways reproductive health services are delivered to and received by working-class urban women and how they incorporate these practices into their ideas of citizenship. part of my research included a cohort analysis. i compared the experiences of women who had older children versus those who had younger children to see how the shift in development rhetoric in morocco informed the ways they think about reproduction, motherhood, and citizenship; these two cohorts of women had their first child under different government agendas for development and modernization (e.g., the older focus on economic development versus the more recent focus on social and human development). the focus of my ethnographic work has shifted from reproductive health to end-of-life care, palliative medicine, and pain management. since 2013, i have been engaged in ethnographic research on the diverse experiences of sunni muslims as they interact with the u.s. health care system during serious illnesses and the end-of-life. my ethnographic research is based in the washington, d.c. area, although i have worked with individuals from around the country. i theorize how the introduction of medical technologies and the utilization of biomedical practices and principles transform or produce new islamic beliefs and religious identities. also, i investigate how faith interacts with medical discourses and recommendations as well as social, economic, cultural, and political factors to influence decision making about care and the end-of-life by patients, families, providers, and other caregivers. in this research, i propose that the dying body is a site through which religiosity and religious identities are formed, changed, or contested. i use death and dying to view how islamic understandings and identities are created or shifted across various spaces and through multiple temporalities. instead of starting from the premise that religious identities and beliefs are created when living—interacting with others and reading sacred texts, for instance—i use the deteriorating and even dead body as the basis to explore individual islamic understandings and muslim identities. my next ethnographic project will focus on palliative care and pain management during terminal illness and end-of-life care in morocco. i conducted preliminary research on this topic in rabat in 2014 and 2015. as part of my new project, i am interested in examining how physical pain and suffering intersect with individual islamic beliefs about death, the body, and illness in morocco, in addition to beliefs about being mortal and sin. within this i intend to explore how a sense of self and personhood is connected to the use of prescription pain medication. a core component of the study is to analyze the use of pain medication within the larger political and economic context of morocco given the government closely monitors opioid prescriptions (e.g., morphine), has strict regulations regarding which health care providers can prescribe these medications, and has limits on the amount that can be prescribed at a time. i am most interested in better understanding how the state, regulations, and bureaucracy impact the ways people suffer and experience their bodies as they deal with pain and illness. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.183 http://anthro-age.pitt.edu hughes rinker | note 3 i had the distinct pleasure of creating a call for papers for an upcoming issue of the journal that focuses on spirituality and religion. you can find the cfp “religion, spirituality, and aging” on the anthropology & aging website. i encourage anyone interested in contributing to the special issue to submit by the deadline (january 15, 2018). i look forward to this special issue and to future issues of the journal that showcase innovative anthropological research on aging. i am very hopeful that anthropology & aging will continue to be staple not just in anthropology, but also in other disciplines that approach issues related to aging and the life course. i am eager to read all future submissions and to meet many of you at conferences or other events. thank you for your continued support of the journal. references hajjar, r.r., t. atli, z. al-mandhari, m. oudrhiri, l. balducci, and m. silbermann. 2013. “prevalence of aging population in the middle east and its implications on cancer incidence and care.” annals of oncology 24(s7): vii11vii24. wiener, joshua r., and jane tilly. 2002. “population ageing in the united states of america: implications for public programmes.” international journal of epidemiology 31(4): 776–781. microsoft word zimmerbrf.docx book  review     review  of  holland,  janet  and  rosalind  edwards,  eds.  understanding  families  over  time:  research  and   policy.  palgrave  macmillan:  hampshire,  england:  2014.    205  pp.  $79.99  (e-­‐‑book)       richard  zimmer     sonoma  state  university                                                     anthropology & aging, vol 37, no 1 (2016), pp. 63-64 issn 2374-2267 (online) doi 10.5195/aa.2016.156       this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.156      http://anthro-­‐‑age.pitt.edu       zimmer  |  book  review  63   book  review   review  of  holland,  janet  and  rosalind  edwards,  eds.  understanding  families  over  time:  research  and  policy.   palgrave  macmillan:  hampshire,  england:  2014.    205  pp.  $79.99  (e-­‐‑book)     richard  zimmer     sonoma  state  university     janet  holland  and  rosalind  edwards  have  put  together  an  excellent  rich  collection  of  essays  about   the  state  of  familial  relations  in  the  united  kingdom.    they  and  various  other  authors,  have  focused  on   qualitative  longitudinal  research  (qlr),  drawn  from  a  series  of  continuing  research  efforts  in  different   parts  of  england  and  northern  ireland,  especially  the  timescape  project.  this  volume  is  part  of  a  series   issued  by  palgrave  macmillan  that  examines  changes  in  all  aspects  of  family  and  personal  life  in  the  uk.     the  research  addresses  changes  in  ages  in  mother  and  father  roles  and  the  changes  in  reciprocal  roles   of  grandparents,  parents,  grandchildren,  and  great  grandchildren.  each  of  the  essays  sets  their  findings  in   the  context  of  political  and  economic  changes  going  on  in  the  uk,  especially  noting  the  ways  in  which   government  policy  and  social  support  institutions  affect  personal  and  familial  choice.    the  authors  embody   their  findings  by  presenting  case  studies/vignettes  of  their  informants.       sheena  mcgrellis  and  janet  holland  present  a  good  example  of  how  both  economic  and  political   factors  affect  one  person'ʹs  career  and  family  prospects.    "ʺmaeve"ʺ,  a  middle-­‐‑class  woman,  left  northern   ireland  with  her  long-­‐‑term  partner  to  further  their  prospects  and  then  returned  during  hard  times:  "ʺ  'ʹit'ʹs   just  the  way  things  are  at  the  moment,  isn'ʹt  it,  the  recession...when  we  left,  everything  was  fine,  and  when   we  came  back  this  had  all  happened  and  we  were  like,  what  is  going  on,  awful,  all  this  bad  news,  left  ,  right,   and  center.  (2014:  58.)  'ʹ"ʺ        it  took  them  several  months  to  adjust  to  the  new  conditions  and  readjust  their   lives.     maeve  and  her  partner  were  lucky  because  of  their  training  and  background.    lower  class  young   men,  especially  ones  who  started  families  early,  however,  found  their  lives  interrupted,  postponed,  and   diverted  by  the  recession  of  2008  and  the  cameron  administration'ʹs  austerity  policies.    bren  neale  and   carmen  lau  clayton  present  "ʺdarren,"ʺ  aged  21,  having  to  deal  with  new  circumstances:  "ʺone  grandmother   in  the  sample  offered  to  become  the  primary  caregiver  once  the  grandchild  was  born...'ʹoh  my  mum...she   was  like  "ʺif  you  can'ʹt  look  after  him,  i'ʹll  take  him  on  as  my  own  but  he'ʹll  still  be  calling  you  mum  and  dad'ʹ   [sic]  and  all  this.'ʹ"ʺ  (2014:76.)  many  young  fathers  in  the  studies  were  willing  to  "ʺstep  up"ʺ  to  the  new  roles   they  had,  including  more  housework,  but  they  still  relied  to  a  great  deal  on  their  parents,  and,  often,  on  the   new  mother'ʹs  parents  to  provide  care  giving  and  financial  support.   nevertheless,  women  continue  to  experience  the  most  conflict  and  adjustment  in  terms  of  managing   family  and  work  roles.      rachel  thomson  presents  "ʺdeborah,"ʺ  a  middle-­‐‑class  woman  as  she  adjusts  to  her   pregnancy  and  new  motherhood.    as  many  women  find,  a  woman,  becoming  pregnant,  especially  when   she   is   visibly   so,   changes   a   "ʺgender-­‐‑neutral"ʺ   workplace   into   a   gendered   workplace:   she   is   obviously   a   woman,  a  person  who  is  becoming  a  mother,  and  will  have  to  adjust,  as  will  the  workplace,  to  her  new   status  and  condition.  she  has  to  decide  how  much  time  to  take  off,  how  much  time  to  work  at  some  point   after  the  child  is  born,  and  how  to  change  her  role  vis-­‐‑a-­‐‑vis  her  mother.    this  latter  point  is  a  good  example   of  her  shifts:      "ʺ...  deborah'ʹs  university  education  and  career  success  created  a  gulf  between  mother  and   daughter.  the  arrival  of  a  granddaughter  has  made  this  a  little  easier.  (2014:117.)"ʺ        thomson  notes  that   deborah'ʹs  mother  has  been  re-­‐‑examining  her  own  past  to  see  that  women  could  and  can  have  greater   independence  juggling  family  and  career.           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.156      http://anthro-­‐‑age.pitt.edu       zimmer  |  book  review  64       as  a  consequence  of  their  children'ʹs  new  parenthood,  many  grandparents  now  faced  new  demands.     many  younger  ones  were  willing  to  take  on  a  greater  role  in  their  adult  children'ʹs,  grandchildren'ʹs,  and   great  grandchildren'ʹs  lives.    this  was  especially  true  of  lower  class  elders.    but  some  people  resented  being   put  into  this  new  role  when  they  were  "ʺtoo  young"ʺ  themselves.  nick  emmel  and  kathryn  hughes  offer  us   the  case  of  "ʺruth"ʺ:  "ʺher  experience  of  grandmothering,  her  feeling  that  she  is  the  wrong  age-­‐‑-­‐‑-­‐‑expressed   through  the  accounts  of  the  way  she  feels  some  of  her  neighbours  judge  her  and  people  in  the  street  think   about  her-­‐‑-­‐‑-­‐‑is,  we  suggest,  the  lack  of  harmony  between  societal  symbol  and  her  reality  (2014:  170.)"ʺ             at  the  same  time,  many  children  of  parents  experiencing  challenges  and  changes  find  that  they,  too,   have  to  adapt  to  the  needs  of  their  parents  and  grandparents.    they  play  a  greater  role  in  housework  and   care  giving.  what  is  particularly  interesting  is  that  they  have  hopes  for  their  parents'ʹ  own  development  and   see  themselves  as  playing  a  constructive  role  in  their  lives  as  they  all  age.    rosalind  edwards,  susie  weller,   and  sarah  baker  present  "ʺrooney,"ʺ  age  16:    "ʺ  ...[he]  talked  about  his  family  sticking  with  and  up  for  each   other...(2014:  44.)"ʺ    edwards  et  al.  see  this  family  solidarity  and  set  of  expectations  contrary  to  the  media-­‐‑ prevalent  narrative  of  intergenerational  warfare  and  resentment  of  the  upcoming  generation  often  found  in   the  uk  and  the  us.    they  say  that  the  resentment,  in  particular,  is  only  experienced  by  a  minority  of  people.     "ʺ[i]nter-­‐‑generational  and  intra-­‐‑generational  conflict  and  solidarity  are  far  from  the  simplistic  divisions  that   intergenerationalists  would  lead  us  to  believe  (2014:44.)"ʺ             the  authors  of  the  various  articles  and  the  editors  intend  that  the  case  studies  and  their  conclusions   provide  the  basis  for  policy  considerations  and  social  service  practice.    throughout  the  book,  it  is  clear   that  economic  policy  affects  family  structure  and  disrupts  adjustment  patterns.    it  changes  opportunities   for  all  involved.    oftentimes  agencies  can  and  do  adversely  affect  families,  as  when  "ʺgeoff"ʺ  and   "ʺmargaret"ʺ  got  a  "ʺmidnight  drop"ʺ  by  social  services  of  their  three  granddaughters  because  mom  was  a   "ʺchronic  heroin  user."ʺ    nick  emmel  and  kahryn  hughes  note  that  there  was  no  warning  of  the  drop  and   no  follow-­‐‑up  in  terms  of  social  supports  (2014;167,  172.)         in  their  conclusions,  janet  holland  and  rosalind  edwards  argue  that  policy  and  future  research   should  help  the  choices  parents,  grandparents,  and  growing  children  should  make,  not  work  against   them.    they  further  contend  that  qualitative  research  should  continue  to  enhance  this  policy  debate  as   well  as  understand  from  a  larger  perspective  what  changes  families  are  experiencing  (2014:190-­‐‑1.)  their   conclusions  and  methodologies  are  also  useful  for  students  of  family  structure  and  policy  in  other   countries.         microsoft word mukhopadhyaybrf.docx book  review     dolan,  josephine  and  estella  tincknell,  eds.  aging  femininities:  troubling  representations.    cambridge   scholars  publishing.  2012.  hardback.  isbn-­‐‑13:  978-­‐‑1-­‐‑4438-­‐‑3883-­‐‑2  ,  isbn-­‐‑10:  1-­‐‑4438-­‐‑3883-­‐‑7  ,  price:   £39.99       carol  c.  mukhopadhyay   professor  emerita,  san  jose  state  university,  san  jose,  california,  usa   carol.mukhopadhyay@sjsu.edu,  webpage:  www.sjsu.edu/people/carol.mukhopadhyay                                                   anthropology & aging, vol 37, no 1 (2016), pp.57-58 issn 2374-2267 (online) doi 10.5195/aa.2016.153 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.153      http://anthro-­‐‑age.pitt.edu     mukhopadhyay  |  book  review  57   book  review     dolan,  josephine  and  estella  tincknell,  eds.  aging  femininities:  troubling  representations.    cambridge  scholars   publishing.  2012.  hardback.  isbn-­‐‑13:  978-­‐‑1-­‐‑4438-­‐‑3883-­‐‑2  ,  isbn-­‐‑10:  1-­‐‑4438-­‐‑3883-­‐‑7  ,  price:  £39.99       dr.  carol  c.  mukhopadhyay   professor  emerita,  san  jose  state  university,  san  jose,  california,  usa   carol.mukhopadhyay@sjsu.edu,  webpage:  www.sjsu.edu/people/carol.mukhopadhyay       media,  cultural  and  feminist  studies,  according  to  editors  dolan  and  tincknell,  have  failed  to  address   cultural  representations  of  aging  women.  implicitly,  only  the  young  and  "ʺyoung  bodies"ʺ  are  worthy  of  the   "ʺtheoretical  gaze"ʺ  [vii].    in  cultural  theory,  older  women  are  marginalized  or  "ʺpathologised."ʺ  yet  aging   women  are  increasingly  topics  of  public  concern,  and  images  of  "ʺsuccessful  aging"ʺ,  especially  celebrities   like   helen   mirren,   are   proliferating.     only   gerontology,   embedded   in   an   essentialist,   body-­‐‑as-­‐‑simply-­‐‑ biology  framework,  seems  to  take  older  women  seriously.     the  editors  hope  this  volume  will  stimulate  reflection  on  and  eventually  reshape  debates  about   "ʺaging  femininity"ʺ  and  "ʺwrest  the  discourse  of  the  aging  body  away  from  a  return  to  essentialism."ʺ  [ix].   they  wish  to  revisit  earlier  feminist  writings,  especially  simone  de  beauvoir'ʹs  deeply  negative  view  of   postmenopausal  women  as  both  invisible  and  filled  with  self-­‐‑loathing.       the   book   offers   valuable   perspectives   on   aging   from   media,   film,   and   cultural   studies.  it   is   the   culmination  of  several  conferences  and  workshops,  beginning  in  2007,  leading  to  the  women,  aging,  media   [wam]  research  network  of  uk  scholars;  and  the  european  network  of  aging  studies.  the  18  authors  (17   from  the  uk),  come  from  the  humanities  [drama,  english,  art,  photography;  film  and  culture  studies]   rather  than  the  social  or  medical  sciences.       the  book  covers  many  representational  formats:  drama,  stories,  paintings,  photography,  tv  series,   films,  popular  singers,  opera,  photography,  festivals,  and  a  beauty  salon.    analyses  come  from  critical   cultural  theory,  with  some  "ʺethnographic"ʺ  research.    women  subjects  range  from  40  to  90,  but  mainly  are   over  55.   after   an   excellent   introduction,   sixteen   chapters   cluster   into   four   thematic   sections.   "ʺcultural   herstories"ʺ   examines   past   representations   of   femininity   in:     post-­‐‑wwi   british   dramas   ("ʺthe   spinster"ʺ);   stories  by  edgar  allan  poe;  "ʺcelebration  at  90"ʺ  by  renown  british  painter  w.  barns-­‐‑graham"ʺ;  "ʺwhistler'ʹs   mother"ʺ;  and  two  uk  "ʺperiod  dramas"ʺ  (downton  abby  and  call  the  midwife).  section  2,  regulations  and   transgressions,  explores  contemporary  representations  in  a  "ʺcelebration  of  age  festival"ʺ;    a  beauty  salon,   and   in   photo-­‐‑video-­‐‑collages   created   from   photo-­‐‑therapy   workshops   for   older   women.     section   3:   problematic  postfeminists?  offers  critical  "ʺreadings"ʺ  of    the  popular  usa  tv  series,  six  feet  under;  the  film   heading   south;   and   media   coverage   of   helen   mirren.   section   4:   divas   and   dolls,   focuses   on   three   celebrities:   79-­‐‑year   old   screen-­‐‑star   honor   blackman,   singers   dolly   parton   and   madonna;   and   the   "ʺthe   paradox  of  age  and  femininity"ʺ  in  the  opera  diva.   for  those  relatively  unfamiliar  with  popular  culture,  the  book  samples  this  powerfully-­‐‑influential   world.  many  uk  productions  and  celebrities  have  global  audiences  ["ʺdownton  abby"ʺ],  as  do  those  from   the  usa.  yet  authors,  research  settings  and  participants  are  solidly  british,  popular  media  commentaries   are  drawn  from  uk  newspapers  or  magazines  like  saga  .    many  scholarly  references  are  from  the  uk...along,   apparently,  with  the  recurring  metaphor  for  aging  ["ʺmutton  dressed  up  as  lamb"ʺ].           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.153      http://anthro-­‐‑age.pitt.edu             mukhopadhyay  |  book  review  58     the  volume  also  illustrates  the  articulation  of  postmodern,  post-­‐‑structuralist  theory  with  cultural   feminist  theory.  the  introduction,  and  many  authors,  draw  upon  theorists  like  foucault,  kristeva,  and   judith  butler    [cf.  gender  trouble:  feminism  and  the  subversion  of  identity,  1990,  london:  routledge.].     representation-­‐‑-­‐‑whether  positive  or  negative-­‐‑-­‐‑-­‐‑entails  issues  of  power  and  control,  the  power  to  discipline   and  regulate  bodies-­‐‑-­‐‑literally  and  figuratively,  externally  and  through  internalized  mechanisms  of  self-­‐‑ policing.    such  subtle,  pervasive,  processes  produce  women'ʹs  "ʺconsent  to  oppression"ʺ  and  their  policing  of   transgressions  by  other  women."ʺ[p.  xi].   bacon  and  brooks  explore  the  beauty  salon  as  a  gendered,  meaning-­‐‑rich  site,   linked  to  "ʺbeauty   treatments"ʺ  that  are  "ʺ...part  of  a  foucauldian  regime  for  the  containment  and  regulation  of  femininity"ʺ   [p.83].    but  such  places  are  becoming  "ʺtherapeutic"ʺ  sites,  where  "ʺhealth  therapies"ʺ  are  consumption  practices   necessary  for  a  "ʺhealthy  lifestyle"ʺ,  especially  for  aging  women  ."ʺ  framed  as  "ʺtreats"ʺ  and  "ʺpleasurable"ʺ,  the   beauty   salon   "ʺcomplicates"ʺ   the   "ʺcontainment"ʺ   perspective   since   women   exert   "ʺagency"ʺ   and   experience   pleasure.(  p.87)   these  and  other  articles  remind  us  of  the  profound  role  popular  culture,  and  a  consumerist-­‐‑driven,   advertising-­‐‑  saturated  society,  plays  in  constructing  contemporary  meanings  around  gender  and  aging.     aging  women  provide  grist  for  the  never-­‐‑ending  consumer  mill.   images  of  "ʺsuccessful  aging"ʺ  seem  to   contradict  long-­‐‑standing  themes  of  aging  as  "ʺdecline"ʺ.    yet  the  new  "ʺhot"ʺ  ["ʺcougar"ʺ]  older  woman  must   constantly   work   [and   buy   products]   to   ward   off   this   still-­‐‑dreaded   state.   women'ʹs   "ʺempowerment"ʺ,   definitions  of  self  and  acceptability  reside  in  their  bodies...even  for  madonna.    and  cultural  transgressions   still  exact  a  price,  at  least  in  movies  like  going  south,  where  "ʺolder"ʺ  women  violate  conventional  age  and   racial  hierarchies.   yet  resistance  is  possible.  drawing  on  bodies  as  "ʺdiscursively  inscripted"ʺ,  the  products  of  culture   and  discourse  rather  than  essential,  biological  entities  (p.111),  women  pose  for  photographs,  "ʺperforming"ʺ   their   version   of   whistler'ʹs   mother.     other   women   create   "ʺperformance   pieces"ʺ   from   photo-­‐‑collages,   challenging  conventional  images,  disrupting  discourse  by  deliberately  re-­‐‑viewing  anxiety-­‐‑linked  bodily   areas,  like  bellies  [the  book'ʹs  cover  photo].       one  can  find  weaknesses  in  any  volume.    since  the  analyses  here  are  not  based  on  anthropological-­‐‑ type  research,  i'ʹm  not  sure  how  to  evaluate  their  validity.    i'ʹm  especially  concerned  about  how  different   audiences,  diverse  by  gender,  culture,  class,  ethnicity,  etc.,  might  interpret  these  representations.      i'ʹd  like   more  "ʺreal"ʺ  ethnography,  that  is,  in-­‐‑depth  exploration  of  "ʺnative"ʺ  perceptions-­‐‑attitudes.    and  cross-­‐‑cultural   comparison  is  lacking,  both  in  the  interpretation  and  the  representations  of  aging  women.   nevertheless,  i  recommend  the  volume  to  anthropologists,  to  anyone  working  in  the  field  of  aging,   including  in  health  and  biological  sciences,  and  to  anyone  who  is  or  will  become  "ʺaged"ʺ  !    the  book  is  "ʺgood   to  think  with"ʺ,  the  introduction  provides  a  useful  overview,  and  one  can  pick  and  choose  from  the  various   short  [10-­‐‑15  pages]  chapters  as  interest  and  time  dictates.    the  editors  have  fulfilled  their  goal!       microsoft word laubrf.docx book  review     midford,  paul,  saito,  yayoi,  campbell,  john  creighton  and  edvardsen,  unni.  (editors).    eldercare  policies   in  japan  and  scandinavia:  aging  societies  east  and  west.    palgrave  macmillan.  2014.    isbn-­‐‑13:  978-­‐‑ 1137402622,  pp.  273.    price  $105  (hardcover)     janice  y  c  lau   postdoctoral  fellow     the  chinese  university  of  hong  kong,  hong  kong                                                           anthropology & aging, vol 37, no 1 (2016), pp. 51-52 issn 2374-2267 (online) doi 10.5195/aa.2016.150 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.150      http://anthro-­‐‑age.pitt.edu     lau  |  book  review  51   book  review     midford,  paul,  saito,  yayoi,  campbell,  john  creighton  and  edvardsen,  unni.  (editors).    eldercare  policies  in  japan   and  scandinavia:  aging  societies  east  and  west.    palgrave  macmillan.  2014.    isbn-­‐‑13:  978-­‐‑1137402622,  pp.  273.     price  $105  (hardcover)     janice  y  c  lau   postdoctoral  fellow     the  chinese  university  of  hong  kong,  hong  kong       the  present  volume  is  an  impressive  collection  of  research  studies  that  grew  out  of  the  2007  ntnu   japan  seminar  entitled  “eldercare  in  japan  and  norway:  organization  and  quality”  held  in  norway..    the   content  is  organized  in  five  sections  with  an  attempt  to  compare  the  models  of  insurance  systems  of  japan   and  norway  where  each  country  has  distinct  ideational  roots.   in  the  introduction  of  this  book,  the  editors  explain  the  reasons  why  the  two  countries  are  selected   for  comparison,  which  include  their  differences  in  terms  of  demographics,  and  their  target  population  for   long-­‐‑term   care   (ltc)   service.     part   i   begins   with   describing   the   development   of   ltc   policy   that   are   interwoven  with  political  and  economic  changes  in  the  two  countries.    the  first  two  chapters  (by  john   creighton  campbell  and  kjell  arne  aarheim)  present  the  ltc  model  in  terms  of  content,  organization,  and   resources.    the  distinctions  lie  in  the  differences  between  the  governments’  roles  and  responsibility  in  the   provision  of  ltc  services.         the  chapters  in  part  ii  showcase  formal  care  provided  by  various  organizations.    in  chapter  3,  yayoi   saito  describes  a  change  of  structure  and  roles  of  stakeholders:  from  the  role  of  family  members  in  eldercare   during  prewar  time,  to  the  formation  of  pluralistic  care  providers  under  the  long  term  care  insurance   system  in  2000  in  japan.    what  follows  is  the  paper  presented  by  steinar  bartstad,  who  discusses  whether   the  complex  needs  for  elderly  can  be  adequately  met  by  the  healthcare  services  in  the  municipals  that  are   underdeveloped  in  norway.       as  a  researcher  conducting  a  project  on  elderly  care  in  hong  kong,  the  part  that  caught  my  attention   was  part  iii  -­‐‑  provision  of  informal  care.    these  chapters  (by  ruth  campbell  and  marit  solheim)  unpack   the  roles  of  informal  support  in  ltc.  they  also  challenge  the  assumptions  of  priorities  of  home  care  in  japan   where   filial   piety   is   traditionally   valued,   and   emphasis   of   the   government-­‐‑funded   social   care   that   are   mandatorily  provided  by  the  municipals.    the  perspectives  of  gender  and  social  changes  are  taken  into   consideration   within   their   discussions   of   the   “negotiation   of   new   ways   of   care”   (p.116)   in   japan   and   direction  to  both  “de-­‐‑familiarization  and  re-­‐‑familiarization”  in  norway  (p.146).    of  particular  interest  to  me   is  chapter  6  in  which  the  author  gives  an  impressive  overview  of  theories,  providing  the  framework  to   conceptualize  the  complex  interplay  between  family  care  and  public  care,  and  giving  key  insights  in  ways   to  explore  politics  and  ethics  of  care  responsibility.       part   iv,   titled   “procedures   of   assessment   and   allocation   of   eldercare”,   the   authors   examine   approaches  of  needs  assessment  used  in  each  country.    noriko  kurube  critically  discusses  the  problem  of   using  a  standardized  tool  to  measure  the  “complex  needs”  of  the  elderly.    in  norway,  as  discussed  by  unni   edvardsen,  the  multiple  purpose  of  the  iplos  used  by  different  levels  of  government  suggests  the  needs   to  reform  the  existing  assessment  instrument.    “mechanism  for  ensuring  quality  of  care”  is  the  final  theme   of  the  volume.    koichi  hiraoka  and  unni  edvardsen  walk  the  readers  through  ways  to  ensure  quality  of   care.    their  accounts  depict  the  need  for  regulation  and  evaluation  that  may  be  resisted  by  service  providers   in  both  countries.    the  end  point  of  the  discussion  lies  in  the  future  where  paul  midford  envisions  the  needs   for  using  technology  to  support  healthcare  labor  in  norway,  and  economic  and  political  forces  on  eldercare   in  contemporary  japan.         anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.150      http://anthro-­‐‑age.pitt.edu       lau  |  book  review  52     contributed  by  ten  experts,  the  greatest  strength  of  this  volume  is  the  structure  of  pairing  of  chapters   surrounding   an   array   of   sub-­‐‑divided   themes.     such   organization   makes   readers   continually   keep   comparisons  in  mind  and  gives  both  sides  of  the  debate  equal  attention.    this  book  definitely  provides  a   wealth  of  information  of  the  historical  development  and  contemporary  reality  of  social  care  policy  in  the   two  different  cultural  settings  through  employing  a  variety  of  statistical  sources  and  ethnography.    several   chapters  (from  chapter  3  to  6)  notably  highlight  female  family  members  as  principal  caretakers.    still  to  be   explored  is  an  examination  of  policy  implications  on  gender  differences  in  caregiving.    the  single  attention   on   the   perspectives   of   care   providers   may   preclude   critical   engagement   of   the   elderly,   whether   as   individuals,  as  classes,  or  as  consumers.    i  would  have  liked  to  have  seen  whether  voices  of  the  elderly  are   heard  and  how  their  opinions  can  be  addressed  in  policy.   supported  by  substantial  evidence  as  presented  in  the  papers,  the  subtitle  “aging  societies  east  and   west”  clearly  invite  the  readers  to  rethink  and  challenge  the  exotic  views  of  “clear-­‐‑divide”  between  the  east   and  west.    this  volume  is  a  highly  relevant  source  for  both  undergraduates  and  graduates  in  the  discipline   of  gerontology  and  public  health.    researchers,  healthcare  professionals,  social  or  health  policy-­‐‑makers  who   are  of  interest  in  practice  and  policy  design  in  aging  issues  will  find  this  eye-­‐‑opening.                           introduction_religion_layout hughes rinker and mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.214 http://anthro-age.pitt.edu 10 religion in times of change the effects of aging on religious lives editors’ commentary cortney hughes rinker levi mitzen george mason university author contact: chughe13@gmu.edu anthropology & aging, vol 40, no 1 (2019), pp. 11-13 issn 2374-2267 (online) doi 10.5195/aa.2019.214 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. hughes rinker and mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.214 http://anthro-age.pitt.edu 11 religion in times of change the effects of aging on religious lives editors’ commentary cortney hughes rinker levi mitzen george mason university author contact: chughe13@gmu.edu anthropologists have long noted that transitioning from one stage of life to another stage—or from one role or status to another—has often been marked by religious rituals. we can easily think of baptisms, confirmations, and bar mitzvahs and bat mitzvahs. there are other transitions that may be marked by religious rituals as well, such as the loss of a loved one, which may take place more often in old age. as one ages, they may also grow increasingly aware of their own mortality. religion may then be used to give meaning to arguably the most drastic and universal transition one makes: the transition from life into death. the anthropological literature has sharply recognized that there is an intricate relationship between religion and aging. religious faith and practices, as well as the meaning of religion for a person, may transform as individuals enter later life. the literature in public health and social work has shown that enhanced well-being and positive health and psychosocial outcomes are associated with different aspects of religious participation. we recognize that religion does not have one universal meaning and that having one definition of religion would discount many of its nuances and various expressions in different cultural contexts (asad 2003). as adults age, religion—in whatever form—may become more salient parts of daily life and conversations. one study (azzi and ehrenberg 1975) found that time devoted to religious services and prayer will be higher among those with “low value” of time, such as older individuals who are retired. being part of a religious community may be a means to combat social isolation and promote interaction among older adults, especially among those that have left institutions that facilitated social connections. religious institutions may also provide services, such as food programs and basic medical care, useful to those afflicted by age-related illnesses. sarah lamb (2018) recently wrote an article that analyzes the meanings of ‘healthy’ and ‘successful’ aging among older white americans from different social classes--phrases that we hear more often not only in the academic literature, but in policy debates, the media, public health, and popular culture as well. one older student who audited a course focused on the anthropology of religion in fall 2018 at george mason raised his hand when talking about the relationship between religion and aging to say that at his age, he reads more about what it means to lead a purposeful and meaningful life and how to keep busy, and religion may be a way for older individuals to feel fulfilled and wanted, particularly as they become older. surveys in the united states and united kingdom found that aging adults tend to affiliate with a religion more frequently, but the extent to which they actually physically practice may differ due to health status or ability limitations (nelson-becker 2018). the later stages of life may include times of self-reflection and greater self-understanding, which are conditions prime for religious engagement. two articles in this issue of anthropology & aging aim to explore the nuances surrounding the intersection of religion and aging, given that it is an area that warrants further investigation in anthropology and the social sciences more generally. this is essential, given that in many parts of the world, the population is aging at a relatively steady pace (he, goodkind, and kowal 2016), although some regions hughes rinker and mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.214 http://anthro-age.pitt.edu 12 are still younger than others and have yet to experience a rapidly aging population. nonetheless, the two articles included here, kang et al. and bafford, interrogate the role of religion in older individuals’ everyday lives through qualitative and ethnographic research in southern california and in appalachia and south africa respectively. although they approach religion and aging through two different lenses—the first through the use of technology among older adults and the second through a cross-cultural analysis of how christian ideology helps practitioners address the daily physical and social effects of aging—both address the ways that the relationship between religion and aging is developed within particular social and individual contexts. the authors also address how religion can provide meaning to older adults’ in their daily lives and make them feel connected to each other. many in the united states assume that the use of technology is more common among the youth and young adults and that older adults are at a distinct disadvantage in adapting to new technology. to an extent, this is true as the formative years of younger generations were spent learning how to use rapidly advancing technology like computers or smartphones. but, the article by kang et al. counters this claim by investigating what scholars have termed ‘gerotechnology.’ kang and colleagues, through presenting data collected from interviews with seniors in three cities in southern california, analyze how their older participants use technologies, such as religious apps on smartphones and tablets and social networking sites, as part of their religious practice. while the adults discussed a wide variety of ways that they use these technologies as part of their religious lives, the authors categorize them into two realms: “compensating for age related changes and capitalizing on unique opportunities for growth in later life.” kang et al. demonstrate that as adults’ roles, status, health, and physical abilities change as they grow older, so do their religious lives. older adults use technologies to enhance or strengthen their faith in part because they are trying to better manage the larger social and physical changes that go along with aging. in his ethnographic research in appalachia and johannesburg, south africa, bafford also addresses how older evangelical christians negotiate the effects of aging and changes in society. bafford points out that even though there is a scholarship on the relationship between health and religiosity among aging populations that spans disciplines, less attention has been given to cross-cultural understandings of this interaction and how social contexts inform it. instead, he examines how christian “end-times” ideology is shaped by historical factors and the local environment by illustrating its meaning and significance in two distinct contexts: kentucky and south africa. ultimately, he makes the argument that further anthropological research is needed into the “malleability of evangelical ideas,” which can result in some issues or needs being prioritized over others by a faith group or a society. bronislaw malinowski (1922) showed that the trobriand islanders used magic to cope with the stress they experienced during sailing due to unfavorable weather conditions. jean and john comaroff (1999) showed that magic is not a retreat to tradition in south africa, but rather being re-tooled and used to cope with the impacts of capitalism and modernization. anthropologists have long highlighted how religion, and the belief in the supernatural, can be given great meaning by individuals in their everyday lives as well as during times of transition, need, or hardship. kang et al. and bafford focus on how physical changes to the aging body, coupled with changes in social roles in later life, structure religious practice and beliefs. but in doing so, they also consider how changes in the contemporary world, and older adults place within it, affect their religious lives. this is an exciting area of research, and a theme that we at the journal hope to explore more in future issues. hughes rinker and mitzen | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.214 http://anthro-age.pitt.edu 13 references malinowski, bronislaw. 1922. argonauts of the western pacific: an account of native enterprise and adventure in the archipelagoes of melanesian new guinea. london: routledge & keegan paul ltd. comaroff, jean and john comaroff. 1999. “occult economies and the violence of abstraction: notes from the south african postcolony.” american ethnologist 26(2): 279-303. asad, talal. 2003. formations of the secular: christianity, islam, modernity. stanford, ca: stanford university press. azzi, corry and ronald g. ehrenberg. 1975. “household allocation of time and church attendance.” journal of political economy 83(1), 27-56. lamb, sarah. 2018. “on being (not) old: agency, self-care, and life-course aspirations in the united states.” medical anthropology quarterly. doi: 10.1111/maq.12498. nelson-becker, holly. 2018. spirituality, religion, and aging: illuminations for therapeutic practice. thousand oaks, ca: sage. he, wan, daniel goodkind, and paul kowal. 2016. an aging world: 2015 international population reports. washington, d.c.: u.s. government publishing office. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.222-223 issn 2374-2267 (online) doi 10.5195/aa.2015.119 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review what older americans think: interest groups and aging policy. christine l. day. princeton, nj: princeton university press. 2014. isbn 978 069 160352 0, 164 pp. price $29.95 (paper) jennifer a. wagner, mph, lnha gerontology program, bowling green state university http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.119 http://anthro-age.pitt.edu book review what older americans think: interest groups and aging policy. christine l. day. princeton, nj: princeton university press. 2014. isbn 978 069 160352 0, 164 pp. price $29.95 (paper) jennifer a. wagner, mph, lnha gerontology program, bowling green state university what older american’s think is indeed the $64 million dollar question to which many professionals, academics, and students are looking and hoping to find an answer. the original copy of this book was printed in 1990 and the reprint was conducted in 2014. as of 2015, we still do not have the answer to this question, although we now have a great deal of insight. the purpose of this book is to provide a now historical account of the political rise of older adults as a special interest group and what makes them so unique and powerful. george santayana has been quoted as saying, “he who does not learn from history is doomed to repeat it”. from that perspective, i find this book useful for those who conduct research, work as activists, or for those who provide services for older adults. let us learn from this historical account and build upon it. personally, i would be excited to read a second edition of this text utilizing current research. the professions of gerontology and geriatrics are ever changing. each generation of older adults bring forward changes in knowledge, experiences, needs, and activism. the political, regulatory, and reimbursement environments affecting the economy, the healthcare system, as well as the myriad of services and programs outside the health care system would greatly benefit by such updated findings. the first two chapters provide a historical overview of the social movements that brought older adults into the political interest group arena such as the beginning of medicare and social security, as well as interest groups such as the american association of retired persons (aarp) and the gerontological society of america (gsa). chapter three delves into the political attitudes of the elderly and the diversity of those attitudes. chapter four discusses how older adult interest groups have survived despite the diversity of those attitudes. this chapter also discusses recruitment and incentive strategies of older adults by the political action and advocacy groups which promote the success of these special interest groups. chapter five provides insight into how policies affecting older adults are developed and the factors that affect those policies by highlighting advocacy movements in the 60’s, 70’s, and 80’s such as the older american’s act (1965), the employee retirement income security act (1974), and save our security (1981). an item that piqued my interest was the role of professionals such as senior organizations, medical associations, and nursing home organizations that play a secondary role in the advancement of policies affecting older adults (p.94). chapter six provides a summary of who represents older adults and the hierarchy of the various interest groups and the role they play in mobilizing older adults and politicians. chapter seven gives a conclusion by sharing thoughts on whether or not the interest groups inhibit programs or restrict policies and services for older adults. the conclusion is followed by a comprehensive appendix and bibliography which provides clarification to research tables presented throughout the chapters. wagner | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.119 http://anthro-age.pitt.edu 223 223 while today in 2015, i do not find the 1990 edition of the text to be of personal interest it has made me more aware of perhaps my own bias in advocacy. the population of older adults that i typically work with in nursing homes is not the majority of the older adult population. while to me their needs are often great, i do need to keep in mind their own personal autonomy regarding their needs and wants. perhaps for others, it is their own fear of aging that motivates them to be such advocates. i feel that this would be a good resource for those who study public policy and are trying to predict patterns of special interest groups and for those who make strategic plans on how to continue to advocate for public policy and programs to serve older adults. _zimmerfinalbr x book review review of holly nelson-becker. spirituality, religion, and aging: illuminations for therapeutic practice. sage: los angeles. 2018. pp. 488. price $41.00. richard zimmer sonoma state university anthropology & aging, vol 39, no 1 (2018), pp. 115-116 issn 2374-2267 (online) doi 10.5195/aa.2018.186 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.186 http://anthro-age.pitt.edu zimmer | book review 115 book review review of holly nelson-becker. spirituality, religion, and aging: illuminations for therapeutic practice. sage: los angeles. 2018. pp. 488. price $41.00. richard zimmer sonoma state university holly nelson-becker has written an excellent and comprehensive book for those researchers and clinicians concerned with the role of religion and spirituality in people's lives as they age. each of the chapters focuses on a different dimension of religion and spirituality in a person's life. one important note here: nelson-becker distinguishes between religion and spirituality. briefly, "religious practices include any common and customary behaviors that are associated with a particular religion or many religions (2018:205.)" as for spiritual practices, those one "...those practices one performs to move into sacred space whether this space is visible, invisible, or has other spiritual practices (2018:206.)" these distinctions may seem a bit vague and/or circular. those concerns are not crucial for the purpose or the intent of the book, which is to help the clinician help her/his clients address their concerns and their needs as they age. furthermore, the intent of the book is to help the clinician her/himself address their own needs as well as they help their clients. nelson-becker reviews previous theories of religion and spirituality in history and in sociological and psychological theory and in philosophy. she provides extremely useful summaries and analyses of different religious and spiritual practice for the clinician. this is especially useful for clinicians who do not have background in these areas. in addition, she provides case studies and raises ethical concerns for clinicians to help them raise and address client concerns. she provides exercises, religious and spiritual, for clinicians and clients as they address these larger concerns. lastly, she includes comprehensive resources for researchers and clinicians on religion, spirituality, and organizations. i would like to specifically address clinical concerns here in this review. i am both an anthropologist and a licensed psychologist. i also teach in an enrichment program designed for "older adults." as a psychologist, i treat a range of clients, including older clients. i also have seen these clients in hospitals, including hospitals that have religious affiliations. i have also seen clients at nursing homes, including skilled nursing facilities. when i first went into practice three decades ago, i added to my intake questions ones about religious and spiritual practice. that was not common at the time. i found it useful to do so as part of understanding my clients and finding ways and words to help address their needs. these kinds of intake questions should be part of clinical practice nelson-becker strongly suggests in chapter 6 and throughout the book. if the client sees religion and/or spiritual practice as helpful in deepening her/his aging and providing new sources of growth and inspiration as s/he ages, and coping as s/he move closer to death, then the clinician should be ready, able, knowledgeable, and resourceful to provide the tools to help the client. while helping the client, the clinician should recognize her/his own religious and spiritual beliefs, realize where they can provide strength to both the client and her/himself, and where they may lead to an ethical boundary violation, such as imposing one's beliefs on another (2018:70-73.) anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.186 http://anthro-age.pitt.edu zimmer | book review 116 one of the many riches of this book is the detail and nuance nelson-becker offers in terms of the sociological research, useful for the clinician and researcher. for example, she addresses generational, gender, and sexual preference differences in religious and spiritual practices. other riches include meditation suggestions and creative art practices. as first noted, her work is filled with these treasures and any short listing would be a disservice to her book. those of us working with seniors in clinical and teaching capacities and with students in the social and behavioral sciences and in gerontology will find this book as a significant and invaluable resource. it is very well-written and is interspersed with moving quotations, charts, and diagrams. my only suggestion is that the print should have been larger for those readers who have vision issues. mikkelsen_finaldoc mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 36 idleness energizing the danish welfare state henrik hvenegaard mikkelsen university of copenhagen author contact: hvenegaard@anthro.ku.dk abstract this article appropriates the concept of energy in order to analyze the interaction between the danish welfare state and the category of citizens referred to among social workers and health professionals as “passive citizens.” while passivity might commonly be seen as mere inactivity—a certain non-action beyond the unfolding of social life—this article argues that in the danish welfare society, the opposite is the case. in fact, in this context various forms of passivity have become the object of concerted political and media attention and the general schism between energy and passivity has become part of a public discourse on elderly health care and aging. by examining the way health care professionals talk about passive senior citizens in terms of a lack of energy, this article shows how, in a wider sense, passivity is framed as a particular problem that can be overcome through the right health care intervention. i argue that energy and passivity have become of key interest to the danish welfare state in managing its aging population and that the attempt to activate the passive citizen in fact energizes the welfare state. keywords: passivity; denmark; welfare society; bartleby; energy anthropology & aging, vol 40, no 2 (2019), pp. 37-47 issn 2374-2267 (online) doi 10.5195/aa.2019.176 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 37 idleness energizing the danish welfare state henrik hvenegaard mikkelsen university of copenhagen author contact: hvenegaard@anthro.ku.dk “nothing so aggravates an earnest person as a passive resistance” herman melville, bartleby herman melville’s (1997) short story, “bartleby,” from 1853, depicts a type of action that, paradoxically, involves not acting. in melville’s story we meet the young clerk, bartleby, who for no apparent reason decides to stop working. his response to his employer is invariably, “i would prefer not to.” trying to understand what has brought about this strange behavior, the employer endeavors to reason with him and tries desperately to persuade him to behave in a way suitable for a clerk. in a sense, the passivity of bartleby seems to energize his surroundings: for instance, he forces his co-workers to question the taken-for-granted nature of their own daily work. thus, by sticking unwaveringly—and calmly—to this brief response whenever he is asked to carry out even the smallest assignment at the office, bartleby becomes a subversive force that gradually deconstructs the company’s entire structure. but how are we to understand this strange situation by which bartleby, as a kind of hero of passivity, excludes himself from society, but through this very act somehow becomes included in the social order as an obstruction that unleashes an immense activity around him? taking this question as the vantage point for this article, i seek to explore certain analogous relations between the story of bartleby and the danish welfare state. this fictional character of bartleby becomes relevant in relation to this particular ethnographic field, since the story depicts the protracted encounter between the unwilling and the willing, the person of no desire and the structure whose sole purpose becomes to infuse the person with desire. a hundred years after the initiation of the welfare state, with its “free” education, homecare for the sick and elderly, paid vacations, medical services, and so on, the most notorious negative byproduct is the “passive citizen.” the critics of the welfare system tend to favor the view that the welfare state (often referring to it as the “nanny state”) breeds a politically detached and passive citizenship, which may pose a threat to democracy itself. in recent years, two cases have circulated in local danish media as part of this debate and have even made it to the front page of the new york times (daley 2013): “lazy robert” (dovne robert) who openly—and proudly—admitted to prefer living on welfare support rather than taking a demeaning, low salaried job, and “poor carina” (fattig carina) who had been living on welfare support for twenty years and who—by her own calculations—had approximately 1,000 usd left each month for food and clothing (after paying rent and utilities and purchasing dog food, medicine, and cigarettes). such cases have become the epitome of a state whose growth has, supposedly, spiraled out of control, welfare systems that have become excessively generous, and a population that has lost its incentive to work for a living. due to a concerted effort by the media and politicians, the passive citizen has become the very physiognomy of all that leads the welfare state towards its inevitable demise. the ethos of this effort is encapsulated in the proverb “idleness is the root of all evil” (lediggang er roden til alt ondt). this phrase summarizes the protestant ethic laid out by max weber (1958) and the ethos of scandinavian thrift and mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 38 diligence. referring to weber’s thesis, the historian thomas r. cole writes, “[discarding] as selfish the monastic ideal of retirement from active life, luther and his followers found the highest form of activity in fulfilling the duties and obligations of one’s station in life” (1992, 23). in effect, the value of lifelong social engagement has its roots back in the reformation, where “one’s whole life became concreted for work” (ibid.). yet, rather than referring to the redemption of work, the proverb identifies a certain contagious malevolence lurking at the core of passivity, as if passivity itself poses a threat to the social order. in this article, i attempt to reverse this perspective by shifting the focus from the political minefield of “people on welfare” and the alleged tendency of the welfare state to render its citizens passive, to the attempt on behalf of the state to activate even those among its citizens who have previously been exempt from such efforts. retirees have previously been expected to withdraw socially, however, in the last twenty years we have seen an increase in the state’s attempts to activate and rehabilitate elderly citizens. i will show that “passivity” is met with an insistent search for ways to improve the life conditions of elderly citizens and an attempt to install in them an orientation towards the future. thus, rather than threatening the social order, as in the story of bartleby, passivity is a core catalyst of the energy of the welfare state. as energia in greek means “in work,” it seems particularly appropriate to evoke this concept in relation to a certain set of values that prowl at the core of the welfare state. this is not a comprehensive case study, but rather a window into a more conceptual discussion of energy and passivity, and the way these are related to ideas of care within the danish welfare state. in this discussion, i apply the concept of energy as an analytic heuristic, which may enable us to conceptualize the welfare society’s reaction towards the passive citizen. finally, i conclude by suggesting that the passivity of my elderly interlocutors could be considered a “tactics of isolation”—i.e., an attempt to maintain a sense of selfhood and autonomy in the encounter with an incomprehensible and intrusive health care system. since this isolation was what fuelled the efforts of the health care workers, the state and my elderly interlocutors were locked together in a selfreinforcing process. “activating care”: the animating case of the passive citizen it has recently been argued that new forms of subjectivation are emerging in denmark (karlsen and villadsen 2016). this can especially be seen by the way health campaigns have become “non-authoritarian” in the sense that they do not first and foremost propagate abstention from harmful substances. rather, a strategy is being applied that integrates desire into health promotion. i agree with this observation, though i believe it overlooks how this subjectivation extends beyond the area of somatic health. in fact, i suggest, across the danish society one encounters activities that aim to engage the citizen, actualize and enforce their potentials as welfare consumers (baldock 2003)—i.e., as subjects who actively chooses between welfare services. to unfold this argument, this article draws on ethnographic material from the rural parts of denmark, where “socially isolated elderly men” has become a social category of key concern within the public health sector. through presenting such ethnographic cases, this article argues that identifying and facilitating ways for activating the citizens have become a key point of entrance in the current “government of life” that is, “the managing, controlling, and optimizing [of] a living population” (villadsen and wahlberg 2015, 1). i lay out how health care workers perceive and approach the problem of non-engaged passivity among elderly men in a danish island community. generally speaking, passivity is framed as a negative and detrimental state of existence, which, by definition, opposes social and physical well-being. thus, the approach of the welfare state are critical elements in the danish configuration of “successful aging,” which revolves around the inclusion and engagement of citizens: the detached must be reattached in some way (mikkelsen 2016). in particular, the article focuses on the encounters with the “passive” elderly who pose a challenge to the local municipalities. in effect, when confronted with this category of elderly citizens all moral demands converge on the single imperative of identifying the ways in which the citizen mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 39 may become healthier and more socially active. if the passive citizen presents a problem to the municipality, however, the nature of this problem is not easy to categorize. passivity does not involve a direct opposition or active resistance. rather, passivity involves an absence—of activity, initiative, or energy. in 2014, i started a fieldwork in the rural areas of southern sealand in the municipality of vordingborg—and especially on the island møn—with the intention of studying socially isolated elderly men. the participants in my study were men who had a minimum of social contact with other people in their daily lives and who had repeatedly declined participating in the programs and activities offered by the municipality. such activities ranged from various forms of physical activity, reminiscence groups, and men’s clubs with trips to festivities and other day-trips. my initial aim was to reach an ethnographic understanding of the experience of loneliness. not surprisingly, this posed a series of methodological challenges—most importantly due to the fact that it was difficult for me to make the elderly men articulate this experience in words. i quickly realized, as phrased by the writer paul auster, that it is indeed impossible “to enter another’s solitude” (2012, 20). møn was attracting special attention from the municipality due to the unprecedented convergence of population aging and depopulation that characterized the demographic developments on the island. while møn, like other areas in the rural danish periphery, is heavily marked by economic decline and an increase in levels of unemployment (nørgaard and andersen 2012), the major threat to the island community is undoubtedly the rapid and escalating depopulation. a recent census from east møn shows that even though today the population consists of 2,114 individuals, 38 percent of these are over the age of 60. by 2030 the population will have dropped by 22 percent. out of these, 1,640 individuals, or more than half, will be over the age of 60.i such a mounting increase in the senior population, combined with general depopulation, will have wide-ranging consequences. in the early stages of my fieldwork, i saw the ensuing reduction in public transportation and the closing of schools and daycare centers for children along with local supermarkets and shops, as examples of a wider de facto withdrawal of the state (scott 1998)ii from the danish periphery. i expected these current trends to have a devastating effect on the area of eldercare. my expectations were proven wrong. in fact, what i encountered during my first weeks on the island was a large, vibrant network of municipal employees who tirelessly and ardently launched new initiatives to aid and improve the quality of life among its aging population. in denmark, senior home care, like other social services, is widely governed through national legislation, but a relatively high degree of decentralization means that it is the responsibility of local government—the municipalities—to organize and plan the provision of eldercare services (mikkelsen 2017). the municipality of vordingborg had recently introduced a new rehabilitation program for the elderly called “activating care.” the program sought to enhance the people’s ability to “manage daily tasks after illness and physical decline.”iii it was evident, however, that certain elderly citizens were unwilling to be “activated.” as a homecare assistant explained to me: “they no longer have any wants” (de ønsker sig ikke længere noget). she continued, that’s the problem with those men that you are getting to know. they are saying no to everything. something happens at some point to those men. they lose their connection to the world around them. and every time i visit them it is as if they just sink deeper and deeper into their armchair. and we normally say that this is a vicious circle. because when they start being like that they lose energy. and you need energy to get out of the armchair. so when we learn that someone is at risk of becoming like that everything is done to support the citizen. mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 40 the account reproduced here is instructive since it points to the way social isolation was both considered as passive acceptance (“they no longer have any wants”) while at the same time involving an action (“they are saying no to everything”). similar notions were reflected in other conversations with health professionals. it was clear across the various accounts that withdrawal of the elderly was perceived as something that “just happened” and simultaneously as something that involved an element of choice. during such conversations it was made clear that passivity was considered a pathological form of deviation (cf. foucault 1986, 25) and that it was the responsibility of the state to enter into the most intimate areas of the citizens’ lives in order to identify their potentials and allow them to recover the zest for life that they had lost along the way. at the same time, the excerpt above depicts how energy becomes a referential category when discussing the situation of the elderly: energy was explicitly applied in order to understand the situation of the individual citizen and in this process a link was made between the (lack of) energy of the citizen and the surging energy of the health care workers that ensued. “activating care” had not only made some of the elderly more active; the encounter with unwilling citizens appeared to energize the municipal system itself. john’s refusal in the early stages of my fieldwork, i drove around the island of møn with a homecare assistant, susan. it was during one of those rounds that i first encountered john. john lived alone in small, old house outside the town, borre. besides his son, who came by every two-three months and the daily visit from the home-helpers, he had no social network. he was a person that i would not have been able to meet had it not been for the homecare assistant. during my visits to his house, he only left the worn couch to relieve himself. the rest of the time he restricted his movements to reassembling the pillows under his legs. from visit to visit he grew almost inseparably connected to the couch on which he draped his body. i asked him, “do you feel pain? i mean, since you are lying down?” john shook his head and said, “i am old enough to decide what to do.” this laconic reply was typical of john. he cut off most attempts to create a conversation. however, while watching tv he would sometimes open himself up in unforeseen ways. i had arranged myself in a worn, padded chair in the living room while john was lying on the couch. someone on the tv was demonstrating an oversized kitchen utensil that, the host explained, replaced a number of other kitchen utensils. we watched the program and neither of us spoke. after a while john started to shift uncomfortably on the couch. i learned that at those moments he would, for some reason, be willing to chat. he explained to me that the only event that broke the monotony was the walk to the gas station down the street where he purchased beers. he took that trip a few times a week. he stayed in the house the rest of the time. sometimes, he explained, he grew tired of its droning familiarity, but mostly he thanked god for the solitude as he recalled the suspicious gazes from the neighbors, the coagulation of traffic in the cities, and the seemingly evermore disconcerting news from around the world that reached him through the tv. over three months, i visited john many times. when i asked him questions, his answers were brief, disengaged, an echo coming from the mist of his solitude. only when talking about the island was he willing to utter more than a few coherent sentences. he said to me that when he was confronted with the developments of the town of borre, he was left with a sense that the entire island was falling apart. he referred to the empty stores in the area that created the feeling that he was living in a “ghost town” – a feeling that had only been intensified by the municipality’s attempts to “beautify” the town by tearing down abandoned, ramshackle houses. now the town had become dotted by empty housing lots that created a powerful feeling of absence. mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 41 besides these conversations about the island, he seemed completely disinterested. although, in my view, he had plenty of things to complain about—for instance, a painful respiratory illness—he never complained. there was just a conspicuous silence, which not only myself but also the homecare assistants found it hard to deal with. one morning as susan tried to convince john to take a bath, he merely replied “no thank you” in a low, rumbling voice. this clearly left her frustrated. “but you have to let us help you,” she said. at that point i joined the conversation, taking susan’s side. i tried to convince john that perhaps it was a good idea to take a bath—and i even added that he should also put on some fresh clothes. he had worn the same yellow shirt for at least the month that i had known him at that point. he did not reply, but let out a heavy sigh. i exchanged a glance with susan and i realized that now i was as frustrated as she was. there was something in john’s unrelenting refusal that provoked us. when susan left, john and i were sitting in the living room watching tv in silence. from his house a constant deep drone could be heard from the machines that were collecting the corn harvest on the fields around the island. i thought about john’s case—and many other similar cases. what is it about refusals that prompt one’s desire to do something? i asked him how he was doing, trying to be a bit cheerful. he remained completely motionless, showing no sign of interest. at those moments he was at the verge of unreachability. yet, after what seemed like long time he just replied matter-of-factly, “i think my light has gone out.” shortly after i became acquainted with john, he began experiencing a severe pain in the abdominal region. i noticed his state of agony as his forehead sometimes became beaded with sweat. in spite of my encouragement, he did not disclose his infirmities to the homecare workers and he asked me not to pass it on. this placed me in a predicament and while i respected his wishes, i asked him about his reasons for keeping his ailments to himself. john said, “i don’t go to the health center. could you imagine me in that cafeteria in my boots?” while i thought at first that john had, as so many times before, changed the subject, i asked him where, then, he liked to go. he said, “i don’t go anywhere anymore. i have nothing to do in that place.” i pushed him further and finally he said, “i’ve worked as a farmer all of my life. work every day. and then at the health center it’s all talk. it’s a place for women. i don’t know what to say…” john had not been changing the topic. rather, he had conveyed to me that he favored his solitary suffering over becoming part of a “place for women,” where he did not understand—or feel comfortable with—the social codes and forms of conduct. i heard similar comments from other men in the area. one of my long-time interlocutors, niels, explained that he hated the inevitable question from the homecare assistants, “so how do you feel today?” he knew that this question was based on both kind and inclusive intentions, but he simply did not know how to reply: “how do you feel, how do you feel?” he said mockingly. “i have no damn idea about how i feel all the time. i want to have a beer, but that’s probably not the answer those women want to hear.” in fact, niels’s representation of the health professionals was unfair. it was based on earlier forms of health management. while he claimed that there was no room for pleasure (drinking a beer) in the feminized world of elderly health care, in fact the opposite was the case. several attempts were made to meet the anticipated wish for alcohol and the forms of pleasure preferred among the elderly. for instance, every year attempts were made to start up a beer brewing club for the elderly men and the parties at the health center were known for involving significant intakes of schnapps. this reflects a wider shift in denmark towards an increasingly non-authoritarian and diversified stance on behalf of public health interventions. john and niels played an important role in the conversations i had with homecare assistants and various health professionals on møn. these two men were the archetype of the socially isolated, elderly mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 42 man. given the fact that especially john declined even the most basic, practical assistance in his daily life and appeared to have no expectations from the municipality, talking about these men persistently brought forth a number of dilemmas in the conversation, such as the extent to which it was the responsibility of the municipality to help them out of their solitude (see mikkelsen 2016). in other words, while these men generated a concerted activity on behalf of the municipality, they also made the health care professionals ask themselves fundamental questions in relation to their practice and responsibility as a whole. in order to unpack this situation further, i will in the following take a brief detour through the literary realm of herman melville. bartleby: a hero of passivity in herman melville’s short story, bartleby provides a mini-cosmos in which the world revolves around a fixed center: bartleby is little known by the employer during the first period of his employment. however, as he gradually stops performing his tasks and as he becomes increasingly incomprehensible to his colleagues, bartleby becomes the hub of the office, the very focal point of all activity. repeatedly he is described as “motionless” and “sedate”—as opposed to the energetic, wildly frustrated reactions from his colleges. in recent decades the figure of bartleby has stimulated a remarkable amount of reflection by various seminal thinkers and has become a point of reference in discussions on especially political resistance (deleuze 1997; agamben 1998; hardt and negri 2000; žižek 2006). the question being raised is how we should understand the nature of bartleby’s “refusal” and, most importantly, to what extent this refusal should be considered a form of political agency. in the critique by michael hardt and antonio negri, bartleby’s negative refusal of work and servitude leads to a futile “social suicide” that does not offer any positive alternative to the current political structures (hardt and negri 2000, 204). according to slavoj žižek (2006), however, bartleby embodies a defiance that transcends the structure itself. žižek distinguishes between two forms of violence. a violence of action affirms and reinforces whatever it sets out to challenge. one could say that this form of violence is the affirmative act of “interpellation” (althusser 1984) on which authority, ultimately, relies in order to function: power is only power when it is recognized as such. the second type of violence involves an act of “impassive refusal,” which has the capacity to change the very point of reference of reality itself (žižek 2006, 381). by not refusing explicitly, žižek argues, but rather passively uttering a preference not to carry out the tasks at the office, bartleby opens up a space beyond the politics of “resistance.” by neither openly challenging nor accepting the requests and pleas from his superior, bartleby gradually undermines the hegemonic position. in other words, passivity has the capacity to lay bare ideological forms of thinking and expose habitual forms of behavior: it exposes power as fundamentally powerless. lines can be drawn from žižek’s reading of bartleby to james c. scott’s (1985, 2012) reflections on the “weapons of the weak” as various anarchic practices. scott argues that the most efficient form of political resistance is “desertion” rather than “mutiny” (1985, 32). confronting power—the state—directly, on the other hand, acknowledges, affirms, and reasserts power rather than dissolving it. scott shows that most anarchic forms of resistance take the form of hidden or passive resistance and develops his wellknown thesis that such resistance is more efficient than direct confrontation (1985, 32). similarly, one may recall pierre clastres’s (2007) pathbreaking writings on the amerindian aché. the aché, he argued, were loosely organized around a “chief without power,” that is, a form of leadership that was excluded from the spheres of exchange and paradoxically stripped of influence. this paradoxical power structure was maintained through the profound indifference of the “subjects.” when trying to exert his role as a chief, he would simply be ignored. by separating the chieftainship from the capacity to exercise mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 43 coercion the aché “rendered power powerless” (clastres 2010, 89–90). this political system can be pictured as being based on “centrifugal dynamics” (vivieros de castro 1992, 3). this term points to a “turning towards the exterior, an exiting from itself towards those regions above and beyond the social” (ibid.). the centrifugal dynamics, one could say, is the state in an inverted form, since the state, as pierre clastres maintains, is a “centripetal force” that draws power towards the center (moyn 2004; mikkelsen 2018). i refer to clastres’ observations because he represents an early anthropological depiction of the way in which “passivity” becomes antithetic to “state”: passivity is identified as an activity that persistently undermines any attempt to consolidate power. what becomes clear, however, when turning our focus back to the ethnographic context of this article, is that rather than undermining the danish welfare state, the passivity of its citizens elicits a concerted reaction from the state. it is by eliciting this reaction that passivity in fact energizes the state. moaning as a “sign of life” during a conversation with two homecare helpers, linda and christina, we tried to map out the group of elderly that they encountered in their daily rounds. this gave me a chance to initiate a discussion about how they dealt with the fact that some of the elderly i had come to know during my fieldwork did not want to participate in any of the social activities arranged by the municipality. during this conversation we pondered the imaginary scenario in which the elderly were simply left to their own devices in accordance with their wishes. why bother helping them if they did not express any desire for help? while it was made clear to me that helping such citizen was a moral responsibility, this, in turn, forced us to reflect upon the extent to which the elderly knew what they actually wanted. and indeed, as our discussion progressed, we discussed what the job of a homecare assistant would look like if the citizens were truly able to decide for themselves. at this point in the conversation linda mentioned that, in fact, she often met citizens who were able to decide. she made a distinction between those elderly who were passive and silent, never asking anything of the municipality, and those who would fervently receive all the help they could get from the municipality while simultaneously complaining about the help. “some elderly,” linda said, “don’t want to be a burden and they hold back a lot. it’s up to us to assess what would be good for them. other citizens have no difficulties in telling us what they want and don’t want. we encounter quite a bit of moaning [brok].” christina added, “yes, but it is not so much the moaning. that may be irritating at times…. most of the time, i think, i don’t even really notice it. i just say, oh shut up, you!” christina laughed. “and they like that,” she continued. “they like it when you talk to them in a straightforward way. it makes me think there is still hope here. moaning is not ideal but it’s a sign of life. no, it’s when they don’t even care to moan – then we start to worry.” linda nodded: “yeah, when they no longer tell us what is going on…and then you will hear about these cases where some man develops diabetes and nobody hears about this before it is too late. and when the media hears about it, then it is our fault!” by drawing the distinction between the elderly who “moan” and thereby display a “sign of life” and the disengaged elderly, it becomes clear that the opposite of “life” is not “death” as in a common, biological, western conception of the concept. rather, “life” implies a willingness to engage with the world around them. for instance, i visited carsten, an 84-year-old man, who lived alone in an apartment on eastern møn. i had been put into contact with him through the head of the local health center, who saw carsten as one of those elderly men “with a lot of energy” who had ”lots of stories to tell.” i came to his door and we shook hands. carsten was sitting in a wheel chair, smiling enthusiastically; his shirt was open exposing a pale, thin chest. even before i had taken off my winter jacket, he headed for the kitchen and launched into the following, animated monologue, which i include here at length: “i was just telling the homecare assistant this morning that i don’t feel too well today. this winter i had a normal diarrhea,” he said, while looking mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 44 through the dishwasher. “most people have that at christmas. but they drove me to the hospital! and then they had to run after me, sweeping the floor with a broom. there was a trail after me!” i nodded, slightly astonished, and bent down to take off my boots. a brief silence ensued. “you understand,” he shouted from the kitchen. “i was shitting all over the hospital! they gave me pills and i asked them, what are you giving me? they said it was part of the treatment. what kind of an answer is that? my spine had completely collapsed! they talk so much crap!” with a cup in his lap he started maneuvering towards the living room where he poured a cup of coffee from a thermos. he handed the cup to me as i entered the living room. he continued, but then after 3 weeks i came back to the hospital. i had already been looked at by my doctor in stege. they didn’t know what they were talking about. it was a question of money! but then they drove me all the way to copenhagen, you see. and they operated on me right away. and when i woke up there was this doctor looking at me and he said that they had made a mistake. there are so many things. my dentist! the nurse had ordered a taxi. and then the taxi driver was standing out there in the middle of the road. he said to me: listen i cannot come up to your house. you have to be standing at the sidewalk – or else i am not allowed to help you. or else you have to ask for extra help. so, he drove away again. but then my dentist had a new address. on the first floor. how could i get up there with my back? they had installed this crane in order to help the disabled. but then halfway up it just stopped. so, i was just hanging there! and you know two nurses came by and helped me. and then what happened. i was sitting in the waiting room for an hour. and i asked the secretary what was happening. and you know what she said. she said that her husband had gone to take an afternoon nap. what the hell! it’s incredible what they do to us! can’t you see the comedy!? from listening to such stories from carsten, i realized that he was a masterful moaner who yielded a wide range of both subtle and explicit types of complaining. he relentlessly and fastidiously laid out the absurdities of the healthcare system as he experienced it: doctors who prescribed the wrong medicine, who overlooked various symptoms and ailments, and who ignored the opinions of their patients. and at times he also talked about the homecare assistants whom he generally considered to be more of a burden than a help. yet, while carsten would spend hours complaining, it seemed that his intention was not to generate any effect. when i tried to talk to carsten about how the homecare assistants could change their routines in order to meet his needs, he simply ignored my questions. the reason why this is interesting in relation to passivity, as seen through the eyes of health care professionals, is that moaning was a clear sign of social engagement. it was a sign of life. the passive and the welfare consumer this article has thus sought to illuminate passivity from within a space marked by activity and energy. the objective of the article has been to probe into the way passivity not only activates but in fact energizes the welfare state; by causing friction passivity becomes a generative force. taking elderly, socially isolated men as our point of departure, this article has argued that rather than seeing passivity as simply opposed to acting, passivity, from the perspective of the state, should be regarded as a form of political behavior that involves an event in its own right. in this respect, passivity can have an ironic effect as it unleashes an immense activity. according to the categories set out by the danish ministry of social affairs these men are “vulnerable” (udsatte). this category is defined as “persons who live on the fringes of society, persons who mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 45 often have a poor health, who rarely have ties to the labor market, and who do not make use of the society’s normal services to the citizens” (socialministeriet 2002). according to this definition, most of the men in my study were “vulnerable.” however, rather than becoming the refuse of society, expelled to the leprous badlands of the welfare state, they become the objects of concerted interventions from the local municipalities. in this sense, the vulnerable citizen is not a disavowed subject. rather, being vulnerable in this context involves a process of progressive loss of energy, which prevents the citizen from participating in the welfare consumerism on which the state relies (baldock 2003). the welfare consumer is the citizen who makes able use of whatever the state or the municipality has to offer. this is a system that encourages life, that encourages the citizens to speak up and be engaged. silence, in this sense, is a state of nonconsumption (sim 2007, 2). one is here reminded of carsten who, by moaning, shows a sign of life and calls for no further attention from the homecare helper. silence, on the other hand, must be foiled and the passive citizen must be activated. this article has explored the relationship between the danish welfare state and the passive citizen through the motif of energy. the overall aim has been to convey the idea that certain incidents and phenomena energize the state—i.e., set in motion various activities. in as sense, it is in the encounter with silent passivity that the energy of the welfare state is unleashed. the question to be raised is what gives rise to the perceived “passivity” among elderly men to begin with. while the answer to this question lies beyond the scope of this article and, admittedly, my disciplinary proficiency as the author, there are relevant insights to be gained from anthropology. most notably, anthropological studies have pointed to the fact that adult personhood in scandinavia is closely tied to one’s ability to manage on one’s own and maintain individual autonomy (krøijer and sjørslev 2011). consequently, aging men often find themselves in a process of emasculation or loss of personhood as their sense of independence is continuously compromised (rehak 2019; tunstall 1966; kastenbaum 1993; thompson 1994). the men in my fieldwork seemed to adopt what one may call tactics of isolation to retain a sense of autonomy. they thereby forced me to consider the idea that rather than a social network being what gives validation to the individual’s sense of self and self-worth (elias 1985), disengagement and cutting oneself off from such networks could in fact be considered a mode of social behavior, which is adopted in order to reclaim autonomy from the all-pervasive forces of commerce, politics, and culture. if passivity presents a problem to the danish welfare state, the nature of this problem is not easy to categorize. passivity, as i have suggested, is a non-verbalized “i would prefer not to.” for agamben, this reply is “the strongest objection against the principle of sovereignty” (1998, 48). the passive silence does not involve the direct refusal, which marcel mauss (1990) reflects upon in his essay on exchange and reciprocity. there mauss realized how the refusal had the potential to cause a powerful, social rupture. in social terms, he wrote, “one has no right to refuse a gift” (1990, 52, original emphasis). curiously, doing so anyway, that is, breaking the fundamental rule of reciprocity, might either be a way “to proclaim oneself victor and invincible” or admit oneself to be “beaten in advance” (ibid.). these two apparently contradictory outcomes, however, have the one thing in common that the person refusing the gift, by being passive, sets himself apart from—either below or above—a social exchange. what makes bartleby remarkable, in this sense, is that rather than setting himself “below or above” the exchange, he sets himself beyond. through his enigmatic reply—the act of “pure patient passivity” (deleuze 1997, 71), this character manages to “escape knowledge, defy psychology” (ibid., 83). through his fundamental passivity, that is, through his constant refrain, he neither negates nor affirms the exceedingly desperate requests of people around him. suspended in a liminal state between negation and affirmation bartleby’s reply involves a non-revolt, which nevertheless challenges the social structures of which he refuses to be a part. as deleuze phrases it, passivity involves a “being as being, and nothing more” (1997, 74). however, mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 46 from an ethnographic viewpoint—that is, a viewpoint situated among existing people—it becomes clear that no subject will be characterized by “pure patient passivity.” in any ethnographic encounter it quickly becomes clear that the abstracted idea of the “man without references, without possessions, without properties, without qualities, without particularities” (ibid.) vanishes before one’s eyes, as the person stands out in his or her peculiarity as a historically situated subject. indeed, the elderly men that i have come to know during my fieldwork often radiate a wealth of desires, anxieties, and hopes for their own future. the character of bartleby, who in his ascetic purity emerges as a hero of passive withdrawal, should then, in the context of this article, not be accepted as an image of a certain group of supposedly resigned elderly citizens within the danish welfare state. rather, the story depicts the dynamics that emerge in the encounter between the state system and elderly people who do not live up to the ideals of active participation as framed within a danish context. notes i https://vordingborg.dk/media/2037996/befolkningsprognose-2016-2029.pdf ii http://www.oestmoen.dk/pdf/strategi/udkast_til_strategi.pdf iii translated by author. http://vordingborg.dk/borger/sundhed/traening-og-rehabilitering/traening-ogbevaegelse-til-aeldre/aktiverende-pleje/ references agamben, giorgio. 1998. homo sacer: sovereign powers and bare life. stanford: stanford university press. althusser, louis. 1984. essays on ideology. london: verso. auster, paul. 2012 [1982]. the invention of solitude. london: faber and faber. baldock, john. 2003. “on being a welfare consumer in a consumer society.” social policy and society 2(1): 65–71. clastres, pierre. 2007. society against the state. brooklyn: zone books. clastres, pierre. 2010. archeology of violence. los angeles: semiotext(e). cole, thomas. r. 1992. the journey of life: a cultural history of aging in america. cambridge: cambridge university press. daley, suzanne. 2013. “danes rethink a welfare state ample to a fault.” the new york times, april 20, 2010. http://www.nytimes.com/2013/04/21/world/europe/danes-rethink-a-welfare-state-ample-to-a-fault.html deleuze, gilles. 1997. essays critical and clinical. minneapolis: university of minnesota press. elias, norbert. 1985. the loneliness of dying. oxford: blackwell. foucault, michel. 1986. “of other spaces.” diacritics 16:22–27. hardt, michael, and antonio negri. 2000. empire. cambridge: harvard university press. karlsen, mads, and kasper villadsen. 2016 “health promotion, governmentality and the challenges of theorizing pleasure and desire.” body and society, 22(3): 3–30. kastenbaum, robert. 1993. “encrusted elders: arixona and the political spirit postmodern aging.” in voices and visions of aging: toward a critical gerontology, edited by thomas cole, 160–183. new york: springer publishing company. krøijer, stine, and inger sjørslev. 2011. “autonomy and the spaciousness of the social in denmark.” social analysis 55(2): 84–105. mauss, marcel. 1990 [1923]. the gift: the form and reason for exchange in archaic societies. abingdon: routledge. mikkelsen, henrik h. 2016. “unthinkable solitude: successful aging in denmark through the lacanian real.” ethos 44(4): 448–463. mikkelesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.176 http://anthro-age.pitt.edu 47 mikkelsen, henrik h. 2017. “never too late for pleasure: aging, neoliberalism and the politics of potentiality in denmark.” american ethnologist 44(4): 646–656. mikkelsen, henrik h. 2018. cutting cosmos. new york: berghahn. moyn, samuel. 2004. “of savagery of civil society: pierre clastres and the transformation of french political thinking.” modern intellectual history 1(1): 55–80. nørgaard, helle, and hans s. andersen. 2012. “motives for moving to rural peripheral areas: work, ‘rural idyll’ or ‘income transfer’.” geoforum perspektiv 22: 32–44. rehak, jana kopelent. 2019. “aging in place: changing socio-ecology and the power of kinship on smith island, maryland.” anthropology & aging 40(1): 47-62. scott, james. c. 1985. weapons of the weak: everyday forms of peasant resistance. yale: yale university press. scott, james, c. 1998. seeing like a state: how certain schemes to improve the human condition have failed. new haven: yale university press. sim, stuart. 2007. manifesto for silence: confronting the politics and culture of noise. edinburgh: edinburgh university press. socialministeriet. 2002. de udsatte grupper: socialpolitisk redegørelse. 2002. copenhagen: socialministeriet. thompson, edward h. 1994. “older men as invisible in contemporary society.” in older men’s lives, edited by edward h. thompson, 197–217. thousand oaks, ca: sage. tunstall, j. 1966. old and alone. london: routledge. villadsen, kasper, and ayo wahlberg. 2015. “the government of life: managing populations, health and scarcity.” economy and society 44(1): 1–17. vivieros de castro, eduardo. 1992. from the enemy’s point of view: humanity and divinity in an amazonian society. chicago: the university of chicago press. weber, max. 1958 [1904]. the protestant ethic and the spirit of capitalism. new york: charles scribner and sons. young, allan. 2012. “the social brain and the myth of empathy.” science in context 25(3): 401–424. žižek, slavoj. 2006. the parallax view. london: mit press. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.218-219 issn 2374-2267 (online) doi 10.5195/aa.2015.116 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review aging bones: a short history of osteoporosis. gerald n. grob. baltimore, md: johns hopkins university press. 2014. isbn 978-1-4214-1318-1, 284 pp. $24.95 (paperback) matthew j. kesterke department of anthropology, university of pittsburgh http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.116 http://anthro-age.pitt.edu book review aging bones: a short history of osteoporosis. gerald n. grob. baltimore, md: johns hopkins university press. 2014. isbn 978-1-4214-1318-1, 284 pp. $24.95 (paperback) matthew j. kesterke department of anthropology, university of pittsburgh in referring to pre-wwii approaches to the study of aging and gerontology, gerald grob refers to the prevailing paradigm of, “old age itself was generally offered as the cause of death” (pg. 3). this idea permeated clinical and anthropological studies until recently, and is at the foundation of grob’s aging bones: a short history of osteoporosis. this book, part of john hopkins’ series ‘biographies of disease’, traces the origins, attitudes, diagnosis, and treatments of osteoporosis from clinical and cultural viewpoints. the book begins with the changing views towards aging in the 18th and 19th centuries, tracing the rise of a pejorative attitude towards “old age” from one of reverence to that of a diminished and devalued population at the fringes of medical research. during this time, clinicians saw age itself as a disease, and ‘senescence’ synonymous with ‘decline’. the opening of this work provides an account of the increase in childhood survival rates, concomitant with the decrease of infectious diseases during the late 19th century, as the primary factor behind the rise in the number of “old” and “very old” in changing national demography. these changes led to an increase in deaths from chronic diseases such as heart disease and neoplasms, with osteoporosis remaining an amorphous, fringe malady of the elderly. coupled with the rise of endocrinology and a better of understanding of bone physiology, nutrition, and bone fracture mechanics throughout the early-20th century, grob weaves medical and social history together in chapters 2 and 3 to paint a picture of the evolving views of osteoporosis and bone biology. central to the discussion are the roles of age and sex in disease and the notions that the likelihood of contracting many diseases increases with age (e.g., heart disease, cancer). therefore was the rise in osteoporotic patients simply a product of an aging population, or was it fundamentally linked to metabolic dysfunction? simply put, at what point does a seemingly normal aging process become a disease (pg. 42)? from a biological standpoint, the author recounts the often-pessimistic approach of past researchers debating whether osteoporosis arose from too little bone matrix formation, poor calcification of that matrix, or too much bone reabsorption. as such, a strict definition of osteoporosis required more elaborate and precise diagnostic criteria before a consensus on the disease process could be reached. confounding this entire process, however, were attitudes towards femininity and menopause, and the prevailing view that menopause was a medical condition to be treated rather than a natural process of life. it was not until the 1980s, when the estrogen-replacement therapies for menopausal women were becoming common medical practice, that osteoporosis gained national attention. beginning with the 1985 senate subcommittee on aging’s public hearing regarding osteoporosis, grob moves on to issues of etiology and diagnostic criteria in chapter 4. integral to this section are reviews of risk factors, kesterke | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.116 http://anthro-age.pitt.edu 219 219 screening methods, and therapy; a three-pronged approach was strewn with political, financial, and practical quagmires. without a consensus on which individuals were at risk for osteoporosis, or how to consistently diagnose the disease, estrogen treatments continued to be the therapy of choice. coupled with their advertised benefit of “preserving youth and vitality”, the popularity of estrogen treatments was largely driven by their pharmaceutical manufacturers. many other therapies (e.g., bisphosphonates, calcium, calcitonin) faded in and out of popularity as the drive to raise public awareness of osteoporosis finally came to the forefront; this led to an international effort to combat the disease. chapter 5 deals not only with the expansion of research and global organizations during the 1990’s, but also the ever-increasing influence of pharmaceutical companies and their multifaceted interests in health. the international interest finally formed a definition of osteoporosis (2.5 standard deviations below mean bmd) and explications of existing prevention and treatment possibilities. clinicians used the same “scale” approach to diagnosing other common diseases such as hypertension, so an “aura of certainty” in diagnosis was finally achieved, as osteoporosis became a progressive, systemic disease rather than inevitable (pg. 135). the international effort also brought about epidemiological studies to evaluate the dissimilar rates of osteoporosis across individuals of varying age, sex, geographic, family history, behavioral, and genetic backgrounds. the final two chapters of the book seamlessly tie the multiple threads together to present an exhaustive and cohesive account of how the myriad of approaches to osteoporosis research attained their current position. with the semblance of a consensus regarding a working definition, along with a better (though certainly not exhaustive) understanding of many of the contributing factors, researchers could finally build a therapeutic arsenal to combat osteoporosis. national and international studies led to a reevaluation of hormone treatments, namely estrogen, though the air of contradictory reports that had haunted past osteoporosis studies still found its way into therapeutic research. grob does an eloquent job in presenting the various contemporary viewpoints regarding hormone therapy, bisphosphonates, and screening techniques to provide the reader with a balanced perspective of the nuanced phase at which osteoporosis studies stand today. hormone replacement therapy now holds less status in the pantheon of therapeutic treatments, partly due to continued studies concerning its efficacy for osteoporosis, and partly due to the refreshing perspective that menopause is a natural biological processes in desperate need of demedicalization. the current, pyramidal approach to treatment, with pharmaceutical intervention being a last resort built only upon effective diagnostic techniques and lifestyle practices, provides a fitting end to an elaborate and well-researched history of a complex disease. grob’s concluding sections provide an articulate outline of current standards for screening, risk factors, and treatments of osteoporosis that proves invaluable for anthropologists, medical researchers, clinicians, and the public interested in aging. 404 not found microsoft word ikelsfinal3 .docx book review review of evolving eldercare in contemporary china: two generations, one decision. lin chen. palgrave macmillan. 2016. isbn 978-1-137-54440-7. xvii-213. ebook. 76,99 euros. charlotte ikels case western reserve university (professor of anthropology emerita) anthropology & aging, vol 38, no 1 (2017), pp. 85-86 issn 2374-2267 (online) doi 10.5195/aa.2017.164 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.164 http://anthro-age.pitt.edu ikels | book review 85 book review review of evolving eldercare in contemporary china: two generations, one decision. lin chen. palgrave macmillan. 2016. isbn 978-1-137-54440-7. xvii-213. ebook. 76,99 euros. charlotte ikels case western reserve university this phenomenological study was carried out in a large government-run facility for elderly in shanghai and originally served as the basis for the author’s dissertation in social welfare. shanghai leads china in the percentage of population aged 65 or above (25.7% in 2012) and thus can serve as a leader in the development of new forms of eldercare. throughout the work the author refers to this facility as a nursing home even though it provides three levels of service including independent living, assisted living, and constant care. the participants in her study are drawn exclusively from the first two categories of care. while entrepreneurs have recently been investing in mega-retirement and continuing care communities, these cater only to the very wealthy. smaller, private nursing homes have been around for 20 or more years with development especially rapid in the last decade. even these homes are usually for-profit, beyond the financial reach of the majority of families, and offer very uneven service. government-run facilities were originally intended as residences (“homes for the aged”) for older people without children or any means of support. in the 1990s under economic pressure government-run homes began to admit paying residents and to diversify their services by offering multiple levels of care. however, adult children and elders themselves had difficulty accepting the idea that elders with children could now live in such a governmentrun facility. even with the family paying all the fees, separation of the generations seemed a violation of filial piety, of the debt that children owe their parents for bearing and rearing them. this book looks at how families come to make this difficult decision. to study this decision-making process chen first introduces “crisis theory and how family caregiving crises may initiate the decision to institutionalize. second, chen defines intergenerational communication and identifies its potential impact…third, chen discusses uncertainty management theory to understand how each generation conceptualizes and manages the potential uncertainties of institutionalization. fourth, chen uses the life course perspective to situate the caregiving decision-making process in the context of both generations’ life courses” (p.41-2). chapter 4 “unexpected reality: etiology and family caregiving” and chapter 5 “intergenerational negotiation: a power play” present the meat of the research. the organization of the book is problematic. the basic text extends to page 140. the remainder of the book consists of seven appendices including an extensive disquisition on phenomenology. much of what the reader would want to know about the methodology (sample, instruments, analytical techniques) is hidden away here rather than in the body of the text. the sample of 12 dyads of elder and adult caregiving child are the survivors of the initial 20 residents whom the facility physician and staff social workers recommended. sixteen of the 20 were formally consented, but when the researcher attempted to recruit their pre-institutionalization caregiving child, only 12 agreed to be interviewed. on average the interviews conducted between july and december of 2012 took anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.164 http://anthro-age.pitt.edu ikels | book review 86 place more than three years after the decision to institutionalize had been made, thus, the study is retrospective not prospective and subject to the limitations of participants’ memories. one of the most interesting findings from this study is that the adult caregiving children, themselves – thanks to china’s only recently modified one child policy largely parents of single children, are much more accepting of the ongoing evolution in elder care. they have firsthand experience with the difficulties of family caregiving and do not expect to spend their last days in a family setting. evolving eldercare is a practice-oriented book. the author is particularly interested in enhancing intergenerational communication and understanding. in this study the author was struck by the disconnect between what adult children saw as their parents’ needs (instrumental care) and what the parents themselves saw as their needs (emotional support). she proposes that more research be directed to communication issues including that between front-line workers and the elderly in institutions. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp.216-217 issn 2374-2267 (online) doi 10.5195/aa.2015.113 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review aging, corporeality and embodiment.chris gilleard, and paul higgs. anthem press. 2013. isbn 978 0 85 728329 0. 228 pp. $99.00 (hardcover) arantza begueria open university of catalonia http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.113 http://anthro-age.pitt.edu book review aging, corporeality and embodiment. chris gillear, and paul higgs. anthem press. 2013. isbn 978 0 85 728329 0. 228 pp. $99.00 (hardcover) arantza begueria open university of catalonia. when one thinks about aging, many commonplaces come to mind: loneliness, social exclusion, poverty or ill-health. likewise, the idea of the aging body resonates with notions of decline, frailty, impairment and disability. the present book addresses the complex and controversial issue of the aging body by offering a more positive perspective that moves away from those notions and develops the paradigm of the “new aging” (gergen and gergen 2000). taking as a standpoint what bryan turner (1984) has called the “somatic turn” in the social sciences, this book draws on the notions of performative identity, agency and self-care to describe an embodied aging that has to do with autonomy, self-expression, pleasure and lifestyle choices in consumer society. the book can be read in three sections. the first one deals with the theoretical grounds of the text and offers the historical background for its arguments. it describes the history of the body in western societies throughout pre-modernity, modernity and second modernity, and focuses, mainly, on the generational schism lived by the baby boomers of the sixties in the us. according to gilleard and higgs, this particular historical period signals the birth of many contemporary conceptions of the body. during the sixties, several binary oppositions such as male-female, black-white, heterosexual-homosexual and able-bodied-disabled were called into question by a young generation who began to perform their (new) embodied identities proudly. by the time that generation grew old, they wished to perform their previous identities as well as their age in a new way of “not becoming old”. thus, the culturally established opposition of young versus old required a new approach. the aim of this book is to fill this gap and develop this new approach. the text constantly seeks a balance between the paradigms of “positive aging”, “successful aging”, “anti-aging”, “natural aging” and “anti-anti-aging” by offering a postmodern poststructuralist standpoint that tries to go beyond those paradigms and develop “a different understanding of aging as a site of embodied and contested difference” (p.22). such an approach would acknowledge the vulnerabilities of age but also see the individual as a desiring subject. following authors like foucault, butler or deleuze and guattari, the book works throughout its chapters on the notions of personal subjectivity, agentic performance, embodied identity and the technologies of self. the second section of the book takes a cultural studies approach to analyze the bodily identities of gender (chapter 3), race (chapter 4), functional diversity (chapter 5) and sexuality (chapter 6). following gilleard and higgs, several social liberation movements that emerged during the 20th century such as feminism, black power, disability and queer movements helped create a more positive social sensibility toward some renewed embodied identities. again, the authors encourage the idea of using the cultural background of those subaltern identities to think begueria | book review anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015. http://anthro-age.pitt.edu 217 217 about the possibility of performing age as if it was any other agentic identity. the text seem to imply that nowadays all those movements have been embraced by the mainstream consumerist society, so any identity performance, including the aging one, would take the form of a consciously chosen lifestyle. the third section of the book turns from embodied identities to embodied practises. the authors argue that many older people are performing those chosen lifestyles through activities such as active sex in later life (chapter 7), the use of cosmetics, clothing and fashion to promote a youthful look and enhance beauty (chapter 8), the practise of body work and fitness to stay healthy and fit (chapter 9) and the use of self-care techniques related to aspirational medicine and cosmetic surgery (chapter 10). this section of the book is highly interesting because it engages with many stimulating issues. first of all, the activities described in this section, which are focused on the notions of “not looking old” and “not becoming old”, are very useful ideas to reflect on the plasticity of the boundaries of human corporeality. furthermore, those activities call into question the concept of what is “natural” aging and what is not. surprisingly, the authors do not discuss the ideas by which health and well-being are culturally equated with youth and beauty, thus leaving this equation implicit. nevertheless, they do address some exciting contradictions in this section. first, the paradox between the desire not to become old and the conscious choice of performing age as a particular embodied identity. furthermore, the tension between a point of view that perceives those activities as practises of resistance and freedom, and a more structural approach, that understands them as a neoliberal alienation aimed at transferring the responsibility for the public good from the institutions of the state to the individual citizens. clearly, the authors seem to be aligned with the former. although the book is more descriptive than analytical, it provides a sociological and historical account of the aging body in western societies. a cultural anthropology reader would expect some cultural comparisons and ethnographic examples of aging in other societies and cultures, but the authors focus mainly on the us culture. undoubtedly, the major strength of the book is the topic itself, the aging body, which is a subject too often eluded by gerontologists, social anthropologists and sociologists. the authors offer a very specific way of thinking about the body and their point of view can serve to broaden and sharpen a debate that was already raised in this journal (danely 2013) about how to interpret the ageing body. bibliography: danely, jason, ed 2013 the body. special issue, anthropology & aging quarterly 34(3). gergen, kenneth j., and gergen, mary m. 2000 the new aging: self construction and social values. in the evolution of the aging self: the societal impact on the aging process. richard w. schaie and jo hendricks, eds. pp 281–306. new york: springer turner, bryan s. 1984 the body and society. oxford: basil blackwell. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 164-181 issn 2374-2267 (online) doi 10.5195/ aa.2015.102 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. societal participation of the elderly information and communication technologies as a “social junction” peter biniok & iris menke furtwangen university contact: bip@hs-furtwangen.de; iris.menke@gmx.de abstract the technoscape as a global configuration of technology influences lifestyles and living conditions; conversely, developing, implementing and utilizing technologies all shape the technoscape. starting from this interdependence between human action and technoscape, we examine how sociotechnical configurations determine social participation among the elderly in rural regions. the primary question is how social space, concretely participation space is shaped by the use of information and communication technologies. specifically, our study seeks to investigate the extent to which social participation of the elderly population may be enhanced by the use of technological devices suitable for everyday life. to this end, a tablet pc with a self-developed communication platform was submitted to a field test. through the provision of low-threshold access to information and communication technology, newly developed or renewed virtual contacts and relationships were expected to lead to real-life interactions. the results of our qualitative analysis show three diverse developments concerning the interrelation between social life and the technoscape: the emergence of a new participation space, the extension of established participation space and engagement within the existing participation space. technology as a “social junction” can thus have positive impacts on the social participation of the elderly. keywords: social inclusion; assistive technologies, rural regions, participation space http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx mailto:bip@hs-furtwangen.de mailto:iris.menke@gmx.de anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.102 http://anthro-age.pitt.edu societal participation of the elderly information and communication technologies as a “social junction” peter biniok & iris menke furtwangen university introduction currently, the development and distribution of assistive technologies such as monitoring systems, intelligent house infrastructures and information and communication technologies are strongly supported by state funding, as these technologies are expected to help meet the future challenges of demographic change (cf. becks et al. 2007; georgieff 2009; lancioni and singh 2014 for “ambient assisted living”). starting from the superordinate question of how the quality of life of the elderly in rural regions may be enhanced, our study investigates to what extent the implementation of information and communication technologies produces effects on the social participation of senior citizens. the study is part of the joint project “sonia – social inclusion by communication devices in urban-rural comparison”1 and focuses on the southern black forest region in germany. this rural region is characterized by a sparse population, isolated farms in relatively inaccessible valleys, improvable infrastructures, long winters with heavy snowfall and inhabitants who are generally viewed as introverted and somewhat stubborn (cf. dorer 2012). furthermore, the region suffers from rural depopulation and cuts in public transportation and medical services (cf. leader aktionsgruppe südschwarzwald 2009). the general trends of rural regions are also evident, such as above-average property ownership and long periods of residence. integration in local networks and care systems is strong, which, in addition to normative values and high social pressure, hampers the acceptance of professional care (cf. walter and altgeld 2002). further characteristics include comparably lower incomes and lower educational levels, shorter distances between places of residence for extended families (cf. bohl 2005) and a limited range of leisure activities and other opportunity structures (cf. scherger, brauer and künemund 2004). participation space depends on many of these and other factors and may be enhanced by various mechanisms that can extend the possibility space of the elderly. one of these mechanisms is the implementation of new information and communication technologies (ict). based on a needs assessment, a communication platform referred to as “space of exchange” was developed for tablet pcs and tested by the elderly. it was hypothesized that by providing user-friendly access to information and communication technology, newly developed or renewed virtual relationships would lead to real-life contacts and interactions. dependent on individual competencies and living conditions, different effects on social participation were observed. ultimately, we can report a positive impact for information and communication technologies; however, this success is tied to requirements and efforts that go beyond technical issues. biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 165 165 theory: social participation and (participation) space the technoscape, understood as the global configuration of technology, is intermingled and intertwined with other spheres of society (cf. appadurai 1990). as appadurai states, the result is a “global cultural flow” (appadurai 1990, 301). this global cultural flow does not exist irrespective of space and time, but differs from one place to another and from one timespan to another. worldwide shared cultural “rules” must be imported into and adapted (as well as translated) to local settings.2 conversely, locally produced “rules” infiltrate global cultural patterns. this interdependency characterizes the technoscape as well. technoscape: technology, humans and space in our view, the technoscape is first of all a global phenomenon with local manifestations. it stimulates the worldwide flow of information (e.g. the world wide web), products (e.g. commercial chains) and people (e.g. traveling). at the same time, local configurations of the technoscape can look entirely different, dependent on specific sets of factors. some local technological landscapes are extremely high-tech (e.g. “silicon valley” in saxenian 2000), while other areas are low-tech (e.g. agribusiness in south america); in some locations, ‘technocities’ arise (cf. downey and mcguigan 1999; also ‘global cities’ in sassen 2001), whereas in small villages, a day-to-day bricolage is often observable (cf. lévi-strauss 1968; harper 1988). the development of technologies is shaped by social and cultural factors (cf. bijker and law 1992; mackenzie and waycman 1999), and the application and usage of technologies have an impact on social life (cf. oudshoorn and pinch 2003; nye 2007). every technological development opens up new courses of action and/or limits human action. machines and devices, local landscapes of technology and the overall technoscape all influence human lifestyles and living conditions. in turn, by developing, implementing and utilizing technologies, humans shape the technoscape. human life is a technological life, and thus the technoscape includes humans and technologies. a third dimension of the technoscape is also of importance: space.3 people inhabit space: they not only fill in the space, but also adopt and shape it according to their needs and desires. conversely, space affects and influences people’s lives (cf. gieryn 2000; löw 2001; schroer 2005). in this sense, space is a social environment: “social environment refers to the societal space and the human action space, i.e. the space is set up by actors (subjects) and not only the reified place (objects)”4 (kessl et al. 2010, 25; see also riege and schubert 2005). in sum, the three dimensions of sociality, technology and space are virtually inseparable; rather, we find sociotechnical configurations (cf. rammert 2007) on different scales that are more or less stable but change over time. social participation and participation space starting from the interdependence between human action, technology and space, we investigate how (local) configurations of the technoscape may determine the social participation of the elderly in rural regions. one definition describes social participation as participation in social, economic and cultural life (cf. köster, schramek and dorn 2008; see also askonas and biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 166 stewart 2000; wansing 2005; schütte 2012). the preconditions for participation are therefore the abilities to move, to act and to interact. activities and activity space (cf. dangschat et al. 1982) diminish in old age due to limited mobility and other factors. the same is true for participation space as a subset of activity space (cf. baumgartner, kolland and wanka 2013). in comparison to other subsets of activity space, this is the specific space where social contacts are stimulated and fostered. from a network perspective, there are two different mechanisms involved in participation in social life: bridging and bonding (cf. putnam 1995). the local participation space emerges out of processes of bonding and develops as a network of trust between family members and/or the immediate neighborhood. in contrast, the extended participation space emerges out of processes of bridging, e.g. by using a car to leave the proximate social milieu, participating in networks of ‘weak ties’ (cf. granovetter 1973) or utilizing information and communication technologies (see also ‘mobility turn’ in urry 2007). this last aspect was of special interest to us. participation space and technoscape depending on societal circumstances and structural conditions, human actions and interactions shape the technoscape and at the same time the activity space (cf. straus 1993). activity space and therefore the social participation of individuals may be enhanced by increased possibilities of action and interaction (cf. ‘opportunity structures’ in merton 1996). this can be achieved either by the modification of structural circumstances or by an increase in individual competencies and resources (cf. läpple 1991 and 1992; bourdieu 1987). attaining knowledge is one way to increase one’s educational level – or, in bourdieu’s terms, the ‘cultural capital’. on the level of living conditions, the availability of community colleges or other educational institutions is one factor that can facilitate an increase in cultural capital. the more competencies and resources an individual has on hand, the greater the possibilities of action and interaction and the broader the realm of opportunities. in this way, the participation space may be extended. information and communication technologies have the potential to extend participation space on both the social (societal) and the cognitive (individual) level. in this perspective, the societal level includes – among other aspects – technological artifacts, semiotic systems and standardization, as well as large technological systems and infrastructures. on the individual level, factors such as know-how, competencies and affinities come into play, directly influencing everyday technopractices. the integration of new technologies into the lifeworlds of individuals must occur on both levels: “access to ict for the promotion of social inclusion cannot rest on providing devices or conduits alone. rather, it must engage a range of resources [...]” (warschauer 2003, 47). in addition to the provision of physical (computers, internet connections) and digital (online material) resources, it is important to provide human (literacy, education) and social (community, societal structures) resources as well. in our study, we investigated the extent to which the use of information and communication technologies (‘bridging’) increases the opportunity structures of the elderly, extending their participation space and thereby their social participation. the aim was to foster technology-based interaction and communication and thus to enable meetings in real life. biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 167 167 research: methods, needs assessment and the “space of exchange” the research question under investigation was how information and communication technologies may be employed to increase the social participation of the elderly in rural regions. methodologically, we applied qualitative research methods and followed a user-centered approach. through this participatory design (cf. green and thorogood 2014), we met the challenge to focus foremost on human beings rather than technology. the empirical data was collected in the southern black forest region in baden-wuerttemberg, germany. these data include a needs assessment at the beginning of the study and a long-term field test involving participant observation and semi-structured interviews. needs assessment and communication concept the needs assessment sought to reveal the needs and desires of the elderly in rural regions and the extent to which elderly people participate in social life (cf. biniok and selke 2014; biniok, menke and selke fc.). under the general topic “life in old age”, we conducted 26 semistructured interviews with narrative sections (cf. schütze 1983; hopf 2005) on biographical backgrounds, social participation, everyday practices, age (and care) in society, support in daily life and the use of technology. the target group of people between 60 and 85 years old has been chosen following specified criteria to ensure a broad variety in terms of personal networks, monetary resources and mobility (meaning both physical fitness and cognitive abilities). these central dimensions of comparison are regarded as indicators of risk and protection respectively and are frequently used in similar studies (cf. mollenkopf and kaspar 2005). the participants were recruited via ads in local newspapers, flyers, workshops and the intermediation of the local domestic nursing services. besides this, over the course of the interviews the use of snowball sampling could be made. the interviews were transcribed by a professional office that specializes in the local dialect. the analysis largely followed the ‘grounded theory’ (cf. strauss and corbin 1990) approach and was based on a category system developed out of the core statements. using ‘thematic coding’, enhanced by the ‘open coding’ approach (schmidt 1997 and 2005; kuckarzt 2010), we found correlations that lead us to the development of a consistent notion of aging in rural regions. the results of the needs assessment capture both individual biographies (selfperception) and living conditions (outside perspective) and were used to develop and implement a communication concept referred to as the “space of exchange”. this online platform was tested by the elderly, which in turn allowed us to analyze and deduce its impact on social participation. the needs and desires of senior citizens in rural regions primarily relate to three issues. first, being mobile (both at home and outside) and able to drive a car is essential in rural areas in order to get to doctors, go to theatres or do one’s shopping, since the local transportation services have a very limited schedule. if elderly individuals are unable to drive they become dependent upon their families, neighbors or service providers. second, support services (e.g. delivery services, medical support) are vital. here, the importance of family structures becomes evident, together with the relevance of a vivid neighborhood as a local resource. this latter factor is, however, of indeterminate duration: neighbors from the same generation will need help in the future as well. third, the need for participation in associations and leisure activities (such as biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 168 hiking and sociality) is stressed. it should be noted that in many towns and villages, associations are faced with membership declines and the problem of finding new leaders. when senior citizens become immobile, when supporting structures decline and when associations are closed down, then they are likely to lose possibilities to participate in social life. from the data, general issues that could be addressed by enhancing communication (such as the motivation to go for a walk or support networks in the village) were extracted and needs that could be satisfied with information and communication technologies were selected: establishing new personal connections, information on (medical) services, campaigning for associations and amusement, among others. subsequently, a concept for technical support was developed and put into practice.5 the aim was to meet the needs and the requirements of social participation in accordance and compliance with already existing regional social and organizational structures (such as community colleges, local foundations, clubs and associations). the core of the conceptual framework was a “space of exchange” that was realized as an online platform with several applications grouped under thematic topics with indigenous terminologies (see figure 1). figure 1: “space of exchange” technology, platform and field test the technological solution was based on an existing platform that was modified in accordance with the results of the needs assessment.6 the elderly were granted access to a “space of exchange” using tablet computers. there, four thematic clusters were provided: a calendar to broadcast association activities (“wa isch los im schtädtli?”), a bulletin board to exchange assistance (“am schwarze brätt”), information on local news and citizens’ bus (“wunderfitz hät d nase gschpitzt”) and a chat function to make appointments or just to shoot the breeze biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 169 169 (“schwätze”).7 many of the applications on the platform were standard apps on the tablet (for instance, email, chat, address book). other functions, such as local weather and newspapers, were integrated as feeds. in addition, some applications were carried over from the basic technology and modified (the bulletin board and the calendar). the advantage of our platform compared to standard online forums is a tailor-made solution to the needs of our target group, especially the regional anchoring and the suitability for senior citizens. the overall objective of the platform was to stimulate and foster interactions in real life. to examine the impact of the technology, a field test with 30 participants between 60 and 85 years old was conducted over a period of at least 6 months; two out of three were female. most of the elderly had also participated in the interviews at the beginning of the study (needs assessment), others joined by use of intermediators and snowball sampling. the group of participants was composed of people from various social milieus (farmers, workers, teachers, etc.) and of both natives and newcomers to the region. most of the participants had never used modern information and communication technologies such as smart phones or tablet pcs before, although some of them were it-literate and had used pcs or laptops. very few were familiar with ict or acquainted with applications or technological infrastructures. thus, technical skills and affinities varied greatly among the participants. the same was true of individual personal networks, financial resources and mobility (meaning both physical fitness and cognitive abilities). each participant received a tablet pc with the “space of exchange” application on it. during the first few weeks, the participants only had access to this space. this was important because many of the elderly participants had never used any smart technology before. over the course of the field test, the tablet was “unlocked”, and all the other functions of the tablet became accessible. during the field test, training was offered in cooperation with the local community college that provided us facilities. other courses took place at furtwangen university (see figure 2). to this end, we received support from a group of volunteers who acted together with the researchers as instructors and as technical contact persons. furthermore, feedback on the technological and substantial aspects of the platform was collected constantly and the platform was improved incrementally. the analysis of impacts on social participation by use of the “space of exchange” included group discussions, observations and one-on-one interviews during the field test. group discussions were conducted in the middle and at the end of the field test to gather information on essential problems and to learn about the benefits of the “space of exchange”. observations were done during the training sessions. here we collected data on individual usage schemes and group dynamics. the interviews at this point of the study were problem-centered (cf. witzel and reiter 2012) and focused the handling of both tablet pc and platform as well as the changes in everyday life. subsequent to each interview a protocol which included a self-reflective review was recorded. the researchers regularly discussed these notes concerning possible influences e.g. the setting of the interview or differences of observed gender-specific answers. only minor factors became apparent, e.g. one researcher feeling uncomfortable in a house as to a very strong smell or the fact that female participants were more likely to talk to a female researcher about their feeling of independence from their husbands. in general, we came to the conclusion that figure 2: schooling session at furtwangen university biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 170 compared to the “bias” owing to the lack of participants of minority groups, as we were not able to recruit e.g. immigrants or disabled persons, this probably only caused insignificant influences. however, our project seems to stimulate communitization effects based on social and not only technological mechanisms. in fact, the meetings, the training and the group discussions already stimulate social participation. this is what we described elsewhere as ‘paradox of intervention’ (biniok, menke and selke fc.). in our view this is characteristic for public research and shows that along with technological solutions comes social structuration. without the specificity of the project – the virtual platform on a tablet pc – this structuration would not have occurred. there is strong interdependence between socializing and technization. insofar the study itself can be regarded as part of a dynamic process, which is followed up and will be analyzed. results: participation space – emergence, extension and engagement in accordance with the diversity of the participants’ personal backgrounds, the motives for participation in the research project and especially the field test were very heterogeneous. they varied from simple curiosity to the urge to combat a long-standing feeling of exclusion from new technologies. “nowadays it is almost impossible to get any information without access to the world wide web. even printed papers refer to this or that homepage” (luise, 82 years old).8 others took part in order to acquire new knowledge or to bring themselves up to date. and some who were already well versed in ic technologies regarded their participation as a possibility to engage socially and help others improve their knowledge. “i simply like to help others. and it’s also interesting to watch the different ways in which people find a solution to a problem” (gerhard, 76 years old). biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 171 171 as mentioned above, one idea behind the study was that territorial space in the perception of the participants would be extended through the use of communication technologies. virtual space would then be added to the physical space in which activities are performed. this growth of the interactivity radius might take place on an individual and/or a collective level. in our view, the interactivity radius refers to the physical, virtual and cognitive movements of individuals that enable them to participate in social life. the results of the study reveal that the implementation of new technologies (i.e. the tablet pc and the “space of exchange”) led to changes in the virtual space and consequently to changes in real life with regard to the social participation of the elderly. three typical developments related to the change in the participation space could be observed: the emergence of a new participation space, the extension of the established participation space and engagement in an existing participation space. emergence of a new participation space the most impressive changes observed in our research project occurred when someone who had none or almost no previous experience with computers became an active and excited user. several participants lost their fear of the new technology and became so skilled that they were able to help others. they even infected the group with their enthusiasm. “things that used to scare me are fun now. i’m getting addicted. […] my neighbor was totally frustrated after the first month and wanted to quit. but i was able to convince her to stay” (maria, 72 years old). the use of technological devices changed the structure and issues of everyday life. “it [the tablet pc] is always here on the dining-room table. the first thing i do in the morning is check the weather” (agathe, 71 years old). participants began to use the tablet pc with great regularity; for example, emails were checked several times a day. applications that were previously of no interest attained a central role in daily routines. “until recently, i thought i didn’t need the internet. now the first thing i do when i come home is check whether there is a new message” (elena, 68 years old). for these participants who had “discovered” the internet for the first time in their lives, a new space emerged with new possibilities of action. however, most of them did not perceive the internet as a (virtual) space. they regarded the internet as more of a book, a boundless encyclopedia. the internet, like the tablet pc and platform, was nothing more than an additional tool to help the participants stay informed about daily life and to fill gaps in their knowledge. although there were frequent challenges to deal with (e.g. technical understanding, the english language and the lifelong imprint of gender roles), in most cases the participants found creative solutions. for instance, a 74-year-old participant who lived in an isolated homestead with no internet access due to the mountains solved this problem by writing emails offline and then cruising around with the tablet pc in her car until she heard the sound that indicates that the emails have been sent. “you can also get free wi-fi at furtwangen city hall. i have arranged for access. but then you have to sit on a park bench in the marketplace – only a good-weather option.” not only did technopractices change, but self-esteem increased as well. elderly participants were praised and supported by family members and friends when they engaged in learning and using ict. the participants identified several aspects that made these achievements possible. for one thing, regular training was crucial. in addition, learning in same-aged groups in biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 172 an informal atmosphere was perceived as stimulating. going to a class at a university was also regarded as very special: “it’s just great to say: i’m going back to university” (gabriele, 83 years old). mutual assistance was a further aspect of low-threshold education of the elderly. meeting outside project events, trying out the platform and advising one another were welcome chances to exchange knowledge. the children (and younger generations) were often not even asked for help, as they were perceived as being too impatient and rushing through the instruction manual. regular use of the tablet pc and the conversations about its usage contributed to the knowledge acquisition of the elderly participants – or, in other words, to the accumulation of individual ‘capital’. more important was its effect at the structural level: new participation space emerged in addition to the activity and participation space previously accessible by physical movement. new forms of communication and meetings in real life created new opportunities for interaction. “i knew one of them [a participant] from our schooldays, but we lost sight of each other. now we’ve gone on a city trip to dresden together” (marita, 76 years old). some people who did not previously know each other socialized and stayed in touch. “i met mrs. mueller in class, and i knew she always went to the spanish conversation regulars’ table. i didn’t dare to go there alone, but now we go together” (christa, 67 years old). others used video-phone programs to get in contact with family or friends abroad or with the younger generation. participants’ grandchildren often expressed pride in their grandparents’ ability to communicate via an instant messenger program. furthermore, female participants reported that they were envied by their neighbors and that they had accomplished personal development through participation, especially a feeling of independence from their husbands: “now i have my own computer, and i don’t need to ask my husband to look something up” was a typical statement. in this way, the technology even contributed to a kind of emancipation or empowerment. this new participation space for elderly people emerged through a modified technoscape and increases in quantity and quality. new devices, new applications and new skills were the basis for new opportunity structures. the technology is adapted to daily routine and regularly used. with this enhancement of self-determination, even the quality of life of the elderly participants may have been improved. furthermore, it was observed that the increase in the participation space was particularly noticeable in individuals whose participation space had been reduced in the recent past, e.g. widows who had spent several years caring for their husbands or people who had moved and thereby lost their social network. in the process of the emergence of participation space the technology turns out as a strong social junction. extension of established participation space another group of participants described changes in day-to-day life that were not as striking as in the former case. the modification of the participation space through the use of new communication technology in this case led to a growth and intensification of social contacts and interactions. these participants often had prior experience with ic technologies, with pcs or laptops from leisure activities or with pcs in former job constellations. for them, the obstacles to using the new technology were definitely less daunting. consequently, the change in their use of technology for communication was less dramatic and sometimes not even realized when asked. it was generally reported that activities such as writing emails that used to be done with a pc were now done on the tablet. some used the tablet as a second tv. in addition, the participants were enthusiastic about the new technology. the advantages of the tablet pc they mentioned included: biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 173 173 it is always operational, it works quickly, it has a handy size and it can be taken everywhere. “i love it! i regularly check emails to see if anyone has written. it is much more fun than i had expected” (franziska, 76 years old). nevertheless, the impact on their social life was notable. instead of an emergence of new participation space, here the extension of existing participation space occurred. with regard to changes in social relationships, many of the participants reported that they already knew the majority of the other participants by sight or from local activities in clubs and associations. their circle of friends and acquaintances did not expand as quickly or distinctly as in the group described above. however, social contacts became closer; people who lived in the same neighborhood started to carpool to the classes and changed the form of address from using the formal “sie” to the informal “du”. people who had previously been strangers or had known each other only by name became integrated into closer social circles. as in the case of the emergence of participation space, various people supported the use of the new technology: neighbors, family members and other participants of the field test. three women who had already known each other established a regular meeting for coffee and practicing together. in other cases, close neighbors met sporadically to support one another in using the platform. the intergenerational exchange within families was also intensified, especially via chat and video chat with family members living abroad. one popular function of these applications was the transfer of photos. “my daughter lives in france. she is so enthusiastic when i send her a picture. the communication is more direct. and i get an answer immediately” (sybille, 77 years old). all in all, with the use of the sonia communication platform, the participation space definitely extended. notably, the qualitative level of communication and interaction changed rather than the pure quantity. conversations and relationships deepened and grew more varied in their thematic orientation. interestingly, in some cases, the distinctions between milieus or origins no longer played a role. in this case the technology has to be considered a medium social junction, as modifications of the technoscape as well as of the participation space are caused to some extent also by social processes. engagement in existing participation space a third group exhibited only slight changes with regard to the use of technology and social relationships. these individuals were either already “it-experts” or were “resistant” towards new technological options. whereas most of the participants intended to learn something new and also to make new acquaintances, the “experts” regarded themselves as voluntary supporters of the project and ascribed themselves a different role. the interest of the experts lay in the potentials of new technologies in comparison to known ones. like many other participants, they already had a broad circle of friends, were involved in several clubs and societies and saw no necessity to establish new contacts. “actually, i don’t really need this. i’m a very active person, i have several hobbies” (paul, 70 years old). nevertheless, this group’s social interaction patterns changed during the course of the project. due to their willingness to support our research and to act as authorities in cases of technical or other problems with the platform, they often came into contact with other participants. although they were consulted quite frequently even in their spare time by other elderly participants, these interactions were seen as professional rather than personal. “i have biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 174 already made at least five home visits” (helene, 75 years old).9 this engagement of volunteers in existing participation space stabilized their own social relationships and those of other elderly participants using the new technology. the “resistance” of other advanced users resulted, for instance, from difficulties using the new technology. they generally preferred tools and techniques they had already used before (i.e. writing emails with a pc with a keyboard instead of using the tablet’s touchscreen, as they made too many typos). “when you are used to a keyboard, data entry with a touchscreen is very exhausting” (franz, 68 years old). in addition, specific advantages of the platform were not recognized. communication styles did not change, and applications beyond the internet chat function were of no interest. the only advantage was the opportunity to look for information on the world wide web very quickly. with regard to the use of technology, here only marginal changes in social participation could be observed. the tablet pc and platform were regarded as one technology amongst many others and served few specific needs. however, with regard to the participation space, the project had an impact on this group’s social life. for one thing, technology and research became the subject of conversation during accidental encounters at the market or at the doctor’s office. in addition, the engagement itself facilitated social participation for the “experts” and “resistors” as well as for the other elderly participants. technology is then a weak social junction taking effect only in combination with social processes. conclusions in this section, first conclusions of our study are drawn and further questions are discussed. it has shown that ict may have the function of a social junction. in this perspective, devices and artifacts have more than a merely technical function. clearly, they digitize, processes and distribute information, but more importantly, they also possess the ability to have a positive effect on social life. as part of the ‘seamless web’ of humans and technology, devices and artifacts act as junctions, mediators and links (hughes 1986; latour 1998; esposito 1993). they bring people together, facilitating new and strengthening existing opportunities for interaction and social life. however, some open questions remain. challenges and further questions although individual competencies and the know-how of elderly participants increased, one epistemic challenge remains: for the elderly, the internet remains a “black-box”. it is a useful tool, but it is uncertain how it works. this could present a problem when the interconnectedness, synchronization and autonomous actions of devices lead to unexpected effects and interruptions. in such moments, the elderly often are unable to cope with the technologies. there should be ageappropriate learning centers and education schemes that target the issue of understanding the function of the internet, the world wide web and the like. here, regional government and education providers are responsible for their citizens and will have to create the corresponding structures. this points to the challenge of sustainability of an interventional study. research projects always have a limited duration and here the question arises how the initiated processes can be stabilized and continued after the end of the project. on the one hand, we tried to delegate biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 175 175 responsibilities to the group of the participants. meanwhile they run training courses themselves twice a month. furthermore they are interested in common leisure activities and organized for instance a summer party on their own. on the other hand, we aim on deepening the cooperation with the local community college and try to acquire public funding for an extension of the present training and schooling courses. apart from these goals to foster the success of our study, two observations suggest further lines of research. first, several female participants reported that their participation in the sonia project had encouraged them to make use of new technology and that they had lost their fear of making mistakes. with their own pc in hand, they became independent from their husbands, and some even felt that they had gained the upper hand with regard to it knowledge. further research is required to determine whether new technologies can provide support for emancipation, in what way and to what extent. second, most of the participants reported that their families were enthusiastic about their participation in the project. several received accessories for the tablet pc (e.g. a cover or a rack) as christmas gifts from their children. in particular, the contact between grandparents and grandchildren seemed to benefit from the project. however, some of the participants have not yet dared to tell their family members that they took part, planning instead to surprise them when they feel confident in the use of the new technology. subsequent research could cover the issue of the promotion of intergenerational exchange through new ict. finally, there is also a methodological challenge. as participation in the sonia project was voluntary, a predictable bias must be considered. the people who participated were already interested in sociability and were willing to learn something new and to cope with all kinds of challenges. but how can we reach elderly people who live in very isolated situations and/or did not participate for physical or other reasons? in fact, we spoke to a number of such people, but they did neither engage in our project nor the field test. however, the individuals who took part noted that they felt more prepared for future health restrictions or mobility impairments. in this way, the study also shows a preventive effect. summary: ict as a social junction successfully implemented new technologies as “social junctions” can have a positive impact on the participation space of elderly people. if the elderly had no or little ict experience, now use such technologies regularly, and benefit from new skills and new forms of communication after the implementation we speak of a strong social junction (type 1). participation space emerges and increases due to technology use in quantity and quality. if senior citizens had some ict experience before, now use these technologies more often, and the established participation space extends we speak of a medium social junction (type 2). the new skills and new forms of communication are effects of the technology use, but coupled with effects of socializing. if the elderly had high ict experience before and there is no significant change in the use of the technologies, we speak of a weak social junctions (type 3). the existing participation space is fostered less by technology usage, but by effects of supporting others in using these technologies and the development of new skills. however, the use of new technologies does not automatically lead to a growth in participation space. the corresponding modifications of the technoscape that occur on different levels must be initiated. people shape the technoscape, and they are able to construct new biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 176 sociotechnical landscapes. these construction activities correlate and depend upon existing cultural patterns of technology. first of all, in our study, elderly people were able to acquire new knowledge and competences. in the best case, information and communication technologies became part of their daily routines. the elderly participants were ready and able to master the use of new ict. moreover, tablet pcs are suitable technologies for inexperienced users to enter the realm of modern devices and the internet (cf. köbler et al. 2011). a crucial aspect in encouraging the use of new technologies is a noticeable benefit from that usage. here, applications for communication were of special interest. dealing with ict had specific impacts on interaction patterns – initially, without regional community-building. family members or friends abroad became accessible or easier to contact. on that individual level, it is important to provide low-threshold learning strategies, regular training courses and comprehensive support. such cognitive modifications are one aspect of a future technoscape. second, community life was stimulated. at the group level, processes of communitization led to new, renewed or intensified actions and interactions in real life. regional activities were fostered by local roots. here, it is important to have or to provide real places that can be easily reached where the elderly can meet, and to integrate local providers of it services, educational institutions and the like. this relates to the question whether the elderly are regarded as a relevant group of the society, and not only seen as consumers. the implied modifications of the technoscape concern local and regional structures. third, the use of technologies may lead to further modifications of the technoscape, e.g. buying wi-fi access or a smartphone. this points to the need for technological infrastructures – a precondition for enabling people to participate in “virtual life” and only one aspect of the ‘digital divide’. especially in rural regions, the lack of infrastructure is an established fact, and the technoscape needs to be improved in its trans-local configuration. all in all, the results of our study demonstrate that the implementation and use of modern information and communication technologies lead to new technopractices and a modified technoscape. this, in turn, can enable elderly people to increase their participation in social life. the inclusion of new technologies in day-to-day practices contributes to the sedimentation of global cultural patterns in local milieus and the modification of the daily routines of individuals. this can have positive effects, as we have seen. however, it also entails challenges that senior citizens should not face alone. in this respect, technology should always be examined with regard to its effects on social life. moreover, the use of technology should be connected to supporting social structures. only then can technologies improve the quality of life as “social junctions.” notes 1.this project (www.verbundprojekt-sonia.de) is funded by the ministry of labor and social affairs, families, women and senior citizens of the federal state baden-wuerttemberg, germany. we thank our project partners at furtwangen university, the fraunhofer institute for industrial engineering (iao) and the fraunhofer institute for systems and innovation research (isi) at the university hospital tübingen, as well as our collaborators at the company “entwicklungszentrum gut altwerden” and the foundation “paul wilhelm von keppler”, for their efficient cooperation and inspiring www.verbundprojekt-sonia.de biniok & menke | societal participation of the elderly anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.102 http://anthro-age.pitt.edu 177 177 discussions. furthermore we are indebted to both of the reviewers, who gave us thoughtful feedback. lastly we are grateful to claire bacher assisting us during the translation of our manuscript. 2. for the case of scientific fields, see the volume edited by merz and sormani (fc.). 3. our use of the term “space” is cognizant of the discussion about the differences and relationships between “space” and “place”. our focus here is on social participation and its relationship to the usage of technology. 4. excerpts from the german-language texts have been translated by the authors. 5. we thank our project partners at furtwangen university, the fraunhofer institute for industrial engineering (iao) and the fraunhofer institute for systems and innovation research (isi) at the university hospital tübingen, as well as our collaborators at the company “entwicklungszentrum gut altwerden” and the foundation “paul wilhelm von keppler”, for their efficient cooperation and inspiring discussions. 6. the underlying technology was developed by the company nubedian (karlsruhe, germany). we thank our project partners from furtwangen university for the extensive modification, adaption and improvement of the sonia platform. 7. translation of the local dialect: “wa isch los im schtädtli?” = what’s going on in town?; “wunderfitz hät d nase gschpitzt” = to be curious about something; “am schwarze brätt” = on the bulletin board; “schwätze” = schmoozing. 8. names and age of participants have been changed for reasons of anonymity. 9. here, the participant used the german word hausbesuch, which is normally used for a home consultation with a medical doctor. references askonas, peter and angus stewart, eds. 2000 social inclusion. possibilities and tensions. new york, n.y.: st. martin's press. baumgartner, katrin, franz kolland, and anna wanka 2013 altern im ländlichen raum. entwicklungsmöglichkeiten und teilhabepotentiale. kohlhammer. becks, thomas, johannes dehm, and eberhardt, birgid 2007 ambient assisted living. neue „intelligente“ assistenzsysteme für 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whom they have cared. yet in three villages in northern benin and northern togo, this intergenerational norm seems to be breached, with older adults living alone and in poverty. however, standardized surveys from a comparative research project established that kin groups do not abandon their older adults, if one considers the kin group to be containing classificatory children instead of the nuclear family with biological children and remittances to substitute for daily care. this article argues that the apparent contradictions between the intergenerational contract and the actual practices of providing care in old age are not so stark. the creative living arrangements of older adults in response to social changes of migration do not challenge the intergenerational contract, but instead are the ways of fulfilling it. the analytical concept of age-inscription (see alber and coe in this issue) helps to explain the gap between discursive norms and individual creative solutions of senior care. the social norm of the intergenerational contract persists through new age-inscriptions. keywords: west africa, elder care, migration, housing, intergenerational support anthropology & aging, vol 39, no 1 (2018), pp. 33-47 issn 2374-2267 (online) doi 10.5195/aa.2018.174 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 33 complexities of elder livelihoods changing age-inscriptions and stable norms in three villages in rural west africa tabea häberlein university of bayreuth author contact: tabea.haeberlein@uni-bayreuth.de introduction when kiyakou-kouroumou is hungry, she goes out for a walk. normally she gets a meal from her daughter or granddaughter who live in the neighborhood. but sometimes they are busy in the market or the fields and nobody comes by to bring her something to eat. kiyakou-kouroumou is about 80 years old; her brother adjanda who is living in the same compound is two years younger. while kiyakou-kouroumou goes for a walk “greeting” the neighbors nearby or visiting her deceased husband’s relatives about two miles away and receives a meal, her brother adjanda stays at home and prepares his own meal. when being asked, they insist being well provided by their offspring. (observations from the village of asséré, northern togo, 2007–2013) this vignette from my field notes among the kabre of northern togo about two aging siblings, who share a compound and yet live in an environment that exposes them to occasional neglect, seems to signal a breakdown of the intergenerational contract, in which adult children are expected to live with and care for their parents (see also foner 1993; roth 2008). the importance of sustaining the intergenerational contract in the village context cannot be underestimated, given that a formal social security system does not exist in this region. while entering the field at the first time in 2006, i asked myself: how can it be, that older adults live alone under such seemingly difficult circumstances while insisting they are well provided? children do not always live in the same compound as their aging parents and sometimes are permanently absent due to migration. like the two siblings in the vignette above, some older people who lived independently seemed at first glance not to be adequately provided for, and yet they said that they were. in west african societies, the social norm of senior care would generally be seen as fulfilled if older adults resided with their children and were provided with sufficient and personal care (as it is described for the ghanaian case by apt 1992; 1995). the unwritten normative expectation of “reciprocity over a lifetime” (groger & kunkel 1995; hollstein 2005; apt 1992, 206) between children and their parents means that after being raised by your parents you have to care for them when they become old and needy. this norm i call the intergenerational contract. the social practice, which i observed during my research, however, caters to a variety of creative individual solutions to senior care, housing, and social relations, with a resident kin member in the neighborhood substituting for migrant and absent children. in other societies in the world, this intergenerational contract shows many variations and discrepancies: grandparents who care for their grandchildren with or without the financial support of the migrant biological parents (leinaweaver 2010), and older people staying in nursing homes (thelen 2015), living together with their siblings (häberlein 2016, 190ff), or staying at home by themselves (bertram 2000). some older adults are financially stable owing to häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 34 the monthly pensions they draw and can live in self-determined ways (see gambold this issue). i would argue that there is a consistent contradiction between a prevalent norm—such as the intergenerational contract—and the diverse practices concerning living conditions in old age. this contradiction applies in particular to african societies, where the image of the wise, respected old person sitting in the shade of the tree surrounded by younger relatives is still powerful. the article answers first the empirical question of how older adults are provided for despite social transformations in housing patterns and migration. carefully observed and collected data from a larger pool of older adults in three villages in rural west africa show that despite appearances of looming destitution, older adults are nevertheless supported—albeit under terms and conditions different than adult children caring for them on a daily basis. secondly, this article asks on a theoretical level, how one can understand the contradiction that people are insisting that they are well provided for under the terms of the intergenerational contract, while social practice tells a different story. as cati coe and erdmute alber observe, interfacing between social norms and accepted social practice are so-called “inscriptions”, or evolving patterns of social practice that tide people over during difficult times, sometimes discussed, but at other times implicit or tentative, so that they either disappear after the condition no longer persists or they become social norms (see alber and coe this issue). as alber and coe indicate, “the somewhat unformulated, experimental, and tentative practices around aging which we call inscription signals the lack of stability of this stage in the life course” (2018, 10). this article uses the analytical lens of “age-inscription” to understand how the seemingly destabilizing factors of migration and changing housing patterns influence the everyday life of older people. the two ageinscriptions that are significant in this situation are: migrants’ remittances being considered a form of care and kin other than the adult children being considered classificatory children who can substitute for the adult children. these two age-inscriptions explained the living conditions of older people in three ethnographic fieldsites in northern togo and benin and why, at a discursive level, they did not complain about a sense of abandonment. at the normative level, the intergenerational contract was accepted and considered to be maintained, while at the level of practice, the basic needs of some older adults were unmet, but most of them do not live in need, even if it might have initially seemed so. van der geest argues that favorable care for older adults depends firstly if they could manage to build a house, and secondly if they could provide care for their children when those were young (2003, 12). i argue that the issue of older livelihoods and care is more complex than this. i found very concrete influences of social change, independent of the accomplishments and behavior of individual older adults, resulting in creative solutions to sustain older adults. my central argument is that the intergenerational contract in society is still binding, despite new housing and migration patterns. senior care in african societies has become more challenging, since migration from villages to other places is important for the younger age groups. this migration is not only temporary,i but can span longer periods of time away from parental home. housing concerns and migration processes deeply affect older people on a daily basis. i argue that the age-inscriptions of remittances-as-care and classificatory children help to maintain the credibility and integrity of the intergenerational contract in the majority of cases. the first section of this article delves into different social structures that shaped the residential patterns in all three villages under investigation. this is necessary in order to understand the ways in which häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 35 the life course and the aging process are determined by a complex interplay between distinctive social structure and other factors, such as natural environment, agricultural use of land, and population density, that all in all result in distinct housing patterns. i also show how those conditions generate new or modified age-inscriptions. the second section delineates the different migration patterns in the three villages. the impact of migration varies, depending on migration patterns, which determine not only the migration demographics but also the configuration of the remaining population and the modalities of circulation of goods and persons. the interplay of absence and presence as a result of the prevailing migratory patterns generate specific age-inscriptions, according to which various modalities of aging are practiced, accepted and acknowledged. the third section presents recent data about older people’s material supply, as a way to illustrate the positions that open up for older adults in daily exchange relations. some of those detected patterns of livelihoods which contrast with the norms can hint at age-inscriptions that calibrate care obligations with the circumstances of the contemporary period, instead of insisting on compliance with timehonored arrangements. methods and the context of the elderly people in rural west africa since i began my studies on senior care in west africa in 2006, i heard older people complaining frequently about illness and physical infirmity in aging. but no one ever complained about his or her own children. of course, there is shame in doing so, as well as a vicious circle of conflict and social pressure. accusing the younger generation means potentially cursing them—and doing so, becoming a witch or a sorcerer. being accused as a witch or sorcerer in old age would decrease the younger generation’s care, not in terms of the essentials of food, but in terms of visits from neighbors and gifts of clothes. i recognized the older person’s concern about the status of his or her social relations. however, it is also shameful for the younger generation to abandon the aging and needy. nevertheless, over the course of a decade of field research with older people, i did see older adults abandoned and hungry, albeit rarely.ii the data presented in this article derives from a larger research project, driven by intense team work. because of respect for the head of the project and my collaborators in the field, i speak of “we” when i discuss the research process. in the analysis of the data, i use “i” to mark my own interpretations. in the larger research project,iii we explored how senior care in three villages in the hinterland of west africa is embedded in general flows and exchanges of resources among kin. in order to better understand the “real” position of older people and senior care provided in rural west africa, we asked people in three villages in benin and togo over the course of one year about their resource exchanges on a bi-weekly basis using a complex questionnaire that included questions such as: what did they receive and earn during the last two weeks, and what did they give to whom? this research design investigated how people interacted with each other through everyday exchanges of goods, money, food and care. we asked people about “care actions” towards their spouses, siblings, and children as well as towards older adults. this standardized research was accompanied by intense qualitative methods that included participant observation and interviews to gain in-depth knowledge about the three villages and their inhabitants. over the course of one year, 2009-2010, we observed and asked a total of 81 persons of different ages and genders in these villages about their daily income and expenditure, provision, and care. all research participants were adults whom we knew personally. among the 81 persons, i focus mainly on the 33 older adults of the sample for this article.iv the three villages we focused on for our study are located in the republic of benin (tebo and häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 36 tchitchakou) and togo (asséré). they are relatively small (tebo has 800 people, tchitchakou has 500, and asséré has 600) and represent different ethnic groups. asséré, in northeastern togo, is a mountainous village that can be reached by car only in the dry season, as the access road is flooded by rainwater in the rainy season. the village is located in the lama (kabre) area near the border with benin. the dispersed settlement of predominantly single farmyards is built on stony soil (see häberlein 2016). however, the area is quite densely populated and used relatively intensively for agricultural purposes. the village of tchitchakou, also a dispersed settlement of farmyards of different sizes, is situated about 12 miles east of asséré in northwestern benin, but as it is built on sandy lowlands, it can be reached throughout the year. the inhabitants identify themselves ethnically as lokpa. they acknowledge kinship to the kabre and conduct coming-of-age ceremonies in a similar way. marriage between the two ethnic groups is common. asséré (togo) and tchitchakou (benin) have a comparatively long history of migration to more fertile rural regions in southern togo and northern ghana respectively. the third village of our sample, tebo, is located another 124 miles east of tchitchakou in northeastern benin, near the border with nigeria. tebo is situated in the area of the baatombu people, an ethnic group structured much more hierarchically than the kabre or lokpa (see alber 2000). in 2009-2010, it was a remote village that could hardly be reached by car. land for cultivation is still available in the surrounding bushlands, enabling shifting cultivation. because the borgu area of benin is less populated and the soil is of richer quality than in the other two villages, tebo has a lower rate of external migration. aside from those differences, the three groups are similar in their livelihood. in all three villages, the inhabitants depend on subsistence farming, cash crops (formerly cotton, nowadays soya), and animal husbandry (poultry, goats and sheep, and a few cattle). albeit to a different extent, all three villages are affected by an increase in the rate of temporary migration among the youth to nigeria and urban centers in west africa. combining data from participant observation, survey and questionnaire responses, and interviews, i will explore the issue of care to older adults in kin-based rural societies in order to bridge the gap between discursive answers and practical solutions of senior care. i argue that all recognized contributions from and to older adults in the presented research are influenced by housing patterns and migration. in the last section, the livelihoods of older adults will be presented to explain to what extent their lives mirrored the social norms despite the local age-inscriptions developed by housing patterns and migratory movements. social structure and housing norms the most characteristic feature distinguishing the villages outlined here is the different forms of settlement, that is, housing patterns, that are deeply interconnected with normative conceptions of village social structure. in asséré and tchitchakou, dispersed settlements of different sizes testify to societies organized by age-class systems. in contrast, the village of tebo is characterized by large closely built compounds. the societal organization here is based on complex hierarchical distinctions. habitat and housing have an impact on the daily life and care provision of older people. here, i describe the influence of those societal housing norms on young as well as older adults to highlight the ways in which different daily routines are bound to social norms and age-inscriptions. the age-class societies in asséré and tchitchakou create dispersed settlements, as men show their capacity to be an adult by building a separate dwelling. in contrast, social stratification among the häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 37 baatombu in tebo demonstrates criteria other than age, especially owing to the prevalence of hierarchies among the royalty and other local stakeholders, and therefore allegiance (alber 2000). in asséré and tchitchakou, unmarried youth have relatively greater personal freedom in deciding to provide care and assistance to their parents, given their acknowledged need to migrate to fend for themselves. yet, living with their fathers also provides them with economic freedom. a part of “becoming adult” by initiation and by marriage is fulfilling the duties of a responsible family member and sharing money, goods, and in the caretaking of their aging parents. youth in tebo, in contrast, experience greater restrictions, and are required to provide care (and even are a source of livelihood) for their aging parents. following marriage, they gain more economic control. a second factor shaping adulthood, especially among young men in asséré or tchitchakou, is the expectation to create their own homesteads, as a way to confirm their adulthood. the social significance of owning a homestead is immense. even if the property is quite small in the beginning, higher status is generated through property ownership, economic wealth, and social independence. if men do not leave the village permanently, they build their own homestead for their wife or wives and children, sometimes not far away from their homestead of origin. these kinds of social structures’ expression in housing affect older people’s lives as well. as a result, an age-inscription emerges in which older parents live by themselves in the “parental homestead,” often an old building falling into a state of gradual disrepair. as verdier (1982, 100) notes for the kabre area, it is a social norm for the youngest son to inherit the father’s homestead. this does not exist in asséré and tchitchakou any longer. when regional migration to other rural areas became more popular for the youth of these areas in the 1960s (alber and häberlein 2011), this social norm was rendered moot. today, what was once an age-inscription already appears to be a norm: the youngest is no longer under that obligation and is now free to decide if he wants to accept this inheritance. it is the prerogative of a son (or a grandson) and his wife to accept, or not accept, the old homestead (including the care obligations for the older persons living in it) as inheritance—and sometimes nobody has the requisite capacities or the desire to do so. that means that older persons are sometimes forced to live alone. in contrast, homesteads are closer together in tebo. young men create their own “foyer,” a common reference to new buildings constructed for the young family directly adjacent to their fathers’. as a result, in tebo, young and old people live together in huge compounds. these different structures—dispersed settlements or agglomerations of buildings inhabited by relatives of different ages—shape the daily care provision offered to older persons.v older persons are provided for in different ways, but also bounded in different ways by social norms of mobility, cooking restrictions, or other kin-related duties (by substituting for migrant adjacent kin). as a result, it is possible for older people in the villages of asséré and tchitchakou to live alone. this, however, does not necessarily imply lack of adequate care such as the provision of a warm meal, access to fresh water for drinking, bathing, laundry, etc. on the other hand, huge compounds, with older people surrounded by younger relatives, like in the village of tebo, do not automatically guarantee care. neglect is possible even in the midst of kin. in all cases, the housing norms contribute to shaping different age-inscriptions: older people in tebo are mostly surrounded by younger relatives, such as their biological or foster children and grandchildren. in contrast, older people of asséré and tchitchakou sometimes live alone, but are not neglected. in all three villages, even in cases when children are not living near their parents, other relatives are. those relatives are not only adult children but include also classificatory children. in biological terms, häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 38 they are nieces or nephews, daughters or sons-in-law, grandchildren or fostered children. furthermore, the age-inscription is gender-related as a result of the housing patterns. in tchitchakou and asséré, older women circulate within their neighborhoods, while older men mostly rest at home and receive visits from others. this symbolizes men’s social status.vi such behavioral norms are reflected in the availability of daily food provision, especially in asséré and tchitchakou with its dispersed homesteads. as previously stated, an older woman can visit the neighboring relatives “to greet” them when she is hungry at meal time and they will give her something to eat. an older man would wait at home, hoping that someone brings over prepared food, or he has to cook for himself.vii dealing with a daily need in this manner would be impossible in tebo. here, a clear responsibility for and affiliation to a special cooking pot or bin of water means an older woman cannot escape a situation of need through “greeting” the neighbors nor an older man by cooking for himself. older people in tebo generally do not live alone. they can stay at home with the expectation of being provided for properly by their surrounding relatives. in other words, tebo people live up to the ideal of the intergenerational contract because there is less migration and the homesteads are more closely built. to conclude, i see two distinct age-inscriptions affecting how older people are cared for in west africa, both affected by housing and by different social structures. these are older parents living by themselves and older women having an advantage in food provision. the first inscription of older adults living alone was probably a former inscription that went on to become a norm. because of the age-class expectation that men build their own homestead as adults and the influence of migration with temporarily absent youth, the probability of living alone at old age has increased in asséré and tchitchakou over the past few decades. the option of living alone is still undesirable, but not an issue one hears them complain about. the older people interviewed showed a great deal of understanding for their children’s new homesteads. furthermore, living alone in old age does not mean having inadequate resources, as i will show in later sections. the second age-inscription i identified was that older women have an advantage in providing for themselves in asséré and tchitchakou, because of gendered behaviors in old age. social change and processes of migration life in all three villages is shaped by migration processes, to the relatively nearby urban centers or to more fertile agricultural zones. this is a “regional” rather than transnational migration, although, technically, migrants do cross state borders when they move to the neighboring countries of ghana, nigeria, or niger. the data we collected from the villages exemplify how migration has become an accepted step in the life course of rural beninois and togolese. migration patterns affect care and livelihood for older adults in the villages, and how people cope with the reality of migrating relatives without breaching the intergenerational contract. typically, three dominant types of migration shape the norms of appropriate aging. the first case is of family migration. this pattern only exists in tchichakou and asséré and is a consequence of the scarcity of fertile soil near the villages. young families migrate to more fertile rural areas (in the case of asséré, to southern parts of togo since the 1920s, and in the case of tchitchakou, to northern ghana since the 1950s). married couples and their children leave and settle in the new places. they return “home” for ceremonies and invest in better housing or some furniture for their parents. some migrants return annually; some come less regularly. at the very least, they come home to be buried, as nobody wants to be buried among “strangers.” a lively stream of exchange of information, persons, and goods exists between their new häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 39 residence and their home in the villages (piot 1999; häberlein 2016). migrants remit goods to their older relatives “back home” once or twice a year. they receive donations on behalf of the extended family in order to redistribute them to the needy, some of them infirm old persons. a second pattern, individual youth migration, exists in all three villages. this migratory movement of unmarried boys and girls became important during the first decade of the twenty-first century. typically, young men (and more and more women) migrate temporarily to nigeria as farm workers and stay there for one or two years, in order to return home with savings and goods for their own use. young, unmarried women from tchitchakou more often work as housemaids in urban households of benin than in nigeria. meanwhile, some of the kabre girls work as waitresses in benin’s urban bars. youth migrate to earn money to invest in their own futures—as a future taxi driver with his own motorbike, as a future tailor with a sewing machine—or to generate start-up funds for a small business or savings for bridal wealth, particularly their trousseau. the parents in the villages usually dislike the idea of their adolescents migrating. firstly, they move out of their social control. secondly, the families lack labor power on their fields. however, youth migration is honored as an independent decision and a sign of taking responsibility for their own life course. moreover, older adults accept that the goods acquired through migration are not meant for their own personal use (see häberlein 2016; ungruhe 2010 on northern ghana). in all three villages, individual youth migration is considered an investment for the future, but in so doing, they also evade the normative social control of their parents until marriage. in this sense, the temporary migration of youth is creating a new generation inscription. nobody would dare to describe the norm of social control of older people over youth as being obsolete, but emergent practices show that youth in these societies have a certain freedom to move out of the control of their elders. furthermore, it becomes clear that youth of this age are no longer “available” or responsible for providing care, in some instances, even to their grandparents. upon their return after a year or two, the age-inscription for youth migrants changes so that they again accept familial duties. youth migration has changed a normative responsibility for youth to provide care for older adults and re-solidified it for adults past the social stage of youth.viii the third type of migration is an intrafamiliar child migration that takes place in a significant way only in tebo. recently, an increasing number of children from tebo were hosted in the households of their urban relatives for schooling (alber 2018). girls who do not attend school are brought to the households of extended kin as domestic workers and to pursue an apprenticeship in town.ix boys are mainly brought to urban households so they can attend school. in consequence, upon their later entry into the urban labor market, those boys marry and establish new households in the towns. the family members in urban centers of benin remit money to their families in tebo once or twice a year (see alber this issue). somewhat similarly, children in tchitchakou often stay with their grandparents when their parents migrate to ghana so they can continue attending the french-language school system. in this way, age-inscriptions occurred in tchitchakou in which grandchildren act as caregivers for their grandparents. parents from tchitchakou who migrate to ghana regularly check in on their children staying with the grandparents, and thereby also visit their aging parents. alongside these three kinds of migrations, there is a seasonal labor migration in the village of asséré, where youth as well as adults travel to the south of togo as seasonal workers. paid in either corn häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 40 and/or cash, they follow this pattern so they can support their families at home. because the described patterns of migrations are to some extent life-course specific, in every kin group surrounding an old person, some of the children will be migrants either permanently or temporarily. however, not every relative of an older adult is a migrant, as some remain in or have returned to the villages. remittances are not many in number but high in terms of value, which creates a division of the labor between those in the villages and the absent migrants. in all four cases of migration, the responsibility of migrants for the relatives “at home”—and here, explicitly older adults—persist. material flows to these areas where families live remain important. moreover, those flows ensure the social belonging of permanently migrant people to their villages of origin. whereas a substantial part of the financial income of older adults is provided by migrants living elsewhere, food and daily support are provided by neighboring village residents. as i show in the next section, old people in particular, in contrast to the very old, benefit from those bonds to migrants. age-inscriptions and the livelihoods of the elderly when simply asking “who cares for older people?”, whether one asks the aging themselves or their neighbors, the response generally corresponds to a normative pattern. the common answer is: adult children take care of their parents when they become old. this answer confirms the normative presupposition labeled as “reciprocity over a lifetime” (groger and kunkel 1995; hollstein 2005) between children and their parents. we nevertheless recognized that some in the three villages lived alone and far away from their migrant children. in order to get to the bottom of the discrepancy of the normative idea that “children care for their parents when they become old and needy” and the social practice of some older adults living alone in their homesteads, we decided to look at their livelihoods and support. here especially, the results of the standardized research became very useful. even the people themselves were not completely aware of some common patterns shown in the results. caring for older adults in the three villages was not an issue: they were not abandoned by their kin and neighbors; almost all regularly received food and were provided with “the essentials.” in other words, someone fetched water for them, and they received two hot meals a day and some help with household chores. items on this kind of everyday care and provision with the daily meal was not included in our questionnaire. however, i know from observations that this kind of caring for older people is normally performed by different persons in rural compounds. analyses of the questionnaires clearly showed that older adults received much less in the form of material exchanges than children of all ages before marriage, and that the gifts they received decreased as they grew older. the fear of being left alone was, in the majority of cases, not an issue, given the fact that most of them, with few exceptions, mainly in the village of asséré (togo), were, despite the absence of some migrant children, still surrounded by other resident children or relatives. a special feature of our research is the focus on the kinds of social relations in which material transactions took place:x in 2009-2010, 52.9% of all donations were direct intergenerational exchanges (combining parent-child, grandparent-grandchild, and uncle/aunt-niece/nephew relations). counting the intergenerational in-law donations, the proportion increases to 63.1%. most importantly, 35.3% of donations are made within the direct parent-child framework. those numbers mirror our qualitative finding that neighboring relatives define themselves as classificatory children of older adults (such as nieces or nephews, daughters or sons-in-law, grandchildren or fostered children). in this way, all these häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 41 intergenerational donations (63.1%) were meant to support aging relatives, such as parents. in daily exchanges in the neighborhood, older people are provided for by their adult children or other adjacent relatives who substitute for the absent children. within the parent-child relation (35.3%), the distinction between parent-to-child or child-to-parent support is important for understanding the care of older adults. as showed in table 1 below, parents provide young and adult children greater financial support in terms of value and frequency. far less support was given by adult children to their ageing parents.xi this outcome is contradictory to the core ideal of financially supporting older people who are defined as needy. in the age-class societies of asséré and tchitchakou, as well as the hierarchical society of tebo, it is common for those in adulthood and parenthood to expend more on their children than their parents. this duty is depicted in table 1. livelihood given within one year (2009-10); n=81 asséré tchitchakou tebo parents to children frequency 288 368 540 sum [usd] 245.19 1,004.93 743.03 children to parents frequency 174 16 11 sum [usd] 48.71 19.51 33.74 table 1: given livelihood for the parents-children relation table 2.1 illustrates the migration impact on financial and/or material support given to older people. nearly all the income of older adults came from outside the village, which means nearly all income is derived from migrant relatives’ remittances. shown as frequency (table 2.2), the difference clarifies the importance of the rare contact with migrant relatives. the old received outside financial and/or material support on an average of 6.3 times a year. in general, older adults were better supported within the village by more regular but smaller amounts of financial or material support such as gifts of clothes, tobacco, corn, or other items. support of higher value nevertheless come from outside the village. 2.1 all received support summed [usd]; 2009-10 sum [usd]  [usd] older adults (n=33) 2,537.21 76.90 therefrom: support from people outside the village [usd], 2009-10 sum [usd]  [usd] total from outside the village (n=33) 2,290.93 69.40 2.2 all received support shown as frequency, 2009-10 eceived support shown as frequency, 2009-10 frequency  [n] older adults (n=33) 1,312 39.8 therefrom: support from people outside of the village [frequency], 2009-10 frequency  [n] total from outside the village (n=33) 208 6.3 tables 2.1 and 2.2: received support for the older adults during one year (value and frequency, all three villages, n=33) häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 42 in order to contrast these findings with other age groups, table 3 presents a comparison of support between the age groups “adult” and “older adults.” first, table 3 shows that all older people received more in value than the adults. the average amount of support was about 3 usd. nevertheless, the value of what the older adults receive from their relatives is often minimal. what counts more than the value itself is the honor of being remembered by the relatives (cf. van der geest 1997). the adults were, in contrast, at a disadvantage: they only received amounts totaling about 1 usd from their children on average. received support (2009-10) sum [usd] n [donations]  usd-sum adults (n=24) 1,659.43 1,435 1.16 older adults (n=33) 3,377.00 1,205 2.80 total (n=57) 5,036.43 2,640 1.91 table 3: received financial and/or material support: difference adults-elderly during one year (2009-10) this quantified data shows two main points with respect to the debate on the socially precarious circumstances of aging people in rural west africa. first, older people are deeply embedded in constant flows of the give-and-take of goods that connect all age groups. even in asséré, where poverty increased in 2009-2010, adult children did not stop remitting to older adults, in contrast to urban ghana (aboderin 2004), urban burkina faso (roth 2010), or in rural tanzania (van eeuwijk, 2011; 2016). secondly, intergenerational care remains important despite out-migration. out-migration is highly differentiated and also has differentiated impacts on senior care. remittances from migrants to the old help to redistribute earnings through the kin group. for example, financial support is considered both to be forms of senior care and substitutes for this care, which could be the case if the older person is expected to purchase food rather than wait for a family member to cook and serve the food. in this way, redistribution ensures continued support for older adults directly as well as indirectly. some literature on the social position of older people in west africa points to the relevance of powerful elders who controlled all the material and personal resources of their families (aguilar 1998; attané 2007; fafchamps 2001), while others focus on the poor and neglected (de jong et al. 2005; förster 1998; colson 2000). this research supports, at first glance, the neo-marxist gerontocratic argument of older people in africa holding power over wealth and people (gruénais 1985; meillassoux 1983). at second glance, the gerontocratic system of powerful old people is supported through migrant remittances, with the outcome that other needy age groups (like children or very old) are supported by means of societal redistribution. nevertheless, regarding daily supply, older adults receive support from their children or “adjacent substitutes” for their children like nieces or nephews. conclusion social structure, housing, ongoing migration patterns and changing life courses are among the most significant factors that studies on the everyday life of older people must take into consideration. the examples i provided demonstrate not just the prevalence of a multiplicity of age-inscriptions that directly address societal and familial mechanisms for ensuring the livelihood and social security of the elderly people, but they also show that societal inscriptions become discernible only in the act of a multiscalar reading of circumstances. the main finding of our research is that the normativity of the intergenerational häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 43 contract remains the same, and so the intergenerational contract, rather than being erased, is being reconfigured in some novel ways. it also explains how inscriptions are reorganizing practices and dispositions in order to maintain social norms instead of overturning them. for instance, the burden of daily caring for older persons is mainly borne by those who continue to live in the villages, and not necessarily by who is expected to provide care: the immediate kin members. viewed through the lens of housing patterns, in combination with migration, older adults are supported not only by their children. neighbors emerge as significant caregivers who cater to their everyday needs and provide them with food, water, and other essentials. adjacent kin, such as classificatory children living in the same compounds or in the neighborhoods, are the main caregivers who guarantee that the everyday needs of the older adults are met. although the substitution of adult children has occurred as a common strategy in senior care, our qualitative research has shown that the social status of older people in the villages is much higher when sons and daughters live close by rather than are successful far away (see apt 1992, 206). kiyakou-kouroumou, the older sibling from asséré (togo) discussed at the beginning of this article, is a case in point. as a widow with a daughter living nearby, she has better social standing in the village and her daily needs, including food, are met with greater regularity. her childless brother adjanda, who was not able to maintain a good relationship with his foster children living elsewhere, was not as well provided for in his old age. contrary to the structural functionalist assumption that the position of siblings is structurally equivalent (radcliffebrown 1971; thelen, coe, and alber 2013, 3), there are two significant differences between them even though they live in the same paternal compound. first, there is a gender distinction: old men maintain their social status by staying home, while women customarily visit neighbors for a chat and a meal, especially if the visit transpires during meal times. another important difference in this particular instance is that kiyakoukouroumou has a daughter living nearby, while adjanda has no biological children. his foster daughter is a migrant living permanently in the south of togo, and his relationships with his foster daughter, and other younger relatives living nearby, are at best tenuous. further, in many cases the old support younger generations, so that in the course of redistribution, the support they receive will be much higher as well. some of the old have considerable power in their community and need money to fulfill the demands of their position. looking at the material support of older adults elucidates the idea of “wealth in people,” a concept that explains why and how money can be transformed into social capital (ferguson 1992; guyer 1993; 1995; guyer and belinga 1995). the effect of migration underlines this conversion. as shown here, in large part, the remittances to older people come from outside the village (mostly from migrant relatives). in other words, remittances from the migrant community support the gerontocratic system “at home.” taken as a symbol of honor, financial and/or material support, no matter how small of an amount, remains important in old age. remittances are taken as a sign of care by migrants. those findings explain the complex interconnections of housing patterns and migration and their influence on new age-inscriptions that reinforce the social norm of according a high social status to older persons. possibly some of these presented inscriptions may disappear soon (if youth migration becomes less attractive through economic revival at home) or even become a norm (if the demographics of youth abroad expands in the ensuing decades). as a result, being cared for by adjacent kin who substitute for children might become a norm. age-inscriptions concerning remittances, migration and residence, as well as generational inscriptions for old age provision, do not contradict the prevalent social norms. looking at ageinscriptions illuminates creative changes to simultaneously maintain and reconfigure the intergenerational contract. häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 44 acknowledgements kiyakou-kouroumou and adjanda died in 2016. the text is written in memory of these both amazing persons. special thanks are due to the head of the research project, erdmute alber, and to essoham solitoke, awaou waloufey, and issifou abou moumouni, who ensured the continuous investigations in togo and benin, and last but not least to elias thiemer, nina haberland and michelle epps, who supported me in statistical data analysis in bayreuth, germany. thanks to cati coe and erdmute alber for intense and fruitful discussions about this paper and to language editor gita rajan. notes i as temporary migration i subsume for example seasonal working for the harvest, staying abroad for one or two years as casual farm laborer or selling food on the markets in neighboring countries. the aim of those temporary migrants is earning money abroad to return with at home. ii for a single case description of denied companionship because of difficult behavior and hardship in later life, see häberlein (2015). iii the results presented in this article formed part of the findings of the research project “family resource flows and intergenerational relations within families in west africa,” which is kindly supported by the german research foundation, and headed by the chair of social anthropology, erdmute alber at the university of bayreuth in germany. this research project compares intergenerational resource flows that transpire within five to six families from each of the three west african villages of asséré (togo), tchitchakou (benin), and tebo (benin). iv the comparison is based on observations and standardized surveys conducted during the period june 2009 to may 2010. in addition, we also accompanied the selected families for a period of several years and conducted qualitative surveys. in our study, we chose three villages, in which we worked using mostly qualitative research methods for a number of years. since this particular team had been working over the years in the designated communities, rapport and goodwill had already been established. the members of the research team were also generally acquainted with the individuals and families who had been directly chosen to participate in the study. local authorities and the participants of our study were informed about our research interests and proceeding before and while conducting research. v care for ill people is not the main focus of this article (see for this purpose häberlein 2015). vi this observation is just the contrary to younger age groups, such as adults. at that stage, women are staying at home or in the neighborhood, whereas men are those who go out for a walk in the village visiting friends or going to the fields. but when growing old and gaining the status as old man, one should sit down and expect others to come and greet. vii cooking by older widowers is a recent phenomenon in asséré and tchitchakou, and thus represents a new age-inscription as a way to cope with the absence of younger relatives. men in other age groups who might be inclined to cook for themselves are a social rarity. another exception would be young, unmarried male youth preparing small game caught hunting together with their peers outside the homestead. others are men working on the fields preparing some yams for lunchtime, or when men are travelling. viii all differentiation of age groups is done because of social emic meaning. age is in this article, according to local understandings of age, defined socially, not biologically or numerically. ix the social role and the belonging of children in the baatombu case, where kinship fostering is the norm (alber 2003; 2014), differs strongly from the kabre and lokpa cases. while the baatombu transfer more rights and duties for their children to the foster parents when a child lives elsewhere, the kabre and lokpa häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 45 parents remain responsible to ensure care for their offspring, even if the children live permanently with other relatives. x all following figures are resulting data from the above mentioned bi-weekly investigation of material resource flows of 81 people of different ages in three western african villages (asséré/togo, tchitchakou/benin, tebo/benin) over one year (2009-2010). in this article, financial and/or material support is shown as in the currency of usd, whereas in the fieldsites the currency fcfa is used. further, all material support is mentioned in its monetary value and as such integrated into the shown calculations. xi here again, asséré was an exception in terms of given support. much less in value was given in more frequent donations. in 2009–2010, asséré was still affected by the cotton crisis. in benin, the production had already shifted from cotton to soya as cash crop. asséré followed this shift in 2010 as well. the support in 2009 to 2010 mirror the strategy of hardship: confirming social relations with small value donations was quite common in asséré, especially to older people, who are the decision makers in the village. references aboderin, isabella. 2004. “decline in material family support for older people in urban ghana, africa: understanding processes and causes of change.” 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nelson graburn, 87-94. new york: harper and row. roth, claudia. 2008. “‘shameful!’ the inverted intergenerational contract in bobo-dioulassou, burkina faso.” in generations in africa: connections and conflicts, edited by erdmute alber, and sjaak van der geest, and susan reynolds whyte, 47-69. berlin: lit-verlag. roth, claudia. 2010. “les relations intergénérationelles sous pression.” autrepart 53 (1): 110-95. thelen, tatjana. 2015. “care for the elderly, migration, community: explorations from rural romania.” in anthropological perspectives on care. work, kinship and the life-course, edited by erdmute alber, and heike drotbohm, 137-155. basingstoke: palgrave macmillan. häberlein | anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.174 http://anthro-age.pitt.edu 47 thelen, tatjana, and cati coe, and erdmute alber, ed. 2013. the anthropology of sibling relations. new york: palgave macmillan. ungruhe, christian. 2010. “symbols of success: youth, peer pressure and the role of adulthood among juvenile male return migrants in ghana.” childhood 17 (2): 271-259. van der geest, sjaak. 1997. “money and respect: the changing value of old age in rural ghana.” africa 67 (4): 559-534. van der geest, sjaak. 2003. “poverty and the “charm” of old age in ghana: a note on irony.” in agids, faces of poverty: capabilities, mobilization and institutional transformation, proceedings of the international ceres summerschool, 27-44. amsterdam: agids. van eeuwijk, piet. 2011. „altern in unsicherheit. gesundheit und pflege von alten menschen in indonesien und tansania“ in alter: unbekannt, edited by carolin kollewe, and elmar schenkel, 83-111. bielefeld: transcript (sozialtheorie). van eeuwijk, piet. 2016. “elderly providing care for elderly in tanzania: against conventions but accepted.” in ageing in sub-saharan africa. spaces and practices of care, edited by jaco hoffman, and katrien pype, 71-95. bristol: chicago press. verdier, raymond. 1982. le pays kabiyé. cité des dieux cité des hommes. paris: karthala. anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp. 93-94 issn 2374-2267 (online) doi 10.5195/aa.2019.220 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of pannor silver, michelle. retirement and its discontents: why we won’t stop working, even if we can. new york: columbia university press. 2018. pp 296. price: $30,00 (hardcover), $29,99 (e-book). claudia huang california state university, long beach http://www.library.pitt.edu/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ huang | book review | 93 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.220 http://anthro-age.pitt.edu book review review of pannor silver, michelle. retirement and its discontents: why we won’t stop working, even if we can. new york: columbia university press. 2018. pp 296. price: $30,00 (hardcover), $29,99 (e-book). claudia huang california state university, long beach in retirement and its discontents, author michelle pannor silver makes sure to clarify at the outset what the book’s objective is not: it is not meant to capture a comprehensive view of how americans experience retirement in the twenty-first century. therefore, it does not, for example, discuss how people struggle to prepare financially for retirement, nor does it investigate the hardships some retirees may experience as a result of health issues or lack of access to adequate care. instead, retirement and its discontents tackles a single, albeit complex question: “what becomes of those whose departure from their life’s work means losing a core and fundamental component of their personal identity?” (3). silver engages with this question through detailed interviews and clear, grounded analysis that interweaves the interviewees’ life histories with their contemporaneous thoughts on what it feels like to be retired and what it means to be a retiree. the introduction and conclusion provide the background and analysis of this theme respectively. the unique contribution of this book is best reflected in chapters two through six, which are devoted to interviews, and are organized according to the professions that interviewees occupied before they began to identify as retirees. chapter two concerns the experiences of five retired physicians. from allan, the er doctor who explicitly wonders what his value is now that he is retired, to wendy, the family doctor who regrets not having cultivated closer friendships, these interviewees all devoted their lives so thoroughly to their jobs that they profess to feeling like “renegades” for leaving the workforce (23). chapter three gives voice to the experiences of former ceos, mostly from the medicine and health industries, to talk about their transitions from the corner office to slower-paced lives after retirement. like the physicians, these interviewees had made their careers the epicenter of their lives, and now all report feeling listless after retirement. chapter four focuses on elite athletes, who differ from the rest of the interview subjects in that they by and large ‘retired’ in their 20s and 30s. reflecting on the concept of retirement while most of their same-age peers are just beginning their careers, these interviewees report struggling with a loss of direction and a need to adapt to a new reality after leaving their respective careers. chapter five details the struggles of retired professors, who, in their reluctance to leave the campuses and roles that had become intertwined with their identities, continue to do the same work they had always done after their retirement – a phenomenon silver describes as “working in place” (125). chapter six takes an unconventional turn by examining the attitudes of homemakers toward retirement. by highlighting how these former housewives identify as retirees despite never being salaried workers, silver addresses both the “universality and ambiguity of the term ‘retiree’ as a marker of personal identity” (191). huang | book review | 94 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.220 http://anthro-age.pitt.edu the fine-grained texture of the interviews calls attention to the remarkable ways in which people’s idiosyncratic life experiences and family histories reverberate into their outlooks on the future in general, and on aging in particular. as a trained social scientist, silver addresses both differences and similarities as they echo across the groups. for example, she notes in chapter six that, though betty, the homemaker, never had a paid job, she nevertheless felt the same profound sense of de-stabilization and loss when her youngest son left home as the ceos felt when they left the corner office (168). by presenting a wide range of experiences, silver convincingly argues that a one-size-fits-all model of retirement ought to be replaced by more flexible and tailor-made approaches, on both policy and cultural levels. in this sense, this book adds to a conversation that began decades ago, when robert butler promoted the concept of ‘productive aging’ to counter cultural forces that isolated and de-valued retirees and elders (butler 1985). with a greying population rapidly becoming a global phenomenon, many countries around the world are forced to revisit retirement policies that were crafted when life expectancies did not so much exceed the age of retirement from work. silver’s book powerfully reminds of the necessity of “delinking chronological age from work-related norms about productivity” (204). however, scholars advocating for decoupling notions of human value from measures of productivity may find some of silver’s conclusions unsatisfying. she makes the case that tearing people away from their jobs when they reach a pre-ordained age makes for bad policy, since people look to their jobs for fulfillment and direction. it seems at least possible, however, that alternative sources of personal meaning can be cultivated and act as viable solutions to the problem of postretirement anomie. reading the chapters on the retired physicians and ceos, for example, i often found myself wondering whether the clearly expressed dissatisfaction can be more aptly attributed to their own overzealous devotion to their jobs at the expense of other aspects of their lives, rather than to ageist assumptions that pushed them out of the workforce. this book paves the way for such critical discussions on how people internalize social narratives that equate personal worth with job performance, what freedom is left in a neoliberal climate to articulate a meaningful life in retirement without economic productivity and – by extension – where socio-economic, political, and individual responsibilities lie in the quest for meaning in later life. it speaks to the strength of silver’s interview methods and the richness of her data that scholars with different disciplinary perspectives can find food for thought when reading this book. retirement and its discontents is written in clear prose and without jargon. it is a scholarly work, accessible to anyone interested in aging, retirement, and narrative gerontology, but may be especially useful for policy-makers: the book provides human stories to complement quantitative data on the challenges of growing old in the us today. retirees may also find in it a helpful starting point to reflect on their transitions out of the workforce and into a new life stage. i look forward to discussing this book with my undergraduate students, who will undoubtedly have much to say on the link between work and personal identity. i also look forward to sharing these stories with my retired interlocutors in china, whose ambivalence about aging and frustrations with finding meaningful pastimes i saw echoed in the words of many of silver’s interviewees. perhaps hearing similar voices from elders halfway around the world will help them realize that they are far from alone. references butler, robert. 1985. productive aging: enhancing vitality in later life. new york: springer publishing. anthropology & aging quarterly 2013: 34 (3) 100 introduction in a call for greater anthropological study of the body, scheper-hughes and lock (1987) argue for examination of three, interrelated bodily forms: the body-self, the social body, and the body politic. anthropologists of aging can most easily identify our work in the body-self when we study aging as a bodily and social experience that varies across cultural contexts (e.g. sokolovsky 2009). the social body refers to how the physical body is used in many cultures as “good to think with” (scheper-hughes and lock 1987: 18) about the nature of society. for example, drawing from janzen (1981), scheper-hughes and lock explain, “every society possesses a utopian conception of health that can be applied metaphorically from society to the body and vice versa” (scheper-hughes and lock 1987,:20). the body-politic refers to how individual and social bodies (first as representations in discourse a r t i c l e s population aging as the social body in representation and real life alexandra crampton department of anthropology marquette university and then as live subjects) are managed through politics and social control. in this article, i argue that population aging is a social body construct through which modern, bureaucratic societies think about aging body-selves as an aggregate that can be managed and modified through social policies and social service interventions. this thinking happens through policy discourse supported by professional research and practice targeting subsets of social bodies such as children, families, and older adults. while population aging is identified by demographers as indications of successful effort to promote health and longevity (crampton 2009; kinsella and phillips 2005), population aging in policy and other social intervention discourse has characterized growing segments of older cohorts as a socioeconomic problem to solve (achenbaum 1978; gee and gutman 2000; victor, scambler, and bond 2009). the dominant construct of old age in population aging discourse is one of individual loss and decline over abstract this article uses three levels of body analysis as presented by nancy scheperhughes and margaret lock to compare old age as a construct in population aging discourse with research on lived experience of people aging in the united states and ghana. i first describe how demographers construct social bodies as becoming “gray” through population statistics and how policy makers then use dependency ratios to rationalize intervention on behalf of older adults in the body-politic. the construction of old age within this discourse is then compared with ethnographic research that suggests this construct leaves out much of the lived experience familiar to anthropologists of aging. rather than debunk the old age construct, however, the purpose of this article is to argue for study of population aging discourse as constituting a social body reflecting cultural constructions of nature and society. moreover, this representation is made real through policy and social intervention work, and with very real effect on people’s lives. as such, an anthropology of aging bodies can include the social life of old age as a social construct. keywords: anthropology & aging quarterly 2013: 34 (3) 101 alexandra crampton population aging as the social body time as a universal, singular, and inevitable experience. chronological age is used to determine when the boundary into that state of loss is reached. this construct helps explain how populations statistically identified as aging are then characterized as “graying.” the image of a populated social body that is going gray then has been used to link population aging trends to economic crisis both nationally and globally (e.g. peterson 1999).  this representation of aging as a social problem is not only a cultural construction but also one that has been highly productive in shaping everyday lives within the body-politic. constructs are operationalized through policy implementation and social service delivery. for example, andrea campbell (2011) argues that the social security act in the united states helped form the social identity of older adults and helped create the social and political category of the senior citizen. at the same time, my ethnographic research from ghana and the united states conducted in 2003, and 2004-5 suggests that the individuals represented in the social body as aging often do not identify as old and instead actively work to preserve autonomy as a mature adult. the disconnect between aging as constructed in the social body and aging as experienced by body-selves in the body-politic may help explain the responses of those in ghana who argued that aging is “a white man’s problem” in ghana as well as those in the us who were aged sixty and over but did not identify as old and rejected aging services. as this construct is made real through social intervention work, however, it does take on a life of its own, suggesting the need to study its social life as part of and apart from that of aging selves.  the first part of this essay presents numbers and narratives of population aging discourse that form a social body subject to policy and other social intervention in the body-politic. i argue that national and global social bodies are formed through demographic statistics and given meaning through demographic transition and modernization theories. proportionate and absolute numbers of older adults relative to working age adults are used to evaluate whether social bodies are acceptably age balanced or require intervention. dependency ratios become assessments of whether there are enough productive adults to support young and old dependents. a social body that is unacceptably young, growing, shrinking or aging may be nationally or globally constructed as a body at risk to economic health and well-being: too many aging body-selves become a burden and a responsibility. the second part of this essay takes these assumptions as a point of inquiry in ethnographic research. how does the aging body-self as represented in the social construction of population aging compare with lived experience of aging bodies in society? the data used in this section are taken from a sixteen-month ethnographic study from 2004-5 of elder mediation programs piloted by nationally recognized elder advocacy organizations in the united states and ghana (crampton 2007). the finding presented in this paper is that the construct of old as frail and dependent was salient to people but actively avoided in personal experience. even those who identified aging as a social problem located that problem more in others than in one’s own body-self. these aging adults therefore avoided services for old people, while drawing from informal resources as necessary.  the concluding section provides a way to connect study of the social body constructed through population aging statistics with the lived experience of aging body-selves by examining how the representation in the former is made real in the social contexts of the latter. i argue that there is a social life to the dominant construct of old age found in the body-politic that is of ethnographic interest when operationalized through policy implementation and social service delivery. rather than a passive embodiment of “old,” people in ghana and the united states actively engage with symbolic implications and material consequences of this construct, potentially transforming both the social meanings and objective implications of aging social bodies in the process. methodology the first part of this essay analyzes population aging discourse and underlying demographic statistics learned through library research conducted for a working paper series for the frederick s. pardee center for the study of the longer-ranger future (crampton 2009), as well as academic and professional training in gerontological social work from 2001-2007. the second part of this essay is based on the ethnographic study in ghana and the us conducted within the context of graduate training in cultural anthropology, social work, and gerontology. the research methods in each country site were similar in that each began as a qualitative program evaluation of the mediation project piloted by the elder advocacy organization selected in each country. this included immersion in the daily work of each nonprofit organization, participant observation of each program (generally beginning with some participation and then “switching hats” to a research role [see crampton 2007]), semi-structured interviews with program participants, anthropology & aging quarterly 2013: 34 (3) 102 alexandra crampton population aging as the social body and examination of program documents and reports. in addition, methods from legal anthropology were used to “follow the ideas” (starr and goodale 2002, 64-5) of old age as social problem and mediation as intervention solution to better understand the underlying assumptions of each program, and how participants perceived program success and failure. data collected included program documents, fieldnotes, and audiorecorded interviews.  as explained by annelise riles (2000, 2004), one challenge in conducting ethnographic work within professional and professionalized intervention networks is how to get outside the logics of the network given that anthropologists have been trained in the same ways of collecting and interpreting data. my approach to following ideas and to getting outside the network was to travel frequently among professional training, intervention, and everyday contexts with the same questions of “who is old,” how is this definition constructed and by whom, and whether/how this question is salient inside and outside of each context. i asked these questions indirectly through participant observation in a range of professional and community contexts, and directly through engaging a diverse range of interlocutors. the latter included professionals who worked and did not work in the field of aging, older adults who used and did not use aging services, and formal and informal caregivers of older adults.  because my research fellowship required professional training in gerontological social work, i frequently moved from professional to informal contexts of aging within and between ghana and the us. i also audiotaped fifteen semi-structured interviews with participants in the us pilot project, while informal engagement proved more useful with program participants in the ghana study. for example, i conducted twenty semistructured interviews with older adults in a ghanaian village but the data from ghana used in this essay are primarily from ethnographic fieldnotes written about informal conversations and interactions in the village (and the capital of accra) that took place outside of more formal interviews. informal engagement also proved useful in the us as well, and examples of strategies used by older adults outside of formal intervention were learned through immersion in us daily life. observation of private mediation sessions and more formal, audiorecorded interviews were obtained with written consent, while informal interviews were obtained with verbal consent in order to not interrupt the flow of interaction. data were collected with irb approval. representing the social body through population demographics numbers and narratives the representation of national and international population aging is constructed through demographic statistics. similar to the photomosaics technique (http:// www.photomosaic.com) in which an image is created from the collection of many smaller photographs, the image of a social body as young, aging or graying is formed through figure 1: population pyramids for china (data source: united nations world population prospects: 2008 revision) anthropology & aging quarterly 2013: 34 (3) 103 alexandra crampton population aging as the social body aggregate ages of individual bodyselves. the numerical image is called a population pyramid, in which each stack of the pyramid consists of a chronological cohort in five year increments. the left side of the pyramid is for males and the right side for females. historically, the most common social body has conformed to a pyramid type shape in which the larger and younger age-stacks taper quickly to a peak representing the relatively few who live into old age (bengston and lowenstein, 7). figure 1 shows how china’s pyramid took this historically classic shape in 1950, and is predicted to change due to declining fertility and mortality rates.  demographers subdivide population pyramids in order to distinguish younger and older social bodies. age fifteen is the typical boundary between young and adult, while the boundary between adult and older adult is more fluid. international statistics typically use age sixty. however, national statistics for countries experiencing a “longevity revolution” (butler 2000: 19) tend to use age sixty-five, while countries characterized as youthful and developing may use age fifty. one measure of population aging is when the proportion of younger individuals is shrinking, stable, or growing at a slower rate than the proportion of older adults. the popular metaphor of graying populations, then, can be misleading when the proportion of older adults is greater simply because the proportions of younger individuals is shrinking, stable, or growing at a slower rate. demographers refer to this as “aging from below” (vallin: 113) as pyramid bases shrink but reduced child mortality means tapering becomes less steep. over time, aging from below produces a pyramid that is more columnar, as can be seen in figure 1 for china in 2050.  in addition to “aging from below,” populations age “from above” (vallin:113). population projections for japan are one example, as shown in figure 2. this is the trend of longevity revolution most remarkable for the numbers of older adults living into old-old ages of eighty-five and older. it is identified through proportional increases (overall numbers or rates of increase) of older adults as well as increases in life expectancy. for example, the current national leader in longevity is monaco, with an average life expectancy at birth of eighty-nine years (cia world factbook 2012). population aging from above, coupled with low fertility results in a shape has been described as an inverted pyramid (crampton 2009). the third most common measure of population aging foregoes the pyramid and cuts the social body in half by a calculation of mediation age. for example, the median age in china is projected to increase from age thirty-foure to forty-eight by 2050 (united nations 2010). in other words, by 2050, half of the individual body-selves of the bodypolitic will be in their late forties or older.  how do national bodies age? although migration does influence proportions of aging body-selves within the social body, demographers focus on fertility and mortality trends within national borders (kinsella and phillips 2005; lloyd-sherlock 2010). demographic transition theory is used to explain how social bodies may predictably move from a youthful first stage of a triangular pyramid shape through stages of population aging. there are four stages that progress from high fertility and mortality to low fertility and mortality. according to population equilibrium theory, social bodies move through each stage and then stabilize at a level in which fertility and mortality rates balance (vallin 2002). at this point, the demographic transition is complete. these stages reflect historic patterns of population age change as countries of the “west” (or “global north”) developed and modernized. since then, analysts use these stages as a universal model to evaluate the aging of national social bodies as predictable, too fast, stalled or reversed (crampton 2009). an example of reversal is in russia, where increasing male mortality contributes to population shrinkage rather than stability (coleman 2006). policy interventions are intended, in part, to assist social bodies in correct progression through stages, figure 2: population pyramids for japan (data source: us census bureau, international database) anthropology & aging quarterly 2013: 34 (3) 104 alexandra crampton population aging as the social body achievement of stable population growth, and manageable age distribution. the global spread of population aging among social bodies is regarded as a result of successful effort to improve health that then can become a problem of surplus older adults (kinsella and phillips 2005).  why would greater numbers of people ages fifty, sixty or sixty-five and over require policy or service intervention? as argued by cowgill and holmes (cowgill, 1974; cowgill and holmes 1972), the answer has been modernization theory (for more recent review, see street and parham 2002 or lloyd-sherlock 2010). while demographic transition theory is used to explain shape shifting of social bodies over time, modernization theory is used to naturalize a particular progression and universal policy prescription for social bodies going gray (crampton 2009; robine and michel 2004). this theory ties the demographic statistics of aging body-selves to social, cultural, and economic contexts. the two-part stage model is a binary from traditional, youthful populations to modernized, aging populations (cohen 1998). in traditional societies, there are comparatively few older adults who are well looked after through kinship networks. through modernization, however, older adults might become casualties of development as younger family members move to cities in search of work, seek outside authority of formal education and professional roles, choose wage labor over hopes of inheriting family land as their main source of wealth, and lose traditional faith that associates elders with powerful ancestors. older adults thus lose status both objectively as they lose control over valued resources, and subjectively as they become a care burden within family systems (aboderin 2004).  the overall result is an inversion of high socioeconomic status from old to young as resources and values shift to younger adult generations. this analysis helps naturalize the historical development of retirement policies and social welfare nets for older adults in market economies. these policies and programs are now expanding to countries with much smaller social welfare states as “traveling rationalites” (craig and porter 2006, 120) within such policy efforts as the madrid plan of action on aging (lane and serour 2008). in social bodies that are becoming “old before rich” (which means population aging precedes expected economic growth, [olshansky et. al. 2011]), solutions are found in help outside the state from nonprofit organizations (ngos) and call for international aid. in making this argument, some scholars argue that elders are still valued and respected but that the objective problem is stress on family systems due to inadequate and uneven benefits of development (aboderin 2004). younger generations travel to cities and abroad out of economic necessity and are simply unable to fulfill familial caregiving roles (ibid 2004). older adults, whose knowledge and skills may have become out of date, are reduced to a burden on families and society. narratives and numbers come together in policy making through dependency ratios.  dependency ratios compare the numbers of people working and thus actively contributing economically to the social body relative to those dependent due to age (goldstone et. al 2012). that is, those under the age of sixteen or over sixty-five are dependent while those aged sixteen to sixty-four are productive because they should be working in the market economy (lloyd-sherlock 2010: 19). the use of dependency ratios helps create old age as a self perpetuating problem for the body-politic; first helping to produce problems of retirement, dependence, and exclusion by definitions used to distinguish adult from old, and then offering policy solutions to enable old people to be secure, independent, and integrated within society. this process fuels a continual need for support as more people reach the age defined and addressed in policy as dependent and in need of rescue. carol estes has criticized such policy and social intervention as an “aging enterprise” (estes 2001) that marginalizes older adults and best serves professionals who build careers on fears of aging characterized by frailty, dependency, and vulnerability. john mcknight (1995) argues that the real purpose of these policies is to help younger workers compete by pushing out older workers and reducing them to consumers of gerontological expertise. as cultural artifact, this construction also embodies fears of aging as decline and loss not only to individuals but also to national populations and economies. for example, donald rowland describes how, “nations with the oldest populations could face the prospect of a ‘demographic winter.’ this would entail severe population decline and excessive aging, rather than the more hospitable ‘demographic autumn’ of population stability where the numbers of children and the elderly become nearly equal and constant” (rowland 2012: 3). dangerous dependency ratios in the social body given that old age has essentially been defined in policy discourse as an antithesis to development (i.e. as unproductive and dependent), it is not surprising when policy makers regard population aging trends with alarm. stephen katz refers to this as “alarmist demography” (katz 1992) while ellen gee and gloria gutman use the anthropology & aging quarterly 2013: 34 (3) 105 alexandra crampton population aging as the social body phrase “apocalyptic demography” (gee and gutman, 1). within national populations, growth in older cohorts are associated with economic drain through retirement and social welfare policies (goldstone et. al. 2012). in addition to the graying metaphor, calls for scaling back social programs have come with comparisons of older adults to natural disasters, such as an “age-quake” and “agetsunami” in mass media (e.g. gettler 2009). population statistics calculating dependency ratios then rationalize fear as objective assessments of economic health and well-being. proposed policy solutions include effort to recalibrate ratios through changing the numbers of younger dependents, older dependents, or both.  ironically, calls for policy intervention have been sounded just as population age distributions change. before fears of a social body that was too old, population policy concern centered on fertility run amok. in the 1950s, the metaphor was of population explosion, which then drove development of family and population planning programs worldwide (demeny and mcnicoll 2006). what was unknown in 1969, when the un population fund was created, was that global birth rates were peaking between 1965-1970 (sadik 2002). concerted policy efforts were therefore implemented just as trends began to change. successful intervention through policy helped fuel fertility decline (caldwell, 2002). this decline is identified as the main driver of population aging, which then brought a new fear of a “gray dawn” (peterson, 1999) and “demographic time bomb” (vettori 2010) thirty to forty years later. policies for control aging trends within the social body include pronatalist policies to increase fertility, migration policy to add younger workers and families, and simply recalibrating the marker of dependency from age sixty-five to seventy in aging policies (crampton 2009; hudson 2009). a newer focus has been to reverse the previously assumed failings of older adults by promoting “active” and “positive” aging (rowland 2012,:186-188). the madrid international action plan on ageing calls for “mainstreaming” older adults to reverse previous exclusion from development policy and projects (lane and serour 2008). as these policies continue to be proposed, the global growth in older adults is peaking, and projected by the un to stabilize by 2050 (börsch-supan 2004). the populated social body as cultural construction the social body as calculated through population statistics is a construction of western thinking, in which society is composed primarily of self-interested individual bodyselves who more often compete rather than cooperate with others for scarce resources. the social is simply the sum of these individuals who can be meaningfully distinguished by birthdays. the predominant construct of old age in the social body of population aging is that chronological age marks when individuals become old, and that old means frail, dependent, and vulnerable. in aging social bodies, the state has to rescue individuals and families from dependency-care burdens. state welfare and service interventions are thus produced for the good of the body-politic on behalf of older adults, families, and communities. while these interventions were first implemented in western europe and north america, they are increasingly applied worldwide through identification of global aging based on demographic statistics and international comparison of dependency ratios.  the predominant construct used to manage aging of the body-politic as a universal and singular problem of becoming old and dependent has long perplexed social scientists and social historians who study the everyday lives of older adults (cohen 1994, edmondson and von kondratowitz 2009; katz 2005). we know through empirical research that growing old is much more varied than facing frailty, vulnerability and dependency as an individual at a specific point in time. multiple examples have been published from rural and urban areas (e.g. sub-saharan african examples in makoni and stroeken 2002, us examples in kaufman 1987), in edited volumes of international research (lynch and danely 2013; sokolovsky 2009) and as global comparative projects, such as the world cities project (rodwin and gusmano 2002). arguments made thirty years ago ring familiar, today, such as this quote about aging from östör in the 1980s, “like time, totemism, and kinship, (aging) is based on an illusion, an assumed and interpreted universal. it is true enough as a general expectation but false as a skeleton to which cultures bring the varying appearances of flesh” (1984). the expression of “no aging” later used in this paper builds from work by lawrence cohen and sarah lamb about rejection of modernist constructions of aging in india (cohen 1998; lamb 2000). yet, across cultures, social scientists have also found a common term and culturally mediated concern for when someone becomes so frail and debilitated through aging that they become totally dependent upon others (apt, 1996; holmes and holmes 1995; kertzer and keith 1984; van der geest 2012). the presumed utility of chronological age to mark this boundary is replaced by an empirical question of when, whether, how and why this happens to body-selves within culturally mediated social contexts in anthropological studies of aging (for research by a development specialist, see lloyd-sherlock, 2010). this next section draws from anthropology & aging quarterly 2013: 34 (3) 106 alexandra crampton population aging as the social body my research study comparing the construct of old age in demographic, policy, and professional intervention discourse as objective fact with old age as ethnographic question in the united states and ghana. my interest was both in whether body-selves accepted policy and professional representation of old as reality, and what realities might this representation either distort or omit. representation meets reality of who is old in ghana and the united states before conducting pre-dissertation research on aging in ghana during the summer of 2003, i sought research permission from the director of the institute for african studies. my proposal was part of policy and professional discourse on aging in that i proposed to study aging as a bodily and social experience of those aged sixty and over. dr. manuh read my proposal and then simply asked, “who is old?”  she flatly rejected the use of chronological age or functional limitation. i then brought this question to colleagues, key informants, and elder mediation participants over the course of dissertation research as a way to test whether the construct of aging in population aging and other professional discourse was commonly part of every day experiences of aging. given such a broad topic, the study focus was on a particular intervention used to address population aging as a social problem by two nationally recognized nonprofit elder advocacy organizations in two countries. the us was chosen as a country of “export” both of constructing aging as a social problem and inventing mediation as a professional intervention solution. the us is also my cultural background and i wanted to better reduce problems of internal validity (thyer 2001, 280) by testing my assumptions of western constructions of old age against those of my fellow americans. ghana was chosen as a country of “import” of both aging as social problem and mediation as intervention solution. that is, research attention to population aging as a social issue in developing countries began in the 1980s (martin and preston 1994).  in ghana, by the time of my research in 2004-2005, there were a growing number of nonprofit “ngo” organizations advocating on behalf of older adults, the development of a national health care policy for adults aged seventy and over, and promotion of national policy on aging (in part driven by the work of helpage international, based in london). at the same time, aging was identified as “a white man’s problem” both for cultural reasons and greater policy concern over youth. in addition, mediation as culturally mediated response to interpersonal conflict was more widespread in ghana than in the united states but the professionalized mediation model was regarded as a us invention. it was being imported through trainings, local legal professionals, and court reform. thus, aging and mediation were being imported not in recognition of local realities as much as part of the geopolitics of social intervention work and international constructions of social problems and solutions. i argue that the representation of aging as social problem has had very real effects in the united states even as it does not fully represent lived experiences of aging, and that these representations are beginning to have more influence in ghana.  in this next section, i present my argument about the relationship between old age as represented in population aging discourse and as lived experience. my data suggest that while a singular construct of old age dominates policy and intervention discourse and service delivery in each country, aging as lived experience is often an act of avoiding identification with this construct and promoting interdependencies and reciprocity over acceptance of total dependence. no aging in the usa?  similar to sharon kaufman(1986) in the united states and “no aging” described by laurence cohen (1998) and sarah lamb (2000) in india, there was often a disconnect in my data between the construction of old age in policy, professional, and advocacy work on the one hand and everyday social meanings and practices on the other. while there was an acceptance of the construction of old as applied to others and within society as a whole, this did not necessarily extend to one’s body-self. for example, an adult who signs up for social security and then delivers meals on wheels to seniors out of sympathy for the elderly, or a seventy year-old professional delivers a speech on the needs of older persons as the apex of a distinguished career rather than a spokesperson for this frail, vulnerable, and dependent population.  the question, “who is old?” was thus both obvious and provocative to answer. although sometimes taken aback, response in the us research site often started with the easy answer of bureaucratic choice, such as age sixty (as used in the older american’s act) or sixty-five (as associated with social security). when resisting an easy answer, however, many stressed that old age is not a number. for example, one more formal interview respondent said, “my mother is ninety and i did not think of her as old until she had a stroke and changed quite a bit. she had anthropology & aging quarterly 2013: 34 (3) 107 alexandra crampton population aging as the social body been the kind of person who is careful to put on makeup and select what she wore before going out and she was no longer interested in that. then, my sister and i noticed she had become forgetful.” another added that people can become old in their forties while there are others she does not consider old who are in their nineties. the difference is one of attitude and activity. thus, “old” was defined by loss of traits identified with mature adults and as a bodily and social experience that is actively avoided. this means policy makers and professionals may often be in the awkward position of serving involuntary clients—that is, people who would rather not identify as “an official geezer.” one clinical social worker explained that the hardest part of her job was convincing an older adult to accept being a client. at a senior center, a staff member described seeking older volunteers in the hope they will be more willing to later use the services themselves.  of course, old age cannot always be avoided. in this research and other studies, however, most old people still eschewed old age services. instead, they turned to informal services and networks. for example, one woman in her nineties relied upon neighbors, church members, and her therapist. she was afraid to live alone and yet even more afraid that social services professionals would move her to a nursing home. so, she cheerfully refused agency help as she became increasingly frail and housebound. her preference was to place newspaper ads for people to stay with her as needed. her informal network helped monitor the situation, and she eventually found someone who would also provide basic nursing care. eventually, she did need formal intervention and moved to a nursing home. however, she was able to avoid this move for several years in comparison to if she had tried to live entirely independently. in her new environment, she continues to both give and receive. although bedridden, she calls out greetings to caregivers and reads to her roommates. she does not self-identify as totally dependent. the importance of social ties and reciprocity in ghana as in other cultural contexts, old age in ghana was based on whether one can support him or herself. in a laborintensive economy, this often meant being physically fit enough to work. for example, the most common response from twenty interviews conducted with older adults was that the onset of old age came when one was no longer able to contribute to one’s own care or that of others. for many ghanaians, this becomes more likely as people reach age eighty and over. until then, many develop strategies to earn income and contribute despite aging bodies. i learned this distinction when working with a research assistant who offered to identify an interview sample of older adults. as i learned her construction of aging as limited to those who are frail, dependent, and vulnerable, and explained my study included anyone over sixty, she complained that this would include too many people and perhaps the entire village.  proverbs are often used in ghana to explain and enforce social norms. one focused on aging is that, “just as the elder helped you as you cut your first teeth, so should you help them as they lose theirs.” this describes a social contract. that is, one does not care for others solely as tradition; one cares for elders because of what they have done for you. those who do not or cannot provide for children as they grow may find that there is not as much care as they grow older (see also van der geest 2005). this is not to say there is a calculated exchange but rather that respect and love as an elder has to be deserved on some level. barbara stucki refers to elder strategies to manage interdependent relationships as “managing the social clock” (stucki 1995). many in the research study also complained that this love was more abundant in times when resources were also more abundant. in villages, children used to be routinely sent to share food with elders during harvests. this practice is less likely as resources deplete. a related comment was that old age seemed to come earlier to people today because of stressful life circumstances. at the same time. people noted that social norms have changed such that older adults cannot expect children to offer help as readily nor for younger people to seek their advice.  overall, old age was not a particular chronological age or even state of being as much as a status negotiated within interdependent relationships. people who have “done well” and shared generously with others are more likely to enjoy their later years as ones of rest and a sense of achievement. one example is an older woman who has become the head of her extended family. this means her opinion is consulted for important matters, her presence is especially requested for special events, and her advice is sought in counseling. she has earned her elder status not only within her family but also in the village through the care she has given to others and for organizing and leading various associations. for example, she has created, “a practical approach” to what she perceives as the problem of old age in her village. she began offering help to old people after a trip to zimbabwe taught her that africans might otherwise turn to creating nursing homes. that is, she visits old people at home, tries to reduce family conflict that compromises elder care, lectures on reciprocity and anthropology & aging quarterly 2013: 34 (3) 108 alexandra crampton population aging as the social body care, and offers health promotion presentations. in doing this work, she has modeled the care she many need if she becomes old. relating representations to realities in both research sites, there was an answer to the question of old age that was similar to the old age construct of decline and dependency. yet, who was old and how one became old was more than a passive response to passing time and the aging of the body-self. most adults aged sixty and over actively avoided identification with old age, and those who had become frail and dependent also found ways to contribute so that the relationship was also one of interdependence. this contrasts with the zero sum relationship of independent and dependent implied through dependency ratios in which a body-self is either productively working or receiving care. this also contrasts with the representation of an aging social body as constructed through population aging statistics, in which the real options and varied choices made by older adults are reduced to description of a highly stigmatized and helpless condition. of course, as pointed out by timothy mitchell (2002), all representations are limited by what information has to be left out in order to provide a coherent construction. at the same time, old age as a number seems better explained by the need for clear, bounded, and mutually exclusive categories for use in statistical calculation and bureaucratic decision-making than as a proxy for the lived experience of body-selves.  the ethnographic significance of this representation is less in how real it is than in how real its impact has been. this is primarily through translation into retirement and social welfare policies coupled with service delivery for “seniors.” policy and intervention implementation across the world have re-distributed financial resources, produced new forms of knowledge (as gerontological expertise), and reinforced associations of aging with frailty and dependency. anthropologists cannot simply dismiss a construct of old age because it is not literally true when it is made symbolically important in discourse, and then given material and social significance through policy and professional intervention. as such, old age as construct has a social life in a similar way to how arjun appadurai suggests we study “the social life of things” (appadurai 1986) made politically and socially significant through culturally mediated exchange. his concept of describing the “cultural biography” of material things as they move across time and context can be usefully applied to identifying a cultural biography of old age and its relationship to the ‘real’ aging of body-selves in the bodypolitic. towards a cultural biography of old in the aging social body previous work by social historians and critical gerontologists provide groundwork for describing the cultural biography of old age as a construct (katz 2005). they focus not as much on aging as an individual, bodyself experience as a highly social and political process. in the united states, for example, w. andrew achenbaum (1982) explains the importance of industrialization and subsequent labor policies of business and then government limiting the workforce beyond a certain age. during the early 20th, century, professionals also replaced older people as the experts on growing older. correlated with this was the association of old age with decline and loss as scientific experts and technical experts promised to address problems and promote the health and well-being of elders. acting out of genuine concern and in service to promotion of their fields, professionals convinced the general public that old age was a time of incurable disease and that long life was not necessarily the reward for living well. as a result, “new scientific theories and data forced people to reevaluate their opinions about the elderly’s values in other capacities” (achenbaum 1982) such as their own expertise on health and well-being learned through life experience. stephen katz (1992) traces the association of old age with disease and decline to changing policies and practices for managing the poor in the us through reform efforts to remove and rehabilitate the able-bodied poor, the relative proportion of old people left in almshouses grew. the mainstream public then began associating old age with poverty and wasted life opportunities. carol estes (2001) explains how an “aging enterprise” among professionals has capitalized on fears of aging in the social body. when this is coupled with lawrence’s (1998, 94) observation that much of gerontological expertise has been exported from the united states and europe through foreign policy and international conferences, a research area opens up on how the construction of old age in population aging and related discourses has taken an active role in shaping what may be a globalization of the aging enterprise. in ghana, for example, an executive summary posted online as a government policy report on a national aging policy passed in 2010 lists several international conferences as sources of commitment to creating such policy (government of ghana 2010). however, the same report explains that lack of implementation had been due in part to “the apparent lack of ownership by older persons” who had not yet anthropology & aging quarterly 2013: 34 (3) 109 alexandra crampton population aging as the social body assumed their presumed role as “primary stakeholders” (ibid, 8).  my research on elder mediation programs in the united states and ghana provides another example of intervention on behalf of older adults who may not respond as grateful clients (crampton 2007). neither mediation project attracted many adults over the age of sixty as old, people in need of help. instead, interest in elder mediation in the united states has been driven by mediators seeking to expand client bases through capitalizing on population aging trends. professionalized mediation in ghana has been brought in through ghanaians trained in the us and usaid funding for court reform. the specialty of elder mediation was not successful within the pilot project even as mediation continued to be used informally as a local cultural norm. in neither study site were the mediation programs able to attract older adults who sought help as frail and vulnerable adults. however, there were adults over the age of sixty in each site interested in training and practice as mediators. and, the organizations in both countries drew from population aging discourse to explain the need for services. in addition, one volunteer in the ghanaian organization, who happened to also be over age sixty, complained of “crafty old people” who exploit agency resources by faking helplessness. in other words, old age as constructed social problem provided funding and rationale for services, and adults engaged with these programs in ways more complex than as younger providers and older (dependent) consumers. the aging enterprise may have a marginalizing impact in discourse and at the same time produce more complicated social relations and interactions in practice. conclusion in this article, i use scheper-hughes and lock’s (1987) call for study of the social body to suggest that anthropologists seriously consider population aging as a cultural construct of anthropological interest. demographers construct this body from population statistics, and then policymakers and other professionals use it to think about how to intervene in the body-politic. this social body is thus not only a cultural artifact providing insight into cultural constructions of the nature of society but also shapes the lives of body-selves as policies and services become part of everyday life. the driver behind this may not come from older adults themselves nor from the lived experience of getting old, and yet it still has a social 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makers.” united nations department of economic & social affairs division for social policy & development. accessed august 20, 2013, http://www. un.org/esa/socdev/ageing/documents/building_ natl_capacity/guiding.pdf. alexandra crampton population aging as the social body http://www.bu.edu/pardee/files/2009/09/pardee_aging-6-global-aging.pdf. http://www.bu.edu/pardee/files/2009/09/pardee_aging-6-global-aging.pdf. http://blogs.smh.com.au/executive-style/managementline/2009/12/18/theloomingage.html http://blogs.smh.com.au/executive-style/managementline/2009/12/18/theloomingage.html http://www.ghanaweb.com/ghanahomepage/blogs/blog.article.php?blog=3442&id =1000008901 http://www.ghanaweb.com/ghanahomepage/blogs/blog.article.php?blog=3442&id =1000008901 http://www.ghanaweb.com/ghanahomepage/blogs/blog.article.php?blog=3442&id =1000008901 http://www.prb.org/publications/reports/2005/globalagingthechallengeofsuccesspdf575kb.aspx. http://www.prb.org/publications/reports/2005/globalagingthechallengeofsuccesspdf575kb.aspx. http://www.prb.org/publications/reports/2005/globalagingthechallengeofsuccesspdf575kb.aspx. http://www.prb.org/publications/reports/2005/globalagingthechallengeofsuccesspdf575kb.aspx. http://www.un.org/esa/socdev/ageing/documents/building_natl_capacity/guiding.pdf http://www.un.org/esa/socdev/ageing/documents/building_natl_capacity/guiding.pdf http://www.un.org/esa/socdev/ageing/documents/building_natl_capacity/guiding.pdf anthropology & aging quarterly 2013: 34 (3) 111 lloyd-sherlock, peter. 2010. population ageing and international development: from generalisation to evidence. bristol: the policy press. lynch, caitrin and jason danely, eds. 2013. transitions and transformations: cultural perspectives on aging and the life course. new york: berghan books. makoni, sinfree and koen stroeken, eds. 2002. ageing in africa: sociolinguistic and anthropological approaches. hampshire, england: aldershot. martin, linda and samuel preston, eds. 1986. demography of aging. committee on population, national research council. washington, d.c. http:// www.nap.edu/catalog.php?record_id=4553. mcknight, john. 1995. the careless society: community and its counterfeits. new york: basic books. mitchell, timothy. 2002. the rule of experts: egypt, techno-politics, modernity. berkeley: university of california press. olshansky, s. jay, simon biggs, w. andrew achenbaum, gerald davison, linda fried, gloria gutman, alexandre kalache, kay-tee kaw, alvaro fernandez, suresh i.s. rattan, renato maia guimaraes, milner, and robert n. butler 2011. the global agenda council on the ageing society: policy principles. global policy. 2(1). östör, ákos 1984. kertzer, david i. and keither, jennie. age & anthropological theory. ithica: cornell university press. peterson, peter. 1999gray dawn: how the coming age wave will transform america – and the world. new york: three rivers press. riles, annelise 2000. the network inside out. ann arbor: university of michigan press. riles, annelise. 2004. “unwinding technocratic and anthropological knowledge.” american ethnologist, vol. 31(2): 392405. doi:10.1525/ae.2004.31.3.392. robine, jean-marie and jean-pierre michel. 2004. “looking forward to a general theory on population aging.” journal of gerontology: medical sciences 59a(6): 590-597. rodwin, victor and michael gusmano. 2002. “the world cities project: rationale, organization, and design for comparison of megacity health systems.” journal of urban health: bulletin of the new york academy of medicine, 79(4): 445-463. sadik, nafis, ed. 2002. an agenda for people: unfpa through three decades. new york and london: new york university press. scheper-hughes, nancy and margaret lock. 1987. “the mindful body: a prolegomenon to future work in medical anthropology.” medical anthropology quarterly 1(1): 6-41. sokovosky, jay. 2009. cultural contexts of aging: worldwide perspectives. westport, ct: praeger. starr, june and mark goodale. eds. 2002. practicing ethnography in law: new dialogues, enduring methods. new york: palgrave macmillan. street, debra and lori parham. 2002. “status of older people: modernization.” encyclopedia of aging. encyclopedia.com. accessed may 21, 2013. http://www.encyclopedia.com/ doc/1g2-3402200387.html stucki, barbara “managing the social clock: the negotiation of elderhood among rural asante of ghana. thesis, northwestern university.” phd diss., northwestern university, 1995. proquest (no. aat 9614845). united nations 2011. “world population prospects: the 2010 revision highlights.” new york: united nations. accessed june 1, 2013: http://data.un.org/data.aspx?d=popdiv&f= variableid%3a41. vallin, jacques. 2002. the end of demographic transition: relief or concern? population and development review 28(1): 105-120. van der geest, sjaak. 2005. life, love, and death: conversations with six elders in kwahu-tafo, ghana. amsterdam: van der geest. van der geest, sjaak 2012 “graceful and successful ageing: observations from ghana and the netherlands” in alter(n) anders denken: kulturelle und biologische perspektiven. ed. brigitte röder, willemijn de jong and kurt w. alt. wien, köln, weimar: böhlau verlag gmbh and cie. alexandra crampton population aging as the social body http://www.encyclopedia.com/doc/1g2-3402200387.htm http://www.encyclopedia.com/doc/1g2-3402200387.htm http://data.un.org/data.aspx?d=popdiv&f=variableid%3a41 http://data.un.org/data.aspx?d=popdiv&f=variableid%3a41 anthropology & aging quarterly 2013: 34 (3) 112 227-238. pdf. accessed on may 28th, 2013. http:// www.sjaakvandergeest.socsci.uva.nl/pdf/ageing/ graceful_2012.pdf vettori, stella, ed. 2010 .ageing populations and changing labour markets: social and economic impacts of the demographic time bomb. surrey, england: gower. victor, christina, sasha scambler, and john bond 2009. the social world of older people: understanding loneliness and social isolation in later life. new york: open university press. alexandra crampton population aging as the social body http://www.sjaakvandergeest.socsci.uva.nl/pdf/ageing/graceful_2012.pdf http://www.sjaakvandergeest.socsci.uva.nl/pdf/ageing/graceful_2012.pdf http://www.sjaakvandergeest.socsci.uva.nl/pdf/ageing/graceful_2012.pdf 404 not found microsoft word lewis-pierrebrf.docx book  review     kazer,  meredith  wallace  and  murphy,  kathy.  nursing  case  studies  on  improving  health-­‐‑related  quality   of  life  in  older  adults.  new  york,  ny:  springer  publishing.  2015.  isbn-­‐‑10:  0826127037  isbn-­‐‑13:  978-­‐‑ 0826127037,  462  pp.  $75.00  (hardcover).     latoya  lewis-­‐‑pierre  ed.d-­‐‑ci,  msn,  rn     university  of  miami  school  of  nursing  and  health  studies                                                       anthropology & aging, vol 37, no 1 (2016), pp.53-54 issn 2374-2267 (online) doi 10.5195/aa.2016.151     this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.151    http://anthro-­‐‑age.pitt.edu       lewis-­‐‑pierre  |  book  review  53     book  review   kazer,  meredith  wallace  and  murphy,  kathy.  nursing  case  studies  on  improving  health-­‐‑related  quality  of  life  in   older  adults.  new  york,  ny:  springer  publishing.  2015.  isbn-­‐‑10:  0826127037  isbn-­‐‑13:  978-­‐‑0826127037,  462  pp.   $75.00  (hardcover).     latoya  lewis-­‐‑pierre  ed.d-­‐‑ci,  msn,  rn     university  of  miami  school  of  nursing  and  health  studies     nursing  case  studies  on  improving  health-­‐‑related  quality  of  life  in  older  adults  focused  on  dissecting   various  health  illnesses  and  relevant  strategies  to  improve  the  quality  of  life  in  the  older  patient  population.   together   with   forty-­‐‑six   multidisciplinary   authors,   the   text   addressed   patient   care   concerns   in   multiple   patient  care  settings  which  include  acute  care,  home  care,  hospice  care,  and  assistive  living  facilities.    the   book  is  organized  into  three  chapters:  1)  foundations  of  life;  2)  activities  to  enhance  the  quality  of  life;  3)   assessment   and   management   of   different   clinical   manifestations.   the   chapters   are   relevant   and   comprehensive  with  the  overarching  themes  related  to  supporting  the  older  patient  at  various  stages  of   health   from   coping   with   the   aging   process   to   promoting   a   peaceful   death.   the   book   is   organized   to   “showcase  the  experiences  of  older  people  as  they  struggle  to  maintain  autonomy,  dignity,  and  a  sense  of   self  amid  the  aging  process    and  declining  health”  (p.  xv).   the  book  cleverly  provides  real-­‐‑life  case  studies  which  include  subjective  and  objective  information.   each  case  study  is  supported  by  extensive  literature  reviews  and  clinical  reasoning  questions.  in  addition,   some  sections  include  ethical  and  cultural  considerations.  the  first  case  study  “quality  of  life”  describes  a   very  real  situation  of  an  older  patient  who  has  lost  a  loved  one  and  is  experiencing  changes  in  her  health.   the  scenario  includes  the  patient’s  concerns  and  the  goals  of  healthcare  providers  in  addressing  the  cultural   and  role  considerations  of  the  patient.  additionally,  thought  provoking  questions  relating  to  the  patient’s   health  care  priorities  are  included.     another   chapter   that   would   interest   readers   is   “autonomy”   by   claire   welford   and   catherine   sweeney.  the  case  study  describes  promoting  quality  of  care  in  a  residential  living  facility.  the  authors   suggest   multiple   strategies   that   promote   and   prohibit   autonomy   to   nursing   home   residents   which   are   delineated  into:  person,  personality,  being  personal,  and  being  personalized.    additional  sections  of  the   chapter   give   examples   of   care   plan   principles.   furthermore,   the   authors   emphasize   the   need   to   create   realistic  expectations  between  the  residential  staff  and  patients  in  a  long-­‐‑term  care  environment.       the   authors   in   chapter   13   titled   “keeping   me”,   focus   on   maintaining   the   residents’   feelings   of   personal   identity.   the   case   study   effectively   described   the   circumstances   surrounding   the   resident’s   admission  to  the  long-­‐‑term  care  facility  and  the  relevant  areas  for  health  care  providers  to  provide  care.  the   chapter  addresses  the  goal  to  address  the  resident’s  “human  needs  and  preferences”  (p.  149).    the  authors   also  focus  on  preserving  the  resident’s  previous  preferences  and  routines  to  support  the  resident’s  transition   into  a  long-­‐‑term  care  facility  and  the  role  of  the  staff  members  to  get  to  know  the  residents  as  individuals.   several  chapters  focus  on  assessing  and  managing  the  clinical  challenges  that  occur  in  older  adults.   in   chapter   27,   “medication   use     and   overuse,”,   diana   mager   describes   the   common   incidence     of   medication  mismanagement  in  older  adults.  many  older  patients  become  confused  with  new  changes  to   their  medication  routine  by  the  health  care  provider.  the  author  describes  the  frequent  incidence  of  adverse   drug   events   (ade)   due   to   miscommunication   leading   to   serious   medication   side   effects   and   needing   medical  attention.  understanding  the  medication  regimen  is  an  important  aspect  of  health  care  maintenance   and  the  topic  is  especially  significant  to  older  adults.  the  authors  suggest  individuals  who  care  for  older           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.151    http://anthro-­‐‑age.pitt.edu         lewis-­‐‑pierre  |  book  review  54         adults  to  include  the  patient’s  family  in  the  doctor’s  appointments/visits  and  have  the  patient  verbalize  the   new  medication  regimen  to  prevent  any  confusion.   in   the   final   chapter,   “dying   well”,   alison   kris   continues   with   the   theme   of   managing   clinical   challenges.  the  author  describes  a  patient’s  transition  from  receiving  a  terminal  diagnosis  to  her  death.  the   case  study  includes  the  different  clinical  and  psychological  manifestations  associated  with  the  dying  process   and   nursing   concerns.   additionally,   the   author   describes   the   nurses’   hesitancy   with   administering   morphine.  the  nurses  in  the  case  study  mentioned  that  “the  nurses  at  the  facility  were  upset  because  they   felt  that  they  were  killing  her  with  the  morphine”  (p.424).     this   book   is   relevant   to   multidisciplinary   health   care   clinicians,   students,   and   educators.     understanding  the  needs  of  the  aging  population  is  instrumental  toward  creating  a  supportive  environment   for  the  individual  to  cope  and  transition  into  different  stages  of  life.  the  opportunities  to  provide  older   patients  with  support  and  independence  is  beneficial  toward  promoting  quality  of  life.                         microsoft word reedbrfdec.docx book  review     meyer,  madonna  harrington.  grandmothers  at  work:  juggling  families  and  jobs.  new  york  university   press.  2014.  978-­‐‑0-­‐‑8147-­‐‑2947-­‐‑2.  293  pp,  $24  (paper)       rachel  sona  reed,  ma   freelance  writer                                                 anthropology & aging, vol 37, no 1 (2016), pp.59-60 issn 2374-2267 (online) doi 10.5195/aa.2016.154             this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.154      http://anthro-­‐‑age.pitt.edu       reed  |  book  review  59   book  review   meyer,  madonna  harrington.  grandmothers  at  work:  juggling  families  and  jobs.  new  york  university  press.  2014.   978-­‐‑0-­‐‑8147-­‐‑2947-­‐‑2.  293  pp,  $24  (paper)         rachel  sona  reed,  ma   freelance  writer     grandmothers  at  work  fills  what  author  madonna  harrington  meyer  identifies  as  a  gap  in  research.   socio-­‐‑economic  shifts  following  the  great  recession  have  contributed  to  an  increase  the  numbers  of  an   invisible  population,  and  harrington  meyer  aims  a  laser  beam  at  the  people  who  comprise  it:  women  who   work  outside  the  home  and  also  care  for  their  grandchildren.     intended  for  students,  scholars,  and  policy  advocates,  the  book  first  presents  an  overview  of  its   themes—balancing  paid  and  unpaid  labor,  the  joys  and  intensification  of  grandmothering—before  devoting   separate  chapters  to  the  phenomenon’s  specific  consequences.  in  preparation,  harrington  meyer  conducted   one-­‐‑hour   interviews   with   48   women,   and   balances   their   personal   testimonies   with   data   from   the   2010   health  and  retirement  survey  (hrs).  the  ways  in  which  the  informants  navigate  gendered  expectations,   familial   duty,   personal   care,   financial   burdens,   and   professional   aspirations   are   as   varied   as   their   backgrounds,  and  harrington  meyer  does  an  admirable  job  of  contextualizing  their  lived  experiences  in  a   broader  social  context.   harrington  meyer  employs  several  lenses  in  her  analysis,  including  a  lifecourse  perspective  and   gender   theory.   she   attributes   the   intensification   of   grandmothering   to   economic   necessity,   “changing   cultural  expectations  about  parenting,  the  rising  rates  of  working,  and  single,  mothers,  and  rising  childhood   disability  rates,”  all  of  which  “generate  a  growing  need  for  assistance  raising  the  kids”  (p.  63).  pointing  out   that  “where  state  supports  are  more  extensive,  grandparents  provide  less  care,”  harrington  meyer  argues   throughout   the   book   that   what   grandmothers—and   society—need   are   policies   and   state-­‐‑sponsored   programs  that  support  women’s  presence  in  the  paid  workforce  (p.  13).     harrington  meyer’s  analysis  of  the  hrs  revealed  that  46%  of  working  grandmothers  “are  providing   at  least  some  hours  of  grandchild  care”  (p.  2).  this,  coupled  with  longer  life-­‐‑spans,  results  in  a  “sandwich   generation”   with   more   layers   than   aarp-­‐‑driven   discourse   suggests.   among   harrington   meyer’s   informants,  38%  were  not  only  caring  for  their  grandchildren,  but  were  “also  caring  for  a  frail  older  relative”   (p.  163).  although  women  are  twice  as  likely  as  men  to  perform  unpaid  carework  [author’s  term]  and  the   informants  bear  this  statistic  out,  these  women  have  internalized  the  cultural  expectation  that  carework  is   a  female  province  (p.20).  “few  mentioned  the  need  for  government  programs  that  would  support  working   families,”  indicating  one  reason  public  policy  has  not  yet  responded  to  changing  socio-­‐‑economic  realities   (p.  229).     overall,  the  book  is  short  on  analysis  and  long  on  reiteration.  because  of  the  way  it  is  structured— considering   each   effect   in   turn—readers   are   treated   to   a   cyclical   groundhog   day   of   minor   epiphanies.   harrington  meyer  routinely  rephrases  her  informants’  quotes,  and  by  the  fifth  time  harrington  meyer   (re)introduces  renee,  age  x,  mother  of  y,  grandmother  of  z,  the  reader  begins  to  wonder  if  the  book  will   ever  break  free  of  its  starting  gate.  several  chapters  cover  overlapping  themes,  creating  the  churning  sense   of  perpetual  rehashing.  a  more  integrated  structure  may  have  better  served  the  subject  matter.   the  book  shines  when  discussing  its  policy  implications.  as  she  argues  throughout,  current  public   policy  runs  a  risk  of  further  exacerbating  inequality  across  all  measures.  disadvantaged  populations  are   largely  left  out  of  employer-­‐‑based  benefits,  which  “are  generally  shrinking”  even  for  those  lucky  enough  to   have  them  (p.  236).  harrington  meyer  sees  the  problem  as  one  both  of  policy  and  of  culture,  as  “we  have   yet  to  meaningfully  redefine  supports  for  working  families  as  a  family,  and  not  a  women’s,  issue”  (p.  237).           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.154      http://anthro-­‐‑age.pitt.edu                           reed  |  book  review  60     persistent  gender  norms  mean  that  women  tend  to  “absorb  the  financial,  emotional,  social,  and   physical  costs  of  providing  carework,”  which  impacts  the  socio-­‐‑economic  fabric  of  the  country  (p.  20).   less  overt  attention  is  paid  to  suggestions  for  further  research.  but  by  illuminating  a  distinct  stage   of   some   women’s   life   cycle,   meyer   creates   an   opportunity   for   other   scholars   to   delve   deeper   into   the   complex  personal  and  social  effects  of  managing  multiple,  conflicting  roles.  as  might  be  expected  in  an   initial  examination  of  a  newly  identified  group,  many  of  the  effects  on  working  grandmothers  are  mixed   and  tend  to  be  more  positive  for  women  with  greater  resources.     with   grandmothers   at  work,   harrington   meyer   provides   what   could   become   a   seminal   text   in   sociology,   gender   studies,   and   gerontology.   the   book   implicitly   argues   that   grandmothering   while   participating  in  the  paid  labor  force  should  be  considered  a  distinct  life  stage.  harrington  meyer’s  research   provides   compelling   evidence   that   this   emerging   life   stage   is   representative   of   a   growing   number   of   women’s  lived  experience  and  is  entangled  in  many  socio-­‐‑economic  shifts  that  have  profound  implications   for  individuals,  families,  and  american  society.                             préparer la retraite: new age-inscriptions in west african middle classes erdmute alber university of bayreuth author contact: erdmute.alber@uni-bayreuth.de abstract new ways of imagining, planning and living old age are actually emerging in the republic of benin, west africa. this process could be understood as the dissemination of an idea of retirement from the sector of formal labor and the corresponding social security system to a general notion of a good life in the late life course. it is preceded by emerging age-inscriptions which are contouring the new up to a point that it is settled and becoming a norm or a dominant pattern. it is also linked to the emergence of new a african middle class. it is going hand in hand with the emergence of other changes in the imaginaries of the lifecourse, for instance new ways of living and imagining youth. additionally, it goes along with an accelerating process of social differentiation, since living old age as retirement is, for the moment, only possible for people who are more or less doing well and able to gain the necessary resources of self-maintenance during a time after work. thus, retirement has become, beyond the sphere of formal work, a generalized notion of new pathways of old age. however, up to now, the desire to live old age as retirement is still an emerging ageinscription and has not become the dominant norm. keywords: retirement, aging, life course, benin, middle classes anthropology & aging, vol 39, no 1 (2018), pp. 66-81 issn 2374-2267 (online) doi 10.5195/aa.2018.171 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 66 préparer la retraite: new age-inscriptions in west african middle classes erdmute alber university of bayreuth author contact: erdmute.alber@uni-bayreuth.de “j´ai déja préparée ma retraite“ (i have already arranged my retirement”) answered doreen,i a 49-year-old trader from northern benin who lived with her second husband in cotonou, the de-facto capital of benin, when i asked how she would manage to visit her sons in france in the future as regularly as today. with a smile on her face doreen talked about the numerous pieces of land she had bought in parakou, the biggest city in northern benin, and which are located here and there all over the city. in view of the constantly rising prices for land all over the country, she explained me, it would suffice to sell only one parcel every two years to maintain herself economically. as she had already bought enough land, she then argued, that would be enough to stay independent in the future. a decent life would even be possible if she should separate from her husband. (march 2016, cotonou, excerpt from author’s field notes) the conversation with doreen was an illuminating moment for my research on new life trajectories of middle-class people in urban benin. the surprising fact that she used the word retraite (retirement) despite working outside the formal labor market is the starting point of this article. i argue that a new way of imagining, planning and living old age is actually emerging in urban benin. this process can be understood as a dissemination of the idea of retirement from the formal labor sector and the corresponding social security systemto a more general understanding of a good life in the late life course. i am therefore using the term to denote a specific class-related perception of old ageii that i observed among middle-class people in west africa in recent years. doreen did not use, as many other women would have done, the word old age (vieillesse) or one of the various expressions for denominating old age or growing old in the local languages. in contrast, retraite is exclusively expressible in french. formerly being used in the sector of the formal and largely french speaking labor market, the term has entered the local languages as a loanword. doreen used the term, although, as a trading woman who had never paid into any social security or pension system, she would never get any formal retirement. retirement meant for her more than having acces to the pension system in her answer to my question about visiting her sons regularly in france in the future, she referred to a new way of preparing, envisaging, and, hopefully, experiencing old age. doreen prepared herself for this phase by buying land, and, therewith, maintaining economic independence when growing old if necessary, without the help of husband or sons. following doreen´s way of speaking, i call this new and emerging concept retirement. people in benin who are envisaging old age as retirement talk about the desire of living without the help of others during the phases of their life after they quit working. their ideas, thus, reflect, what the international labour organisation (ilo) already suggested four decades ago when arguing that the introduction of a “sufficiently efficient modern system of social protection” would help integrate people into the wage economy and change the “traditional mentality” that promoted constant travels between urban, anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 67 industrialised centres and rural family homes (mouton 1975, 112). observing these changes in how old age is talked about and lived, i argue that the emergence of retirement as a new way of living old age is going along with emerging age-inscriptions. however, up to now, retirement is still a heterodox and slowly emerging concept of old age in benin. few people in benin would easily call old age retirement, as is the case in euro-american societies. even more, because of lack of ressources, not everybody who envisages retirement for his or her future would really be able to experience it. the concept is largely contoured by new age-inscriptions and not by state-induced change. this is the case because up until now, there has not been a general pension system in benin that covers the whole population, as was introduced in some parts of southern africa, like botswana, mauritius, namibia, south africa and lesotho.iii however, despite the fact that until today, the pension system in benin is only covering a small part of the population, understanding old age as retirement is nevertheless related to the introduction of the pension system for some people. for, their way of living old age has become a model for others. it has become a life concept, an idea of old age which means, among others, a phase of the life after work, and, maybe even more important, at which somebody is, although no longer working, nevertheless able to live using his or her own resources without the help of children.iv the emergence of retirement is linked to broader transformations, mainly the emergence of the african middle class (see scharrer, o´kane, kroeker 2018; melber 2016; lentz 2016; or coe, this volume), or, more generally, the global middle classes (heiman et al. 2012). it is going hand in hand with the emergence of other changes in the imaginaries of the life-course, for instance new ways of living and imagining youth (see alber 2011). also, it goes along with an accelerating process of social differentiation, since living old age as retirement is, for the moment, only possible for people who are more or less doing well financially and able to gain the necessary resources of self-maintenance during a time after work. and finally, the emergence of retirement as a distinct phase in the life course is also linked to the gradual institutionalization of the life course in benin (kohli 1985, 2009, for africa see also nicolas 2009). in the following sections, i will first introduce the institutionalization of the life course and then reflect about debates on the african middle classes in the light of debates on the life course. in the sections that follow, i will outline my research setting by presenting empirical results that illustrate some more specific elements of retirement and the related age inscriptions. i am here referring to coe´s and alber´s notion of age-inscription as the way that transitions, expectations, and markers around age and stages in the life course shift in practice (coe and alber, this volume). positioned in between rules, laws and norms on the one hand, and individual feelings, emotions and actions on the other, the concept is especially valuable for the description of changes of old age that are not implemented by politics or law, as it is the case in benin. in the conclusion, i will argue that retirement has become a generalized notion of new pathways of old age, which is linked to the idea of being independent from one´s own children in old age and being nevertheless able to maintain a middle-class life style. the institutionalization of the life course sociologist martin kohli (2009) has argued that the life course is an often underestimated dimension of structuring society. it is a social fact in its own right generated by a system of rules and norms and undergoes historical transformations. every society provides its own notions about how the life course should be. of special interest for my research, following kohli, are moments of structural transition anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 68 from one life-course regime to another. the transition he aims to analyze is the one from what he calls premodern time to modernity, i.e., the transition to an industrial economy in europe in the 19 th and 20th century (2009, 387f.) kohli outlines that this process is going along with what he calls the temporalization of life which is oriented by chronological age. this leads, following kohli, to a chronological standardization of the life course, often produced by legal frameworks. furthermore, kohli sees the chronologization as part of a process of liberating individuals from their (rural and urban) bonds, and, therewith, as a process of individualization. last, but not least important, the life course in modern societies is organized by a phase model that derives from the idea of modern industrialized work and its three phases of childhood and youth seen as a phase of preparing for the phase of work; then, the phase of active work, and, finally old age as the phase after work (kohli 209, 388). the institutionalization of the life course is not only a consequence of the changing world of work and labor, but also of the increasing importance of institutions such as school, grades, registry offices or retirement payments, framed by the state and its attempts at caring for the life courses of the inhabitants (for the institutionalization of childhood see also haukanes and thelen 2010). the institutional and legal capacity of standardizing life trajectories holds not only for industrial societies, but all over the world. at the same time, the process of the institutionalization of the life course is thought as going along with a process of individualization that pushes sometimes against the corset of the institutionalized program. the above mentioned elements of an institutionalizition of the life course could be observed in the actual processes of changing life-trajectories in contemporary benin. even more they can be identified as concepts of how people in benin are seeing and imagining ongoing transformations. first, with the introduction of identity papers, birth certificates, or the legally introduced compulsory education and other administrative measures, people perceive their life courses as temporalized through paperwork.v second, even if notions of social age and age status persist (expressed, for instance in the notion of seniority, or in the social status of becoming an elderly person when one´s children are getting married), these elements of temporalizing emerge in the form of chronological age. this age is then fixed in administrative processes, like in the making or using identity documents or retirement payments. in benin this life course-related temporalization is also connected to people´s perceptions of the processes of individualization. to give one example, many people argue their migration to the cities is an attempt to avoid some of the binding norms in the rural areas, or just, the daily social control by others in the villages. the desire for liberty and individuality is often expressed as a motive for migration. however, these perceptions and also the desire for liberty and individual choice should not be taken as a sign of a general tendency towards individualization in benin and a complete disentanglement of urban people from their rural ties. as it is discussed in the literature (cooper 2012; lentz 2009; mberu et al. 2013; smith 2004), the connections to the region and place of origin are not only maintained by urban migrants. above all, nobody would deny that caring for kin is seen as a very important and unavoidable task. however, the idea of self-determination and choice is nevertheless a driving force of many people’s future planning, even if they are continuing previous bonds and obligations. fourth, the trajectory of childhood as a learning phase and adulthood as a working phase, then proceeded by retirement is framing ideas about what the “modern” life course should be in benin, as is clearly expressed in the statement by doreen that i recalled at the beginning of this article. outlining parallels between the process of the institutionalization and individualization of the life course in modernizing europe and comparable processes in contemporary benin, i do not want to argue that contemporary benin is repeating the european paths of modernization, as modernization theory has anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 69 failed to foresee.vi nor do i argue that all individual life trajectories in benin could be seen within the frame of an institutionalized an individualized life course. kohli´s ideas about the temporalization and chronologization of age should not be taken as fully encapsulating the processes of change in the lifecourse regimes of industrialized countries. as even in post-industrial europe or america, relative age status, beside chronological age, is still important. it makes much more sense to understand chronological age and the institutionalized life course in industrialized countries as well as heterodox inscriptions that emerged in contexts where older inscriptions and norms continued to exist in parallel ways. rather, for my case study in benin, i want to retrieve the emergence of a still heterodox re-framing of old age, which could be understood with reference to the institutionalization and individualization of the life course. middle classes the growing literature on the new, or the global, middle classes in the countries of the south is mainly focused on their economic and social positioning and consumption patterns as well as the political consciousness of social climbers. the emergence of this literature has been driven by the hope of overcoming poverty and gaining liberty and democracy in developing countries. furthermore, “middle class” has become a descriptive term in many publications to signal urban life styles, and sometimes a kind of ordinary, mostly urban, people who are neither rich nor poor.vii however, the life course, and especially the retirement phase, of african middle classes has not yet been a matter of debate. class has been defined by focusing on processes of works and especially access to the means of production and the related consciousness, expectations and sometimes normative ideas (see neubert 2014, 25ff.; solga et al. 2009). though, in general, the concept has for a long time not frequently be used in social anthropology (lentz 2016). the emphasis on work and the means of production in the debates on social class might have been one factor as to why ways of living middle class in the after work phases of the life course might have been broadly overseen. scholars of european history have convincingly argued that class status has not only been thought of as encompassing all members of a household and equalizing relatives in different generations. especially in the 19th century, there was an increasing tendency towards a horizontalisation of kinship relations and towards endogamous marriage practices that increased the homogeneity of class status among kin. (sabean and teuscher 2007; johnson 2015, 7ff; see also alber 2016). these assumptions of class stability within kinship relations and households do also imply an assumption of class stability over the life course. however this is not at all evident for african societies and their middle classes. almost all participants in my research started their life trajectories as children of rural peasants or small craftsmen in northern benin and became middle class after a phase of social climbing in later phases of the life course. none of them experienced class stability over his or her life course, and even more, the majority of them are pioneers in their families in living in the cities. everybody has parents, siblings or other close kin who are living in very different socio-economic situations than oneself. furthermore, there is often a remarkable economic difference between husbands and wives. thus, social heterogeneity is the norm and practice that characterizes not only the social relations between relatives, but also those within households of middle-class people in benin (alber 2016). this is very different from 19th century europe, where there was a tendency towards homogeneity, endogamy, and class equality within kin groups (johnson 2015, 18ff; sabean 1998, 406ff). when using the term “middle class” in africa, one should be aware of these differences and the complexity of transferring a term from 19th century europe to anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 70 other parts of the world. i do nevertheless use the term “middle class” for signaling urban households of professionals and people who see themselves as “better off.” it has become a frequently used self-description not only in benin, but in many countries of the global north and south, even if the boundaries of what is still middle class are not extremely rigid within these self-descriptions.viii in benin, middle class is relatively unusual as a self-description in public, but a frequent descriptor of others. if asked explicitly about their position in society, many people with whom i did research saw themselves as being “between poor and rich.” i would therefore call the middle class in benin those urban, relatively well-educated people who have a reasonably stable income that allows them to care for their household and related persons. many, but not all of them, have access to formal social security services; almost all are living in heterogeneous households, often of different classes. some, but not all, of them might also form the functional elites of the rural hometowns. households of people from northern benin in cotonou during three months of field research in winter 2015/16, i investigated changing life courses in the households of migrants from the borgu region in the capital and biggest city of the country, cotonou, located in southern benin. this work i built upon my previous two decades of research in benin.ix together with two field assistants, fidèle ballo and souleymane modibo,x we worked in ninety-eight households: seventy-three households of baatonum and twenty-one of dendi speakers. many of which were already known to me given my previous research in the country. this ethnic composition and geographical location of my research site also affected the specific class positions. the households are in general of better-off people who share not only higher educational achievements, but also are wealthier than average in benin. there are almost no “poor” households from the borgu region living in cotonou. additionally, almost all the members of the elites from the borgu region are living in the households included in my research. therefore, almost all households self-positioned themselves as middle classxi and nearly all met the criteria of being middle class as set by the african development bank (2011). furthermore, beside many “ordinary” people working as professionals in the labor market in cotonou, there are also members of these households who are representing and working on behalf of the borgu region in national politics and the economic sector. this is due to the fact that the predominant part of the labor market for civil servants in benin as well as the universities are concentrated in the region of cotonou. this makes it attractive for people from northern benin to migrate to cotonou when seeking education and jobs dependent on high levels of education. however, the prices and living conditions also cause the return to the north for those who are less successful in their working careers. this pattern is confirmed by the results from my questionnaire: almost all of the heads of households i interviewed had been born in northern benin with more than two-thirds of them born in small villages to parents who were rural peasants. in general, the interviewed persons had left their villages and their parents’ households during their childhood or youth, mostly for schooling. the main reason to migrate to cotonou was access to university or other forms of higher education. at the same time, all interviewed people mantain social relations in northern benin and this is why baatonum and/or dendi is spoken in all of the mentioned households. a main way the individuals i interviewed invest money is by purchasing land or constructing houses in the north. many of the household heads are the functional elite of their region of origin. they are working in ministries, as state officials, or in the private formal sector in large corporations. some are representing anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 71 their home region in regional associations or work as politicians or social brokers for their home areas. however, not all the members of the households have the same social status as the heads of household. the household composition is relatively diverse and does not include only parents and children. on average 6.4 people form a household in cotonou. within the household, there are often other adults, such as siblings of the head of the household or other family members, who are unable to build their own households because of the high costs of housing. of the average 4.2 children living in each of these households, 1.4 children are not living with their biological parents, but as foster children or domestic workers. whereas the foster children are mainly close kin of the household heads, the domestic workers are often, but not always, seen as non-kin. these numbers show that many of these households are hosting other people from northern benin in order to give them access to education and jobs, but sometimes also to help them, as cati coe argues (this volume). the fact that more than half of all the households are hosting not only foster children, but also domestic workers, also shows the relative wealth of the households. this is also expressed in the fact that 73 percent of the households included in my research have at least one car. there is relative high educational achievement in the households as well. of the 246 adults in the households in total: eight of them have finished university; another twenty-five finished secondary school. forty-five persons have attended at least some classes in secondary school, whereas fifty-three finished at least primary school. only forty-three adult household members never attended school or they did not earn any educational degree even though they attended school at some point. this stands in contrast to the low rate of literacy, which unicef estimated at 28.7 percent for adult people in benin in 2011. the high level of education is also evident in the fact that 113 adults from these households are working as state officials in formal jobs. these are mainly the male household members, for as in the example of doreen, the vast majority of the wives have a lower level of formal education, and the most frequent occupation for the women is trading. a remarkably high degree of household members (48 percent), are covered by health insurance. for benin, this rate is extremely high and illustrates the wealth of the households included in my research. for, in benin, it is only large corporations and the civil service that offer health insurance to their employees. that means that only a very small part of the population is covered by health insurance. additionally, even if the state is offering health insurance to its civil servants, it is only themselves, their spouses (if they have undergone a civil marriage), and their minor children who are covered. other members of the household, such as foster children, domestic workers, or other relatives who are living with them, are excluded. thus, even though the majority of the household heads i interviewed were covered by health insurance, almost all the households i visited had at least some members who were not. my description of the composition of the households and educational achievements illustrates that central indicators for the institutionalization of the life course are present.xii i will now analyze the imaginations, plans and projects of old age i have found among them. age-inscriptions enabling retirement until today, being cared for by relatives is still the most common way of living old age in benin. in general, the inter-generational contract demands children in benin care for their parents during old age, as häberlein (this volume) has argued for rural togo and benin. this holds, with the exception of some countries in southern africa, for the whole continent (fry 2000, 772). the fact that population rates are still increasing all over africa with less than 6 percent of the population over the age of sixty, makes caring for the elderly statistically relatively easy for these societies. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 72 this is predicted to hold true even in years to come since between now and 2050, it is expected that the percentage of people older than sixty will only rise to about 10 percent (mathiason 2003, 100). this is much less than in europe for instance, where even today, more than 30 percent of the population is older than the age of sixty.xiii in benin, where the an annual population growth rate is nearly three percent, a large majority of people still does not receive any retirement payments, since they never participated in the formal labor market, and thus, did not contribute to the pension system during the time of formal work. with very few exceptions, a majority of the parents of my interviewees are living off of their children’s resources. therefore, living old age as retirement is not only still an exceptional way of living and envisaging old age in benin, but can only be lived out by relatively few, quite often also in contrast to their parents’ experiences. the majority of the parents of people i worked with are rural peasants. this usually means that fathers do agricultural work together with their sons and other male household members. normally they gradually cease active farming as they get older, handing over the physical work to their sons. when talking about old age, rural people worry if and which of their children would stay in their compound or return to it. however, this is generally not seen as a major problem, due to the fact that birth rates are still very high. if people do not have sons to care for them, they almost always have nephews or other kin who will keep up the large compounds. sometimes, parents are discussing and deciding who of their children would stay or return to the village in order to take over the responsibility of the compound (see also coe 2017). with these decisions that guarantee continuity, caring for elders is generally resolved without being discussed explicitly. rural parents simply expect their children to take care of them since they live together, and this is an obligation that is deeply engrained in the mindsets of urban people from northern benin as well. changing ways of organizing care for the elderly in benin could be triggered by migration processes and other factors. however, receiving food and physical assistance daily are easily assured in the compounds. in general, this provision of basic care is expected during old age in the villages, and is supplemented by some income-producing activities by the aged themselves. people living out these norms generally do not prepare for old age, since they count on their children to take over the agricultural work and to take on the responsibility of caring and supporting them in their compounds. they do, however, prepare to behave properly towards their sons and daughters, which is seen as necessary duty in the intergenerational contract (see to this point häberlein, this issue). the expectation that children have to care for their parents also holds in urban contexts in situations where parents are not able to maintain themselves physically or financially. this norm of caring for parents provides the background against which, and in addition to which, the new middle classes have started inscribing retirement i will now describe key components of retirement for the people from the borgu region, which i take as emerging new age scripts that are gradually on the way of becoming general norms. i have mentioned that only a minority of the people in benin are enjoying social security in the form of health insurance or pension payments. only civil servants and former employees of the formal sector of big enterprises receive pensions, which is, in total, only 6.8% of the labor force of benin (world bank 2017). however, even these people never feel completely sure that they will get these benefits. there have been times when civil servants have had to wait for their salaries for several months; therefore, there is a common credo that one should, if at all possible, never completely depend on one´s formal pension. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 73 also, high inflation can quickly devalue the worth of a pension. this is especially true in light of the fact that people quite often retire at a relatively young age. since 1986, retirement in benin has been fixed on the age of fifty-five or after thirty years of service (republique du benin, presidence de la republique 2005). from 2005 onwards, this was modified several times with the aim of increasing the age of retirement and subsequently to reduce the costs of the pensions for the state. in consequence, retirement was, for some time, fixed at sixty-five, but in 2015 it was lowered. actually, a complex regulation is applied that fixes different ages of retirement for different professions within the civil service (actubenin 2015, republique du benin, assemblee generale 2015). it has been very common for people to retire early enough to have a long period of active life following their working years, but during this phase of their life they could experience economic changes. the first inscription enabling retirement that is new is that it is now seen as a phase that has to be prepared for carefully. retirement is seen as something that requires longtime planning. this differs fundamentally from the older way of living old age in which it was expected that an older person would be cared for by kin. people now are very aware of the necessity of planning retirement, and many of my interview participants had concrete strategies in mind, involving small businesses, land acquisition, and house-building. some excused themselves for not yet having acted on these strategies, but they expressed their worry about the future. one of my interview partners, for instance, expressed that he was actually finishing building a house in cotonou. after that, he would like to start investing in a small business, but for the moment, all the available resources were spent on the house. he then explained that at least this house would contribute to a decent life in the future. the importance of preparing for retirement is obvious in the case of people like doreen who are not expecting to receive formal retirement payments. however, it is also important for those who expect to receive these payments because pensions can be uncertain, not only due to financial risk such as inflation, but also due to a real possibility that they are not paid in time or correctly. the notion that retirement has to be planned is a relatively new one in benin. this is changing individual perceptions of the life course in addition to notions of security. these changes are taking place in the form of new strategies and life visions. one major point is that urban middle-class people in cotonou are preparing to care for themselves economically during old age. this is a very new concept that changes not only the phase of old age itself, but also the time before, since planning retirement is becoming an important part of the phase of working adulthood (see also cohen and menken 2006, 9). the second script of retirement is, therefore, that it is understood as an individual task, not the task of one´s children. establishing small enterprises or building houses to be rented out would generate additional income in case the pension would not suffice help an older person live on their own. this expectation of self-reliance is triggered by the pension system that—at least in the imagination—should assure the everyday expenses of those who are beneficiaries. this desire of building one´s future old age independently from one´s children could generate many changes to intergenerational obligations. however, for the younger generations, this age-inscription does not at all change the norm of being obliged to care for one´s own parents. i could observe this when talking with roubatou, a successful young married mother of three small children who is working as a manager for the national water company in cotonou. whereas her husband, also a professional in cotonou, is the son of an illiterate anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 74 craftsman, she is one of the very few professionals in cotonou from northern benin whom i met whose father had already been working in the public service. after having worked as a forestry manager in different places in benin, he retired and settled in parakou. although he is living with his wife on a good pension, roubatou sends a fixed sum of money from her salary every month. she explained to me that she felt obligated to do so because children should to care for their aged parents. her husband did the same for his parents who were really in need, so she felt she should do the same, although she acknowledged that her parents had worked hard in order to be successful in their lives. she asked, “why should they then be harmed by their own success, by not getting money from their children?” her husband confirmed that the two of them would do everything they could in order to assure their children a good education and, if possible, a better future. however, they would not do it for their own security in old age, but for the future of their children. (cotonou, march 2016, excerpt from author’s field notes) the example of rubatou and her husband underlines that the emergence of new age-inscriptions, namely the attempt of being financially and physically independent during old age, does not automatically replace older norms, such as caring for parents when they grow old. however, the norm that children should care for their parents coexists with people´s desire of not relying on their offspring, but rather on their own resources in old age. furthermore, nobody knows if one could attain this independence in the end. people are aware that many things could happen, such as inflation or an unexpected sickness for which costly health care could drain saved resources. therefore, a prevalent idea is that because one has to try to balance risks with additional income generation during the working phase of life, the same should be done during the time of retirement. together these two inscriptions emphasize the reorientation of retirement to be a more individualized process. it follows the model of employed work. in fact, the moment of becoming retired is fundamentally shaping the life trajectories of the people from northern benin who live in the south, in so far as almost all of them are envisioning, at least at some point in their life, to return to northern benin after retiring re-placement at the moment of retirement for the people i worked with, a key activity for preparing retirement is building a new house in northern benin. interestingly, these new houses are described in the literature (pauli this issue, mberu et al. 2013) as frequently being built in their villages or towns of origin, but they build them rather in parakou, the biggest city of the borgu and its commercial and administrative center. there are several reasons for this decision. first, parakou is the ideal place for maintaining networks. given many returnees from cotonou are constructing their new houses in parakou, their social networks from their previous employment could be maintained easily. additionally, in parakou comforts like electricity, running water, or availability of markets and consumer goods to which the migrants have become accustomed, are available. the urban life style could easily be continued there. furthermore, as parakou is relatively close to the villages of origin, retired people could participate in economic activities in their villages of origin without actually living there. for instance, trading with staple foods or the management of nearby farms can easily be realized. mberu et al. (2013, 277) have discussed the hardship of kenyan urban migrants returning to their rural homes in old age, despite older people’s expressed desire to return. given these anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 75 challenges, building houses in parakou is seemingly a good choice for older people from northern benin as the location will allow them to meet their different needs. another aspect of building new households for retirement is that retired people are continuing to care for other kin, either by taking them into their new households or by offering them places to stay in cotonou if they maintain their households there as second homes. therefore, even if individuality—in the sense of being independent from one´s children—is a central element of retirement, it is still combined with caring for others and providing them with a place to stay. however, those who are retired and built the new households will decide who will live with them. i am talking here about new households of retirement and not of “retirement migration” (see van der geest, mul and vermeulen 2004, 434) because many of the people building new households in parakou are not migrating, but instead enlarging their networks by maintaining their places in cotonou. a last aspect of the decision to build new households in parakou and, if possible, to maintain those in cotonou, is that people are then able to maintain closeness to their children by offering them different places to be (see also van der geest, mul und vermeulen 2004, 434). some of the people who are maintaining two houses have (adult) children as well in both locations. roubatou´s father, for instance, still hosts his son, a medical doctor, along with his wife and one small child, in his house in parakou, until they finish building their own house. in cotonou, he hosts his youngest son, a student. maintaining these households also means there is the opportunity to be surrounded by kin. case studies: variations in the emerging age-inscription in this final section, i will show how new age-inscriptions are realized by providing concrete case studies. these are also illustrative of how new inscriptions are combined with older notions of old age. the cases i describe focus on couples. couples in benin are handling their economic activities independently from each other, but at the same time, these activities are related to one another. aliou and beatrix until his retirement in 2015, aliou worked as a geologist in a ministry. for more than thirty years, he has been married to beatrix, a trader, who has opened a small boutique in front of their house in cotonou. she has also purchased a small territory in cotonou and is still hesitating if she should build an appartement in order to rent it out. the couple is living together in a house aliou has built, as husbands are seen as being responsible for the family´s housing. it is a comfortable villa, where they were living in 2016 together with their only daughter, her sons and some other kin they were caring for. aliou had always planned to return to parakou after retirement; therefore, in recent years, he constructed a villa there. different from his brother, he did not construct it in the vast ground of the family compound in the center of parakou where their elderly mother lives and to whom he provides financial assistance. he built his own house on a purchased parcel of land, but in the family compound he constructed three apartments that he rents out in order to have additional income. however, his plan of returning to parakou has changed because aliou found work as an independent geological consultant after retirement. thus, he decided to stay in cotonou, and to travel regularly to parakou, his home city and second home respectively. aliou´s brother adam, a school director who is still living in the family compound, commented on his brother´s behavior: “he had the chance to anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 76 construct something of his own in parakou. he does it because he does not want to have all of us around when he visits parakou. all the small family problems, all the demands of resolving something. if he has his own villa, he can come and visit us when he wants. this is what all of them are doing.” far more than describing the behavior of his brother, adam is commenting on a general behavior of seeking independence by those who left their region of origin. even when they partially return, he expresses, they maintain the independence of living on their own and on separate land that they purchased outside of the compound. in the borgu region of benin, the usual pattern of rural living has been that sons created their own houses or households within their father´s territory, and therefore close to his household. this has led to large agglomerates of different housholds on family land. however, in this style of living, sons remain under their father’s authority up to the point that one son takes responsibility for the whole family land. founding one´s own household on one´s own territory has, therefore, always been meaningful for claiming independence. georges and gloria whereas aliou and his wife spend most of their time together in cotonou, and also travel frequently together to parakou, georges and gloria have developed another form of retirement. georges, a retired tax officer in cotonou has, like aliou, also built a large and nice villa there. about forty years ago, he married gloria, who has been working as a medical doctor. she established a private medical practice next to the villa georges has built for the family. so, as in the case of beatrix, gloria has also started a business in their compound that generates additional income for her. as in the case of aliou, georges has also built a new house in parakou, on a purchased, not inherited, parcel of land. years ago, he has constructed a smaller house on his father´s land in parakou, but when he became sufficiently rich, he built the house he is now living in. for, different from aliou, he immediately moved to parakou after retirement. his wife gloria, who is from southern benin, has remained in cotonou where she continues to work in her private practice after retiring from her job in the hospital, one of their children is also living with her in the house his father has built and is still owning. so, as georges does only travel to cotonou for short and mostly administrative affairs, the couple has separated in fact. however, they did not officially divorce and are therefore sometimes still jointly attending ceremonies or other events, which husbands and wives should attend together, as for instance the funeral ceremony of gloria´s father. but whereas georges sometimes stays in his house in cotonou when he has something to do in the south, gloria never travels to parakou and visits him there. therefore they are seen as de facto separated by their close relatives and friends. georges´ brother, for instance told me that his brother has opted for a gradual separation from his wife without being officially divorced. (march 2016, field notes) the existence of the two houses allows them to live the phase of retirement relatively independently from one another. whereas both houses are georges´s property, gloria has invested money in apartments in cotonou that she has rented out while personally living in georges´s house, as a wife should do. jacques jacques, a former primary school teacher who had also worked as a broadcaster in local languages for the national radio and television station, has been less successful than georges and aliou in retirement. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 77 he has never been able to construct a house in cotonou during his active working years, but invested in a piece of land in parakou. just before his retirement in 2004, his wife, a nurse, became seriously ill, therefore he used all his savings for her treatment. despite the medical attention, his wife died. as the house had not been finished, he first stayed in cotonou. however, five years later, his son who was working in a ministry in cotonou gave him the money to finish the construction of his house in parakou. he is now living there. this case shows another variation of caring for the elderly on the one hand, and the desire for individuality and independence on the other. instead of taking him into his own house in order to care for him—as others would have done—his son respected jacques´ desire for independence (and maybe his own desire for maintaining independence from his father) by enabling him assure his own and independent life in parakou through the construction of a house. jacques´ example proves that not all middle-class people are able to maintain themselves without care from their children. furthermore, it shows how children´s care for retired parents is also changing and adapting to the new age scripts. désiré and doreen i have already mentioned doreen, a trader living with her second husband désiré, in his large house in cotonou. désiré has worked in a ministry. recently being retired, he is still struggling to finish his house in parakou. meanwhile, the couple, when travelling to northern benin as they frequently do, are hosted in doreen´s small apartment in parakou which she had built for renting it out years ago. this is seen critically by their relatives, since it is the obligation of the husband to provide his wife with housing. as soon as the construction of désiré´s house will be finished, doreen will immediately rent out her apartment again. but nevertheless, both prefer staying in her house—against the common norms of housing as the obligation of the husband—than to be hosted by désiré´s relatives. here, again, individuality in the form of independence is more highly valued than closeness to kin. désiré and doreen are not yet sure in which city they will finally reside. probably they would, dependent on their economic activities, live in both places. both have pieces of land in the two cities. désiré has another important obligation in parakou. he has built a small and simple house for his old mother, a quite rural woman whom he does not want to have in his own household, but feels, as the only son, responsible to care for. as is obvious in all cases discussed in this article, kinship relations are becoming objects of renegotiation in this new phase of retirement. this also affects the relations of couples as some are developing strategies for and living out old age together, and some are opting for independent futures. all the people from northern benin who are working in cotonou aim to construct a house in parakou, and those who have the money are actually building the house. it is not only a marker of status and class position, but also this creates a new space that maintains distance from other kin and their demands, but at the same time, allows them to be “back to the north” and living retirement at least partially there. the new houses are also markers of belonging to the north, something which middle-class people who moved away wish to share with those who have stayed there. finally, creating and maintaining new households is a sign of economic power and self-reliance. this is why people like georges and aliou, having lived in cotonou and wish to establish a household in parakou, are rarely constructing their houses on family land or within compounds of their relatives. rather, they prefer to build new villastyle houses on their own purchased land. this new age-inscription is also shaping the face of parakou. more than ever, the city has become a hub of connections between people who belong to the borgu, anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 78 independently from where they have spent their years of active work. conclusion my article has addressed new ways of experiencing old age among urban middle-class people in benin who were mainly quite successful. i have called it, following a local way of speaking, retirement. retirement differs notably from how their parents have lived and conceptualized old age. it is related to a notion of the life course structured by work that foresees a phase after work. however, as shown by the example of women who are not working in the formal sector, retirement has expanded beyond the sphere of formal work to become a generalized notion of new ways of aging. these are linked, as i have argued, to a notion of the institutionalized and a somewhat individualized life course. in the center is the idea of maintaining independence from one´s own kin, and especially from children in old age, by living a middleclass life using one´s own resources. new age-inscriptions, such as the attempts to create new spaces in the form of retirement households in parakou, are developing. constructing new models and lifestyles for each phase of the life course is, as i have shown, an important part of the production and reproduction of class. however, up until now, the desire to live old age as retirement is an emerging inscription that has not become the dominant norm. older norms of living old age, such as the obligation to care for one´s parents, are still present. therefore a multiplicity of norms and scripts are present in benin. people have some choice, but they are nevertheless also dependent on their economic resources as well as the obligations they have towards others. the construction of homes in different places is the key activity to prepare for a “proper” old age, an old age that allows closeness to the region of origin as well as independence from the extended kin group. the new retired want to have a place on their own if any possible, but they also want to be close to those with whom they are related (their parents, siblings and children). time will show if the ageinscriptions which are developing around the notion of retirement could become a dominant norm of old age. however, an important pre-condition would be that large parts of the population would be able to live more independently from their children than has been the case up to now. acknowledgements the field research for this paper was realized in 2015 and 2016 in the frame of the sub-project “middle classes on the rise” financed by the bayreuth academy of advanced african studies, university of bayreuth. i wish to thank doreen and all my informants for their openness and friendship. my thanks go as well to cati coe, tabea häberlein, lena kroeker and carola lentz for critical readings of this paper, and to my colleagues in the bayreuth academy. notes i all names were changed in order to respect confidentiality. ii i use the term old age here as a comprehensive concept for the late phase in the life course. in contrast, retirement is a specific concept within old age. iii for lesotho see e.g. tanga 2008. in south africa, the introduction of general pension payments to each elder person has influenced the position of the elderly in the households but also that of others. as case and menedez (2007) have shown, the money does not only increase the status position of the elder, but it is also used for a better care of the children in the households. boden (2008) argues quite similarly for the case anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.171 http://anthro-age.pitt.edu alber | 79 of namibia. iv if i am calling retirement as a new and heterodox concept that emerged in the concept of an older one, i do by no means see this older concept as being the timeless way of living old age in africa. recently, coe (2017) has shown the constant transformations in the ways of elder care by kin during the 20th century. v even if this is especially relevant for the urban population, it has also affected the rural populations. nobody could grow up in benin any longer without at least having a birth certificate and identity card, and thus, a fixation of the year and date of birth. vi cf. modernization theory and a description of the way african families would take from extended, kinbased families towards individualistic nuclear families see goode 1963. vii despite the inflationary use of the term, there are only few attempts to conceptualize the term itself, especially in social anthropology. among these see especially lentz 2016, kroeker et al. 2017, neubert 2014. viii in a very impressive way, this was argued by mosa phadi´s documentary movie “phakathi: soweto’s middling class” (2013) in which she argued that about 60 % of all people living in soweto, are calling themselves middle class. see also kroeker and lentz (2015). ix see alber 2000, 2014 x fidèle ballo has also worked with the results of the questionnaires. see ballo 2017 xi because of the mentioned complexity, i am distinguishing between middle-class persons and middleclass households. the latter are households run by at least one or a couple of middle class 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(accessed 13-4-2017) republique du bénin, presidence de la republique. 2005. loi 86-014 du 26 septembre 1986, portant code des pensions civiles et militarires de retraite. cotonou: presses de olimp. republique du bénin, assemblee nationale. 2015. loi n° 2015-19 modifiant et complétant la loi n° 86014 du 26 septembre 1986 portant code des pensions civiles et militaires de retraite. cotonou. sabean, david. 1998. kinship in neckarhausen 1700-1870. cambridge: cambridge university press. sabean, david and simon teuscher. 2007. “kinship in europe: a new approach to long-term development.” in kinship in europe. approaches to long-term development (1300-1900), edited by david sabean, simon teuscher and jon matthieu,1-32. new york, oxford: berghahn books. smith, daniel jordan. 2004. “burials and belonging in nigeria. rural-urban relations and social inequality in a contemporary african ritual.” american anthropologist 106 (3): 569–579. solga, heike, peter a. berger and justin powell (eds.). 2009. soziale ungleichheit: klassische texte zur sozialstrukturanalyse. frankfurt am main: campus. tanga, pius, t. 2008. the impact of old age pension on households and social relationships in lesotho. review of southern african studies vol. 12, no. 1 & 2, p.184-215. https://opendocs.ids.ac.uk/opendocs/bitstream/handle/123456789/6406/pius%20t.%20tanga.pdf?seq uence=1unicef statistics. 2017. accessed 12 april 2017. https://www.unicef.org/french/infobycountry/benin_statistics.html. van der geest, sjaak, anke mul and hans vermeulen. 2004. “linkages between migration and the care of frail older people: observations from greece, ghana and the netherlands.” ageing & society 24: 431–450. world bank 2017: pension matters. http://documents.worldbank.org/curated/en/743801468190183781/pdf/98131-nwp-1503public-box385180b-pension-matters-africa.pdf erdmute alber erdmute alber anthropology & aging quarterly 2013: 34 (2) 157 marginalization through national historical politics in contemporary poland, older people often describe and experience old age as a time in the life course marked by discrimination and marginalization. in the public sphere, older people speak of rudeness on city buses and trams (“no one gives up their seat for us”), and of feeling “transparent” (“przeroczysty”) on the street. in the private sphere, older people describe feeling lonely after they retire as their network of social contacts shrinks, losing a sense of purpose outside their family. some older people go so far as to describe growing old as losing one’s personhood. in the media, old age is often portrayed in negative terms, defined by physical and mental decline and social isolation, silver linings: older people defying expectations challenging marginalization at the universities of the third age in poland jessica c. robbins-ruszkowski woodrow wilson international center for scholars weiser center for emerging democracies, university of michigan and often couched in the language of demographic fear (wilińska and cedersund 2010, zierkiewicz and łysak 2005). this cultural devaluation and marginalization of older people is associated with national political-economic shifts that have occurred during the lifetimes of the oldest generations in poland, in which older people have become socioeconomically disadvantaged (calasanti and zajicek 1997, synak 2003, trafiałek 2003). moreover, contemporary interpretations of the past that link the lifetimes of older people, and especially older women, to a nationalist catholic understanding of the polish nation can further exclude older poles from full inclusion in society.  the most visible challenge to such temporal, bodily, and social exclusion occurs through universities of the abstract older people in poland often describe and experience old age as a time in the life course marked by discrimination and marginalization. in this postsocialist context, a still-dominant cold-war logic links older people to the devalued socialist past and younger people to the present and future of the polish nation-state. contemporary media portray old age as defined by physical and mental decline and social isolation. the most visible challenge to such temporal, bodily, and social exclusion occurs through universities of the third age, where older people learn new skills, cultivate hobbies, and explicitly theorize growing old as a positive phase of life. drawing on twenty months of ethnographic research, this article traces key sociocultural, political-economic, and historical factors that contribute to discrimination against and empowerment of older people in poland. by analyzing national politics and media representations of old age together with ethnographic data from universities of the third age, this article highlights the practices through which older poles feel themselves to be transformed in old age—and asks who may be excluded from such practices—thus contributing to gerontological discussions of “active aging” and anthropological understandings of sociality in late life. keywords: active aging, postsocialism, universities of the third age, poland. anthropology & aging quarterly 2013: 34 (2) 158 jessica c. robbins-ruszkowski challenging marginalization third age, where older people learn new skills, cultivate hobbies, and explicitly theorize growing old as a positive phase of life. universities of the third age are currently experiencing a “boom” in poland, with half of the almost 400 universities of the third age nation-wide having been founded in the last ten years.1 this increase in universities of the third age is occurring at the same time as european governments are focusing on policies promoting “active aging” as a response to demographic changes (see perekbiałas et al. 2006 for a discussion of active aging policies in poland and the czech republic; see boudiny 2013 for a critical analysis of the multiple meanings and uses of active aging).  universities of the third age have a deep history in poland: the first polish university of the third age was founded in 1975 in warsaw, only two years after the first-ever university of the third age was founded in toulouse.2 although the specific activities and pedagogical styles vary greatly in universities of the third age worldwide (see formosa 2012 for a recent global history of universities of the third age), they all share a focus on providing education for older adults in the so-called “third age,” or “the span of years between retirement age and the advent of age-imposed limitations” (weiss and bass 2002:29; see laslett 1996 for a canonical explication of the “third age”). in poland, there are varying models of institutions—some are associated with universities, while others are free-standing organizations—that have varying models of payment and participation, ranging from the nearly free (e.g., 30 usd per year) to the more expensive (e.g., 30 usd for each class). some people organize their whole lives around the institutions, attending a class or workshop nearly every day, while others attend only one class. nationwide, over 80 percent of attendees are women, which, in addition to the greater number of older women in the population, can be explained by gendered patterns of sociality and ideologies of the life course, in which women are thought to be most deeply connected to other people from childhood to late life, while men are understood to be more strongly connected to the world of things and nature.3  worldwide, universities of the third age aim to improve the lives of older people through a range of educational activities. as has been well-established by research that demonstrates improvements in a variety of physical, social, and psychological measures of older people who participate in these programs, these efforts are often quite successful (e.g., formosa 2012; kozieł and trafiałek 2007; moody 2004; swindell 1993, 2012; swindell and thompson 1995; zielińska-więczkowska and kędziora-kornatowska 2009; zielińska-więczkowska et al. 2011). despite these improvements in the wellness of participants, however, there is other evidence that critiques these institutions for their age-segregation (formosa 2012) and their tendency to attract elite members of society (e.g., formosa 2006, moody 2004, wilińska 2012). in the scholarly literature on education in later life, however, universities of the third age are recognized as important institutions through which many older people around the world can work to eliminate the marginalization and exclusion that they face as older persons.  in poland, these transformative goals are explicitly part of universities of the third age (ziębińska 2007); these institutions thus pose a productive site in which to investigate how older people in poland can overcome stereotypes in old age. moreover, the high prevalence of women at polish universities of the third age provides a direct contrast to the stereotype of the babcia, or grandmother, in which older women are primarily associated with the family (wilińska 2010, wilińska and cedersund 2010). polish women who attend universities of the third age thus seem to be overcoming stereotypes that are both general to older people and particular to older women.  in this article, i draw on data from twenty months of ethnographic fieldwork that i conducted in educational and medical institutions in wrocław and poznań, two cities in western poland, from 2006 to 2012, with the longest fieldwork period occurring between 2008 and 2010. the primary educational sites of study were universities of the third age in wrocław and poznań, where i attended classes and weekly lectures, interviewed participants and staff, taught conversational english classes, and reviewed institutional archival material. i also conducted interviews with participants in an ngo-run educational program in wrocław called @ktywny senior (@ctive senior). this article draws on the 39 interviews and many hours of observations that i conducted at educational institutions, as well as interviews and observations from my time at the medical institutions where i conducted my fieldwork.4 the interviews were open-ended and i tried, as much as possible, to let the interviewee guide the conversation (briggs 1986). in addition to interviews, i also had more informal unstructured conversations with participants and staff.  i interpret this ethnographic data in the context of national politics and media discussions of aging in an attempt to merge microand macro-level perspectives on aging in poland. by tracing key sociocultural, politicaleconomic, and historical factors that contribute to discrimination against and empowerment of older people in poland, this article aims to create a holistic discussion of aging in poland. first, i will analyze two political events of the last decade to demonstrate how popular discourse on the polish nation links the figure of the old woman with anthropology & aging quarterly 2013: 34 (2) 159 jessica c. robbins-ruszkowski challenging marginalization that of the polish nation. next, i will analyze an influential newspaper series on aging in poland in which a prominent social psychologist criticized universities of the third age. then, i will use ethnographic and textual evidence from the university of the third age in wrocław to show how older women perceive their participation in this institution as a response to contemporary discrimination and a lifetime of labor for others. by combining an analysis of popular media with ethnographic observations and interview data, this article both elucidates the nationalpolitical aspects of stereotypes of older people in poland and describes popular attempts to overcome these stereotypes.  understanding the discursive links between older people and the polish nation demonstrates the moral stakes of older people’s participation in universities of the third age in poland. my theoretical perspective is grounded in anthropological studies on personhood, and especially those of marcel mauss ([1925]1990, [1935]1985) and t. o. beidelman ([1986]1993), in which personhood is formed through social relations and cosmological imagination, and is thus inherently moral. therefore i see the moral personhood of older people in poland as intimately tied both to discursive imaginations of the polish nation and to everyday practices of aging. this article highlights the practices through which older poles feel themselves to be transformed in old age—and asks who may be excluded from such practices—thus contributing to gerontological discussions of “active aging” and anthropological understandings of sociality in late life. mohair berets and defenders of the cross two moments during the last decade demonstrate particularly well the connection between older people and the nation in poland. talk about older people in both the media and daily life can become evaluative conversations about the state of the polish nation. these are often deeply gendered discourses (graff 2009; mcclintock 1996; mosse 1988). in other words, older women become figures of the nation (see cohen 1998 for related connections between old women and the nation in india). these two historical moments demonstrate the degree to which the figure of the old woman is associated with a particular nationalist catholic understanding of the polish nation.  the first example relates to polish national elections, which in recent years have shown the extent to which age and generation can index political worldviews. as has been well-documented across eastern europe, political opposition to the former socialist state sometimes brought about the rise of right-wing nationalism (e.g., verdery 1993). in postsocialist poland, denouncing the socialist past is still a common move among far-right politicians, who draw on the historical legacy of partitioned poland and soviet rule to champion an independent polish nation that is ethnically polish, catholic, and ardently anti-communist. the strength of this ideology perhaps reached its zenith in poland in 2005 when the law and justice party (prawo i sprawiedliwość, or pis), led by the identical twin brothers lech and jarosław kaczyński, won both presidential and parliamentary elections. pis came to power on an anti-corruption, anti-communist, and strongly catholic platform. for pis, to be a proper polish citizen is to uphold “traditional” family values, epitomized in the performance of clearly demarcated patriarchal gender roles (graff 2009). because pis did not win a large enough percentage on their own, they had to form a governing coalition; their coalition partners were the league of polish families (liga polskich rodzin, or lpr) party, an extremist nationalist religious party, and self-defense (samoobrona, or so), the so-called peasants’ party. support for these parties among older people was extremely high, especially among those from more rural, eastern regions of poland.5 this coalition government ultimately proved unstable, and pis lost parliamentary elections in 2007 to the more center-right pro-business civic platform (platforma obywatelska, or po) party.  this political instability manifested in generational terms in the months leading up to the 2007 parliamentary elections. the link between older women and the conservative nationalism of pis took the figure of the moherowe berety (mohair berets). this term refers to the wool caps that many older polish women wear, and has come to stand for groups of older rural women who support pis and listen to the conservative nationalist catholic radio station radio maryja, the flagship member of a media conglomerate run by the controversial, conservative priest father tadeusz rydzyk.6 a widely circulated image from the months before the 2007 parliamentary election depicts a large group of older women wearing these hats attending what is presumably a mass, with the added caption “vote, or else they’ll do it for you!”7 intended as a get-out-the-vote campaign targeting younger voters, this image demonized elderly women en masse because of their politico-religious views. another ad urged, “take your grandmother’s identity card!” (thereby making it impossible for her to vote).8 in both these images, it is not merely older people who are seen as threatening here, but specifically older women. in other words, in the popular imagination in poland it is particularly older women who are associated with the conservative nationalist views of pis and radio maryja. significantly, it is when these older women come together as part of a voting bloc that they become dangerous; one older woman who listens to radio maryja is harmless, but hundreds of such women are dangerous. anthropology & aging quarterly 2013: 34 (2) 160 jessica c. robbins-ruszkowski challenging marginalization  more recently, the controversies over the placement of a cross following the tragic plane crash in april 2010 that killed 96 people near smoleńsk, russia, can also be understood in generational terms. this tragic accident occurred as the president, lech kaczyński, and many top governmental officials were traveling to smoleńsk to mark the 70th anniversary of the massacre of polish officers in the katyń forest. it soon became clear that the party of the late president and his supporters understood this as the latest event in polish national martyrdom. people spoke of a second katyń and conspiracy theories ran rampant, blaming po or russia for the crash (lech kaczyński was running for re-election at the time of the crash). the event became cemented as part of the national mythology of suffering when the president and his wife were buried in the crypts of wawel cathedral in kraków, alongside polish kings. after the crash, public spaces throughout the country were filled with memorials of flowers, candles, pictures, and messages. outside the presidential palace in warsaw, girl and boy scouts erected a large wooden cross as a memorial. when the newly elected president (bronisław komorowski, from po) tried to move the cross to a nearby church, people refused to let it be moved. even though this move had the approval of the church, people guarded the cross and refused to let it be moved; the deceased president’s twin brother, jarosław kaczyński, who had just lost the election for president to komorowski, also supported leaving the cross in the current position. these protests sparked a counter-protest by people who wanted the cross moved.9 media coverage of the events, which lasted for months, depicts those protesting the removal of the cross as older, and those demonstrating for its removal as younger. in august, after a failed attempt at moving the cross to the church, explicit conflict broke out between the two protest groups. the polish political philosopher leszek koczanowicz describes the groups in generational terms: one crowd consisted of young people who organized a kind of carnival playing popular songs and performing short scenes that in eyes of the second crowd were on the verge of blasphemy, for instance, making a cross out of beer cans. the second crowd consisted largely of older people praying, listening to priests and speakers, and singing religious songs. [2012:822-823]  although koczanowicz (2012:823) finds these groups united in their individualist-based rejection of various authorities, i would highlight the generational differences of these groups. certainly not all who wanted the cross to stay were old, or all who wanted to remove it were young, but given the broader political context of poland, it is clear that important national ideological differences have generational fault lines.  in both events, older poles, and especially older women, were central figures in public discourse about the future of the country. this popular dismissal of older poles as out-of-touch was echoed in conversations i had with poles of roughly my own age (in their late twenties to thirties), who would explain anti-semitic, racist, or conservative religious comments made by an older person by saying things like, “these older people just need to die off.” “our society won’t move forward until the older generations are gone.” however, such comments about anonymous older poles contrast with the same person’s warm feelings towards his or her own grandparents. that is, the animosity towards the anonymous or unknown older person, or the elderly en masse, contrasts with the warmth that people feel for specific older people that they know. in these conversations with poles of my own age, exactly which part of the past made older people problematic for the national future was not always clear. it was often their association with the nationalist far-right and its exclusionary policies and visions, as described above, but sometimes it was the very fact of their having come of age and worked during the socialist era, leading them to have a socialist-era mentalność, or mentality. regardless, it was their association with the past that made their future inclusion suspect.  this link between older people and the socialist past, and younger people and the capitalist, democratic, and globalized present and future, i argue, is a key way that older people, exemplified by older women, are made marginal to the present and imagined future of the polish nation-state. yet this marginalization of older people exists in other domains besides the explicitly political. in the next section, i will focus on one interview with a prominent polish psychologist that motivated a series of articles about aging in a leading polish newspaper. analyzing this interview serves to demonstrate in more detail the moral stakes of negative perceptions of old age in poland, which attendees of the universities of the third age attempt to overcome. “no country for old people” the series “polska to nie jest kraj dla starych ludzi,” or “poland is no country for old people,” ran for ten days in gazeta wyborcza (electoral gazette), poland’s largestcirculating non-tabloid daily newspaper, in november 2008.10 the paper of record in poland since 1989, gazeta wyborcza emerged out of the solidarity movement in the 1980s as the major independent daily newspaper. this series emerged out of a provocative interview with a wellknown psychologist, wiesław łukaszewski, on the topic of aging and is one of many such occasional topical reports that gazeta wyborcza publishes.11 the series consisted anthropology & aging quarterly 2013: 34 (2) 161 jessica c. robbins-ruszkowski challenging marginalization of 17 articles and 33 letters from readers, published on weekdays for two consecutive weeks. beginning with a survey on perceptions of old people and an extended interview with łukaszewski (wodecka 2008), the articles in the first week focused on the discrimination common to many poles’ experiences of aging, taken to the extreme in a terrifying story about an abandoned old woman, władysława baranowska, left to die alone in her apartment (kasperska 2008). also including articles about upcoming changes in the social security system, discrimination in the media, an economic comparison of old age today and in the 1970s, recommendations for being healthy in old age, and a manifesto called “old age is beautiful,” the first week presented aging as a largely negative experience, and made clear the newspaper’s attempts to change this.  the second week, which included fewer articles and more letters from readers, reported on dire demographic changes and the state of medical care for the elderly in poland, and described the relationship between elderly people and new technology (e.g., computers, cell phones). ending with two stories about older people’s experiences of discrimination in the workplace, the series seemed to conclude in the same place it started: namely, discrimination. the series seemed to emphatically confirm its title, that indeed, poland is not a country for old people. by covering such a wide range of topics and encouraging readers to share their experiences (many articles end with the provocation, “is poland a country for old people? write in about your own old age”), the newspaper attempted to create a national dialogue on old age in poland.12  throughout the articles on aging in gazeta wyborcza, a vivid vocabulary emerges to describe aging. for example, a scholar lists some of the negative words used to refer to older women, including “megiera,” a word for a nasty, ill-tempered old woman derived from magaera, one of the greek furies, and “mother-in-law” (zawadzka 2008), which one polish friend equated with megiera. the use of the word “still” (jeszcze) in survey questions (e.g., “do i still earn money?” or “what do you still want to do in your life?”) signals an expected end to a particular activity or dream (klimowicz and sokólska 2008); in other words, asking if one is “still” doing something in old age reveals an expectation that activity might have ceased.13 taken together, these words evoke painful histories, problematic everyday social encounters, and difficult positions within families, all shaded by expectations of decline in old age. this vocabulary is overwhelmingly negative and depressing.  gazeta wyborcza presents aging persons in two morally distinct categories. who was responsible for creating such good, bad, or non-persons, however, remains ambiguous throughout the series. the major difference between these moral categories was determined by levels of activity or social engagement; the many older people portrayed as isolated, lonely, depressed, poor, and ill, are the typical negative examples of growing old, while the few people who are described as active, sporty, and socially engaged are the positive examples of growing old.14 the primary distinguishing characteristic between negativelyand positively-presented old persons is whether one is the same or different person than when one was younger; what counts as sameness and difference in personhood is imagined on the basis of activity. if one has the same degree and quality of (mental, physical, and social) activity as when one was younger, one can maintain a continuous personhood. if, however, one’s engagement with the world diminishes, shrinking and dwindling until the end of life, then one becomes a different sort of person in old age. this different sort of personhood is a lesser sort of personhood; that is, being less active makes one less fully human than one’s more active and younger peers.  but the experiences of łukaszewski suggest that activity in old age is not enough to stave off such discrimination. as a professional older man who is still working, according to the ideals of active aging, he should have been satisfied and fulfilled. nevertheless, he experiences intense discrimination. how can independent ideals of self-fulfillment, self-reliance, and flexibility explain his situation?  in an article entitled “when i go rollerblading, the brats yell: to the grave, grandpa!”(wodecka 2008), łukaszewski describes various instances in which he has experienced discrimination as an older person. for example, he feels “przezroczysty” (“transparent”) on the street, where younger people look through him as if he were not there, and in other public spaces (clubs, stores, parks), ads, and on internet forums. he attributes this to a contemporary culture that privileges a quick pace over a slow one, and in particular, blames poland’s “monopolistic” culture for encouraging discrimination. besides, polish culture is monopolistic, meaning that we have one language, one faith, one system of values. such cultures are very dogmatic and prone to discrimination. even in the polish village there is no respect for the old. in the past, they were the main source of knowledge, but now the television has taken the role of wise old people. the elderly have lost their basic function as carriers of culture. they’ve become second-class citizens. they’ve become untermenschen (sub-human). it seems to me that in the opinion of many young people, an old person belongs to a completely different species. neither homo nor sapiens.15  łukaszewski’s use of the word untermenschen is striking; meaning ‘sub-human’ in german, the term is associated with nazi race science and was used to label anthropology & aging quarterly 2013: 34 (2) 162 jessica c. robbins-ruszkowski challenging marginalization slavs (including poles) and jews as inferior types of persons, appropriate for extermination. as an older pole, he was certainly aware of this word’s history, and was most likely using it consciously and deliberately. it is hard to imagine a stronger or more damning word for a pole to use to describe experiences of discrimination, making łukaszewski’s characterization of old age emphatically and unequivocally negative.  the interviewer’s response is to suggest not consenting to practices of discrimination, to which the professor says that he himself does not, but that as a group, “old people are socially and economically poor” and therefore afraid.16 łukaszewski attributes this fear to poles’ lack of trust in others, reflected in the lack of trust that dominates the whole of polish social life. because older people are afraid, he says, they want to remain anonymous, which is why so many older people are active within the church and in universities of the third age. neither the church nor universities of the third age expect “acts of personalization” from its participants, łukaszewski claims.17 “instead the opposite, [they] expect anonymity, depersonalization. that’s an excellent niche for old frightened people.”18 he describes universities of the third age as places that aim to fill up the endless empty hours of “unfortunate old folks,” having nothing to do with actual universities or learning.19 he instead suggests that the government fund the education of a few old people at undergraduate universities, where they could study alongside their younger peers, rather than spending their time at so-called universities making pots or tapestries, just so they can feel needed.  the professor emphasizes older people’s desire to feel needed in his comments regarding relationships with adult children. the interviewer describes older people whom she knows who support their children and grandchildren financially “so that my kids will have it better,” but are really afraid that if they stop caring for their offspring, they will cease being necessary.20 the professor responds that such care provides older people with proof of their importance, but that they provide such care out of a sense of duty, rather than real desire.21 “it’s the language of necessity: i have to be at home because stefan is coming with the kids and i have to make crepes. they don’t say that it’s fun or a blessing. the word ‘i have to’ is the key, it’s the testimony to continuous duty, the fulfillment of which is the reason for their usefulness.”22 in other words, łukaszewski claims that older poles who care for their kin are doing so to avoid the discrimination and dehumanization that accompanies old age. however, he sees these ties of obligation, evident in the language of necessity, as excluding a genuine desire to care. given that it is primarily older women who provide care within the family, and that one can simultaneously be obligated to and desire to care, i read łukaszewski’s statements as possibly denigrating the genuine efforts of older women to help their kin.  łukaszewski thus gives an authoritative voice, as both a professor and a man, to experiences of discrimination in old age. not easily dismissed or ignored, as a woman or less-educated person might be, by including his perspective early in the series the newspaper reinforces the strength of such negative understandings of old age. intentionally provocative, łukaszewski’s words prompted several angry letters of response from those who supported universities of the third age, and people at the university of the third age in wrocław were so outraged that they held a special meeting to discuss the professor’s incendiary remarks. the moral practice of aktywność at universities of the third age the interview with łukaszewski in the gazeta wyborcza series struck a nerve with university of the third age słuchacze (attendees) in wrocław.23 his denunciation of universities of the third age as old-age ghettos deeply upset many słuchacze, who felt that they had been misunderstood and misrepresented. on a thursday afternoon in december 2008, master’s-level students studying for their degree in andragogika (adult education) moderated a two-hour discussion with słuchacze in the main meeting room of the university of the third age, at the institute of pedagogy at the university of wrocław. around 30 people attended, mostly słuchacze but also a few students in andragogika. i attended the meeting as part of my fieldwork at the university of the third age. throughout the discussion, słuchacze and students alike extolled the virtues of universities of the third age for the opportunities it provides to create a good old age.  both older and younger students spoke passionately about their participation in the university of the third age, and said that łukaszewski did not really understand what went on there, for if he did, he could never had categorized it thus. one słuchaczka, who is involved in the administrative work of the university of the third age, criticized łukaszewski for not having a better understanding of what happens at universities of the third age. in her view, słuchacze are “crossing certain barriers” that are not expected of older people: the very act of learning itself, walking up the stairs at the university (she said she had only recently come to see this as a barrier), and being artistic.24  through these activities, słuchacze are defying expectations of their role as older people in society. despite this słuchaczka’s critique of łukaszewski, he anthropology & aging quarterly 2013: 34 (2) 163 jessica c. robbins-ruszkowski challenging marginalization redeemed himself in her eyes by discussing the importance of spending time with younger people. she has greatly enjoyed her time in classes and workshops with younger people; these gatherings leave her smiling. moreover, she thinks that słuchacze can show younger students how to age. she attributes the rudeness towards older people in public as a result of a lack of contact between older and younger people. through breaking these boundaries of what is expected of them, słuchacze can encourage younger people to think that “this age isn’t so terrible,” and that “one would like to experience this old age and would like to be old.”25 an older man also saw part of his role in old age as teaching younger people how to grow old, which he did by encouraging the younger people in the room to read deepak chopra’s (1993) aging body, timeless mind, and to cultivate a “strategia” (“strategy”) for growing old, in which one should have “aktywność maksymalna” (“maximum activity”) in all spheres of life: intellectual, physical, psychological, and moral.26 through such strategies, people can learn to approach old age “with the hope of a life that could be even better and more interesting.”27 his comments were met with a loud round of applause.  throughout this discussion, older and younger people alike reiterated the moral aspect of universities of the third age. one student spoke of how inspiring it was for her to see older people participating in such a diverse range of activities; from this she has learned that how one grows old is one’s choice. “i am really glad that you are showing us, especially young people, that everything depends on us. and that it’s really our decision what this phase of our life will be like.”28 another student critiqued łukaszewski for his positive portrayal of the west because that student had spent time as a child in the u.s., where his friends did not even know their grandparent’s first names. he took this as a sign of the weakness of kin ties in the west, and contrasted it to the strength of kin ties in poland. here, he said, “these ties exist between the young and old generation – this is also our capital, on which we can work for the future.”29 this comment was also met with applause.  this discussion crystallized much of what i see as key to how słuchacze in both wrocław and poznań understand their participation in the university of the third age. through practices of aktywność (activity), older people no longer have to be the stigmatized, isolated adults described in gazeta wyborcza. rather, through the lectures and classes at the university of the third age, people can transform themselves into moral exemplars for the younger generation. becoming such a moral exemplar occurs through the practice of aktywność across domains of life: physical, mental, spiritual, and social. this ideal of setting an example for younger people is accompanied by the intense determination of słuchacze to make aging a positive experience, in ways that contrast with their lives until this time. mostly well-educated upper-class women who had retired from jobs as teachers, accountants, or medical workers, słuchacze described their lives before their participation in the university of the third age as busy with work and family. at the university of the third age, these women told me that they can finally robić coś dla siebie, or do something for oneself.  the practice of aktywność is explicitly theorized and promoted by the leaders of universities of the third age and other “active” aging programs. in the words of walentyna wnuk, a former director of the university of the third age in wrocław, “we have to learn how to age well” (2009:5).30 a current adviser to the mayor on seniors’ affairs, she is trained as a “cultural organizer” (“kulturalny animator”) and sees herself as skilled in helping people achieve their potential. she is active in efos (european federation of older students at universities), an international coalition of universities of the third age. this group’s goals, as described on their english-language brochure, are to “activate elderly people, integrate them in the learning society and stimulate the intercultural dialogue as a transfer medium. in this way we will contribute to an active citizenship of the elderly people.” wnuk aims to foster such “active citizenship” through organized trips to brussels and strasbourg in which utw students meet their european parliament representative.  according to wnuk, słuchacze described these trips as transformative because they changed the minds of people who had opposed poland’s eu membership. older poles need to learn to be “open,” she said, in contrast to the socialist past, when society, and therefore persons, were “closed.” she sees the university of the third age as helping to create a new model of aging and a new type of person—a “eurosenior”—who better fits with the current world order. a binary cold war logic underpins this comment, in which a closed, socialist poland is opposed to an open, capitalist, democratic western europe. the chance for polish retirees to meet with their european parliament representative or travel to brussels is part of a teleology in which the west remains the ultimate goal.  although universities of the third age often offer a variety of classes and workshops, ranging from practices often associated with older people (e.g., embroidery, cabaret groups) to those more commonly associated with youth (e.g., learning foreign languages, volleyball), it is the latter sort of activity which carries ideological weight at the universities of the third age, both for the słuchacze and the institutions. currently, english language and computer classes are among the most popular courses of study. these topics fit well with the political economy anthropology & aging quarterly 2013: 34 (2) 164 jessica c. robbins-ruszkowski challenging marginalization and culture of contemporary poland, where english and computer skills are requirements for many jobs and symbolize the capitalist, globalized present. older people who speak english (instead of the russian that they were forced to learn as children during state socialism) and who can use computers thus have access to the symbolic capital associated with these practices. however, both english and computer skills are also useful for the many older poles who have family living abroad in englishspeaking countries. that is, many older polish people want to learn english to communicate with non-polishspeaking kin via computer programs such as skype (the verb “skajpować,” or “to skype” has become common in spoken polish). this practical use is at least as important as the political economic and cultural significance of these skills, suggesting the need to focus analytic attention on the social dimensions of the universities of the third age.  one retired teacher, jolanta, who has attended the university of the third age for over eight years, in many ways seems to be the ideal example of an older person who has been thus transformed through attending the university of the third age. jolanta began attending the university of the third age after she had been retired for ten years and both her children moved away. widowed, jolanta became lonely and sought out the university of the third age as a way to overcome this loneliness. her strategy for aging was to fill in what she felt she had missed out on during her life; for example, she learned to swim at age 70. jolanta describes her experience there as providing her with a “druga rodzina,” or “second family.” this “family” gives her support, companionship, and above all, she says, advice for coping with health problems. jolanta’s “second family” now takes up her time in a way that prevents her from seeing her kin; she regrets that she can only visit her daughter in england during breaks in the university of the third age’s school year, and that she does not often visit her husband’s or parents’ graves because of the time she spends at the university of the third age.  jolanta is typical of many of my research participants at the university of the third age. these women found in the university of the third age a way to form new social relations to overcome the loneliness accompanying retirement, and often, widowhood (cf. wilińska 2012). they describe retirement and aging as negative experiences that have been improved through participating in the university of the third age, through learning new skills and learning how to cultivate a sense of personhood in old age. yet, although jolanta was proud of the new skills she had learned through the university of the third age, it was the new social relations that seemed most important to her. in other words, jolanta’s transformation from a lonely older person into an active senior occurred not only through the kinds of skills and international cultural groups encouraged by institutional leaders, but also, and perhaps even primarily, through the cultivations of new ties of relatedness (carsten 2000, 2004) that supplanted her previous kin ties. this significance of social relations contrasts both with the language of individual empowerment that was evident in the discussion at the university of the third age about łukaszewski’s comments, and with popular discourse that links older people to national frameworks. rather, the significance of close friendships and new social relations for jolanta and other women like her suggests that greater anthropological attention should be paid to the social dimensions of “active aging” and empowerment. the limits of empowerment jolanta’s experiences highlight social dimensions through which older people in poland can combat dominant cultural stereotypes of aging. słuchacze find these institutions to be empowering; older women can regain personhood lost through retirement, widowhood, and negative stereotypes. however, these empowering experiences are not equally available to all older people. health and especially mobility are key factors determining access to the universities of the third age (see formosa 2012:14 for a critique of universities of the third age for their exclusion of those with disabilities). poland’s urban spaces are difficult, if not impossible, to navigate for those with mobility impairments (see bujacz et al. 2012 for a study of the city of poznań according to the needs of older people, and phillips 2011 for an ethnographic study of mobility and disability in ukraine), to say nothing of multi-story apartment buildings with no elevators. for people who do not have the bodily capabilities to attend the universities of the third age on their own, or other socioeconomic resources to help them do so, such institutions remain essentially off-limits. moreover, the rhetorical ideology of “active aging” is not equally available to all, as it relies heavily on 19th-century bourgeois ideals of personhood in which leisure time and the pursuit of certain hobbies become markers of high class status (see jakubowska 2012 and robbins 2013 for a further discussion of the legacy of the 19th-century among older people in contemporary poland). in other words, the moral ideology of “active aging” produces and reflects different classes of persons and bodies. in order to make concrete the socioeconomic aspects of the possibilities for “active aging” in poland, i will present a final example from the gazeta wyborcza series on aging.  it is impossible to imagine the retired professors and engineers of the gazeta wyborcza series, so vibrant, busy, and healthy, in the position of władysława baranowska, an older woman whose tragic old age and death is detailed in anthropology & aging quarterly 2013: 34 (2) 165 jessica c. robbins-ruszkowski challenging marginalization a long article in the series. this older woman was brought to the hospital “in a state of extreme emaciation, neglected, with bedsores, with white worms in her wounds.”31 the admitting doctor remarked, “only homeless people come to us in such a state.”32 the article describes a failed network of care that led to this end; despite a daughter living nearby, paid caregivers, and multiple trips to the hospital, nothing prevented ms. baranowska from “[coming] to such an end as if she were trash,” in the words of her neighbor.33 this neighbor blamed baranowska’s daughter for neglecting her mother, while also recognizing that their shared apartment building was not a suitable environment for an older person living alone. baranowska’s son-inlaw, meanwhile, blamed three different government institutions (the city social aid department, the hospital, and long-term care institutions) for failing his mother-inlaw. there was no clear way for ms. baranowska to receive adequate care.  this damning article presents a jumbled and confusing maze of institutions and individuals that are supposed to provide care, in which meager personal, familial, institutional, and systemic resources do not add up to a dignified life or death for władysława baranowska.34 as a reader, it is hard to know where responsibility should lie; one sees genuine efforts and missteps made by each actor. each health-care institution ultimately blames baranowska’s daughter and family for her condition, while the family blames the institutions. the healthcare system appears fragmented and poor, with no one doctor or institution assuming ultimate responsibility for the patient’s care. the diagnosis of “old age” in ms. baranowska’s chart suggests that at least some medical personnel consider old age itself a disease, raising the question of how earnest any medical treatment of an older person can be, since they will still have the disease of “old age.” the doctor’s comment that he only sees homeless people arrive at the hospital in such a state suggests the existence of a group of people for whom such a bodily state is expected. how can adequate care be provided when the assumption is that old age is a disease, or that homeless people will have worms crawling in their wounds? what kind of old age is possible for such people?  indeed, throughout the articles and letters that comprise the gazeta wyborcza series, persons of different social classes appear, yet class status is rarely explicitly discussed in the moralizing discussions on successful and active aging. that is, those who brag about their own successes or encourage such successes in others do not address the financial or social conditions that play a role in their own successes, and in the “failures” of others. those who share financial and social hardships rarely voice concerns about active aging. while these disjunctions are less overtly dramatic than the shocking details of ms. baranowska’s life and death, they all skirt the same issues: namely, the ideals of a successful, active, old age are incompatible with the everyday lives of many older poles, who, for reasons having to do with finances, social relations, and bodies cannot live according to the ideals of active aging. these older people can be ignored as objects of care, as indicated by the surgeon’s comment about the homeless, fall through the cracks of a broken system of relations, as in the case of władysława baranowska, or be discriminated against by their peers, families, and society, as in the examples of the many older people who wrote letters expressing sadness and loneliness. all become less fully human in their deviations from the ideals of active aging. is there any role for universities of the third age in such cases? might the transformative role of social relations for women such as jolanta have some relevance for women such as ms. baranowska? seeking commonalities at the level of everyday practices of relatedness (carsten 2000, 2004) across such diverse class and ideological contexts suggests that there might be even more possibilities for combatting negative stereotypes of old age in poland. such attention to relatedness could shift the focus of debate from individuals to collectives, as some scholars have suggested (e.g., katz and laliberte-rudman 2004). that is, sidestepping conversations about “euroseniors” and their implicit class hierarchies could provide ways for older poles to forge new forms of personhood that are not so closely aligned with entrenched socioeconomic and national modes of belonging.  in this article, i have tried to frame polish universities of the third age in the context of national historical politics and public conversations about old age. from this macro-perspective, women who attend universities of the third age can be understood as challenging dominant stereotypes of old age in general, and of old women in particular, through their practices of aktywność. institutional focus on poland’s membership in the eu can be understood as an attempt to overcome negative associations of older people with the socialist past, while learning new hobbies and skills can be understood as an attempt to overcome negative stereotypes of old age as a time of decay. however, the example of ms. baranowska suggests that the bourgeois ideals implicit in the activities and rhetoric of universities of the third age, as well as the bodily health required to attend, can exclude many older people from access to a culturally-sanctioned good old age. yet the new social relations that many słuchacze form at universities of the third age suggest that ties of relatedness may be as helpful in combatting negative stereotypes of old age as are the practices or ideals of the universities of the third age themselves. a renewed focus on the sociality of old age, then, may help to show links across socioeconomic divisions and help to expand the anthropology & aging quarterly 2013: 34 (2) 166 jessica c. robbins-ruszkowski challenging marginalization possibilities for personhood among the most marginal in society. acknowledgements this research was funded by the wenner-gren foundation (dissertation fieldwork grant #7736), the national science foundation (ddrig #0819259), and several units at the university of michigan. this article benefited from the constructive suggestions and creative vision of lindsay dubois, liesl gambold, the anonymous reviewers, and jason danely. i am grateful to the universities of the third age in poznań and wrocław for making this research possible by generously welcoming me into their worlds. notes 1. (accessed 6 june 2013). see the recent study “zoom http:// zoomnautw.pl/wp-content/uploads/2012/05/informacja-prasowa_ zoom_na_utw.pdfna utw” for a comprehensive overview of the activities of the universities of the third age in poland. 2.international association of universities of the third age, http:// www.aiu3a.com/origins.html (accessed 1 april 2013). 3.this information on gendered ideas of the life course comes from the author’s long-term ethnographic fieldwork in poland, and is also supported by the research conducted as part of the project “zoom na utw” (towarzystwo inicjatyw twórczych“ę” 2012:46). other possible explanations for the predominance of women at polish universities of the third age are the better health of older women as compared to older men, the later retirement of men, the predominance of retired teachers at universities of the third age and the feminization of the teaching profession in poland (towarzystwo inicjatyw twórczych“ę” 2012:46-50), and cultural understandings of men’s importance solely in the domain of paid labor and of old men as weak (wilińska 2012:299-300). additionally, it should be noted that the feminization of universities of the third age is not limited to poland (see williamson 2000 for a discussion of women’s participation in an australian university of the third age, and wilińska 2012 for a comparison of this case with poland). 4. the medical institutions included a small catholic-run rehabilitation center, a larger state-run home for the chronically physically disabled, and a day center for people with alzheimer’s disease. 5. see rmf24 2005 for a polish-language summary of exit polling. 6. other media outlets include telewizja trwam (i persist television) and nasz dziennik (our daily). 7. „głosuj, albo one zrobią to dla ciebie!” “one” is the feminine third-person plural form, indicating that this is specifically directed towards women. 8. see http://www.nytimes.com/2007/10/21/world/europe/21poland. html?pagewanted=all&_r=0 for an english-language discussion of this generational conflict and to see a video clip of the ad. the rock band big cyc also had a song entitled “moherowe berety”; see https://www.youtube.com/watch?v=yji_unigwdq (accessed 13 may 2013) for a video of the song, which features many images of “moherowe berety” and the conservative politicians that they are thought to support. 9. see porter-szücs 2011:201-202 for a discussion of these events in terms of the relationship between pis and the church. see the 16 december 2011 edition of “this american life” (http://www. thisamericanlife.org/radio-archives/episode/453/transcript, accessed 25 august 2012) for an english-language popular media description of the controversies after the plane crash in april 2010. see zubrzycki 2006 for an analysis of a past controversy at auschwitz about the placement of crosses 10. http://www.zkdp.pl/, accessed 14 october 2011. the tabloid fakt has been outselling gazeta wyborcza since at least january 2010. 11. june 2011, marzena kasperska, personal communication. 12. “czy polska to jest kraj dla starych ludzi? napisz o swojej starości” 13. “czy jeszcze dorabiam?” “co chce pani/pan jeszcze w życiu zrobić?” (klimowicz and sokólska 2008). see also janelle taylor’s 2008 article in which she discusses the common use of “still” to describe the abilities of people with alzheimer’s disease. the usage of “still” in gazeta wyborcza to describe older people without dementia is an example of the fuzzy boundaries between “normal” and “pathological” aging. 14. see katz and laliberte-rudman 2004 for a discussion of exemplars of old age and retirement in the canadian press. 15. “poza tym polska kultura jest monopolistyczna , to znaczy, że mamy jeden język, jedno wyznanie, jeden system wartości. takie kultury są bardzo dogmatyczne i skłonne do dyskryminacji. nawet na wsi polskiej nie ma szacunku dla starych. w przeszłości to oni byli głównym źródłem wiedzy, ale teraz rolę mądrych starców przejął telewizor. starzy utracili podstawową funkcję nosicieli kultury. stali się drugorzędnymi obywatelami. stali się untermenschen. mam wrażenie, że zdaniem wielu młodych ludzi człowiek stary należy do zupełnie innego gatunki. ani homo, ani sapiens” (wodecka 2008). 16. “są to ludzie biedni ekonomicznie i społecznie” 17. “aktów personalizacji” 18. “wręcz przeciwnie, oczekuje anonimowości, depersonalizacji. to jest doskonała nisza dla starych przestraszonych ludzi.” 19. “nieszczęśni starcy” 20. “by dzieci miały lepiej” 21. “ta troska to dokumentowanie swojej ważności.” 22. “to jest język konieczności: ja muszę być w domu, bo przyjdzie stefan z dziećmi i ja muszę zrobić naleśniki. nie mówią, ze to frajda, ze szczęście. słowo ‘muszę’ jest kluczem, jest świadectwem nieustannej powinności, których spełnianie jest dowodem użyteczności.” 23. following local usage, i use słuchacze throughout this article to refer to participants of the university of the third age. its english translation would be “auditors,” which shares the connotation of listening (the polish term could also be translated as “listeners”) but the polish term does not share the english meaning of inspection. 24. “przekraczamy pewne bariery.” 25. “ten wiek nie jest taki straszny, i chciałoby się przeżywać ta starość, i chciałoby się być starą.” 26. the polish edition of aging body, timeless mind was published in 1995 as życie bez starości, which, back-translated into english, would be a life without old age. 27. “…z taką nadzieją na może jeszcze ciekawsze lepsze życie.” 28. “bardzo cieszę się, ze państwo pokazują nam, szczególnie osobom młodym, że wszystko zależy od nas. i tak na prawdę jest naszą decyzją jaki będzie ten etap w naszym życiu.” 29. “istnieją te więzi, między młodym i starym pokoleniem – to też jest jakiś nasz kapitał, na którym możemy pracować na przyszłość.” 30. “dobrego starzenia musimy się uczyć,” wnuk, walentyna. 2009. „późna dorosłość to czas pomyślny.” kurier utw: nieregularnik uniwersytetu trzeciego wieku. wrocław: uniwersytet trzeciego wieku. 16:5. 31. “przywieziona w stanie skrajnego wyniszczenia, zaniedbana, z odleżynami, w ranach białe robaki” (kasperska 2008). 32. “w takim stanie trafiali do nas tylko ludzie bezdomni.” 33. “koniec miała, jakby śmieciem była.” 34. see cohen 1998:81-82 on the trope of abandonment of older people. anthropology & aging quarterly 2013: 34 (2) 167 jessica c. robbins-ruszkowski challenging marginalization references beidelman, t. o. 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trzeciego wieku [quality of ageing and old age in personal opinions of the members of university of the third age]. gerontologia polska 17(3):137-142. zierkiewicz, edyta, and alina łysak, eds. 2005 starsze kobiety w kulturze i społeczeństwie [older women in culture and society]. wrocław: marmar. zubrzycki, genevieve 2006 the crosses of auschwitz: nationalism and religion in post-communist poland. chicago: university of chicago press. _commentarytannistha[4] the “good life”: third age, brand modi and the cultural demise of old age in urban india tannistha samanta, phd department of humanities & social sciences indian institute of technology, gandhinagar, gujarat, india author contact: tannistha@iitgn.ac.in abstract in this piece, i outline the possibility of understanding old age through the lens of cultural gerontology highlighting the intersecting logics of age with consumption, leisure and identity. i argue that with rising affluence and demographic aging, india is poised to experience an emergent cultural movement, the third age (laslett, 1989), wherein access to cultural capital and an active participation in a leisure culture will offer social membership among upper middle class older adults. using examples from luxury senior housing projects and travel/holiday packages, i reflect how this process of agentic consumerism with a focus on the ideals of youthfulness, choice, self-expression and pleasure is turning the decline narrative (typically associated with “natural” aging) on its head. the success of this market-driven cultural model, i argue, lies in the celebration of a project on the self where the responsibility to “age well” rests with the individual-a key political economy of the neoliberal regime-absolving the state of public provisions and social security. in conclusion, i show how age and political masculinity intersect to create, what i call, brand modia potent vision of active and ageambiguous consumer citizenry. through this construction, i argue, life-stage has been suitably marketed to match the aspirations of a greying cohort marking a new stage in the cultural constitution of age in urban india. keywords: cultural turn, third age, brand modi, consumerism, india anthropology & aging, vol 39, no 1 (2018), pp. 94-104 issn 2374-2267 (online) doi 10.5195/aa.2018.208 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 94 the “good life”: third age, brand modi and the cultural demise of old age in urban india tannistha samanta, phd department of humanities & social sciences indian institute of technology, gandhinagar, gujarat, india author contact: tannistha@iitgn.ac.in introduction indian gerontology is replete with the popular trope of an eroding joint family system as keepers and caretakers of older adults whose lives are defined by disease, frailty, burden and social detachmenta gradual yet meaningful decline in preparation of deathi. contrary to this narrative of decline, post-reform india capitalizes on the growing demographic minority of older adults as active, emancipated participants of the consumer market. significantly, one sees steady marketing efforts directed at older citizens through senior housing communities, vacations/holiday packages and dating sites that celebrate post-retirement lives as “young”, “joyful”, “active” and “fun”. is this potentially uplifting agentic view of older adults enjoying leisure and independence ushering an era of “third age” (laslett, 1989) where social membership to an ageless culture is guaranteed through consumption? i argue that this invitation to participate in the leisure culture has important sociological implications. first, this self-selecting retirement lifestyle seems to offer “permanent personhood” (lamb, 2014; 2017) to all who can afford it thereby replacing the traditionally aspired purposeful dependence of old age with class-based conspicuous consumption. second, with its youth-oriented focus, this emerging market forces a chronological continuity and promises a fairy-tale narrative of eternal youth. finally, this ushers a new project that enhances the “self” (e.g. selfconsciousness, self-management and self-surveillance) among the urban elderly marking a significant shift from family care to the service market of property, investment, insurance, leisure and cosmeceutical industry. in the process i show that this consumer-led retirement lifestyle aligns neatly with indian prime minister narendra modi’s public representation of capably reformulating the discourse around consumerist modernity. i contend that this complements the neoliberal ideals of an aspired individualist personhood absolving the state of public provisions and social security, typically expected of aging nations in the global south. ultimately, this presents a gradual cultural change that refashions the process of growing old among the urban upper middle class with its emphasis on consumption (of leisure) marking class identification and distinction. overall, in this piece i use gerontology as a cultural critique to highlight the intersecting logics of age with consumption, leisure and identity and demonstrate how post-retired lives can offer a new, culturally focused social gerontology in india. the “good life”?: third age and the marketing of life-stage bauman (1988) famously noted that the good life is increasingly constructed out of consumer choice. if one pays close attention to upmarket housing advertisements or holiday packages in urban india, it is not uncommon to find how marketers see the “new-age elderly” as important participants of this inviting anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 95 market. for example, glossy advertisement brochures with housing projects carefully labelled as “evergreen” (adani realty, shantigram project, ahmedabad) with a marketing tagline that says “stay young, stay happy” or senior citizen tour packages such as the “golden age” (heera holidays) or “50 + voyagers” (marketing tagline: life begins at 50: connecting people, living adventure, celebrating life) offer the seductive promise of a retirement life where leisure and experience can be purchased without the loss of a productive and vital self. this stands in contrast to the traditional notion of growing old where interdependence and filiality within a familial setting is expected. although this “new” process of growing old that lies at the nexus of consumption, leisure and choice cannot be applied to all elderly, however one can argue that it is ushering a “new age for old age” (gilleard & higgs, 2007) for a select section of older adults in urban india. this sociological interrogation is relevant at a time when india is poised to experience a demographic bulge in its older population (60 & above)-projected to increase from 9 percent to 19 percent in 2050 encompassing 323 million people (population reference bureau, 2012). this profound demographic shift is happening at a time when india’s rising affluence and growth story promise a loyal consumer base with the share of affluent and elite consumer households (those with annual gross household income more than $15,400 ) projected to increase from 8 percent in 2016 to 16 percent in 2025 (boson consulting group, 2017 ii ). additionally, sociological analysis of horizontal divisions (e.g. generation and age group) receive less intellectual precedence over vertical divisions of caste and gender in social science scholarship in india. significantly, insights from the discipline of social gerontology can offer explanations of processes that are rooted in diversity, differentiation and the politics of distinction. in particular, i ask if this cultural shift is emblematic of a “third age” (laslett, 1989)-a phase that is recognized as a key development in the transformation of later life where post-retired lives are healthy and free from responsibilities of work and childcare with an heightened participation in mass consumer society. laslett in his seminal contribution, a fresh map of life, envisioned this emergent cultural revolution in post-war western society (namely, the decade after the 1950s) where he “integrated history and demography with individual development to define what he saw as a “new” personal and collective identity” (gilleard & higgs, 2007: 14). in this view, the extent and nature of household consumption as a defining characteristic of social life (edwards, 2000) as well as a construction of a “lifestyle” based on consumer-driven distinctions (slater, 1997) are salient markers of this new stage in life. despite its criticism of a conceptual conflation of cohort with generation (see gilleard & higgs, 2007 for a discerning discussion on the cohort versus generational perspectives), the theory of third age has been fruitfully adapted by scholars to show the salience of generational location rather than social class membership on postretirement consumerism in post-war britain (gilleard & colleagues, 2005) or the social significance of the baby boom cohorts in the united states (gilleard & higgs, 2007) or the political economy of the new right in the context of the british healthcare system (gilleard & higgs, 1998). borrowing from these studies, i argue that life-stage is emerging as an increasingly significant source of market segmentation with the rise of upmarket housing communities, vacations, fashion, media and publishing housesall targeted to the post-retired consumers (ages 60 and above) where “cognitive age” (that captures multidimensional aspects of feel-age, look-age and do-age, see roscoe. et al, 1977) prevails over the chronological age. business scholars (schiffman & sherman, 1991) have shown that this idea of marketers appreciating the elderly as a subculture who are particularly experiential in their value orientation (as opposed to accumulation of possessions) holds the key to the coming of an ageless market. the emphasis on youthful value-orientation where “feeling”, thinking” and “doing” younger things is central in the forms of “generational marketing” is epitomized in upmarket senior housing projects. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 96 although, not intended to be an exhaustive content-analysis of promotional brochures/catalogues, i provide an excerpt from the adani realty’s senior housing project in ahmedabad, “the evergreen” that begins with a motivating, yet helpful questioniii: how to stay evergreen? as you grow older, life throws a lot of challenges at you. heath becomes a major concern. your children become busy with their lives, leading to the feeling of isolation.….this is where we want to make a difference. because we look at old age a little differently. we see old age as the time to put your feet up, give up responsibilities and have the time of your life” later, a few pages into the glossy advertisement brochure, it asserts its (marketing) philosophy “we believe the key to happiness is feeling young and alive…that’s why when we built the evergreen, we tried to stay true to our motto. stay young. stay happy”. the last two lines are repeated several times in the brochure as well in their promotional billboard. meanwhile, the website of a popular senior citizen holiday/tourism and wellness operator, the 50+ voyagers, have images of active seniors infused with words such as “adventure” and “wild encounter”. another mumbai-based tourism operator targeting senior citizens, heera holidays, uses the stereotypical trope of an “exotic india” where active adventures can be seamlessly combined with “medicinal spas and rejuvenation resorts”.iv brochures and online catalogues of these leisure-based companies are replete with images of racially ambiguous, well-toned, able bodied older adults in heterosexual pairs, mildly balding (for men), yet emotively “young at heart” partaking in energetic activities against unidentified tropical backgrounds. special needs such as health/emergency care are explained with images where happy seniors are engaged in physically demanding pursuits reinforcing the idea of youthfulness and energy as crucial markers of “successful” post-retirement lives. the images and language used in these promotional discourse communicate a bold new vision of aging among the urban and the affluent through the routes of individual agency, choice and consumerist aspirations. as tourism scholar, dann (2008) puts it aptly in his examination of senior tourism in the uk “it is this accentuation of communication, as promotional devices, brochures have to sell holidays to potential customers via a language of motivation that matches the qualities of the destination (pull factors) with the needs of the client (push factors)” (p. 12). clearly, the marketers in all these examples look at elderly as a niche consumer group with careful attention given to their special needs in terms of health, well-being and safety but at the same time privileging the cognitive age over the chronological age. market analysts consider this balance between too much emphasis on health (can be interpreted as a loss of individual liberty and control) versus greater care and supervision, an important dimension in effective targeting (ibid). in effect, as gilleard & higgs assert, “the third age is purchased and consumed as other lifestyle choices” (p. 234) turning the decline and dependence narrative (typically associated with natural aging) on its head. what does this cultural demise of old age hold for the urban upper middle class india? in other words, is there really a concern if the third age becomes a reality where a growing section of urban elderly in india become the motif of a new market marked by lifestyle, attitude, activity and choice? borrowing from lamb & colleagues (2017) important contribution to understand the notion of “successful aging”-an unavoidable cultural movement of our timesi invoke a cultural gerontological critique to argue that although third age promises positivity and inspiration, its implications are not benign. in what follows, i show how these new paradigms of lifestyle align neatly with both the making and the maintenance of “brand modi” as a anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 97 moral-cultural imperative in times of neoliberal consumerist modernity. i argue, in subsequent sections, how the intersection of age and political masculinity creates inequities of class, gender and relational personhood. consumerism as a cultural ideology: the promise of an ageless market? there is perhaps little doubt that asserting identity through lifestyle choices can be achieved only through the vantage point of physical and material wellbeing. cultural anthropologists lamb and colleagues (2007) critique this consumer-driven ageless enterprise as one that overlooks social inequalities since it pays no attention to who and how such lifestyles are purchased. by supporting an active agentic consumer this cultural movement promotes a state of “permanent personhood” (lamb, 2014) implying a sense of ageless, enduring permanence where declines, vulnerabilities and ephemerality are denied. in fact, lamb and colleagues argue that this refashions growing old as a moral-cultural and biopolitical project where a “good biocitizen” (greenhalgh, 2015) is the one who by pursuing healthy lifestyles (primarily acquired through the consumption pursuits of diet, exercises, activities) is fostering a healthy self as well as a productive society. in this perspective, greenhalgh reflects (cited in lamb. et al 2017) that those do not engage in productive pursuits or adapt the ethic of busy-ness to stay active are assumed to be burdensome for the state. by extension, a good citizen is the “one who reduces healthcare costs to the body politic by taking responsibility for his or her own health through lifestyle modifications” (greenhalgh, 2015, 21). this polarisation of the consumer society between those who have access to bodily and material resources and those whose choices remain limited to bare essentials not only deepens social cleavages around class but also constructs a particular motif of aging where being a bad consumer or being ill/disabled are attributed to individual failings (crawford, 2006; greenhalgh, 2015). this emphasis on personal responsibility aligns well with the neoliberal ideologies of self-governance, self-surveillance along with a valorization of free market and consumer sovereignty. it absolves the state of social provisioning (through insurance, social security and healthcare) for old age and instead shifts the burden to the individual, family and business entities (steger & roy, 2010). under this new “governmentality” (foucault, 1988) the aging self is, ideally, an ageless self with an authority of consumption, a liberation from the embrace of dependency culture and an appropriate cultural capital to make effective use of leisure. gilleard & higgs (2007) sums up this tension associated with the third age astutely: ‘the underlying logic of the field [third age] is structured by consumption, a post-scarcity consumption that supports the search for distinction and that implicitly or explicitly rejects, denies or marginalizes “old age”. the practices that define this field are routines of individualized consumption, routines whose function can be defined by or which support what foucault (1988) has referred to as “technologies of the self”’’ (25). overall, i have shown how the contemporary consumer culture assists the new-age older adults to remake their post-retirement identities through new modes of production and consumption in the leisure industry. i will further argue that indian prime minister, mr narendra modi’s, public representation typifies this process with a steady continuity of (consumerist) choices and consequently, a postponement or a denial of old age. this growing salience of personal identity and class over the traditional structures of age and gender is reified by the creation of what srivastava (2015) calls the “modi-masculinity”, whose “peculiar characteristic lies in its judicious presentation of indian manhood as both deeply national as well as global. subsequently, it offers a model of choice that is based around the notion of moral consumption” (p. 335). building on this argument, one wonders if mr modi’s storied designer outfitsv and fitness regimes is facilitating a third age wavea forceful image in consumerist modernity, showing middle aged indians anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 98 how to appropriately participate in consumerist activities. media’s attention to modi’s clothesvi in this new consumer-driven social space is of particular interest from a cultural gerontological perspective. twigg (2007) in her penetrative review of clothing and age assert how clothing form a “vestimentary envelope that contains and makes manifest the body, offering a means whereby it is experienced, presented and given meaning in particular social contexts” (286). in fact, this is particularly perplexing since most discourses on dress and clothing have been around the female body (or feminine chastity) while men’s preoccupation with dress can be condemned as effeminate. however, twigg (2007) argues that in recent years this condemnation has given way to the emergence of new masculine subjectivities such as the ‘metrosexual man’. significantly, the image of a ‘metrosexual man’ is invariably a younger man suggesting that modi’s clothes, choice of color and style are rupturing the age-ordering (lurie, 1992: cited in twigg, 2007) in dress, giving way to new fluidities and plasticities, commonly associated with the third age (as an extension of mainstream consumer culture to the non-youth). through the carefully crafted brand modi (and its attention to age-neutral clothes), life-stage has been suitably marketed to match the tastes and aspirations of a greying cohort marking a new stage in the cultural constitution of age in urban india. finally, the remarkable silence on modi’s (chronological) age in media is equally noteworthy. instead, media’s enduring focus on modi’s predilection towards healthy diet, expensive clothes and admirable fitness regimes is ushering a new biomoral consumer identity (khalikova, 2017)vii) where his “manly” style (both personal and political) is routinely recognized as ‘efficient, dynamic, potent and capable of overcoming the “policy-paralysis” that had putatively afflicted the previous regime’ (srivastava, 2015, 334). scholars have noted that this construction of “brand modi”-a prime agency that promises to bring good times to common man (kaur, 2015)-is rooted in the political economies of neoliberalism where the selfregulating, individualized subject is encouraged to embrace the “ideologies of youthfulness-symbolised by the consumerist quartet of virtues-choice, autonomy, self-expression and pleasure” (gilleard & higgs, 2007, 26) . in this view, modi offers an idealized image of an (ageless) self, resonating with the broader cultural visions of an able, age-ambiguous consumer citizen of post-reform india. concluding reflections at a time when consumption has come to dominate an increasing influence in shaping personal identities, a select section of urban upper middle class older indians with adequate residual spending power and cultural capital, have opportunities to redefine later life in newer ways. using instances from luxury senior housing projects and tourism, i have shown how the neoliberal market infuses hedonistic aspirations by allowing inspirational elements of choice, autonomy, vitality and self-expression among the greying cohort. authors have argued that this culturally emergent phenomenon, epitomized by the term the “third age” is in essence a rallying cry to counterattack the negative stereotypes of ageism (gilleard, 1996; holstein & minkler, 2003) and to assert the continuity of the life-stage through consumerist desires. although a relatively recent phenomenon, this “americanization” of later life (with its emphasis on the ideal of independence) resonates with the transatlantic cultural transformation that occurred in the postwar west. however, one of the most pressing criticisms of this emergent “movement” is that it is not only class-blind (as discussed earlier), but also ironically, ageist. the success of the movement lies in the belief that the idealized senior is the one who is able bodied, youthful, active or ageless –a denial of the fundamental transience of human condition. as lamb and colleagues (2017) reflect in their cultural critique‘in a way, both the binary “ill-derly” and “well-derly” models of aging are expressions of the same agesit culture, “arguably two sides of the same coin (martinson & berridge, 2015: cited in lamb, 2017), signifying that it is not okay to be old’ (13). in a society, where majority of older adults still live in anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 99 intergenerational households (samanta, chen, & vanneman, 2014) and filiality is expected and carefully cultivated (lamb, 2014), how does this shape the moral personhood in later life? with the political message of the new right in valorizing the project on self through the language of brand modi, will there be a forceful emergence of a “senior market” in india? might this cultural project produce new forms of vertical and horizontal social inequalities? though in this paper i did not attempt to address these questions directly, i have utilized the cultural turn (twigg & martin, 2015) in the field of gerontology to provide a deeper engagement with the politics of age in contemporary india. and in doing so, i have showed that for the coming-of-age, third agers, the logic of consumption masks the traditional hierarchies of age and to some extent, family in upper middle class india. the implication on family is a significant one since research on india suggests that the morality of spending in leisure among the upper middle classes has reconfigured the notions of relatedness and kinship. for example, anthropologist minna saavala (2012) in her ethnographic study on the new middle class in the south indian city of hyderabad shows how the popular truism about the sharp dichotomy of the “selfish ‘western’ nonchalance” with that of the “indian commitment to the ethics of relational personhood” in navigated and lived. she finds that although the consumerist urban context has reshaped social relations (e.g. increasing primacy of friends), social relatedness among the middle class is still organized along hierarchies of kith and kin. what does this mean for the emergent wave of third age, with its individualistic aspirations of independence, autonomy and self-care? how does the paradox of a consumer-centric old age and the demands of kinship play out for the (upper) middle class indians? gilleard & higgs (2007) penetrative commentary on a potential demise of old age in contemporary culture, offers an useful insight to this cultural dilemma. for gilleard & higgs, “as the signifier of material and symbolic bankruptcy, old age is simply not a choice” (26). anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta |100 source: adapted from the promotional brochure of the “evergreen” senior housing project, adani realty, ahmedabad, gujarat. available at: https://www.shantigram.com/ anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 101 references bauman, z. 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(2012). middle-class moralities: everyday struggle over belonging and prestige in india. orient blackswan. samanta, t., chen, f., & vanneman, r. (2014). living arrangements and health of older adults in india. journals of gerontology: series b psychological and social sciences. schiffman, l. g., & sherman, e. (1991). valur orientations of new-age elderly: the coming of an ageless market. journal of business research, 22, 187-194. slater, d. (1997). consumer culture and modernity. cambridge: polity press. srivastava, s. (2015). modi-masculinity: media, manhood and "traditions" in a time of consumerism. television & new media, 16(4), 331-338. steger, m., & roy, r. (2010). neoliberalism: a very short introduction. new york: oxford university press. twigg, j. (2007). clothing, age and the body: a critical review. aging & society, 27, 285-305. twigg, j., & martin, w. (2015). the challenge of cultural gerontology. the gerontologist, 55(3), 353-359. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 103 notes i noted anthropologist, lawrence cohen (2000) in his provocatively titled book “no aging in india: alzheimer’s, the bad family and other modern things” (university of california press) addressed this question head-on. he observed that gerontological writing and practice in india is largely dominated by a “powerful and seldom challenged narrative of the decline of the joint family and the consequent emergence of old age as a time of difficulty” (p. 88). significantly, the public imagination of old age was organized around an anxiety, which cohen called the “problem of aging”: more old people and less desire and ability to take care of them. meanwhile in academia, demographic knowledge (e.g. cohort size, population projections) was appropriated to explain the impending grey tide where older indians were ultimately reduced to “dependency ratios”. this intellectual narrative, alarmist at best, motivated gerontological examinations of economic provisions, livelihood, living arrangements, ailments, care and support structures of older indians for several decades since the 1980s. even in a fairly recent review of gerontological scholarship on india, ramamurti and colleagues (2015) highlight the “challenges” confronting the nation in terms of income security and changes in family structure (although empirically shown to be very gradual) among older adults. this resilience of the decline narrative despite significant progress been made in data collection efforts, gerontological education and social policy, is perplexing. perhaps what is more baffling is a serious omission in the examination of age through the lens of social class at a time when new middle class identities, moralities and subjectivities are forged in neoliberal india. ii complete report available on bcg website, “the new india: the many facets of a changing consumer” (march 20, 2017). https://www.bcg.com/en-in/publications/2017/marketing-sales-globalization-new-indianchanging-consumer.aspx iii brochure and promotional catalogues available: https://www.shantigram.com/ iv adapted from the website of heera holidays: http://heeraholidays.com/speciality-tours-golden-age/ v modi’s public representation has been of interest to journalists and political analysts. as blogger vrinda gopinath (2014: cited in srivastava, 2015) puts it: modi’s empire line is most flattering to himselfopulent turbans adorned with pearls and feather, rath chariots of gold and chrome, a machismo swagger with his self-proclaimed ‘chappan chatti’ (56-inch chest), ……an intoxicating cocktail of hyper masculinity, virility and potency”. again, noted media commentator shiv vishwanathan (2013) reflects “…his pros forged a more colourful modi, a brand modi more cheerful in blue and peach, more ethnic in gorgeous red turbans…hair transplants and ayurvedic advice served to grow his hair” (cited in srivastava, 2015) modi’s enthusiasm in staying fit through yoga is now well-known. he convinced the united nations to establish june 21 as the international yoga day and leads thousands of people in yoga demonstration every year. recently, he has been known to launch a cartoon video (demonstrating himself) on his official youtube page (yoga with modi: indian pm stars in cartoon video of poses, the guardian, march 29, 2018. accessed at: https://www.theguardian.com/world/2018/mar/29/indian-pm-narendra-modi-releasesyoutube-video-of-yoga-poses) anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.208 http://anthro-age.pitt.edu samanta | 104 vi there is usually breathless reporting on modi’s wardrobe during international visits and summits. for example, during us president barack obama’s visit to india in 2016, we had “narendra modi’s clothes have left behind everything else in this summit”, huffington post, july 15, 2016 (https://www.huffingtonpost.in/2015/01/26/modi-wear-obama-india_n_6544368.html) or during modi’s much celebrated trip to the us in 2015, we were presented with “you are what you wear: modi changes clothes four times in a day” (hindustan times, sept 28, 2015) vii see khalikova, 2017 where the author explicates the nexus between biomoral consumerism and neoliberal politics with the rhetoric of a popular indian guru, baba ramdev. the author shows how the discourses of yoga and the expansion of the ayurvedic market, although symbolically foregrounds a brand of ‘homegrown’ nationalism, but ultimately are political tokens of a neoliberal quest in consumerist desires. microsoft word gronladejaerfinal3.docx the institutional aging process ethnographic explorations of aging processes and dimensions in danish schools and eldercare institutions lone grøn senior researcher, kora, danish institute for local and regional government research, copenhagen, denmark author contact: logr@kora.dk else ladekjær researcher, kora, danish institute for local and regional government research, copenhagen, denmark author contact: elol@kora.dk abstract in this paper, we will present an analysis of the institutional aging process in childhood and old age in contemporary denmark. we will take as our point of departure jennifer johnson-hanks’s observation that aging should be seen both as an experiential and an institutional process, and we will apply ingold’s topographical phenomenology and his notions of maps, landscapes and wayfaring to our ethnographic data. drawing on field work in danish schools and elder care institutions, we explore aging processes through their spatial organizations and progressions. we sum up by reflecting on the similarities and differences between aging processes in early and late life. we argue that even if the institutional aging process can be seen as a map of the aging landscape – which acts as a powerful construct in experiences and practices of aging – wayfaring through that same landscape takes place between several poles: chronological, biological, social and phenomenological age – and involves considerable creativity and ongoing work and negotiation from both children and elderly. keywords: aging, old age, childhood, institutional aging process, phenomenology anthropology & aging, vol 38, no 1 (2017), pp. 1-16 issn 2374-2267 (online) doi 10.5195/aa.2017.139 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 1 the institutional aging process ethnographic explorations of aging processes and dimensions in danish schools and eldercare institutions lone grøn senior researcher, kora, danish institute for local and regional government research, copenhagen, denmark author contact: logr@kora.dk else ladekjær researcher, kora, danish institute for local and regional government research, copenhagen, denmark author contact: elol@kora.dk introduction in this paper, we explore aging processes in childhood and old age, drawing upon fieldworks in danish schoolsi and eldercare institutionsii. demographic transformations – and the social, cultural and political transformations that follow in their wake – are carving out an aging landscape of growing diversity (sokolovsky 2009). in the words of biggs and daatland: “that there are more older adults around than at any time in history is now well known. it is less well understood that, as the population ages, it becomes more diverse” (biggs and daatland 2004, p.1 cit. in baars et al. 2006). concepts of “third” and “fourth” ages point toward an increasing difference between those who age healthily, actively and successfully, and those who do not (buch 2015, philips et al. 2010), as well as an often “later onset” of old age than for previous generations, whereas the concept of “tweens” indicate shifts in the transition from child to teenager and point toward “earlier” onset of teenager hood (ladekjær 2016). significant markers of this can be found in how elderly people dress, travel and use the internet (grøn and andersen 2014), as well as in the way tweens dress, the music they listen to, how they use the internet and marketing strategies targeted at tweens (gjødesen 2010). we explore how we should perceive and understand contemporary aging processes by comparing two ethnographic fieldworks conducted in schools and eldercare institutions, respectively. we take as our point of departure jennifer johnson-hanks’s observation that aging processes should be approached as an interplay between institutional projects and personal aspirations (johnson-hanks 2002). in contrast to classic structuralistic theory, focusing on life stages and “rites de passages” between them, johnson-hanks argues that aging and processes regarding transitional phases are much more complex than earlier theoretical perspectives indicate – and that they more often than not differ from the view of fixed life stages inspired by van gennep (ibid). johnson-hanks’s inspiration comes from pierre bourdieu’s practice theory, but due to the spatial organization of the aging processes of our fieldworks, we will rely on tim ingold’s topographical phenomenology, and his concepts of maps, landscapes and wayfaring (ingold 1991, 2000, ingold 2007, ingold and vergunst 2008). also, we expand johnson-hanks’s two dimensions (institutional projects and personal aspirations) and explore aging processes in relation to several aging dimensions: chronological, social, biological and phenomenological age. through an analysis of the institutional aging process in contemporary anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 2 denmark, we will focus on the complex interplay of these diverse aging dimensions in both childhood and old age. ingold’s topographical phenomenology ingold describes the way humans live their life as wayfaring through landscapes. this is put in opposition to navigating using maps. the concept of wayfaring expresses how humans move, orient themselves and find their way, and the concept of navigating how we plan and carve out routes from a distance (ingold 1991, 2000, 2007, ingold and vergunst 2008). we apply this distinction in order to capture both how institutions map and carve out spaces for aging processes – and how processes of aging as wayfaring through actual landscapes complicate the mapped routes. according to ingold, maps create distance between humans and the landscape through which they are moving and by which they are surrounded (ingold 2000). in this sense, ingold’s two concepts of maps and landscape are related to two different types of knowledge (for similar distinctions between ways of knowing at a distance and close up, see de certeau 1984, jackson 1989). you can study a map and the possible routes from one location to another and decide on a route, or you can merely start your journey and decide which roads to travel as you move along. in this perspective, your goal or destination can change several times along the way, and this describes how we mostly live our everyday life (ingold 2000). a map will outline possible routes, but does not tell us anything about the practical experience and wisdom needed to move through life. where the map as a metaphor points toward mental conceptions about routes, the landscape as a metaphor includes the body, as well as earlier experiences with wayfaring. landscapes are varied and ever-changing, whereas maps are more static once they have been drawn. chronological, biological, social and phenomenological age in our fieldworks, several concepts of age are relevant, both in relation to the map and the landscape of aging. along with other demarcations, such as gender, race and ethnicity, age is often perceived as a natural or biological given. a wealth of studies have established, though, that age is a composite and complex phenomenon that can be conceptualized in various ways. the literature is comprehensive, and we cannot do justice to the wealth of studies within the limited space of this paper. below, we will give a brief introduction to the notions of chronological, social, biological and phenomenological age. chronological age chronological age is a measurement of years lived since birth based on a standardized and western calendrical system. chronological age proceeds progressively at a constant pace. it is irreversible and independent of genetic and societal variation, and as such it has been a highly popular independent variable in a variety of studies, also where chronological age is not part of the research interest (beall 1984). meyer fortes has argued that chronological age marks our relationship to the state, as it is a number that does not stem from our place or status within the family or the intimate social network (fortes 1984). chronological age, he argues, is related to citizenship and marks our political and judicious rights (ibid). fortes, like beall, highlights how chronological age is objective and independent of biological, social or psychological characteristics, and that in the west chronological age regulates our lives from birth to death on a personal, economic, civilian, moral and educational level. social age as shown by fortes and other anthropologists working in “non-western” societies, this perception of chronological age is far from universal. according to fortes, what can be ethnographically demonstrated as universal is what he calls “states of maturation”, which are related to our biological anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 3 foundations. such states of maturation have been identified, conceptualized, culturally recognized and built into the social structure in all known societies (ibid.). thus, in classical anthropological theory age and gender are seen as basic principles of social organization and differentiation (hylland eriksen 1998). based upon fieldwork among the tallensi, and on a long list of studies of aging in an african context, fortes suggests non-chronological social or kinship-based ways of representing age: birth order and generations within families (not the nuclear but the extended family) and “age set” (e.g. being part of a group, the members of which go through initiation at the same time). fortes’s analysis of age in relation to the extended family, to a village or larger social group or in relation to an age set testifies to the complexity of aging as a principle of social organization (fortes 1984). these “ages” do not converge, but are linked to specific social spheres, relations, events and places. in social gerontology – and in studies of aging in western contexts where chronological age is dominant – social age is linked to norms and attitudes regarding aging, specifically social expectations related to specific (chronological) age categories or life phases (phillips et al. 2010) biological age the taken for granted ways in which we think about chronological age are not only undermined by family, kin or ritual-based aging, as described by fortes. biological age, which we according to a common sense view often perceive as the foundation of chronological age, does not correspond with chronological age (beall 1984). in physical anthropology, biological age is determined in relation to specific body parts, specifically the teeth or the skeleton. all children with the same skeletal development are seen as having the same biological age, even if they vary in chronological age (ibid.). biological age or senescence – decline of a cell or an organism due to aging (phillips et al. 2010) – thus marks the physical body’s aging process. what we want to take from this is not the specific concept of biological age as understood in physical anthropology, but rather the point that chronological and biological age do not correspond to one another. what we intend to capture with the notion of biological age is bodily age in a broader sense – as in body size or sexual maturation in teenage years or onset of sickness and physical/mental debility in old age – as an age dimension in its own right. phenomenological age how to conceptualize aging is further complicated by how age is experienced – or what you could term phenomenological age. steven katz mentions a study on this subjective aging dimension, which concludes that, in old age subjectively experienced age is often lower than chronological age, and that the distance between the two seems to increase with progressive aging (katz 2006). others have demonstrated that the continuity of the self through the course of a life characterizes the aging experience, rather than old age as a distinct phase of life (kaufman 1987), and that old age is experienced as an ever-increasing gap between the ages of the body and the mind (leder 1990, desjarlais 2003). through this short introduction to a vast discussion, we hope to have shown that aging understood as “stages of maturation” can be conceptualized in quite different ways. moreover, that different parts of what constitutes a human being – the physical body, social and psychological dimensions, and the time of birth – can be seen as the basis of such conceptualizations. in the following, we explore the institutional aging process in danish schools and eldercare institutions with attention to these diverse aging dimensions and through the notions of maps, landscapes and wayfaring. first, however, a short introduction to the ethnographic fieldworks will be provided. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 4 ethnographic fieldworks both the fieldwork carried out among children in school and among elderly in different institutional settings can be characterized as “multi sited”, i.e. spread over different locations, which are united through a practical or thematic concern (marcus 1995). moreover, they were both conducted as fieldwork “on the move” or as “go-along fieldwork” (kusenbach 2003). here, the anthropologist follows her interlocutors, while they move around their landscapes carrying out daily activities. the anthropologist in this go-along fieldwork gets an embodied experience of shifting sensory inputs of persons, places and spaces. the analysis from the danish school is based upon fieldwork that started in the spring of 2010 and ended around christmas 2011. in this period, else ladekjær followed children from two classes at two different schools in the same municipality. in the spring of 2010, the children were finishing 5th grade, in the school year 2010/2011 the children were in the 6th grade, and in the fall of 2011 the children were in the 7th grade. thus, she followed the same children over a period spanning three school grades. participant observation, interviews, informal fieldwork conversations and go-along were the dominant methods in the fieldwork. the fieldwork was conducted as part of else ladekjær’s phd (ladekjær 2016). the fieldwork in eldercare institutions was conducted by lone grøn from 2013 to 2014 and divided into two phases. the first phase, running from april to july of 2013, was carried out in three municipal elder care centers that provide services for the elderly in a mid-sized danish town. in each center, the same threeweek process was repeated: the first week was dedicated to elderly people living in their own homes and receiving home services or care, the second to elderly people living in institutions, and the third was used to follow up on any other relevant sites that emerged during the first two weeks. the fieldwork thus took place in an institutionally and geographically diverse landscape involving both urban and rural, and well-off and deprived neighborhoods. in the second phase, from november 2013 to february 2014, grøn focused on nine elderly people who represented some of the diversity in the life situations and histories from the first phase. the data for this paper is mostly drawn from the first phase of fieldwork. the fieldwork was conducted as part of a study of vulnerability in old age in contemporary denmark (grøn and andersen 2014; grøn 2016). mapping the institutional aging process in fieldwork marked by feelings of doubt and uncertainty about age, what it is, how and when one ages etc. there has been a remarkable consistency when it comes to what grøn has termed “the institutional aging process” and ladekjær “the institutional age” (grøn and andersen 2014; ladekjær (former olesen) 2013iii). the institutional aging process denotes progressive aging through diverse welfare institutions and services. at one end of the spectrum, children move through the different childcare and schooling institutions, such as nurseries, kindergartens, schools and after-school clubs, which are designed with specific chronological ages in mind. in relation to this, it is important to mention that the institutional settings and their various purposes have a far-reaching significance for children’s everyday life, as well as their life span in a danish context (højlund 2002; gulløv and højlund 2005; gulløv 2009). at the other end of the spectrum, we find institutions and services that are organized around biological age and increasing physical and mental decay in old age: patient schools for people with chronic diseases at community health centers, activity centers, home care services, day centers, housing for the elderly, nursing homes and dementia wards. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 5 when doing fieldwork in these welfare state institutions, you get an almost physical sensation of moving from one age phase to the next, when moving from one location to the other: from one section of the school to another, or from one floor or section of the municipal eldercare center to another. in the following, we will introduce this topographical and progressive aging process, first in the context of the school and then through various elder care institutions. from child to teenager in school in the following, the focus will be on the journey from child to teenager within the institutional map of the danish school. the school system is characterized by being a national unity cultural institution (qvortrup 2003). in danish schools, institutional views on specific ages and aging are pervasive and ever present. the school is organized according to the children’s chronological age. this is evident in the grade structure, as all the children born in the same year belong to the same grade. moreover, the school is organized in three sections according to specific age groups. first, we have the introductory period from the 0th to the 3rd grade, then the intermediate stage from the 4th to the 6th grade and finally the final stage from the 7th to the 9th grade. in a typical danish school, the division into three sections and ten different grade levels is also evident in the spatial arrangement of the school, both indoors and outside. this determines which parts of the school yard the different sections have access to, which parts of the school the classrooms of the different sections are located in, and which rules of conduct apply to a specific section or grade. the fieldwork carried out among children at two schools shows that both the material and symbolic surroundings are relevant when focusing on children’s transition from child to teenager (ladekjær 2016). thus, both the material and symbolic organizations of the school space support the children’s route through the institutions of childhood (højlund 2009). in the following section, we will walk through the halls of one of the two schools from the fieldwork, in order to show how the material and symbolic surroundings collectively shape the school space – and provide the sense of moving forward in terms of age, as the children move from one grade to the next and from one section to the next. moving around “vestervangsskolen” you notice and sense differences among the three sections. the section of the school for the introductory period is characterized by a lot of color, for instance from the many paintings and drawings displayed on most walls. the furniture is small, there are locked cupboards with pictures of scissors, glue and paint – and all sorts of outdoor clothes, shoes and bike helmets are lying about in the hallways. moving to the section of the school intended for the intermediate stage, the décor is characterized by posters illustrating the characteristics of specific countries, word classes, mathematical rules and historical periods, and poems written by the children. chairs and tables have grown in size, and there are sofas in the common room. a few of the chairs and tables are larger than the rest, reflecting that some of the children’s bodies do not fit the average furniture intended for the intermediate stage. moving to the spaces dedicated to the final stage, the stories told by the décor and furniture changes once again. here the walls are embellished with posters of pop and reality stars as well as posters from the local youth clubs and associations promoting various activities, such as homework assistance, parties, plays and excursions. there is access to computers, and the locked cupboards contain end-of-term exams, not utensils for painting and drawing. moving from one grade to the next, the transitions from 3rd to the 4th and from the 6th to 7th grade is marked not only by a shift in classrooms, but also by shifts from one part of the school to another. this means that the children will use different entrance doors to the school and walk through different parts of the school. in some schools, the shift between sections also involves getting new teachers, and the shift from the 6th to anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 6 the 7th grade can mean entering a new school as well as a new class. the children’s shifts in both the organizational and physical surroundings thus mark shifts in the institutional aging process. the division into the three sections is also mirrored in the schoolyard, each section having its own part of the schoolyard. the division of the schoolyard is not necessarily marked physically by buildings, fences or hedges, but the children know the boundaries between the different areas. this is evident, when the children are asked to show me their schoolyard, as the following example with jane and mona illustrates: we walk out of the door and onto the terrace, the girls agree that this is a place that they are allowed to use – but they seldom do. jane says that last year they used to spend a lot of time on the terrace. today it is empty except for a few girls standing by the railing looking down on the playground below them. we walk down the stairs from the terrace to a plateau. here, there are swings, a climbing frame, other playground equipment and a lot of younger children. the girls point to different places and explain where they are allowed to go and where they are not allowed to go. a large part of the area is for the youngest children at the school (the introductory period) only, but the older children (the intermediate stage) are allowed to use a few areas in the playground. the girls say that they seldom come to this area of the school grounds. they mostly use the other side of the school buildings (where there are no playground facilities). mona says that the playground is for “babies”. jane laughs and says that they actually do not know that much about this particular place. the girls’ tour demonstrates that the school yard for the introductory period is usually a playground with swings, sandboxes and climbing frames. the area for the intermediate stage is typically organized with soccer fields and other types of playing fields, whereas the part of the schoolyard intended for the final stage usually has benches, open spaces and maybe a basketball field or similar. the organization of both the schools’ indoor and outdoor areas communicates the institutional perspectives on and expectations to the different age groups (højlund 2009), or social age as it is conceptualized within social gerontology. the organization of the school yard shows that the youngest children are expected to be active in a variety of ways and be challenged physically by their surroundings, whereas the school yard for the intermediate stage is characterized by particular ball games and fields for these games – showing expectations of increasing bodily mastery of specific sports or games – while the outdoor areas for the eldest children are not oriented towards movement. the division into grades and sections – the map of the institutional aging process – is a central part of the invisible pedagogy at school that informs the children’s affiliation to specific spaces, i.e. where specific age groups are meant to be, and also how they are expected to behave in these places. from the beginning to the end of old age the institutional aging process at the end of the life starts out in people’s homes, with home visits from social and health workers and nurses. below, excerpts from field notes are given. we arrive at a villa close to the fjord. a huge, new luxury winnebago, an expensive, small, white sports car with the roof down and a more ordinary car – a vw polo – are parked in the driveway. huge old villa, huge garden. in the living room, a woman about 65 years old is lying on the couch. her husband is also there, keeping in the background. she complains a lot: about him, about her situation, about pain – but in ways that seem out of sync, she is obviously demented. the husband looks tormented and exhausted; and the tension and despair inside this house is palpable. the next house is located on the outskirts of town, close to the fields and the woods. an old and dilapidated smallholding. it looks neglected, like a hermitage. and it is. the social and health worker explains that it has been quite a struggle to be allowed to enter. the male resident suffers from chronic obstructive lung disorder, but he wants to manage on his own. she is allowed anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 7 in now to wash his back, and twice a week she also washes his feet. he is a bachelor and always has been. we enter into an entry room with a rough cement floor. raw and cold as in a barn. then we enter the kitchen where a radio is playing loud german “schlager” music. everything is brown, deteriorated and dirty. there’s an oil cloth on the table. next, we move on to an apartment located in another part of town. it is a new building, yellow brick, and most residents are referred to this housing complex from the municipality due to some kind of problem. the social and health worker explain that the male resident used to be an alcoholic, now he drinks less but suffers from alcohol dementia. we enter an apartment on the second floor, a strong smell of cigarette smoke, and a broken glass on the toilet floor. there are cigarette butts, tobacco leftovers (he rolls his own cigarettes) and dirty dishes everywhere – and drops of jam on the floor. cleaning under the bed, i find 8 used lighters – and more cigarette butts. while we do a rough clean up, the male resident is picked up by the bus, which drives to the day center, where he gets food and twice a week also a bath. finally, we return to the part of town where we started out in the morning. before we enter, the social and health worker explains that the man in this house is paralyzed in one side. he is living here with his wife, and is driven to the day center every day for baths, meals and physical training. their residency is a small house with a small garden. we enter through the kitchen to a hallway with two rooms at the end. he sleeps in the room on the left, she in the one on the right, so that the helpers do not wake her up. he sleeps in a hospital bed, the floor lift is next to it and behind it hangs a framed picture: a heart with their names on, congratulations, 50 years and 2004 written on it, surrounded by flags. they must have celebrated their 50th wedding anniversary almost 10 years ago. the social and health worker says that they used to be very social, festive and outgoing, but his sickness has changed all that. after she has woken him up, washed him and lifted him from the bed to the wheel chair – all accompanied by joking exchanges – he wheels himself to the hallway, opens the door to the other room and calls his wife’s name. as she slowly wakes up, she joins in the joking conversations. the institutional aging process at this end of the spectrum is organized around biological age, the deteriorating mind and body, compensated by institutional care. in the beginning of this process, we see the diversity in living spaces and situations, progressive aging creeps in on both well-off and marginalized people. in homes there are material markers of life lived over time, of social position and relations and the biographical self, even when these spaces are also marked by increasing institutional presence. all this changes when we enter into the institutional spaces. in close proximity are activity centers, day centers, nursing homes and dementia wards as well as offices for the staff that carry out home visits for those still living at home. as we move from one section to the next, the people there are increasingly sick, though due to the proximity people from different section’s paths cross, as when the demented move through the hallways to go to some event. this puts the residents of “earlier phases” of the institutional aging process in the same place as those in the “later” phases. elderly people in activity centers expressed strong fears of one day finding themselves in these physical spaces of “the old” (grøn 2016). several interviewees expressed hopes of dying, rather than progressing through the later stages of the institutional aging process. the spaces look the same, like little worlds or societies unto themselves, and it is difficult to orient oneself, both within the spaces themselves and in relation to the surrounding world. where i am doing fieldwork today, there is a nursing home and also a large day center. the dementia ward and the dementia day center are also located in this block, which is exceedingly large. there are clothes for sale in the entrance hall, when i arrive in the morning. later in the day, when i am leaving, the same entrance hall is full of elderly people in wheel chairs: day center participants who, after activities, food, a bath and a nap, are waiting to be picked up by red busses. it is a slightly disturbing image, like seeing children in pushchairs about to leave anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 8 for a picnic. only they are not children, and even though there have been some activity during the day at the day center, knitting, looking through gardening books, singing, what is striking is the lack of activity, motion and movement. unless it is meal time or there is a training session with a physiotherapist, many of them just sit in their chairs, some asleep, without talking to each other. in all institutional spaces, efforts are being made to make the spaces homely. nevertheless, it is difficult to shake off the institutional feel of these places: hospital beds, all kinds of lifts and medicine in locked cupboards are some of the disturbing presences. the organizational structure also marks these spaces: the daily work routines which are planned to fit the staff’s working hours and tasks, giving a strong uniformity to each passing day. a summing up of the institutional aging process will be based on different dimensions of age in each site: for children in schools it is based on chronological age, for elderly people on progressive bodily decay and sickness, i.e. biological age. in fact, chronological age is almost completely absent from these institutional spaces. in terms of biological or physical age, there is also a remarkable difference in the amount of physical activity: children’s spaces are filled with activity, but through the institutional aging processes they are taught, by the invisible pedagogy, to move less or to move in specific ways, whereas the spaces for elderly people are marked by progressive stillness, only interrupted by meals and training sessions aimed at keeping them active. this of course has to do with the biological aging process, but also very different aspirations and hopes: the children aspire to grow older – most of the children cannot wait to move to the next grade or for their next birthday. turning thirteen, becoming a teenager and attending the 7th grade and out-schooling (the 7th to the 9th grade) are very important age markers on children’s path from child to teenager. the children generally have a strong drive to moving forward in their institutional settings, while the opposite is the case among the elderly. what we want to suggest from this map of the institutional aging landscape is its centrality to how progressive aging is perceived and practiced in a danish context. the picture drawn by the map of the institutional aging process might seem overly simplified in being based on either chronological or biological aging, but when we get to the wayfaring through the aging landscapes, intersections and clashes between different aging dimensions complicate the map. wayfaring through the institutional aging landscape too big, too old, too small or not old enough the former section on the map of the institutional aging process showed that the school as an institution is a vector of certain views on and ideas about children (sørensen, gilliam and waltorp 2010; gilliam & gulløv). a large proportion of these ideas evolve around connections between the body, movement, chronological age and grade. children can act and move age-appropriately – or according to specific age imaginaries (alexander 2010). a large proportion of the children comply with these age imaginaries and specific expectations to a certain degree, but several children deviate from the norm. most of these children are oriented “upwards” age wise, but there are also children for whom the opposite is the case. in the following, we will see examples of both cases. alex is among the most physically developed of the boys in his class. this was the case in the 5th grade, and in the 7th grade he still stands out from most other boys in his class. alex’s body looks older than his chronological age – this was especially the case in the 5th grade. however, the way alex uses his body in the 7th grade hardly differs from the way the boys used their bodies in the 5th grade; he is very physically active and does not want to stay inside during breaks – which several of the other children do, since staying inside during breaks is a sign of being older. alex likes to climb trees, run around the school grounds or play anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 9 basketball. alex says: “their [the younger children’s] play things are more fun and they have the best climbing threes. they are over there (by the playground)”. after the breaks, alex often comes back into the classroom with dirt on his pants, and one day when alex enters the classroom wiping sweat of his forehead with his shirt, hanna whispers to sarah: “i’m glad i’m not sitting next to alex, when he smells like sweat like that”. sarah looks at alex and wrinkles her nose. alex is not one of the boys mentioned when the girls talk about boys – just as he does not appear on any of the girls’ top 3 lists of the boys they would prefer as boyfriends. he does not comply with the social expectations for his chronological age and school grade. in other words, his biological, chronological, social and “institutional” age do not concur. however, most of the time alex succeeds in staying in his preferred areas of the school grounds, even though he is not supposed to be there. alex describes his strategies: you have to be nice to the younger children and maybe play with them, but you must not be too wild, like on that day on the swings, where simon [one of the teachers] sent me away. but most of the time you are allowed to stay there, as long as they [the teachers] do not see or notice you too much. like alex among the boys, britt is one of the tallest and most physically developed girls in her class. in the 5th grade, britt told me that she was the first girl in the class to get her period. when it is that time of the month, she sneaks out to the restroom to change her sanitary towel and she does not feel comfortable participating in physical education during those periods. on one day, there was a queue for the restroom: britt is holding a case with her sanitary towels while she is waiting to get in. asger, the shortest boy in the class, asks: “what is that?” britt answers, “nothing!”, and turns away from asger, who shakes his head, looks at me and says: “girls!” before he runs out the door. britt: “i have only told jane, you know she can keep a secret… it’s just no fun, when you know you are the only one, then you can feel a bit left out. it’s the same when i don’t join in physical education. luckily, my mom has written a note for the teacher, but what am i supposed to tell the others?” britt is normally one of the most active girls in physical education, and for this reason her classmates notice when she does not participate. in the 7th grade, the situation has changed, and several other girls have caught up with britt – but now she feels left out of the community of girls in other ways. several girls have started using make-up, but britt is not allowed to do this by her mother. britt sits still, not saying a word, while some other girls eagerly discuss the make-up they use. when we are alone, britt tells me that she would like to use just a little bit of make-up at school, but that she is not allowed to.iv both examples show how alex’s and britt’s chronological, biological, social and institutional ages do not match, but alex and britt have different strategies. alex consciously chooses to act like a younger child by taking part in physical activities typical of 5th graders and using the area for younger children. britt actively seeks to fit in with the other girls and her social age, but has her physical maturity and her mothers’ rules as obstacles. the examples with alex and britt illustrate the immense difference between the map and the actual practice of moving through the institutional aging process, and how wayfaring requires creativity, cunning and effort – often an ongoing effort to try to fit in or negotiate an exceptional position for oneself. the significance and ambiguity of age is also evident in other cases. one of them being that of niels, who is a year older than his classmates. thus, niels’s chronological age does not match the institutional placement in his grade. moreover, niels is very tall – he is the tallest in the class, and his table and chair are larger than those of the rest of the pupils in the 5th and the 6th grades. niels is very interested in sports, but he does not take part in the ongoing soccer games during breaks. niels tells me that he would like to join in the soccer games, as he likes soccer and is good at it. niels used to play soccer with his classmates in the local anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 10 soccer club after school, but due to his chronological age the national tournament rules do not allow him to be a part of the same team as his classmates. in the beginning of the 6th grade, their soccer coach was not aware of this rule and after a victory the opposing team filed a complaint over niels’s age and him being a part of the team. both the coach and the rest of the team are very concerned about their results. as a consequence, niels is no longer on the team. he could play for another team with boys born in the same year as him, which would give him membership based on chronological age rather than institutional grade age. niels stopped playing soccer, though, and he no longer participates in the boys’ soccer games after school or during breaks at school. being a year older or younger than your classmates in terms of chronological age often means that body and age group in school are in conflict with each other, as can be seen from the case of niels. niels’s chronological age impacts his social relations and opportunities for participating in specific activities and communities. previously, niels always knew with whom and where he would spend his breaks, but now he is left to find other activities and communities. just as is the case with alex, niels tries to initiate activities and recruit playmates, but no matter how much he tries, he does not succeed. unlike niels, tim wishes he was older than he is, that his chronological age was higher, and that he was in a higher grade. tim says that he does not feel that he belongs in his class. tim is tall and thinks a lot about which clothes he wears. tim does well in school but does not spend a lot of time doing homework. he is good at sports, but he does not practice any sports at the moment, because he thinks it is childish, and, as his class teacher says, tim can play the guitar and melt all the girls’ hearts. tim has one close friend in his class and finds the rest of the girls and boys too childish for him. after classes, tim disappears just as quickly as the boys heading for the football field, but in another direction. during breaks, tim spends time with the older girls at school. tim often stays indoors during breaks, even though he has not reached that phase of the institutional aging process himself. tim avoids the categories and rules that come with being a pupil in the 5th and 6th grade. as tim puts it: “they (the teachers) probably think that i belong with them – that we have the same rules.” the empirical examples show that the children’s diverse biological ages, as evident in body size or movements, and their chronological, social and institutional grade ages are not in a one-to-one relationship with each other. this complicates the map of the institutional aging processes and the examples demonstrate the work they put into moving along as they go, the wayfaring through the landscape of tweens, which requires considerable practical wisdom and creative skill. being too well or too sick, too old or too young as we saw in the map of the institutional aging process in old age, progressive aging is not related to chronological age, but to the progressively deteriorating body and mind. the institutional aging process starts out in people’s home, through their increasing need for compensation and care. we return here to the house of the couple where the husband is paralyzed in one side. the wife explains that vulnerability emerges when one gets sick. it is a daily struggle. all help is directed at her husband and even though she is in a lot of pain due to back problems, they expect her to be able to take care of him. the amount of washing if he has had an “accident”, for instance, can wear her out completely and it is very hard to coordinate with the helpers. sometimes they scold her if she is in the bathroom in the morning, when they need it for him, or if one of her blouses is in the laundry; they only have to wash his clothes. it is the not the individual social and health worker that is the problem, most are really good, especially their main helper, but the system, which is unfair, inhuman, she says. they cannot make it anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 11 fit their particular situation. they have applied for an apartment in a nursing home, because they cannot cope with the situation any more. but then again, their situation might not be seen as sufficiently bad, because she is counted as a resource, which is seen as reducing the severity of his predicament. as this couple vividly explain, what has made them suddenly old is sickness, not chronological age. they cannot do the things they used to, they need help from both institutional staff and their daughter. it is a painful process, and what becomes apparent in this example is how the institutional sphere creeps in on their home space: the presence of staff banishing the wife from the bathroom, and as we saw earlier the hospital bed and the floor lift. moreover, we see the impact of social or relational age on biological age – and their place within the institutional aging process. their biological ages are both subtracted from and added to one another: her deteriorating health is subtracted from his, the help and services only apply to him, but when they ask to be moved to a nursing home, her better health can be added to his – preventing them from “progressing”. this social or relational dimension of age is also seen in the following example, where old age is negotiated between a resident, dagmar, and a helper in a nursing home. i am following the helper on her morning round. dagmar is lying in bed when we enter, and i am told that she is perfectly capable of doing things herself, but that she likes to complain. she has to have a bath on that day, which she loathes. while we help her get out of bed, the following conversation takes place. dagmar: “when do you get old?” helper: “i don’t know. when?” dagmar (with force): “i am asking you!” helper: “you’re not old!” dagmar (hesitating): “yes, i think i am beginning to get a bit old …” dagmar is asking the helper to look at her from the outside and help figure out whether she is old now, but she is also asking someone who requires something of her – that she should get out bed, get dressed, have a bath – and who drags her off to all kinds of social activities. given the helper’s description of dagmar, she could be trying to negotiate. if she is in fact old, could she then be allowed to be less active and maybe even be excused from the social activities at the nursing home? would this mean that she could avoid taking the dreaded bath? we see the evaluation of being active as something that signals being “younger”, i.e. a social expectation, or to do with social age, which is institutionally backed in recent transformations toward enablement in danish elder care policies and practices (rostgaard 2014, 2015). in the institutional spaces, conflicts and tensions also emerge between those placed in shared spaces. even though there are large-scale divisions in the state of mental and physical decline between actual spaces – activity centers, day centers, nursing homes and dementia wards – people who inhabit these spaces are not at the same stage of deterioration. this gives rise to considerable tension and conflicts between residents preoccupied with the precarious business of being in a better or worse state than others. at the dinner table in the nursing home, a conflict builds up between ragnhild and karen. ragnhild is demented and deluded, karen is not. she used to be quite sick but has recovered and now seems to be in a considerably better state than the other residents. ragnhild is declaring in a loud voice that she has to go to the hospital. karen responds dryly: “hmm, you also had to go yesterday.” ragnhild responds that it was closed, but that now her son-in-law is coming to pick her up. karen: “lucky you!”, “ragnhild: “well i am very happy about that.” ragnhild then explains how her daughter is on her way in a helicopter to pick her up, but that she is afraid of flying. karen responds wryly and with ill-concealed irony that then she can just take an ambulance instead. at no point does karen state directly that ragnhild is lying, but she hints at it, anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 12 and ragnhild gets it. at one point, she shouts: “are you saying that i am lying?” banging her fist into the dinner table. karen backs off and says no. she shakes her head looking to the staff or me for support. meanwhile, ragnhild is “seeing” people in front of her and talking to them (mostly the daughter approaching in the helicopter), and she signals to people at the dinner table to move out of the way. then, karen again asks wryly who she is talking to. another exchange at a dinner table in a dementia ward also shows how your physical and mental capacity, your biological age, is central to the institutional aging process, here also linked to morally proper ways of behaving, or social age: oda is making conversation with esther. they are the two who are most well, meaning that they small talk and make conversation at the dinner table. they both say several times that one should stay active, not just sit there doing nothing (with direct reference to other residents at the table who are immobile and unable to talk). it seems like oda and esther are having a good time and that they accept the (lack of) presence of the others. they simply feel superior to them. when at one point oda laughs heartily at something esther says, esther responds sharply: “you’re not sitting there laughing at me, are you?” “not at you, with you,” oda responds, and keeps laughing. here, a possible conflict is prevented from escalating, but smiles and laughter can be sensitive issues in these institutional spaces. who is more demented? the one who laughs or the one who does not want to be laughed at? this makes social age, or expectations regarding behavior in the institutional aging process, unpredictable: some are physically impaired, some mentally impaired, some, like karen, not so impaired, which makes social interaction quite challenging and often highly frictional. this exchange, like the exchange between dagmar and the helper above, demonstrate that being active or passive are strong age markers in the institutional aging process, much stronger than chronological age, which is not mentioned at all in the above exchanges. chronological age is not absent, though. in the following fieldwork excerpt, i introduce poul, who is only 58 years old. in the map of the aging landscape, we entered his flat, which was full of cigarette butts, broken glass and lighters under his bed. here we are at the day center, where he goes on all work days. after having breakfast, we sit in the smoking room. apart from the dinner tables, this is poul’s preferred spot in the day center. i ask him about old age. he says, that it is no fun, if you just have to “sit like that”, showing with his body how many of the elderly here just sit, unable to hold their bodies upright, staring into space with their mouths open. how do you think that feels, i ask. he says not to think about it. “if you think too much about it, you become old.” a social and health worker comes to get us, asking us to take part in an activity. when we get there, ten elderly ladies and two social and health workers are sitting around the table. some are sleeping, some are talking loudly about grandchildren. they are of very different physical and mental abilities. poul just sits there, not talking to anybody. several times, the staff invite him to join in, to make some candy. “no thanks, i will just watch”, he replies politely, but firmly. several times – both before, during and after the candy making – he looks at me and says: “sometimes, it’s a hell of a long day!”, or “you see, nobody says a word, except what needs to be said!” there is a lot of silence, but in fact he is the one who stays most silent. when people have a conversation, he refrains from participating. grøn only followed poul for a few days, but often saw him while carrying out fieldwork at the eldercare center. these glimpses confirmed the first impressions: he just sat there, day in and day out, either at the dinner table for meals, or in the smoking room trying to light a cigarette. looking at all those who, in his words, have “one foot in the grave” and for whom the next stop involves “digging a hole in the ground”. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 13 he is still a young man, chronologically, even though he is old in terms of institutional age. he does not mingle, and this goes against the social expectation of this space and this particular event: if you are well enough, like poul, you are expected to participate and thereby place yourself among those who are able; if you are impaired you are exempt from activity and participation. but what is poul trying to accomplish? does the distance he keeps serve as a form of protection, a bulwark against becoming old like them? if you do become old, as he states, by thinking too much about it, then you might also become old if you were to involve yourself with those with “one foot in the grave”. poul’s observation – that it is somehow dangerous to think or talk about getting old – is widely reflected in this fieldwork. phenomenological age, or how you feel or think about aging, is seen as a very important causal factor of aging. chronological age is referred to by many as being “just a number”. what counts, they say, is your state of mind. how you think and feel about your situation determines whether you are (getting) old. thus, we have seen that the main marker in the mapping of the institutional aging process in old age can be summed up under the biological age dimension, the level of physical and mental decline, and also that activity in general indicates whether you are younger or older. in the absence of chronological age, being in a better or worse state than others indicates your place in the institutional aging process, yet social or relational age complicates any simple reference to biological aging. people develop strategies for how to maneuver within these institutional spaces, even though they do not actually fit their place within the institutional aging process. moreover, due to the multitude of possible ways of being impaired, as well as the diverse possibilities of being in a better or worse state than others, social interaction is demanding and often frictional. and while chronological age in some cases does play a minor role in how people fare, we have also seen that phenomenological age, or how you think or feel about your age, is seen as an important dimension in this institutional aging process – as a bulwark against progressing to the later phases. conclusion in this paper, we have asked how we should perceive and understand contemporary aging processes, in the face of dramatic demographic, social and cultural transformations of both local and global aging landscapes. we have compared aging processes from two ethnographic fieldworks conducted in schools and eldercare institutions, respectively, and taken as our point of departure jennifer johnson-hanks’s observation that aging processes should be seen as an interplay between institutional projects and personal aspirations (johnson-hanks 2002). due to the spatial organization of the aging processes of our fieldworks, we have relied on tim ingold’s topographical phenomenology and his concepts of maps, landscapes and wayfaring (ingold 2000; ingold 2007; ingold and vergunst 2008; ingold 1991). moreover, we have expanded johnson-hanks’s two dimensions (institutional projects and personal aspirations) (johnson-hanks 2002) and explored aging processes in relation to chronological, social, biological, and phenomenological age. we have found that the institutional aging process is based on different dimensions of age in the two sites: for children in schools it is based on chronological age, for elderly people it is based on progressive bodily deterioration and sickness, i.e. biological age. in fact, chronological age is almost absent in the institutional spaces of old age. in terms of biological or bodily age, there is also a remarkable difference in physical movement: children’s spaces are filled with movement, but through the institutional aging processes they are taught to move less or to move in specific ways, whereas spaces for the elderly are characterized by progressive stillness, only interrupted by meals and training sessions aimed at keeping them active. the children aspire to grow older and have a strong drive towards moving forward, while the opposite is the case for the elderly. the elderly persons in the earlier phases of this process who are confronted with the subsequent phases express strong fears of one day finding themselves in these physical spaces of old age and “the old” (grøn 2016). what we want to suggest from this mapping of the institutional aging landscape is its anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.139 http://anthro-age.pitt.edu grøn & ladekjær | 14 centrality to aging processes in settings like denmark, where childhood and old age are highly institutionalized. while the picture drawn by this initial mapping of the institutional aging process might seem overly simplified, when we get to the actual wayfaring, intersections and clashes between different aging dimensions complicate this image. the empirical examples of wayfaring through the aging landscape show, that the children’s diverse biological ages, as reflected in body size or movement, thoroughly complicate their placement within the institutional aging process, and that their chronological, social and biological ages are not in a one-to-one relationship with each other. this complicates the map of the institutional aging processes and demonstrates their ability to move along as they go, the wayfaring through the landscape of tweens, which requires practical wisdom and creative skill. in the wayfaring through institutional landscape of old age, being in a better or worse state than others indicates whether you are younger or older in the institutional aging process, though the map is complicated by social or relational aging dimensions. people develop strategies for how to fare well in these institutional spaces, but due to the multitude of possible ways of being impaired as well as the diverse possibilities of being in a better or worse state than others, social interaction is demanding and often frictional. also, while chronological age in some cases does play a minor role in how people fare, we have also seen that phenomenological age, or how you think or feel about your age, is seen as a very important dimension in this institutional aging process. the complexity at the core of the notion of age is pervasive, even though, at first sight, the institutional aging process maps specific aging trajectories. thus, the indeterminacy of a social marker like age does not only show up through deconstructivist and cultural comparison approaches. we have taken a phenomenological approach and found both determination and indeterminacy to be central to aging processes in contemporary denmark. maybe this complexity is to be expected, if we consider that aging processes relate to big questions: what makes up a human being – body, mind, soul or community – and what is time and development over time? these questions have occupied the natural and social sciences, philosophy and religion for decades, and they still tend to evade our attempts at grasping them. references alexander, p. 2011, learning to act your age: negotiating age imaginaries in an english secondary school (phd thesis), university of oxford, oxford. anderson, s. 2000, i en klasse for sig, gyldendal uddannelse, københavn. 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(introduction: school’s children and society’s citizens. antropologi 62, pp. 3-18) acknowledgments this article would not have been possible without the generous participation and critical insight of our research subjects in the three health centers and two schools where our fieldworks were conducted. else ladekjær’s fieldwork was made possible by a grant from the danish foundation trygfonden and lone grøn’s fieldwork by a grant from the danish foundation velux fonden. we also wish to thank tine rostgaard who provided important insights and critical comments on earlier drafts of the article, and finally the two anonymous reviewers whose questions and comments have been extremely helpful in bringing both empirical and conceptual clarity to the argument made. notes i. in denmark municipal primary and lower secondary school or “folkeskolen” covers the 0th to the 9th grade. the danish “folkeskole” is a central part of the danish welfare state, the school is funded through taxes and is thus free to attend. approximately 81% of danish children attend the danish ”folkeskole” (https://www.uvm.dk/service/stat”istik/statistik-om-folkeskolen-og-frie-skoler/statistik-om-elever-ifolkeskolen-og-frie-skoler/elevtal-i-folkeskolen-og-frie-skoler?allowcookies=on). ii. denmark along with other nordic countries has developed and implemented, over a number of years, wide-ranging and encompassing social policies leading some researchers to label the nordic countries “caring states” (leira in rostgaard 2015). access to benefits is based on citizenship, not merit or contributions, and social services for both children and elderly people are based on the universal and public welfare model. the state and local authorities in combination subsidize care services over income and local taxes. (rostgaard 2015). iii. the publication ”bevægelser fra barn mod teenager i folkeskolens rum og regler – et antropologisk perspektiv” (movements from child to teenager in the spaces and rules of school) was written by else ladekjær using her maiden name olesen. iv. the example with britt’s position in school points to parents and parenting as an interesting phenomenon in relation to children, age dimensions and school. are parents involved in creating the map, do they guide children’s wayfaring, or how does the parent play a role? parenting as another dimension could be a highly interesting supplement to the analysis of children and institutional age. unfortunately, the ethnographic material at hand does not cover this area. the relations between child and parent as well as child and teacher is significant in relation to institutional age in school. the teachers role is unfolded in ladekjær’s thesis from 2016. endtimes_layout bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 31 aging and the end times evangelical eschatology and experiences of elderhood in the united states and south africa douglas bafford brandeis university author contact: bafford@brandeis.edu abstract recent trends in aging studies and popular u.s. discourse reformulate elderhood as a valuable, not necessarily negative, experience, and these new models of aging have extended to a consideration of religious practices that can make old age particularly meaningful. among evangelical christians, a shared cosmological (and specifically eschatological) narrative structure provides solace and semiotic coherence in the face of challenges characteristic of the “third” and “fourth age.” what remains less clear is the interplay between transnational religious forces like evangelical ideology and local social contexts in which they are enacted, a process illuminated only through cross-cultural comparison. drawing on ethnographic fieldwork conducted in kentucky and in south africa, i argue that rather than viewing evangelical rhetoric as narrowly determinative, anthropologists ought to broaden common understandings of christians’ end-times ideology as something that may, contingent on socio-historical context, alternatively help older congregants cope with the physical effects of aging or allow for reconciliation amid rapid societal change. u.s. evangelical churches often address existential concerns faced by a growing population of elders while downplaying the significance of race, yet white south african christians employ a similar religious cosmology to place their actions during the apartheid era in a symbolically legible narrative. both settings indicate the malleability of evangelical ideas to foreground certain concerns while erasing others, challenging assumptions about the uniform effects of global evangelicalism. keywords: evangelical christianity; eschatology; successful aging; race; apartheid anthropology & aging, vol 40, no 1 (2019), pp. 32-47 issn 2374-2267 (online) doi 10.5195/aa.2019.197 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 32 aging and the end times evangelical eschatology and experiences of elderhood in the united states and south africa douglas bafford brandeis university author contact: bafford@brandeis.edu american popular rhetoric surrounding aging presents it as a crisis: at turns a social change in roles and relationships (johnson 2005), an economic challenge to u.s. society’s ability to provide materially for aging people (long 2003), or an existential threat to personhood (kimble 1990). however, how does the meaning of old age transform when it is conceived not as the end but only as the antechamber for the next, transcendent world? evangelical christians around the globe share at least some elements of a cosmology that positions the contemporary world along a biblical trajectory from god’s creation of the universe to the end days in which the perfection of god’s plan will be realized once again. although conservative christians face opprobrium for their rejection of the values of liberal secular modernity, anthropologists over the past few decades have begun to direct their attention toward an examination of evangelical lives as semiotically complex systems (harding 1991, 2000; bielo 2011). these ideologies may help mitigate anxieties associated not only with the threat of physical decline in old age but also the rapidly changing social worlds elders face. older evangelicals operate from a model of aging in which the later stages of life demand preparation for eternity and the purposive helping of others in the present world. at the same time, questions of how evangelicals have engaged in self-fashioning in other societies remain to be addressed by ethnographic data, as aging does not mean the same thing everywhere (lock 1993; childs 2004). the academic literature on religion and aging in the united states has burgeoned in the 1990s and early decades of the twenty-first century, with incisive monographs (e.g., coleman 2011) and even wholly dedicated journals, such as the journal of religion, spirituality & aging. much of this inquiry has centered on the ways in which religious belief and ritual practice improve the health of aging adults (ai and ardelt 2009; corwin 2013; koenig 1994). despite this extensive focus on the relation between religiosity and health in old age, less explicit attention has been devoted to comparing these experiences across cultural settings and informed by ethnography. even less consideration has been given to exploring how religious eschatology specifically—that is, discourse concerning the end times and what happens after death—affects subjective experiences of aging (although see gerkin 1989 and barclay 2016 for examples from a pastoral perspective). my project constitutes an attempt to introduce evangelical notions of the end times into academic understandings of the aging process through a cross-cultural and anthropological approach. i present three case studies in this article from the world of evangelical christianity, drawing on four months of ethnographic research conducted in 2014 and 2017 in northern kentucky, u.s.a., and the peri-urban neighborhoods of johannesburg, south africa, respectively. these linked projects emerged out of an attempt to trace the dynamics of transnational evangelical networks (which include the circulation of common speakers, resources, and theology) as they spread christianity to differently positioned audiences. first, i draw on ethnographic material from kentucky, at an independent baptist congregation and an encroachment, as a means to illustrate how white evangelicals cope with the prospect of death and suffering in the world (i.e., an answer to the theodicy question) while also constructing race as an antibiblical concept. next, i extend my ethnographic findings from this field site by turning to textual primary sources consumed within u.s. evangelical networks that address the roles and virtues of old age, putting bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 33 my observations in conversation with broader national trends. finally, i adduce data collected in johannesburg as an example of evangelical christianity’s role in shaping the life reflections of white south africans as they reach elderhood. this article addresses a recurrent theme that appeared in the background of my interlocutors’ discussions across national and cultural boundaries: the relation between elderhood and christianity’s role in making sense of the world. older congregants and church leaders reflected, at times more or less explicitly, on the role of their religious cosmology—especially their notions of eschatology—in constructing a coherent worldview. rather than viewing evangelical rhetoric as monolithic and determinative, anthropologists ought to broaden common understandings of christians’ end-times ideology as something that can, depending on the salient social context, help older congregants cope with the physical effects of aging or provide a framework for reconciliation, even if it reinforces other dominant ideologies, such as narratives about race. in so doing, the dynamics between global religious phenomena and local particularity emerge ever more strongly. preliminaries: the multi-sited ethnography of evangelical christianity and the construction of an alternative temporality before a consideration of each case study in turn, i will provide a brief methodological comment on the study of evangelical christianity from a transnational perspective. one of the defining characteristics of christianity has been its demonstrated ability to take root in diverse cultural environments. whether perceived as threat or panacea, the global spread of conservative christianity in particular has introduced a recognizable cosmology into what appear in other respects to be vastly different social groups. indeed, it is this universalism, especially in its boldest proselytizing forms, that has powered its ascent into one of the world’s most pervasive religious frameworks (e.g., landau 2013). anthropologists have focused on the hopeful character of christian rhetoric, as well as its malleability, as keys to its international sway (keane 2007; robbins 2004). on the one hand, this missionization and conversion engenders a seemingly shared experience for people otherwise separated by geographic and cultural distance, thus creating a population that, at least in certain ways, can be meaningfully studied as a social unit. at the same time, however, it must be analyzed in ways that do not flatten its diverse local manifestations, a task i undertake by drawing examples from different national contexts. comparative ethnography, if conducted long enough to develop a proper snapshot of quotidian life, highlights the features of a social group that are unique to a local cultural setting while acknowledging how they are continually shaped by broader, even global forces (comaroff and comaroff 2016; lock 1993). while relying on multiple field sites risks producing superficial cultural understanding, the conclusions drawn here use the parallels among evangelical cultures as an advantage to gain a semblance of the complex forms that evangelical theology can take and the effects it can have across the life cycle. to explore the role of religion in constructing the experience of old age across otherwise disparate societies, i adopt what might be labelled a “multi-sited” approach (marcus 1995). my research follows the movement of conservative interpretations of the bible in order to ask how those ideas shape people’s lives and how people in turn channel them into unique forms of christian practice. at its most basic level, conservatism refers to an ideological posture of valuing traditional authority (variously conceived) over contemporary social change. while conservatism often overlaps in its cultural, economic, and philosophical varieties (zumbrunnen and gangl 2008), christian conservatism specifically refers to a clearly-articulated resistance to any hermeneutics that depart from a literalist reading of the bible; in other words, the theological perspectives of early reformation figures like john calvin are privileged over reinterpretations bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 34 in the light of contemporary social norms (e.g., on shifting gender roles) or even scientific developments (e.g., on the time depth of cosmic history). even within a single national context, conservative evangelicals do not constitute a single congregational, or even denominational, unit. the christians who come under the heading of “evangelical” or “fundamentalist” in the united states are heterogeneous, with contrasting theological beliefs and religious practices, to say nothing of their differences along other social dimensions (harris 1998). complicating this image are the multiple terms used to describe these christians in north america and south africa. nonetheless, in analyzing how evangelical ideas have spread, i take these communities to exhibit “family resemblances” in the wittgensteinian sense of not sharing a single set of criteria yet being similar enough to elicit recognition as part of a group (see saler 2000[1993] for an application of family resemblances to the study of religion). shared evangelical beliefs center on the role of jesus christ as exclusive savior and god’s absolute authority in the text of the bible. they prioritize an individual’s need to be “born again” in accepting christ, whom they understand as having died to absolve all people of their sins. this personal relation with christ, along with a conservative, literal reading of the biblical text as the sole source of religious authority, marks off evangelicals from relatively more liberal protestant and catholic sects (harding 2000). here i use the term “evangelicals” to describe christians who privilege a born-again experience and understand the present world as a sin-filled prelude to an apocalyptic second coming. within this common framework, however, evangelicals’ eschatologies differ in terms of the minutiae regulating the sequencing of christ’s return, whether it happens before or after the prophesied tribulation and whether god’s people will have been “raptured” away before it commences. to understand this cosmology and its effects on aging, it is helpful to think of it as an alternative model to secular temporalities. evangelicals emplot (cf. mattingly 1994) everyday life onto a cosmic narrative that begins with god’s creation of a perfect world as described in the first two chapters of the book of genesis. with the disobedience of adam and eve and humanity’s subsequent fall into sin, people suffered an estrangement from god and found themselves in a world plagued by death, pain, and evil. the messianic figure of christ offers the potential for rebirth and redemption from this world in a prophesied future. in simplified form, notwithstanding the minor disagreements in eschatological sequencing mentioned above, evangelicals share an understanding of time as divided into the phases of a perfected creation, the corrupted period in which we are now living, and the promise of a utopian future once christ has returned (guyer 2007; cf. mcgovern 2012, 250-4). these transitions are abrupt, so that “evangelical thought is dispensationalist, in which the entire working of the world changes from age to age according to the nature of god’s presence in it” (guyer 2007, 414). while the periods themselves are abrupt and total divisions, evangelicals’ notions of the distant future inflect their enactment of the same overarching narratives in the present, so much so that susan harding (2000, 240) describes them as living in a “future unfolding.” it is this omnipresent specter of christian eschatology in the present that has significant implications for how old age becomes discussed and lived within evangelical communities in the united states and south africa alike, albeit in distinct, structurally mediated ways. death and aging in kentucky “the matter of greatest concern to the biblical writers was not aging as such but the telos toward which the aging process leads: mortality. a biblical perspective on growing old will cause us to focus on death as the end toward which we move—and yet as the last enemy confronted by god’s redemptive power” (hays and hays 2003, 4). bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 35 in the summer of 2014 i conducted ethnographic fieldwork in northern kentucky with evangelical baptists, several of whom were affiliated with the nearby interdenominational apologetics organization answers in genesis (aig), which aims to defend a young-earth view of creation in opposition to all evolutionist interpretations of the distant past. this project traced creationists’ integration of scientific and religious rhetoric, as well as how this discourse becomes implemented in everyday life. in august 2014, i attended a workshop hosted by aig to equip a christian audience to defend the faith through the topic of origins. i listened to and asked questions during presentations designed to foreground the creation/evolution debate’s relevance to spreading the christian message more broadly. various speakers, most of whom focused on a single topic or area of inquiry like geology or biology, taught that all the suffering in the world could be traced to the origin of human sin in the garden of eden. dr. georgia purdom,i a molecular biologist and creation evangelist, argued in one such speech that the genetic mutations that lead to diseases like cancer occur only because of the current state of life governed by “fallen,” corrupted physical laws. in explaining “the reason that there is pain and suffering and death in this world,” she narrated the difficulties she and her husband faced in conceiving a child; it was only when she “understood the history in genesis” that this predicament became less senseless and more bearable. when she turned to scripture, she realized the inability to have biological children “wasn’t god’s fault; it was man’s fault, right? and it all started back in the garden of eden when adam and eve chose to disobey god; they sinned, and because of my sin through adam, everything is affected, right? everything is cursed, including my body, my husband’s body, it’s all affected as a result of that.” this curse of sin has produced a physically degraded world into which pain and suffering intrude. at the same time, as purdom and her husband started considering adoption from a foreign country, she was forced to consider her existing prejudicial ills. she admits that growing up in a homogeneous midwestern town, “i was raised in a christian home, and i would not have considered myself a racist, but in reality i was.” later, she encountered aig teachings and began to see the same biblical “curse” as having not only brought biological degradation into the world but also segmented the human race into artificial social divisions that today form the basis for different “races.” in a parallel argument to one made by anthropologists (cf. boas 1949[1931]; american anthropological association 1998), she emphasized the lack of a biological basis for race. instead of drawing this conclusion from race’s social construction, however, she considered racism a consequence of humanity’s sinful nature in destroying the perfect unity designed by god in the world’s original state. as ken ham, the ceo of aig, said during the same conference, purdom’s material on the biological fiction of race was sorely needed in ferguson, missouri, which at the time was the site of anti-racist protests in the wake of michael brown’s death at the hands of a police officer. ham’s suggestion that there would be no need to protest if the protesters only realized we were all “one race” (i.e., the human race) exemplifies an attempted erasure of the ongoing structural significance of u.s. racism (alim and smitherman 2012). i return to the politics of this implicit non-racialism later in this essay; for now, however, the relevant point is the elaboration of a cosmology in which contemporary social and physical ills, including physiological decline and social inequality, are attributed to the introduction of sin into god’s creation. dr. tommy mitchell, a clinical physician with years of experience advising patients with terminal diagnoses, addressed most directly the anxieties over mortality people face specifically as they grow older. when confronted with the question of how god can allow so much death to impede on human life, he encouraged christians who want to spread the gospel to distinguish “eternal” from “physical” life, a rhetorical strategy in line with evangelicals’ extension of temporality beyond the single life course. he acknowledged the bodily suffering that often comes with old age in the physical world, but these pains, he said, ought to be faced alongside god’s promise of salvation through the repentance of sins. he called for recognition of a “strength in trials”: the fortitude to endure a world corrupted by sin with the hope of bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 36 redemption around the corner. mitchell came to terms with the loss of his own mother by understanding her death as part of an unfolding narrative of sinful corruption that does not end with individuals’ lives but will be overcome at an unspecified future time. the eschatological narrative he enacted in this presentation offers a way to reinterpret old age not as the terminal stage of life but instead as a natural step along the path toward escaping this world and reuniting with god after death. while mitchell’s eschatology motivated his own attitude toward death and suffering, it is only through participant observation with older christians that the everyday effects of hearing these claims become perceptible. during time spent attending services and interviewing participants at an independent baptist church near aig’s headquarters, i met milton, who exemplifies some of the ways in which an evangelical orientation to the world can provide comfort with and greater acceptance of the physical challenges of old age. milton was a white married man in his seventies who attended church services regularly (typically thrice per week) with his wife, dolores. always with an infectious smile, he walked around the chapel and the attached annex with the help of a tennis-ball-footed walker and the steady, loving hand of his wife. dolores, although only a few years his junior, was more mobile and with fewer pressing health concerns than her husband. besides church services, he and i joined a gender-segregated evening prayer session each week and attended sunday school together. as he insisted, it is never too late in life to continue learning more about christ, and in fact there were more adults than children at these sunday classes. an important component of milton’s story, and one that surprised me when i first started talking to him, is that he had not been a christian for very long. it was only a few years prior to 2014 that he was “saved” and committed his life to christ. dolores had been a devoted member of the church before that, and their difference in religiosity led to milton staying home each sunday as she attended services. when milton started experiencing health concerns, especially those involving his back and his ability to walk unassisted, he started looking for answers not just in the medical realm but in the religious narratives his wife would share with him in an effort for him to be born again in christ. at some point, milton described the realization of god’s message as something that “hit” him like an epiphany, and he started attending services with his wife. since he was relatively new to evangelical worship, he was eager to attend the adult sunday school lessons at which most congregation members sat in. although an elder in the physical sense, he considered himself only a child in faith, someone still growing in his understanding of the bible and of christ. since aging in the church was not the explicit focus of my research, the following analysis of his newfound salvation and his experience of aging is based principally on observational data rather than interviews or questionnaires. nevertheless, his declaration of faith in later life points toward the work that evangelical narratives did to help him give meaning to his life’s trajectory. it was only after his health started to decline and he needed to retire from a rewarding career that he acceded to his wife’s attempts to pull him into the fold of the church. what his faith gave him was a way to make sense of his shifting physical capabilities within a different narrative from that of a perpetually active body associated with u.s. successful aging discourse (cf. rowe and kahn 1998; katz 2000; lamb 2017). the fruits borne by his faith were most publicly visible in the weekly prayer sessions we attended together. during these quiet meetings before sunday evening services, the pastor and men of the church congregated in an office to invoke before god specific problems facing themselves and loved ones. the pastor would usually ask about milton’s health and his frequent medical appointments and call on god, if he willed it, to help the doctors find a palatable solution to ease his pain in walking. milton thanked the others for keeping him in their prayers, and his comfort may have come at least in part from being within a communal setting (see koenig 1994 on the health benefits of religious communities). at the same time, bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 37 however, he would observe that he was approaching the end of his life and was looking with anticipation toward the final judgment. he openly confided that he was not as frightened of the prospect of death as he was before he was saved and that he knew he could trust in christ to bring him and his wife everlasting life and force the world back to perfection after a period of trials and tribulations. these patterned, ritualized prayer meetings offered milton both comfort in the moment (i.e., knowing he was part of a caring community) and reassurance that his physical pains in this world would not last forever but would give way to a transcendent, utopian existence at the end point of a teleological evangelical narrative. a focus here on milton’s experiences, while not representative of all u.s. evangelicals, is also not idiosyncratic. an ongoing concern voiced in after-church discussions was the noticeable aging of the congregation as a whole. in other words, the average age of the congregants was rising, with fewer young people of childbearing age taking part in regular services. this anxiety is felt not only at this setting but among conservative christians more broadly (e.g., ham, beemer, and hillard 2009), who sense a crisis of social reproduction in an age in which secular temptations threaten to draw youth away from the church. as the “graying” of conservative churches continues, they may become sites at which people make sense of old age surrounded by compatriots facing similar struggles; what the longterm effects such a change may have among future generations of evangelicals remains uncertain. evangelical transcendence in the united states “to every thing there is a season, and a time to every purpose under the heaven. a time to be born, and a time to die” (ecclesiastes 3:1-2, king james version) this theme of eschatology’s impact on elderhood can be placed in its theological and social context through a turn to popular evangelical literature in the united states. while conservative christians imbue several valuable and transcendent qualities into later life stages, nowhere is rhetoric directed more explicitly toward the demands of aging than in famed evangelist billy graham’s (2011) book on the topic, nearing home. throughout the latter half of the twentieth century, graham, who died in early 2018, was a southern baptist preacher and a leading figure in the spread of evangelical christianity through large-scale public events, or “crusades.” in this section i offer a close reading of several critical passages of his memoir that contextualize some of the findings that emerged during field observations in kentucky. graham describes how older people can search for a renewed sense of purpose without falling into isolation from family and friends or complete disengagement from worldly pursuits.ii for him, this sense of purpose is motivated by a conviction that, even as elders age and often face growing physical challenges, god has kept them here for a reason, which they must take an active role to fulfill. challenging dominant cultural attitudes toward old age, graham writes, “while [u.s.] society may not believe that growing old is a respectable phase of life, my prayer is that believers in jesus christ will walk the last mile of the way triumphantly, as moses did when he died at age 120” (ibid., 15). here he takes the biblical figure of moses as a positive role model for fulfilling god’s purpose, even—indeed, especially—in later life, in contrast to the less “respectable” attitude he sees circulating within american society. such a stance positions evangelical approaches to aging as embracing unique god-given virtues of older men and women. among these virtues, graham emphasizes the importance of helping others in the community turn to god. with their increased wisdom and life experiences, elders have a role to play in fostering younger christians’ spiritual commitments, especially as they now, in a post-retirement age, have more time to devote to ecclesiastical matters. in turn, their integration into congregational communities will help them cope with the deaths of peers and loved ones and to prepare for their own deaths (ibid., 104-5). religious bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 38 leaders like graham insist that, even in the face of growing physical challenges, older adults ought to focus on these important evangelistic roles they can now play, roles that parallel the careers of earlier generations of christians who suffered to promote the gospel. as graham (ibid., 40) exhorts his followers, “some of us may be bedridden or confined to a wheelchair, but we still have important work to do.” one response to physical decline in older age would be to mourn the loss of the youthful person, but graham calls for an embrace of the suffering in old age as an obstacle to be overcome in the overall evangelistic process. he draws parallels between the narratives of those christians who have suffered to save souls and elders who continue to fight to do their “important work” on earth.iii in this way, his model of older christians positions people like milton as fulfilling a key purpose in the life of the evangelist whose lives are, therefore, inherently valuable, not a mere imitation of youth. graham is not alone in finding divine purpose in old age. charles pinches (2003), for example, although speaking from a more liberal protestant perspective, likewise recognizes certain unique virtues in aging. he associates old age with greater simplicity in life, or a tendency for older people to travel lighter on their journeys. this language of leaving behind more complicated ties to the world behind in preparation for the final period of life resonates with a broader literature on the ideal of transcendence. lars tornstam (1999), for instance, has written of what he calls “gerotranscendence” as a path to superseding the demands of everyday life and, ultimately, to accept a shifting social role. within this model, as people move from an emphasis on doing (physical activity and being relied on by others) to being (acceptance for their mere presence), they attain a kind of transcendence that “is a natural and important part of the process of ageing in the fourth age” (mackinlay 2006, 161).iv for the christians who adopt transcendence as a virtue of old age, as with the appeals of graham and other evangelicals, elderhood is a life stage set apart from others by its unique virtues imbued by god. uniquely evangelical interpretations of “transcendence” focus particularly on the ongoing, lifelong development of the moral self. william yount (2009, 89), a southern baptist, explains that “evangelicals see our development here and now as having eternal consequences for our life there and then. this places far greater importance on spiritual development in senior adults since physical death is not the end—there is an eternal existence to develop for” (emphasis added). from this standpoint, later years serve as a time of serious preparation for people’s future “life in the kingdom of god,” which begins in the corporeal world through the cultivation of devout praise and mindfulness of god (ibid., 102). in this version of transcendence, aging qua existential crisis (cf. rowe and kahn 1998) is replaced with aging as a time to take stock and shore up spiritual commitments before the afterlife. while this stance may not be unique to evangelicals—recall that the category “evangelical” itself is porous and widely encompassing— it is perhaps most perceptible among them, as they tend by definition to be deeply invested with faith in the world to come. although they differ on other theological points, these christians share a concern with reinterpreting aging from an anxiety expressed throughout american culture to something divinely authorized, and therefore spiritually meaningful. social atonement and transcendence in south africa “[bishop reteif’s] initial response to the massacre was to heroize the south african police and to demonize the pac [pan africanist congress] youth as the ‘instruments’ of evil forces. after the trc [truth and reconciliation commission] hearings, the bishop was contrite and conscious of the ‘blindness’ of his evangelical church to the suffering caused by apartheid and to the ways that his congregation had benefited from the suffering of the majority population” (scheper-hughes 2007, 219). bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 39 in turning from the u.s. context—with its obsessive focus on individual redemption—to south africa, new concerns emerge with which evangelical communities have been forced to grapple: viz., the rapid, uncomfortable, and ongoing uncertainty in how the nation has transformed since the fall of apartheid in 1994. i began an ethnographic project in johannesburg in 2017 working with christians to trace the challenges and effects of globalizing a literalist reading of the bible through transnational evangelical networks. this fieldwork has entailed attending religious services, listening to conference presentations on church planting efforts across denominational lines, and interviewing church elders to elicit the changes they have observed in the spread of christianity since the fall of apartheid. by constructing an argument highlighting the contrast between these cultural contexts, i do not wish to imply that south african christians distance themselves from a concern with individual soteriology; indeed, as in other parts of the world, evangelicals here stress the need for people to accept jesus as their personal savior, and the overlap in the religious narratives they adopt allows them to draw on similar discursive repertoires as u.s. evangelicals. nevertheless, conservative christianity has not been imported “wholesale” into south africa, a recurring theme in the anthropology of african christianity (cooper 2006; klaits 2010; meyer 1998); instead, it has been part of a complex mediation between africans’ social worlds and the religious and material forces that have circulated throughout the continent. in the case of south africa, white evangelicals have placed a global born-again cosmology in the service of speaking to the concerns they face transitioning from a dominant minority to an uncertain status in the “new south africa.” writing in the leadup to the fall of apartheid governance, vincent crapanzano (1985) illuminated these worries among both english-speaking and afrikaner whites. despite cultural differences and mutual suspicions, these two groups shared a “rhetoric of the future” centered around waiting for an unknown fundamental change they were powerless to stop (ibid., 42-46). in response to their unease, many whites turned to religious revival, seeking “to escape through a transcendental language” (ibid., 30). the nervous experience of “waiting” for an indefinite national future was coupled with visions of an impending apocalyptic doom, both for the conservative (and apartheid-affirming) dutch reformed church and for charismatic prophetic teaching (ibid., 93-98, 214). one of crapanzano’s informants described religious services as “a rehearsal for the day of reckoning,” affirming his “faith in a transcendent power” that would see the community through tense times (ibid., 45). however, in these hopes of deliverance through transcendence, even whites who ostensibly supported the anti-apartheid movement and rejected any theological basis for racial divisions in the church nevertheless found themselves uncomfortable with the prospect of radical integration (see also du toit 1983). crapanzano thus illustrates the dual role that christianity served on the one hand to offer hope for a promised utopian future life yet on the other hand to mediate south africa’s existing racial divisions without erasing them. since the fall of apartheid, hopes for a multiracial country have been tempered with the reality of ongoing poverty and, in some ways, even increasing inequality (worden 2012, 158). despite the outward appearance of sizable change, structures of dominance remained in place during the years of apartheid’s decadence (johnson 1994). in this unique historical moment, whites “are selecting, editing, and borrowing from the cultural resources available to them to reinterpret old selves in the light of new knowledge and possibilities, while yet retaining a sense of personal congruence” (steyn 2001, xxi-xxii). these “old selves” they feel the need to “reinterpret” were those embedded in apartheid-era social life, as a consequence of which they now face a cognitive dissonance between professed values and the social ties that made them part of the apartheid system. through the example of struggle figures like desmond tutu, the christian emphasis on mercy permeated the ethos of the truth and reconciliation commission, yet critics, including fellow anti-apartheid preacher and ex-member of the afrikaner dutch reformed church c.f. beyers naudé, decried a lack of many leaders’ true repentance and admission of guilt for past sins (graybill 1995, bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 40 126). it is in this context that white evangelicals, especially those who grew up during the height of apartheid and are currently approaching older age, are grappling with the ethics of self-fashioning in a post-apartheid era. the story of a newly retired, english-speaking pastor indicates poignantly the role taken during elderhood of white christian atonement for racial injustice that occurred in the past and to which he and others had been blind. anthony and i sat down before lunch in a quiet, suburban house he and his wife, sharon, were preparing to leave for an old family home on the coast where they planned to spend their retirement. he was finishing the process of handing over stewardship of a small evangelical church in an upper-middle-class suburb of johannesburg to a younger pastor. raised in a baptist household, he had stayed in the baptist tradition all his life, attending theological school in the city as a young man who felt a calling for the church. after serving at a handful of different ministries across a fifty-year career, he was now preparing to leave formal leadership roles and transition to the last stage of his life. in the final few weeks of their preparations to leave for retirement, he and sharon spoke to me about their thoughts on recent changes to christian life in south africa. although my questions related to their sense of contemporary struggles in spreading the gospel, anthony shifted our focus toward reflections on what it was like to grow up in a white baptist household in a racially segregated society: up until the time of the change of the new south africa [in 1994], i was born and brought up in a particularly – in the heart of the apartheid era, very much so. and yet my, i would say that my parents were those who were, in terms of their political point of view, well recognized the dangers of apartheid and so on, and yet there was never a very strong opposition, and so we just embraced that kind of life and lifestyle. and looking back, one regrets perhaps some of the things you sort of almost turned a blind eye to or participated in without really thinking. it was purely a cultural sort of environment. following historic efforts at truth and reconciliation as part of the transition to democracy during the 1990s, south african politics was marked by an effort not simply to punish whites who were complicit with racial injustice but to understand how such a system could be perpetuated in the first place (scheper-hughes 2007). what anthony’s narrative indicates, however, is how this politico-legal project had also to be undertaken by everyday white south africans. in this account he positioned himself as guided by positive moral goals—his family “recognized the dangers of apartheid”—but nonetheless they “almost turned a blind eye” to inequalities, something he attributes to a “cultural” phenomenon, something imbued implicitly through habit. at other points in the interview—and in evangelical discourse more broadly— “culture” takes on a negative tone in opposition to “biblical,” thus becoming a kind of epiphenomenon that acts merely as ornamentation over a religious, or godly, substratum (i.e., god created the world; what humans create is “merely” culture). in this framework, apartheid is understood through its ability to be adopted subconsciously, not the result of god’s plan but as a human corruption of divine morality. this reckoning of his role in a segregated south africa is ongoing in the present, a kind of post facto attempt to reconcile an individual ethical personhood with the reality of what is internationally remembered as a period of moral darkness. his account echoes what janet mcintosh (2016), writing about white kenyans’ unawareness of their complicity in societal racism, calls “structural oblivion.” curiously enough, anthony was mindful of the oblivion he and other whites lived within, as he made even clearer later in the conversation when we discussed a lack of attention given to race: we were seeing through a glass very darkly, in a sense, and it was never really drawn to our attention the specifics of that. and, yeah, by the time the new south africa had come about in ’94, yeah, many of us were already on the, moving in that direction, feeling that it bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 41 was the right thing to do, but then in hindsight looking back, to realize it’s almost come too late, really. these obscured optics extended from his family to the baptist churches in which he was brought up, which he claimed were not as politically involved as those of other denominations. toward the mid-1980s and later, cursory efforts at addressing apartheid were undertaken, but on the whole, baptist churches “had embraced the cultural/political situation of the day.” turning to the contemporary legacy of apartheid, anthony remarked that the goals of a non-racial paradise are far from being met. while most south african commentators would headily agree with such an assessment, his eschatological framework caused his explanation to map the contours of an evangelical cosmology. in this period prior to christ’s second coming, anthony insisted that all people and nations continue to be mired by sin, including south africa’s post-apartheid majority-black government: it’s twenty-four years since the transition took over, and i think sadly, and again it may be because i’m a white european saying this, but there really has been an absolute transference of apartheid from the black being suppressed almost to the whites, and now we’ve almost got the opposite. and we’ve not integrated as we ought to have…. at the moment there’s a real sense in which because the anc [african national congress] is basically a black political party, one can understand that most of the positions are filled by black people, but there is at the moment a real sense of it’s just been a reversal of the apartheid system, which is very clearly to me an indication of an outworking of the sinfulness of one’s own heart, in the sense that sin is at the root of it, and we’ll look after our own, in the same way that the apartheid folk looked after their own kind, we’re seeing this here, and there’s always been corruption under the old government. it just seems to have blossomed very quickly under the new government. on the one hand, this explanation resembles the discourse of “reverse racism” and the oppressedbecoming-the-oppressors narrative that triggers some whites’ anxiety both in south africa (hook 2015) and the united states (norton and sommers 2011). there is an element of that here, as he himself acknowledged at the start of the quotation; ironically, his continued recourse to the language of white victimhood is a further way in which he is still “seeing through a glass very darkly,” another layer of structural oblivion. more fundamentally, anthony’s case constitutes an attempt to understand south african life through the lens of universal notions of sin. from an evangelical standpoint, no ordinary human being is without sin, so it would make sense that a black-majority government would commit similar sins as a white-dominated one, even though he recognizes that he is especially attuned to its effects on whites “because i’m a white european saying this.” what he describes as an “outworking of the sinfulness of one’s own heart” is part of a globalized evangelical model to make sense of the inhumanity of racial segregation: as a physical manifestation of human sin against god’s creation, with the only solution being repentance and being born again in christ, who transcends all human divisiveness. if anthony’s christianity places blame for south africa’s ongoing struggles at the feet of sin, it also offers the potential for societal redemption, just as it does for individual salvation: i think the church needs to develop the model where the political parties and the world can look at our local churches and see that radical transformation of oneness and unity and respect for one another, and positions being held in our local churches of leadership irrespective of the color of your skin but in terms of your giftedness and your qualifications and so on. bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 42 such a response echoes the dreams of a post-racial south africa as embedded in the state metaphor of the “rainbow nation,” a multiracial paradise in which skin color is not a factor in determining success (gachago and ngoasheng 2016). like white kenyans’ attempts at “linguistic atonement” through their adoption of african languages, these efforts to ameliorate the sins of the past nevertheless “tacitly keep european authority in place,” despite ostensible attempts at reconciliation (mcintosh 2014, 1193). what is unique here is that anthony adopts a religious justification for his racial/political stance, drawing on church leadership and the biblical principles of “oneness and unity and respect for one another” to influence secular south african society. despite some progress in his congregation “becoming completely multiracial” in its membership, anthony held no illusions about the difficulty of the road ahead. while the church could offer a path forward, human fallibility rooted in sin would ensure that, at least in a “fallen” world, perfection is impossible. much could be read into anthony’s explanation of his life history and contemporary south africa, but the relevant point here is to consider how age factors into his self-reflection. when i met him, he was finishing the process of abdicating leadership responsibilities and finding more free time to reflect back on his experiences traversing the “old” south africa and the “new.” this additional time, coming at the end of a lengthy career in ministry, served as a juncture at which to think retrospectively through the lens of a cosmology that places human beings in a state of sinfulness. while elderhood is not the exclusive period of self-reflection, evangelicals stress the need to spend this time in moral preparation for the coming age and in discipleship (mentoring/guidance) of younger christians, as discussed earlier. although south africans of all ages deliberate about the legacies of apartheid—to use terms from sociolinguistics, increased racial awareness may be less a synchronic change from one age grade to another than a diachronic “change in progress” (bailey 2003; labov 1966)—it is during older age at this particular historical juncture that such concerns arise most clearly. besides having more time to reflect on the post-apartheid condition (as anthony had), contemporary south african elders were adults during not just the downfall but the height of the apartheid regime. the dilemma of living in a world fundamentally different from the one in which they grew up permits the current generation of south african elders to reach for a framework with which to explain such a problematic transition; for evangelicals, christian eschatology offers them a semiotically cohesive answer. if older white south african evangelicals have a uniquely positioned response to apartheid, the experiences of younger christians serve as an instructive foil. for today’s youth born after or just before the transition to democracy, while the residues of apartheid continue to be tangibly felt, these men and women are not engaging in the same kind of reflection their elders have been forced to consider. many of the evangelicals i interviewed were in their twenties or thirties, whose formative education took place in a world of revolt and ripe possibility. while they still enacted evangelical cosmology—identifying the problem of sin at the roots of south africa’s social crises—they were less preoccupied with explaining apartheid-era erasures and segregation and more directed toward other problems, such as making conservative churches more inviting to young people and to non-whites. drawing attention to these generational divisions, els van dongen (2010, 162) has found that many of the older south african christians she spoke with have taken refuge in professions of faith as a way to regain a form of “successful aging” on their own terms, defining themselves in opposition to the “impure” behaviors of younger generations. paradoxically, however, many, though not all, of the evangelical churches i attended were infused with young people (cf. coe 2018, 20 on the opposite trend among ghanaian presbyterians), in sharp contrast with the anxiety of a “graying” conservative church in the united states. this observation may have multiple explanations, including south africa’s low life expectancy and demographic leaning toward younger age grades (cook and halsall 2012, 72-3) or the fact that older blacks are less likely than their bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 43 children to be as fluent in english (ruden 1999) and therefore less likely to attend english-dominant evangelical services.v thus, demographic measures diverge in different evangelical contexts, from america’s growing space for elders finding solace and community to south africa’s vanguard of a new, younger evangelical movement. to return to the material collected in kentucky, evangelicals across national boundaries seem to adopt at least outwardly similar rhetorical strategies. through presentations at aig in the u.s. and testimonies of white south africans about their past injustices, social problems concerning race are understood as emerging from sin and an alienated relation between people and god. christian theology is mobilized to construct a non-racial utopia, although tellingly, these visions take on different roles in elders’ personal narratives of transcendence. while whites in south africa have been forced by their recent national history to confront racial prejudice in their personal lives, white evangelicals in north america have not had to grapple with their country’s racial animus in such a forthright way as they reflect back on their lives. instead, people like milton still find redemptive power in christian eschatology, but the object of these reflections is more centered on u.s. preoccupations over individual autonomy and physical decline. in this way, although motivated by a similarly articulated cosmology, evangelicalism in south africa can occupy a different role for elders than it does in the united states. conclusions and further applications what meaningful conclusions can be drawn from these three ethnographic and textual vignettes? my argument here has traced the myriad meaning-making functions attributed to older evangelicals as a result of their eschatological ideologies. by considering evangelical culture in transnational perspective, a broader scope of the role religion can play in everyday life—and differentially across the life course— emerges. spending time with older evangelicals in kentucky reveals the ways ordinary people adopt broader eschatological narratives to confront the specter of bodily decline; reading widely-circulated accounts by u.s. christian leaders provides a sense of what cultural resources are available to congregants as they find newly meaningful roles in the third and fourth age; and speaking with south african evangelicals suggests the potential for christian narratives to inform responses to social inequality even as they reproduce the sinful racial divides they decry. the possibility for these religious narratives to have a positive impact in the lives of elders is not exhausted by the newfound roles and understandings described above; there are already several problems that disproportionally affect older populations that might be ameliorated within an evangelical framework. as an example, the anxiety over the loss of personhood in dementia could potentially be eased through the adoption of such a religious stance. western notions of the self as individual cognition are threatened by dementia and its gravest form, alzheimer’s disease, because an assault to the capacity for memory is so closely tied to personhood (deal and whitehouse 2000; taylor 2008). however, as john swinton (2010) argues, christian theology offers an alternative to this anxiety over dementia. swinton (ibid., 253) encourages affected patients and their families to take comfort in the principle that “god remains with us and for us even when we can no longer cognitively be with and for god.” by placing the relation with god at the center of a person’s being while deemphasizing people as cognitive beings, this more socio-centric (or, rather, “deo-centric”) approach may reduce the tragic loss exacerbated by cognitive notions of personhood. despite these wide-ranging potentials, my hope is that the use of ethnographic data here might provoke a movement away from a rigid understanding of existential dilemmas of old age as a universal human experience—even if there are common experiences that, like family resemblances, crop up in one bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 44 guise or another across the globe—and inspire a greater attunement to the cultural specificity of how the life course plays out in different settings, especially as it may be affected by religious cosmology in unexpected and locally peculiar ways. terms like “gerotranscendence,” while useful in their power to call attention to broad patterns, are also liable to erase nuanced cultural responses to shared anxieties. interviewing a larger sample of elders like milton and anthony about their experiences of growing older could help shed light on the dynamic interplay between eschatology and aging, as well as the social environments to which they are made to speak. to what degree is evangelicals’ religious cosmology successful in challenging dominant u.s. models of “successful aging” (rowe and kahn 1998; katz 2000) that take bodily integrity as the sine qua non of the idealized older individual? what alternatives exist on the global christian stage to age differently and accomplish culturally relevant goals? further observational and interview-based ethnography at churches across different settings is well positioned to address these additional questions. what is clear from the current analysis is that evangelical narratives of spiritual salvation offer alternative models for aging that put elders in a position to challenge extant expectations for older individuals in the present world—and to reflect back on the world of the past—by gazing toward the next. acknowledgments i am indebted to the colleagues, interlocutors, and especially the elders across two continents for the generosity of their time and their support in publishing this work. milton passed away in 2018, a loss that grieves me in spite of his anticipation that he was “nearing home.” i will always be grateful for the lessons he deigned to teach a stranger like me. brandeis university in waltham, massachusetts, provided critical funding for the ethnographic research on which the piece is based—in the form of research grants from the andrew j. mellon foundation, the graduate school of arts and sciences, and the department of anthropology. i thank margaret morganroth gullette for enlightening and provocative conversation and fello panelists at the 2015 meeting of the american anthropological assocaition, especially madeleine mcleester, for engaging with part of the material on race presented here. the university of the witwatersrand in johannesburg, south africa, warmly hosted me as a visiting researcher during a portion of its writing. two anonymous reviewers offered especially insightful and productive comments that helped clarify terms and synthesize parts of the argument, and i thank them for substantially improving its final form. finally, many thanks are due to sarah lamb, who read an early version of this essay and encouraged me to share it with broader audiences. her kindness and creativity never cease to inspire. notes i. for public apologetics staff whose works are widely available, i have used their real names; all congregants and interviewees i met at the churches in which i conducted research, however, are referred to pseudonymously. ii. on this point, note the parallels to successful aging discourse that pushes back against older “disengagement” models of aging (e.g., rowe and kahn 1998, 46). iii. note also the curious parallel with rowe and kahn’s (1998, 47) emphasis on “giving and receiving social support” as a means of finding fulfillment in older age, albeit a different kind of “support.” iv. anthropologist anna corwin (2013) offers the positive experiences of catholic nuns in letting go of attachments to the physical world as a potential model for how to age as easily as possible. see also sarah lamb (2000) for a comparison with a south asian cultural setting in which transcendence of social attachments in old age is an acknowledged virtue, if problematic to attain. v. even anthony mentioned language as a factor in keeping white churches separate from, in his case, xhosa-speaking churches planted during apartheid (and, to an extent, post-1994 as well). bafford | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.197 http://anthro-age.pitt.edu 45 references ai, amy l., and monika ardelt, eds. 2009. faith and well-being in later life: linking theories with evidence in an interdisciplinary inquiry. new york: nova science publishers, inc. alim, h. samy, and geneva smitherman. 2012. articulate while black: 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cloutier, 3-18. grand rapids, mi: william b. eerdmans publishing company. hook, derek. 2015. “petrified life.” social dynamics 41(3):438-460. johnson, malcolm l. 2005. “the social construction of old age as a problem.” in the cambridge handbook of age and ageing, edited by malcolm l. johnson, 563-571. cambridge: cambridge university press. johnson, walton r. 1994. dismantling apartheid: a south african town in transition. ithaca, ny: cornell university press. katz, stephen. 2000. “busy bodies: activity, aging, and the management of everyday life.” journal of aging studies 14(2):135-152. keane, webb. 2007. christian moderns: freedom and fetish in the mission encounter. anthropology of christianity. berkeley: university of california press. kimble, melvin a. 1990. “aging and the search for meaning.” in spiritual maturity in the later years, edited by james j. seeber, 111-129. new york: the haworth press. klaits, frederick. 2010. death in a church of life: moral passion during botswana’s 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27(2):239-260. mcintosh, janet. 2016. unsettled: denial and belonging among white kenyans. ethnographic studies in subjectivity, 10. oakland: university of california press. ----. 2014. “linguistic atonement: penitence and privilege in white kenyan language ideologies.” anthropological quarterly 87(4):1165-1200. meyer, birgit. 1998. “make a complete break with the past: memory and postcolonial modernity in ghanaian pentecostalist discourse.” journal of religion in africa 28(3):316-349. moody, harry. 2009. “from successful aging to conscious aging.” in the cultural context of aging: worldwide perspectives, edited by jay sokolovsky, 67-76. westport, ct: praeger. norton, michael i., and samuel r. sommers. 2011. “whites see racism as a zero-sum game that they are now losing.” perspectives on psychological science 6(3):215-218. pinches, charles. 2003. “the virtues of aging.” in growing old in christ, edited by stanley hauerwas, carole bailey stoneking, keith g. meador, and david cloutier, 202-225. grand rapids, mi: william b. eerdmans publishing company. robbins, joel. 2004. becoming sinners: christianity and moral torment in a papua new guinea society. ethnographic studies in subjectivity, 4. berkeley: university of california press. rowe, john w., and robert l. kahn. 1998. successful aging. new york: pantheon books. ruden, sarah. 1999. “thoughts on english in south africa.” michigan quarterly review 38(3). saler, benson. 2000[1993]. conceptualizing religion: immanent anthropologists, transcendent natives, and unbounded categories. new york: berghahn books. scheper-hughes, nancy. 2007. “violence and the politics of remorse: lessons from south africa.” in ethnographic investigations, edited by joão biehl, byron good, and arthur kleinman, 179-233. berkeley: university of california press. steyn, melissa e. 2001. “whiteness just isn’t what it used to be”: white identity in a changing south africa. albany: state university of new york press. swinton, john. 2010. “forgetting whose we are.” in successful ageing, spirituality and meaning: multidisciplinary perspectives, edited by j. bouwer, 237-261. leuven: peeters. taylor, janelle s. 2008. “on recognition, caring, and dementia.” medical anthropology quarterly 22(4):313-335. tornstam, lars. 1999. “late-life transcendence: a new developmental perspective on aging.” in religion, belief, and spirituality in late life, edited by l. eugene thomas and susan a. eisenhandler, 178-202. new york: springer publishing company. van dongen, els. 2010. “misery, medicine and morality: successful ageing and spirituality in south africa.” in successful ageing, spirituality and meaning: multidisciplinary perspectives, edited by j. bouwer, 151-167. leuven: peeters. worden, nigel. 2012. the making of modern south africa: conquest, apartheid, democracy. malden, ma: wileyblackwell. yount, william r. 2009. “an evangelical view of transcendence and senior adult attitudes.” journal of religion, spirituality & aging 21:88-103. zumbrunnen, john, and amy gangl. 2008. “conflict, fusion, or coexistence? the complexity of contemporary american conservatism.” political behavior 30(2):199-22. anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp.82-84 issn 2374-2267 (online) doi 10.5195/aa.2019.228 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of stafford, philip b. the global age-friendly community movement: a critical appraisal. 2019. new york: berghahn books. pp. 272. price: $120 (hardcover); $34,95 (e-book). jeremy cohen mcmaster university, hamilton, ontario http://www.library.pitt.edu/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ cohen | book review | 82 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.228 http://anthro-age.pitt.edu book review review of stafford, philip b. the global age-friendly community movement: a critical appraisal. 2019. new york: berghahn books. pp. 272. price: $120 (hardcover); $34,95 (e-book). jeremy cohen mcmaster university, hamilton, ontario the world health organization estimates, by the year 2050, 22 percent of the world’s population will be over sixty years old. low to middle income countries may face the toughest burden, with over 80 percent of the world’s older populations residing within their borders by 2050. as part 5 of the berghahn series life course, culture and aging: global transformations, anthropologist philip stafford’s the global age-friendly community movement: a critical appraisal, provides a multidisciplinary look at this contemporary aging phenomenon. with this volume, stafford points to the importance of building the type of community that “addresses basic needs; optimizes physical and mental health and well-being; promotes social and civic engagement, and maximizes independence for the frail and people with disabilities” (7). thematized into five sections, this volume’s twelve chapters cover a broad range of topics, such as equity and sustainability, the building of age-friendly neighborhoods, cross-generational collaboration, aging in rural communities, and well-being in old age. contributions in this series address research and policy issues, using a variety of methods and covering numerous disciplines, including sociology, social gerontology and urban studies. this variety of research positions – not in the least those of public health researchers and workers who speak from everyday experience – is one of the publication’s main strengths. by seeking to “reject the psychological reductionism so dominant in the study of aging” (xi), it adds significantly to a growing body of literature on gerontology and age-friendly communities worldwide. part 1 offers a critical appraisal of the age-friendly movement, by challenging commonsensical assumptions, such as that it only benefits the lucky few. tine buffel and chris phillipson (chapter 1) address some of the research and policy issues that come with attempts to build age-friendly communities, and sharon baggett (chapter 2) examines a pilot project in indiana, which sought to develop age and ability-friendly community initiatives. here, training citizen advocates in their respective communities empowered groups that have been traditionally marginalized. baggett notes that research is needed on the long-term effects of this intervention (49). chapters 3 and 4 discuss the possibility of incorporating various sustainability practices – pedestrian-friendly streets and mixed-use development – into the design of safe and inclusive communities. part 2 looks into two urban case-studies in berlin and new york respectively, that highlight the importance of collaboration in the creation of strong, lively communities. mia oberlink and barbara davis (chapter 6) explore this participatory methodology through the development of the advantage initiative in new york city. collaborating with an organization that assists aging individuals in the performing arts, the authors identified some elements of vital cohen | book review | 83 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.228 http://anthro-age.pitt.edu importance to the ageing manhattan population, such as the impact of the city’s traffic, the lack of service networks and transportation resources (133). part 3 complicates claims that building age-friendly neighborhoods necessarily benefits all age groups. corita brown and nancy henkin (chapter 7) look at development projects in arizona and elsewhere to underscore the potentials and pitfalls of multigenerational spaces. chapter 8, in its turn, gives an example of an effective collaboration across generational lines, through the creation of ibasho café’s, which provide opportunities for intergenerational knowledge sharing in rural japan (169). part 4 moves from urban realities to the challenges faced by small towns and rural areas. through case studies in the midwestern u.s. and rural japan, chapters 10 and 11 respectively examine challenges in the revitalization of struggling communities. providing aging populations with sustainable employment opportunities, and fostering intergenerational networking, may keep younger generations from leaving rural environments, while dampening the impact of a disappearing workforce. the last part of the volume, presents an ethnographic study of well-being in the united kingdom, with a strong focus on collaboration with older research participants. marian barnes (chapter 12) identifies what well-being means for her participants by focusing on the intersection of community spaces, individual health and social structures, among other metrics. age-friendly initiatives with far-reaching potential are found in part 2 and 4, which provide different models that could be effectively applied in a variety of rural and urban communities. the rural economic models proposed by zachary benedict (chapter 10) and nanami suzuki (chapter 11) could be expanded to mid-sized cities facing economic downturn and the disappearance of major industry. urban development strategies that focus on intergenerational collaboration and training can compete with heories that prioritize youth and “creative-classes” in attempts at urban revitalization (florida 2002). birgit wolter (chapter 5) examines the challenges faced by aging immigrant populations and resource-poor elderly in her berlin case-study. she examines a voluntary network of citizens, business owners, organizations and health professionals within a berlin social housing estate, though the limited reach of the network across cultural boundaries potentially limits important social and informational networking at large (120). given that “60 percent of the world population aged sixty and older lives in developing countries” (189), chapter 9 addresses the lack of representation of low income and developing countries in literature on aging. arthur namara and kristin bodiford look at an intergenerational community development project in uganda and discuss some of the demographic changes in africa. the authors acknowledge the lack of scholarship on aging populations in africa (190), but also note some of the cultural and social challenges facing the elderly that are unique to uganda. readers may be disappointed by the lack of attention this volumes pays to non-western countries, especially given the scholarly interest in gerontology and the developing world (nangia 2016; panruti, liebig & duvvuru 2015). while designations of developed and developing can be problematic, the scope of this volume felt less global than one would expect. the global age-friendly community movement, provides an excellent critical appraisal of the challenges, successes, theoretical models and their practical applicability in the building of agefriendly communities. importantly, this volume suggests that the age-friendly movement must consider the needs of populations at large, or risks further segmentation and isolation of various age-groups. as alan delatorre (chapter 4) notes, policies will have to meet current and future needs through sustainable development without assuming a particular gendered, racial or aging cohen | book review | 84 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.228 http://anthro-age.pitt.edu composition of the population (95). the authors invite us to move away from the individual and the local as the smallest unit of health, to take into account the complex social conditions affecting a globalized world. references florida, richard l. 2002. the rise of the creative class: and how it's transforming work, leisure, community and everyday life. new york: basic books. nangia, ethel ngere. 2016. "care for older persons in cameroon: alternatives for social development." africa development / afrique et développement 41 (4): 47-69. panruti, ramamurti v., phoebe s. liebig and jamuna duvvuru. 2015. “gerontology in india.” the gerontologist 55 (6): 894–900. family, time, and meaning toward the end of life in japan susan long john carroll university long@jcu.edu abstract in contrast to media images of lonely deaths, stereotypes of the japanese calm acceptance of dying, and the “naturalness” of dependency in old age or illness, this paper explores the complex ways in which changing perceptions of time refocus people towards the question of how to live. time both narrows to the level of medication schedules and bodily functions, and expands to more immediate engagement with others in the past and future. the idea of a moral timeline of such changes builds upon recent work in the anthropology of morality by recognizing shifting ideas and actions people take to retain agency through suffering. people near the end of life in japan commonly employ cultural idioms of effort, reciprocity, and gratitude to express their continual striving to be moral persons in a social world. ultimately, such efforts determine not only how they see themselves and are seen by others through their final days, but whether theirs will be judged to be a “good death,” and thus the nature of the person’s continued social existence in spirit and memories after death. the moral timeline expressed by many of the people i met reflected intensified concern with becoming a burden and with reciprocity as the end of life came close. for many, that deepened their sense of engagement, sometimes transforming their relationships with others who would survive them or who had preceded them in death. the ethnographic data in this article come from a participant-observation study of adults of all ages with life-threatening illnesses, and from an interview study of frail elderly and their family caregivers in the early 21st century in urban and rural settings. keywords: dependency; perceptions of time; moral timeline; striving; reciprocity; gratitude; good death anthropology & aging, vol 41, no 2 (2020), pp. 24-45 issn 2374-2267 (online) doi 10.5195/aa.2020.246 long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 24 family, time, and meaning toward the end of life in japan susan long john carroll university long@jcu.edu we tend to think of dangers and uncertainties as anomalies in the continuum of life, or irruptions of unpredictable forces into a largely predictable world. i suggest the contrary: that dangers and uncertainties are an inescapable dimension of life. in fact...they make life matter. they define what it means to be human. kleinman 2006, 1 introduction recent attention to “lonely deaths” in japan has raised disturbing questions about the nature of a society in which old people die alone, having no human relationships and no one who cares. when their bodies are discovered, days or weeks after they die, often no one is even willing to claim the remains. the causes of these situations are located in the elusiveness of stable, well-paying jobs and the security and maturity to marry and have children. it might also be related to the geographic mobility required in japanese corporate culture, and what many claim is the disintegration of the family. identifying such reasons leads to judgments about the morality of a society in which social ties are weak, values are materialistic, and individuals facing precarity experience such hopelessness that they give up on life (allison 2016; onishi 2017). the need for people to find social connectedness and meaning in their lives in the post-lifetime employment world of retirement and/or contemporary japan are legitimate concerns of scholars, journalists, and government officials. yet, these reports can also be viewed as sensationalizing a relatively small proportion of deaths in japan. while recognizing the need to address the situation, mainly by promoting innovative programs to local governments (e.g., ministry of health, labor, and welfare n.d.), the japanese government does not report the number of such deaths, and there is no legal definition of what is officially called “isolated deaths (koritsushi).” thus, there is no official number of lonely deaths nationally; the estimates i have found range from “several thousand” (onishi 2017) to 40,000 (japan news 2017). regardless of the exact number, this is certainly too many sad and aesthetically repugnant cases (cf. fifield 2018) in a society in which dying alone is the epitome of a “bad this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 25 death” (long 2005). yet, even if we accept the highest estimate of 40,000, we see that less than 3% of japan’s deaths occur this way.1 what is it about the current moment that draws attention to this horrific phenomenon? one factor is concern for the future of japanese society due to the apparent increase in the number of lonely deaths. however, without accurate measurements and a clear definition, this is difficult to show definitively in an era in which total deaths are also increasing. what of the other 97% of deaths in japan? during my fieldwork, i have met people struggling to cope with life’s pressures and disappointments. although aware that some are unable to find meaning and hope in their lives and might be pushed to decide to die alone or even take their own lives, most people i met kept pushing ahead, trying again, exploring new paths, and not giving in to the helplessness or feelings of isolation they sometimes experience. nor is the existence of programs designed to help retirees find activities or relationships that offer a sense of purpose new (cf. traphagan 2000). local governments have employed part-time community social welfare volunteers (the nature of their appointment and roles have changed over time) since 1919 (adachi 2000, 195). programs to check in on elderly residents living alone were brought up in the interviews i conducted in the kansai area as far back as 1990. with the general aging of the population, the content of the work of local government welfare offices has increasingly focused on the needs of community-dwelling elderly residents. moreover, japan has a universal health insurance system, and thus medical care is available to all who are willing and able to reach out for such help. undoubtedly, there are plenty of cracks through which people can fall, plenty of bad relationships, and individuals who are less than caring as they do their work. there are people too focused on their own problems or their own successes to pay heed to people in need around them, including family members. as jason danely shows in his work, loss and abandonment, feared or actual, are often a significant part of this period of life (2014). these experiences are deserving of policy maker’s attention. yet, sometimes media sensationalism of a problem results in “moral panics” before serious solutions can be clearly seen (cf. toivonen and imoto 2013). recent media stories have resulted in visible government searches to find “missing” people, and unsurprisingly, they have been successful, both in finding corpses and in raising fears about the direction of such an “uncaring society.”2 the political-economic motivations and implications of such attention deserve study, but that is not the purpose of this paper. rather, i wish to provide an alternative, on-the-ground perspective of what it is like to die in japan. the stories i heard during my fieldwork reflect the experiences of people from all walks of life, but with a bias toward middle class and relatively in-tact families. people died, but none of them died without some level of attention from family and/or medical staff in their last months or days. some people felt the hopelessness of their embodied knowledge of impending death, but for the most part they had support (and sometimes the aid of anti-depressants) to help them overcome despair. as i explore some of the widely available cultural resources in which their responses were framed, we see not the premature social death of the person, but rather the continued search for meaning as they attempt to live a moral life in their remaining time dying is not the same as being dead, but rather refers to the last phase of being alive. someone whose biological death is imminent is not only still breathing, but remains a cultural being (that is, human) as long as he or she acts in the world with ideas, goals, and some degree of agency to promote them (that is, a self). this paper explores the nature of that stage of life in a particular cultural context, japan in the late 20th and early 21st centuries. i ask how someone in this last stage of life draws upon cultural patterns and expectations, and prioritizes personal goals to make sense of altered perceptions of time and personhood. what does it mean to know, or at least suspect through embodied experience of serious http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 26 illness and frailty, that death is on a near horizon? how is agency, as limited as it may be, utilized to live meaningfully so that one’s life is judged by oneself and one’s community as a “good” life? to answer these questions, i begin with the experiences of “ordinary” people, asking the question arthur kleinman (2006) centrally asks in his treatise on living a moral life, “what matters most” to them? how do their ideas, goals, and actions reflect what michael lambek and his colleagues (2010) have termed “ordinary ethics” of contemporary japanese society? in raising the issue of a moral life, i refer on one hand to the “ordinariness” of morality as a modality of social interaction in a particular local context (2010). yet, ordinary does not mean static, and any approach to thinking about a good or moral life must recognize changes through across the life course and through historical time. i also share zigon’s concerns (2014) that we not impose a priori moral concepts and values from western philosophy, calling forth the need for ethnographic fieldwork and analysis to understand people’s own expressions of morality. yet, whereas zigon argues that morality emerges in response to “moral breakdown,” my discussions with people near the end of their lives did not indicate moral crisis, but rather growing awareness, the existence of what we might call a “moral timeline.” it was not some moral failure of society that motivated changes in their thoughts and behaviors, but smaller shifts in priorities and understandings as people experienced ongoing bodily changes and altered social circumstances. the moral timeline concept implies change, and thus, as zigon (2014) and mattingly (2014) claim, an openness to possibilities; it focuses on altered experiences of the meaning of time, as well as the social spaces that allow for moral striving as a response to suffering. this concept might be easily appreciated in east asian cultures in which a confucian heritage laid the groundwork for valuing a life of continual striving for self-improvement (plath 1980). what my interviews and observations broadly evoke is a sense that “what matters most” is not being good in contrast with being evil, but rather of continually striving for possibilities, to be a shikkari shita (steadfast, responsible) human in and of society. in japan, this means striving not for some abstract notion of goodness, but for altering behaviors and styles of interaction in accordance with one’s stage of life. thus, traphagan (2000) speaks of the efforts of the elderly rural residents of his fieldwork village as striving to be a good rojin (old person), or “good person in the category of elderly persons.” by carrying out activities and maintaining attitudes considered to be the appropriate ways for old people to participate in society, they believed they would ward off boke, a morally inflected folk concept of dementia. evidence from my ethnographic fieldwork has led me to the notion of the moral timeline. in particular, three topics within my field observations and interviews proved significant in exploring temporal experiences and moral priorities in the face of death. concerns and pleasures of people near the end of life show that time seems to both narrow and expand compared with the focus of healthier japanese adults on daily life activities and relationships. several japanese idioms help to frame the behavioral response to these shifts in the experience of time, ideas about maintaining hope and agency. moral priorities based on cultural values regarding human relationships ultimately determine whether the final days will be judged to be a “good death,” and thus the nature of the person’s continued social existence in spirit and memories after death. the paper first sets the ethnographic stage by providing background on death and dying in japan. it then turns to a dilemma of great cultural significance, finding the appropriate and shifting balance between dependency and burden. the remainder of the paper takes up the three themes in turn that shed light on the question of what matters in the final stage of living: the meaning of time, the cultural framing of hope, and the moral way to be human in relationships with significant others. despite increasing dependency, the concerns expressed and cultural idioms engaged point to ways that people http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 27 in the final stage of life adjust their ideas and behaviors to maintain a sense of agency and thus their ability to make moral choices in the face of despair and suffering. to explore these questions, i draw on two decades of fieldwork, interviews, and writing on late life in japan. the first project was a solo study of end-of-life decisions (see long 2005) and the other was a collaborative project on family-based elder care (see takahashi and suda 2010; long et al. 2010). the earlier study utilized a fully ethnographic approach of participant-observation and interviews in an institutional hospice, a university hospital, and a government specialty hospital, supplemented by visits to other medical and elder care facilities and private homes. the central figures in my study were those with a variety of very serious illnesses (mainly cancer and heart disease, the two leading causes of death in japan), and ranging in age from people in their early 20s to those in their 80s, although as i point out below, most of those in this situation were older adults. i interviewed patients, family members, and health care providers, as well as experts in bioethics and thanatology. the patients included both men and women, mainly middle and working class people who lived in metropolitan areas, although a few i spoke with had been referred to an urban hospital from smaller towns. as part of my participant observation, i occasionally accompanied a visiting nurse or physician making house calls and observed a wide variety of living situations, from a wealthy four-generation family with a large home and garden to a memorable frail, elderly woman with limited mobility. she was living alone in a tiny, disheveled house, and at the time of our morning visit, had only a daikon radish in her kitchen for food (she told us that her part-time aide, provided by the local welfare office before long term care insurance, would shop for her when she came). in the collaborative study of elder care, an interdisciplinary team of researchers collected quantitative and qualitative data on home-dwelling elders who qualified for the government’s long term care insurance program and their family caregivers. the study was conducted a in a largely working class section of tokyo and in a small city and surrounding rural areas in northern japan. i was involved with the qualitative team. we conducted yearly interviews over the span of five years (or as long as those involved were willing and able to meet with us) with 15 elder-family caregiver pairs in each location, totaling 30 elders enrolled in the long term care system. caregivers, often themselves elderly, and care recipients came from varied backgrounds, including a wealthy small business owner, middle class urbanites, farm families, former migrant construction laborers, and people who once held blue collar jobs. our meetings were in the elders’ residences, which in some cases moved over time from the family home to an elder care facility or hospital, and rarely, back again. each interview focused on the elder’s health condition, use of and satisfaction with the long term care system and services, and the daily life, social relationships, concerns, and satisfactions of both the elders and family caregivers. all of the care recipients’ ages ranged from the mid-60s to mid90s when the study began. most of them were quite frail and had diagnosed medical conditions, most commonly heart disease, stroke, diabetes, and dementia. over the course of the five years, all became increasingly frail, and eleven had died before the end of the study. both of these projects provide the perspectives of individual japanese people, who are aware through their bodily experience as much as the verbalized diagnoses, of the existential danger they faced. the uncertainty to which the epigraph refers is thus not the question of biological death, the inevitability of which is well recognized. rather, it is the personalized uncertainty of when, where, and how my death will occur; who will accompany and remember me; and how do i continue to construct myself as a human being in society? as the biological end nears, the prospect of a post-death self in the form of ashes, spirit or memory remains. the answers to these questions often cannot be known in advance, and therefore a person must strive to achieve a moral end. the interviews and observations revealed the participants’ thoughts and attitudes about what life meant to them in their precarious situations, http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 28 what was important to them, and how they tried to lead a good life while face to face with their limitations, even if that came to mean pursuing a good death.3 the setting: death in japan biological death in contemporary japan is characterized by old age and chronic disease. long past the epidemiological transition from communicable diseases at any age to death in old age, the life expectancy at birth in japan in 2018 was more than 87 years for women and over 81 years for men. more than 67,000 people in the country are over the age of 100 (compared with 153 in 1963). primary causes of death are cancer and heart disease, followed by cerebral-vascular disease, pneumonia, and accidents, although the categories and rankings vary by age group. three generations ago, the death of a family member from infectious disease in the home was a common experience (e-stat 2019). other than the rare situations of sudden death due to an accident or heart attack in a public space, deaths in contemporary japan occur in one of four settings. the vast majority (84%) take place in medical facilities or nursing homes, even if people are moved there in their last days or hours, to die under medical supervision. other deaths take place in homes, with the assistance of family care and services of the long term care system. hospice care in japan is most often provided within a hospital setting, but home hospice and long term care insurance services have become more common in providing support for dying patients. place number of deaths percent of total* hospital or medical clinic 1,004,210 73.7 skilled nursing home** 35,483 2.6 other elder care facility 109,596 8.0 at home 186,205 13.7 others 26,976 2.0 total deaths 1,362,470 100.0 * i have combined the statistics bureau categories of hospital and medical clinic (which may have a small number of inpatient beds). ** my translation. these are residential elder care facilities that provide medical and rehabilitative services, but not at the level of a hospital. table 1 place of death in japan, 2018 (e-stat 2019) in contemporary japan, death is understood as a biological event requiring professional management by both health care providers and funeral directors (suzuki 2000).4 it is also an uncertain social transition that is less sharply defined by a moment in time, but rather by a gradual movement from one type of culturally defined being to another. dependency and burden in interpersonal relationships in japan http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 29 regardless of the setting in which death occurs, what is striking about these humans is their dependency on others. ruth benedict (1946), in her study of japanese culture during world war ii (and thus relying on informants available in the united states), is well-known in japanese studies for her concept of an “arc of freedom and indulgence” (1946, 254), defined by permissive childrearing and close mother-child emotional ties at one end of the curve and freedom and dependency in old age at the other. psychiatrist takeo doi (1973) believes that japanese culture uniquely values the early mother-child bond as an ideal model of social relations and socializes children to emotional interdependence rather than individualism. subsequent generations of scholarship have demonstrated that the emphasis on dependency, permissiveness, and the suggestion of a happy, free old age especially, are highly overdrawn (for example, see plath 1989; regarding the personal and interpersonal challenges of old age, see lebra 1984; kinoshita and kiefer 1993; traphagan 2004; kawano 2010; danely 2014; kavedžija 2016). yet, there is general agreement that japanese cultural values have emphasized the interdependency of humans in families and other groups, rather than radical individualism. good interpersonal relations are highly valued and at least the appearance of “harmony” is encouraged in japanese social institutions. but, tensions exist between the attraction of indulgence from and reliance on others on the one hand, and a desire for individual autonomy and achievement on the other. benedict (1946, 104) herself, in a discussion of the burden that comes with relationships, suggests that people do not casually enter into them when obligation might interfere with personal freedom. danely (2014, 83) points out that many japanese individuals are socialized both to desire dependency and to be sensitive of excessive dependence. we also know that the ideal of the happy and free old person has for centuries been balanced by fear of abandonment (reflected the obasuteyama legend, in which an elderly woman is taken by her son and abandoned on a mountain) or exclusion when one is no longer able to fill productive social roles, a fate that anthropologist david plath believes to be considered worse than death itself (1980, 217). one of the least desirable aspects of aging in japan is the decline in the ability to act autonomously. retirement and/or the departure of adult children is sometimes experienced as liberating, but still represents loss of status as contributing members of society. social roles for healthy elders beyond those in a multigenerational household have emerged, such as participation in senior centers and hobby clubs, serving as volunteers, or taking a post-retirement job (kavedžija 2013; moore 2017). yet, ultimate cognitive and/or physical decline portend an often lengthy period in which a person struggles to remain engaged in normal social activities (for example, attending meetings of the local senior citizens’ group, traphagan 2000) and becomes reliant on others for both day-to-day survival and a sense of emotional support. if japanese culture values interdependence, why do frail elderly people and seriously ill people find it so undesirable? some of the people i interviewed were limited in their independence by varying degrees of dementia; they could no longer navigate even simple tasks of daily life themselves. others experienced dependency due to physical disabilities of illness or its medical treatment. many in advanced old age suffered both cognitive and physical limitations, but even young people experienced greater dependency on family and medical staff than they would have preferred. a 21 year-old with primary pulmonary hypertension admired the dedication of the medical staff in the hospital, where she was a patient during holidays and even an earthquake. she described her family’s commitment to spending time in her hospital room, expressing that “i feel really badly that everyone adjusts their schedules, their lives, to my being in the hospital.” an 80-year old with advanced parkinson’s disease told us, “the most difficult thing is asking for help.” another 80-year old woman, who had suffered a stroke, said that she has stopped doing some of the things she enjoyed like cooking and traveling. she felt that even if she intended to help, she might do it poorly or drop dishes.moreover, if she fell while on vacation with family members, it would just create a bigger mess for others to clean up. these personal remarks http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 30 exemplify the tension between wanting and needing care on one hand, and on the other hand, showing restraint in order to minimize the burden that their needs impose on others. the value in japanese society of interdependency is predicated on the ability to reciprocate in some way. reciprocity in human relations is a value taught to children from an early age, and many characteristics of a ‘good person’ are those it takes to reciprocate: restraint in the expression of personal desires and opinions, empathy for others, and the practice of civility (smith 1983, 44-45). as psychiatrist takeo doi (1973) states, extreme one-way dependency means that those characteristics are not evident, either because they are not yet fully developed, as with children, or they represent a clinical presentation of infantile craving for emotional dependence on others. in either case, such a person is not seen as a fully capable adult. among the ill and frail people i interviewed, with a couple of possible exceptions, most were not looking to avoid self-responsibility. rather, people spoke about not wanting to become meiwaku, a burden on others, whether they were family members or professional caregivers. dependency that creates problems for others represents the inability to reciprocate, and thus be fully human (lebra 1984; traphagan 2000; young and ikeuchi 1997). on the other hand, many scholars have noted that dependency in advanced old age is considered a “natural” life stage (cf. benedict 1946; tsuji 2001; traphagan 2004; danely 2016), that leads to greater dependence on surviving family members once they become departed ancestors. the hospice, where i spent a great deal of time, had as one of its goals to not only relieve pain, but to provide physical and emotional relief for patients and families. i often heard the doctors and patient-intake nurses assure potential patients with words such as, “don’t worry. please put your trust in us and we promise to take care of you.” one hospice doctor, for example, was speaking to a man with terminal cancer, trying to convince him that it was natural to accept help and be admitted for terminal care. the doctor asked what work he had done. “i was a barber, and then worked in a tea shop. it was only service work,” the man replied. the doctor responded, “so you have been giving service to others all these years; now it’s your turn to receive service,” and reassured him that the staff there would do everything they could to keep him comfortable. thus, there is a sense that while undesirable, increasing dependency with illness or old age “can’t be helped,” to translate the japanese common phrase, shikata ga nai. yet, shikata ga nai does not call forth a simple acceptance of one’s fate (long 1999). rather, it is a complex call for simultaneous acceptance and adjustment of approach. it is not a giving up, but a recognition of the need for a new action or way of thinking. danely (2016, 22) translates shikata ga nai as “active acceptance,” which i think captures the nuance of the phrase. it is illustrated behaviorally in the phenomenon of pokkuri dera, buddhist temples specializing in prayers for a pokkuri [sudden] death. visiting such a temple, even if just to get an amulet or nod one’s head to a buddhist image, expresses the acceptance that aging and death are inevitable, but also attempts to influence their course. to die suddenly minimizes the burden on others which a long illness and lingering death generates.5 iza kavedžija (2015) found in her study of older adults that well-being required negotiating contrastive values and orientations to the world, including those of autonomy and dependence. likewise, people at the end of their lives are engaged in navigating a shifting orientation to time that reveals the persistent problem of finding the right balance of independence and burden. time and the moral timeline: concerns of the very ill and frail in understanding the experience of frailty and bodily distress, it is important to consider the relation between chronological time as objectively understood and the subjective experience of time (cf. gell 1992). this includes social time involving statuses and relationships, and the cultural markers and http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 31 understandings of time as commonly understood in a society. working with study populations in the united states, american psychologists found changes in time perception for older adults compared with younger adults. those in old age showed declining interest in instrumental goals regarding daily life and future possibilities such as careers, but increased self-acceptance and greater prioritization of what is considered personally and culturally meaningful in the face of a closer end-point to life (hendricks 2001; kennedy, fung, and carstensen 2001). carstensen and her colleagues describe how when one’s time horizons are constrained, regardless of age, motivations change toward more meaningful emotional experiences, resulting in a stronger sense of well-being, but also increased poignancy and depth of meaning (2006). these studies support the notion of a “moral time line,” a changing temporal experience that focuses on “what matters most.” it is not a moral crisis that initiates these changes but rather the gradual and embodied experiences of aging or illness. the worries expressed by the people i observed and interviewed in japan similarly suggest that toward the end of life, concerns shift away from the everyday matters of finances, work, and play toward a different sense of time that places greater priority on the moral issues of the boundaries of self, historical change, and social relationships. on one hand, the focus of time narrows. the demands of the body for food, drink, and elimination often take center stage, sometimes along with pain. this calls for “work on disorder,” including not only of bodily functions but also of control of one’s own feelings (hollan and wellenkamp 1994). the medicalization of the end of life also means that people’s time is highly structured by drug regimens and the demands of life in a japanese hospital or elder care facility. 6 people did worry about the day-to-day management of their disease and most of the conversations i heard in hospitals focused on that. there, too, was the tension between self-management and dependency. as one woman in her late 70s with advanced cancer told me, after hearing that the doctors wanted to start her on heavy chemotherapy that would have significant side effects: “dr. f. at first said i’d have surgery. i’m actually just as glad not to be having that—i really don’t like surgery, the idea of someone cutting into me. so if the doctors say the [non-surgical] treatment will be better, well, what choice do i have really? shikata ga nai. so i’ll do what they recommend. i’ll fight the disease, because if i don’t . . . [silence].” in this utterance, she expresses both the preference for independence and her willingness to comply with the doctor’s advice as expected of someone in her situation. her reasons are moral ones in that they express social expectations and cultural values. as with the people hollan and wellenkamp (1994) met, overthinking concerns about the future only hinders someone from keeping their necessary focus on today and tomorrow. beyond these concerns with bodily management in the present moment, informants revealed other concerns that extended to the distant future, including relationships beyond death. kavedžija (2016) notes that aging relates to fears of meaninglessness, or the responsibility that comes with freedom and of isolation. but, she adds, once old, people no longer have these anxieties (see also tiefenbach and kohlbacher 2017). i would say, rather, that at the very end of life, these fears shift in focus to the concern for minimizing the burden of their dependency, as discussed above. although the concern about bothering or asking too much of others is commonly expressed among many people of all ages, the concern near the end of life seems intensified as dependency increases. additionally, some people we interviewed expressed anxiety about marriages for children or grandchildren. several mentioned that they worried about their grandchildren’s future after graduation from school, particularly whether they would be successful in getting good jobs in a depressed economy. a few expressed their concerns for the younger generation more generically in relation to changes in japanese society, with expressions like, “young people nowadays...” or spoke of their own family as “good people” but felt that many in japan no longer adhered to past values. a few older women expressed worry regarding their spouses. a woman in her late 80s with terminal cancer told me http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 32 that she was prepared to die and was hoping hospice could minimize the pain she was suffering. she continued, “my only regret is my 90 year old husband.” she worried about his being able to manage on his own after she died. these are concerns for the well-being of others beyond the span of their own lifetime. many women have spent their lives “cultivating mutuality (danely 2014),” so this might be considered a habitual approach to others. yet in facing death, a woman’s concern has the added element of participating in what danely (2014) calls the “economy of care,” that assures her humanity will no longer be possible for her. men, in their well-known focus on instrumental career, may feel or express this to a lesser degree, resulting for example, in gendered differences in how meaningful rituals of caring for ancestors are to them (2014, 174). yet in my interviews, some men also expressed concerns for the future of family members, particularly for children and grandchildren. for example, a now-sober, 70year old man suffering from the long-term health effects of alcohol dependency, expressed concern about his wife’s health going forward. in a discussion about his own health, an 82-year old was asked about his anxieties for the future. he responded that he worried most about his grandson, a senior in college, and whether he could get a job when he graduated. another common concern i have heard over the years has to do with relations between the living and the dead, which brings together past and future. determining the proper location for one’s physical remains has become more complex in the last few decades. until recently, the burial of cremated remains in family graves accompanied by buddhist rituals was assumed, but urbanization and commercialization have challenged the feasibility of this practice. its high cost, along with dramatic changes in demographics and values regarding family, contribute to the abandonment of family gravesites, or at least arouse fear of abandonment. recent studies have explained the contemporary japanese attraction to newer options for bodily disposal such as the [secular] scattering of ashes at sea (kawano 2010; rowe 2011), or natural burial with only a tree planted as one’s marker (boret 2014). they might alternatively modify buddhist practices such as burial with non-patrilineal kin, or individually contracting sites for a gravestone in a water garden, a mausoleum, or a columbaria with ashes accessible via conveyer belt retrieval (rowe 2011; uriu, odom, and gould 2018). securing a desirable geography of death now means making choices in life. often in interviews, people reflected with satisfaction that arrangements had been made, whether purchasing a new site for a nuclear family couple, or choosing a tree burial or ash scattering as a way to “return to nature.” the elderly rural residents in the elder care study were more likely than urbanites to have family graves, and could presume that was where they would be buried. ideally, such graves would be regularly tended and standard memorial rituals would be performed by decendents. for people who had not taken active steps at an earlier age,7 or when the family grave was assumed but geographically distant, as with some of the urban dwellers, appropriate disposal of their remains was a major source of worry. family graves in the 21st century represent financial and time commitments for taking care of the grave and markers and for hosting memorial services. yet, not making arrangements before one’s death certainly led to burdens for survivors in terms of time, cost, and affective energy. despite japan’s postmodernity and science-based worldview, there continues a strong underlying assumption of some type of ongoing relationship between the living and the dead. spirits are dependent on the living to remember and care for them, especially for the 50 years after death until they join the de-individualized ancestors whose personhood is beyond the memory of the living (plath 1964; smith 1999). yet, social change has led to uncertainty that this can or will be done, and if it is, at what burden to one’s children (kawano 2010; danely 2014; rowe 2011). this uncertainty about remains was shown in the question of a rural 94-year old woman with dementia, who suddenly interrupted a conversation on an unrelated topic to ask what would happen to her bones when she died. in part her question was about her post-death residence, but it also expressed her concern about whether relationships would continue in the form of seeing to her after death. her daughter-in-law reassured http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 33 her that she would be in the family grave with everyone and that the family would bow and recite sutras for her, just as they did for all the ancestors. that seemed to be a comforting response. she immediately became calm again and the discussion returned to the previous topic. several others spoke of concern that their own death would break a promise to care for parents and other ancestors. a woman in her 60s, crippled with rheumatoid arthritis reflected, i promised my father something when he was dying. he didn’t want to end up as a muen botoke [a “hungry ghost,” that is, a spirit with no one to care for him]. he is buried in [a nearby city] so i could care for his grave. however, now that i am unable to move, there is no one to look after the grave… i worry what will happen to his grave in future after i am gone. . . . i promised my father. in her interviews in other parts of japan, kawano (2010) found similar concerns for continuing care. a promise of care, whether voiced or assumed, is a method of extending the past and present into the future, and a kept promise reflects the character of someone who keeps that promise.8 facing death, to many of my informants too, meant a timeline at once constricted and expanded. the concerns they expressed reflected both an intense focus on the management of disorder in the moment and also concerns that recollected the past as they looked to an unknown, but rapidly approaching, future beyond death. shikata ga nai, “blues hope,” and moving forward if hope is an orientation toward the future and that living future is obviously limited, we might expect among terminally ill and extremely frail humans that a mood of despondency would prevail since their conditions represent the epitome of hopelessness and lack of agency. there is no long-term future for these people in the world of the living. stereotypes of buddhism and of japanese culture suggest that the hopelessness of impending death should lead to a calm acceptance of one’s fate. indeed, i heard a number of discussions among staff in the hospice setting as to whether a patient request for anraku (peace, comfort) was a plea for euthanasia reflecting hopelessness and clinical depression, or a request for good pain control on the way to an accepted death (long 2001). the sense of hopelessness expressed by some hospice patients was sometimes expressed through silence. one example i remember clearly was when a physician asked a hospice patient whether she had any concerns about the course of her illness, and his question was greeted with silence. in our elder care interviews, when we talked about what the frail person enjoyed doing, we sometimes received responses such as “nothing,” or “there is no pleasure now.” the woman mentioned earlier, who had stopped helping in the kitchen, told us, “i can’t do anything anymore,” and when we left, promising to come back the following year, added, “if i’m still here.” these complaints were not questions about how to be in the world that identified a problem to be resolved, but rather were diffuse, totalizing expressions of what jason throop calls a “moral mood,” a recognition of the impossibility of returning to a longed-for past (throop 2014, 66-69). however, this same recognition can offer a path to personal development that can be judged by others and the self as moral action. here, i want to develop the theme of shikata ga nai introduced earlier. shikata ga nai requires not depression but adjustment and moving on—tnot blind optimism, but “responsive hope” (grøn and mattingly 2018) that persists in the face of the interruption of biography and the intensified sensations of past and future. bodily pain and dysfunction require both physical and emotional management. in a society that stresses reciprocity, their very dependency on others calls http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 34 forth, not despair, but social obligation. a remnant of agency remains, that of attitude. thus, for most people, the response to impending death is not to withdraw from the human world, but rather to try to continue to live and to hope, by engaging in relations of reciprocity. but for those with severe impairments, what does reciprocity look like? over and over, i heard two japanese words, gambaru and maemuki, from people from all walks of life, which i believe help answer this question. gambaru, an intransitive verb, refers to persistence and trying hard, the sort of attitude that in this context says, “life is not pretty but i’m still alive and not giving up.” the phrase “gambatte kudasai” might be used the way americans say, “good luck,” if a student is about to take an important exam, but suggests doing well is not so much a matter of luck but of having prepared hard and well. in the context of illness and dying, the phrase, gambatte kudasi, is commonly used as encouragement to “hang in there, keep trying.”9 the woman quoted earlier who was about to begin chemotherapy, expressing that she didn’t feel she had any alternative, concluded her remarks to me with the thought, “i’ll work hard at this, because if i don’t....[silence].” the japanese term that she used was “gambaru.” another hospice patient, who had lost her appetite, told me, “if i can’t eat, that’s the end. i’ll keep trying hard (gambaru).” another woman was explicit that fighting the disease was an obligation of reciprocity: “i don’t dare say i want to die when everyone is working so hard (gambatte iru) to take care of me.” maemuki literally means forward-facing. danely defines it as moving with purpose even if the goal is elusive or non-attainable (2016, 14). when there is no hope, that is precisely when adjustment is needed. in a sense, gambaru is one expression of that idea that stresses the tremendous effort required. maemuki is not optimism, but rather the calmer “active acceptance” of the situation, perhaps something close to what cheryl mattingly (2010) calls “blues hope.” based on research among seriously ill african american children and their families, she describes the ways that parents took steps to make their child’s situation better, from negotiating with medical staff across socioeconomic and cultural barriers, to reaching out to help other families to create a future that incorporates the present but does not succumb to it (2010). maemuki, too, is what one does in the context of lack of resources to solve the problem, positively moving ahead to an uncertain future, doing one’s best, and not giving up—transforming self, family, and community in the process. certainly, many of the people i interviewed in japan did not confront the lack of material resources or the racism that mattingly describes, but the older people with whom i spoke had experienced suffering and want, particularly during and immediately after world war ii. everyone currently faced extreme constraints regarding what they could do with their bodies; some had limited cognitive function, or social resources. maemuki was a term i initially had trouble understanding in the context of dying. how could someone be positive about such a situation? through my informants, i came to understand the way people found purpose and meaning in that positivity. it allowed them to continue to be moral human beings in society through their ideas, attitudes, and manner of interacting with others. in the face of extreme constraints, sometimes the expression of maemuki was very simple. for some patients, being maemuki, looking ahead, meant to continue to learn. two terminally ill patients told me they were learning new computer programs. a college student majoring in english studied her language books whenever her disease and medication regimen allowed her the energy to hold a book. for one imminently dying older woman, maemuki was to wear a pretty, pink scarf around her neck in the midst of the gray tones of a japanese hospital. a nurse reported, when i commented on her absence one day, that mrs. a had died, with her pink scarf on. she had kept her positive attitude until the end. the impossibility of recovery means that what one hopes for is not to be healthy and strong again, but perhaps to die without pain, or to meet deceased family again, or to minimize the burden of the death on others, to be a “good” person. these goals seem more achievable than a cure, but nonetheless require http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 35 effort to gambaru, be it to provide a bit of cheer for others, to seek medical assistance, or to make logistical or spiritual preparation for death. nearly universally, frail and ill people spoke of gambaru. as one frail elderly woman explained, “i think that i have to do it. i never think that i can’t do it.” being maemuki meant that although they did not expect a cure, they tried hard to do as much as they could. the woman with parkinson’s disease told us she wished she could do more for herself. but her goal was to live “akaruku, maemuki ni” (“cheerfully, facing forward,” in other words, with a positive attitude). moreover, she was not only taking on a shikata ga nai attitude as an adjustment to her physical decline. she also saw adopting a positive attitude as the best way to show appreciation to the family for their attentive care. when a recently widowed caregiver spoke about her life after the death of her husband, she expressed, “aging is shikata ga nai, but i want to be healthy until the end, and show appreciation for help.” this active acceptance was also heard in response to a question we asked in our elder care interviews: looking back, when was the best time in your life? “now is the best,” replied several informants. (see also wu 2004, 77). the geriatrician on our research team, dr. ryūtaro takahashi, suggested that these positive assessments may be an expression of “gerotranscendence,” greater life satisfaction due to a shift in perspective in late life away from the material toward greater transcendence. it may also be a matter of being comparatively positive about the present. these elders had lived through the losses and destruction of the pacific war (world war ii to americans but beginning in japan with its annexation of manchuria in 1931). they experienced the dislocation and poverty of the immediate post-war period in addition to the usual struggles of everyday life. they were now old and facing senility, disability, and death, yet they focused on the positives of their present situation: the lack of war, japan’s affluence from which they benefitted, and the “goodness” of family members providing on-going assistance. perhaps, as kleinman (2006, 9) claims, “it is life’s trials—bad luck, suffering, and even calamity, that teach us endurance and acceptance of genuine reality.” the generation of elders in our project were well-schooled. a frail woman in her 90s with some dementia stated, “we struggled in the past, but now things are better.” another woman in her 90s indirectly expressed an ethic of appreciation in our yearly meetings. when asked about the hardest time in her life, she first thought of the tokyo earthquake (1923), and then reconsidered and said that it was during world war ii. but, she added, "relatives helped. there was no money. when there was no money and people helped, that was the best.” in the same interview she told us, referring to her coresiding family but perhaps also to government health and long term care policy, “i’m thankful i’m well taken care of.” when the interviewer asked, “is there anything you are not thankful for?” she replied, “nothing. i am happy if someone comes, especially the cute grandkids.” in a different year’s interview, she made the observation that compared with other people, she was happy. others worry about her, and take care of her now that she can’t do anything. other elderly women expressed similar sentiments: “now is the best time because everyone is looking after me.” the presence of their caregivers at the time the praise was spoken suggests that this was an opportunity to reciprocate to some small degree, their caregivers’ great efforts by showing appreciation. mattingly (2010, 6) claims that hope is most centrally about the practice of creating lives worth living. maintaining a positive attitude and continuing to try one’s best in spite of a terminal diagnosis or extreme frailty perhaps serves also as a central focus of life for many who find themselves undesirably dependent on others. the term ikigai is variously translated as “purpose in life” or a “sense of wellbeing.” that fulfillment may be grounded in the value of participation in a group or organization, deriving meaning through its values and social roles. more frequently in contemporary japan, ikigai is conceptualized as the pursuit of self-realization (mathews 2013). but in either case, ikigai refers to what matters most to the person, how she or he envisions death and the afterlife, and what makes life http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 36 meaningful. psychiatrist mieko kamiya explained in a bbc interview that ikigai “is what allows you to look forward to the future even if you’re miserable right now” (mitsuhashi 2017). perhaps “working hard” and acting as though there is a future is enough to reach toward that fulfillment when one is near death; perhaps it is what gets such people through the day. trying not to be a burden and maintaining a maemuki approach to life may be the ikigai that concentrates the remaining energy of some people as they face death, and thus gives their life continued meaning. it asserts continued agency despite great disability. living a moral life while dying: gratitude and reconciliation i have suggested that trying hard and having a positive attitude are ways to continue to engage in relations of reciprocity. when little more can be done for others and when a person knows that she or he is a burden on family and professional caregivers, the one continuing avenue to paying back, at least a little, is gratitude. in daily life, verbal expression of gratitude is often absent in the closest relationships that are characterized by general reciprocity and the assumption of ongoing interaction. yet, the verbal expression of gratitude is ubiquitous in more formal relationships, among more distant family and friends, work colleagues, and acquaintances, that are characterized by a more balanced form of reciprocity. one of the things i had to learn in japan was to remember to say thank you, seemingly to everyone, for whatever exchange had occurred in our most recent transaction. that might mean, “thank you so much for inviting me to your home last might.” or it might be something in the past: “thank you for your introduction to mrs. suzuki last time i was in japan. she was very helpful in my research.” even when there is no specific item or favor, people often greet each other with a generic, “thank you very much for last time.” that a sense of gratitude is basic to japanese values is also seen in naikan therapy, where healing comes through meditation, in which a person comes to understand and appreciate all that others do for him or her (ozawa-de silva 2006). the explicit cultivation of an “attitude of gratitude” is not limited to those seeking therapy, but a common goal at any stage of life, including among the older adults kavedžija discusses in her article in this issue. in the final weeks, days, or moments of life, the spirit of the “thank yous” of balanced reciprocity seems to intersect with the need for closure in intimate relations. the long-term relationship with an intimate can no longer be assumed when death is near, and a mature person will recognize and acknowledge all that has been done, in terms of caregiving, but perhaps more importantly, throughout the relationship, appreciating that it has been a valuable part of the dying person’s life. as survivors reflect on the death of someone close to them, a key criterion for a good death is that the person had expressed thanks before he or she died. during fieldwork, i noted this preference for words of gratitude that was in contrast to many americans’ farewell words of “i love you” (long 2005). i remember seeing a book on end of life aimed at a general audience which was entitled, “sayonara, arigato, minna-san (goodbye, thank you, everyone). expressing gratitude is in part closure, and in part a means to reconciliation. the main location for the hospice portion of my fieldwork was a christian institution, and it was here that the vocabulary of reconciliation was most explicit. the staff viewed the deathbed as an opportunity for apologies for past words and deeds, and to bring closure (and thus a good death) through just “being there” at the end.10 in staff conferences discussing a death retrospectively, i sometimes heard observations such as “she changed a lot, to where she could express gratitude to staff and family.” although the specific vocabulary of reconciliation was influenced by the christian theology on which the hospice was based, concern for family relationships of, and the expression of gratitude by, the dying were not limited to that setting. dependency, frailty, impending death—these alter the sense of time, both in the shrinking of the future for generalized reciprocity, but also of bringing the past in to sharper focus. expressing http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 37 gratitude such as telling researchers that her daughter or daughter-in-law is a “good” person in contrast to imagined others helps to mend relationships that had been fraught with tension and sometimes bitterness. caregiving wives and daughters-in-law voiced newfound empathy for the people in their care, as they watched them struggle to be moved in a wheel chair or to speak a sentence, and interpersonal relationships of power were reversed. in such a situation, an expression of gratitude might simultaneously be a thanks and an apology. if aging is about continuously redefining oneself in relation to intimate others, the end of life offers final opportunities to reset these relationships. death itself also resets relationships of reciprocity. ties to intimates continue beyond death, but with increased dependency of the deceased on the surviving family (plath 1964; tsuji 2001), who may or may not remember and care for the spirit. the ancestors represent the family in the spiritual world, protecting them and offering guidance. but family are expected to do a great deal in exchange, including maintaining the grave and family altar, offering favorite foods and drinks, reciting sutras, and sharing family happenings with the deceased. consideration for the deceased and the practice of related rituals (“doing concern” for others, traphagan 2004) may be done by anyone, but it involves a set of responsibilities often taken up in various ways and to different degrees by the elderly men, and especially women, of the household (traphagan 2004, 179; daneley 2014, 174). this work involves memory and a sense of gratitude for the gift of their own life as well as guidance, care, and favors given while alive (see smith 1974, 344). although women are more likely to engage in ancestral ritual than men and find it meaningful, men, too, are expected to develop the capacity to see their lives in the context of the gift of life from parents and ancestors, and the social exchanges with intimates over time that have made them who they are. lebra (1984) found that care for the dead and memorial rituals begin in middle age for women, often with the death of a parent or in-law, but that relationships with the dead change with time. unlike the middle-aged ritual caregiver, “the aged woman sustains herself by an intensified identification with the ancestors...no longer is an ancestor an object of worship, but rather the image of the worshipped and worshipper come to overlap” (1984, 289) as the elderly consider their post-death continuity. danely (2016, 24; 190) also found that among the elderly kyoto residents he interviewed, many felt a sense of increasing intimacy and identification with the hotoke (former humans who have become enlightened and thus become buddhas after death) and ancestors, and that this increasing identification is seen as natural in the course of aging. i noted in my fieldwork that not infrequently, a bed-bound elderly person lies in the main living room of the household. this may be in part for convenience or due to lack of space for a hospital bed elsewhere. but if the family has a buddhist altar for the ancestors, that is also in that same room. i doubt that it is insignificant that the elderly person’s head was, in all cases i observed, pointed toward the altar. for the living, memorializing those who have already died means both remembering past relationships for which gratitude is (or should be) felt and considering one’s own relationships after death with living family members, and thus reconsidering the favors and tensions of the past and present. these reflections may represent hope for (or displeasure at, in some cases) being reunited with family in the other world (danely 2016, 25), as expressed by many people with whom i spoke. a 64-year old hospice patient with widely metastasized breast cancer anticipated this in detail. she envisioned her deceased father returning to get her at the upcoming bon holiday (a yearly time when the ancestors are thought to return to earth for a brief visit to their families) and guiding her to the other world. another woman said, half-jokingly, that she wondered whether her husband would recognize her when they meet again, since he had died young and she had changed so much in the last 50 years. moreover, the reset with descendants may be made through the choice of non-traditional mortuary ritual such as ash scattering, conveyor-belt columbaria, or green burial as a way to adjust relationships with descendants, to avoid http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 38 burdening them with continuing care of a grave, and to hope for a reunification with nature (boret 2014; gould, kohn, and gibbs 2018; kawano 2010; rowe 2011; tsuji 2018; uriu, odom, and gould 2018). gratitude and reciprocity are the foundation for relationships with the living and with the dead, and thus for living a moral life. conclusion drawing on the words of frail elderly and terminally ill people, i have offered a picture of dying in contemporary japan that contrasts with that of a hopeless, lonely death. the increasing proportion of elderly people living alone may ultimately lead to many more dying alone, despite national anxiety and government encouragement of programs and services to avoid it. we cannot interview people who have died in this way to know what they were thinking and what they valued. perhaps she or he had a sudden heard attack or stroke, or suffered from dementia that leaves a person confused and disoriented. perhaps, there was no family member to call, due to geographical distance or estrangement. among the oldest old are many who are uncomfortable asking “outsiders” to the family for help. to do so is to incur a burden that cannot be repaid.11 perhaps, they choose to gambaru on their own, or to do their best. we do not know, but i suspect that some of the same cultural tools that i have described in this paper are drawn upon, but in the context of poverty, isolation and/or depression or other mental illness. it is also difficult to know whether as they age, younger generations will experience the intensification of the values and behaviors i have described as they get close to death. cultural values and idioms of expression change, and along with them, moral timelines. yet, based on the voices of the few young people in the study who were facing death, we cannot expect that these will become irrelevant to people in japan any time soon. people may be sad or they may feel extreme loneliness, even while living with family members, but in the picture i saw, their physical and existential suffering, leads not to giving up on life, but to small steps in pursuit of as good a life as possible in their circumstances. to say it in that way suggests compromise, that an ideal “good life” might not be possible when a person is ill or fading, leading to some degree of resignation to less than the ideal, without giving up entirely. on the other hand, the notion that one should pursue a “good life” seems bounded to western philosophical notions of individual freedom in opposition to social expectations. in that context, pursuing a good life might create tension with being a good social person. however, i believe this is an example of the problem to which zigon (2014) refers when he critiques ordinary ethics for assuming that we can recognize values such as dignity and human rights in all human interaction. freedom and fulfillment as understood outside that western tradition need not always be in conflict with fulfilling social obligations. while most contemporary japanese would highly value such “goods,” they are not the ones most people prioritize in defining what it is to be a good person.12 for most of the people i have come to know through my fieldwork, “goodness” is contextspecific and focused on sociality. moral selves are created by being a good old person, a good patient, or a good daughter or mother-in-law. “as good a life as possible,” then, refers not to compromising a goal of a “good life,” but to striving for moral self-improvement in social relationships. the important elements to many of the people with whom i spoke are the attention to social relationships and the striving itself. without such efforts, they are no longer recognized, or see themselves, as full members of society. http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 39 the stories of people i interviewed and observed contribute to this special issue’s themes of time and meaning at the end of life because they show terminally ill or frail people pursuing “ends” that are meaningful to them and morally significant in japan. a buddhist ideal of accepting death is balanced in japan by a confucian-inspired value of self-cultivation and continuous self-improvement (plath 1980), and those paths are available to those confronting their own deaths. most of those i interviewed, whether young or middle-aged adults with terminal diagnoses or very old adults suffering extreme frailty, illness, and/or cognitive impairment, focused on the latter as a way to try to maintain harmonious relationships, and thereby their own self-worth. by acting, even in small ways, they continue to cultivate their moral selves as a way of being in the world (lambek 2010). the concerns and worries they voiced reflect a time orientation that is both based in the immediacy of their bodily experience of disability or illness and that stretches relatively far into the future. this may be possible because of japan’s affluence and public policies. although most were not themselves wealthy, none suffered from the day-to-day worries about having food to eat or paying for medical care that are frequently seen in the united states. their longer term concerns were generally related to family relationships, either worrying about how family members would fare in the future, or whether their own relationships would continue beyond death, as traditionally envisioned. by expressing these concerns, they reveal the importance of family, regardless of the quality of the relationships in the past, in giving their lives meaning. the second theme concerns the nature of these relationships while still alive. reciprocity is a key value in japanese society, and the “good person” and responsible adult are defined by keeping track of social debts and knowing how, when, and whom to reciprocate. at the end of life, options for paying back the people who are providing care, and on whom they are extremely dependent, are limited. people spoke frequently of two attitudinal strategies, that of gambaru, effort, and maemuki, “forward-facing.” doing one’s best and maintaining a positive attitude demonstrate a continued desire to live in society as a full human being. i believe that these attitudes contribute not only to their relations with others, but give their own lives continued purpose when the future of life is short. relations of reciprocity do not end with dying or death. in dying, a “good person” who is mature and able to reflect on relationships will continue to enact reciprocity through verbal expression of thanks. gratitude and reconciliation at the deathbed were frameworks in which the past was brought into conversation with the future. people seemed to feel gratitude not only for current caregiving, but also for all that has been done for them over a lifetime with convoys (plath 1980). some express this to intimates for the first time. the past and present also come together in an increasing focus on what will happen to their body and spirit after death. relations of reciprocity with ancestors past and future seem to be deeply considered in the face of death, with concern about the continuity of ancestral care applying to the deceased relatives of the past, and also to themselves. thus, both meaning and time at the end of life are tied to the recognition and valuing of relations of reciprocity. culturally based idioms such as gambaru, maemuki, and ancestorhood are tools with which they pursue these values. despite the extreme dependency of this time of life, social personhood can be maintained through continued attempts to actively engage in and to appreciate relationships with those closest to them, whether it is their own future survivors or those who have preceded them in death. that moment is one of the physical body, but what really matters engages the longer scope of time. acknowledgements http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 40 the research projects on which this article is based were conducted with the financial support of an abe fellowship and grants from the japanese ministry of education, culture, sports and science; the japanese ministry of health, labor and welfare; and the univers foundation. the solo project and the qualitative part of the collaborative study had the oversight and approval of the john carroll university irb. i would like to thank my co-members of the qualitative research team, asakawa noriko, asano yūko, izumo yūji, kodama hiroko, muraoka kōko, nishida masumi, nishimura chie, shimmei masaya, suda yuko, takahashi ryutaro, and yamada yoshiko, and especially ruth campbell, for sharing insights concerning the interviews, and co-pis of that project, ryutaro takahashi and yuko suda. earlier versions of this paper were presented at the annual meeting of the american anthropological association and a dartmouth university faculty seminar. the feedback on these earlier versions from those in attendance has helped to improve the paper. i especially appreciate the beneficial comments and suggestions of glenda roberts, amy borovoy, iza kavedžija, and three anonymous reviewers. my deepest gratitude is owed to facilities and caregivers that hosted me for this work, and to the people who were willing to speak with me about difficult topics, as they strove for their own course forward. notes 1. the tokyo medical examiner’s office (tmeo) reports statistics based on the definition of an isolated death as someone aged 65 and over, living alone, who died at home (but excluding suicides and homicides). in 2013, that number was 2733, and the number of such deaths that occurred in public housing and which were not found for a week or more (producing the sensational stories reported in the press) was 157 (cabinet ministry 2014). one source reported in a presentation the 2733 tokyo figure and added that there were 15,000 isolated deaths nationally in 2013, citing ministry of health, labor and welfare data (waterson and tamura 2014). in 2017, the yomiuri shimbun extrapolated data it was able to collect from around the country using the tmeo definition and concluded that the number of lonely deaths nationally reached over 40,000 (japan news 2017). i have discussed ideas about a “good death” in japan extensively elsewhere (long 2003, 2005). it is worth noting the likely impact of the ideal of a death attended by family on the level of concern expressed by elderly japanese. approximately 40% of the elderly living alone are seriously worried about dying alone. in a ministry of health, labor, and welfare survey (2015) of elderly living alone, respondents were asked about their level of concern about an unattended death. of the respondents, 44.5 % indicated that they were “very seriously worried” or “somewhat seriously worried” about dying alone; 52.1 % of them replied that they are “not much worried” or “not at all worried.” we might also attribute this high level of anxiety about lonely deaths to the media coverage. not only is being unattended not consistent with a “good death,” an undiscovered death in particular adds a burden on those who have to clean things up. a study by tiefenbach and kohlbacher (2017) found that in a 2013 study, concern for dying alone was correlated with lack of satisfaction with where they lived. but contrary to expectations, the oldest respondents indicated less worry than younger respondents. 2. the media coverage of this phenomenon is reminiscent in some ways of the “moral panics” that have arisen in japan in recent years concerning religion (reader 2001), government-business coziness that became starkly visible after the post-march 11 fukushima nuclear meltdown (e.g., gill, steger and slater 2014), the widely acknowledged increase in economic disparity in the 21st century, youth and employment, demographic changes, and so on. toivonen and imoto (2013) define “moral panics” as responses to perceived threats to social values and interests that are promulgated in the mass media, and to which expert advice is thought to be required to diagnose and find solutions to the problem that has been labeled by such experts and media. his model of investigating these “moral panics” is to distinguish between the “panics” and longer, ongoing discourses of a social issue, drawing on the empirical approach of roger goodman (2012) that examines the evolution of such discourses over time. http://anthro-age.pitt.edu/ long | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.246 http://anthro-age.pitt.edu 41 3. although these projects included people of varied backgrounds, including gender, educational background, residence (urban vs. rural), and socioeconomic status, it is difficult to generalize about how these differences, as well as variation in diagnoses and individual life experiences, impacted their approaches to death. where possible, i have included in my discussion some observations about gender and residence as appropriate, but with such a small sample size, i cannot draw firm conclusions. while recognizing the importance these factors in shaping a person’s perspectives, i concentrate here on some of the commonly expressed elements of their coping with frailty and/or impending death that transcended such sociocultural variables. in describing these approaches to dying and death, i also do not mean to imply that the issues of balancing dependence and independence (see, for example, hashimoto 1996, leland 2017), of how to maintain social relationships, and of relationships with the dead are “uniquely japanese.” in this paper, rather, i explain how experiences of aging, frailty, and severe illness played out in several settings in japan in the late 20th and early 21st century. 4. see also, walter 1994; kellehear 2009. 5. young and ikeuchi (1997) point out that although death is not within one’s control, from a japanese buddhist perspective a “proper” adult prepares by visiting temples, studying, performing rituals, or reciting or writing sutras. pokkuri means to die in a timely way. among my informants, the most important preparation is to avoid becoming a burden by living too long. young and ikeuchi explain, “to die pokkuri is also to exit gracefully from this world and to extract oneself from its web of relationships...without having to succumb to...helplessness and hopelessness” (p. 237, emphasis mine). 6. this is discussed in long 2005 for japan, and is addressed for the us in kaufman 2005. 7. a ministry of health, education, and welfare survey (2015) found that approximately 40% of the elderly living alone have made little or no preparation for their terminal care, funerals or graves 8. a link between promises, morality, and hope is also seen in a case study by anthropologist devin flaherty (2018). she describes a situation in which a promise made many years earlier has great significance near the end the life of a woman she calls ms. donovan. a terminally ill elderly woman from st. croix, us virgin island, she suffered from pain and numerous bodily dysfunctions. she received home hospice care and her condition conveyed to her that soon she would be unable to care for her grandchildren, a promise made to her daughter on her daughter’s deathbed. keeping that promise was what mattered most to ms. donovan. it motivated her to maintain her active self indefinitely, all the while knowing that she faced an imminent end to her ability to keep that promise. her sense of a meaningful life until then, and a self that was still human, depended on it. 9. i appreciate an extended exchange with sachi schmidt-hori on the nuances of gambaru and maemuki. 10. see long 2005 and fetters and danis 2002 on the expectation of family presence at the time of death. 11. the ministry of health and welfare survey of elderly living alone (2015) found that elderly men in particular do not want to ask others to do a small task for them or do not have any one to ask. about a third of those without a child respond that there is no one they would like to ask for long-term care and life support, but even those 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routledgecurzon. young, richard, and fuki ikeuchi. 1997. “religion in ‘the hateful age’: reflections on pokkuri and other geriatric rituals in japan’s aging society.” in aging: asian concepts and experiences past and present. edited by susanne formanek and sepp linhart, 229-355. wien: österreichischen akademie der wissenschaften. zigon, jarrett. 2014. “an ethics of dwelling and a politics of world-building: a critical response to ordinary ethics.” journal of the royal anthropological institute 20(4): 746-764. http://anthro-age.pitt.edu/ javascript:__dolinkpostback('','mdb~~sih%7c%7cjdb~~sihjnh%7c%7css~~jn%20%22journal%20of%20the%20royal%20anthropological%20institute%22%7c%7csl~~jh',''); diy aging retirement migration as a new age-script liesl l. gambold dalhousie university author contact: liesl.gambold@dal.ca abstract the post-retirement aging process involves making many decisions. strained social welfare programs for the elderly have met with a generation well-versed in ‘do-it-yourself’ (diy) projects resulting in a novel script for diy retirement, aging and dying. for decades baby boomers in north america and europe have valorized personal freedom and independence and are now carrying these values into retirement. some are seeking tenable, independent retirement options abroad in response to inadequate retirement savings, a fear of rising medical costs and lack of faith in local and state systems. based on ethnographic research among diverse retirees in north america and europe this article argues that age-scripts and retirement are actively being rewritten by those compelled to diy. keywords: retirement, migration, do-it-yourself, age-scripts, europe anthropology & aging, vol 39, no 1 (2018), pp. 82-93 issn 2374-2267 (online) doi 10.5195/aa.2018.175 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 82 diy aging retirement migration as a new age-script liesl l. gambold dalhousie university author contact: liesl.gambold@dal.ca introduction changes in social norms have created a complex variety of seniors on the life course trajectory venturing into new retirement territory. some seniors find themselves with an expanded number of options available to them after leaving formal, full-time employment while other seniors recognize that the safety nets and support systems that were in place when their parents retired offer neither the guarantee of support they need, nor the kind of living situation they want. this article critically examines retirees who are taking a do-it-yourself (diy)-approach to aging and retirement; those who are international retirement migrants in mexico and southern europe.i these retirees feel a sense of responsibility for their own wellbeing and have decided that in the face of insufficient and contracting social safety nets, they must be the agents and architects of their later years. among international retirement migrants, many cited economic instability and fear as a primary impetus for their international relocation. here i argue that three components are acting as pillars of this new approach to aging and retirement: the shifting neoliberal scripts of successful, active and healthy aging; baby boomers’ familiarity with a do-it-yourself approach to life projects; and the impact of social and policy supports. retirement as an institutionalized phase of the life course is a complex and dynamic process with several stages. the blurring of what has previously been a fairly predictable and unidirectional progression for older adults (keith et al. 1994) offers a contemporary reflection of the individual and group repertoire of adaptive behaviors in the later years. these adaptations can be linked to the general acceptance that in most western societies, lives, including the lives of the aged, have become “less predictable, less collectively determined, less stable, less orderly, more flexible, and more individualized” (brückner and mayer 2005, 28). aging tropes continue to shift and multiply as the world’s population turns grey at an unprecedented pace and retirees maneuver through aging in novel ways. furthermore, american baby boomers (meaning the post-war generation born between 1946 and 1965) have received countless messages through media and governments that they must have a good aging plan in place because many communities and governments do not. the 72 million baby boomers in the united states are reaching the age of 65 at a rate of approximately 10,000 a day. in the european union the aging trend will lead to an increase in the population aged 65 and older from 87.5 million in 2010 to 152 million in 2060. similarly, there are nearly 10 million canadian baby boomers which amounts to approximately 32% of the population—a far greater proportion than other countries where baby booms occurred. the governments of these aging people are scrambling to determine how they are going to provide the pensions, healthcare and end-of-life care for this grey tsunami (barusch 2013). the changing nature of age scripts is creating an environment that suggests individual aging citizens themselves ought to be busy thinking about and preparing for old age housing and care. hence, aging norms are being rewritten as retirees violate previously held expectations and actual behavioral patterns, and the result is a cultural push toward making seniors more economically, psychologically and physically independent. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 83 part of this is reflected in the ways that the socio-political context for the physiological process of growing older has become increasingly neoliberal and entrepreneurial, thus creating a shifting expectation of the process to which citizens must respond. age-scripts, as coe and alber describe here in the introduction to this issue, exist in and also signify flux. building on their description of the formulation of age-scripts, this article will demonstrate the way that age-scripts among international retirement migrants signal a ‘discursive organizing’ of the ‘unease’ they face in their retirement. for many baby boomers, making sense of taking a do-it-yourself approach to your retirement and aging involves creating a discursive explanation around independence and the ‘new’ retirement in the face of greater demands being made on the individual by american health and aging policies. these informal articulations of growing old are resulting in changes, one of which reflects a tendency of retirees to be personally engaged in pursuing ‘successful’ and ‘active’ aging. aging actively and successfully is the new diy project of those entering retirement. baby boomers in the united states have been retiring and taking up the challenge of successful aging with great enthusiasm. many have decided they are too busy creating full and meaningful ‘new’ lives to bother with ‘aging’ at all, seemingly putting it off for the future. others are carefully crafting where, how and with whom they age. do-it-yourself the diy movement as a consumer movement has been around since the early 20th century. it originally focused on “how to” maintain, improve or repair things around the home and today is comprised of various publications, television shows and websites instructing people with a vast array of “how to” content. today the term “diy” is being used much more broadly to describe any activity that uses an element of creative skills to make or design something on your own. as brit morin reported in the huffington post, “makers [or diyers] are forming communities of their own, and more people around the world are becoming influenced to be makers” (morin 2013). the underlying message is that if you do not like what is available, create your own. although this could simply reflect a matter of aesthetic, as in the case of creating your own headboard from found driftwood, i argue that not liking what is available also points us toward recognizing that what is being offered falls short of what we need. this provides an opportunity for entrepreneurs to fill the gap by creating new goods and services for consumption. finding that what is available is inadequate also strengthens the pillar of neoliberalism that supports the ethos of individuals, rather than states, as the responsible creators and supporters of their own wellbeing. similarly, there has been a western bias toward the individual as the locus of action, health, and efficacy in transforming ‘normal’ aging into ‘successful’ aging (rowe and kahn 1998). as articles by alber and by pauli and bedorf articles in this issue show, retirement is no longer simply a phase of the life course that one enters and finds some way of accepting, it is an important moral project requiring individual vision, commitment and tenacity. the diy ethos on the surface appears to be one of production, but it also entails consumption, so it has been referred to as a form of productive consumption (dinda 2008). this manner of consumption has been linked to forms of self-production and improvement that creates or enhances value rather than merely depleting it (moisio, arnould and gentry 2013, 300). this is an easy link to make to diy home improvements, but it can also be tied to the shifting period between formal employment and retirement. productive consumption contributes to identity (troye and supphellen 2012) and is a primary factor in creating new age-scripts in a neoliberal state. studies of consumers focus mainly on those in their early and mid-adulthood (belk and costa 1998; kates 2002). however, some argue that retired consumers anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 84 actually enter an important space of increased breadth and depth in identity-related consumption, or “consumer identity renaissance” (schau, gilly and wolfinbarger 2009, 255). this consumptive behavior is associated with life transitions, like retirement, and schau, gilly, and wolfingbarger argue, “retirement has become a time of growth when identity is broadened, expressed, and completed through consumption” (ibid., 256). this idea of retirement and aging offering some kind of renaissance, or rebirth, works well in a diy world where the “consumer cum bricoleur” is engaged in “restoring, renewing, and rewriting their identities” (ibid., 258). the view that productive consumption is a “dynamic response to identity conflict” (moisio and arnould and gentry 2013, 300), the result of an internal conflict associated with transitioning from active employment to retirement, ignores the systems and structures that force retirees into the act of doing it themselves. social policy and aging one of the most critical aspects of neoliberalism is the creation of markets in areas such as health care and social security in order to commodify all forms of human behavior. aging practices and paradigms have shifted toward the neoliberal model. david harvey, outlining this perspective, says, “human well-being can best be advanced by liberating individual entrepreneurial freedoms and skills within an institutional framework characterized by strong private property rights, free markets, and free trade” (2005, 2). over the past twenty years, the united states government has increasingly pursued policy agendas including a “normative privileging of the individual” and a preference for privately funded and delivered care (teghtsoonian 2009, 28). this is not to overlook the importance of obamacare (the patient protection and affordable care act), enacted in 2010 and currently threatened by president trump. obamacare was the most significant change in the provision of healthcare in the united states since the 1965 passage of medicare and medicaid. however, obamacare was still dependent on being delivered through the private insurance market, with increased government regulation of that market. these policy agendas reflect the way that neoliberal governance requires diy citizenship. underpinned by a reconceptualization of the social in economic terms, individuals come to be understood as rational, calculative actors “who [are] active in making choices in order to further their own interests and those of their family” (rose 1998, 142). this shift involves “the generalization of an ‘enterprise form’ to all forms of conduct” (burchell 1993, 275), including the manner in which citizens understand and manage their retirement years. these developments are visible in discourses of responsibility directing individuals to become “enterprising selves” who work on, or invest in, themselves in various ways (rose 1998). as thomas lemke has argued, [t]he strategy of rendering individual subjects “responsible” (and also collectives, such as families, associations, etc.) entails shifting the responsibility for social risks such as illness, unemployment, poverty, etc., and for life in society into the domain for which the individual is responsible and transforming it into a problem of “self-care” (2001, 201). the pervasiveness of these new norms in the united states contributes to the fact that the u.s. has the greatest number of international retirement migrants in the world (miller 2004). part of the weight tipping the balance comes from decades of healthcare policies and social welfare programs being nudged onto the shoulders of the aging themselves. another weight is the lifestyle movement that celebrates a desirable new, successful aging as the last form of baby boom rebellion. in 1999, the international year of older persons, the who launched a new campaign highlighting the benefits of active aging. in 2002 the second united nations world anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 85 assembly on ageing was held in madrid, spain. the active ageing policy framework publication resulting from that assembly grappled with the very real policy, economic and social implication of a rapidly aging population while fundamentally highlighting the need for the older person themselves to optimize “opportunities for health, participation and security” (who 2002, 12). a critical reading of this and other campaigns like it suggests that the physiological chronic conditions affecting many older people worldwide, such as cardiovascular disease, hypertension, stroke, diabetes, cancer and mental health conditions, can be reduced through policies and programs which encourage “personal responsibility (self-care)” and “personal efforts to adopt positive personal health practices at all stages of life” (ibid 17). marketers were also ready to get in on the baby boomers’ new ‘active aging’ platform as seen in cadillac’s use of the led zeppelin classic “rock and roll” to kick off their 2002 advertising campaign. the company used the tagline “breakthrough” and was going for a hip, new image since their traditional audience was dying off. the advertisement aired for the first time during the 2002 super bowl and sales rose 16% the following year (halliday 2003). shifting political and social policies in the west promoting successful aging have ironically resulted in the unconscious creation of a class of those who age unsuccessfully (rubinstein and de medeiros 2014). like feminist arguments about the danger of discourses around “natural” childbirth creating a class of women who inevitably experience “unnatural” childbirth (macdonald 2013, in the current climate of greater individual initiative, agency and responsibility in the west, those who age unsuccessfully apparently do so due to their own shortcomings. sign-posts for diy successful aging are everywhere with messages that obligate the individual while making no connection between the individual and society. negative depictions of the elderly in long-term care facilities have been supplanted by images, and expectations, of a very physically active, happy, mobile, engaged, independent, and financially secure population of retirees. although there is tremendous power in being able to affect the direction and changes in one’s life, we should be questioning the ethos which abdicates governments of responsibility for aging citizens while necessarily convincing seniors that their well-being and happiness is a project entirely up to them. part of the strength of the diy ethic, for better or for worse, is that it seeks to overthrow the idea that we will be cared for—we will have to do it ourselves. this is all well and good for those who have learned how to change their own car oil, retile their bathroom floor or trim a rose bush, but it is an entirely different matter when it comes to the far more important issues of provision of care and housing for our aging population. the case studies i discuss in this article offer individual accounts of later-life decision-making around retirement location and housing but taken together should provide a composite picture which begins to illustrate various ways in which a diy approach to aging is indicative of late neoliberal trends. even though each person i interviewed was experiencing unique factors influencing their migration and housing decisions, there are important overlapping features of real or potential economic hardship, fear of rising medical costs, the ability to envision themselves living abroad and lack of faith in the state system at home. methods the data presented here on international retirement migration comes from my lengthy, openended interviews with 78 international retirees in mexico, france and spain. most of the retirees in mexico were american and most in france and spain were british. interviews lasted from 60 to 120 minutes each and were collected during a year of extended fieldwork in 2009-2010 and during shorter research trips in 2014 and 2015. for all of my interviewees, the way they managed their aging and anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 86 retirement was often influenced greatly by the way they had lived their life before retirement, so it was necessary to talk in depth, often for hours, about their preand post-retirement life. this life course approach was especially important because these particular retirees exhibited a relatively greater degree of deliberation and agency in their transition from full-time work to retirement. the international retirement migrants i interviewed were from diverse social classes. one of my surprise research findings was that people with relatively modest pensions or retirement savings were not daunted by an international move and those with greater means were not convinced that their relative wealth would go as far as they once thought it would back in the u.s. international retirement migrants were formerly believed to be members of the upper-middle class. however, my research found a great deal of social class diversity among the retirees. similarly, in their research on american retirees in mexico, amin and ingman found that 36% of retirees (n=80) earned usd$15,000-44,999 per year (2010, 26). regardless of social class, all of my interviewees expressed concerns that if they had remained in their home country, they would have had to significantly re-craft their lives in order to afford the retirement they had previously envisioned. with this in mind, and with the opportunity to move abroad, many said that it seemed easier to simply leave everything and start from scratch elsewhere. the data analysis process was iterative. i coded all interview transcripts in search of patterns. during the data analysis process, i adopted the “constant comparative method” (glaser and strauss 1967, 587), which meant that the analysis entailed continual tacking back and forth between data categories in the multiple sites. i recognize that as the researcher i have created the comparison. a strength of this approach is in its ability to display that retirees in mexico, spain and france, were all involved in a diy approach to their retirement becoming the architects, agents and advocates of their own aging. retirement abroad: “just another fixer-upper” making a post-retirement international move is not very common; however, it is more common than it used to be. formerly understood as a seasonal choice of the affluent (king, warnes and williams 2000; gustafson 2001) or, in some cases, aged migrants who have decided to return to their natal country, the majority of retirees are simply too entrenched in their local lives and communities to imagine leaving it all behind. most also do not want to move away from children and grandchildren. however, with more affordable flightsii, internet banking, skype and other video chatting formats, moving away does not necessarily mean you feel like you are away. this has allowed seniors who even a decade ago would never have considered international migration to take a risk and create a new life in a foreign land. in an interview with the author on october 16, 2009, european commission researcher ettore marchetti estimated that 5-6% of pensioners leave their home country to retire abroad but he admits to having scant data on the actual numbers of retirement migrants and their final destinations. this is largely due to non-registration since the treaty of rome and the treaty on european union guarantee the legal right of eu citizens to reside in any member state. despite the difficulty in accurate enumeration, scholars argue that this population and its significant fiscal impact will continue to grow (cooper 2008; rochefort 2000, 2004). today over 1 million british pensioners live abroad and by 2050 as many as one in five (3.3 million people) will, though with the recent brexit vote, these estimates might soon shift. currently over 450,000 retired us citizens have social security checks mailed to them outside of the u.s.iii as of 2011 anyone who applies for social security benefits must receive these benefits electronically. as a result, tracking the numbers of retirees living outside of the country is now all the more challenging. in addition, anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 87 due to security concerns, the u.s. department of state ceased publishing demographic information on u.s. citizens living abroad as of 1999 (dixon et al. 2006, 23). the most popular international destination for american retirees is mexico and depending on the source, estimates vary from 358,000 american retirees claiming permanent residence in mexico, using mexican census data (warner 2007), to at least 1,000,000 (u.s. department of state 2010). this number is likely to increase as the u.s. population continues to age. the data on these retirees remain imprecise and might conceal more complex situations such as the percentage who might be return migrants, those engaged in secondary or repeat migration or whether they are engaged in a temporary or definitive return. mexican politicians and entrepreneurs are well aware of this trend and have begun opening assisted living homes targeting american seniors, especially in mexican towns where there are already sizeable numbers of expatriates, like lake chapala and ajijic. many north americans long for extended vacations on mexican beaches while others remain fearful of the violence that often makes the news. but for many, international retirement in mexico is seen as the only way they can manage to create an independent and financially comfortable retirement. grant, a seventy-four year old retired manufacturing manager from michigan, moved to mexico with his wife in 2001. he argued that in many ways it would have been easier to stay in michigan, as the logistics of selling their house and packing up their entire lives was more than he had bargained for. we were both a little worried, truth be told. we were in good health and we had worked hard all of our lives. but we didn’t have much saved. we had helped my mother-in-law when she got sick and my wife’s brother had some mental problems so we always helped pay for extra care for him. didn’t think twice about it. it’s what you do for your family. we were able to put our daughter through college. but, we realized we didn’t have much besides our house and two modest pensions. and we were both tired of winter. having only visited mexico once for a beach vacation at an all-inclusive resort, for grant and his wife the idea of relocating permanently to central mexico was daunting. but like many hesitant retirees they rented a small house for one winter to “try it out.” grant stated, “after two weeks, you know, once we figured out where to shop and how to find what we needed, we realized we couldn’t go back to living in michigan. we both felt so much better because we could enjoy ourselves outside, play golf, go for a swim. and it was january! in michigan, when we skyped with our daughter, the snow was up to the back door. i just shook my head, ‘no’!” grant went on to explain other things influencing their move: well, we knew a few people who went completely broke because of medical costs. and we were eligible for medicare and social security and our pensions and all, but we were still worried about some big medical cost wiping us out. everyone thought we were crazy because they said ‘how can you trust mexican doctors and hospitals!? you’ll never know what they’re talking about!’ that’s why we came down, to talk to people. everyone, and i mean everyone, has had overwhelmingly positive experiences with doctors down here. of course there have been some bad ones, but that happens all the time in the states. everyone told us where to go and how to find a good doctor that speaks english, and [if] we are going to fall apart and die somewhere, might as well not go broke doing it and be somewhere with this view! similarly, joanne, a sixty-nine year old widow from eastern washington said, anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 88 you spend your whole life thinking you’re going to be ok. you will work hard then retire and rest, do what you want. but you never can imagine that you’ll live in fear, wondering if you’re one step—or one fall, ha ha!—from losing everything. i didn’t have kids and then my husband died—he was much older than me—so i really didn’t know what to do. but my friend’s cousin had moved here, to san miguel, so we came down to visit her and i don’t know, i just thought, ‘why not?’ i guess i’m a bit of a rebel, but i’m also practical. i have to watch my money and i’d rather watch it here where it gets me a little more. i rent a little apartment and as i like to say my new project is my life—my new little fixer-upper! grant and joanne have good reason to worry about high medical costs. the american medical association reports that the biggest reason for bankruptcy in the u.s. is medical debt. this contributes to the creation of the new age-script of moving abroad in old age. social safety nets and policies often fall short, making a safe, low stress and healthy aging process less tenable for many. the organisation for economic co-operation and development (oecd) calculates by country the degree to which pensions cover pre-retirement after-tax income in an attempt to analyze the potential financial health of the growing number of retirees in developed world. for average income earners, canada and the united states have low income replacement rates relative to most other oecd countries, at 57.1% and 51.0%, respectively (oecd 2005). however, because of universal health coverage in canada, most canadian citizens and permanent residents will not risk forfeiting their health coverage by moving out of the country. a real estate agent in los cabos, mexico reported in 2008 that 70% of his clients were from the united states while only 20% were canadian (lizárraga-morales 2008, 105). one common feature among the retirement migrants i interviewed was that if they had more money, they would have chosen to maintain a home in their natal country and spend at least part of the year there. however, due to financial concerns, they decided to move permanently to a place where they could maximize their retirement incomes. for many baby boomers and other retirees i interviewed, having enough money saved for retirement was an idea they had given up on years ago. cooper (2008) asks as one of her chapter titles in the new retirement, “have boomers saved enough for retirement?” (140) this and the myriad commercials, print advertisements, newspaper features, radio spots and internet pop-ups send the same, pointed message: boomers have not saved enough for retirement and we (i.e., society) are going to have to pay. in other words, a generation’s inability to hold on to enough of the wealth they have generated will soon cripple welfare and healthcare systems around the world. but how much is enough? cooper argues, “you will need a retirement nest egg of between 20 and 25 times the level of additional desired pre-tax income (over and above government and employment pensions) to generate the extra income you need” (cooper 2008, 174). this translates into a “nest egg” of usd$700,000 for someone who wants to have a pre-tax retirement income of $50,000 a year over and above any government or other pensions. this is a daunting figure for many people and unattainable for most, including many retirement migrants. what resulted was a new agescript reflecting the shifting economic terrain of aging experienced by so many seniors. sixty-one-year-old william was sure that his retirement would be spent between his home in huddersfield, england and an apartment he would rent from january to april on the costa del sol in spain. he had already spent three winters discovering the pleasures of wintering in spain and making friends among the expatriate community near malaga. william said that he was forced to leave england permanently because he had to sell his house to pay off debt that the construction company he co-owned with his two brothers incurred during the economic crisis in 2008. william said that he was not prepared anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 89 for the financial downfall he experienced. i thought i was pretty good in terms of my set up, ya know. i had my little house paid off, but my brothers, they were the ones who handled all the finances for the business and i trusted them. i still don’t think they did anything wrong, not knowingly, but we had to pay off more than £200,000! i can still barely say it. anyway, they both had wives who had good jobs, decent income, ya know, that they basically had saved for 30 years, but i was on my own. i had about £15,000 saved and that’s it…so, in the end i just thought, i can’t re-jig everything here and make it work. i didn’t even know where to start. i sold my house, paid my part of the debt we owed and drove down here for good. my brothers thought i was daft, but really, i just sort of panicked. i knew that in spain i could find a place much cheaper to rent, i knew a few people in the community and they could help me figure things out. so, i was sort of an economic refugee you could say [laughs]. everything’s too expensive in england now and so crowded. here, the cost of living is so much lower and when i need peace and quiet i can find it. kind of helps that i don’t speak spanish so i can tune most people out [laughs]. for more than 60% of my interviewees, the bottom line was a mix of economic strategizing and a lack of belief that “the system” at home was going to provide them with a desirable situation in which to retire and grow old. the “desirable situation” of most retirees was characterized by some common elements: first, reduced financial stress; second, an engaging and exciting environment; third, adequate and affordable healthcare services, and; fourth, a sense of agency. climate was another important factor because it supported other desirable elements. for example, reducing the need for winter clothing and heating also reduces expenditures, and living in an environment where daily outdoor excursions are not hampered by dangerous snow and ice increases the likelihood that one will spend more time outside and be physically active, thus improving the overall quality of one’s later years. desiree, sixty-eight years old, credited the mild temperatures with her improved mental and physical health. she had been suffering from high blood pressure and arthritis at home in london before she moved to beziers in southern france. she said that not having to worry about money was important in her decision to leave london for good, but that it was the lifestyle in beziers that enabled her to improve her health overall. she was convincing when she said, “stress. that’s it. it was killing me, or at least crippling me. i don’t know anything, but all i know is i moved here, started this crazy adventure, started walking and joined an exercise group, and i showed stress the back door. i live simply—but i feel rich!” my fieldwork with retirement migrants provided clarity on two critical points. first, these were not all globe-trotting individuals on a quest for a cosmopolitan place in which to grow old. most of them had travelled some as adults but did not consider themselves to be very ‘international.’ denise, sixtyeight years old, said that she was nervous about living in spain and perhaps becoming a victim of crime. she knew of no one who had been robbed but she had worked herself up to being fearful of living amongst strangers. “i didn’t have much experience,” she said, “but i am a good planner and i guess when i put my mind to something i do it. i was afraid of what i didn’t know. now i know it and love it!” second, the retirement migrants were unsure about how adequately their governments would be able to care for them. all of the people i interviewed described the amount of planning and effort their relocation took but decided, often rather impulsively, that they did not have a plan at home that seemed acceptable and they felt they could not rely on state services. mary, a sixty-four-year-old retired teacher who had been living in southern france for six years, said, anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 90 this was not my plan at all. but then i didn’t have one, did i? i started to imagine myself being put in some home, wherever they could find room for me, and all my control would be taken away, out of my hands like that. so, i decided that while i was healthy i would just reinvent my life…i was very scared, but i knew if i needed to i could go back to manchester. i just couldn’t think about sitting there and waiting for…who knows what! mary was very active with other british ex-patriates living in the area and she was tutoring local school children in english, providing her with additional income. she also said that she has a steady stream of visitors from england so is rarely alone. mary’s character was typical of those who had made a similar move. chiswick (2000) argues that migrants favorably self-select. anyone who migrates, but especially economic migrants, tend “on average, to be more able, ambitious, aggressive, entrepreneurial, healthier…than similar individuals who choose to remain in their place of origin” (chiswick 2000, 64 quoted in o’reilly 2000, 43). these transmigrants spend most of their time in one country while maintaining their bonds with their community of origin. the establishment of new communities and households allows for the development of multiple social, economic, and political bonds that transcend borders (appadurai 1996). we might refer to aging mavericks like these as the bricoleurs of a new way of aging. while there are important elements of critical need for many of these individuals, they are also those among the rapidly growing aging population who have found what it takes to be proactive and create a different, and more supportive, age-script. conclusion doing it yourself, or diy, signifies a great deal more than simply crafting or hand-making as a popular independent aesthetic moment. while the growth of the diy movement is solidly rooted in home and decorating activities, the ethos has spread to join with neoliberal scripts of successful, active, healthy aging. if, as goddard and wierzbick (2004, 154) argue, a cultural approach is evidence-based and looks particularly to linguistic markers then “do-it-yourself” as a common saying of the early 21st century is particularly revealing of cultural norms and values. a reflection of one of these values is the way neoliberal governments have taken over social processes to create the conditions inside them amenable for market mechanism. key elements of civil society have been usurped in order to transform the social landscape into a field of individuals. the individual as an “entrepreneur of oneself” (lazzarato 2009, 111) forms the apex of the diy ethos privileging individualism and the assertion of creative authorship. in this article, i have explored the intersection of the diy paradigm with aging and retirement in the form of international retirement migrants. international retirement migrants are responding to the shifting cultural norms around aging and retirement. these norms are characterized by a pronounced shift of responsibility from the state to the individual and by discourses of successful aging. as a result, many americans and europeans have become very actively and creatively involved in crafting their post-retirement lives in the form of new agescripts which reflect these processes of societal change. these emergent age-scripts are visible in the steady growth of intentional communities designed for foreign retirees in places like mexico and southern europe, in online platforms designed to provide support for retirees seeking to move south, and in the actual migration patterns of baby boomer retirees. because humans are living longer, and often healthier, lives, this ‘third age" is extending further than in any previous generation and thus invites more deliberate, creative planning and thought. in addition, baby boomers are a generation of impressive self-advocates and agents of change; why would they leave their ‘golden’ years to the cultural norms of another anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.175 http://anthro-age.pitt.edu gambold | 91 generation? as coe and alber argue in the introduction to this issue, the tensions and ruptures that arise between social norms, here the provision of state and community care of the aging, and the world in flux, a dissatisfaction with those norms, create new age-scripts. although the retirement migration age-script is not dominant in terms of aging norms, its persistence as a viable option signals real change in the contemporary culture of aging. as my data presented here shows, international migrant retirees are normalizing their decisions within the available diy discourse. some might argue that retirement migrants are not necessary migrants but more convenient migrants. i hope that i have illustrated that what has been viewed as a lifestyle trend embarked on by only those with enough financial capital, is actually signaling a critical moment in the social history of aging and retirement. seniors are vigorously persuaded by propaganda and popular culture to manage their physiological, economic and social aging as a diy project worthy of facebook posts and pinterest pages. however, all of this active and healthy aging belies the real uncertainty so many aging seniors experience. having to “diy” one’s aging is a sign of and response to a problematic cultural shift. as unsuspecting members of the new precariat, the diy labor power of retirees is indicative of exploitation and a shifting political subjectivity (gill and pratt 2008). doing it yourself underlines the fact that no one else is thinking about doing it for you. aging and retirement have shifted from previous cultural norms of accepting physiological troubles, economic hardship and narrowing social fields with state and policy support to a new terrain of individual agency and entrepreneurial responsibility. for some, this results in creating a new age-script of a life abroad where fiscal stresses can be minimized and new experiences and expectations fostered as international retirement migrants challenge social norms and successful aging discourses by rolling up their sleeves to diy. notes i support for this research was provided by a sshrc rdf grant and the jean monnet european union centre of excellence at dalhousie university. the author also thanks the very generous and helpful comments provided by the editors. ii especially in europe where low-cost carriers like ryan air make international travel very inexpensive. iii many of these might be return migrants, as gilbertson and singer (2003) note, with regard to the dominican republic. references amin, iftekhar and stanley r. ingman. 2010. “retiring in a foreign land: how do the american retirees deal with health care issues in mexico?” journal of aging 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however, it is more common than it used to be. formerly understood as a seasonal choice of the affluent (king, warnes and williams 2000; gustafson 2001) or, in some cases, aged migrants w... in an interview with the author on october 16, 2009, european commission researcher ettore marchetti estimated that 5-6% of pensioners leave their home country to retire abroad but he admits to having scant data on the actual numbers of retirement mig... today over 1 million british pensioners live abroad and by 2050 as many as one in five (3.3 million people) will, though with the recent brexit vote, these estimates might soon shift. currently over 450,000 retired us citizens have social security che... grant, a seventy-four year old retired manufacturing manager from michigan, moved to mexico with his wife in 2001. he argued that in many ways it would have been easier to stay in michigan, as the logistics of selling their house and packing up their ... we were both a little worried, truth be told. we were in good health and we had worked hard all of our lives. but we didn’t have much saved. we had helped my mother-in-law when she got sick and my wife’s brother had some mental problems so we always h... having only visited mexico once for a beach vacation at an all-inclusive resort, for grant and his wife the idea of relocating permanently to central mexico was daunting. but like many hesitant retirees they rented a small house for one winter to “try... grant went on to explain other things influencing their move: well, we knew a few people who went completely broke because of medical costs. and we were eligible for medicare and social security and our pensions and all, but we were still worried about some big medical cost wiping us out. everyone thought we wer... similarly, joanne, a sixty-nine year old widow from eastern washington said, you spend your whole life thinking you’re going to be ok. you will work hard then retire and rest, do what you want. but you never can imagine that you’ll live in fear, wondering if you’re one step—or one fall, ha ha!—from losing everything. i didn’t ... grant and joanne have good reason to worry about high medical costs. the american medical association reports that the biggest reason for bankruptcy in the u.s. is medical debt. this contributes to the creation of the new age-script of moving abroad i... cooper (2008) asks as one of her chapter titles in the new retirement, “have boomers saved enough for retirement?” (140) this and the myriad commercials, print advertisements, newspaper features, radio spots and internet pop-ups send the same, pointed... sixty-one-year-old william was sure that his retirement would be spent between his home in huddersfield, england and an apartment he would rent from january to april on the costa del sol in spain. he had already spent three winters discovering the ple... i thought i was pretty good in terms of my set up, ya know. i had my little house paid off, but my brothers, they were the ones who handled all the finances for the business and i trusted them. i still don’t think they did anything wrong, not knowingl... for more than 60% of my interviewees, the bottom line was a mix of economic strategizing and a lack of belief that “the system” at home was going to provide them with a desirable situation in which to retire and grow old. the “desirable situation” of ... my fieldwork with retirement migrants provided clarity on two critical points. first, these were not all globe-trotting individuals on a quest for a cosmopolitan place in which to grow old. most of them had travelled some as adults but did not conside... this was not my plan at all. but then i didn’t have one, did i? i started to imagine myself being put in some home, wherever they could find room for me, and all my control would be taken away, out of my hands like that. so, i decided that while i was... mary was very active with other british ex-patriates living in the area and she was tutoring local school children in english, providing her with additional income. she also said that she has a steady stream of visitors from england so is rarely alone... conclusion doing it yourself, or diy, signifies a great deal more than simply crafting or hand-making as a popular independent aesthetic moment. while the growth of the diy movement is solidly rooted in home and decorating activities, the ethos has spread to joi... anthropology & aging quarterly 2013: 34 (2) 184 this paper further explores international retirement migration (irm) as a calculative alternative to aging ‘at home’. specifically, the research examines why single women are retiring internationally, leaving behind their culture, friends and family. the focus here is on single women for three reasons. first, while much of the literature on irm includes demographic data on gender (king, warnes & williams 2000; warnes 2009; o’reilly 2002) there is very little focusing specifically on women.1 frances carp (1972), in her comprehensive look at retirement as a transitional life stage, wrote that social anthropologists could benefit from studying “sex differences in reactions to retirement” (129). oliver (2008) notes in her comprehensive study of british retirees in spain, most of the interviewees were married couples but among those who were not retirement abroad as women’s aging strategy married, women outnumbered men. examining single women’s experiences as international retirement migrants will shed light on how and why this might continue to develop as a single woman’s retirement strategy.  second, i was genuinely surprised at the number of single female retirees i encountered during my research and argue that these kinds of serendipitous findings offer researchers an opportunity to discover the rare, the outliers, that might end up becoming the most relevant and important finding. research is both planned and serendipitous. while i did not, in my research protocol, set out to focus on unmarried female retirees participating in irm, the data i collected is relevant and offers an occasion to examine with more care some of the gendered aspects abstract understanding the culture and lifestyle choices of retirees has never been so crucial. the aging baby boom population bubble means that by 2030 eighteen percent of the u.s. will be 65 or over. the lifestyle decisions of these individuals will have far-reaching implications culturally, politically and economically. since more women are living their post-retirement lives alone and in economically challenging situations, this paper examines the mobility of older women in the form of international retirement migration as a strategy to ameliorate levels of economic and general well-being. historically people have retired abroad for various reasons, but current practices suggest that retiring permanently in a foreign country has become an increasingly popular aging strategy. retiring abroad does not come without serious challenges, however, as the strains of navigating the aging process are interwoven with living in a foreign culture. based on research done in mexico, and southern france, this paper highlights the efforts put forth by aging women to avoid the welltrodden path of retirement before them and to forge a new path, choose a new homeland, and perhaps, reinvent themselves a bit along the way. key words: gender, aging, retirement, migration liesl gambold department of sociology and social anthropology dalhousie university silver linings: older people defying expectations anthropology & aging quarterly 2013: 34 (2) 185 liesl gambold retirement abroad just 13 % of men.5 the mobility of these individuals can have far-reaching impacts.  like tourism, international retirement migration streams can affect the economies and communities of favored retirement destinations, sometimes profoundly so, acting as a powerful form of direct foreign investment. retirees buy or rent homes, provide employment for local workers, consume goods and services, and may attract greater investments and more foreign visitors to retirement areas. for example, in costa rica foreign retirees contribute significantly to the $1.4 billion a year in direct spending by americans.6 as the baby boom generation ages, this stream is increasing in size. in 1979 dumont et al. wrote that “europe has a cancer” (14). that terrible invading killer was the aging of the french population, “la france ridée”, but far worse was the denial of the potential impacts that aging populations would have on europe (ibid.). there is no denying the aging of most of the nations in the western hemisphere.  the rapidly aging population has been seen as a potential disaster waiting to happen, too many too quickly which will overwhelm service systems and government funded care providers. in fact, some argue that the united states—and other nations struggling to provide adequate care for the rapidly aging populations—should negotiate agreements with willing partners to provide increasingly favorable opportunities to citizens willing to retire to the south (mead 2007; oppenheimer 2006). the impact of aging northern populations is being felt in multiple global sites as the historic south-north migration is partially being recast as a north-south trajectory of non-working seniors. ironically, this new pattern is characterized by many of the same elements which have inspired countless nationals from the south to move north, including the potential for greater economic well-being and stability, having access to healthcare, and the possibility of an overall better quality of life. the primary difference, of course, is that south-north migration patterns are motivated first and foremost by employment-seeking. in the latest reverse trend, retirees are seeking an accommodating place to not work, and some of these retirees are single women.  retirees in north america (sullivan 1985; otero 1997) and western europe (king, warnes & williams 2000; oliver 2008) have a long history of migration. while the most common trend has been temporary, seasonal moves, fleeing cold and damp winter weather in search of southern sun and warmth, historically there have always been a few outliers who chose to relocate permanently, leaving friends, family and familiarity behind. these retirement migrants were most often affluent (cooper 1996) or had formerly worked in some form of government (warnes & of international retirement migration. in both mexico and france i came across many women who had chosen to relocate alone in their retirement. the literature (mutschler 1992; cuba 1992; savishinsky 2000) and common sense both led me to believe that retired, single women were unlikely to move to a foreign country alone. despite the fact that most of the people i interviewed were part of a couple, the stories of the single women i met drew me in and begged further examination. understanding why single men retire in thailand doesn’t take much of a stretch of the imagination (warnes 2009; howard 2008),2 but trying to understand why a divorced woman from ohio moved to central mexico did, at least for this researcher. with serendipity what researchers do not know has the potential to become more significant than what they do know. one must pay attention to unexpected findings and assess the importance of this observation in relation to a particular research question, and to interpret what was discovered. the relevance of serendipitous findings can easily be overestimated, underestimated, denied or fabricated. i think that in the case of irm, the data presented here suggests that the salient features in these women’s decision-making processes will continue to impact more women in the near future, therefore making irm a calculative option for many.  third, single women outnumber single men in terms of current aging and retirement statistics, thus, due to their sheer number and the potential far-reaching impacts of their decisions, researchers and policy-makers alike ought to pay close attention to the context of women’s later life choices. there are more aging women than men in the united states, canada and the european union (u.s. census bureau; statistics canada; european commission) and more of these women live alone than men in the same age range. for example, in canada, 2011 census data showed that the share of the population that lived alone was fairly low and stable until about the age of 50 for women, and until approximately age 70 for men. after these ages, the prevalence of living alone increases for both sexes, but more sharply for women. among seniors aged 65 and over, women were nearly twice as likely to live alone—31.5% compared to 16.0% of men.3 older women are more likely to live alone in the united states as well. in 2012, only 45 percent of women aged 65 and older were married compared to 75 percent of men which impacts their living arrangements accordingly with 37.3% of women and 19.1% of men were living alone.4 similarly, according to the european union labour force survey for 2005, there are many more women than men aged 65–74 living alone, some 30 % in the eu as a whole (or rather in those countries for which data are available — i.e. excluding denmark, ireland and sweden) as opposed to anthropology & aging quarterly 2013: 34 (2) 186 liesl gambold retirement abroad certainly their social roles and relationships change. after having raised their children and without daily contacts with coworkers, many argue that older people may lose a critical context for social integration (cruikshank 2009). therefore, maintaining long-standing social contacts with friends and family are arguably critical for a retiree’s health and well-being (berkman 2000; lubben & gironda 2003). this could explain why long-distance migrations are mainly undertaken by married couples in order to ensure that one has at least one point of emotional support and contact (king, warnes & williams 2000; savishinsky 2000). in fact, in a review of the databases of six surveys carried out between 1995-2003, all studies agreed that retirement migration from north to south “is undertaken predominantly by couples” (casado-diaz, kaiser & warnes 2004:360). despite these cultural and historic conceptions of the aged and transnational mobility, as the world’s population grows older every day, retirees are motivated, and some might argue, forced, to forge new lifestyle pathways.  we are moving ever closer to the first time in history when the number of people over the age of fifty will be greater than those under the age of seventeen. by 2030 one billion people worldwide will be sixty-five or older. currently there are 506 million people over sixty-five worldwide. in light of such demographic shifts, one can only imagine that the expectations and experiences of aging, retirement and the “third age” are being rapidly transformed. it is not merely the size of the population that is recasting old age, but also the meanings given to it. this transformation of what it means to age is the result of intersecting contemporary realities such as the economic downturn of 2008? being experienced in many countries, neoliberal policies (polivka 2011), and the transformative effect the baby boom generation has had previously on each stage of the life course (gilleard & higgs 2002; jönson 2012; williams et al. 2007). however, while the generation as a whole will be entering and negotiating their retirement in ways unlike previous generations, women do face genderspecific aging challenges (barer 1994; dailey 1998), and consequently may be inclined to make unique retirement decisions. since the longevity of women results in them being dependent for longer periods of time on retirement income, the uncertainty of their economic and overall well-being is a real burden. the subtle shift from amenityseeking to economic retirement migration is fueled by seniors seeking an affordable full-time retirement, many of them women.  women face unique economic issues in their retirement years (meyer 1990). income from pensions is the major source of income for women in old age (cruikshank 2009), but the pensions women receive are lower than those of patterson 1998) or military service (karnow 2010) abroad and decided to stay or return upon retiring. while these kinds of migrations have happened in diverse areas of the world, due to proximity, and more recently the ease and low cost of air travel, permanent international retirement migration has always been and remains more popular in europe than in north america or other regions (zeltzer 2008). despite the complexity and variability of retirement migration routes, for the most part mobility patterns have been “channelized”, very predictable and limited to a few well-trodden destinations (longino 1998: 62). baby boomers have recently been stretching the parameters of potential retirement locations (zeltzer 2008; peddicord 2010). they are increasingly unable to afford, or uninterested in, the retirement scenarios of previous generations which resulted in enclaves of the aged in places like cannes and nice in france, and florida and arizona in the united states. these ‘amenity-seeking’ forms of retirement migration have closely resembled one another, wherein wealthy seniors moved to both maintain their high status lifestyle and also to enjoy the possibility of having a private swimming pool, playing golf year-round, hiring more domestic help, and crafting a life that closely resembled a permanent vacation.7 today, however, for seniors in disparate areas of the world and in varied states of economic well-being, experiences of affordable tourism, unbridled access to electronic banking and social media internet sites have contributed to a growing number of ex-pat retirement communities cropping up in places like malaysia (abdul-aziz et al. 2014; ono 2008; toyota 2006), costa rica (van noorloos 2011; zeltzer 2008), panama (wilson & crowder-taraborrelli 2013; golson 2008), thailand (howard 2008), dominican republic (zeltzer 2008) and nicaragua (egan 2011). in addition, russell (1993) argues that there are greater values for independence, the entrepreneurial spirit, and personal empowerment among middle-class baby boomers further facilitating a shifting international retirement scenario. despite the increasing possibilities for irm, however, transnational relocation is still not the norm.  significant, deliberate life changes such as international moves are typically not associated with the lifestyle of seniors. in fact, dr. robert butler, former head of the national institute on aging, has been quoted as saying, “the best place to retire is in the neighborhood where you spent your life” (cf boyer & savageau 1987:vii). even short distance moves are usually precipitated by a crisis of some kind; a developmental model of later-life migrations suggests that migrations of less than ten kilometers are usually motivated by the onset of frailty or ill-health, or the inability to live independently (litwak & longino 1987). the common western image of an aging person is one that reflects a general narrowing of scope. as people age, anthropology & aging quarterly 2013: 34 (2) 187 liesl gambold retirement abroad social security checks mailed to them at an address outside of the u.s.9 but as of 2011 anyone who applies for social security benefits must receive these benefits electronically therefore tracking the numbers of retirees living outside of the country is now all the more challenging. in addition, due to security issues in identifying its citizens, the u.s. state department ceased publishing demographic information on u.s. citizens living abroad as of 1999 (croucher 2012: 6; dixon et al. 2006: 23). depending on the source, estimates vary from 358,000 (using mexican census data, warner 2007) to at least 1,000,000 american citizens living in mexico (u.s. state department 2010). in 1997, the number of english citizens receiving their pensions overseas was 763,000 (king, warnes & williams 2000). by comparison, the number of french retirees receiving a pension outside of france was 63,396 in 2002 (attiasdonfut 2004). european commission researchers estimate that 5-6% of all eu pensioners leave their home country to retire elsewhere, but, similarly, they admit to having scant data on the actual numbers of retirement migrants and their final destinations. this is largely due to the issue of non-registration since the treaty of rome and the treaty on european union guarantee the legal right of eu citizens to reside in any member state. also troubling is the fact that in migration studies, the mobility of seniors has been both underestimated and under researched.  in addition to the economic difficulties women face as they retire and age, many are influenced by the drive for sustained independence that accompanies the neoliberal model for self-care. thus older women become coerced into self-reliance by government policies and societal expectations, a problem whose magnitude is inadequately evaluated by both feminists and gerontologists (cruikshank 2009). i deliberately frame this relationship in a somewhat contradictory manner to highlight its’ complexity. on one hand, women are cognisant of trying to maintaining their economic independence and agency as they age. on the other, they have little choice since the support offered by current state systems can easily be seen as insufficient. in fact, the failings of the neoliberal model and the erosion of the u.s. system of retirement security begs for a comprehensive overhaul of not only the infrastructural supports for retirees but also a recasting of the collective ideology around aging and seniors (polivka 2011). since any efforts to implement progressive economic and retirement security policies have encountered vigorous resistance, it appears likely that as baby boomer women age, they will be left to come up with creative ways to manage their retirement years (dailey 1998). in spite of the challenges faced with gathering reliable data on the rates of irm, most argue that it is increasing (attias-donfut 2004; warnes 2009; ono 2008; zeltzer 2008; oppenheimer 2006; croucher 2009, 2012) and i would argue that logically men. the main causes for the pension gender gap are that women earn less than men on average, work more often in part-time jobs and hold atypical contracts (tyson 1998; harrington meyer & herd 2007; cruikshank 2009). they are also more likely to work in the informal labour market, have interrupted working careers and retire earlier. women’s involvement in caregiving contributes to their disadvantaged economic position as they age. for example, current estimates suggest that 85 percent of eldercare in the united states is provided for free, by family members, usually women (eaton 2005). these conditions have an impact on women’s lifetime earnings, influencing the duration and level of contributions to their pension and the type of pension schemes to which they have access. as a consequence, income levels for older women in most countries are significantly lower than for men, especially single women. despite the long-term improvement in contribution-based pensions and the existing old-age allowances, aging women continue to experience higher poverty risks than their male counterparts, especially when over the age of 75. in the u.s., for example, older women were more likely than older men to live in poverty in 2010—11% compared to 7% respectively—(federal interagency forum on aging-related statistics 2012).  another recent trend impacting women’s retirement is the increase in divorce among those 55 and over. in the united states these so-called “gray divorces” have more than doubled over the past two decades (clift 2005; brown & lin 2012) while the overall divorce rate has decreased. more than 600,000 americans ages 50 and older divorced in 2009 (brown & lin 2012). thus, baby boomers increasingly are facing their retirement years alone, whether by choice or not, and these divorced senior women are more likely to be in a compromised economic position, and to remain living alone (savishinsky 2000).  aging and retirement affect men and women but also their family, the community and the state (conway & houtenville 1998; walters 2002). understanding the motivations and outcomes of single women choosing to retire abroad is critical, especially as more could be convinced that this is the best way they can live comfortably and fully retire. their webs of social contact both local and those left behind can be greatly impacted by their decisions as well as those making and managing aging and health policies. the channels of retirement migration can lead to similar channels of elder-care workers, thus impacting employment opportunities. it is difficult, however, to get a sense of the true scale of irm because the data available is partial and does not offer a reliable comparative of retiree experiences cross-culturally. for example, according to the social security administration’s 2012 annual statistical supplement over 450,000 retired americans have their anthropology & aging quarterly 2013: 34 (2) 188 liesl gambold retirement abroad  while research was conducted for only two weeks in san miguel d’allende, mexico, 5-6 hours per day were spent with various international retirement migrants outside of the time i spent interviewing research participants. i accompanied them on shopping trips, at their formal and informal gatherings with other foreign retirees, to the library, in their many volunteer activities, to religious services, and to the doctor.  in france, i lived in mèze, a small coastal village in the languedoc-roussillon region 25 minutes from montpellier. there were a few foreign retirees living in mèze but most were living in other small villages scattered in the inland areas where owning a property was more affordable. i spent most of my time with retirement migrants in and around the town of pézenas, 30 minutes inland from mèze, and known locally for the large population of british and other foreign retirees. once a week i attended the tuesday club in pézenas, a gathering open to anyone but developed and organized by british retirees. someone typically gave a short talk in english on that week’s topic, and then there were followed by refreshments and time for informal discussion. weekly topics included: “how to buy a car in france”; “property ownership in france”; “wines of the region”; “making stained glass”; “creating your last will and testament in france”;, and,; “french phrases and idioms”.11 there were also fieldtrips organized in place of some regular tuesday gatherings to visit local sites of interest. i met most of my research participants at the tuesday club but others contacted me through my posting in ‘blablablah’ or through snowball sampling.  since purposive sampling was used, the only requirement for participation was that the individual was a foreign retiree whose permanent home (at least 10 months out of the year) was in mexico or france. purposive sampling was justified because the goal of the project was to examine and understand the characteristics and experiences of retirees who had decided to move permanently to a foreign country. individuals who met that criteria and contacted me were generally invited to participate in an interview. my methodological goal was to take a processual approach to understanding these retirees’ histories. therefore, i opted at this phase of the research to look at the unfolding of the retirement abroad experience and “how [retirees] through their collective and separate activities reproduce and modify the realities of their past and present lives, elaborating features or losing them, enhancing their coherence or dismantling it” (barth 1993:8). we will see increasing numbers of single women choosing irm in the future. methods qualitative data for this paper were collected in several ways. methods hinged on using an interpretive research approach to explore and describe the range of plans, experiences and expectations for retirees who moved permanently to a foreign country. i started preliminary research in mexico for two weeks in 2009 and continued in france over seven months while on sabbatical in 2010. during this time many observations of international retirement migrants were made and 68 individuals were interviewed. participants were recruited through a convenience sample. first, retirees were recruited through websites and blogs aimed at providing information and support for current or potential international retirement migrants in mexico and france.10 second, an announcement was posted in the monthly publication, ‘blablablah,’ published by expat retirees and geared towards the anglophone population— retirees or tourists—in the languedoc-roussillon area of france. i interviewed a total of 68 individuals (53 in france, 15 in mexico), 39 women and 29 men. forty-two of the participants were married or with long-term partners, 8 of the men were single compared to 18 of the women (7 in france, 11 in mexico). all of the interviewees were white and came from a range of income brackets but were mostly middle to upper-middle class. participants ranged in age from 55 to 93.8 for the purposes of this paper, data analysis and description focuses only on the interviews with the 18 single women. closer examination of the comprehensive parent study data will be completed at a later date. photo credit liesl gambold anthropology & aging quarterly 2013: 34 (2) 189 liesl gambold retirement abroad findings while the idea of retirement migration might still seem exotic and appealing, the question remains; why would an older, single woman take the risks involved in leaving everything behind to move abroad? several themes emerged in this study, but here i focus on two factors that were particularly salient to the women i interviewed: (a) economic solvency, and, (b) what i am calling, “fear of the known”. economic factors people didn’t believe what i was going to do. but then, they didn’t understand either. i earned a decent living, but i couldn’t save very much and social security wasn’t going to support me. i had a sort of panic, and then i thought i just better do something. i had a friend whose sister moved to mexico so i thought i’d write to her and ask her about it. we sent some emails back and forth and i decided to visit about five months later. my daughters were older then. i just felt such relief when i saw what her life was like. i didn’t have the ability to rent a place as nice as hers, but i got my little two bedroom apartment, i can afford for maria to come twice a week to cook and clean for me, and i don’t worry about prices going up too much. i just felt this dread back home. life’s not perfect here, but i have never regretted my decision.  this is how sandy, a 67 year old woman from michigan, explained to me how her decision to move to san miguel de allende came about eight years ago. in her small but quaint kitchen, she told me of her 17 year marriage and her eventual divorce when she was in her early forties. as a then single mother, sandy tried to provide the best possible life for her two daughters, then 17 and ten years old. this meant budgeting wisely since her salary as an accountant for a small business just barely covered the basics. she had visited mexico only once with her ex-husband and while she enjoyed it, she could not say she really knew mexico. she did not speak spanish and “was not fond of spicy food, not one bit!” so sandy surprised herself when she found herself wanting to know more about her friend’s sister who had retired and moved to san miguel with her husband. i just saw myself daydreaming about it, ya know. when you don’t even realize you’re thinking something and then, well, there ya go again, thinking about the same thing over and over again. i guess i was starting to worry. about money and retirement and i just felt tired and worried. even though my daughters were gone, they were everything to me. and my sister and i are close, but she lived 6 hours from me and i don’t like driving that far anymore, especially in the snow! so i guess i thought i could just let myself think about it a   as longino et al. (2002) and savishinsky (2000) pointed out, one of the challenges of studying the migration decision is the fact that it is a process. for these women, irm was a process that they ultimately undertook alone. lamb argues that anthropology explores in-depth “particular people’s answers—within any cultural and historical setting—to abiding human questions” (2000: xiii) which supports the somewhat more biographical approach i took to understanding this particular facet of irm. one of the outcomes of the parent project was the collection of rich qualitative data creating a baseline from which future follow-up research will be done among these same participants. it is only through longitudinal research and analysis that we will improve our understanding of the international retirement process as it continues to unfold. some have argued that what has been missing from much of the debate about the aging population is a deeper appreciation of the values, aspirations and attitudes of the aged themselves (bishop 2005: 2). while attending to these areas, the research goals were also forward-thinking, creating an opportunity to examine the pragmatic and personal shifts that occured in aging abroad. such an approach warranted lengthy interviews combined with descriptive demographic data (age, gender, marital status, former living situation, basic work history, family structure).  semistructured interviews were conducted in person, which led to descriptive interpretations of the decisionmaking process and subsequent experiences of women who have retired internationally. topics included prior retirement strategies that might have been abandoned; feelings of being alone in their retirement; major influences in their decision to leave their home country; how they decided upon their current retirement location; the reaction of family and friends; barriers and benefits to international retirement migration; and their degree of integration with the local native population.  the interviews ranged from 0.5 to 2.5 hours in length. four of the interviews in france were conducted in french since the interviewees were of german and belgian descent and not as comfortable in english, while the remaining 14 interviews were in english. interviews were tape recorded with simultaneous written notes taken of key words and phrases to highlight and reinforce particular issues of importance. interview transcripts were reviewed and analyzed to identify key themes and observations which were then developed into categories. transcriptbased thematic analysis using unabridged transcripts was undertaken and themes and subthemes were coded in an instrumental way to interpret the data for the final analysis. the primary investigator alone completed all stages of the analysis. anthropology & aging quarterly 2013: 34 (2) 190 liesl gambold retirement abroad were a strong factor among seventy-seven percent of the single women i interviewed, and especially those living in mexico. most cited their low fixed retirement income as being a major motivating factor in considering migration.  dorothy, a 59 year old woman from idaho, said that she never saved for retirement. never really gave it much thought. i knew i had social security but no significant savings account or anything. my parents never talked about saving much money. they couldn’t because they had to feed the kids and anything my dad earned went into his business. he had a garage. he was a mechanic. so i worked all my life, as a school teacher, and suddenly, i was nearing retirement age and knew things would be tight. i lived ok before and took trips with a few friends. we liked to go to maine in the fall to see the colors. i went to vegas a few times. i did have a little house, but it wasn’t worth much and not many people were moving to such a rural area in idaho! i figure i had about $900 a month to live on and that just didn’t sound like much, especially if something bad came up medically. i never married. not lucky in love i guess…so i read a newspaper article about a couple who lived in mexico and i thought about it. i had never even been out of the united states, and here i am. i didn’t know i had it in me…but here my money seems like more than enough…i still live carefully, but i never worry about money. that’s a great gift at my age.  dorothy found a few people online who were living in san miguel and arranged a visit in the winter of 2004. a retired couple offered to rent her their spare room for two weeks. she described how nervous she was at first because of the language and the cultural differences. but after her hosts introduced her to other american retirees she began to see how they had made their new lives work and very quickly the far-fetched idea of moving by herself to mexico seemed more of a distinct possibility. in the late fall of 2004, dorothy shipped some of her belongings to san miguel and flew down a week later for good. i had a place to rent for a month and during that time i looked for my own place. oh, i had a lot of people to help me. everywhere you turn there’s someone who’s retired there from the states. they were so helpful. i didn’t venture out very far…i wanted to be close to the city center because i felt safer. i found my little apartment, two bedrooms, and knew it would be perfect for me. no more snow! i had to pinch myself. couldn’t believe i was doing this. but i pay $550 in rent and food is next to nothing here so i feel like for the first time in my life i have some money. i don’t do much with it. sometimes i go on little trips with some of the other women, and i even have some in savings. i almost wish i’d done it earlier, but i hadn’t really thought about it. little. no harm in that, right? well, be careful what you think!  when sandy decided to see for herself what life in san miguel was like, despite the fact that she felt relief when she recognized that she could have a different life, perhaps a better life, it was not an entirely easy decision. sandy had never considered irm and when she was married it was never discussed with her husband as a retirement possibility; “we didn’t really talk much about it. we were far off from retirement, but i imagine we figured we would just stay put. maybe some time in arizona during the winters if we could manage that.” living in a onebedroom apartment in san miguel, sandy cannot afford to go back to the u.s. very often to visit—she’s made only two trips in eight years—but one of her daughters and two friends have visited. contrary to the argument that “[t]he retirees who are most likely to relocate are those who have the fewest moorings” (longino, perzynski and stoller 2002: 45), sandy described her friendships at home as “deep and supportive” and showed me a small photo album filled with pictures from various social events with her friends at home. she was also an active member of her local church. despite having no complaints about her social support system back in michigan, upon retirement, sandy felt uncertain and worried.  retired women are more adversely affected by the current economic climate. according to the census bureau, two million women over the age of 65 hold assets, not including their homes, averaging just $7,754 (boak 2013). european and national studies point to the recent trends in pension reforms, and especially the tightening of linkages between benefits and lifetime contributions and the shift to diversified multi-pillar schemes which have slowed down the narrowing of gender gaps in pension benefits. on average, in the eu27, the gender differences in the at-risk-of-poverty rates in old age are even greater, reaching in 2008, 20.1% for women and 14.9% for men, due to women’s lower pension entitlements and expected longevity relative to men.12  longino (1998) suggested that we would see increases in retirement migration primarily among the upper-class baby boomers, but this prediction—a reasonable one before the unforeseen economic crisis—did not meet with the reality uncovered in this research. for single women, their decision to migrate was an economic strategy based on their already weakened financial situation, and they were retiring independently more than men were. in the lake chapala region in mexico a survey indicated that it was no longer the quality of amenities like golf courses and beachfront access luring retirees from north to south, but the lower over-all cost of living, namely affordable health care and housing (sunil et al. 2007). indeed, economic concerns anthropology & aging quarterly 2013: 34 (2) 191 liesl gambold retirement abroad doctor and setting up banking. in the end, none of these worries came to fruition since there was already a vibrant and visible population of american retirees in san miguel. the real estate agent who helped her find her apartment and made the arrangements for her utilities., sshe met other single retired ex-pat women very quickly who walked her through the rest of the necessary pragmatic adjustments, and she had extra money “to treat [myself] to a dinner out or something new for my apartment, which made [me] very happy. i felt free and independent!”  similarly, gina, 64, moved from ohio to san miguel de allende but had not planned to do so. her husband suddenly left her when she was 53 and since she had never worked outside of the home she had very little in terms of a pension. while married, she and her husband made occasional improvements to their home and had talked about how to further modify it to accommodate them as they aged. they had never discussed leaving when they retired. after the divorce gina stayed in ohio, downsized, and tried to begin rebuilding her life. she found comfort in her friends, her children and grandchildren, but she began to worry about her ability to live comfortably as her medical costs continued to slowly rise. she also had a close friend who had to declare bankruptcy after a prolonged illness left her with over $75,000 in medical bills. in 2005 gina took a “culture & arts” trip with a small group of friends to san miguel: some women in san miguel had experienced divorce later in life leaving them suddenly more vulnerable and fearful as they faced their retirement years while others simply felt that their finances would go further if they downsized. for a few, the prospect of leaving their homes and moving into a condominium or apartment “at home” caused greater stress than the idea of completely uprooting themselves and making a fresh start.13 janice, 68 and widowed for 19 years, explained: i knew i couldn’t stay in my home. i was alone, my kids all moved away and the house was getting harder for me to care for, especially the yard. there were some nice apartments around but i sort of figured, if i am going to move into an apartment, i won’t have much space to entertain the way i liked to and it just made me feel strange. i’d have the same friends and sort of be expected to do the same things, ya know, like potlucks and bridge club. none of my other friends were having to downsize and i just didn’t want to have to do all that and i was too young to move into a nursing home! better just to make a big move. well, a big move to make a small move!  only three of the women i interviewed said that they had thought of international relocation as a retirement option well before they retired and they were all british. while marjory, a 68 year old american in mexico, was somewhat adventurous in life, she never imagined permanently leaving her friends and family in oregon. she was single when she retired as a librarian six years ago. her son wanted her to move into a trailer on his property since she had very little in savings, and while she seriously considered this option, in the end she felt her life would begin to close down little by little if she did so. i knew that i would probably end up struggling once i retired but i also didn’t want to work until i was 70. i wanted to enjoy my golden years. i mean, you never know how much longer you have and even though i love books, i didn’t want to die in the library! i was married twice, but never married for money, so i never got rich in marriage or divorce. one day at work i saw a book called ‘retire in mexico on $700 a month’, and i thought, ‘i can swing that!’ so i planned a two week trip to san miguel and had rented an apartment before i left. my son thought i was going crazy, but all i knew is i would have sunshine and extra money at the end of the month.  marjory went back to oregon, packed her things and drove to san miguel de allende where she has lived ever since. she said the peace of mind she felt financially far offset the problems of assimilation. having no spanish language skills, marjory said she worried about getting settled and taking care of things like activating the utilities in her apartment, changing her car registration, finding a photo credit liesl gambold anthropology & aging quarterly 2013: 34 (2) 192 liesl gambold retirement abroad contemporary economic migrants that runs counter to the continued argument that increasing affluence is what has enabled more later-life international migration (howard 2008; longino et al. 2002). fourteen of the women referred specifically to concern over their economic well-being as being the most significant influence in their migration decision. cindy, a 63 year old retiree from north london, said that it was “all pounds and pence” which led her to france. she rented a small two bedroom apartment in rougan, not far from pezénas, where she’s lived for 4 years. “i just couldn’t think about staying in london and living like a poor person for maybe 25 years!” she explained. “i don’t need much—you can see i live very simply—but i never thought i’d work all my life and then have to stop having fun, like going to a restaurant or just being able to relax.” cindy was a former hairdresser, never married, and a single mother of two grown children. one of her clients moved to pezénas and after a visit, cindy began to think she could make such a move as well.  others with a more comfortable economic situation were more concerned with the possible long-term effects high taxation might have on their retirement years. helen, a 65 year old retiree from portsmouth, england explained, “in france you can have an income as a pensioner of almost €25,000 and your top rate of income tax would be 14 percent, whereas in the uk it would be 22 percent. so being a pensioner in france is pretty tax efficient for me since i am alone and if i live twenty more years i don’t think i’ll end up on the streets.” european union retirees benefit from more portability and sharing of healthcare costs. eu member states vary in the extent to which they allow the export of social security benefits but there are numerous bilateral agreements which give the citizens of one country reciprocal rights of access in the other (eu commission interview).in france, retirees receiving a state pension from another eu country are entitled to the same health benefits as french retirees and british citizens are automatically entitled to free basic healthcare in france as long as they have a european health insurance card. while financial stability weighed heavily on the minds of these and other female retirees, the interviews revealed a more surprising factor—high anxiety over a practically and socially-fixed future with very little individual agency. fear of the known the importance of financial security for retirees is predictable, especially among single people, but another more subtle anxiety the women expressed took me by surprise. more than half of them described feeling constrained by both internal and external expectations regarding their imagined trajectory in retirement. the vision of their futures and the dread that accompanied it i walked into a real estate agency and i’m not even sure why. i just asked about rental prices and suddenly i was looking at properties! they showed me a completely run down bed and breakfast and suddenly, and obsessively, i had to have it. i needed $30,000 so i borrowed money from my kids and my friends for the down payment then i sold my condo and used that money and savings to fix it up. even my friends who were on the trip with me and could see how nice san miguel was couldn’t understand why i would do such a thing. i just felt like i could simplify my life and live a good life and not sit at home worrying about whether i was going to die from natural causes or from poverty. of course my kids would help me but i didn’t want to burden them. they have their own families. i guess it was crazy, but i’m so glad i did it. i’ve never felt more alive!  while gina has paid for supplemental health insurance in mexico, she has not had any serious health concerns and said, like all of the others i interviewed in san miguel, that she receives excellent medical services at a reasonable price. she also said that the care was more personal and she appreciated that. however, all of the women in san miguel would be pleased if the u.s. and mexico could agree on a policy to extend medicare to american citizens in mexico. the fact that medicare benefits are not internationally portable, meaning that age-eligible americans living abroad cannot access the program without returning to the united states, was a complaint shared by retirees. many emphasized that a policy change providing medicare coverage abroad would benefit both american retirees and the u.s. government, since treatment in mexico and other latin american countries would cost far less than it would in the united states.  these concerns were similar to those of retired foreign women in france. sara and fay, (ages 62 and 69) moved from brighton, england to southern france in 2007 when fay, an academic, retired and sara, an artist, decided she could leave the arts community she had been a part of for so long. while these women had the benefit of migrating as a couple, they were faced with relying only on fay’s retirement pension—to which sara had no legal access should fay predecease her—and there were no prospects of seeking care or support from children as they had none. for these women, the decision had many complexities, but in the end was easy to make: we are economic migrants. we could get a lot more here for the little money and pensions we had. it was a simple decision when we looked at it that way. you have to eat. but we wanted to live, and eat. and we weren’t as worried once we knew we wouldn’t go broke for health services.  this calculative approach is an important feature of anthropology & aging quarterly 2013: 34 (2) 193 liesl gambold retirement abroad died of an illness, she asked herself “what do you want to do?” her friends in york encouraged her to volunteer and engage in other social activities with them, but she visited friends in pezénas and decided to move. she said, “i didn’t come down here for strictly financial reasons. i just felt like i needed to start over and i realized i was free to do that wherever i wanted. but it would have been harder back in england. too much baggage.” marie, 68, was a dental assistant in belgium before she retired to france. she divorced when she was 56 and while visiting her son who was at university in montpellier drove through the region on a short side trip. she said the sunshine and the countryside “lured” her in, but it was the possibility to truly create a “troisieme âge” on her own terms that helped her make the move: i was not interested in spending the rest of my years in the town where i was raised and had worked my entire life. i couldn’t see anything new for me, beyond new aches and pains! at least here, i feel a sense of wonder and discovery. i can always go back [to belgium] if i need to, but i hope i don’t have to. i’m learning and meeting new people and i actually feel like it’s good for my health…when i do visit my friends, i see what they’re doing and i know i made the right decision.  the older woman has, in the past at least, been seen as someone more settled, expressing her commitment to family through a reliable and benign maternalism, even as she ages and requires more support herself (see gannon 1990; rosenthal 1990). increasingly such stereotypes are being dismantled. spurred on by the burgeoning antiaging industries, new, successful and active aging are now an aspiration, if not expectation, of millions. while much of this creates an unwelcome suggestion that women ought not age, there is also the hint that one can age in many different ways (see jönson 2012). older women with the necessary economic, social, and cultural capital are now more likely to expend it on things like travel and acquiring new knowledge and experiences than on settling for an invisible retirement.15 the opportunity to delay the “narrative foreclosures” of old age or even reinvent what it means to be elderly is increasingly apparent as growing old no longer holds out the same definitions, or limitations, of gender identity and behavior. while this may facilitate a freedom in thought and action for some women, for others the discourse and cultural expectation of “active aging”, “positive aging”, and “prescribed busyness” (cruikshank 2009) feels restrictive (minkler & holstein 2008).  irm might be a response to this “new aging” regime insofar as it helps answer the question, “how do i achieve this in my current circumstances?” international migration certainly suggests a retiree who is reasonably active and an agent in her own aging process, as well was what i call, a ‘fear of the known’. as they reflected on the end of their formal employment or years of being a homemaker, many were struck with worry about this next phase primarily because it seemed to unfold along a fixed and pre-arranged path. retirement, giddens suggests, ought to be a segment of the life-course in which one is freed from “externalities associated with pre-established ties to other individuals and groups” (1991: 147), but these women foresaw a closing down of potentialities due, in part, to their pre-determined social milieus. friends who had already retired were anxious for them to join in their regular social activities never imagining that alternative scenarios might be desirable. denise, 70, from california, said: many of my friends were already planning their retirement and i had others who were retired. they were all saying how great it would be when i could play tennis on tuesday afternoons with them and go for chinese food on friday at lunch. i knew i could never say ‘no’ and i felt it would be better to make a clean break than be there and try to create a new life when there’s so much pressure to just do what everyone else is doing.  freeman describes this kind of fear as “narrative foreclosure” (2011:3) where an aging individual experiences a diminishing of options and a feeling of reduced agency characterized by a sense of, “dead ends, the point of no return, irrevocability, and existential despair” (ibid.). several of the women interviewed seemed more prone to such fears especially if they had divorced late in life. having occupied themselves with the needs of their children and husband they felt that their futures are retirees presented yet another role into which they were conscripted without many options; too late for a respectable mid-life crisis, too early for the nursing home. for denise, she loved her job in finance but retired relatively early. financially stable and quite independent, she was confused by the feeling of dread she could not escape as her retirement loomed; “i wasn’t so worried about not going to my office every day, but i certainly wasn’t excited about whatever else i was going to do. i felt like there was absolutely no mystery ahead, really not much to discover. not very inspiring, is it?”  the women i interviewed who tackled all of the hurdles to an international retirement expressed an appreciation for their new found sense of independence and the possibilities to reinvent themselves that would have been very difficult to achieve had they retired ‘in place’. this was particularly salient among women who had strongly identified as wives and mothers throughout their adult years. for example betse, a 62 year old living in pezénas, france, said that after her kids were gone and her husband anthropology & aging quarterly 2013: 34 (2) 194 liesl gambold retirement abroad past, but my new friends and neighbors don’t worry about it. they are experiencing me, and getting to know me without strings or baggage attached. that’s incredibly liberating at my age. it causes terror in some, who are so highly invested in their own past that they can’t imagine living without wearing it like a neon sign, but not me. not those of us who find ourselves here. conclusion this paper has argued that single women will make up a growing number of those choosing irm as both a calculative and sometimes reactive approach to unforeseen eventualities of retirement. using qualitative data on single women who have retired abroad, the paper thus contributes a female-focused perspective to the growing irm literature. while the data used represent only a fragment of data gathered for the larger parent study, the serendipitous discovery of these single women restructuring their retirement years abroad suggested a remarkable facet to the mosaic of the new old age. international retirement migration south is still not the norm for northern retirees, but it is growing and given the demographic reality of elder women in terms of total numbers, longevity and financial (in)stability, the pathways aging women choose to follow require close consideration. the women’s experiences presented herein reflect some of the typical concerns of retirees such as financial worries but also shed light on a form of agency rarely attributed to aging single women, that of migration in order to age unencumbered by the past and the expectations others held for them in the future. none of the women interviewed had planned to move abroad when they retired. in attempting to interweave the more ‘rational’ reasons for relocating (economic) with the sometimes more poorly defined or inconsistent (fear of the known) we are forced to recognize the potential that irm represents an interruption in the paths of these women as well as in our “tendency to assume explicit rationality on the part of potential migrants” (walters 2002: 43).  the rational-choice tendencies of many aging and retirement studies too easily lose sight of the suggestion that there has been, and always will be, a ‘new old age’ (jönson 2012) and that people can choose to age in unexpected ways. variations in geographic, political, economic, health policy, and gender schema constructs necessitate an acceptance of understanding that aging, retirement, and migration are all cultural constructs influencing the decisions individuals make. betty friedan said, “aging is not lost youth but a new stage of opportunity and strength.” for some of the women in my research, the portability of pensions and access to healthcare was important, but there was also a clear sign that they wanted to view their retirement as a as someone who is challenging the stereotypes of single retired women. however, it might also be seen as fitting quite neatly into ‘new aging’ “as a form of governmental rationality, a neoliberal geometry that maximizes individual responsibility…minimizing dependency and universal entitlements” (katz 2005: 146). outsourcing the elderly, while it would not work as a public health campaign, would work for some retirees and certainly for those government agencies already complaining that they cannot support the care costs of the baby boomers (oppenheimer 2006; rasalam 2008).  for peggy, a 73 year-old british woman who had been living in southern france for three years, these neoliberal discourses had created a subtle internal dread she was literally working hard to ignore. still employed in real estate, peggy explained that many of her friends in england said “oh, you must be looking for an adventure!” when she announced she was selling her house and moving to a small french village after a ten day vacation in the region. in fact, she had already begun to feel constrained in her life in england. one day after the tuesday club we sat in a café where she tried to untangle the path that lead her all alone from a reasonably comfortable life in england to buying a former post office which she would vow to make her new home. peggy was older than most international retirees when she arrived in france but she was active and in good health. she wanted to keep working but she also knew that she wanted to slow down a bit, but “once you start ‘slowing down’, people assume you need help, then you become a liability in a way. i didn’t want to be a worry. i didn’t really know what i wanted!” one thing she did know was that as soon as she saw a glimpse of the possibility to retire in france, she couldn’t imagine any other outcome for herself. while the example might seem insignificant, it signals a deeper sense of the inability peggy felt to reconstruct her identity as she aged: i didn’t need an adventure. i can make an adventure anywhere i go! i was happy. but i guess i also saw a bit of the end in sight, you know. you see more endings than you do beginnings at some point. it’s hard to explain, but i just felt free to experience things more and to experiment more here. for example, if i’d stayed in england i could have never started wearing hats, because amongst my friends and family, i was not a woman who wore hats. but once i got here i decided i wanted to wear hats. and i do. and i look quite smart if i may say so! sixty-eight year old thea, a german woman who retired in france, echoed this sentiment nicely: there’s no one hanging on to your past for you when you retire in a new culture. i would never lie about my anthropology & aging quarterly 2013: 34 (2) 195 liesl gambold retirement abroad references abdul-aziz, abdul-rashid, cheng-lit loh, and mastura jaafar 2014 malaysia’s my second home (mm2h) programme: an examination of malaysia as a destination for international retirees. tourism management 40:203-212. administration on aging 2011 a profile of older americans: 2011. allman jr, phillip h. 1981 a new form of international migration: us military retirees in central america. :134-149. attias-donfut, claudine 2004 new patterns of migration and transmigration a life course perspective. barer, barbara m. 1994 men and women aging differently. the international journal of aging and human development 38(1):29-40. barth, fredrik 1993 balinese worlds. university of chicago press. bekhet, abir k., jaclene a. zauszniewski, and wagdy e. nakhla 2009 reasons for relocation to retirement 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putting their fears and the judgements of friends and family aside. in doing so it seems they were able to gain a strong sense of independence and freedom and create their own silver lining in aging. notes 1. some notable work which engages a robust gender analysis includes howard 2008. 2.this intends no disrespect to howard’s (2008) work. his principle research method was an online survey aimed at “all westerners who lived or who had lived in thailand for at least one year” from which he gained 152 respondents who were retirees and “all but one [of these retired] respondent was male” (ibid.: 153). thus, his convenience sample was not diverse in terms of gender, but this reflects more the reality of irm in thailand than any lack of rigor in the research design. 3.statistics canada. annual demographic estimates. 2012. (http:// www.statcan.gc.ca/pub/91-215-x/2012000/part-partie1-eng. htm) 4. bureau of the census. the statistical abstract of the united states. table 57. marital status of the population by sex and age. 2010. (http://www.census.gov/compendia/statab/2012/tables/12s0057.pdf ) 5. eurostat, statistical book. 2008. 6. the costa rican government does not differentiate between retirees and long-stay tourists. 7. in the united states, new ‘channels’ of economic retirement migration have been developed resulting in tremendous growth rates of older populations in places like nevada, alaska, utah, and new mexico (frey 1999). 8.http://www.ssa.gov/policy/docs/statcomps/supplement/. 2012 9. see for example: http://www.mexperience.com/retirement/; http://www.fallinginlovewithsanmiguel.com/; http:// internationalliving.com/where-to-retire/; http://www.cremede-languedoc.com/languedoc-property/relocate-retire-france. php; http://www.aplaceinfrance.co.uk/retiring_in_france.htm 10. sometimes interviewing older people, especially regarding possible financial or emotional strains, can be emotionally tricky, but i should note that the interviewees were quite open and enthusiastic in talking to me. follow-up interviews, when necessary, were easy to arrange and many later engaged me in lively email exchanges upon further reflection of their paths to international retirement migration. furthermore, i have maintained casual email contact with all of the participants. 11. i was also invited to give a talk on anthropology and my research interests. 12. eurostat, statistical book. 2008 13. this was a sentiment shared by many of the couples i interviewed as well. 14. while i argue that irm is economically strategic for these women, i recognize that this kind of mobility does require some guaranteed level of retirement income out of the reach of many women. http://www.statcan.gc.ca/pub/91-215-x/2012000/part-partie1-eng.htm http://www.statcan.gc.ca/pub/91-215-x/2012000/part-partie1-eng.htm http://www.statcan.gc.ca/pub/91-215-x/2012000/part-partie1-eng.htm http://www.ssa.gov/policy/docs/statcomps/supplement/ http://www.mexperience.com/retirement http://www.fallinginlovewithsanmiguel.com/ 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migration: promises and potential, barriers and burdens. elder lj 16:211.lubben, james, and melanie gironda 2003 centrality of social ties to the health and wellbeing of older adults. social work and health care in an aging society:319-350. microsoft word 184-657-1-rv.doc research report advance care planning: training and providing an anthropological critique of cultural competence to health care professionals cortney hughes rinker department of anthropology, george mason university author contact: chughe13@gmu.edu megumi inoue department of social work, george mason university author contact: minoue2@gmu.edu rebecca vargas-jackson m.d., researcher-educator, george mason university author contact: rjackson@gmu.edu anthropology & aging, vol 38, no 2 (2017), pp. 4-9 issn 2374-2267 (online) doi 10.5195/aa.2017.140 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu hughes rinker, inoue, vargas-jackson | 4 advance care planning: training and providing an anthropological critique of cultural competence to health care professionals cortney hughes rinker department of anthropology, george mason university author contact: chughe13@gmu.edu megumi inoue department of social work, george mason university author contact: minoue2@gmu.edu rebecca vargas-jackson m.d., researcher-educator, george mason university author contact: rjackson@gwu.edu introduction “three days of horrible suffering, followed by death. that could happen to me at any moment, he thought…but then right away…the more customary thought came to him that this had happened to ivan ilyich and not to him, that this should not and could not happen to him.” leo tolstoy wrote this in his 1886 novella the death of ivan ilyich. set in 19th-century russia, the story traces the suffering of the high court judge, ivan ilyich, and details his ultimate death from terminal illness. he never gave thought to his death before having to confront it surprisingly one day. even though this novella was written over one-hundred years ago, tolstoy’s words ring true today with many people in the united states (and around the world) not wanting to discuss death in general and especially not wanting to discuss their own death with loved ones or health care providers. this lack of communication—while not universal—can be due to cultural taboos about death or just a fear of discussing what may not be known. there is a plethora of cultural beliefs and practices that need to be considered when talking about people’s wishes for end-of-life care, as different cultures and communities approach death and dying in a multitude of ways. with a population that is aging overall, there is little doubt that end-of-life care is an urgent, yet highly sensitive, matter in the united states today. this is in part highlighted by the vast body of literature on the topic, ranging from decision-making (luce and white 2007) to bereavement (schulz et al. 2003) to evaluations of end-of-life care in hospitals (chapple 2010). in 2010, the obama administration proposed that medicare could reimburse medical providers for discussing end-of-life options with their patients. just a short while later in 2011, end-of-life planning was removed under the medicare benefit for fear that it would encourage people to use advance directives to reject life-extending measures. we must note that advance directives (such as a living will or a durable power of attorney) are meant to document a patient’s wishes, which means there is a wide range of what they may state, from doing everything possible to stopping all aggressive treatments and providing comfort care to something in-between the two. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu hughes rinker, inoue, vargas-jackson | 5 research shows that end-of-life discussions between medical providers and patients do not occur soon enough, often leaving patients unaware of their options (kaufman 2005, silveira et al. 2000) or thinking—as in tolstoy’s account—that death cannot happen to them. one reason why end-of-life conversations may not happen as frequently or as early as they should is because death strikes at the heart of cultural, religious, spiritual, moral, and political beliefs. for some, it can be a difficult topic and emotionally fraught. given the united states’ population is truly diverse in many different ways, it is reasonable to consider how various communities approach the end-of-life. even within a single society like the united states, the ways in which death is discussed and end-of-life care is administered can vary and be influenced by cultural and social identities. advance care planning this research report is focused on a project that we put together and implemented around advance care planning (acp). acp is a process in which an individual will plan for future medical care in the event that they are unable to make decisions or speak for themselves (sudore and fried 2010). there are many other people besides just the person who is planning for future care involved in this process, such as health care professionals, family members or friends, and/or legal representatives. acp involves multiple methods, such as conversations, education, and officially documenting wishes for care in advance directives or more formally with an order from a physician, such as do not resuscitate (dnr) (sabatino 2010). it is important to recognize that legal requirements for documenting wishes can vary from state to state in the united states. acp is able to facilitate patient autonomy in end-of-life decision-making and can empower individuals to make their own choices about future medical care. it also allows them to document their wishes before they are unable to do so due to deteriorated physical or mental capacities that have resulted from a specific disease or advanced age. in light of this, acp is viewed as a key component of care that is person-centered and has been shown to improve satisfaction with health services and reduce anxiety among patients and loved ones (detering et al. 2010). however, a lack of acp due to personal, institutional, and/or structural reasons can be an obstacle to providing high-quality end-of-life care and can create tension or worry among staff and surviving loved ones when someone is approaching death (sudore and fried 2010). with support from the virginia center on aging (specifically the geriatric training and education fund), our objective was to address the general lack of acp and to help make the overall process a little more transparent by developing and implementing a training session for staff members at medicare/medicaid agencies—primarily nursing homes and assisted living facilities—located in northern virginia (and the d.c. metro area in general). these staff members are the ones who are mainly responsible for providing information on acp to residents or clients when they are admitted. there were two main components to the training: 1) clarify the purposes and functions of various types of acp and 2) enhance the abilities of the staff to communicate with their patients and residents regarding acp in culturally competent ways. as a multi-disciplinary team comprised of a medical anthropologist (hughes rinker), a professor of social work (inoue), and a physician and professor of public health (vargas-jackson), we each brought our own expertise and interests to the table while designing the training, which we ran on three separate occasions between march and may 2017. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu hughes rinker, inoue, vargas-jackson | 6 purpose and context of the training one of our aims for the training was to help the participants build their skills and confidence so they can effectively engage in acp with their residents, clients, or patients. we advertised the training to and designed the training for primarily staff at nursing homes and assisted living facilities in the region. since these are medicare and medicaid funded institutions, they are required to give their residents or clients written information about advance directives when they enroll; this is in accordance with the patient self-determination act (psda) of 1990. given this requirement, we wanted to provide staff with tools and skills they could use when having discussions about end-of-life care with residents or clients and with resources that could aid in the process of documenting medical wishes. northern virginia, which typically refers to the counties surrounding washington, d.c., such as arlington, fairfax, loudon, and prince william, has an extremely diverse population on many different levels. for example, we conducted one of the three training sessions at a nursing home and assisted living facility in may 2017 in prince william county. this county’s population has increased 43% between 2000 and 2010, and this is in part due to migrant growth. over half of the residents of the county identify as african american, hispanic, asian, or another minority race/ethnicity. the county’s hispanic population is roughly 22%, which is higher than the state of virginia and the united states in general. in addition, nearly one-third of the population in prince william county speaks a second language besides english. similar demographic trends can be found in other counties in northern virginia too. in fairfax county, where george mason university is located, approximately 40% of the 1.1 million county residents who are over the age of five speak a language other than english at home, with the most popular language being spanish (13.2%). those who identify as asian/pacific islander (not hispanic) make up the second largest ethnic group in the county after those who identify as white (not hispanic). the counties in northern virginia have higher than average median household incomes, as compared to the united states, with loudon and fairfax counties being two of the counties with the highest in the whole country. however, as economists and anthropologists both have already illustrated, wealth is not always distributed equally in many communities (farmer 2003); some people reap a majority of the benefits and have increased access to resources, while others are excluded—this also holds true for the region. given the diversity of the population, it is critical that local health care professionals at medicare and medicaid funded agencies, as well as at other types of care facilities, are aware that there are many different perspectives on issues related to acp. these perspectives are molded by people’s unique cultural and social backgrounds. this does not just mean race, ethnicity, and language must be accounted for, but also education, religion, family dynamics, and economics, among other factors. we designed this training with the intention of helping the staff develop their abilities to communicate with residents and clients, as well as with families or loved ones, in sensitive ways that are attune to both cultural differences and similarities. training structure together, the three of us developed a training that drew on literature in anthropology, public health, social work, medicine, and the social sciences relating to issues of acp, but would be relevant to a professional (not particularly academic) audience. we attempted to make scholarly research and theoretical concepts from within these fields applicable to everyday health care practices, but without losing sight of their rigor or significance. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu hughes rinker, inoue, vargas-jackson | 7 the training was multi-disciplinary in that we each facilitated one section of it given our areas of expertise: inoue discussed the purposes and benefits of acp and the different types of documents involved, such as advance directives, dnr, and physicians orders for scope of treatment (post), and also presented some of the challenges that have been documented in having these completed. vargas-jackson discussed health literacy and the need for care that meets residents or clients where they are as well as stigma in health care. and finally, hughes rinker presented ethnographic examples from her own research as well as anthropology that related to culturally competent care at the end-of-life. combined the three sections made up the three-hour training. we facilitated three identical sessions, two of which took place at george mason university with attendees coming to campus. the third session took place at the facility in prince william county that was discussed in the previous section. integrating a critique of cultural competence into training design and implementation anthropologists have already masterfully demonstrated that cultural competence is not easy to define and have pointed out that there is an overall lack of a standard definition in medical education— even though it is a key concept in contemporary american medicine. baker and beagon (2014) observe it is often reduced to referencing ethnic and racial minorities, which leaves out other cultural and social forces and excludes certain populations who may need other considerations or have different types of needs. furthermore, it denies the fact that people “belong to multiple cultures, but those cultures are neither coherent, static, nor do they always join together seamlessly” (baker and beagon 2014, 581). arthur kleinman and peter benson write, “one major problem with the idea of cultural competency is that it suggests culture can be reduced to a technical skill for which clinicians can be trained to develop expertise” (2006, 1673). this critique of cultural competence was a theme that wove together all of our presentations in the training. we were able to unfold this critique to participants by offering examples from our research projects, the literature, and even our own personal experiences with acp and end-of-life care. for example, hughes rinker, whose latest study is on the diverse experiences of sunni muslim patients and families in the d.c. area during serious illness and end-of-life care, pulled two particular examples from her interviews that were contradictory. in one, the muslim middle eastern son of a dying patient was much appreciative of the opportunity to speak with a muslim physician at the hospital about his father’s condition, and gave his medical opinion more credence than the other non-muslim providers. in the other, a daughter was happy to find out that the attending physician at the hospital was muslim, like her and her elderly mother, who was originally from east africa and was actively dying. she was going to be transferred to hospice soon after the interview. but then, after meeting with this physician several times and discussing her mother’s condition, she said, “i realized he’s not muslim like me. then we had [another physician] who is not muslim and we liked him a lot more. he was more in line of what we wanted for our mom.” just within the two examples from hughes rinker’s project, the attendees were able to see that cultural competence does not always mean matching patients and families with providers who may identify in a similar way, but there are many other dynamics and beliefs that must also be taken into consideration. they also demonstrated the complex relationship between religion and culture that is not cut-and-dry. these examples, and the discussion among participants that ensued in the training after they were presented, may also point to the narrowness of cultural competence as it is usually applied in medical practice—as baker and beagon (2014) call our attention to in their work. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu hughes rinker, inoue, vargas-jackson | 8 at the same time, we had to balance this critique of cultural competence with emphasizing the actual importance of providing health care that is attentive to various social and cultural factors. culturally competent care is regularly described as part of offering high quality health care in the united states (saha, beach, and cooper 2008). such care is also viewed as patient-centered and as treating the whole-person, rather than isolating health and the physical from their social and cultural contexts. anthropologists have previously shown that the physical and the cultural cannot be separated and frequently work together to create unique illness experiences (kleinman 1988, shapiro 2011). one aim of the training was to encourage participants to think more about how individuals (and even themselves) interact with the u.s. health care system and how acp unfolds across different spaces, times, and relationships. we also considered some of the individual and institutional challenges that acp involves. while in our presentations, we stressed the need to offer culturally competent care—particularly in a diverse region like northern virginia—we also wanted to caution against stereotyping or assuming that because a resident or client identifies in a particular way culturally, socially, or demographically, they will hold a particular set of beliefs or want particular types of services (kleinman and benson 2006). at one of the trainings, a participant, who helped coordinate the session and advertised it to her staff, made the comment that this was one of the most salient parts of the training. she said that in health care, it is important to understand that even though a patient population may identify in a similar way (whether it be first-language or ethnicity, for instance), this does not mean that there is complete homogeneity among them and they have the same health needs or wants. final thoughts overall, the 34 participants who attended one of the three trainings were receptive to our multidisciplinary approach. through the examples that they shared during our discussions, it was evident that the cultural critique resonated with their experiences with acp in their daily work. there was little disagreement among the participants that cultural beliefs and practices are key to how their residents or clients made decisions about end-of-life care and how they approached acp in general, but yet they also saw how other factors played an equally important role in their decision-making, such as financial resources or religious beliefs. we believe that the multi-disciplinary training was able to provide these health care professionals with a more holistic view of cultural competence and a better understanding of the vast diversity within particular patient populations—as kleinman and benson (2006) note, there is no “typical” patient within any racial or ethnic group. additionally, after we completed facilitating all three training sessions, we found that participants had better recognition that cultural competence is in fact a collaborative and learning process between providers and patients or families, and one of the first steps necessary is just being open to listening and learning from others and accepting that there are multiple ways to view the body, care, and death. anthropology & aging vol 38, no 2 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu hughes rinker, inoue, vargas-jackson | 9 references baker, kelly, and brenda beagan. 2014. “making assumptions, making space: an anthropological critique of cultural competency and its relevance to queer patients.” medical anthropology quarterly 28(4): 578–598. chapple, helen stanton. 2010. no place for dying: hospitals and the ideology of rescue. walnut creek, ca: left coast press detering, km., ad hancock, mc reade, and w. silvester. 2010. “the impact of advance care planning on end of life care in elderly patients: randomised controlled trial. bmj 340(c1345). doi: 10.1136/bmj.c1345. farmer, paul. 2003. pathologies of power: health, human rights, and the new war on the poor. berkeley, ca: university of california press. kaufman, sharon. 2005. and a time to die: how american hospitals shape the end of life. chicago: university of chicago press. kleinman, arthur. 1988. the illness narratives: suffering, healing, and the human condition. new york: basic books. kleinman, arthur, and peter benson. 2006. “anthropology in the clinic: the problem of cultural competency and how to fix it.” plos medicine 3(10): 1673–1676. luce, john m., and douglas b. white. 2007. “the pressure to withhold or withdraw life-sustaining therapy from critically ill patients in the united states.” american journal of respiratory and critical care medicine 175(11): 1104-1108. sabatino, charles p. 2010. “the evolution of health care advance planning law and policy.” the milbank quarterly 88(2): 211-239. saha, somnath, mary catherine beach, and lisa a. cooper. 2008. “patient centeredness, cultural competence, and healthcare quality.” journal of the national medical association 100(11): 1275-1285. schulz, r., ab mendelsohn, we haley, d mahoney, rs allen, s zhang, l thompson, and sh belle. 2003. “end-of-life care and the effects of bereavement on family caregivers of persons with dimentia.” new england journal of medicine 349(20): 1936-1942. shapiro, j. 2011. “illness narratives: reliability, authenticity, and the empathetic witness.” medical humanities 37(2): 68-72. silveira, maria j., albert dipiero, martha s. gerrity, and chris feudtner. 2000. “patients’ knowledge of options at the end of life: ignorance in the face of death. jama 284(4): 2483-2488. sudore, rebecca l., and terri r. fried. 2010. “redefining the ‘planning’ in advance care planning: preparing for endof-life decision making.” annals of internal medicine 153(4): 256-261. wiener, joshua r., and jane tilly. 2002. “population ageing in the united states of america: implications for public programmes.” international journal of epidemiology 31(4): 776–781. _laufinalbr book review review of douglas wornell. sexuality & dementia: compassionate and practical strategies for dealing with unexpected or inappropriate behaviors. demos medical publishing: 2014. pp. 200. price $17.95. janice y c lau the chinese university of hong kong anthropology & aging, vol 39, no 1 (2018), pp. 117-118 issn 2374-2267 (online) doi 10.5195/aa.2018.188 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.188. http://anthro-age.pitt.edu lau | book review 117 book review review of douglas wornell. sexuality & dementia: compassionate and practical strategies for dealing with unexpected or inappropriate behaviors. demos medical publishing: 2014. pp. 200. price $17.95. janice y c lau the chinese university of hong kong the purpose of this monograph is a comprehensive guide for generating understanding, and more importantly, provoking insights into and awareness of providing compassionate strategies regarding sexuality of demented patients in the context of care. the volume begins with an overview of sexual behaviors in connection with different dementias. it then discusses issues and challenges confronting families, nursing home staff and primary care doctors in dealing with unexpected sexual behaviors, and ways to support both patients and the people around them, both medically and psychosocially in the subsequent chapters. the book, divided into two parts, starts with five chapters exploring the breadth of sexuality of patients living with dementia, and the relationship dynamics created with the people around. the introduction points out the common occurrence of sexual behaviors among these patients that exemplifies wornell’s reason for choosing the topic. in chapter 2, wornell brings together a range of patient stories that are examined in depth, while suggesting ways to support patients and families who are disturbed by the changed intimate relationships. chapter 3 addresses the effects of neurobiological changes on sexuality. what follows is an illustration of how stronger bonds are built between families and patients as the healthy family members come to better understand the complex changes that have led to the behavioral challenges. chapter 5 presents the impacts of sexuality and dementia on others, which is more relevant to nursing care settings and highlights the difficulties, dilemmas and ethical issues confronting families and care providers in dealing with sexual expressions. the remaining chapters (6-10) offer a medical perspective on current approaches in managing inappropriate sexual behaviors in people affected by dementia. chapter 6 begins with an outline of a spectrum of age-related dementias that focuses on their risk factors, symptoms, treatment and prevention. chapter 7 discusses genetics, toxin, brain injuries or infection as contributing factors for young-onset dementias, as well as how they affect one’s sexuality. chapter 8 further widens the readers’ horizons towards an understanding of how factors such as delirium, drugs and other substances can bring about uncontrolled sexual behaviors, which must be considered during the process of evaluation. chapter 9 proposes some practical steps to support nursing care staff in managing sexual inappropriateness in longterm care dementia residents, as well as a detailed summary of treatments across various domains of medical knowledge and therapies, which are useful tools to prepare someone for advancement of their professional practice. in conclusion, wornell raises his concern of how the best interests of these patients, who lack decision-making capacity, can be served in face of personal interests of others and changed moral beliefs. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.188. http://anthro-age.pitt.edu lau | book review 118 authored by dr. douglas wornell, a geriatric neuropsychiatrist with profound expertise in supporting geriatric and neuropsychiatric services in long-term care facilities in the us, the greatest strength of this book is an attempt to emphasize the use of humanistic approach where compassion in care may serve the new and positive direction. wornell grounds its theme in the real world through his clinical experiences, medical knowledge, research and storytelling. the facts, stories, reflections and strategies are neatly interwoven together that successfully engage and communicate with his readers. wornell is able to re-create the scenes of stories and bring them to life, where multiple perspectives from different people resembles a coherent narrative. these stories are short yet thought-provoking and emotionally inspiring. wornell intents on reassuring readers that having sexual symptoms among this population is not uncommon, and that it is possibly supported by available treatments and therapies. this volume contributes to promoting a taboo-free discussion on sexuality and dementia in the community, and developing positive, supportive, and proactive attitudes among carers. by treating everyone as individuals and each situation as unique, the sharing of his consultation experiences also contributes to raising awareness among healthcare professionals about the need for prioritizing patient-centeredness. the short stories perfectly display the qualities that health providers should have, i.e., to observe, to actively listen and to ask the right questions in order to formulate appropriate strategies to support care. considering the demographic makeup in the us though, the work lacks a discussion of impacts of cultural values on carers in coping with the situations, practices in nursing homes, and policies. given that the lay readers may not be familiar with the scientific jargon, wornell writes with clarity and uses life examples to relate them to the scientific context. the scholarly work is therefore readable for both the professionals and the general public; family carers, nursing home staff, social workers, physicians, nurses, and sex therapists can all gain great insights from it. in all, this volume shows wornell’s immense care towards his patients, fueling his readers a desire for positive changes. anthropology & aging quarterly 2013: 34 (2) 199 introduction witchcraft beliefs are a part of every day life in ghana and a part of aging in ghana as well. this is typically not a problem for older adults, in a country where the connotation of the english word “old” is more positive; a colloquial term for translating, “i am old” means “i have grown” (van der geest 2005). in addition, older adults who are known to have the wisdom that comes with knowing witchcraft are more often feared and respected rather than feared and abused (awedoba, personal communication 2005, van der geest, 2002). on the other hand, older women marginalized within family systems are vulnerable to attack and even abuse. the national and international media have reported on horrific cases in which older women were murdered as suspected witches (e.g. smith 2010). follow up reports then focused on “witches’ camps,” to which the accused may flee for protection where they are also effectively imprisoned if family and/or community refuse to let them return. there a r t i c l e s no peace in the house: witchcraft accusations as an “old woman’s problem” in ghana alexandra crampton department of social and cultural sciences marquette university are no national statistics on the scope of this problem, and reports counting numbers of “inmates” apparently trapped at shrines and in camps vary from hundreds to thousands. the national government’s commission on human rights and administrative justice (chraj) publishes a census of inmates and accompanying children in four of the camps but these reports offer contradictory numbers (e.g. chraj 2009; quason 2009). a general estimate of 1,000 inmates seems to be the most stable number for the six camps typically used for statistics (e.g. whitaker 2012). the unhcr, the united states state department and the u.k. border control address witchcraft accusations as a human rights problem. their reports are used in assessment of asylum cases from those either accused of witchcraft or accused of inflicting witchcraft (schnoebelen 2009; uk border agency 2013; u.s. department of state 2012). since the 1990s, nongovernmental organizations (ngos) have implemented projects to address witchcraft abstract in ghana, older women may be marginalized, abused, and even killed as witches. media accounts imply this is common practice, mainly through stories of “witches camps” to which the accused may flee. anthropological literature on aging and on witchcraft, however, suggests that this focus exaggerates and misinterprets the problem. this article presents a literature review and exploratory data on elder advocacy and rights intervention on behalf of accused witches in ghana to help answer the question of how witchcraft accusations become an older woman’s problem in the context of aging and elder advocacy work. the ineffectiveness of rights based and formal intervention through sponsored education programs and development projects is contrasted with the benefit of informal conflict resolution by family and staff of advocacy organizations. data are based on ethnographic research in ghana on a rights based program addressing witchcraft accusations by a national elder advocacy organization and on rights based intervention in three witches camps. keywords: older women, witchcraft, ghana, advocacy, human rights, development anthropology & aging quarterly 2013: 34 (2) 200 alexandra crampton no peace in the house violations broadly and to “free” or assist camp inmates. the long-term impact, based on research and assessments by reporters and advocacy workers, is unclear at best, and those with sustained involvement have softened from a focus on rights violations to a more culturally sensitive approach of family conflict resolution. the purpose of this paper is to provide anthropological analysis of witchcraft as an older woman’s problem that has not been well solved using rights-based intervention. data presented are from a larger ethnographic study of elder advocacy work by a nationally based ghanaian ngo between 2003-2005. i call this organization ghanaian aging resources (gar). specific data on witchcraft accusations and elder advocacy are from gar’s rights program and field research on intervention work in three of the camps in the villages of gambaga, kukuo, and ngnani, which are located in the northern region. updates on rights based intervention are provided through results of an internet search yielding about 100 documents in the form of governmental reports, ngo sources, and news stories published between 1996 and 2013. findings build from work by sjaak van der geest (bleek 1975; van der geest 2002b) on how witchcraft is part of aging in ghana, and add data on elder advocacy intervention. rights based intervention work attempting systemic change has not been effective but is becoming a common part of public discourse and life in at least one witches’ camp. as such, i argue it is an evolving form of cultural practice linking global audiences to local contexts that cannot simply replace local moralities and social response. what has been more effective advocacy is to work from within cultural norms through informal conflict mediation among family and community systems. background the anthropology of aging in ghana study of aging in ghana began with the work of nana araba apt in the 1970s (apt 1996, 1993, 1971; see also van der geest 1997). subsequent work has continued to examine what it means to grow older in ghana in the context of extended family, culture, and socioeconomic contexts (aboderin 2006; brown 1992; stucki 1995; van der geest1997; 2006). a common proverb both in the literature and in conversations about aging with people in ghana identifies the importance of interdependent relationships: “just as the elder helped you as you cut your first teeth, so must you help them as they lose theirs.” in other words, aging is not characterized as an individual as much as a social experience very much dependent upon reciprocal relationships and demonstrated respect (van der geest 2002a). the rights of young and old are not stressed as much as the responsibilities accorded to social roles within extended family systems. older adults who have “done well” over the life course financially and socially have supported younger generations, and then can expect to be supported in return as they reach old age. even as they may become weaker physically, they are valued for their wisdom accumulated through life experience. as one elder explains, he is happiest when the younger generations seek his advice (van der geest 1998). in addition to wisdom through accumulated life experience, older adults are also associated with knowledge of potentially destructive knowledge glossed as “witchcraft” in english. they may be feared for having this power and thus treated with respect. they may use this power to curse another and bring misfortune. this attribution can also be a form of social sanction by accusers for not sufficiently sharing resources when another seems to have acted selfishly or succeeded unfairly. as in other african contexts, these accusations can be analyzed as interpersonal conflicts of jealousy and also as intergenerational power struggles when youth accuse elders of preventing success within families and communities (auslander 1993; bleek 1975). in zambia in the 1980s, for example, youth led by a self-appointed witch finder conducted village “cleansings” in which older adults and especially older women were prime targets. the cleansing temporarily subverted local power dynamics but elders eventually regained power (auslander 1993). although both women and men may use witchcraft, the association between women and witchcraft is particularly negative in ghana and other african contexts (druckerbrown 1993; hoch-smith 1978). accused women include those who are unusually successful or unsuccessful. scholars interpret this as meaning women are sanctioned for any deviance from social expectations, which includes following a cultural norm of subordination to men (amoah 1987; drucker-brown 1993). as in the media accounts of violence, those most vulnerable in witchcraft accusations are late middle aged, post-menopausal women and older women. these accusations are not necessarily serious. as van der geest found in a study of witchcraft accusations within an extended family system in the 1970s, accusations among family members not only target the elderly, and rarely become more serious than gossip (van der geest, personal communication, 2005). in follow up research focused on aging in the mid to late 1990s, a respondent explained the dynamics of witchcraft accusations within family systems, and his regrets as a young man: if an old woman is in the house and the young in the house don’t prosper, they will regard her as a witch. anthropology & aging quarterly 2013: 34 (2) 201 alexandra crampton no peace in the house but if the young in the house are successful, they won’t regard the old woman as a witch. if old women use witchcraft for the success of their children, it is referred to as good witchcraft, bayi pa. people seldom mention it even when the term is mentioned. it is said as a joke, but the young in the house constantly insult those with bayi bone (bad witchcraft) and on some occasions they even threaten to attack them… most of the accusations are not true. the young do it because they are desperate. when they face difficulties they tend to accuse the old wrongly. when i was young and struggling in life i used to insult my mother whenever i got drunk and i constantly accused her of witchcraft… it is like when you have lost an item; you think of everyone as a thief. (kwame opoku quoted in atuobi et. al, 26) as expressed in this quote, the associations between age, gender, and witchcraft may be positive or negative. implications are found in relation to individual and family functioning rather than on age and gender in isolation. the anthropology of witchcraft in ghana witchcraft has long been of interest to anthropologists of africa, and ghana has hosted some of the disciplines most famous scholars, such as jack goody (1967, 1962) and meyer fortes (1945, 1940). this is in part because witchcraft is part of spiritual beliefs and practices that permeate much of daily life in ghana within a multicultural region of many ethnic groups and multiple languages. quoting from an anthropologist, anthony appiah explains spiritual beliefs persist from, “being born into a culture with ready-made patterns of belief which had the weight of tradition on them,” and that this tradition includes witchcraft (appiah 1991, 117). witchcraft is hard to explain and beliefs vary but it is generally believed in ghana and across west africa to be a term to explain how misfortune and loss are caused by one who has inflicted evil as illness, accident or death (simmons 1980). one may acquire witchcraft intentionally as a “medicine” or may unconsciously receive it from another witch (drucker-brown 1993, 533). in other words, not all witches are aware they have this power or how they acquire it. at the same time, there are positive constructions of witchcraft as a power to bring good fortune to oneself, which is mainly criticized if that good fortune is at the expense of others. a common proverb is used to explain that only people close in kinship ties and geographical proximity can cause harm, which is that it is “the insect in your cloth that bites you. “ very generally, one who is accused or fear they have the witchcraft may consult a shrine. a shrine priest holds power to divine who is a witch and to ‘dewitch’ through medicine and ritual. typically the shrine priest is an older male who has the same witchcraft powers but uses them for different purposes (drucker-brown 1993, 534). in gambaga, the village best known internationally having a “witches’ camp,” there is no shrine but the chief has the power to render witches harmless. he performs the divination and offers the necessary ceremony to “dewitch” if the person is guilty. he does not require the accused to remain in the camp after they pay for the dewitching but in practice lack of “peace in the house” in the home village may mean that the accused cannot return with or without a finding of guilty. lack of peace refers to unresolved strife within a “house” that is typically several houses clustered within an extended family compound. as argued by geshiere, witchcraft accusations are part of the “dark side of kinship” (ciekawy and geshciere 1998, 4), given that accusations are only among close family members. the camps then become a place of refuge if peace cannot be restored. as described by karen palmer, a journalist who studied the camps over several months in the mid 2000s writes, “accused women took their demolished reputations and hid themselves at the witch camps, since they knew no other remedy for the anger and violence that came with the accusation” (palmer 2010, 216). witchcraft beliefs have been studied both as an explanatory theory and as a means of social organization (stewart and strathern 2003). in particular, the “witchcraft idiom” (van der geest 2002b, 450) is a way to answer existential questions about misfortune and loss. as explained by e. e. evans pritchard, it helps explain not necessarily the material aspects of why something happened, such as the underlying illness that caused death, but rather why a particular loved one had to be the victim at that particular time (evans-pritchard in appiah 1991, 117-119). as a means of social organization, victor turner famously described the “social drama” (turner 1972) that may erupt due to underlying tensions of kinship and competition that are then blamed on an outsider. witchcraft accusations are a way to surface interpersonal conflicts, air grievances, and then restore social relations to a more harmonious whole (stewart and strathern 2003, 4). in this process, a moral order is challenged and then affirmed. this structural-functionalist view came under criticism within anthropology as the durkheimian assumption of social harmony as a norm was replaced by greater attention to how conflicts may not simply serve to stabilize social systems. moreover the seemingly isolated ethnic groups studied as self contained groups in the typical village study were in fact part of modernity and larger colonial projects of governance and political economy (comaroff and comaroff 2003). social tension underlying witchcraft accusations can be linked to unequal incorporation of villages and regions into capitalist market systems (e.g. anthropology & aging quarterly 2013: 34 (2) 202 alexandra crampton no peace in the house parker 2006). contributing factors to accusations against a family member then may require understanding what paul farmer refers to as the “structural violence” of poverty and social inequality (farmer 2003). anthropologists study witchcraft beliefs and accusations as stabilizing and destabilizing forces within colonial and postcolonial contexts of conflict and socioeconomic change. as todd sanders explains, “african notions of witchcraft are neither archaic nor static but are highly flexible and attuned to the conundrums of our contemporary world” (sanders 2003, 338). witchcraft is thus a way in which people interpret and construct modernities as well as seek to resolve tensions and misfortune within modern contexts (sanders 2003, 339-340; simmons 1980, 447). this is important to consider in asking why the camps are located in northern ghana, which is a region historically deprived of development investment and yet used to support a southern based economy through colonial and postcolonial government policies (drucker-brown 1993). witchcraft accusations against older adults have not been a sole focus in these studies. in ghana as in other parts of sub-saharan africa, accusations tend to be among kin but are not exclusively imposed on older adults. for example, susan drucker-brown studied the mamprusi in gambaga (drucker-brown 1993). the famous gambaga witches’ camp was formed during precolonial (and pre-written recorded) times. her fieldwork was in the 1960s with a follow up in 1991. she writes that most of the women inmates had been banished there in late middle age, were widowed, and that most were now older adults. the local term for the camp is pwaanyankura-foango, which translates literally as, “old ladies section” (drucker-brown 1993, 535). she noted that most but not all of the women were old. in the 1960s, few of the inmates were mamprusi, and people in the village were not afraid of the witches who came from the surrounding region. in 1991, however, she found that most of the women were now mamprusi and people told her that, “witchcraft had become more frequent and more serious” (drucker-brown 1993, 539). this parallels research in other parts of sub-saharan africa in which anthropologists find that witchcraft concerns rise with rather than recede with benefits and stresses of modernity (ciekawy and geshiere 1998, 3). her analysis of the situation in 1991 and changes since the 1960s focused not on age but on gender. she argued that the basis of the accusations was in gender relations and attempts to restore a patriarchal order in the face of socioeconomic changes that had allowed women to make more gains and for men to lose resources. some of the accused living in the camps had been unusually successful, and some were vulnerable within family power dynamics and thus easy to attack. traveling to gambaga and interviewing nineteen women in 2006, yaba badoe reached a similar conclusion (badoe 2011). the intersection of gender, age, marital status, and children led her to note that, …those most vulnerable to witchcraft accusations were widowed women in late-middle age, who were forced to move back to their fathers’ houses after the death of their husbands; successful businesswomen who headed their own households; women without children to provide them with leverage within the extended family; and women without an adult male brother from the same mother to protect their interests in the extended family (badoe 2011, 42). jon kirby links gender and age with political economy in a 2004 essay in which he describes how ngo work to empower youth and women had been fueling witchcraft accusations by men left out of development projects (kirby 2004, 1). in these analyses, tensions fueling social drama come from the vulnerability of women without male allies in extended family systems within the stress of inadequate and uneven development interventions. rights discourse on witchcraft as a social problem in ghana in contrast to a small number of academic studies on aging, gender, and witchcraft accusations, there are hundreds of articles printed and reproduced through national and international media on the plight of women, mostly older women, attacked, banished, and murdered as witches. stories collected for this article were published between 1996 and 2013 but drucker-brown suggests media interest was already strong in 1991 (druckerbrown 1993, 537). the majority of these articles were written within a rights discourse that also informs much of the advocacy work on this issue around the country. the gambaga camp serves as the icon for representing witchcraft beliefs as a social problem and rights violation against women, particularly older women (for a dramatic example, see sosywen, n.d.). as icon, the construction of the camp is one reminiscent of colonial era village studies in the 19th century. that is, the camp supposedly exists within an isolated village that seems lost in time. here, traditional beliefs control people’s lives. few outsiders have traveled so far to discover surprising insights of how modernization has not yet reached this place. ignorance is the source of elder women’s marginalization and abuse. the camps are a national disgrace within ghana and a global human rights violation. demands are made to disband the camps and return the women to families. poverty is named as the root of the problem—poverty of education, of resources, and of the ability to rise above anthropology & aging quarterly 2013: 34 (2) 203 alexandra crampton no peace in the house supernatural thinking. development is then the answer, in the form of education and development assistance. modernity is not the problem but rather the solution. as such, rights discourse potentially serves the self-interest of government agencies and ngo organizations soliciting development funds. they become the self-appointed sources of “awareness creation” through conferences and the production of educational posters and brochures. they argue that public education will change beliefs in part by enlightening communities of scientific explanations for illness and death. at the same time, the characterization of the discourse for this review has been simplified for the sake of brevity. it is not monolithic and is subject to change through engagement with publics in and outside of the camps as well as intervention projects. the point is that media representations of witchcraft as an older woman’s problem omits the more complex power dynamics and socioeconomic contexts in which accusations arise, and isolates the problem as self-evident rather than as subject to interpretation and negotiation. my research indicates far greater ambiguity and complexity in linking age, witchcraft and abuse as a problem demanding formal intervention by the government and ngos. research design, methods, and results are next presented. methods research design and study sites the data used in this paper were collected as part of a larger cross national study of elder advocacy projects piloted by a nongovernmental organization in the u.s. and one in ghana. i called them american aging resources (aar) and ghana aging resources (gar). in both projects, the dominant research methods were participant observation, ongoing informal interviews with key informants, semi-structured interviews with program participants, and document examination of materials used as part of the program. in both sites, i was able to literally participate initially as a mediator and mediator trainer due to a request by gar that i offer skills rather than merely conduct my own research. this entry to research, then, was like that of anthropologists who work as consultants in the organizations they study (see strathern and stewart 2004). mediation training and project development was followed by data collection for research purposes as my role changed from participant to observer. in both sites, this data collection followed the methods of legal anthropology to ‘”follow the ideas” (starr and goodale 2002, 64-5) underlying intervention rather than to focus on individual case analysis. these ideas included old age as a social problem, witchcraft accusations as an elder rights problem, and rights work as a solution. in ghana, i chose additional sites in which to observe mediations as conducted by ghanaians who were trained by americans but not by me. one was a legal aid board that hears cases diverted from court. i also extended my focus to a legal rights program because the mediation project was ideally going to become part of this program. the project was funded from 2004-2006 with a focus on three types of rights violations against older adults; property disputes, disinheritance of older adults, and witchcraft accusations against older adults. the legal rights program generally solicited “legal challenge” cases that could be used to uphold existing laws or challenge those that discriminated against older adults. there were also two urban and two rural sites targeted for community meetings and educational “awareness creation” about rights. i studied the rights program through examining awareness creation documents, such as posters, and traveling to each of the targeted community sites. i lived in village k for three weeks and village m for a month. data were collected with irb approval. although witchcraft accusations had already been identified as a problem by gar, it was located by many in conversation and in the press as a problem experienced by others—for example, those in other parts of the country or with less formal education. in addition, the legal challenge program yielded no cases during the study period. the one case in the program between 2004-2006 was a property dispute. in order to expand data collection on witchcraft and older adults, three witch camps were added as field sites. gar has never worked in these camps so that my gar affiliation as a mediation consultant was less relevant than my affiliation with the institute for african studies at the university of ghana as a researcher. i was, however, immediately recognized and assigned a role as curious outsider with questions similar to those of travelers, journalists, ngo professionals, and rights activists. this brought a second problem, which ann-elise riles refers to as the ‘insideout’ problem in her study of a women’s network (riles 2004). the problem is when one studies a practice that is already familiar, that comes already analyzed. in her study, the problem was that she was already familiar with networks because this was part of a familiar cultural norm. her task, then, was how to make the familiar strange by looking at spaces between the more obvious variables for data collection. in this study, the camps have been so often visited that they are new to outsiders but the outsiders are all too familiar to insiders. i therefore focused on understanding the sources of this familiarity and insider perception of outsider visits, particularly in trying to anthropology & aging quarterly 2013: 34 (2) 204 alexandra crampton no peace in the house intervene through ngo work. data from visiting the camps and interviewing government officials and ngo staff who have been engaged in intervention work was updated by internet searches of reports and intervention work since 2005. searches were conducted using terms gambaga, witch, witches, witchcraft, and ghana in proquest, lexisnexus databases as well as google. this document review included ten government reports, a unhcr analysis (schnoebelen 2009), an ngo research report (houde n.d), a research report by a journalist (badoe 2011), and over seventy-five news articles dated between 1996 and 2013. karen palmer’s journalistic account of the camps published in 2010 helped verify and add data about the camps and intervention work solutions from the 1990s through 2006. limitations the main research limitation was time for fieldwork. because witchcraft accusations were not the focus of the larger study, there were only three weeks of data collection in the region hosting the camps. within two trips to the northern region, seven days were spent in direct data collection in the camps within three weeks that included interviews with government officials, pastors, and ngo staff based in the cities of tamale, yendi, and bimbilla. and, while english is the official language of ghana, there were several local languages used in these field sites that were not mastered. mediations at the legal aid board were generally in english but sometimes in one, two or three additional languages. interviews at the camps required a translator. the more specific focus on witchcraft accusations was difficult to study. this was in part due to stigma attached to admitting one’s spiritual beliefs are real when talking to academics (or as academics). in ghana, many people of all levels of education believe in the supernatural and in witchcraft but hide this from outsiders who might disdain these beliefs as exotic and false. formal interviews and survey research can lead to unreliable results, as is described in the results section. i therefore relied upon the serendipity of ethnographic research, in which chance encounters and informal, ongoing conversation provides better data. these data were recorded as field notes and then used in subsequent conversations in effort to best achieve “interpretive validity” (fetterman 1998) of the data. results lessons from gar i first learned of witchcraft in relation to the potential mediation program. it was in the context of helping me prepare for a mediation training as requested by gar in 2003 by offering an example of a potential mediation case. the example was a past case in which an adult son had accused his mother of being a witch and kept her “in a structure.” gar staff were unable to convince him to change his mind or take better care of her but they were able to negotiate to provide her with food and clothing on their own. the focus of staff attention was similar to that of professionals who intervene in elder abuse cases in the united states, in which the problem is a neglectful or abusive caregiver who is therefore both the problem and the ideal source of solution. when i returned in 2004, gar had secured funding for the rights program previously described from an overseas ngo for a grant period from 2004-2006. there were no witchcraft cases in this program during the study period. the observable parts of witchcraft in the legal rights program were educational materials produced for “awareness creation.” for example, one had an old man as a wizard covered by a red circle and slash. the text read, “old age is not the start of witchcrafting.” when attending a community meeting in village m where the posters were distributed, the reception was muted. this reaction is probably related to how members of the village had already told the ngo that they did not need assistance. i was told that they had their own internal system of settling disputes and did not need the intervention of a rights program. at the same time, when asked directly about accusations, a key informant first described how a nephew had accused an aunt within her family and then how she had been accused on occasion. however, she was the head of the extended family, and expressed this more as an annoyance than a serious problem. witchcraft accusations also did not seem to be a common preoccupation for older adults requesting gar services and was not an obvious part of agency activities at the main office or in the communities where they worked. i did collect one more example of witchcraft accusation, which was narrated as follows: a gar woman was accused of being a witchshe had donated land on which a church was built and a visiting pastor told the congregation she was a witch and it has ruined hershe has lost friends, people won’t buy firewood from her, etc. and the church is trying to say it’s anthropology & aging quarterly 2013: 34 (2) 205 alexandra crampton no peace in the house not their fault, it was a visiting pastor but (volunteer) said that the people there must have had some agenda against the woman and used an outsider to come in and condemn her so that people would believe it and believe it coming from a pastor and so gar has asked to bring the visiting pastor back so he can say it is not true. in addition, of the dozens of settlement cases observed at the legal aid organization, there was one case involving an older woman and witchcraft. the head of the family explained that the woman who had owned the property was accused of being a witch by a younger family member, and that is why she left that one out of the inheritance of property and room. this statement brought a shocked reaction from the room, and the young family member’s lawyer protested that this accusation was not relevant to the case, but one of the legal aid lawyers replied that it was relevant if it was related to the inheritance issue. these brief examples suggest that witchcraft accusations happen within a context of conflict and contest. they can be quite serious, involving elder abuse and financial loss. they may also remain at the level of family rivalries and gossip. as narrated to me, each case implies a false accusation unfairly used against an older woman. while the formal program did not yield a legal case to submit in court, gar staff used informal methods of negotiation and conflict resolution to help in cases brought to their attention. funders of the rights program rejected requests to include this type of mediation into the rights program, which was focused on identifying cases for court rather than conflict resolution. the lack of information substantiating severity of a problem of course may simply indicate need for more data collection. in order to learn more, i traveled to the one area of ghana in which one was guaranteed to find problems of witches, age, and gender. this turned out to be a wellworn path in a region of the country historically neglected by development efforts by the colonial and postcolonial government. the extra attention given more recently to gambaga was welcomed, criticized, and resented. successful advocacy for the inmates came through more informal and long term efforts to resolve family tensions and negotiate return. lessons from camps my first trip began with gambaga. “we get people like you all the time,” was the general response i received upon arrival. this was evident from the numerous signs posted to advertise the good work of usaid and ngo projects. gambaga was hardly an isolated village trapped in time but was rather the ongoing recipient of outsider beneficiaries and travelers. i located an ngo guesthouse. the staff first criticized me for bringing a young man as a translator and then introduced me to a replacement. hawa, a woman who is mamprusi and has lived in gambaga, became translator, guide and friend during this trip and my return to the village about one month later. the first step was to meet david, who ran an ngo sponsored by the presbyterian church called the gohome project. although david no longer works there, and the ngo project ended in 2009, the church’s ministry had been the only longstanding intervention presence in the camp. this ministry to the accused witches began in the 1960s, and the go-home project was established in 1994. camp census numbers recorded between 1994 and 2009 ranged from 52 to 128 women (houde n.d, 29). the project provided charity, such as funds for school fees, and income generating projects but the work stressed to me in 2005 was about family conflict resolution. david acted as a social worker to investigate cases, meet with families, and negotiate return. investigation included whether the person was married, if any children were grown or not, if family came to visit whether the relationship seemed cordial, and if there was family back home who would care for her. as david explained, he visited the families to find out if people back home were not happy and/ or likely to kill her. david also assessed whether they were “wild” or angry. sometimes he was successful, and reported the project had helped 300 women. he provided a positive image of sending the person back and having a big gathering with the chief in the village. however, when yaba badoe filmed two of these returns in 2006, she highlighted how the women seemed to be unwelcome (badoe 2010). she also noted that all but one of the nineteen women she interviewed had some ongoing contact with family (badoe 2010, 42). david complained of how outside groups come from the capital and only stay a short time. he was particularly angry at a national women’s legal organization, whom he said only came for one day and used his report. when cnn came a few days later, he refused to give them the report. when i asked about an anti-witchcraft poster david had in his office, he said dismissively, “that’s just awareness creation.” after we talked and he gave me instructions on how to be sensitive to the chiefs concern about bad press, i had dinner with hawa. during dinner, she told me of how she was once bewitched by an aunt and then recovered. anthropology & aging quarterly 2013: 34 (2) 206 alexandra crampton no peace in the house the next morning, i followed the next expected step, which was to greet the chief and seek his permission to interview the women. the chief answered my questions curtly, and narrated the common origin story of how he became guardian of the witches. that is, some generations ago, people fled to a local imam for protection from persecution and in fear of their lives. because this matter concerned traditional beliefs, the imam told the gambaga chief that he should look after them. the current chief, therefore, inherited this responsibility along with the ability to detect and disarm witches of their powers. conversation with several women willing to meet me was awkward. my impression was that the women had a short but precise agenda to protect themselves by protecting the chief and the go home staff. for example, when asked about growing older, one response was, “it’s good to grow old here in the camp because the chief takes care of us.” and in response to asking, “why are you here?” came the response, “because there is no peace in the house.” the interviews were a repetition of typical responses already published in blogs and news stories. each woman had been falsely accused through blame for an illness, accident, or death. there was enough ongoing tension in the family that they were advised by a chief or determined on their own that it was better to stay in the camp. in asking hawa about why published stories are so uniform, she replied that most seemed to get details “from the outside.” outside in this case both refers to people living outside the village as well as people with outside agendas, such as ngos that are trying to establish themselves through intervention projects. “you can not believe and you can not not believe” hawa continued to help bridge the gap between a staged trip and what the realities might be for people living in gambaga. on this trip and on the second trip, we talk about witchcraft along with her friends and family. one person explained that witchcraft is used to “progress.” sometimes, people are merely jealous and use witchcraft to prevent progress in others. white men, however, have used witchcraft to create things like tv and cell phones. in other words, witchcraft can be positive and negative. apparently, younger women are more likely to stay in the camps temporarily and then leave. people have more faith in rehabilitation for younger people. sometimes younger people simply have more strength and willingness to leave the area completely and move to the capital. whether those accused of witchcraft actually stay has a lot to do with whether they have any other place where they can go. in addition to the witches, others also come to live in the camps. sometimes, children are sent to live with the witch and help them out. this continues a common cultural practice of fostering young children among family members. in a different example, a man followed the woman to the camp and tried to help her return with the help of david. she was not accepted but they married and eventually settled outside the camp. the popular image of total banishment and isolation turns out to be more complex in practice. young children sent to care for the accused also benefit from funds given by the gohome project to pay for school fees. the local hospital no longer charges for visits. the banished are then ironically resented for charity received. as one informant cynically commented, “the ngos are happy they (the women) are there” because they are so popular as a source of donor funds. hawa also told her story of bewitchment a few more times. the story begins with an unexplained and persistent illness. she is having panic attacks. she seeks help from the hospital and was given medication for heartburn. when she returns to the hospital, she refuses the medication because it is the same as before. in one version, she was sent to live with the chief for a year. in most versions, she has a dream in which her aunt drives a stake into her chest, exactly where it hurts. initially, her father resists accusing the aunt but hawa is not getting better. in one version, the aunt has already been accused of bewitching another family member. although the woman protests that she is not a witch, her daughters say things that indicate they know she is guilty. five chickens are killed, and all of them indicate guilt. the woman then confesses that she has taken hawa’s spirit and turned it into a cockroach. the insect is in a jar in the garbage dump. the jar is found, proving the truth of the confession. the aunt stays for a short time in the camp, is “dewitched,” and returns home. hawa sleeps well for the first time the night after the conviction and does not have major health problems after that. as she says of her experience, “you can not believe and you can not not believe.” i also walk around town and talk to more people in the presbyterian church. in tamale, i had met a presbyterian pastor who had served in gambaga before the camps “gained so much attention.” he made a point to say that the women had been among his best parishioners and he also noted that sometimes they believe they are witches. for example, they talk of cooking people and eating them. arguments sometimes come up about whose turn it is to kill and gather the meat. in gambaga, the pastor mentions that he offers exorcisms in the church, but the women remain segregated within the church. although the women can walk freely about town, many keep their anthropology & aging quarterly 2013: 34 (2) 207 alexandra crampton no peace in the house distance from others in public spaces, such as markets and church services. another common attitude in town seems to be that while there may be some who are wrongfully accused and are innocent, there are also those who are guilty and would be very dangerous if not kept there. “our names have traveled to places we have not been” i met with government officials and ngo workers in larger towns and cities of bimbilla, yendi, and tamale. however, the information i learned was not substantially different from that found in the rights discourse of intervention work. i also visited two more camps. the protocol for both ngnani and kukuo was similar in that i needed the help of a translator and i also needed to first seek permission to talk to the “inmates.” kukuo was described as more of a “clinic” for people to be cured of witchcraft and leave. unlike gambaga, it was not a camp that had been created for witches but over time so many additional people had come to live there that it was becoming a town that included witches who were not segregated but part of the settlement. a newspaper article in 2011 recorded an ngo census of 130 women and 171 children (selby 2011). ngnani is a much bigger camp and has both men and women. as many as four to ten people arrive each week but many also return within a week. i was told overall numbers are hard to know since some leave “so early… or (stay) forever.” the numbers had increased quite a bit in the wake of ethnic conflict between the dagombas and konkonbas in 1994. the result was a large number, this time, of dagombas. an ngo estimate as reported in a 2011 news article was 750 women and 400 children (selby 2011). as previously mentioned, these census numbers are estimates taken at one point in time. in addition, estimates of age can be difficult given how uncommonly older adults in ghana know their age by when they were born. rather than ask for exact ages, my colleague asked for the age of respondents when ghana became independent from england in 1957 to help with estimation. there happened to be a divination in progress when we arrived, and we were allowed to observe. the basic activities were those already described in the literature the focal point is when a bird is pierced and everyone watches as it dies to see which way it falls. if it dies face down, the person is guilty, and if face up, the person is innocent. the first bird indicated guilt, and so the woman protested and the ritual was repeated. unfortunately, the second one was the same. there followed a sort of pause. everyone seemed to accept the outcome. in these conversations with twenty women in ngnani and one leader in kukuo, i’m told that there is more concern about witchcraft that in the past, and more false accusations. i also learn more about family ties, as recorded in my fieldnotes: the family brings you or you bring yourself. once you are old, you need protection and seek help from the god at the shrine in dagbon, when you become old, likely they accuse you, you don’t have to wait and go for protection and some stay and beat them. ...once they are here, they are under the protection of the shrine. you go here and take medicine at the shrine. if your family is strong, you are sent back to the community. otherwise, find an old lady for you to stay with and you move in. the family collaborates with community members to put up the house (where you live). the family provides material, the people around help to build it. the family might come with a child and prepare food and help. ... there is still a link (to family). especially if you came here voluntarily, the family will follow up. some of the women were there because they had followed when their mothers were accused of witchcraft. over time, it was easier for them to stay. as in fieldnotes, due to the conflict in 1994, she moved to yendi but her mother was in camp and so she came to assist her mother. she was with her mother when her mother died, and now she is also old. so, she will stay. if she goes back, she may face problems. she has been here for five years and was a child during independence. when asked about ngo work, replies were that groups and individuals sometimes come. they usually only come once, donate some things, and then leave. there were no ngos in particular, but in the past they had received a grinding mill, public latrines, help fixing roofs, doors, food, blankets, clothing, mats, and cotton for spinning. although most were not aware of media stories, one translated response was, “some time ago, they came and shot pictures and later those on radio heard stories and voices of colleagues and they were happy, realized their names have gone far—even to where they had not gone.” the camps are a complicated site for ethnographic work given the range of interlocutors and familiarity with the iconic representation of witches camps as a rights violation. however, even a brief visit revealed how there is more variation in accusations and aftermath than the simple politicized story of an old woman wrongfully accused of loss or misfortune, who is then permanently banished by ignorant family. there is a disproportionate number of older women living in the camps. gambaga and kukuo only have women, and ngnani and kptinga anthropology & aging quarterly 2013: 34 (2) 208 alexandra crampton no peace in the house have a very small number of men. this does not mean that only old women are accused but rather older women who are unable to resist accusations are also unlikely to have resources to leave if the family will not take them back. the women may first arrive as daughters or grandchildren expected to support the accused relative, and then have to stay. “awareness creation” versus “bringing peace in the house” the camps are attractive as a human rights problem to tackle and yet sustained engagement is rare. awareness creation takes place in conferences held far from the camps, and through sporadic public presentations that are unlikely to change deeply ingrained beliefs that seem to explain otherwise unexplainable loss. political struggle over resources, whether at the micro level of families or the more macro level of communities are unlikely to be resolved through lectures or brochures. existential questions of why one person succeeds while another fails or falls ill are not really answered by rational or scientific explanations. the “dark side” of kinship is not simply eradicated by passionate speeches against ageism or sexism. these explanations could be reasons why a women’s legal aid organization raised funds to “free” the witches in 1998 but most of the women refused to leave. one who did return had her ear cut off and came back to the gambaga camp with a warning that the other ear would be cut off if she attempted to return again (ameyibor 1998). bringing peace to ensure a safer return requires greater engagement, time, and persistence. the few examples of successful intervention learned through gar and through the go-home project were examples of informal conflict resolution. this requires direct engagement with perpetrators of accusation and abuse that might result in partial rather than total victory. similar to the dilemma of working with families in which there is elder abuse in the united states, this requires working with those who caused harm and who may feel they are victims rather perpetrators. gar staff, for example, were not able to convince the son that his mother was not a witch but they were able to provide her with food and clothing. accepting spiritual beliefs while trying to address dimensions of abuse is also consistent with culturally sensitive gerontological and social work practice. another culturally sensitive dimension to this intervention is to use mediation. that is, a common response to interpersonal conflict in ghana is to seek a third party who can fairly assess the situation and advise but not impose a solution (lowy 1973). the mediator role is to convene meetings for communication and reconciliation. gar staff and david became mediators when asked, and also negotiated to play that role in seeking to bring peace in families and communities. successfully negotiating return may not be the last step in helping to bring security. when karen palmer followed up to visit a woman who had returned after decades as a leader in the gambaga camp, she found a woman whose health and physical functioning had declined considerably during the year of her return. she commented that perhaps the woman was eating less well than in the camps due to sharing scarce food with children and grandchildren (palmer 2010, 223-4). return from the camps and follow up research in 2013 after returning from the camps, i realized that belief in the supernatural was far more common than seemed obvious before i left. the reality of witchcraft was taboo in most professional settings, such as academic seminars and in ngo work. the very real beliefs in witchcraft came out indirectly, such as a comment by a staff member that perhaps they could work in the camps since i had demonstrated an ability to go to the camps and not return a witch. gar staff often narrowed the legal rights program from witchcraft to witchcraft accusations and then to false accusations leveled against older people as easy targets in the midst of personal or family misfortune. this focus is a point of compromise for those who believe and who cannot not believe. and, respect for the elderly in ghana can be demonstrated through outrage against false accusations by perpetrators of elder abuse without changing general belief in witchcraft. as one professional explained, “they will not accuse an older woman who is successful but accuse the one who is poor when it may be someone else who is the witch.” in 2005, the internet was a way to research some basic information about the camps through u.s. state department reports and numerous news stories. in 2013, there is far more material. it has developed into a more uniform discussion of human rights abuses and the need to solve the witches problem through intervention in the camps. what were scattered statistics in government files i reviewed in 2005 are now published online in government reports. the reports appear to offer clear, unambiguous numbers that are in reality very hard to verify and always subject to change. these reports include the age, gender, and number of years spent in the camps for each inmate as well as children living with them. recent crises in the u.k. over children killed as suspected witches (morrison 2012) anthropology & aging quarterly 2013: 34 (2) 209 alexandra crampton no peace in the house may be a part of this newer focus on child targets. without a follow up visit to the camps, it is hard gauge if intervention work has brought greater change than was apparent in 2005. there is nothing in the news media or rights reports indicating significant change. palmer’s more in depth accounting of intervention efforts does not include sustained successes. however, there is one significant change in status of the village inmates. in 2012, a news agency reported that politicians had visited the camps to solicit votes from the witches (salifu 2012). this is a remarkable example of how the women are not simply subjects of intervention work but also treated as citizens who vote. conclusion there are two social realities explored in this paper. the first is how witchcraft is part of aging in ghana. review of past scholarship and data from this study indicate that while the rights-based interpretation of particularly horrific cases is understandable, these cases are not representative of how witchcraft beliefs more commonly shape older people’s lives. witchcraft is used in explaining successes and harsh losses, and can be regarded positively and negatively. older adults who have this kind of wisdom may be feared and respected for having an ability to curse. at the same time older women are far more likely to be attacked by witchcraft accusations in verbal abuse, as in the man who would get drunk and call his mother a witch. these accusations are not necessarily taken seriously, and may be forgotten over time. in their intervention work, ghanaian rights advocates are keen to highlight problems not of witchcraft beliefs but of false accusation. in fact, what seems like rallying against superstition can be interpreted as a means of upholding cultural values that respect older adults. rather than focus on witchcraft accusations as an older woman’s rights problem, a more useful approach may be to address harmful accusations as a form of elder abuse that disproportionately impacts women. one parallel between witchcraft accusations and elder abuse as studied in the us and globally is that elder abuse is not a typical part of aging for most older adults, and neglect by caregivers is a far more common problem than outright physical attack (statistic brain 2013). in other words, attention to the camps is important but may miss more commonly experienced marginalization and neglect. another is that abusers are most commonly family members, and thus elder abuse is another example of “the dark side of kinship” (anetzberger 2012, statistic brain 2013). a third parallel is in risk factors. that is, one identified risk factor identified in elder abuse is caregiver dependency upon older adults for housing and money (anetzberger 2012; phelan 2013, 14-22), which is reminiscent of the man who accused his mother when he was “struggling in life.” another risk factors is marginalized status within family systems. the story of the man who kept his mother in a structure reminds me of a legal case in the u.s. portion of my study. an older woman was dependent on a son who severely neglected her and provided only chips and soda for food. successful prosecution would have also removed the primary caregiver. if this case were in ghana, the informal solution of family conflict mediation would be likely. the second social reality is about elder advocacy as culturally mediated intervention work. within rights based discourse, the moral boundaries of witchcraft violations appear far more clear than they may to those who genuinely fear witches. whether one believes or not, the reduction of witchcraft to a problem of violence against women of whatever age misses a larger social context of ambiguity, contingency, and negotiation. more importantly, the solution to simply banish beliefs or force change has been resisted in the camps and does not seem to be taking root in the country as a whole. as in studies offering advice on aids and substance abuse intervention, one moral (or scientific) system cannot simply replace another as an explanatory framework or means of resolving social drama (farmer 1990; roy et. al. 2011). however, more modest intervention goals seem to have been possible. although the data presented here relies on anecdotes from ngos, and journalistic reports, it seems that gar and the go-home project have achieved some success by working from within cultural systems and negotiating with abusive accusers. intervention work itself is thus informed by cultural values, such as values of individual rights or social responsibilities, and become subject to change when engaged in local contexts. further research into intervention as “culture on the make” (strathern 2002) could more closely trace the mutual impact of dialogue and intervention between rights and elder advocates and the locations where witchcraft accusations escalate to elder abuse. this, in turn, may help identify more sustainable and culturally appropriate solutions in partnership with local communities. references aboderin, isabella. 2006. intergenerational support and old age in africa. new brunswick, new jersey: transaction. ameyibor, edward. anthropology & aging quarterly 2013: 34 (2) 210 alexandra crampton no peace 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ghana: ongoing anthropological research.” ghana council newsletter. 10:5-6. whitaker, kati. “hundreds of women trapped in ghana’s ‘witch camps’; up to a thousand elderly women in ghana have been banished to remote camps as alleged witches.” telegraph (uk), 30 august 2012. accessed october 7 2013. http://www.telegraph.co.uk/ news/worldnews/africaandindianocean/ghana/9509493/ hundreds-of-women-trapped-in-ghanas-witch-camps.html http://www.ukba.homeoffice.gov.uk/sitecontent/documents/policyandlaw/countryspecificasylumpolicyogns/ghana.pdf?view=binary http://www.ukba.homeoffice.gov.uk/sitecontent/documents/policyandlaw/countryspecificasylumpolicyogns/ghana.pdf?view=binary http://www.ukba.homeoffice.gov.uk/sitecontent/documents/policyandlaw/countryspecificasylumpolicyogns/ghana.pdf?view=binary http://www.state.gov/documents/organization/204336.pdf http://www.telegraph.co.uk/news/worldnews/africaandindianocean/ghana/9509493/hundreds-of-women-trapped-in-ghanas-witch-camps.html http://www.telegraph.co.uk/news/worldnews/africaandindianocean/ghana/9509493/hundreds-of-women-trapped-in-ghanas-witch-camps.html http://www.telegraph.co.uk/news/worldnews/africaandindianocean/ghana/9509493/hundreds-of-women-trapped-in-ghanas-witch-camps.html microsoft word kaounwantedhelpnov.docx the  unwanted  help?     enslaved  african  americans  and  their  aging  white  masters     philip  y.  kao   university of pittsburgh abstract this  essay  explores  whether  or  not  the  enslaved  african  american  provided  caregiving  to  their  aging  white   ‘masters’  and  other  elderly  whites  in  early  america.  although  there  is  plenty  of  historical  mention  of  the   ‘house  slave’,  housework,  and  caregiving  for  the  children  of  slave  owners,  there  been  very  little  mention  of   eldercare  across  racial  lines  before  the  20th  century.    this  essay  does  not  provide  any  new  historical  data.   instead,  it  sketches  out  the  possible  issues  involved  in  the  racialization  of  care  and  suggests  options  for  its   potential  historiography.         keywords:    american  slavery,  race,  aging,  caregiving                     anthropology & aging, vol 37, no 1 (2016), pp. 1-8 issn 2374-2267 (online)doi 10.5195/aa.2016.143 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           1 the  unwanted  help?   enslaved  african  americans  and  their  aging  white  masters        philip  y.  kao   university of pittsburgh   introduction   aging  and  the  business  of  caregiving  bring  to  the  foreground  the  nature  of  family  and  social   relationships,   and   that   most   sacred   american   value—the   self-­‐‑made   individual,   autonomous   and   independent  to  the  bone.    against  this  backdrop  is  a  competing  sentiment,  one  that  idealizes  the  traditional   bonds  and  emotionally  charged  ‘kinships’  that  keep  society  together.    in  this  vein,  the  real  fear  is  not  so   much  that  society  is  breaking  apart,  but  rather  that  no  one  really  cares  about  your  wellbeing  when  you   reach  old  age—not  your  doctor  and  quite  possibly  not  even  your  adult  children.  in  this  context,  caring   about  caregiving  is  just  another  political  slogan.    who  then  is  providing  the  care  work?   in  this  essay,  i  float  the  idea  that  enslaved  african  americans  provided  caregiving  to  their  aging   old  white  masters,  but  since  it  was  such  a  taboo  subject,  not  much  has  been  accounted  for  in  the  historical   archives.  eldercare  is  still  predominantly  found  in  the  family,  but  today  more  and  more  people  are  living   longer  and  developing  conditions,  such  as  alzheimer’s,  that  require  further  hands-­‐‑on  and  incessant  care.     for  many  of  the  elderly  residents  in  these  long-­‐‑term  care  facilities,  this  means  being  washed,  bathed  and   fed  by  a  non-­‐‑family  member,  and  quite  possibly  as  the  anecdote  goes,  by  someone  (primarily  female)  with   a  darker  shade  of  skin.    the  racialization  of  care  is  not  something  new,  but  it  has  evolved  in  complicated   ways  bridging  the  global  north  and  south  in  a  political  economy  that  devalues  caregiving  and  sometimes   (ironically)  the  recipients  of  care.    in  her  book  on  the  devaluation  of  care  work,  sociologist  evelyn  nakano   glenn  points  out  that,  “gender,  class,  race  and  citizenship  status  are  central  axes  in  the  social  organization   of  caring”  (glenn  2010,  184),  and  that  two  types  of  coercion  have  come  to  shape  care  work.      the  first  type   of  coercion  is  status  obligation  pertaining  to  the  role  of  women  as  dutiful  mothers,  wives  and  daughters.   glenn  refers  to  the  second  type  as  “racialized  gendered  servitude”  (glenn  2010,  7).    what  i  want  to  focus   on   here   is   a   consideration   of   the   caregiving   relationship   between   particular   people,   or   rather   that   relationship  as  a  structural  feature  in  the  social,  economic,  and  historical  context  of  american  slavery.  by   looking  through  the  racial  double  mirror  of  today,  and  turning  our  attention  to  history,  this  essay  will   formulate   a   set   of   preliminary   heuristic   responses   to   the   following   question:   did   enslaved   african   americans  provide  caregiving  to  their  elderly  and  aging  white  slaveholders?     there  has  been  much  written  about  the  kinds  of  domestic  work  and  unpaid  labor  the  enslaved   african  americans  had  to  perform  in  the  slave  economy.    allen  argues  in  a  revisionist  way  that  the  ‘mutual   helping  tradition’  from  africa—uprooted  and  planted  in  ‘black  america’—gave  rise  to  what  is  better   known  today  as  caregiving  (allen  1999,  2).      yet,  there  is  a  seeming  lacuna  in  the  historical  accounts  of   certain  kinds  of  intimate  work.  quite  simply,  there  is  a  dearth  of  evidence  suggesting  that  interracial   eldercare  occurred  from  the  early  colonial  period  of  america  through  to  the  early  20th  century.             anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           2 betwixt  and  between,  the  silent  proximity  of  a  taboo     being  destitute  and  elderly  was  a  harsh  reality  for  many  in  early  america.    if,  “the  history  of  old   age  in  the  united  states  has  been  shaped  largely  by  the  search  for  economic  security”(fleming  et  al  2003,   919),  then  enslaved  african  americans  who  had  the  fewest  resources  were  the  most  vulnerable.  according   to  kruger,  “slaves  were  considered  to  be  too  old  for  the  slave  trade  at  age  thirty-­‐‑six  to  forty”  and  that  a   “receipt  given  to  the  captain  for  his  cargo  of  290  blacks  states  that  a  group  of  impartial  men  had  judged   89  of  them  to  be  over  thirty-­‐‑six  years  of  age  and  that  therefore  ‘three  of  them  must  be  counted  for  two’”   (kruger  1985,  chapter  9).    many  enslaved  african  americans,  however,  continued  to  work  well  into  old   age;  some  were  given  menial  jobs  while  others  were  sold,  hired  out  or  simply  abandoned.    president   george  washington  writes  in  his  will  that,  “there  may  be  some  [slaves]  who  from  old  age,  or  bodily   infirmities  and  others  who  on  account  of  their  infancy,  that  will  be  unable  to  support  themselves,  it  is  my   will   and   desire   that   [they]   be   comfortably   cloathed   and   fed   by   my   heirs   while   they   live   […]”   (see   washington’s  will).  this  gesture,  however  historically  defined,  did  not  typify  the  fate  of  older  enslaved   african  americans.      reginald  allen  reminds  us  that,  “during  the  slavery  epoch,  the  label  of  ‘quadruple   jeopardy’  was  characterized  for  elderly  african-­‐‑american  slaves  [as]:  1)  being  old;  2)  african;  3)  poor;  and   4)  as  a  slave”  (allen  1999,  43).   the  plight  of  old  age  and  kinship  (both  real  and  fictive)  surrounding  eldercare,  especially  within   the  enslaved  community,  contributed  to  a  sense  of  morality  and  responsibility.  for  frederick  douglass,   neglect  of  the  elderly  even  became  an  abolitionist  theme.  douglass  tells  us  of  his  old  grandmother  in  his   well-­‐‑known  narrative.    when  she  was  found  to  be  of  ‘little  value’,  her  slaveholders  “took  her  to  the  woods,   built   her   a   little   hut,   put   up   a   little   mud-­‐‑chimney,   and   then   made   her   welcome   to   the   privilege   of   supporting  herself  there  in  perfect  loneliness;  thus  virtually  turning  her  out  to  die!”(douglass  1998,  2021).     douglass  goes  on  to  say,  “if  any  one  thing  in  my  experience,  more  than  another,  served  to  deepen  my   conviction  of  the  infernal  character  of  slavery,  and  to  fill  me  with  unutterable  loathing  of  slaveholders,  it   was  their  base  ingratitude  to  my  poor  old  grandmother.  she  had  served  my  old  master  faithfully  from   youth  to  old  age”  (douglass  1998,  2021).    the  plight  of  old  age  was  not  lost  on  the  whites,  but  it  took  on  a   decidedly  harsh  reality  for  the  enslaved  african  americans.    there  are  some  accounts  of  loyal  slaves  who   were  freed  in  old  age  or  accorded  some  level  of  gratitude.  in  a  published  and  archived  interview  with   mary  henry,  a  slave  and  nurse  to  mrs.  julia  dent  grant  (wife  of  general  u.s.  grant),  the  reader  is  told   that  mrs.  dent  wrote  a  letter  and  enclosed  a  sum  of  money  for  mary  henry  on  her  death  bed.    according   to  the  interview,  “[mary  henry]  is  calmly  awaiting  the  end,  buoyed  and  consoled  by  the  religion  “old   boss”  and  mrs.  dent  gave  her  […]  she  wants  to  die,  as  she  says,  to  join  “old  boss  and  miss,”  and  to  be   buried  in  the  same  lot  and  in  the  same  soil  in  the  cemetery  where  rest  their  bones”  (st.  louis  globe-­‐‑ democrat  1900).     one  might  be  tempted  to  assume  that  since  enslaved  african  americans  were  working  not  only   in  the  field  but  also  as  nursemaids,  midwives  and  house  servants,  there  had  to  have  been  instances  of   eldercare.  given  that  the  enslaved  african  americans  most  likely  sympathized  with  senescence  and  the   plight  of  old  age  for  the  whites,  was  there  a  functional-­‐‑cum-­‐‑emotional  human  connection  being  created   between  enslaved  african  americans  and  their  aging  white  masters?  if  so,  did  this  arise  from  the  intimacy   and   nature   of   a   nascent   caregiving   relationship?   did   enslaved   african   americans   take   care   of   old   slaveholders  and  their  aging  white  family  members?           anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           3 there  are  documented  instances  of  deathbed  scenes  where  enslaved  africans  were  called  upon  to   pray  for  and  sit  with  their  masters.    in  one  moving  and  comical  account,  former  slave  mary  gladdy  recalls   a  story  told  to  her  by  her  grandmother,  edie  dennis,  about  an  enslaved  african  american  named  chuck.   in  this  story  taken  from  the  work  projects  administration  (wpa)  collection  of  former  slave  narratives,   chuck—a  religious  and  industrious  enslaved  african  american—prays  for  his  ill-­‐‑stricken  and  atheist   master.  we  are  told  that,  “chuck  then  went  to  his  master'ʹs  bed  side  […]  and  the  white  man  recovered,   was  converted,  joined  the  church,  and  became  an  evangelist.  he  also  freed  chuck  and  made  an  evangelist   of  him.  then  the  two  got  in  a  buggy  and,  for  years,  traveled  together  all  over  the  country,  preaching  the   gospel  and  saving  souls“  (works  project  administration  2007,  23).      slave  narratives  often  mention  that   enslaved  african  americans  did  most  of  the  housework,  especially  women  who  cooked  and  took  care  of   the  masters’  and  overseers’  families.      ellen  brass,  a  former  ‘slave’,  says  rather  bluntly  near  the  end  of  her   session  with  an  interviewer  that,  “white  folks  ain’t  got  no  reason  to  mistreat  the  colored  people.  they  need   us  all  the  time”  (federal  writers’  project  2001).    for  bankole,  “africans  were  active  participants  in  the  care   and  treatment  of  illness/disease;  and  in  assisting  whites  in  maintaining  their  own  general  health  care”   (bankole  1998,  141).  yet  given  the  paucity  of  primary  18th  century  records,  more  research  needs  to  be   done  to  explore  the  extent  to  which  enslaved  african  americans  were  allowed  to  interact  with  their  old   white  masters  and  mistresses.  were  they  allowed  to  provide  direct  caregiving  in  the  sense  of  ‘bed  and   body  work’,  or  were  their  services  only  warranted  in  the  deathbed  scenes  of  annals  past?   since  i  am  arguing  that  it  is  reasonable  that  the  enslaved  african  american  did  take  care  of  their   aging  and  old  masters,  let  me  now  set  forth  some  conjectures.  to  begin  with,  perhaps  there  is  an  historical   silence,  signaling  another  reality  where  the  enslaved  african  american  did  not  provide  any  substantial   caregiving  to  the  elderly  whites.    geriatrician  kevin  c.  fleming  claims  that  from  1650  to  1850,  the  number   of  elderly  americans  was  small,  consisting  of  less  than  2%  of  the  population  (fleming  et  al  2003,  914).   high  birth  rates  and  mortality  meant  that  old  age  (and  mainly  for  the  whites)  was  commonly  defined  as   life  after  the  age  of  60.  few  survived  to  old  age,  but  old  age  was  not  a  defining  factor  for  work  or  social   life   in   early   america;   birthdays   were   accorded   no   special   observance   until   the   latter   half   of   the   19th   century   (chudacoff   1989).   furthermore,   some   elderly   african   americans   continued   to   work   as   sharecroppers  well  into  old  age—even  after  the  emancipation  proclamation.    they  lacked  property  rights   and  were  thus  prone  to  indigence  and  dependence.    in  the  agricultural  economy  of  preindustrial  america,   the  standard  of  living  for  young  and  old  alike  was  bleak.  the  price  of  labor  mirrored  the  cost  of  living,   and  so  people  in  general  did  not  save  much  for  their  declining  years.     there  is  insight  to  be  gleaned  from  investigating  what  aging  meant  culturally  and  socially  for  the   majority  of  whites  before  the  industrial  turn  and  the  onset  of  poorhouses.    for  example,  carole  haber   asserts  that  some  (white)  elders  did  in  fact  enjoy  great  power  and  prestige.    but  this  was  not  because  they   were  afforded  special  status  simply  by  being  old,  but  rather  these  elders  were  able  to  participate  in  society,   and  to  maintain  certain  authority  over  valued  assets  (haber  1983).    for  some,  old  age  contributed  to  their   high  status  as  venerable  elders.  haber  suggests  that  even  into  advanced  years,  and  in  light  of  the  fact  that   two  decades  could  separate  the  birth  of  one’s  first  and  last  child,  elders  retained  their  parental  roles  and   responsibilities.   additionally,   david   hackett   fischer   contends   that   during   the   colonial   period,   gerontocracy  existed,  and  that  the  old  regulated  social  norms  and  behaviors  (fischer  1977).  for  fischer  it   was   ultimately   the   changing   cultural   beliefs,   religion,   political   theory   and   philosophy   more   than   economics  that  signaled  the  end  of  gerontocracy  and  the  beginning  of  gerontophobia.    between  1770  and   1820  fischer  found  that  the  revolutionary  generation  sought  a  world  as  a  young  republic  founded  on   revolutionary  ideas,  which  removed  elders  from  their  thrones.    in  other  words,  “republican  principles  of   equality  and  liberty  served  to  displace  virtues  of  old  age.       anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           4   with  [white]  people  of  any  age  free  and  equal,  there  was  little  reason  to  reproduce  the  hierarchy  of  age”(   haber  and  gratton  1994,  5).     of  course  the  story  is  not  so  simple.  there  are  instances  where  some  elders  were  in  fact  able  to   command  respect  and  honor  from  their  control  of  resources,  but  they  did  not  always  command  affection   or  sympathetic  understanding.  the  usual  line  of  argument  posits  that  the  elderly  did  not  conform  to  the   spirit  and  culture  of  self-­‐‑improvement.  in  order  words,  they  were  an  embarrassment  to  the  cultural  regime   of  self-­‐‑control  and  self-­‐‑sufficiency.    moreover,  aging  whites  in  colonial  america  were  supposed  to  detach   from  the  world.  they  were  to  be  somber,  temperate  and  fixated  on  withdrawing  from  the  quotidian  world   in  order  to  prepare  for  salvation.     therefore,   who   exactly   were   these   old   aging   white   masters   and   mistresses   that   the   enslaved   african  americans  could  have  cared  for,  and  what  constituted  their  attitudes  towards  aging?      paula  scott   argues  that  many  americans  in  the  18th  and  19th  century  believed  that  god  had  set  the  age  of  man  firmly   at  70  years  (scott  1997).  scott  draws  upon  18th  and  19th  century  books,  poems,  plays,  almanacs,  and   newspapers  to  ascertain  ideas  on  aging  and  the  american  elderly.    scott  found  that  old  age  in  its  religious   context  was  not  a  time  of  repose  or  relaxation,  but  of  serious  and  unrelenting  soul  searching.  old  age  was   a  time  of  fortitude,  a  didactic  modelling  and  a  season  of  preparation  for  another  world.  god  intended  this   season  to  test  the  old,  pushing  them  toward  spiritual  betterment—so  goes  the  ideology.  scott  quotes   cotton  mather  saying,  “a  trifling  and  childish  and  frolicsome  sort  of  carriage,  all  buffoonery  in  an  old   man  is  very  disagreeable”  (scott  1997,  33).  meanwhile,  medical  narratives  professed  something  similar  to   the  religious  discourse  at  the  time.  dietary  restrictions  and  temperance  could  offer  better  control  of  one’s   health  and  longevity.    but  just  how  much  foothold  did  religious  attitudes  and  medical  prescriptions  have   toward  aging  is  still  not  very  clear.     all  in  all,  this  is  a  longwinded  way  of  saying  that  slaves  might  have  provided  caregiving  for  their   aging   white   masters,   but   in   a   quite   different   way   than   we   think,   because   caregiving   was   not   about   elongating  life  and  battling  disease,  but  about  spiritual  caregiving  and  salvation.    did  the  enslaved  african   american  have  a  direct  role  in  the  meaning  and  exigency  of  old  life  and  death  in  the  white  christian   world?  since  many  of  the  black  family  members  were  sold  and  scattered  throughout  various  plantations,   they  were  not  afforded  the  luxury  of  having  nuclear  family  households.  furthermore,  if  we  take  it  that  the   elderly   were   culturally   and   religiously   expected   to   wean   themselves   from   worldly   and   quotidian   concerns,  then  (re)assigning  house  servants  to  care  for  the  elderly  might  have  been  be  too  much  of  a  real   world  reminder  and  intervention.     another  major  issue  soon  arises,  namely,  that  the  slaveholder’s  brand  of  paternalism  was  used  to   regulate  and  justify  a  system  of  exploitation  (for  more  see  genovese  and  fox-­‐‑genovese  2011).      it  was  the   slaveholder’s  romanticized  and  ‘compassionate’  rationalization  of  ‘christian  slavery’  that  led  enslaved   african   americans   to   be   considered   children   and   property   that   needed   to   be   looked   after.   one   distinguishing  point,  however,  has  to  do  with  the  status  of  the  female  house  slave.      much  has  been  written   about   the   mammy   stereotype.     the   mammy   cooked,   cleaned   and   above   all   else   raised   the   master’s   children.  mcelya  argues  that  the  ambivalence  and  assertions  of  black  people’s  contentment  with  servitude   alleviated  white  fears  on  the  one  hand,  but  reinforced  racial  hierarchy  on  the  other  thus  perpetuating  the   mammy  stereotype  (mcelya  2007).  moreover,  sharla  fett  suggests  that,  “african  american  midwives   sustained  their  calling  by  joining  their  skills  as  birth  attendants  to  an  astute  consciousness  of  both  intimate   and  public  forms  of  power  in  antebellum  slave  society”  (fett  2006,  65).     anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           5  these  midwives  crossed  lines  of  class,  community  and  race  in  fascinating  ways.  stacey  close  argues  that   while  women  house  servants  formed  a  link  between  slaves  and  their  slave  owners;  they  also  exerted  small   acts   of   resistance   (close   1995   and   close   1997).     for   example,   they   taught   the   slave   owners’   children   superstitions,  how  to  count  in  an  african  language,  and  aided  runaway  slaves.  yet  even  in  this  light,  and   despite   the   fact   that   the   mammy   was   often   regarded   as   being   closer   to   the   white   family   than   her   counterparts  in  the  field,  did  she  and  was  she  allowed  to  provide  eldercare  in  the  master’s  bedroom?     another  reason  why  there  might  not  be  any  explicit  evidence  regarding  how  enslaved  african   americans  cared  for  their  aging  white  masters,  centers  around  the  notion  that  caring  for  the  elderly  was   not  just  a  religious  and  spiritual  matter  but  also  a  medical  one.    sharla  fett  argues  that  there  existed  a   cultural   divide   between   two   different   models   of   health,   the   body,   and   medicine   in   southern   slave   plantations.     the   power   dynamics   involved   in   these   regimes   might   have   dissuaded   such   caregiving   instances.  according  to  fett,  “enslaved  african  americans  were  not  passive  victims  of  medical  malice,   nor  were  they  helpless  dependents  on  white  health  care.  instead,  communities  in  slavery  nurtured  a  rich   health  culture,  a  constellation  of  ideas  and  practices  related  to  well-­‐‑being,  illness,  healing  and  death  that   worked  to  counter  the  onslaught  of  daily  medical  abuse  and  racist  scientific  theories”  (fett  2002,  2).  it  is   not  a  surprise  that  slave  owners  subjugated  african  americans  under  regimes  of  control;  the  enslaved   african  american’s  overall  state  of  health  was  by  extension  related  to  his/her  wealth  in  the  marketplace.   furthermore,  glenda  sullivan  discusses  the  “sick  house”  as  a  place  where  slaves  received  medical  care  on   larger  plantations  (sullivan  2010).  enslaved  african  americans  were  distrustful  of  white  physicians  and   their  medical  institutions.  the  sick  house  functioned  as  a  space  where  masters  and  plantation  mistresses   could  supervise  their  slaves’  progress  and  convalescence.  in  other  words,  institutional/white  medical  care   were  sites  of  disciplinary  power  and  control  tools  over  their  ‘financial  investments’.    on  the  flip  side,  black   healers  grounded  their  healing  work  in  notions  of  spiritual  power,  human  relationships  and  community   resourcefulness,  addressing  a  wider  range  of  healing  and  cosmic  exigencies  than  the  slave  owners  found   legitimate.  fett  goes  on  to  say  that,  “self-­‐‑reliant  traditions  of  african  american  doctoring  countered  these   objectifying  definitions  of  slave  health  with  an  original  and  compelling  view  of  human  well-­‐‑being.  unlike   southern  planters,  enslaved  men  and  women  did  not  assume  that  they  shared  mutual  health  interested   with  their  enslavers”  (fett  2002,  198).  not  only  were  competing  views  of  personhood  being  articulated   through  white  and  black  medical  systems,  but  the  hierarchal  nature  of  slave  society  made  it  hard  for   whites  (even  if  they  wanted)  to  accept  forms  of  caregiving  that  were  holistic  and  what  we  might  describe   today  as  person-­‐‑centered  care.  if  elderly  whites  constituted  their  own  practices,  is  it  reasonable  to  assume   that  the  enslaved  african  american  still  found  a  way  to  integrate  themselves  into  a  system—which  shaped   illness  experience  and  end  of  life  care/support?     finally,  there  is  the  thorny  issue  of  touch  and  intimacy.  perhaps  the  sight  and  thought  of  a  black   hand  on  an  old  white  body  was  taboo,  inhabiting  an  uncomfortable  space  of  abjection.    it  might  have  been   the  case  that  having  an  enslaved  african  american  wash,  bathe  and  assist  with  toileting  proved  too  much   of  an  affront  to  an  old  slave-­‐‑owner’s  sense  of  self-­‐‑professed  dignity.      if  acts  of  intimate  caregiving  did   occur,  they  were  certainly  not  out  in  the  open  or  readily  talked  about.      enslaved  african  americans  and   elderly  whites  signified  two  vulnerable  groups,  two  interdependent  pariahs  which  might  have  come  into   brief  contact,  sparking  a  liminality  that  put  care  before  the  juridical,  women  before  men,  old  before  young,   and  black  before  white.  approaching  death  and  losing  their  positions  in  society,  white  elders  ‘faded  into   blackness’.  caregiving  depends  on  degrees  of  trust.    the  issue  is  not  one  of  betrayal,  but  rather  would   caregiving  have  undermined  the  nature  of  power  and  the  forms  of  legitimacy  the  whites  had  over  the   enslaved  african  americans?  sociologist  viviana  zelizer  describes  certain  facets  that  obtain  when  people   give  and  receive  care  in  intimate  settings.       anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           6 for  zelizer,  “everywhere  and  always  intimates  create  forms  of  economic  interchange  that  […]  reproduce   their  relations,  and  distinguish  those  relations  from  others  with  which  they  might  become  confused:  are   you  my  mother,  my  sister,  my  daughter,  my  nurse,  my  maid,  or  my  best  friend,  [my  slave]?”  (zelizer  2012,   277).  taken  at  face  value,  the  intimacy  embedded  in  acts  of  caregiving  would  have  called  into  question   relations  of  servitude,  power,  and  control.    it  is  thus  likely  that  people  thrown  into  situations  where  labor   and  intimacy  collide,  “draw  on  available  cultural  models,  and  they  use  power  and  persuasion  to  negotiate   unequal  social  relations”  (zelizer  2010,  277).  ultimately,  “care  in  intimate  settings  raises  the  fundamental   questions:  who  are  we,  and  what  do  we  owe  each  other?”  (zelizer  2010,  277).    thus,  it  is  quite  possible   that   the   enslaved   african   american   was   distanced   from   these   intimate   and   vulnerable   care   sites,   especially  if  one  recognizes  that  subtle  acts  of  resistance  threaten  to  undermine  (even  just  momentarily)   the  ideology  of  paternalism.     conclusion   rather   than   argue   conclusively   that   enslaved   african   americans   did   or   did   not   provide   caregiving   for   their   aging   white   masters   and   mistresses,   i   have   tried   to   point   out   some   possible   perspectives  and  the  issues  at  stake.    there  are  also  some  theoretical  points  that  need  to  be  taken  up  and   elaborated.    for  one  thing,  how  does  a  sociological  theory  such  as  social  stratification  situate  itself  in  the   context   of   slavery   and   cross-­‐‑racial   caregiving?       does   caregiving   for   the   elderly   cut   across   social   stratification  in  a  way  that  carves  out  an  intimate  space  that  is  too  taboo  to  abnegate  or  even  to  think   about?  if  there  was  in  fact  elder  caregiving  going  on  between  slaves  and  their  aging  masters,  how  were   their  relations  informed  by  the  available  emotional  regimes  of  the  time  (reddy  2001)?  in  other  words,  a   theoretical   treatment   of   the   interactions   between   specific   emotional   capacities   and   the   unfolding   of   historical  and  changing  social  circumstances  could  cast  caregiving  in  a  new  political  light.  antislavery   sentiment  and  what  reddy  calls  emotives,  or  rather  intersubjective  emotional  negotiations,  could  come  to   reframe  our  understanding  of  particular  (and  relational)  histories.  we  need  to  know  more  about  just  who   these   aging   masters   were   and   whether   or   not   enslaved   african   americans   in   the   north   differed   significantly  in  their  interactions  with  elderly  whites  than  their  brothers  and  sisters  in  the  south.    finally,   how  was  the  life  course  valued  alongside  the  nature  of  work  during  slavery  and  even  in  the  postbellum   period?    from  africa,  the  enslaved  african  americans  brought  with  them  “[…]  their  beliefs  about  the   universe,  their  views  on  death  and  dying,  their  conception  of  human  existence,  and  a  tenacious  reverence   for  the  aged”  (pollard  1965,  228).    old  age  was  a  ‘time  approaching  power’,  and  “old  folks”  were  afforded   honorable  status  with  the  trappings  of  wisdom,  experience  and  ancestral  views  (close  1997,  wimberly   1997).                                                           in  the  end,  we  are  left  with  an  uncomfortable  situation,  which  is  most  likely,  a  racist  holdover   from  the  past.  one  can  find  a  handful  of  elders  scattered  across  communities  in  america  who  still  refuse   to  be  cared  for  by  attendants  who  are  ‘darker  skinned’.    slavery  might  be  a  sin  of  the  past,  but  the  intimacy   of  touch  and  its  racialization  means  that  for  some  people,  those  with  black  skins  and  white  masks  will   always  be  unwanted,  even  if  they  are  ‘the  help’.  it  is  true  that  slavery  as  an  economic  institution  no  longer   exists  in  the  united  state,  but  informal  racial  segregation  still  does.    some  whites  and  blacks  have  learned   to  ignore  each  other  for  different  reasons,  but  because  of  the  growing  crisis   in  care  and  aging,  those   ‘racialized  worlds’  will  no  doubt  collide.    by  uncovering  and  investigating  certain  historical  gaps,  we  can   look  squarely  at  how  our  conditioned  habits  of  thought  and  relations  come  to  inform  our  current  practices,   such  as  caregiving,  in  the  hopes  of  doing  away  with  prejudices  once  and  for  all.   anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           7 references     allen, reginald l. the influence of historical roles of caregiving on african-americans today: a multi-dimensional perspective. ms thesis, university of utah, gerontology; 1999. bankole, k. slavery and medicine: enslavement and medical practices in antebellum louisiana. new york: garland, 1998. brignac, kelly. “exploring race and medicine through diaries: white perspective on slave medical care in antebellum mississippi”, primary source volume ii: issue i, fall 2001. chudacoff, howard p. how old are you?: age consciousness in american culture. princeton, n.j.: princeton university press, 1989. close, stacey k. elderly slaves of the plantation south. new york: garland pub., 1997. close, stacey k. “elderly female slaves of the antebellum south stabilizers and resisters”. in black resistance movements in the united states and africa, 1800-1993: oppression and retaliation, written by felton o. best. lewiston: e. mellen press, 1995. douglass, frederick. narrative of the life of frederick douglass, an american slave, written by himself, chapter x, in the norton anthology of american literature, ed. nina baym, 5th ed., vol. 1, new york and london: w.w. norton & co., 1998, p.2041 federal writers' project, and library of congress. 2001. born in slavery: slave narratives from the federal writers' project, 1936-1938. [washington, d.c.]: library of congress. http://memory.loc.gov/ammem/snhtml/snhome.html fett, sharla m. working cures: healing, health, and power on southern slave plantations. chapel hill: university of north carolina press, 2002. fett, sharla m. “consciousness and calling: african american midwives at work in the antebellum south.” in new studies in the history of american slavery, edited by edward e. baptist and stephanie m. h. camp. athens: university of georgia press, 2006. fischer, d. hackett. growing old in america. new york: oxford university press, 1977. fleming, kc, jm evans, and ds chutka. “a cultural and economic history of old age in america,” mayo clinic proc. 78(7) (jul 2003): 914-21. genovese, eugene d., and elizabeth fox-genovese. fatal self-deception: slaveholding paternalism in the old south. cambridge: cambridge university press, 2011. glenn, evelyn. forced to care: coercion and caregiving in america. cambridge: harvard university press, 2010. haber, carole. beyond sixty-five: the dilemma of old age in america's past. cambridge: cambridge university press, 1983. haber, carole, and brian gratton. old age and the search for security: an american social history. bloomington: indiana university press, 1994. kruger, vivienne l. born to run: the slave family in early new york 1626 to 1827, phd diss., columbia university, 1985. accessed dec 1, 2012. http://newyorkslavery.blogspot.co.uk/2007/08/chapter-one.html mcelya, micki. clinging to mammy: the faithful slave in twentieth-century america. cambridge: harvard university press, 2007. pollard, l.j. aging and slavery: a gerontological perspective in journal of negro history, 228-233, 1981. reddy, william m. the navigation of feeling: a framework for the history of emotions. cambridge: cambridge university press, 2001. scott, paula a. growing old in the early republic: spiritual, social, & economic issues, 1790-1830. new york: garland, 1997. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.143    http://anthro-­‐‑age.pitt.edu   kao  |  the  unwanted  help?           8 st. louis globe-democrat. she was mrs. grant’s “mammy” (interview with mary henry). retrieved july 5, 2016, from http://www.yandtblog.com/?p=1482s sullivan, glenda. "plantation medicine and health care in the old south," legacy: vol. 10: iss. 1, article 3, 2010. washington’s will. w.w. abbot, ed., the papers of george washington, retirement series, vol. 4, april december 1799. (charlottesville: university press of virginia, 1999), 477-492. accessed dec 1, 2012. http://gwpapers.virginia.edu/documents/will/text.html wimberly, a.s. (ed.) honoring african-american elders: a ministry in the soul community. san francisco: josseybass, 1997. work projects administration, slave narratives: a folk history of slavery in the united states (from interviews with former slaves, georgia narratives, part 2). project gutenberg ebook, 2007. accessed december 5, 2012. http://www.gutenberg.org/files/22166/22166-h/22166-h.htm#page_17 zelizer, viviana. “caring everywhere”. in intimate labors: cultures, technologies, and the politics of care, edited by eileen boris and rhacel salazar parreñas. stanford: stanford university press, 2010.   anthropology & aging quarterly 2013: 34 (3) 51 jason danely editor-in-chief editor’s introduction to the issue: the aging body jason danely, ph.d.department of anthropologyrhode island college jdanely@ric.edu “the body” has long been a fertile topic for anthopological exploration, grounding the ways we consider everything from the molecular and genetic evolution of the human species, to the sense-mediated experience of culture, gender, sexuality and power. aging too is an embodied process, though the body may also be used to contest and refashion aging in ways that dissociate from ageist stereotypes and the stigma of bodily dependence. as a site of these contestations, it becomes a window into ourselves and our social life. how does old age and aging contribute to anthropological conversations on embodiment, bodily aesthetics, health, biopolitics, and longevity? aging presents itself first through the body, but it is a body woven into the fabric of cultural and social life. the temporality marked by the aging body may be linked to changes in attitudes and selfperceptions, as in james hillman’s vivid description from his bestseller the force of character and the lasting life (1999): in later years, the pull of gravity takes over. ambitious, upwardly mobile social climbing, career and class, no longer offer glamour. you no longer need to be among the beautiful people or standon on the top deck shouting orders. instead, the great sag: eye pouches, double chins, jowls, pendent breasts, hanging skin on your upper arms, droopy belly, butt, scrotum, labia; even the earlobes grow long toward the floor. if we listen closely, hillman’s description is full of freedoms granted by the aging body; a kind of relief presented somatically by the graceful “great sag.” this month’s cover art and portfolio feature visualizes hillman’s words. takacs’ work not only demonstrates the potential aesthetic beauty of the older subject, but it also expresses the joy found in working with those subjects, providing a space for recognition and engagement that extends far beyond the canvas. as anthropologists, we are keenly aware of how presntations and practices of the aging body can bring about new reflections on the embodied self, bodily-mediated relationships, and cultural values. since the topic of the body has already been examined from numerous angles within anthropology, we thought it appropriate to begin this issue with a theoretical commentary by phd student, ender ricart. ricart brings a critical perspective to some of the fundamental paradigms of the body in anthropology, and suggests ways in which chronotopes of aging might help us to expand and develop the field even more. ricart’s provocative commentary is followed by short response by katrina moore, whose work on aging and the body has also been based in japan. aaq received many inquires and submissions for this issue, and is happy to publish five full articles ranging from an a biological evolutionary perspective on menopause and women’s health (froehle) to a phenomenological perspective on filipina caregivers and their israeli patients (mazuz). they reveal the centrality of the aging body as located in social and political spaces of demography and home care (penney, crampton) as well as in biosocial communities of leisure (steadman). we hope that this broad range of content is a useful resource for teaching and research, encouraging and inspiring even more discussions in this field. mailto:jdanely@ric.edu anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp. 76-78 issn 2374-2267 (online) doi 10.5195/aa.2019.230 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of hromadzic, azra and monika palmberger, eds. care across distance: ethnographic explorations of ageing and migration. oxford: berghahn books. 2018. pp 183. price: $110 (hardcover); $27,95 (e-book). kristin elizabeth yarris university of oregon http://www.library.pitt.edu/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ yarris | book review | 76 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.230 http://anthro-age.pitt.edu book review review of hromadzic, azra and monika palmberger, eds. care across distance: ethnographic explorations of ageing and migration. oxford: berghahn books. 2018. pp 183. price: $110 (hardcover); $27,95 (e-book). kristin elizabeth yarris university of oregon in care across distance, azra hromadzic and monika palmberger, anthropologists based at syracuse university and the university of vienna respectively, have brought together an edited volume focused on what are arguably two of the most significant phenomena of contemporary life: ageing and migration. as with much current anthropological work, care is the analytical and empirical thread that grounds these anthropological investigations of ageing and migration. the volume consists of eight ethnographic chapters that provide fruitful ground upon which to enhance our conceptualization of care in ways that account for cross-cultural continuities and complexities. the book opens with a short introduction by the editors, followed by the ethnographic chapters. these chapters are in turn grouped into four specific thematizations of “care across distance”: “materialities and technologies”, “spirituality and intergenerational care”, “communities” and “failures”. the final chapter, written by anthropologist sarah lamb, is titled “epilogue”, but provides such a solid conceptual framing of the volume’s content that it could as well have been included as an introductory chapter. the introduction maps the volume’s core concepts – “ageing”, “migration” and “care” – to be further theorized in different ways across the ethnographic chapters. this is also the book’s strength: it brings together a wide range of ethnographic cases, drawn from various global settings, where ageing unfolds in diverse migratory contexts and where care is differently embodied, enacted, and circulated. in this review, then, i focus on five threads from across the book’s chapters that can contribute to a more “glocal” (appadurai 1996) theorization of care across experiences of migration and ageing: heterogeneity and malleability of care networks, care as a moral and biopolitical issue respectively and failures of state policies to meet social challenges on the convergence of ageing, migration and care. across the volume’s chapters, care circulates in a myriad ways, ranging from intimate, “relational care” (kleinman and van der geest 2009), within family, kin, and social networks, to “anonymous care” (stevenson 2014), offered by states, ngos, and other bureaucratic actors. for instance, among the nepali-bhutanese refugees that retika desai writes about (chapter 1), the money circulated within transnational families is a form of kin-based care, as for other transmigrant families in this book. on the other hand, also “anonymous care” is at work in this relational network: as evident marriage dissolution is a means for refugee women to be deemed eligible for assistance within this humanitarian regime. in chapter 3, susan rasmussen describes how tuareg kin networks articulate care through negotiations over inheritance to account for family members’ yarris | book review | 77 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.230 http://anthro-age.pitt.edu absence due to migration. in this case, as for the case of middle class tanzanian migrants to the u.s. discussed by andrea patricia kaiser-grolimund (chapter 2), migration is often experienced as upsetting expectations of care across generations, precisely because kin-based care presupposes physical copresence. also namgyal choedup’s chapter illustrates well how migration can result in kin-based obligations going unmet. rasmussen and choedup respectively show how tanzanian and tibetan elders expect their adult children to return from abroad in order to attend to rituals necessary to ensure a “proper departure” (89). these two chapters, on “spirituality and intergenerational care”, also point to the ways in which cultural anxieties about ageing harbor existential dilemmas about dying. issues of death and dying merit greater exploration in these, as well as other, ethnographic investigations of ageing in cross-cultural and migratory contexts. while breakdowns in care are paramount in this volume, equally important are the ways in which families and networks in different settings creatively respond to migration by fostering novel care relations across borders and beyond physical absence: web-based communication technologies, remittance transfers, and even healthcare technologies enable transnational families to continue caring in familiar ways. chapter 2, for instance, documents how tanzanian migrants living in the u.s. supply blood glucose meters to ageing parents in tanzania. in chapter 5, monika palmberger describes the innovative social networks, developed by elderly turkish migrants in vienna, wherein local migrant associations operate as surrogate kin and foster new social relations of care. in this and several other chapters, the authors’ analyses coalesce around the idea that care is a fundamentally moral practice, which exists in, and emerges from, intimate relationships between people. in chapter 7, yvon van der pijl therefore argues that, while social institutions and kinship are important, “questions of subjectivity and morality” should be central to our research on ageing and care (150). other chapters focus more on the biopolitical dimensions of care. desai (chapter 1) argues that english as a second language classes are a form of biopower, insofar as refugees in the u.s. must attend these classes to be deemed deserving of state resettlement assistance. states are also powerful mediators in the access to social care through distributions of pensions (chapter 2 and 8), thus regulating worthy and unworthy elderly citizens. these chapters only indirectly raise questions of citizenship and belonging, while pursuing this question further might have allowed for an analysis of hierarchies of deservingness and access to social care as these inequalities intersect with social values, such as (in)dependence, able-bodied-ness, or productivity. the two chapters in the final part of the book, “failures of care”, show how there is no one-to-one causal relation between breakdowns in care and migration. in chapter 8, azra hromadzic uses the powerful metaphor of the “suffering, bruised, blood-stained, and swollen” body of an elderly bosnian woman (165) to illustrate the absence of care, where both family and state have failed to adequately protect the life and health of older adults. this case, specifically, addresses the failures of a socialist state to deliver on its promises of securing the welfare of its citizens through a social contract fractured by state retrenchment and expanded migration flows. this chapter thus raises broader but vital questions about what social care that fulfills the needs of older adults and transnational families might look like in an era wherein both the social phenomena of ageing and migration undergo crucial changes. the chapters in this volume indirectly pose the question of how we might imagine states supporting health and wellbeing in ways that strengthen intimate social relations, rather than undermining them. to conclude: this ethnographically-rich and comparative volume is of importance for scholars of migration, ageing, and care. it should be accessible for upper-division undergraduate yarris | book review | 78 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.230 http://anthro-age.pitt.edu and graduate courses in these subjects. the book could have been further strengthened by offering readers a stronger conceptual framing for the three main concepts (care, migration, and ageing), either in an expanded introduction, or in introductory remarks prior to the book’s four thematic sections. whereas the complexity of this volume’s chapters invites us to continue to push our conceptualization of care within cultural anthropology, care across distance might have further probed the socio-cultural dimensions of ageing. in her thought-provoking final chapter, sarah lamb critiques the global active ageing discourse by situating the meanings of older age within specific cultural contexts. overall, however, the authors in this volume seem to take ‘ageing’ as a given, synonymous perhaps with biological age. inspired by lamb’s critiques, the authors might have considered the ways in which social meanings of age are historically contingent, shifting across settings marked by transnational mobilities and by inequalities in access to care. references appadurai, arjun. 1996. modernity at large. minneapolis, mn: minneapolis university press. kleinman, arthur and sjaak van der geest. 2009. “‘care’ in health care.” medische anthropologie 21 (1): 159-168. stevenson, lisa. 2014. life beside itself: imagining care in the canadian arctic. berkeley: university of california press. grendellbrfdec book$review$ ! prendergast,!david!and!garattini,!chiara.!(editors).!aging!and!the!digital!life!course.!berghahn! publishers,!new!york.!!2015.!isbn:!978k1k78238k691k9.!300pp,!$120.00!(hardcover)!!isbn:!978k1k78238k 692k6.!(ebook).! $ ruth$n.$grendell,$dnsc,$r.n.$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ anthropology & aging, vol 37, no 1 (2016), pp.48 issn 2374-2267 (online) doi 10.5195/aa.2016.147 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology$&$aging$ vol$37,$no$1$(2016)$$$$issn$2374h2267$(online)$$$$doi$10.5195/aa.2016.147$$http://anthrohage.pitt.edu$ ! $ $ $ $ $ $ $ $ $ $ $ grendell!|!book!review!48! $ book$review$ $ prendergast,!david!and!garattini,!chiara.!(editors).!aging!and!the!digital!life!course.!berghahn!publishers,!new! york.!!2015.!isbn:!978k1k78238k691k9.!300pp,!$120.00!(hardcover)!!isbn:!978k1k78238k692k6.!(ebook).! ruth$n.$grendell,$dnsc,$r.n.$ $ dr.$david$prendergast$is$a$social$anthropologist$and$principal$investigator$in$the$intel$collaborative$ research$institute$for$sustainable$connected$cities$with$imperial$college$and$university$college$london.$ his$research$over$the$last$fifteen$years$has$focused$on$later$lifehcourse$transitions.$$$dr.$chiara$garattini$is$ an$anthropologist$working$as$part$of$the$health$&$life$sciences$group$at$intel.$she$has$a$particular$interest$ in$exploring$the$way$in$which$people$understand$and$interact$with$technologies,$and$the$challenges$faced$ when$technology$is$translated$from$the$lab$to$the$real$world.$ the$twentyhseven$contributors$have$advanced$degrees$and$hold$positions$as$researchers,$professors,$ lecturers,$authors,$consultants$and$directors$of$organizations$on$global$aging$issues.$ the$ purpose$ of$ the$ text$ is$ to$ convey$ global$ research$ findings$ that$ address$ the$ “complexities$ surrounding$ the$ emergent$ technologies$ and$ sociohtechnical$ practices$ encountered$ within$ the$ later$ life$ course”.$$the$collection$of$studies$explores$a$wide$range$of$topics$including$social$media,$robotics,$chronic$ disease$selfhcare$management,$caregiving,$gaming,$migration$and$data$inheritance.$$the$guiding$themes$ were:$“people$want$to$focus$on$what$they$can$do,$not$what$they$cannot;$aging$in$$place$means$more$than$ staying$at$home;$health$perception$is$not$an$objective$quality;$people$often$make$the$progression$of$aging$ by$watershed$events;$healthy$aging$is$inextricably$linked$to$social$participation;$and$health$care$networks$ are$large$and$increasingly$complex”.$$ the$chapters$are$grouped$under$three$sections$that$designate$topics$on$(1)$connections,$networks$ and$interactions;$(2)$health$and$wellbeing;$and$(3)$life$course$transitions.$$the$emphasis$of$chapters$in$ section$one$is$on$the$use$of$technologies$for$maintaining$social$contact$with$family$and$friends.$$the$findings$ indicated$that$engagement$in$the$use$of$complex$technology$by$older$adults$depends$upon$the$context$ where$learning$takes$place.$unless$people$had$previous$contact$with$computers$in$the$workplace$prior$to$ retirement,$only$basic$technology$was$used.$$informal$peerhpeer$learning$and$games$are$more$effective$than$ formal$classes$in$building$confidence$in$using$the$devices.$$barriers$to$using$computers,$tablets$and$smart$ phones$were$unsatisfactory$past$experiences$and$dissatisfaction$with$inadequate$technical$support.$$costs$ for$purchasing$and$maintaining$the$equipment$were$also$cited.$ the$ chapters$ related$ to$ health$ and$ wellbeing$ centered$ on$ maintaining$ social$ connections$ and$ remaining$ independent.$ $ technical$ devices$ that$ aid$ people$ with$ behavioral$ change$ and$ selfhcare$ management$ of$ chronic$ diseases$ and$ telehealth$ monitoring$ are$ currently$ focused$ on$ longhdistance$ physiological$monitoring.$$attention$to$the$psychological$and$social$factors$is$needed$to$avoid$the$‘iceberg$ effect’$that$fails$to$develop$an$effective$relationship$when$the$technologies$are$viewed$as$‘companions’$in$ the$selfhmanagement$process.$$$ the$chapters$related$to$life$course$transitions$provide$information$on$a$global$trend$of$moving$ away$from$familiar$settings$to$other$more$economical$areas$and$countries;$the$development$of$digital$social$ networks;$motivation$and$engagement$in$digital$games;$and$using$technology$for$creating$and$sharing$ personal$content$that$is$important$about$their$lives$to$pass$on$to$family$and$others.$ the$text$provides$critical$information$on$the$global$aging$population$and$the$use$of$technology$in$ the$twentyhfirst$century.$$$research$findings$demonstrate$excellent$material$for$application$in$a$variety$of$ settings,$and$for$further$research.$$it$will$be$interesting$to$discover$the$differences$in$the$use$of$digital$ technologies$by$the$next$older$generation.$$$$$ $ $ $ $ anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 110-111 issn 2374-2267 (online) doi 10.5195/aa.2015.121 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. of technoscapes and elderscapes editor’s commentary on the special issue “aging the technoscape” jason danely oxford brookes university contact: jdanely@brookes.ac.uk no abstract available keywords: technoscape, elderscape, anthropology, http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 1, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.121 http://anthro-age.pitt.edu of technoscapes and elderscapes editor’s commentary on the special issue “aging the technoscape” jason danely oxford brookes university it was 2006 and i had just come back from eighteen months of fieldwork with older adults in japan. suddenly everyone seemed to be talking about something called “youtube,” but the first few times i looked at the site, i was pretty unimpressed. then one day i saw a video of an older english gentleman, sitting in front of his webcam with a pair of headphones on, telling his life story. there was something about his use of this new technology to reach out to a world of strangers with nothing more than his one and only story that hooked me instantly. i followed peter oakley’s (a.k.a. geratric1927) intimate, no frills videos for years, and i was far from alone. when he died on 23 march 2014, at the age of 87 younger youtubers posted video dedications about how this “grandad of youtube” inspired them to rethink the possibilities of the medium. how did oakely, a widowed pensioner with basic digital production skills change the way i viewed this new technology? in the simplest terms, he made it feel safe. in many ways his calm and regular videos (he made 350 of them over the years) were a pefect example of what margaret mead (1970:72) saw as the role of older people to teach youth “not what they should be committed to, but the value of commitment.” while technological innovations, materials, and know-how circulate the globe, and as technologies are increasingly designed for older users, how will our relationship to technology and to age change? are we in the midst of global shift in the values that propel technological flows? will the technoscape be “aged” to reflect a richer and more diverse range of experiences and outlooks? aging the technoscape means rethinking age through technology while rethinking technology through age. here appadurai’s definition of the technoscape as configurations of technology that move across “previously impervious boundaries” (1990:97) can be applied not only to national or cultural borders, but to the separations between generations, developmental stages of a life course, or to the borders between the personal home and care institution. technologies are moving more rapidly than ever across and between these boundaries, creating the grounds for new abilities and disabilities, ways to better include older adults in society, and disjunctures that marginalize them. while the majority of research on aging and technology privledges arenas of care, bob de schutter and vero vanden abeele’s commentary shows us that older people also play computer games, lots of different kinds of games, and sometimes they do so for the joy of play. de schutter and vanden abeele are not merely interested in older adults who happen to play games, but argue for a field of gerontoludics through which we will be able to see with greater clarity the ways ageist assumptions about the medicalized older person are embedded in gamescapes and the ways that game players point to a broader possibilities that have been too rarely explored. de schutter and vanden abeele’s research on gerontoludics is the kind of work that opens, rather than closes new doors of inquiry for anthropology. to explore these paths further, https://www.youtube.com/watch?v=qj6b2qofp7y https://youtu.be/xnnkxmsn9ay http://tcs.sagepub.com/cgi/doi/10.1177/026327690007002017 http://www.gerontoludicsociety.com/ danely | of technoscapes and elderscapes anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.121 http://anthro-age.pitt.edu 111 111 a&a invited responses from experts on our editorial board. these responses, and the authors’ reply that follows them, give a sense of the intellectual debates relevant to other areas of aging and technology. in what circumstances does technology enhance life by affording opportunities for creativity and self-expression, social contacts and even alternate identities? following this discussion of gerontoludics are two essays on design and engineering, the imagination and production of the embodied technoscape. caitrin lynch’s commentary centers on the opportunities for empathic imagination that arise as students enrolled in her design for aging course learn to use participant observation and person-centered approaches to research with older people. here, the collaborative process of design, the emotional, reflective experiences of the project are instantly recognizable to the ethnographer/educators who themselves are also implicated in the flows of technical production. baldewijns, croonenborghs and vanrumste echo lynch’s concern that when it comes to technology, little attention is paid to the experience of the older adult users themselves. their research report details how taking engineers into the “field” of the elderscapes not only improves the design outcomes, but can have results, like building ongoing relationships between engineers and users. as engineers cross into the care homes to seek technological solutions to the need for care, lutz provides a critical examination of the possible transformations or distortions these kinds of crossings may produce. as forms of mediation and surfacing, care and surveillance technologies suggest relational meanings, of oneself and others. as if to mirror lutz’s idea of surveillance and “care-valence,” bes young’s portfolio depicts subjects longingly dreaming out windows or into the distance, seemingly alone in the care home for person’s with dementia in japan. doors are unattended, unobserved. is this a space where technology has not yet penetrated? what then is the role of the camera, or the one who documents and mediates such spaces? the two remaining articles both examine technology in activities for older adults. in the article by peter biniok and iris menke, technology not only crosses boundaries into rural spaces, but it also then creates an expansion of the terrain of participation in social life near and far. kaplan, sánchez and bradley are also interested in the ways technology mediates connections, and how it can be used to develop innovative activities. they survey 46 programs that employ techniques similar to the “social junctions” described by biniok and menke, going on to develop a valuable thematic overview of the strengths and challenges of intergenerational technoscapes. even with these exciting contributions, there is much more to be said regarding age and the technoscape, conceptually and practically. the mix of contributions to this issue represents some possible avenues for future collaborations and exchanges at the convergence of technoscape and elderscape. jason danely, editor-in-chief references appadurai, arjun 1990 disjuncture and difference in the global cultural economy. theory, culture & society 7 (2): 295– 310. mead, margaret 1970 culture and commitment. garden city, ny: natural history press/doubleday & company, inc. anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp. 85-87 issn 2374-2267 (online) doi 10.5195/aa.2019.236 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of buch, elana d. inequalities of aging: paradoxes of independence in american home care. new york university press. 2018. pp 263. $30 (paperback). erika carrillo purdue university http://www.library.pitt.edu/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ carrillo | book review | 85 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.236 http://anthro-age.pitt.edu book review review of buch, elana d. inequalities of aging: paradoxes of independence in american home care. new york university press. 2018. pp 263. $30 (paperback). erika carrillo purdue university in her debut book, inequalities of aging: paradoxes of independence in american home care, sociocultural anthropologist elana buch provides an outstanding and timely critical examination of the sociopolitical realities of aging and care in the us. by engaging similarly with the intricacies of the lives of older adults, paid home care workers, and home care agencies in chicago, buch sheds new light on care exchanges in elderly home care. she argues that, while home care workers safeguard older adults’ independence, these care exchanges systematically generate inequalities and limitations for paid home care workers. buch’s research scrutinizes these and other intrinsic paradoxes embedded in elderly care infrastructures and discourses in the us. by fleshing out contradictions between contemporary ideologies of “good” care for older adults and the ways paid home care is practiced, inequalities of aging calls for a reexamining of the ways care for older adults and care labor is valued and imagined in the us. the introduction sets the stage for this ethnographic analysis, with a critical examination of how the us care crisis has been framed in recent decades. here, she introduces readers to the concept of “generative labor”: the social and biological practices that generate and extend life. by building on theories of reproductive labor from critical feminist scholars, buch extends the concept beyond the scope of biological reproduction to the entire life course. this concept provides the means to analyze care labor as a life-giving, creative and dynamic process, that also generates and reproduces inequality in practice. in chapter one, “generating independence”, buch uses ethnographic methods including participant observation, interviews, and life histories, to compose moving portraits of us older adults. she uses this collection of data to demonstrate how older adults’ practice both the cultural constructions of personhood and visions of us american independence and how it relates to control over one’s own home and personal property. for example, many older adults feel transitioning from private residence to assisted living to be particularly threatening to their independence and personhood. for this reason, many seniors opt to continue to live in their homes regardless of their need for home care assistance. chapter two, “inheriting care”, shifts the lens, with a similar ethnographic sensitivity, to the lives of paid care workers. like many paid care workers in the us, the employees at the two chicago care agencies where buch conducted her research are predominately low-income women of color and immigrants. they are often paid little over minimum wage, rarely have job stability or receive health insurance. buch introduces a historical perspective to demonstrate how the overrepresentation of women and people of color in domestic, low-wage work, is linked to the long lasting legacies of discrimination and racism in the us work force. carrillo | book review | 86 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.236 http://anthro-age.pitt.edu the third chapter, “making care work”, provides a historical overview of how care work was conceptualized in the us. she investigates the various instruments that were developed to determine older adult’s vulnerability, as well as the code of ethics and professional standards that care agencies enforce upon the home care workers. these labor infrastructures frame care exchange as unidirectional: paid care workers are expected to maintain close, even loving relationships with clients while, at the same time, workers are prevented from sharing details from their own personal lives. thus, the policies that seek to maintain autonomy and independence for older adults simultaneously disregard the well-being and the subjectivities of the paid care workers. these contradictions are deeply entangled with the standards for good care and, as buch argues, consolidate a system that aggravates inequality between home care workers and their more affluent clients. chapters five and six (“embodying inequality” and “independent living” respectively) demonstrate that despite care agencies’ established rules of professionalism and the condensing of care work into standardized activities, care relationships between care workers and elderly clients are complex and multifaceted. by examining specific cases of caregivers’ interactions with their clients, buch shows how care workers utilize their expertise and moral imaginations to preserve each older adult with their own desired ways of living. through embodied care practice, care workers practice “good” care when they put their clients’ needs before their own. thus, they help older adults maintain a social status of independence and living at home, as before the onset of any physical frailty. this upkeep of homes and the sustaining of their client’s independence inevitably renders the labors of care workers invisible. the sixth chapter, “when care falls apart”, is particularly poignant, as it foregrounds the effects of the physical and emotional demands placed on home care workers by their clients and the care agencies that employ them. paid workers’ own familial responsibilities (eg. as mothers, daughters, and caregivers to other kin) are often trivialized in comparison to the needs of their clients. without formal policies, like medical or family leave, workers often have difficulty juggling the needs of their clients with their own personal and familial needs. buch effectively demonstrates how family or medical issues easily bring care workers in precarious positions, since they can be penalized by the care agencies who seek to maintain consistent schedules with their clients. consequently, the demanding work and low wages contribute to the extremely high turnover rates in care agencies, which inevitably worsens the quality of care for older adults. in her conclusion, buch argues that this system, which frames care work as low skill labor, is unsustainable if not destructive since it generates inequality and poverty among care workers. additionally, it limits the care workers’ ability to provide qualitative and reciprocal care for their clients as for their own kin. buch highlights the complex entanglement of poverty and care, and in doing so, urges policy makers and care agencies to develop solutions that address issues of poverty and care in tandem, rather than problematizing them as separate domains. the depth of buch’s interviews with her participants is impressive. the book’s level of detail and knowledge of home care work demonstrate a great deal of trust and rapport buch established with her participants. her work focuses mainly on care workers who are american women of color, excluding the life histories of those who lived outside of the us. i find this particularly curious considering the high number of immigrant care workers in the us. buch’s ethnography, though exceptional, may be enhanced by future research that examines the lives of other types of care workers, especially immigrants. such research can enhance the anthropology of aging more carrillo | book review | 87 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.236 http://anthro-age.pitt.edu broadly, as it will contribute to the growing research in diverse populations and draw more research attention to intragroup difference and diversity of care and aging experiences. overall, the book is excellent and would make a valuable resource for those interested in the topics of old age and caregiving, and in feminist and gender studies. the book would be useful as a teaching resource for upper level undergraduates, graduate students or anyone working in the areas of medical anthropology, public health or gerontology. renske_layout visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 4 going beyond the dwelling challenging the meaning of home at the end of life renske c. visser university of surrey author contact: r.visser@surrey.ac.uk anthropology & aging, vol 40, no 1 (2019), pp. 5-10 issn 2374-2267 (online) doi 10.5195/aa.2019.215 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 5 going beyond the dwelling challenging the meaning of home at the end of life renske c. visser university of surrey author contact: r.visser@surrey.ac.uk introduction populations are aging worldwide and this raises issues regarding where older people will receive care, and where they will die. place of care and place of death matters in the end of life care strategy of the department of health in england and wales (department of health 2008; department of health 2017). where people die, and where people receive care is at the core of the current end-of-life care policy in england and wales and ‘home’ as a place has evolved to be considered the place where most people want to die, and the place where most people should die (borgstrom 2016). many papers on palliative care and end-of-life care start with a phrase similar to ‘the majority of people want to die at home, yet most people die in hospital’. it is assumed that when people speak of ‘home’ they speak of their dwelling, yet in research on the meaning of home it has been suggested that home can have a plethora of meanings (mallett 2004). the implication of this is that when people speak of ‘home’, alongside referring to a place (easthope 2004) they may refer to people (bowlby et al. 1997), or a larger entity like a city, or country (duyvendak 2011). recent research has questioned this notion as home as preferred place of death and scholars have argued that the numbers underpinning this idea do not hold up as many people are not being asked their preference, do not have a preference or cannot state their preference (hoare et al. 2015). additionally, hospital deaths, are often considered to be cold and clinical and are therefore considered ‘bad deaths’ reflecting inadequate end-of-life care (pollock 2015). since home deaths are equated with ‘good deaths’, and hospital deaths with ‘bad deaths’ this may make it is difficult for people to voice alternative opinions concerning their desired place of death (pollock 2015). a reason why ‘home deaths’ are considered the gold standard is that hospital deaths are considered ‘bad’ deaths (jacobsen 2017). medical anthropologist sharon kaufman argues in her book ... and a time to die on dying in hospital in the united states, that the way hospital deaths are perceived are strongly influenced by public perceptions. kaufman (2005) argues that the way death occurs in hospital is a cultural fabrication which has evolved out of a particular historic, political and economic situation. kaufman shows the complexity of people dying in hospital and describes the interplay between doctors, nurses, patients and their family. despite the fact that the majority of deaths occur in hospital this place is unable to shake of its bad reputation. but if, as kaufman (2005) argues, considering hospital deaths as bad deaths is a cultural fabrication, we can change that narrative. undoubtedly dying in hospital can be improved, but we can also improve public discourse on dying in hospital. there are political and economic reasons that underpin the interest in place of death. dying at home could potentially reduce the costs of care, as home deaths are significantly cheaper compared to hospital deaths (higginson et al. 2013). however, research on place of death, mainly focuses on the importance of choice, and does not account for the ‘hidden’ costs of home deaths, such as the delivery of informal care (solé-auró & crimmins 2014). this is mirrored in the current end-of-life care policy where much attention is given to the issue of choice regarding peoples place of death. as a consequence, ‘home’ visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 6 has evolved to be the ideal place of death as this represents ‘what people want’ (higginson et al. 2013; gomes et al. 2013). the additional motives for policy makers and healthcare professionals to reduce the cost of care does not receive much attention in public debate. this essay is informed by research with older people (aged 85 and over) who were ambivalent about dying at home. some older people were very vocal about their wish to ‘die at home’, yet personal experiences such as heart-attacks in public places showed the limitations of those desires and demonstrated how death can just ‘happen’ in any place, at any time. i argue, therefore that the emphasize on the importance of place of death is an unfruitful exercise and rather meaningless. importantly, some older people did not want to die at home, but would most likely die in their dwelling. ‘home’ as a temporal, diverse and fluid concept the meaning of home at the end of life is diverse. on the one hand, it can signify safety and comfort, but on the other hand it can be a potent reminder of loss (peace 2015). in social sciences, it is widely acknowledged that home is more than a physical place. home can be a feeling or a state of mind which is not tied to any place (mallett 2004). while feelings of home can be related to the dwelling, this does not necessarily have to be the case. understandings of home can be attached to physical structures and range from houses, streets, neighbourhoods, cities and countries (mallett 2004; duyvendak 2011). this complexity of home and how people relate to it is important when thinking about ‘home’ as a place of death. what makes a house a home are ‘homemaking practices’ (bowlby et al. 1997; blunt & dowling 2006). these practices refer to habits and routines that make a house feel safe and comfortable. these include mundane activities such as cooking, cleaning and practicing hobbies. burrell argues that homemaking is a continuous process in which people try to get control over their living space (burrell 2014). yet, she acknowledges that this process is often disrupted by factors both inside and outside the dwelling, such as neighbourhood noise, or other people inhabiting the living space. frailty and decreased physical capacities can hinder (older) people in their homemaking practices, and as a consequence the dwelling may not be the ideal nor the desired place to be at the end of life (penney 2013; peace 2015). while there may be interruptions from the outside world, home, as used in policy language, is often understood as a place where people are unhindered in their homemaking activities, as it signifies independence and autonomy. this perceived autonomy ignores the fact that for many people their home is not a desirable or suitable place to be at the end of life (penney 2013) or how homemaking activities may be affected by performing end of life care in the home. recently some studies have demonstrated the diversity of the meaning of home at the end of life (peace 2015; collier et al. 2015; venkatasalu et al. 2014). as the uk has a diverse population, notions of ‘home’ at the end of life are similarly complex and varied. a study on beliefs on dying at home among south asians living in london revealed that place of death was considered less important than being able to perform certain rituals and cultural practices (venkatasalu et al. 2014). for many ‘home’ referred to the home land, the country they had migrated from prior to living in england (venkatasalu et al. 2014). an australian study suggests that using ‘home’ as a proxy for good care does not adequately capture the quality of care at the end of life (collier et al. 2015). researchers in this study suggest that understanding home as a fluid concept would be helpful to better meet the needs of dying patients and their families. importantly, throughout a lifetime people can create ‘home’ in multiple places. for example, it has been argued that people are very good at making public places like hotels ‘feel like home’ (duyvendak 2011). previous research has shown that people are capable of creating a sense of home in other places such visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 7 as nursing homes (hauge & kristin 2008), or hospices (kellehear et al. 2009). this shows that homemaking could be done anywhere, and is not confined to people’s houses. even if people do not move in later life, home is not a static unchanging concept, but a process that requires work. in other words, simply being inside one’s dwelling does not automatically make it feel like home. home is the complex interplay of space, relationships, the body, and time. the question to what extent older people feel at home in their current living space, therefore, needs frequent revisiting. aging and dying for the first time while patient autonomy is valued both in the english as well as the american healthcare system (borgstrom & walter 2015; kaufman 2005), kaufman’s (2005) ethnography shows that while patients and their families are included in medical decision-making, they have a hard time making decisions regarding treatment or non-treatment. an important notion that comes to the fore in kaufman’s work is that people do not know what they want in terms of care. taking kaufman’s notion further, i suggest that the same issue of ‘not knowing what to want’ applies in relation to place of death. as people are aging and dying for the first time, these decisions are made on an ad hoc basis. some people die in their own dwelling because they ‘wanted’ to. similarly, people will want to die in a hospital, nursing home or hospice. i suggest that the majority of dying is happenstance, it is how life unfolds. in my research with older people in the southwest of england, their narratives included a lot of things older people did not want, because a neighbour, family member or friend had died that way. much harder was it for participants to pinpoint what they did want. importantly, some participants changed their narrative of what they wanted each time i visited them. while participants spoke about the loss and death of others, they were less willing (or perhaps able) to talk about their own mortality. this absence of talk about dying was unexpected given their readiness with which they would detail life-threatening events, such as strokes and heart attacks. as participant myrtle commented (aged 88), when prompted to reflect on her own mortality: “that [dying and death] is for the future”. while people may have preconceived notions on where and how they want to die, these ideas will change over time. with this in mind, the way home is understood in social science disciplines such as anthropology is helpful in accounting for and anticipating the temporality and relationality of the meaning of home. stories told by my participants reflect the unpredictability of dying, and the challenges older people face when ageing (and dying) in their dwelling. my oldest participant was marie, 98 at the time of our meeting. six years earlier marie had experienced a stroke in her house. from being ‘independent’ and doing most things on her own she suddenly had to rely on other people for basic things like showering and the food shopping. marie described the event as follows: i was upstairs. and i came down. i knew there was something wrong with me but i could not think what it was, and i fell down and crawled across the floor and my phone was over there somewhere”, [she points to another place in the sitting room], “and i dialed 999. and the girls [ambulance personnel] tried to get in. of course i had the chain on the door and i couldn’t open the door, and they could not use the key. so i managed to knock out one of the little catches on the window [in the sitting room we were in] and they crawled through the window. marie almost died in her own dwelling when she had the stroke. she had been able to reach her phone but she was aware that she could have been dead in her house for some time before anyone would have found her. while people were visiting her on a daily basis at the point that i met her, this had not been the case visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 8 before the stroke. her son would ring her often, but there could have been days where no one would have visited her house or telephoned. marie’s experience further raises the important question of the extent to which ‘the home’ is equipped for death and dying. the ambulance personnel were not able to enter the house through the front door and were delayed in helping her. however, if marie had died there and there, statistically it would have been considered a ‘good death’ as she had died ‘at home’. in policy terms it would be considered a success as it shows that people die in the place ‘they want’. marie’s experience shows how dying can ‘just’ happen. here we see the problematic nature of just focusing on place when considering death in older age. dying is messy. one the one hand, people could die in their sleep, peacefully in their own bed, but on the other hand people could die from a major health event, or a falling accident. it is important to acknowledge the range of ways ‘dying at home’ can occur. one of my participants, june, a 93-year-old former librarian, died during the course of my study. june had been very clear about what she did and did not want. she had written everything down: she wanted to die alone and she wanted to die in her current dwelling. june had been experiencing health problems for quite a while. at the time of our meeting she had been diagnosed with bowel cancer which interfered with the way she had envisioned her own death. she had been very determined not to receive any medical interventions but with the particular case of this cancer she had to face the reality of how to cope. she told me, “i have to make some important decisions, i thought i made all the decisions i needed at my age”. at the point of her bowel cancer prognosis there was growing disjuncture between her wishes and reality of her end of life. while june had anticipated her death and dying, her expected ending could not be achieved with the bowel cancer prognosis, as she would die in a lot of pain if this was left untreated. it also made it impossible for her to die in her own dwelling. in other words, her lived reality challenged her envisioned future and death. as it became apparent that june could not remain in her own dwelling she had to think about where else she could go. i did not speak to her about this but after june’s death i interviewed one of her close friends who told me: the only thing she asked for was a white uncluttered room, with a view. a familiar english view. that was what she wanted. and she wanted her bed to face the view. that was all she asked. and we found that for her. and within a day of all of this happening there she was looking at quintessential english countryside. june did not die in her own dwelling, but in a care facility. her death shows the limitations in understanding ‘home’ as one particular place whereas ‘home’ can be so many things in a person’s life. for june ‘home’ at the end of life was the ‘quintessential english countryside’ and by looking at this she was ‘at home’ albeit not in her own dwelling. this is crucial in understanding the complexity of ageing and dying. older people are ageing and dying for the first time and coping with issues as they arise. it is very difficult for people to anticipate what is desirable and what not until they are confronted with particular issues. discussion if the focus is to remain on preferred place of death, it is important to unpack what people mean when they say they ‘want to die at home’. here i have suggested that policy could benefit from a broader understanding of home, informed by the social science research on this topic. ultimately, a ‘one size fits all’ approach to understanding the preferred place of death is not helpful as it does not take into account the continued evolution of individual life stories and the dynamic relationship between people, places and visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 9 their bodies. accordingly, considering a home death as the gold standard is problematic, as it does not make room for the actual lived experience of people and their individual preferences. rather, the notion of ‘home’ is in constantly in flux and people’s relationships with their dwellings are not always positive. furthermore, an unquestioned preference for the home as the ideal place of death can obstruct any meaningful discussion and provision for people who do not wish to die ‘at home’. at present, ‘home’ is presented in end of life strategy documents (public health england 2014; department of health 2012) as a clear ‘best place’ to die, meaning that those who reject this can be regarded as deviant. the key to future best practice is therefore to ensure there are opportunities for older people to discuss their preferences over time, including acknowledging that their wishes may change according to how they are experiencing their body and dwelling, as the aging process develops. similarly, the notion that some people do not have any preferences or desires to plan ahead deserves more attention too. older people are aging and dying in a myriad of places. while the dominant discourse emphasizes the importance of dying at home, this is problematic for various reasons. firstly, there is empirical evidence that the home-environment is not always safe and comfortable to be in at the end of life (penney 2013; means 2007). secondly, a large group of older people is not aging and dying within the home-environment. many older people age in nursing homes and care homes. additionally, while not the topic of this paper, a growing number of older people are aging in prisons and forensic settings. furthermore, there is also a growing group of homeless people dealing with end-of-life issues. what this shows is that aging and dying in any place is complex, and this complexity has to be taken into account when practically thinking about the reality of death, irrespective of location. this paper has suggested that the dying at home discourse could be lifted from the physical boundaries of the dwelling and moved to other locales; what does dying ‘at home’ in hospital; dying ‘at home’ on the street, or dying ‘at home’ in prison look like? these are questions that have to be answered as people will die in these places, irrespective of what people might perceive as the ideal. any place can become someone’s home and therefore, potentially, dying in any place could be a home death. however, in some places it is more difficult to create a ‘home-like’ environment, particularly in a place where you don’t want to be. older people have a lifetime of experience of homemaking, and therefore may have various and perhaps contradictory understandings of what is ‘home’, and what not. people’s lived experience shapes the way they envision their death and process of dying. older people can have specific ideas of what they want to happen in life, but their experience of their bodies, relationships and space can develop and evolve in unpredictable ways right up until the moment of death. hence, the fluidity of and temporality of homemaking has to be taken into account when thinking about good policy and practice. by understanding ‘home’ as a complex multi-layered concept, ‘home deaths’ potentially could occur in any setting, may it be the dwelling, hospital, nursing home or hospice. references andrews, g.j., evans, j. & wiles, j.l., 2013. re-spacing and re-placing gerontology: relationality and affect. ageing and society, 33(8), pp.1339–1373. blunt, a. & dowling, r., 2006. home, london and new york: routledge. borgstrom, e., 2016. national end-of-life care policy in the english context: the problem and solution to death and dying. in l. foster & k. woodthorpe, eds. death and social policy in challenging times. houndmills, basingstoke: palgrave macmillan, pp. 35–53. borgstrom, e. & walter, t., 2015. choice and compassion at the end of life: a critical analysis of recent english policy discourse. social science and medicine, 136–137(2015), pp.99–105. visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 10 bowlby, s., gregory, s. & mckie, l., 1997. “doing home”: patriarchy, caring, and space. women’s studies international forum, 20(3), pp.343–350. burrell, k., 2014. spilling over from the street. contextualizing domestic space in an inner-city neighborhood. home cultures, 11(2), pp.145–166. collier, a., phillips, j.l. & iedema, r., 2015. the meaning of home at the end of life : a video-reflexive ethnography study. palliative medicine, 29(8), pp.695–702. department of health, 2012. end of life care strategy. fourth annual report., london. department of health, 2008. end of life care strategy. promoting high quality care for all adults at the end of life, london. department of health, 2017. one year on: the government response to the review of choice in end of life care, london. duyvendak, j.w., 2011. the politics of home. belonging and nostalgia in western europe and the united states, london: palgrave macmillan. easthope, h., 2004. a place called home. housing, theory and society, 21(3), pp.128–138. gomes, b. et al., 2013. heterogeneity and changes in preferences for dying at home: a systematic review. bmc palliative care, 12(7). hauge, s. & kristin, h., 2008. the nursing home as a home: a field study of residents’ daily life in the common living rooms. journal of clinical nursing, 17(4), pp.460–467. higginson, i.j. et al., 2013. dying at home – is it better: a narrative appraisal of the state of the science. palliative medicine, 27(10), pp.918–924. hoare, s. et al., 2015. do patients want to die at home? a systematic review of the uk literature, focused on missing preferences for place of death. plos one, 10(11), pp.1–17. jackson, m., 1995. at home in the world, durham and london: duke university press. jacobsen, m.h., 2017. ‘the bad death’: deciphering and developing the dominant discourse on ‘the good death.’ in v. parvaresh & a. capone, eds. the pragmeme of accommodation: the case of interaction around the event of death. new york: springer, pp. 351–373. kaufman, s., 2005. ...and a time to die. how american hospitals shape the end of life, new york: scribner. kellehear, a., pugh, e. & atter, l., 2009. home away from home? a case study of bedside objects in a hospice. international journal of palliative nursing, 15(3), pp.148–52. mallett, s., 2004. understanding home: a critical review of the literature. the sociological review, 52(1), pp.62–89. means, r., 2007. safe as houses? ageing in place and vulnerable older people in the uk. social policy & administration, 41(1), pp.65–85. peace, s., 2015. meanings of home in later life. in j. twigg & w. martin, eds. routledge handbook of cultural gerontology. london: routledge, pp. 447–454. penney, l., 2013. the uncertain bodies and spaces of aging in place. anthropology & aging quaterly, 34(3), pp.113– 125. pollock, k., 2015. is home always the best and preferred place of death? bmj, 351(october), pp.31–33. public health england, 2014. what we know now 2014, london. solé-auró, a. & crimmins, e.m., 2014. who cares? a comparison of informal and formal care provision in spain, england and the usa. ageing and society, 34(3), pp.495–517. venkatasalu, m.r., seymour, j.e. & arthur, a., 2014. dying at home: a qualitative study of the perspectives of older south asians living in the united kingdom. palliative medicine, 28(3), pp.264–272. visser | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.215 http://anthro-age.pitt.edu 11 visser, r.c., 2017. “doing death”: reflecting on the researcher’s subjectivity and emotions. death studies, 41(1), pp.6–13. wye, l., percival, j. & purdy, s., 2012. independent evaluation of the marie curie cancer care delivering choice programme in somerset and north somerset final report october 2012 university of bristol evaluation project team, (october). woodward_culbert_finaldoc aage and age a conversation with dr. christine l. fry, founding president of aage janis woodward george mason university author contact: jwoodwa6@gmu.edu brandan culbert george mason university author contact: bculbert@gmu.edu keywords: aging; age; anthropology; aage; gerontology; fieldwork anthropology & aging, vol 40, no 2 (2019), pp. 72-75 issn 2374-2267 (online) doi 10.5195/aa.2019.233 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. woodward and culbert | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.233 http://anthro-age.pitt.edu 72 aage and age a conversation with dr. christine l. fry, founding president of aage janis woodward george mason university author contact: jwoodwa6@gmu.edu brandan culbert george mason university author contact: bculbert@gmu.edu “age is time, and time is everything, time gets you into the questions of persistence and change, everything is moving through time.” this was a statement by dr. christine l. fry, the founding president of aage and emeritus professor at loyola university chicago. dr. fry is a seminal figure in the development of the field of anthropology of aging and has played an important role in fostering a community of scholars dedicated to understanding gerontology and the life course. in may 2019, in commemoration of the 40th anniversary of aage, we had the opportunity to interview dr. fry and discuss her career and the future of aage, all while simultaneously gaining important insights about gerontology and anthropology. we began by asking dr. fry what led to her interest in anthropology and more specifically, aging. she jokingly gave us an agatha christie-esque answer, “i married an archaeologist and he likes old things.” but her honest answer was that her interest in anthropology and aging had been cultivated by an immense curiosity of the unknown. she was first exposed to a culture different than her own when she went to new mexico. the native american culture inspired her to explore the vast intricacies of other cultures and social dynamics. she then went on to graduate school at the university of arizona and was drawn to a community development program that focused on, “applying anthropology to solve problems for people in the third world.” dr. fry spoke more about this program and how it was a gateway to her discovery of aging research: in that seminar, i discovered old people. one of the assignments was to find a community that was in trouble and go out and do ethnography. and that i did. there was a retirement community that was in bankruptcy because it had just been developed and the people bought into the community. . .and then the developer went into bankruptcy. so, the recreation hall, the streets, all the infrastructure was in limbo. . .so i went out there and i said, ‘this is different’ these people are not like my grandparents or any of the older people that i knew in any of the communities i lived. after the seminar, i moved into another one [adult community]. the social distance that was defining old just disappeared and these people were just people. they were living, working, and actually creating a community. her experience in the seminar led us to discuss aging as a specialization in the field of anthropology. we wanted to know the benefits of having aging as a specific area of research and expertise within anthropology. dr. fry began by discussing aging as a field of study in academia at the time, or the lack thereof: in terms of the switch to aging as an area—that was not an option in the program i was in. there was no gerontology. there was only one sociologist who had any connection to woodward and culbert | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.233 http://anthro-age.pitt.edu 73 gerontology. and i started trying to write a master’s thesis and i was really kind of disgusted by the literature. it had nothing to do with nothing in terms of the professional literature. except there was margaret clark. i remember the u of a library—one day i walked out and there was culture and aging sitting on the display for recent books. it was clear that here was an area that needed help and also an area that had opportunity. i started looking at trying to connect what i was doing in these retirement communities with anthropology but also with gerontology. what i discovered—i think we all discovered— was that gerontologists were welcoming us but primarily for the cross-cultural. it became a niche for anthropology. the benefit of this is, she explains, “if you have a niche in which to expand, you can use anthropology to show that you can actually do much more than the cross-cultural. with the help of anthropologists like margaret clark and jay sokolovsky, and the advent of aage, dr. fry was able to expand this niche into an actual corporate entity. dr. fry’s endeavors helped to create a foundation for future studies in the anthropology of aging. dr. fry reiterated the benefits of anthropological studies of aging: “anthropology enables us to ask -in the long termquestions about the social structure that make old age problematic. old age itself is not problematic except we made it problematic. it turns out that the old are another version of the ‘other’ that needs explanation.” this was a revelation to us. as students of anthropology, edward said’s (1978) concept of ‘the other’ is something that we often utilize when studying different cultural contexts. however, we had never thought of applying this concept when trying to understand age. older people are often othered and socially divided in the united states, where we are based, whether we realize it or not. it happens consciously and subconsciously; it is through the way we treat and view older people. dr. fry added, “that’s what anthropology is good at—to decrease that social distance, the divisions we use in everyday social life. age is just one of them.” staying on the topic of aging and research, we asked dr. fry about one of her major research endeavors called, project age. dr. fry was the co-director of this project, alongside jennie keith. the project was an almost 20-year cross-cultural research study dedicated to understanding the meaning of age and the experience of aging across different cultures. the geographic locations of this study spanned across seven different sites, from the !kung in africa, to ireland and hong kong. not only was this a huge endeavor, but it was also complex and multifaceted. dr. fry explained to us the many trials and tribulations of first, trying to get the research project started and second, of the actual fieldwork itself: project age is huge. it took at least fifteen to twenty years of work. it is an experience in and of itself. there are all sorts of dimensions to it. first of all, the infrastructure of setting it up. there was the whole learning of how to work with nih, getting into budgets and accounting. and then it was getting the team together because this was a team project, it could not be done by two people. so, we had the individual anthropologists, who were individually responsible for each of the seven sites. that was interesting in and of itself because we used aage to identify the people with the expertise to be able to hit the ground running when they got to ireland or hong kong or botswana. dr. fry continued the discussion of project age by sharing the challenges of conducting fieldwork. she remembered that the !kung had an aversion to the formal interview. therefore, the anthropologists had to find alternative ways in which to communicate with the !kung and gather data. dr. fry explained how they utilized both qualitative and quantitative data in an attempt to be as holistic as possible. project age is said to be one of the most comprehensive and sophisticated studies of cross-cultural aging. what we found the most fascinating is that dr. fry utilized aage to achieve this. woodward and culbert | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.233 http://anthro-age.pitt.edu 74 moreover, we inquired about her thoughts on the digital revolution and the digitizing of anthropology& aging, the official publication of aage. she described herself as actually witnessing the digital revolution right before her eyes. speaking about her experience further, “that is something that most professional organizations had to deal with back in the 1990s. it clearly was the future.” to dr. fry, the digitizing of the journal was very advantageous, it allowed for the journal to be accessible and discoverable to all, especially since it is open access and peer reviewed without fees for authors. all the work of aage over the course of its existence was neatly organized into one website. since its origins, aage has transitioned through immensely positive changes: in 1979, when we were creating aage, what it's presently doing was not even on the distant horizon in the 80s and 90s. in the beginning, it was only the newsletter, the membership list, and annual meetings. there was no margaret clark award, there was no journal. there was no website—there was no web. there was no email! dr. fry shared with us in an email that in 2004 she had lost contact with aage, but that did not hinder her pursuit of gerontological research. in 2011 she published “culture and meaning: strategies for understanding the well-being of the oldest old,” emphasizing the conversation concerning older individuals and how well-being is experienced is important for the medical community to understand. she noted that well-being is the “big question” but currently does not have a good answer. the problem is—this was learned from project age—well-being is cultural. in culture there are a lot of different ways from getting here to there. it becomes difficult to establish a simple connection between economic issues and well-being. you would like to have a linear connection between wealth and well-being. you would expect from the african sites, to the irish sites, to hong kong and the united states that there would be some linearity and there wasn’t. you do have a connection ultimately. well-being has evolved into a question of successful aging. with all of the complexities within stratified societies, defining a link between socio-economic factors and well-being on the perceptual impact of successful age is a challenge. the only definite that was shared concerning socio-economic factors is that poverty is not beneficial towards well-being, to which she explains, “is not new.” poverty is stressful because it requires a great deal of energy and time because a person has to constantly think through their next move, their next meal, and their next bill. continuing the conversation on age and class we decided to ask why well-being was an important idea for the medical community to understand. her reply was that medical anthropologists should be concerned with conceptualizations of “successful aging” and how age has become medicalized: the medical industrial complex is a market that stands next to the military and federal budget. the middle class goal is to access the medical establishment but what about the other classes like the working class and poverty? even the healthiest and wealthiest individuals in the end are likely to experience less than successful aging. add time to the dimension of successful aging and the goal is to keep aging off as much as you can. the culture surrounding age within the united states essentially defines successful aging in terms of your material security and health. as dr. fry points out, no one is exempt from the factor of time; moreover, it appeared that time seemed to affect individuals in poverty more so than those of middle and higher economic classes; financial circumstances interrupt access to medical establishments to the point of being considered unattainable. woodward and culbert | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.233 http://anthro-age.pitt.edu 75 as our conversation neared the end, we, as then two senior college students, asked dr. fry if she had any advice for anthropologists seeking to establish a career in aging studies and anthropology. she shared that it is important for scholars to figure out what strikes their curiosity and what they find interesting. she believes that anthropology provides “an excellent platform to do almost anything.” she acknowledged that many anthropology students follow different career paths, such as education or medicine, but they still continue to function through an anthropological mindset. for those that choose to continue a career in anthropology the most practical advice she gave was to do fieldwork and to, “understand anthropology and the world that supports it.” she continues, “and that’s the social world. culture diversifies much faster than the social world that supports it because the social world has constraints.” we believe dr. fry’s assertion of discovering a niche is especially important and nearly limitless as cultures continue to change and diversify. there are nuances in cultures that could spark an interest for any prospective anthropologist to discover. although dr. fry has retired from the field, her interest in aging has not disappeared. in 2018, she and her husband decided to restore a house in the historic district of bisbee, arizona. restoring the past is what anthropologists do, all while trying to understand the nuances of the present. dr. fry’s impact on the anthropological study of aging still remains as poignant as the house she decided to rebuild. this is evident with the success of aage. we asked dr. fry what she would like to see become of aage in the future: “back in 1979, we incorporated aage to make it a social person. we gave it eternal life and that transcends any personalities that were involved anywhere along the line. hopefully, it will go on forever.” however, she did recognize the struggles and tough times that any association, including aage, may face throughout its life course. after years of being an association, it can be difficult to find new people who are willing to take on leadership positions. “it can end,” she said, “but i think as a social entity, aage will go on doing mostly what living things do and that is, respond to the context in which they are working. i think that aage in its success forms a platform to creatively find new ways to meet and discover new needs for its members.” for dr. fry, aage is an important part of her identity and she has been able to build a community of dedicated and passionate people, who also see it as a part of their own identities. dr. fry foresees a bright future for aage, and how far the association has come since its origins in 1979 has been immensely gratifying. she said that it is anthropology students like us that help expand the networks and communities of aage. by doing so, we are adding to its longevity. dr. fry’s words stirred within us the immediate urge to tell our fellow anthropology peers, and even peers from other majors, to participate in groups and communities, like aage. it is important now more than ever to attend annual conferences, aaa meetings, and even create our own associations based on our new anthropological interests and curiosities. in meeting other anthropologists and having conversations, we have a great opportunity to learn something new. it is a way in which we can become active anthropologists and create meaningful communities that will outlive us all. references said, edward. 1978. orientalism. new york: random house, inc. anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.248 http://anthro-age.pitt.edu book review review of hill, twyla j. family caregiving in aging populations. new york, ny: palgrave macmillan. 2015. pp. 132. price: $67.50 (hardcover); $67,50 (paperback); $49.99 (ebook). valerie j. smith california state university, east bay “ anthropology & aging, vol 41, no 1 (2020), pp. 107-109 issn 2374-2267 (online) doi 10.5195/aa.2020.248 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ book review | smith | 107 anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.248 http://anthro-age.pitt.edu book review review of hill, twyla j. family caregiving in aging populations. new york, ny: palgrave macmillan. 2015. pp. 132. price: $67.50 (hardcover); $67,50 (paperback); $49.99 (ebook). valerie j. smith california state university, east bay in family caregiving in aging populations, sociologist twyla hill carefully reviews the existing literature on the contemporary “caringscapes” (bowlby, 2012) for adults 50 and over who are providing family caregiving. she depicts the complexity and multiplicity of ‘family’ within these diverse terrains, and the impact of the particularities of these relations on the burden, the cost and the emotional aspects of caregiving. hill’s focus on family caregiving (or informal care), rather than on institutional care (or formal care), very well encapsulates today’s situation for older adults facing one or more health problems. she reminds us that 75% of all help needed by the elderly is rendered by family members and friends, and that the kinds of relationships in which care is delivered are very diverse and deserve more specific, bottom-up research. as is common in the field, hill uses a broad definition of ‘informal caregiving’, which includes unpaid caregiving assistance to provide direct services, physical care, care services coordination, emotional support, and/or financial support. the book mainly aims to meticulously and systematically review existing aging research on informal caregiving. hill rightly diagnosis both the persistent lack of adequate numbers of minority groups and of an accurate representation of diversity within ethnic and racial categories withing this body of literature. in a similar vein there is an all too easy assumption of a nuclear family structure. where possible, she includes discussions of what is known about these diverse groups, including nontraditional families such as lesbians and gays, but clearly more research needs to be done in these areas. chapter 1 provides sociological and historical contexts of u.s. caregiving in later life. here the author reminds us how and why the need for caregiving in later life has significantly altered, both in degree and in kind: with an increase in life expectancy from 60 years old at the beginning of the 20th century, to 70 to 80 at present, a concomitant rise in disabilities and chronic diseases is only natural. hill launches a wake-up call, by reminding us that the percentages of americans in longterm residential care facilities is quite low at only 4% for those 65 years old and older and 15% for those 85 years and older. the remaining older adults live in the community and for elders who require assistance, most help comes from unpaid informal caregivers. this means many of us will provide caregiving for a spouse, parent, or other loved one in our lifetimes, especially with the greater need for caregiving as the baby boom cohort ages. many of us will also receive care from a loved one, peer, or friend in the not so distant future. the bulk of the book is organized conveniently by the relationships of the caregiver to the care recipient. this relational perspective complicates more generalizing conceptualizations of ‘care relationships’ and ‘family’, highlighting the existential difference it makes in which kind of relation care is articulated (spouses, children, same sex partners, …). in chapter 2, hill finds, in her focus on spousal and intimate partner caregivers, that husbands and wives typically provide care differently: with different costs, effects, rewards, and consequences, along with differing amounts and types of http://anthro-age.pitt.edu/ book review | smith | 108 anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.248 http://anthro-age.pitt.edu support from others. for example, men tend to report more than women that they perform household chores such as laundry, housework, and shopping as part of their caregiving role. this suggests that taking on a new task outside of conventional gender roles highlights the caregiving aspect of the work. hill briefly surveys the sparse caregiving research about older same sex and cohabiting partners, contrasts it with research on married couples, and then concludes that in general married couples have a privileged status, with married older persons being healthier and having more resources. while marriage laws are changing for same sex couples, these older couples have endured challenges over the years of their relationship that heterosexual couples have not, such as not having access to their partner’s health insurance. in chapter 3 hill focuses on variations among adult children caregivers. sons and daughters generally offer different amounts and types of care, with 75% of adult children caregivers being daughters. sons tend to wait to be asked for help, to enable their parent to maintain some selfsufficiency, whereas, daughters typically step in to fill the existing needs . variations in adult children caregiving occur by ethnicity, race, socioeconomic status, and other factors. children experience different caregiving consequences and rewards than spousal caregivers and more factors affect the provision of care by children than by spouses. chapter 4 reviews the more limited research on caregiving by siblings, grandchildren, inlaws, ex-spouses, other relatives, or fictive kin, and discusses team caregiving and secondary caregiving. the percentage of secondary caregivers, is higher for minority groups than for nonhispanic whites. this may mean they can more easily call upon other relatives for assistance, but not necessarily that more caregivers are available. while fewer than half of primary caregivers receive help from a secondary caregiver, some families have formed caregiving teams which usually consist of at least three people coordinating their schedules to provide care for the family member. in this chapter, hill includes kin care within sexual and ethnic minority groups most research for sexual minority groups tends to focus on gay men providing care for someone with aids, although the relationship of the caregiver to the ill person is not typically specified, nor are racial or ethnic differences within these groups discussed. lesbians take on more caregiving burden and traditionally female tasks than gays, similar to trends of females doing so more than males in the general population. chapter 5 concludes with an excellent overview of current policies and policy implications regarding caregiving. two policies concentrating on informal, unpaid caregiving are described which can assist a person once they decide to become a caregiver: the family and medical leave act (fmla) of 1993 and the national family and caregivers support program (nfcsp). about 60% of us employees are covered by the fmla which offers up to 12 weeks off work per year. however, many informal caregivers are unaware of this program, or don’t know that the policy applies to them if they are caring for a relative related by blood, adoption, or marriage. instead, they view the policy as a benefit only for new parents. the nfcsp in turn, offers a variety of support for caregivers, including lgtb family members,, with respite care being the most commonly used assistance. while few federal or state laws directly address informal caregiving by family members, several policies can indirectly influence whether people choose to become caregivers at all. hill explains how social security, medicare, and medicaid affect some people’s willingness and ability to become caregivers. while adult children become caregivers for aged parents for a variety of reasons, such as affection, a sense of obligation, or an interest in reciprocating, for those who include expectations of an inheritance in their reasoning, social security and medicare can help to maintain their parent’s assets and can positively influence their choice to provide care. however, older http://anthro-age.pitt.edu/ book review | smith | 109 anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.248 http://anthro-age.pitt.edu caregivers must also weigh how working fewer hours or retiring earlier than planned because of caregiving will reduce their own social security income in the future, since benefits are calculated based on paid participation in the labor market. hill concludes that most us policies reward participation in the work force, whereas more recognition and support is needed for this large group of unpaid familycaregivers, , such as allowing social security credit for time they provide in unpaid care. hill conscientiously and deliberately integrates the multiplicity of ‘families’ in caregiving, with a particular focus on ethnic, racial, and sexual minority groups and the way they are differently embedded in existing caregiving infrastructures. this of course also implies discussing the way societal gender expectations entangle with hegemonic perceptions of ‘normal’ caregiving. the writing is purposely descriptive of the caregiving literature, by which the reader comes away with a solid factual analysis. family caregiving in aging populations however, contains ample suggestions for future research, such as analytical attention for differences in caregiving among and within diverse ethnic groups; research focusing on caregiving in later life among gays and lesbians or equivalent representation of “fictive kin” (friends), grandchildren, and other nontraditional caregivers. this research would represent a more progressive, realist configuration of contemporary caregivers. the book will be especially valuable for upper-division and graduate classes in gerontology and aging studies across disciplines. it provides an overview of existing literature, diagnoses a lack in this research with regard to the multiplicity of family caregiving relations and the implications for everyday affective practice, and contains suggestions for improving services for patients and clients and their closest (care) ecologies. references bowlby, sophie. 2012. “recognising the time—space dimensions of care: caringscapes and carescapes.” environment and planning a: economy and space 44(9): 2101–2118. http://anthro-age.pitt.edu/ _grendellfinalbr book review review of geeta dnair. macroeconomic aspects of aging and retirement of college and university teachers. indo-french perspectives. palgrave macmillan: mumbai, india: 2017. pp. 74. price $69.99. ruth n. grendell, dnsc, r.n. anthropology & aging, vol 39, no 1 (2018), pp. 121 issn 2374-2267 (online) doi 10.5195/aa.2018.198 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.198 http://anthro-age.pitt.edu grendell | book review 121 book review review of geeta nair. macroeconomic aspects of aging and retirement of college and university teachers. indo-french perspectives. palgrave macmillan: mumbai, india: 2017. pp. 74. price $69.99. ruth n. grendell, dnsc, r.n. the author describes the palgrave pilot project based on a post-doctoral india-france collaborative exchange fellowship of the india council of social science conducted in 2013. “mapping global population trends indicate a dominant increase in longevity and life expectancy in the 21st century”. contributing factors include better nutrition, sanitation, access to medical care, education and economical changes. nair identifies additional concerns regarding the shrinking of the younger generation due to late marriages, infertility, and emergence of double-income families and distance in living conditions that can result in unavailable family members to care for the elderly who need physical and financial assistance. nair mentions the findings of the madrid international plan by the united nations organization regarding the world-wide impact of modernization and urbanization that has resulted in a decrease in large families and inter-generational support; while there is a decrease in government support and an increased need for additional care for the elderly. “this is an emerging field of topical importance in general human development throughout the world”. the purpose of the study was to explore the similarities and differences related to longevity and the potential impact on individuals, families, and societies of france, a developed nation, and of india, a developing nation. college and university teachers were selected as the study participants that are regarded as valuable resources for their role in educating the nation’s future generations. separate chapters of the text are devoted to each country describing the specific factors related to longevity and the impact on the society at large. although a variety of retirement plans and pension systems were created in developed countries several years ago, little attention has been given to retirement assistance in india, africa, and other developing nations. however, many of the retirement benefits are not sufficient to meet the needs of the older individuals, and efforts to revise them is ongoing. projected estimates indicate one-third, or 16 billion, persons will meet the stated retirement age of 67 in france. the number of older citizens in the developing countries is, also, expected to rise. world-wide, many older adults are not actively involved in their retirement planning and express they prefer to age with security and dignity and to continue to participate in their societies as citizens with full rites. however, the nation’s designated retirement age is needed to provide job opportunities for younger workers. these global issues, certainly, pose many challenges. these study findings can be a resource for further research and understanding of the critical issues related to longevity at the local, national, and global areas. global monitoring organizations including the world health organization are prime areas for ongoing research, and recommendations for change. the continuing debate about what age is old requires serious consideration. the average age may be extended in the future, then “perhaps the mean age will be 75 by 2050”. no single retirement package can fit all situations, nor be effective over time; there is a need to create a society to meet the needs for all ages. book review | gangopadhyay | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.252 http://anthro-age.pitt.edu 109 book review review of bildtgård, törbjörn and peter öberg. intimacy and ageing: new relationships in later life. bristol: policy press. 2017. pp 224. price: $42,37 (paperback). jagriti gangopadhyay manipal centre for humanities, center for women’s studies, karnataka anthropology & aging, vol 41, no 1 (2020), pp. 110-111 issn 2374-2267 (online) doi 10.5195/aa.2020.252 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ book review | gangopadhyay | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.252 http://anthro-age.pitt.edu 110 book review review of bildtgård, törbjörn and peter öberg. intimacy and ageing: new relationships in later life. bristol: policy press. 2017. pp 224. price: $42,37 (paperback). jagriti gangopadhyay manipal centre for humanities, center for women’s studies, karnataka in intimacy and aging: new relationships in later life, social gerontologists törbjörn bildtgård and peter öberg, focus on various forms of late-life intimate relationships among heterosexual couples. the book is a part of the ageing in a global context series, and traces notions of intimacy among older adults against the backdrop of modernity. whereas later life is usually associated with widowhood, loss and pain, this book attempts to debunk these stereotypes and highlight that, and how older adults deal with late-life intimacy. the authors draw from international research and data, and also use their own swedish case studies to address older people’s expectations and experiences of late-life repartnering. bildtgård and öberg first and foremost address the existing knowledge gaps in the discipline of gerontology and family sociology concerning late-life intimacy, such as the lacunae in scientific research on late-life repartnering. the book uses a mixed methods approach and applies different theoretical models to counter the “data rich theory poor” (birren, 1999: 459) challenge in the discipline of gerontology. adopting an interdisciplinary perspective, this book successfully covers vital dynamics at the intersections of culture, intimacy and aging. in chapter 1, the authors suggest this book is particularly relevant for gerontologists, family sociologists and sexologists, as it transcends the common sensical association of old age with loss and decline. from chapters 2 to 4, the authors outline the theoretical foundation of the book and establish the phenomenon of intimate relationships in later-life as “a historically and culturally dependent social institution” (7). chapter 2 argues that it is in the emergence of the third age, based on consumer culture – which nurtures self-development and flexibility in relationships among older adults – and supported by digital technologies – which provide information and access to alternate lifestyles – that the rise of laterlife intimacy can be understood. additionally, the authors also trace the cultural context of sweden as their case study and suggest that with the rise of modernity and “state supported individualism, which facilitates individual autonomy and equality in intimate relationships” (7), late-life intimacy has become a more accepted phenomenon in this country. in chapters 3 and 4 the authors draw from qualitative interviews and international demographic data. these show how western societies are shifting from a culture of marriage, to a culture of divorce, thereby producing a “society of divorcees” (8), comprising largely older adults. these data also reveal that due to increased longevity, a large number of older divorcees have become available in the partnering market. hence, it are these older adults, the authors argue, that, with the help of digital technologies, are forging new connections, and are exploring alternate forms of union than marriage. at the end of this chapter, the authors conclude that most older adults prefer living apart together (lat) over marriage, and in this process shatter the myth that they are cultural carriers of tradition and values (49-50). they explicitly critique the official census, which only partially represents intimate lives of older adults, and leaves alternative later life romantic relationships or reparterning invisible. http://anthro-age.pitt.edu/ book review | gangopadhyay | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.252 http://anthro-age.pitt.edu 111 chapters 5 to 9, use survey data and individual biographies, to discern how intimate relationships are constructed in the lives of older adults in sweden. in particular, these chapters illustrate the attitude of the older participants towards their romantic relationships in later life, show how a new late-life partner acts as a resource for social support and how intimacy goes beyond companionship. sex appears to play a key role in these relationships. in chapter 10 the authors use heidegger’s existential theory of time to address the paradox of time in late-life relationships: on the one hand older adults have ample free time to nurture a new relationship, on the other hand they have limited lifetime. continuing their theme of time, in the final chapters, the authors summarize the major findings and elucidate how the older adults navigate between the two faces of time in their lives. overall the book reveals important, often marginalized facets of late-life intimacy, by indicating that older adults herein prefer living apart together over the traditional romantic ideal of marriage, and that sex is an important element in their lives. the book also draws from significant sociological theories to bridge the gap between empirical data and theory in the discipline of social gerontology. the language of the book is extremely lucid, and provides a theoretical as well as empirical understanding of late life intimacy. though the book makes important contributions, there are some shortcomings, for instance with regard to transparency on methodology and the research trajectory. the book would have benefitted from some sections on the experience of the authors in collecting data for such a private theme. for instance, one of the goals of the study was to understand expectations (socially, sexually, financially, emotionally and informal care) associated with later life intimacy. the responses indicate that the authors could gather fairly detailed information regarding the expectations of the respondents. however, how the authors gained trust or built rapport with their respondents, as to obtain this kind of data, is not discussed. details regarding the process and approach of doing fieldwork would have added more methodological value to the book. additionally, certain sections and themes of the book are quite repetitive and the length of the book could have been reduced by at least one or two chapters. the theme of chapters 8 (theme: a new partner as a resource for social support) and 9 (theme: the partner as the key to autonomy) is very similar and there is no added value in splitting them up, on the contrary. finally, while the book highlights significant findings with regard to changing attitudes towards marriage, sex and re-partnering, with a focus on the cultural landscape of sweden (modernity, rise of individuality and globalization) as explanatory framework (chapter 2), it fails to establish a direct link between the empirical data and the social structures of sweden. this book is written largely for scholars of gerontology and policy makers, and findings empirically and theoretically add to the knowledge gap on later life and intimacy. in particular, this book will g ive gerontologists and policy makers a deeper understanding of the intersections between aging, individual autonomy and digital platforms among older adults in sweden. additionally, the book also provides a holistic account of how later life intimacy provides various forms of support (social, sexual, emotional, financial and informal care) to both partners. overall, the book is a must read for academics conducting research on older adults, as it offers very important insights about growing old in a globalized and digital world. references birren, james e. 1999. “theories of aging: a personal perspective.” in handbook of theories of aging edited by v.l. bengtson and k.w. schaie, 459–471. new york: springer. http://anthro-age.pitt.edu/ lassen_finaldoc lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 22 agencements of reanimation facilitating an active old age through danish co-creation initiatives aske juul lassen university of copenhagen author contact: ajlas@hum.ku.dk abstract contemporary healthy and active aging policies coincide with new forms of governance in european welfare states promoting active citizenship, which in denmark has been termed “co-creation.” as active aging and co-creation policies go hand in hand, new forms of health promotion programs and public-private collaborations emerge. this article centers on two initiatives that target older people in two danish municipalities: a local copd-choir in vordingborg and the local department in ishøj of the (inter)national cycling without age association. the municipalities take on the assignment of reanimating old age through such initiatives, by challenging the institutional barriers of the municipality. the article describes how cocreation is a redistribution of agency in the european welfare states and how older volunteers are called upon to participate in the organization of municipal initiatives, while at the same time these initiatives come with pre-fixed definitions of “good” old age. the article explores the co-creation initiatives as indicative of the agencements (çalışkan and callon 2010) of reanimation that endeavor to revive old age and subjectivise older people as active citizens. while such agencement involves health promotion, this article argues that the aim of initiatives is instead to engage older citizens, and hence to facilitate an active old age. keywords: energy; co-creation; cycling without age; copd; active aging anthropology & aging, vol 40, no 2 (2019), pp. 23-36 issn 2374-2267 (online) doi 10.5195/aa.2019.166 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 23 agencements of reanimation facilitating an active old age through danish co-creation initiatives aske juul lassen university of copenhagen author contact: ajlas@hum.ku.dk activating older people in denmark has become a key policy issue, especially for the municipalities, which have the responsibility for prevention and health promotion programs. the concern is that retirees can easily become trapped in a vicious cycle of passivity, which is then seen as leading to a rapid onset of diseases and decline, thereby making older people a burden on the healthcare sector (lassen and jespersen 2017). in the context of this policy concern, a wide range of municipally established and/or supported types of initiatives targeted at older people has seen the light in recent years. initiatives such as reablement programs (aspinal et al. 2016; schwennesen 2017), activity centers (lassen 2017) and patient schools (nielsen and grøn 2012) endeavor in different ways to activate older persons experiencing varying degrees of frailty. this article centers on two initiatives in two danish municipalities: a local choir for people suffering from chronic obstructive pulmonary disease (copd) in vordingborg and the local department in ishøj of the (inter)national cycling without age (cwa).i this article explores how the municipalities aim at reanimating old age through such initiatives, and how they also attempt to distribute this reanimating endeavor. as such, the ideals of old age that are enacted in the initiatives come about through a merging of active aging and co-creation policies, which has become more widespread in recent years (see (scheele, vrangbæk, and kriegbaum 2019). under the realm of active and healthy aging, reanimating old age have become key for its management in western welfare states. inscribed into this policy framework is the idea that an active old age is necessarily a “good” old age; an idea that took form through the 1990s and is being pushed by international policy organizations such as who and the eu (e.g., (europe 2011; kalache and gatti 2003). as i have argued elsewhere (lassen and moreira 2014), active aging constitutes an unmaking of old age through its ambition to transgress thresholds that constitute old age—such as retirement and increasing frailty—through pension reforms and health promotion programs. as such, while active aging relies on a variety of differing theories of aging and take on many different forms in different organizational bodies, overall policies of active aging tend to articulate activity as rejuvenating and associate passivity with frailty and speeding up the aging process. therefore, activity has become central to the way old age is managed (katz 2000). this has been widely criticized as forming part of a neoliberal agenda blindly focused on productivity and efficiency throughout the life course (e.g. van dyk et al. 2013; katz 2013; lamb 2014; rudman 2015). such policy programs articulate aging as a key policy concern, as changing demographics pose a key societal challenge (partridge, deelen, and slagboom 2018). however, while demographics tend to be the immediate explanation forming the so-called aging society, this problematization of aging relies on uncertainties regarding technology, production and health, and promises thereof, which are just as central in this regard (moreira 2016). this endeavor to reanimate old age coincides with a shift in governance ideals, from the muchcriticized new public management, with a focus on control through documentation, evidence and authority, to new public governance emphasizing active citizenship, collaboration and public-private partnerships (osborne 2010). in denmark, this governance model has been translated into samskabelse, lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 24 danish for co-creation, which has become a buzzword in recent years in denmark and highlights collaboration and community rather than a municipality acting as the sole authority. as ideals of active citizenship go hand in hand with the endeavor to activate older people and reanimate old age, co-creation has become an explicit ambition in healthy aging policies ((scheele, vrangbæk, and kriegbaum 2019; voorberg, bekkers, and tummers 2015). through co-creation policies, municipalities aim to reanimate old age by relying on the energy and free spirit of civil society organizations that engage volunteers to create social gatherings and outings at nursing homes—so-called visiting friends for lonely older persons with reduced mobility who are living at home, or the like. this involvement of volunteers in welfare work has become widespread in europe (la cour 2012). with the prefix co-, the term co-creation alludes to a joint effort, wherein all actors in society face and solve the challenges and uncertainties of the aging society. co-creation is not limited to the healthcare and old age sector, but it has gained particular commitment in denmark due to the increasing expenditure in this part of the administration, as well as the expected benefits from activating older people in the welfare services. as such, co-creation aspires to increase participation amongst the independent senior citizens— thereby leading to better quality of life and better health— and to lower the public expenditure on services to the care-dependent senior citizens, as the co-creation initiatives often target the social and care needs of this group. the ambition of this type of collaboration is to create a feeling of community and shared responsibility across the public and civil spheres. this coalescence between active aging and co-creation, i argue, is a rearrangement of the possibilities of agency within the welfare state; an agencement of reanimation, wherein agency is distributed to a wide range of actors, and older people are urged to be active and not be victims of past prejudices about the maladies of old age. the term agencement refers to arrangements endowed with the capacity to act, which generate specific forms of action, create differing agencies and positions and are socio-technical in the sense that they are comprised of bodies and material, technical and textual devices (çalışkan and callon 2010: 9). as such, the reanimation of old age relies on a shift in the infrastructure of the welfare state. instead of acting as authority, the municipality attempts to facilitate co-creation processes among municipal care workers, associations, and volunteers. this is a paradoxical assignment, as much of the literature, and often the municipalities themselves, point to the idea that it is the 20th century welfare institutions themselves that are responsible for passivity in old age (see for example (townsend 1981; walker 1980). the same institutions that have been criticized for sucking the life out of old age are now endeavoring to reanimate this life phase. while active and healthy aging policies aim to set older people free from the constraints of 20th century old age policies and instead highlight their potentials, these policies also massively improved the living conditions of older people in the western hemisphere (walker 2008: 77). with the co-creation policies, older citizens are enabled to become so-called masters in their own lives—a term much used in danish municipalities when defining the good old age. as such, they are also institutionally enabled to act, be active and participate in the many collaborations and networks offered. good citizenship is active citizenship—also for older citizens. as my analysis will show, reanimating old age through activities is often a task that requires continuous engagement on behalf of the municipalities. supporting and initiating activities is rarely sufficient, and the municipalities are constantly attempting to find ways of starting sustainable, self-driven initiatives that can continue without municipal involvement. in this regard, the interlocutors in this study (municipal employees and older people engaged in the initiatives) often talk about energy when referring to the aging process and co-creation initiatives. lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 25 as rupp has shown in her analysis of new yorkers’ conceptions of energy, energy is a concept that constantly shifts meanings. people tend to slide between different registers when talking about energy (rupp 2013). in this line of thought, energy is difficult to define. we know its capacities, but not exactly what it is (mcginn 2011). energy has the capacity to make people and things move, but is often treated as an object, where it should instead be seen as an interpretation (coelho 2009). when experimenting with how mechanical power turns into heat, the conversion as something measurable relies on an interpretation of the way heat is also a form of motion. as such, energy is a methodology that enables interpretation of the ways that things convert (ibid.). in other words, the agencements of reanimation aim at investing municipal funds into initiatives that create more active and healthy older citizens through the invocation of civil society and through a redistribution of agency in the danish welfare state. denmark is a welfare state organized around universal rights to healthcare, education, basic pensions, unemployment subsidies, and so on that are financed through taxes. as part of the scandinavian model, denmark has succeeded in surviving as a small state through social reforms, ensuring a high level of citizen satisfaction, security, and livability. while public old age care has been much criticized for its poor services, the municipalities provide home care and care facilities, as well as supportive structures such as preventive home visits (otto 2013). denmark has a long tradition of volunteerism and associations of various kinds. forty-five percent of citizens aged 70+ are engaged in volunteer work, and they spend an average of 20 hours monthly as volunteers (center for frivilligt socialt arbejde 2017). in a country with less than six million inhabitants, there are approximately 101,000 associations. there is a folk saying that if there are two guys in a village collecting stamps, they will establish a local stamp-collectors-association. the largest association in denmark, daneage, has more than 850,000 members (more than half of the population 65+ are members), and engages in the rights of older people through political lobbying and a huge network of 19.000 volunteers. these associations are increasingly called upon to enter collaborations with the local administration, in order to solve some of the challenges in the care and social sector. as such, old age is reanimated through agencements forming and engaging active older persons. before describing how this plays out in the two initiatives, i will briefly describe the methods and setting of my study. methods and setting the abovementioned field sites (the copd-choir and cwa) are part of a larger ethnographic study about co-creation policies and initiatives targeted older people in danish municipalities. through the collaboration between the centre for healthy aging at the university of copenhagen and three municipalities — copenhagen, ishøj, and vordingborg — i have followed the municipalities’ co-creation initiatives for two years (2015-2017). in this process, i have conducted 19 qualitative interviews with employees in the three municipalities, from front line personnel like home-helpers to managers of the health and old age administrations. moreover, i have conducted participant observation at several initiatives and meetings between municipal employees and local actors, as well as interviewed volunteering citizens and organizers. of particular interest in this article is the fieldwork i have conducted amongst the careand administrative staff in vordingborg and ishøj, the copd-choir in vordingborg, the local section of cwa in ishøj, and the employees from the cwa association, as well as the volunteers involved in the initiatives. the copd-choir is an initiative where the local music school (“vordingborg musikskole”), the municipality, and the region ii have collaborated to offer local copd patients a place and a choirmaster to sing. the choir has been a huge success, and according to them, the participants have experienced both an increased ability to breathe as well as a better quality of life. at the time of the fieldwork, the initiative was lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 26 in its 3rd and 4th seasons. it was the health authorities in the municipality who originally took the initiative to put together the choir. they wanted to create some new initiatives for fragile groups of older people and had decided on a football team for men with cancer and a copd-choir. they wanted to include the local football club and music school in the initiatives. the region supported it with some money for salaries, third halves (a social gathering with cake and coffee after each session, which i will discuss in the analysis) and marketing. i have participated in the class for the copd-choir and interviewed some of the members, as well as the choirmaster and the organizers from the local music school and the municipality. cwa is a danish initiative and association started in 2013 that has spread all over the country and worldwide. using local volunteers as so-called pilots, older people with reduced mobility are offered rides on rickshaw bikes. the bikes are usually placed in care homes and financed by the municipality. in ishøj, i have volunteered as a so-called pilot, which is a person who bikes passengers around on a rickshaw. the passengers are usually receiving homecare or living at a nursing home. my interest in the fieldwork has first and foremost been the pilots, as they are often also retirees. i have participated in events where groups of pilots meet to bike passengers together. i have also interviewed pilots and been a pilot on typical biketours where i have driven one or two passengers around. moreover, i have followed the municipal office of old age services where cwa is organized, as well as the office’s initiative “ældres netværk” (old people’s network), which is a collaboration among the co-creation initiatives targeted at older citizens by the office. i conducted semi-structured interviews during fieldwork that centered on themes such as volunteering, ideals of old age and collaboration. all interviews have been transcribed verbatim. i conducted different forms of participant observation, as i have followed the different initiatives as either a volunteer (cwa) or a participant (copd-choir). during participant observation, i took short notes and photos, and then i filled in my fieldnotes shortly afterward. transcriptions, photos and field notes have been coded and analyzed according to themes emerging in the data. in the spirit of the collaboration with the municipalities, the analysis has been tested and developed through dialogue with municipal employees, local cwa organizers and volunteers, as well as some of the copd-choir participants and organizers. the two sites have been chosen in order to shed light on two distinct ways of reanimating old age through co-creation. with regard to the choir, it is a co-creation between the municipality and a local business (the music school) that endeavors to use singing in order to transform the lives of the participants. with regard to cwa in ishøj, it is a co-creation initiative that aspires to transform the entire community through a reshuffling of the relations among older citizens, civil society and the municipality. the volunteers, the employees, and the older recipients of the service are all engaging in the community through cwa. but these distinct initiatives, despite their particularities, are both examples of the ways in which old age is reanimated through new agencements in the welfare state and through coinciding ideals and policies of active aging and co-creation. the copd-choir: reanimation through singing vordingborg is a geographically large municipality by danish standards. a rural area, with 45,000 inhabitants on 625,000 km2, it is sparsely populated. although it is only 90 km from the capital, copenhagen, it is often considered as part of the outskirts of denmark, with emigration to the urban areas by younger people and the older citizens and low-income families staying behind. while this picture is of course much more nuanced, the municipality is challenged by its demography and unequal access to health care. this has led to a range of co-creation initiatives endeavoring to reanimate old age by reshuffling the barriers between the municipality and civil society. lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 27 an example of such co-creation, is the collaboration between the municipality, the region and the local music school resulting in the copd-choir. while the region provided the initial funding, the region also enabled the music school to organize the choir by providing support from healthcare professionals about how to handle the copd patients, “they helped us to understand the social realities there are about being a copd-patient. it is not just about decreased ability to breathe, but people that have huge social problems, people who are lonely and introverted” (henrik, music school manager, november 2015).iii as such, the copd-choir is not just about singing, but also constitutes an important social network for the participants. the choir was free in the first season, but afterwards they needed to introduce a small monthly fee; however, the music school has decided to keep the fee to a minimum and pay part of the choirmaster’s salary themselves. they receive support from the national board of culture to teach children and had never had students in this age group before. due to curiosity about what music and singing can do for another user group, they found it valuable to support the copd-choir after the immediate funding ran out: music has the ability to change something for you, and it can also change them, and they can feel that. when you let go of the blocks that make you unwilling to participate, which they were in the beginning. but now they are with me, and they can feel the effect, it creates a change for/in them (mette, choirmaster, march 2017). on my first visit to the copd-choir in vordingborg in november 2015, i entered a room with a feeling of intensity and collectivity that i had not experienced previously in my fieldwork amongst municipal initiatives for older people. due to bad weather, i was running half an hour late. when approaching the classroom, to which the door was open due to the need for ventilation because of the participants’ breathing conditions, i was struck by the force and quality of the song, which was heard across the cultural center where the choir is located. i reached the entrance to the room as the song, which had reverberated through the hallway while finding my way, was about to end. while the song had struck me, the scenery that revealed itself from the doorway was equally striking. located at the banks of storstrømmen, a sound connecting the two seas kattegat and the baltic sea, the back of the room had a huge window connecting the rather dull room with the wildly tossing sea and the rainy and stormy sky this november morning. the song powerfully performed by the group of copdpatients and the charismatic choirmaster mette melded together with the raw outside elements. this togetherness and intensity are, according to participants, part of what has made the choir a popular activity amongst the copd-patients in the municipality. the choir attracts patients in such severe stages of copd that for some, the choir is the only time of the week when they are out of their homes. mette ascribes this to the connecting powers of singing: song is something that connects us, because it is something that we do all of us at the same time. we vibrate at the same frequency (...) it is a feeling of community that you cannot entirely explain. it is more than words. it is something in the air, the beautiful lyrics, the memories (...)there is an energy that is higher than what you can deliver yourself. it is multiplied by many. (mette, choirmaster, march, 2017) when the song ended, mette introduced me to the choir. i took a seat amongst the participants and was handed a song sheet. before singing the next song, mette explained a breathing exercise in a rather technical manner, wherein the participants were urged to scrape their upper ribs while inhaling deeply. during the song, mette continuously shouted “scrape the snow off the ribs.” often, the breathing exercises are an integral part of the songs. it was obvious that the participants were used to thinking about their lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 28 breathing, and that the choir was part of their way of handling copd. after another song, mette told a tale about the importance of being in the moment while singing, and how this can give a feeling of freedom. but this requires a will to struggle to breath. even though breathing can be a challenge for those with copd, singing can structure their breathing and force them to take deep breaths. as such, the choir has some immediate effects in the lives of the participants, who experience improvements in lung capacity, social activity and wellbeing. this reanimation relies on a specific agencement where the municipality is constantly looking for ways to motivate citizens to become involved in initiatives, and for ways to break down institutional barriers. for example, one municipal consultant during a seminar in january 2016iv stated that in order to create sustainable and self-driven initiatives, the municipality needed to understand the ‘existential motivators’ of their citizens to engage in their local community. the consultant explained that such motivators were not likely to consider institutional barriers (e.g., between the municipality and the region). therefore, the municipality should act more as facilitators and ambassadors of citizen initiatives, rather than as initiators. the same consultant stated in an interview in march 2015, “we tend to talk about the municipality as if it us, the employees, who are the municipality. but the municipality belongs to the citizens. they are the municipality. our role is to support them, enable them to do what they want to, motivate them to be active.” so, the key focus for this consultant was to network and talk with the citizens, in order to facilitate local initiatives that are joint efforts. in this regard, the reanimation of old age relies on an agencement that redistributes agency to citizens, while at the same time has the specific goal to motivate them to be active. this agencement generates specific forms of good actions and position the engaged seniors as ideal senior citizens. this way of collaborating has been criticized for being a colonization of the social life of citizens, wherein the public domain tries to reshape those they collaborate with (hodgson 2004). at the same time, co-creation proponents argue that the colonizing collaboration belongs to the outdated mode of governance in new public management (see brandsen, trommel, and verschuere 2014 for an overview of this debate). when interviewing mette and henrik in november 2015 about the effects of the copd-choir on the members, they did not mainly talk about lung capacity or health, but about singing as awakening and capacity-building: mette: singing awakes the will to breathe from within, through spirit, images, memories, life, the life we have within us. (…) we talked about that word today [in class], that beautiful word that means to breathe, inspiration, to take something in that you are then able to give. those images of breathing can wake us up in another way; can awake some new senses, which have been blocked. there are many resources, which we don’t get through the medical and physical world, because we don’t reach them where they can act. (...) henrik: it is important to note here that they are not met as patients, they are met as humans, and they are met as a choir that needs to make something synchronous. it is not just a process. it is also a product. it is still not good enough, so let’s forget for a moment that we are sick and that it is hard, and then you do it. for henrik and mette, singing in the choir is a way for the participants to create something together. the choir establishes a mutual dependence, where all parts of the collective need to be synced and engaged. you need to be completely present in the music and in the song for it to work and sound good. henrik and mette both talk about how this is possible through high expectations, and they contrast this to the way that the participants are usually seen: as patients with limitations. thus, the target subject differs from the subject embedded in most health initiatives, as focus here is not on the disease. in this way, the reanimation lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 29 of old age is also done through a redistribution of agency, as the singers are not patients, but are provided the capacity and responsibility to act through the music school, mette, their diagnoses, expectations, mutual dependence, exposure, the window facing storstrømmen, and so on. while mette draws attention to the link between breathing and inspiration, another origin of breathing links it to the spiritual. the latin word for breathing, “spirare,” was later translated as spirit, and in many religions singing is an important way of relating to god or other divine figures. one can receive the spirit through song, and it connects to something higher. while mette and henrik do not refer to the religious aspects of singing, they talk about singing as possessing connecting powers. within the same spiritual framework, mette points to the sharing of vibrations and the seducing elements in music. indeed, while the stretch from municipal initiative to spiritual experience might seem far, this is exactly what the municipal consultant points to when addressing the need for understanding the existential motivators of the citizens. the agencement of reanimation requires the municipality to distance itself from being solely an authority, and instead to become a motivator and a facilitator. the collaborators involved in co-creation with civil society advocate for different interpretations of health, energy and subjectivity, than what is put forth in narrow official health guidelines. but the co-creation initiatives are also in accordance with recent danish health campaigns that aim to foster subjects with reflexive stands towards the balancing between pleasure and risk (karlsen and villadsen 2016). one of the existential motivators that the municipality often alludes to is the need for social activity, in particular when addressing citizens such as the copd-choir-participants, who often lack the energy to go out during the week. addressing such existential motivators is also seen as key to engaging people in the long run after municipal funding has run out. while most of such initiatives end when the municipalities withdraw, vordingborg is deliberately attempting to solve this by establishing strong social bonds between the participants. after every activity for older people connected to vordingborg municipality there is what they call a “third half,” which is a gathering around cake and coffee. an employee explains, we have been very conscious about it and think that this is really the key and sometimes more important than the activity itself. we always arrange the third half whenever we are part of an activity, and strongly encourage the activities to continue with the third half once we withdraw. this is where the magic happens and people feel that they are part of something (municipal employee in vordingborg, january 2016). after the municipality has withdrawn from the choir, the third halves have continued, due to a common will and a woman in the choir who bakes before every class. while the concept of the third half comes from sport activities, where it is usually a euphemism for drinking beer, in vordingborg, they have changed the concept to coffee and cake, which seems to sit well with the generation and danish traditions for togetherness. while the activity (in this case the copd-choir) provides the content for conversation, the third half provides the participants with the opportunity to stay and talk with the other participants. as a health initiative, the copd-choir differs from many health promotion programs, such as disease management programs and courses for stress or obesity. it does so by engaging in an activity—singing— which is usually seen as recreational and cultural rather than health-related. consequentially, it also differs by inserting a health initiative into a cultural institution (and business) like the music school. the municipality breaks down its institutional barriers in its attempt to reanimate old age. this way of challenging the boundaries of the municipality and health initiatives is characteristic of the sort of activities involving older people initiated under co-creation in the danish municipalities. also, such a health lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 30 initiative targeting older people also differs by emphasizing social relations and community rather than specific health measures. it is an agencement of reanimation that redistributes agency and challenges traditional administrative boundaries among municipal administrations, the state, and the community. the second field site i discuss in this article, which i will turn to now, is also an example of this. cycling without age: reanimation through co-biking with 22,000 inhabitants, ishøj is a small suburban municipality south of the capital copenhagen. while ishøj has its share of social problems, it is also a closely-knit municipality where many are engaged in the local community. a large portion of the residents has lived in the municipality for many years, and people tend to know each other as they would in a village. despite the cold and dark winters, denmark is a country with a widespread biking culture due to tradition, investments in infrastructure and promotion of good biking behavior (larsen 2017). as the extract from the field notes below describes, many passengers find it too cold to bike on the cwa rickshaws during winter. and, as the excerpt below also shows, cwa is about much more than just biking: i finally biked with some old people today. it has been a long winter and hard to get passengers. they have all said it was too cold. when calling inge last week, she expressed the same concern, but when i told her jokingly that spring would surely arrive when we went biking, she accepted. (...) and spring did arrive. although it was still chilly, we had a lot of spring flowers. i went with inge and her friend kirstine to the marina and down the coast, and the two friends were buzzing with joy, constantly affirming the blissfulness of the situation with statements like “oh, this is life,” “what a sweet time of year,” and “i already feel recharged, like a new person” (excerpt from field notes, march 2016). on the day the field notes above were written, spring had just arrived in denmark. this is a special time of the year at this latitude. after months of rain, cold winds, and few hours of sunlight, the days are getting longer, the sun is shining brighter, and eranthis (buttercups) are peeping up from the ground. this brings a radical change in behavior, where people are flocking to the parks, streets, cafés, bars, woods, and coastline. people typically state that in the spring, they feel recharged. inge and kirstine met each other seven years ago, living next door to each other in social housing in ishøj, and are now very close as they engage in the many activities for seniors in their local community together with other neighbors and sometimes inge’s ill husband. they are no longer able to visit the marina, the local art museum, and the coastline landscaped as a park with fields, bike lanes, a long beach, and small woods, as this would require good walking or biking ability, which they no longer have. inge and kirstine both have long histories in the municipality and often use the bike trips to visit biographically meaningful places, like former homes, work places and their children’s schools and kindergartens. thus, cwa is both a way of having good company, “getting wind in the hair” (part of the motto of the cwa association), experiencing the local landscape, and reconnecting with their life stories. all of which “recharges” them, an expression they used on many occasions during our trip. cwa started in 2013 in copenhagen and within five years has spread to three-quarters of denmark’s 98 municipalities, as well as to five continents. the founder, ole kassow, lived close to a nursing home in copenhagen, and often saw an old man sitting on a bench in front of it, looking at all the passing bikes as if he would like to go biking as well.v one day ole rented a rickshaw and offered to drive some of the residents at the nursing home around. it was an instant success, and when he contacted the municipality lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 31 to ask if they would fund a bike, it turned out that they had a pool of money waiting to support active citizenship. they had just been waiting for ideas like this. they funded five rickshaw bikes to five nursing homes and the story immediately spread across the country. in 2017 there were more than 3,000 so-called pilots driving old people around, primarily from nursing homes and senior housing. the pilots themselves come from all age groups and both men and women, but the initiative has attracted many retired men as pilots, a group that is often difficult to reach in municipally organized activities focused on physical activity. while cwa started as a citizen initiative, and therefore is often highlighted as the golden standard for co-creation, it spread across denmark through the municipalities. media coverage has made the organization successful and it engages volunteers and employees who spend time conversing with new potential partner municipalities (torfing 2015). as such, it is a form of co-creation that has come to rely on a strong organization providing the concept and infrastructure (e.g., bikes, online booking system, events), a municipality (or sometimes a fund) buying the bikes and providing a place to park them, and volunteer pilots. under the slogan “everybody has the right to wind in the hair,” cwa is underpinned by the danish biking culture and a widespread belief that biking and fresh air is healthy, and that biking can strengthen the community and break down barriers between public authorities and civil society. like the copd-choir, cwa forms part of the reanimation of old age by reshuffling the agencement in the welfare state. the pilots and the passengers experience new forms of agency. in what has been termed activation policies, citizenship in old age becomes increasingly linked to activity (van hees et al. 2015). in cwa, volunteering pilots often become ambassadors of their local community and embody active citizenship through the way they help the passengers, salute passersby and pick up trash, as well as through the empowering lingo of cwa. likewise, passengers are not only provided the opportunity to reconnect with their old neighborhoods, but also disseminate history about the local community and become proof that it is never to late to take a bike ride. while cwa provides much of the infrastructure, the municipality has to facilitate bike rides and support the precarious relations among pilots, passengers, sheds for bikes, nursing homes, the home care department, batteries, flat tires, etc. as such, in order to organize volunteer bike trips, the municipality needs to invest in the bikes and find volunteers, as well as to sustain the initiative by fixing bikes and running the online booking system. the agencement of reanimation endeavors to create active older citizens mastering their own lives, but at the same time, such requires constant facilitation. the redistribution of agency within the welfare state is often criticized for being merely a way of saving public funding, but while many (often aging) volunteers engage in the care of frail, older citizens, the endeavor to reanimate old age through co-creation also requires municipal employees and funds to organize volunteers and their efforts. the agencement of reanimation is formed through a variety of means. first, physical activity is used as a way to create more energetic lives for the older volunteers, as they are believed to get in better shape mentally and physically through biking. second, the social activity of pilots and passengers are seen to improve the quality of life of the participants. in particular, the social activity embedded in the initiative is staged to be about togetherness, community and life stories. the togetherness is visible in the conversations between passengers and pilots and the smiles and chit-chat with people they pass. the community is facilitated by a strong sense of identity and storytelling on behalf of the cwa association through events, slogans, media and merchandise. the life stories of the passengers are given much emphasis in this storytelling, where the bike rides become occasions for reconnecting with past events and what has been termed biographically meaningful places (rowles 1983). third, it is comprised of a variety of sociotechnical devices such as powerpoints, town hall meetings, bikes, batteries, pedaling bodies, nursing lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 32 homes, etc. and fourth, the fresh air and scenery in itself, as shown above with inge and kirstine, enables the participants to recharge. as such, the reanimation of old age is fuelled by participants, movement, devices, history and nature, as well as the constant articulation of the ways institutional barriers are broken down: what is important is to get the bikes on the roads. we (municipal employees) should not decide how. just because the tax money enters the municipality’s account, it is not our money, nor is it our decision. we facilitate good lives in old age. we want the bikes on the roads by april, but we don’t want to do it the usual way. in this way, there is much more ownership. we all decide, so we all have the responsibility for spreading the word. they [the citizens] must be part of the process and the decision about what to do with those bikes. (municipal consultant in ishøj, march 2015). in the above quote, the municipal consultant was just about to launch cwa in ishøj. however, in accordance with the push towards democratic participation in co-creation (pestoff 2009), she did not want to decide on how to organize cwa. rather, she involved citizens and local associations in deciding where to build the shed, how to repair the bikes, how to spread the word, etc. as facilitators of good lives in old age, the municipality aimed at distancing itself from the authority provided by legislation, and instead become a positive and wanted presence in the everyday lives of its citizens. the agencement of reanimation is as such paradoxical in its nature: in its endeavor to become more than authority, the municipality invites citizens into the decision process of how to organize cwa. at the same time, due to budget constraints and project funds, they need to decide the rules of the collaboration. the goal is to get the bikes on the roads and to do so by april 2015. as such, the municipality cannot escape from its role as an authority. while the introduction of cwa in 2015 succeeded, the municipality experienced that they needed to constantly nurse the initiative by looking for volunteers, patching bike tires and adjusting routines around the bike shed, batteries, lock, etc., as well as managing differing positions regarding such routines among the involved volunteers. in november 2015, the ‘old-people’s-network’ office managing cwa invited all senior citizens and associations in the municipality to a meeting about how to spend next year’s funds on 100,000 danish kroner (around $20,000 usd). around 25 senior citizens and association representatives attended the meeting, which started with a powerpoint presentation from a municipal co-creation consultant stressing that this was the future of municipal work. where traditionally the municipality would focus on the relation between itself and citizens and between volunteers and associations respectively, they would now focus on local participation and how the municipality could become part of the larger network. the municipality would usually hand out assignments, define the framework, take the initiative, deliver services and communicate with the public, but now it would now define renegotiate the assignments and framework together with citizens, be more open towards citizen initiatives, and engage in continuous dialogue with local actors. however, the next slide of the presentation by the consultant emphasized that the common focus for all who were engaged was to counteract loneliness and improve the quality of life among senior citizens, which should be done through meaningful relations, good health and the ability to master one’s own life. next on the agenda was a plenum, where a municipal consultant would write directly in a projected microsoft word document the attendees’ suggestions on how to operationalize this focus. this topic would then be discussed by all with the consultant moderating the discussion. while these examples are local and situated, they illustrate how the agencement of reanimation works. to reanimate old age, a redistribution of agency is required, and civil society with all its many actors is invited to the table. but, the ambition to redistribute agency entails its own kind of (authoritative, lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 33 municipal) agency, and as such, the municipality becomes paradoxically trapped in its ambition to transcend its role as authority. while the municipal co-creation consultant above connected well with the attendees, she had already framed the meeting and decided the focus of the network. as the funds were allocated to citizen initiatives targeting senior citizens’ loneliness and a specific version of quality of life, this formed a particular subject engaged in a particular way of reanimating old age. as the following example illustrates, the involved citizens in the initiatives seem to embrace this paradoxical subjectification unproblematically because they want to bike and be active citizens. jørgen is one of the local ambassadors of cwa in ishøj. he is a man in his early 70s, who bikes the rickshaws four to six days a week when he is not ill or hospitalized, which happens more and more frequently due to the wide range of conditions he suffers from. he started as a pilot in order to retrain his knee, as he no longer had the balance to bike on normal bikes (the rickshaw has three wheels and is therefore easier to balance). as such, it was a way for jørgen to be physically active in a way he has enjoyed throughout his life. but it was also a way for jørgen to get the fresh air that he craved and did not get sufficiently, according to him, as his health declined. cwa became an occasion to exercise and to get outdoors and became an obligation towards the passengers. moreover, while jørgen did have friends, his family lived far away from him (by danish standards), and he mostly saw them during their vacations. cwa was not just a way for him to give the passengers company and good experiences, but it served as a mutual exchange through which jørgen also kept his occasional loneliness at bay. as jørgen explains it, the exercise was part of the reason to become a pilot, but it has become less important, as he has seen his social life thrive from his new role: the talks we have on the bikes are amazing. and they really enjoy the fresh air. many of them seldom come out from the nursing home. so, the energy they give me when they do come out, i really enjoy. it’s amazing to hear their stories and feel how happy they are to get out. you can really bond on such a trip. i don’t think i would be able to bike up sjællandsbroen [a bridge connecting the two islands sealand and amager, 15 km from ishøj], were it not for them and the good company (jørgen november 2015). jørgen spent a great deal of time biking and repairing and maintaining bikes as well as arranging events, but as he explains in the quote above, he gains energy through the trips and the passengers. jørgen has enthusiastically engaged in cwa and makes a concerted effort to keep the local cwa department going by constantly promoting it to potential pilots, passengers and those he passes by; investing time and resources into the initiative; and giving feedback and advice to the municipality. the example of jørgen is key to understanding the way the agencement of reanimation works through cwa and in danish municipalities focused on co-creation. firstly, the agencement of reanimation promotes older citizens volunteering, which benefits both the recipients (often frail, older people) as well as themselves, as volunteer work keeps them engaged and active. secondly, the agencement more broadly subjectivizes older persons as active citizens who engage in their local community. thirdly, physical activity is seen as rejuvenating and reenabling, and it is often said that it is never too late to start exercising. and finally, although denmark is a small country and family rarely lives far away, the social ties of older people are often dependent on the local community and associations. as such, the agencement of reanimation combines active aging and co-creation policies. lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.166 http://anthro-age.pitt.edu 34 conclusion while old age is changing, the way the new old age is formed in denmark is a question of welfare politics, the vigor of the current generations of retirees, and a shift in the way agency is distributed—the way reanimation is arranged. as i have shown in the article, the reanimation of old age relies on a particular agencement, which differs in many aspects from the way the administration of old age has been organized in european welfare states in the 20th century. comprised of the socio-technical devices described here, this agencement promotes an active old age by urging older people to participate and/or organize local initiatives promoting specific forms of activity—such as singing or biking—that differ from stereotypical old age activities. through such generation of actions and positions, the agencement questions the distribution of agency among older citizens, the municipalities and civil society associations. within co-creation and active aging, the municipalities become facilitators rather than authorities. such form of governance requires the municipalities to learn about ‘existential motivators,’ and with this, issues such as spiritual experiences, the social worlds and ideas of nature and scenery of older people become relevant for the municipalities. the co-creation activities presented in this article configure a different version of old age. they also configure a different version of health promotion, as the initiatives seem mostly concerned with engaging people in an activity, rather than limiting such activity to merely being physical. the activities do not promote cardiovascular or muscular exercise per se, but rather an ideal of active citizenship in old age. the energy articulated by many of the interlocutors in the study seem to be a way of describing a new old age— a way to interpret the possibilities of the 21st century life course. the active citizenship in the reanimated old age requires a particular subject, which the municipalities subjectivise in their many encounters with older citizens. local associations and individual older citizens are constantly urged to participate and are invited into the decision-making processes in the municipalities, while at the same time, the municipalities have a clear agenda: to engage older citizens. as i have shown, older citizens involved in the initiatives embody such engagement and are active citizens. while this is partly enabled by an aging population with an increasing health span, it is also a result of the agencement of reanimation. such agencement demonstrates how increasing life expectancy interlinks with forms of governance in contemporary welfare regimes. notes i http://cyclingwithoutage.org ii the public administration in denmark is divided into 5 regions and 98 municipalities with different areas of responsibility. iii all quotes from the fieldwork have been translated from danish, and all the names of the interlocutors have been changed in the interests of confidentiality, except for henrik and mette, who are difficult to anonymize and have specifically asked to be mentioned with their right names. iv during the collaboration between center for healthy aging and vordingborg municipality, a range of seminars was organized to share and discuss research findings between researchers and municipal employees. v a ted talk about the beginning of cwa has later been produced: https://youtu.be/o6ti4qua-ou lassen | anthropology & aging vol 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"commentary: the emergence and application of active aging in europe." journal of aging & social policy 21 (1): 75-93. anthropology & aging quarterly 2013: 34 (3) 113 in the united states since the 1980s, there has been a growing political and social imperative for “aging in place.” however, the value, experience, and processes involved in remaining at home for the elderly have not been sufficiently investigated, particularly in this time of economic insecurity, scale backs in social services, and uncertainty about entitlement reform. aging in place is a period of change and the work, adaptations, and resources required to support and enable remaining at home can be fraught with complications.  home health (hh) care often provides bridging care for persons with chronic illness. following acute health problems, frequently involving hospital and or rehabilitation stays, hh professionals assist patients in their home on a short-term, intermittent basis. receipt of increasingly high-technology care in the home allows an otherwise relatively immobile, ill person to remain at a r t i c l e s the uncertain bodies and spaces of aging in place lauren penney school of anthropology university of arizona home. while these processes can lend a sense of assurance in the face of uncertainty, they also must be negotiated among household members and can involve individuals in new ways of experiencing and acting upon their bodies, and inhabiting their homes. when hh necessarily ends, people are often left to do the work of chronic illness and manage uncertain futures in an environment of few known supports and threats to benefit programs. background aging in place throughout the 1900s, the percentage of older adults institutionalized within nursing homes grew steadily (estes and harrington 1981). within the us, this trend was facilitated by gains in longevity, rise in chronic disease, medicalization of aging, changing family residence patterns, specialization of hospitals, increasing abstract in the united states, “aging in place” has been established as the preferred method of aging. this article examines the work, processes, and tensions involved in aging in place in the southwest us, focusing on the experiences of chronically ill older adults receiving medicare-reimbursed home health care. based on an in depth ethnography, it examines the resources and work that go into aging in place amid uncertainty, and highlights how processes related to the integration of person and place are negotiated and contested between older adults, family members, and home health nurses. drawing on definitions of place from geography, i argue that aging in place should be understood using a processual lens to highlight the ways that health regimes aimed at facilitating aging in place can, at times, reinforce and introduce sense of bodily risk, shift embodiment and daily practice, and require negotiations among household members. i also point to the difficulties people face in maintaining aging in place when supports are lacking and futures uncertain. keywords: anthropology & aging quarterly 2013: 34 (3) 114 lauren penney uncertain bodies and spaces of aging in place government support for these facilities, and development of the nursing home industry within a medical model (johnson 1987).  the idea of “aging in place” gained broad prominence in the 1980s along with positive development theories of aging (e.g., atchley’s continuity theory, concept of “successful aging”). these theories purport that frail older adults can remain more independent and enjoy a better quality of life, as well as avoid the trauma of relocation, by residing at home. they contend that especially for the elderly, an attachment to place is adaptive (rowles 1993). advocacy for aging in place took place amid broad social and economic shifts, such as deinstitutionalization efforts, concerns about nursing home quality and safety, and reforms in hospital reimbursement. advocates argued against previous age-segregation approaches to the problem of aging and for more inclusive, integrated solutions. policy makers facing fiscal crisis, were concerned about the high costs of health care and the expense of handling aging issues within facility-based medical models (estes and harrington 1981). they were also subject to lobbying efforts of the health care industry and providers of community health services. providing care in the home and community became viewed as a more cost-efficient means for caring for older adults in their later years. thus, advocacy takes into consideration both humanistic and economic concerns (estes and harrington 1981; wiles 2005). elements of place the construction of place is a lifelong process. homes as places are multifaceted, subjective and objective, as well as dynamic. they are sites for the weaving of social relationships and practices, and the production of narratives of self (dyck et al. 2005). as such, place must be analyzed in relation to its physical and relational contexts (wahl and lang 2004). one such relationship is that between person and place.  while home is often conceptualized in a bounded way, as a personal and private space standing outside public life, it is better thought of as a permeable space, at times more or less accessible to the outside world. homes are permeable both physically (e.g., through the introduction and exit of people, materials, and equipment) and ideologically (e.g., social values), and thus affected by broader conditions, supports, and demands. because the home is not fixed or bounded, moss (1997) has suggested the concept of home be pushed in a relational sense, to be “home environment.” in the context of the elderly, particularly those with chronic conditions, understanding the relationship between the home and the outside world becomes important in understanding how aging in place is accomplished.  the imperative to age in place draws on cultural understandings of place and home. within the us, the successful acquisition and maintenance of a home has become a sign of adulthood, competency, and independence. home is often taken for granted as a safe and therapeutic landscape, a site where control and dignity can be maintained. in the context of aging, this stands opposed to hospitals and nursing homes (fairhurst and vilkko 2005; wiles 2005). these institutional settings segregate residents, disrupt normal social relationships, limit residents’ control over their space and time, and reinforce associations between old age and dependence (hugman 1999; johnson 1987). they evoke many negative emotions and are sometimes perceived as sites where one waits to die (wiles 2005).  by contrast, living alone can signify mastery, control, and competence (rubinstein, nagy, and kilbride 1992; sixsmith and sixsmith 2008). definitions of place often stress a “rootedness” or “centeredness,” and senses of belonging and purpose (williams 2002). aging at home is represented as providing opportunities for individuals to construct their daily activities and networks of support in ways that are individually meaningful and coherent (rubinstein, nagy, and kilbride 1992), and giving a sense of comfort, security, and privacy (sixsmith and sixsmith 2008). it is also described as ensuring continuity in environment, independence, and social ties (barrett, hale, and gauld 2011), and generally a better quality of life.  the discourses that take aging in place as the ideal have linked old age as a problem of place, and made it imperative that the domestic sphere be the “arena for aging” (fairhurst and vilkko 2005:2). successful aging is realized whence one is able to continue in place, when one is able to “stay put.” however, despite homes’ positive associations and the comfort they can provide, homes are not always safe or comforting places, especially when supports and resources are scarce (sixsmith and sixsmith 2008). lack of access to safe, accessible and affordable housing and transportation have been identified as barriers to aging in place (farber et al. 2011). while there are broad rhetorical supports for aging in place as both a humanitarian and financial good, acknowledgement of the social and material supports needed for its realization are lacking. anthropology & aging quarterly 2013: 34 (3) 115 lauren penney uncertain bodies and spaces of aging in place aging bodies in places  the materiality of a place is dynamic, changing with the composition of people and things within it and the resources available . when person-environment fit, place contributes to well-being and is thus therapeutic (williams 2002). the fitness of places and people are in constant flux, as both people and environments change. people actively create their homes and surrounding environments toward certain ends, arranging materials such that activity and pursuit of interests are facilitated (rosel 2003). the process of place integration is a lifelong one (cutchin 2003), however for older adults with chronic illness, particular shifts are highlighted. while discourses attempt to present a more positive representation of the process of getting older through the ideal of aging in place, aging in itself remains a highly marked endeavor, inscribed at every corner with risk. perils such as loss of senses, falling, dementia, dependence, abuse, and being forced from one’s home are socially salient and associated, at a societal level, with the conception of aging.  the medicalization of aging emerged in the twentieth century with changing family patterns, the marginalization of older adults, the rise of gerontology as a discipline, and, ultimately, the construction of “old age” as a problem (arluke and peterson 1981; estes 1979; estes and binney 1989). narratives within medicine identify the aging body as physiologically distinct, which helps to legitimize the surveillance of older adults for signs of deviancy. such signs are then medicalized and intervened upon (powell and longino 2001). tools such as geriatric assessments are used to uncover abnormalities and extend the medical gaze from the person into his or her behavior, social system, and environment (kaufman 1994). as medical institutions’ processes define, manage, and treat within the narrow medical model, the potential increases for the management of the elderly (estes and binney 1989), particularly within the home.  as functional status declines, items in the home can become barriers, with adaptations necessary for best fit and practical utility. once mundane objects can become hazards. these new dangers reinforce and make more visible the riskiness of the bodies associated with them, and by extension, the vulnerability of being old (barrett, hale, and gauld 2011; fairhurst and vilkko 2005). as one’s space is conceived of as a place of potential risk and harm to the self, it can in turn affect the embodiment and practices of the older person within a once known and familiar space (sixsmith and sixsmith 2008), and enhance the sense of uncertainty. the inscription of bodies and spaces with risk provokes attempts to control those dangers with therapeutic checking and treatment practices (e.g., medical assessments and monitoring, medications, exercise) and material adjustments (e.g., assistive devices). these changes generally aim to bring person-environment back into better fit, however they might have unintended consequences (e.g., create new hazards) and be resisted by household members because of what they symbolize or how they change existing home practices (sixsmith and sixsmith 2008). throughout these processes, there is a tension between risk, uncertainty, and control.  as efforts are made to help people age in place, new care practices and materials enter the home space from the medical sphere. as yet, there is little literature on how the home becomes site for new caregiving regimes (wiles 2005) and how this affects bodies within spaces. below, i examine the dynamic nature of aging place within the context of home health care. mediating through home health care medicare, the us insurance program for people older than 65 years of age and/or disabled, has a home health (hh) care benefit. hh is one of the few home-based supports for which medicare reimburses. persons deemed to be homebound, with intermittent (acute) skilled need can have hh ordered by a medical doctor, if their condition is expected to improve under that care. care is provided by nonand for-profit medicare-certified hh agencies.  depending upon needs determined by a standardized assessment, hh services may include skilled nursing care, physical and occupational therapies, social services, and hh aide help. there is no limit on number of visits for a beneficiary during a care episode. persons with original medicare plans (i.e., administered by the government) are given 60 day care episodes which are reimbursed according to assessed needs; hh agencies decide how many visits to allot during that period and/or whether additional care episodes are needed. persons with medicare advantage plans (i.e., administered by private insurers contracted with the government) are often authorized for a handful of visits at a time, though this depends on the nature of the plan (e.g., hmo, ppo); hh agencies can request additional visits as needed.  the strictures of medicare hh benefit, which stand as a model for other us private insurers, lock the provision of care in a medical framework (cabin 2007; hood 2001). while nursing care in the home has traditionally been anthropology & aging quarterly 2013: 34 (3) 116 lauren penney uncertain bodies and spaces of aging in place more custodial in nature, the medicare benefit was always intended for acute not chronic care (cabin 2007). thus, the acute, intermittent limitations placed onto the benefit affect how patients are assessed and treated. because care takes place in private homes, provision brings health care field logics and practices into the home (exley and allen 2007), where they interact with existing practices (angus et al. 2005; martin et al. 2005).  hh, in the form of nurses, routines, medications, can be welcomed and needed. at the same time its treatment processes can be contested as they meet conflicting desires and practices of patients and their families (exley and allen 2007). home care often affects the existing modes of activity and manners of engaging with the space, posing a threat to privacy and sense of identity (dyck et al. 2005). all of these impact and structure sense of embodiment and lifestyle to varying degrees as will be discussed below.  in examining the complexity of this encounter, we can begin to deconstruct the static notions of place that seem to adhere to “aging in place.” much of the existing literature takes aging in place as an objective, something to attain, without examining aging in place as a complex material and social process (wiles 2005). taking the concept of place from humanistic geographers, we can start to understand home in a relational sense, as a site of social relations, and one’s perspective shifts to the processual and formative nature of aging in place.  it is too simplistic to think of “aging in place” as something that just happens. following the work of cutchin (2003) and stafford (2009), i argue for understanding aging in place as a process that is not without tradeoffs. people work with available material and social supports to adapt bodies and spaces amid changing circumstances. during times of economic crisis, this work can be especially tenuous and fraught. i also follow kearns and joseph (1993) in examining the processes involved in health care, illness, and caregiving, and the impact those have on the experience and meaning of bodies and homes. as the provision of hh is aimed at preventing the institutionalization of older adults, as bodies and needs change, the flows of resources into the home and the practices and relationships within the home shift. hh care is a support that helps bridge institutional and community-based care, assisting in the reintegration of acutely ill persons back into the community and preventing future facility-based care. hh nurses accomplish some of this work by identifying bodies and spaces as risky, and introducing new devices, spatial arrangements, and practices. patients and their lay caregivers are critical to these efforts, particularly given the private nature of the space. people manage these experiences and practices in a variety of sometimes contradictory ways, such as through active participation, tolerance, and resistance that vary according to circumstances.  in this article, i explore the experience of aging in place and how it is mediated by hh care. using ethnographic data, i flesh out issues identified in medical geography, nursing, and sociological literatures, providing a picture of the nuances of the experience of aging in place through the mediation of hh care. i do so by first asking how the experience of and practices within the home shift with ill health. within that context, through what methods does hh care intervene and affect aging in place? finally, how do people experience, contest, embrace, and regulate these interventions? methods data for this paper have been principally derived from 12 months of ethnographic fieldwork in a metropolitan area in the southwest us (november 2009 to november 2010). the study was approved and conducted in accordance with the university of arizona irb.  this paper rests heavily on observations gathered during job shadowing of nine hh nurses from two medicarecertified, for-profit hh agencies. job shadows were also utilized to recruit patients into the study. patients aged 65 and over, with medicare or medicare advantage plan paid hh episodes, were eligible to participate. i asked nurses to recommend participants with chronic illnesses and at risk for future hospitalizations or acute health crises. twenty-two patients (10 men and 12 women) initially agreed to participate in three interviews over the course of five months. patients ranged in age from 65 to 94, with a median age of about 82. all patients were white. the older adults had a range of formal and informal support arrangements: 41% (n=9) had a child caregiver, 36% (n=8) had a spouse caregiver, 9% (n=2) had a friend or other type of informal caregiver, and 41% (n=9) had a paid caregiver of some type. housing also varied: 45% (n=10) lived in freestanding homes, 27% (n=6) in age-restricted manufactured home parks, 18% (n=4) in apartments, and 9% (n=2) in independent living facilities. patients occupied a range of socioeconomic situations, from low income and living off government assistance, to middle income and mostly living off social security and some additional retirement assets, to high income. anthropology & aging quarterly 2013: 34 (3) 117 lauren penney uncertain bodies and spaces of aging in place  many were being treated for pressure ulcers or open wounds, while others were recovering from and being monitored following strokes or falls. however, their situations were generally complicated by chronic conditions such as heart and other circulatory issues, pulmonary diseases, as well as diabetes and various cancers. their episodes of care varied dramatically, from a handful of visits spread over the course of a few weeks to six months or more of biweekly visits.  i conducted 55 semi-structured interviews with patients. while i attempted to interview each informant three times, given patients’ health problems, scheduling follow-up interviews proved difficult. fifteen patients participated in all three interviews, one declined participation after the first interview, two had health problems that precluded participation after two interviews, and four could not be reached after one or two interviews. interviews with patients lasted between 40 minutes and three hours (averaging about an hour). interviews covered a wide range of topics, including patients’ experience receiving hh and aging, thoughts and feelings about their homes, and hopes and fears for the future.  nine nurses (all women and white) were each shadowed through the course of a standard work week. i spent between one to four days shadowing each nurse, for a total of 23 days. during the 77 patient visits i observed, i made deeply descriptive notes on setting and interactions between nurses, patients, and caregivers. this allowed for the documentation of mediation of hh care in real time. in between visits, i rode with the nurses in their cars and conducted informal, unstructured interviews.  nine current hh nurses (four of whom also participated in job shadowing; seven women and two men) and six women with previous nursing and hh experience (n=15), also participated in semi-structured interviews of about an hour in length. approximately 73% were white (n=11), 7% were asian (n=1), 7% were native american (n=1), and 13% were of indeterminate racial or ethnic background (n=2). interviews centered on their experience being a hh nurse and their practice. additional interviews (n=29) were conducted with family and other direct caregivers to provide additional perspectives and insights into the experience of hh care specifically, and aging at home more generally.  audio and detailed notes were taken at all interviews, and audio from the interviews were partially transcribed. interview, observational, and other fieldnotes were uploaded into an atlas.ti database and coded. codes were constructed based on original research questions, themes drawn from the literature, and emergent topics from fieldwork. bodies out of places/spaces many patients are provided hh care following an acute health problem and stay in a facility, such as a hospital or rehabilitation center. the time away from home for treatment took people out of their daily lives and familiar contexts, reduced their access to privacy, and limited their control of space and activity. most patients and their caregivers were happy to return home, but their experiences were sometimes conflicted and often marked by uncertainty. while homes were sources of comfort and stability for patients, continued ill health and social isolation could contribute to their feelings of discomfort, fear, sense of risk, and boredom.  for the most part, patients described returning home as an opportunity to relax into a known and more controllable environment. being in a personal space, amid customary sounds and smells, with family and pets, and part of household rhythms lent to a sense of being rooted in place and grounded in a personal history (see also stafford 2009). evocative objects in the home, such as photos and memorabilia from travel, contributed to this. donald, a 93 year old, described returning home as “a little breath of heaven.” for other informants, the sensation of relief was palpable but difficult to articulate.  people found consolation in plush chairs, stretchy clothes, and supportive beds, and pleasure in sitting in the sun, reminiscing or receiving affection from pets. however, they described the tiresome monotony of being housebound, where days might feel “endless” or, as one described, like a series of transfers from bed, to living room, bathroom, and back again. doctors’ appointments were sometimes welcome opportunities to leave the home but were also exhausting. with limited mobility and assistive devices, trips outside the home required time, effort, and planning. in general, many of the people i met at least initially had their days structured by previously mundane activities, such as getting out of bed, taking medications, and watching television shows. these became new orienting points that set both a comforting and sometimes tiresome tempo to their days.  while returning home was a hopeful time for many, marking a step toward possible wellness (cartier 2003), it was also a liminal period. with hospitals releasing patients “quicker and sicker,” a large percentage of patients were anthropology & aging quarterly 2013: 34 (3) 118 lauren penney uncertain bodies and spaces of aging in place quite ill and waited in dread for the next health crisis. some with few social and economic supports also worried about obtaining help. andrew, an 85 year old man, said, “i felt that i was being discharged [from rehab] and i was on my own. i had no idea that we were going to get any help after my discharge.” his 91 year old wife added, “we were both very scared. scared, insecure. alone, no help of any kind.” many faced similar uncertain futures, not knowing their needs, insurance benefits, or where to begin to find help, and dealing with living as an at-risk person.  physical constitution and mobility were affected by a range of factors, such as weeks of being relatively bed bound, medications (and their synergies), infections, broken bones, and changes in blood flow. embodiment also changed, with one woman saying that after she returned home from the nursing home, on water pills, with constant diarrhea, and nearly bed bound, she felt like a “wet noodle.” others provided anecdotes about their bodies acting in unexpected and perplexing ways. these changes could leave one feeling at-risk, particularly for falling.  falls presented logistical difficulties for caregivers, and were a particularly salient social and physical signifier of vulnerability and dependence. those with a history of falling articulated a fear of falling and a sense of embodied risk. abe, an 87 year old, described these sentiments to me during a friendly afternoon visit: i worry about falling. this “whole mess” started when i fell and broke my hip. now when i fall, because my wife can’t get me up and my leg strength is so diminished, we have to call 911. one day, before going out, my wife left me in her bathroom. i fell and was stuck, because her bathroom doesn’t have grab bars like mine. i crawled out into the bedroom and fell asleep on the floor. when my wife came home, she thought i was dead. she was very upset. we called the firemen to get me up. it really does something to your ego to be in such a situation and to see your physical capacities diminishing. i have this swelling in my legs that i don’t know what to do about. i can’t find a position that is comfortable and that will allow me to still do things. and i’m worried about my wife, she does so much for me, i don’t want her to break. (from fieldnotes, abe, older adult)  this conversation illustrates the emotional complexity and sense of lingering vulnerability involved in falling that was echoed by other informants. abe expressed a sense of embarrassment, shame, frustration, and guilt at his circumstance that he felt more generally in day-to-day life, but that was brought to acute awareness in the event of falls.  fall risk also brought to focus how mundane objects in the home, such as stairs and rugs, could be transformed into hazards and barriers to action (williams and wood 1988). to negotiate, people described adapting their behaviors in their spaces in order to accomplish tasks and practices, and reduce embodied risk. they might only shower when they knew someone else was in the home, walk around the edges of rooms to use walls as support, and avoid spaces with rugs. regulating flows and surveillance the opening of the home, a domestic and private space, to the unfamiliar nurses has the potential to change the meaning of home (milligan and power 2009). nurses, generally, enter patients’ private spaces as strangers, their presence and authority legitimized through their occupation (fairhurst and vilkko 2005). through surveillance of the patients’ lifeworlds, nurses suggest physical and behavioral changes to enhance patient (re) adaptation to their condition and environment, and prevent patient displacement to facilities.  hh care personnel and practices were not always warmly embraced by patients. as noted, transitioning home can be a scary and overwhelming time for patients and their caregivers. often patients were not able to clearly articulate how hh came about. for many, hh referral most likely occurred during discharge from a hospital or rehab facility, a time many described as rushed, emotionfilled, and confusing. informants described varying levels of activity in managing their use of hh. some accepted hh because doing so allowed them to leave a facility, others did so at family members’ urging. many were uncertain who would pay for hh or whether taking hh would erode their medicare benefits and negatively impact their access to other health care. it was not surprising that many informants returned home without a clear sense of what would transpire.  despite the potential power of nurses to intervene, almost everyone i spoke with in doing fieldwork (e.g., patients, nurses, community providers) constructed hh, as opposed to facility-based care, as empowering to patients. nurses continually positioned the home as the purview of patients and highlighted patients’ freedom of choice in complying with treatment. however, given the fragile states of many of the patients, it was often evident that informants did not have many practical choices. anthropology & aging quarterly 2013: 34 (3) 119 lauren penney uncertain bodies and spaces of aging in place  in some cases, nurses’ presence in the home was limited to a handful of visits and only a minor disruption. episodes which lasted longer might be integrated into the normal rhythm of the home. for patients and caregivers who spent most days at home, these visits could be an opportunity to talk to someone new, vent frustrations, get practical tips, share a laugh, and find sympathy. however, at other times, i found interactions stilted and uncomfortable. some patients complained of nurses who had been unprofessional or were inconsistent in their visits. no matter how much the nurses were liked, depending on the frequency of the visits, the number of hh people involved, the patient’s condition, comfort level, and support from caregivers, the visits could also be exhausting and disorienting. however, patients and caregivers’ complaints were often slight and most expressed gratitude towards hh as a useful support to their condition and home life.  with the entrance of nurses and other hh personnel into the home, the medical gaze extends into the normally private space of the home and lifeworld. the surveillance can be difficult for patients who might feel at their worst and for caregivers who might perceive they are being judged. but being overseen by medical professionals was also a source of comfort, especially in a context of uncertainty about health and desires to regain wellness.  surveillance in patients’ homes allows experienced nurses to identify potential problems. they can spot possibly risky behavioral practices or noncompliance which might be effectively hidden in other medical settings. nurses valued this because patients were often viewed as unreliable sources for information. nurses explained that patients might not fully disclose to them to avoid shame or because they do not know or fully understand their health history and why certain pieces of information might be relevant.  surveillance was a negotiated process. patients attempted to collaborate with, limit, and shape hh professionals surveillance through management strategies. they might define spatial boundaries for the visits (e.g., not give access to certain parts of the home), clean spaces before visits (e.g., throw out bottles of alcohol), and physically present themselves in particular ways during those visits (e.g., bathed and dressed, feet elevated) to garner more or fewer interventions. nurses likewise chose where to and not to intervene. i observed nurses opting to attend to and follow up on, or to ignore cues suggesting home life difficulties. nurses were sometimes caught in the middle of conflicts between their patients and their families, which could be difficult to navigate. in several instances i observed nurses trying to change the course of conversations when patients started to discuss family problems, even in cases where the issues might point to abuse or neglect.  measuring was essential to surveillance efforts, as well as in reinforcing and mediating informants’ embodied risk. informants’ bodies were already marked by diagnosis, physical condition, and roles when they entered hh, and each visit their bodies were further highlighted as they were scanned visually and tested with instruments for signs of improvement or ill health. urine clarity and odor, consistency of feces, blood pressure, wound drainage color and texture, and smell of bile were all potential fodder for evaluation. body relations during the act of measuring and treatment were frequently intimate. nurses kneel and bend by, and come into bodily contact with their patients. expressions of pain could be audible, but also palpable in gripped tables and chairs, grimaces, and quivering limbs. while instruments (e.g., pulse oximeters) were routinely used to obtain precise measures to document, nurses relied heavily on their sensory observations and conversations with patients. they looked beyond the physical body for signs like poor grooming or tense social relationships that might suggest abuse or neglect. identification of signs that were perceived as problematic for treatment opened up opportunities for intervention (e.g., occupational therapy, social work, adult protective services) to ensure best fit and reduce risk.  informants became habituated to being objects of surveillance and topics of intimate discussion, and were called upon to engage in self-measurement. i frequently spotted blood pressure monitors and glucose meters in dining rooms and kitchens. for informants, the measures became new frames in how they viewed their bodies and cues for assessing their health. often this was a continuation of a practice they had been socialized into in facilities and doctors offices. they showed varying interest in the measures. some would become visibly anxious if the measures differed from what was normal or would show relief when the scores had not changed. the act of measuring reinforced the construction of the body as at risk and socialized informants to new relationships with their bodies and home practices, while also providing a sense of control.  embodiment was further affected by prescribed changes to bodily comportment, such sitting and walking. nurses and other health professionals worked to reset informants’ expectations for their bodies, encouraging them to pay attention to their feelings and to rest when anthropology & aging quarterly 2013: 34 (3) 120 lauren penney uncertain bodies and spaces of aging in place feeling tired, and dissuading them from thinking about what they could no longer do. many were prescribed physical therapy exercises that could be difficult, draining, and discouraging. some of those with histories of falls expressed fear about having to do these exercises. for example, 88 year old beatrix refused physical therapy when it was offered because the therapist wanted her to practice walking on the road by her home. throughout our interviews, she expressed generalized anxiety about her condition and lack of social supports, but a very particular fear of falling that contributed to a reluctance to leave her home. by contrast, other informants were diligent in their exercise, described it as their personal responsibility to perform, proudly demonstrated to me what they were able to do, and seemed to hold out hope that they would continue to see improvement in their conditions if they maintained their exercise practice.  while there were certain formalities and obvious surveillance activities, hh nurses often adopted informal approaches to interacting with and gaining information from patients and their caregivers. this helped them negotiate the control issues that came with practicing in home spaces. by gaining access to patients’ places, nurses had access to a broader perspective of patients’ contexts, allowing a more patient-centered intervention, tailored to addressing the fit between patients and their environments, thereby reducing risk and, hopefully, supporting aging in place. these practices also worked, however, to create a representation of informants’ bodies, and in a less direct way aging bodies, as risky and needing of monitoring and control. combined with factors such as physical condition upon returning home and other particular circumstances, this also shifted informants’ embodied experience and involved them in new, medically oriented practices. changing spaces the penetration of intimate space occurs through increased gaze on informants’ bodies, as well as in the reconfiguration of spaces and activities. assistive devices were integral in helping to improve body-environment fit to lessen perceived risk. they also helped people improve their range of activity and independence of action, in some cases reducing what they felt was a burden on their caregivers. during the course of hh, nurses might suggest using preventive materials and other durable medical equipment, such as cushions, air mattresses, and motorized wheelchairs.  the homes i visited were populated with such artifacts. the introduction of aids changed spaces both materially and practically (fairhurst and vilkko 2005). i often navigated walkers and scooters when visiting informants, and frequently found myself surprised when i encountered hospital beds in living and dining rooms. materials not only changed spatial arrangements and flows, they also brought in new smells and sounds, like the sucks and hums of an oxygen concentrator.  for many, devices and equipment were constant companions. emma, a 76 year old with multiple sclerosis who had received hh for a pressure wound, was sitting on a gel cushion on her couch, with her feet propped up on her motorized scooter, next to her hospital bed, as she explained the equipment that meant most to her: “the bed, the scooter, the bathtub bench, things that make me feel…comfortable, i can take a shower without anybody’s help. i feel like i’m independent that way. and this cushion i’m sitting on, i couldn’t sit on the couch by itself, because that would make pressure points on my behind. [chuckles] […] right now, i don’t feel like i need anything. i feel pretty well in control of my life.” (emma, hh patient)  these materials were enabling for her, assisting her in having independence and the ability to direct her life. even though she spent most of her time in the privacy of her home, the devices were likewise important to her in her social sense of self. during a previous visit she had explained that her cushion enabled her to get out of bed and, even though largely housebound, to sit up and, as she put it, “feel like i’m part of society.”  however, people expressed fears about adopting and adapting to assistive devices. emma, who above described the instrumental qualities of these materials, later talked about how difficult it had been to decide to get her first motorized scooter: “it tired me out to walk around. [pause] it really hurt my legs […] and when i got on the scooter i felt, oh! so relieved. i didn’t like givin’ upi didn’t, you know, i don’t know if i gave up. i gave up walkin’ because it was more comfortable to drive around, it hurt my legs to walk around.” (emma, hh patient)  as emma describes, adopting an assistive device could be experienced as a sort of defeat, giving up on certain capacities. however, taken practically, devices could provide much relief, make one better fit in their environment, and increase functioning. anthropology & aging quarterly 2013: 34 (3) 121 lauren penney uncertain bodies and spaces of aging in place  while assistive devices were generally enabling and lent a sense of security, they could also be limiting, even risky, and fit awkwardly into existing life. devices could become burdens and challenges to navigate both physically and socially. spatial challenges might include maneuvering a walker through a narrow doorframe, while practical maintenance issues could mean figuring out how to replace spent oxygen tanks. these could be difficult even when family members were available to help. in addition, sometimes it took time, effort, and bumps and bruises to acquire the body knowledge to use a new device. people described abandoning devices because they were frustrating or otherwise did not fit into their life.  equipment often had to be negotiated and sometimes interfered with engaging in meaningful activities. for marsha, while large oxygen concentrators provided her body with oxygen, they could be social barriers: “my two best friends […] do things together. i’m never invited any more. i’m left out. because they’d have to take my walker and take my oxygen and be, they’re afraid that i will fall again and get hurt. so my social life is zero.” (marsha, hh patient)  thus, her perceived riskiness, proven by her falls and health problems, and symbolized in the materiality of the devices, as well as the logistics of moving with the devices, disrupted her normal social life.  informants and family members varied in the degree to which they were willing, and able, to change the environment and behaviors. seventy-six year old celia explained that her home was not the same as it was before her stroke. she said, “i like my house but it’s a prison for me now.” she walked me around her home, showing me the paint and drapes she had put up when she moved in. when we arrived to her bedroom, she pointed to her handmade bed and gestured to the commode next to it. she explained, “my bedroom used to be a very welcome place, but now i’m almost afraid of it. i don’t sleep that well.” while celia had many things going on in her life that left her quite unhappy and frustrated (including lack of familial support), the aesthetic disruption of the home she had so carefully nurtured seemed to be an irritant and reminder of her changed state. she struggled to accept the changes, much as she worked to negotiate her new sense of embodiment.  many homes were family spaces and changes had to be negotiated with other household members who might not be supportive. theodore explained that the rugs layering his home’s floors, while functionally a hazard to him and his sometimes dragging leg, were kept at his wife’s insistence. he felt for the sake of the relationship that he had to support her wishes and as a prompt to pick up his leg. however, during my next visit, i found him shaken after tripping on a rug. coffee still stained the kitchen floor where he had fallen, vomited, and lain for five minutes waiting for the dizziness to subside. while in talking to me theodore transformed the rugs from objects of risk to objects of pleasure and body-helpful challenges, they were still obstacles that at least periodically reminded him of his changed physical state.  as noted above, home routine was altered for persons receiving home care. people’s altered movements within and without their homes were to a degree structured by new assistive devices, medicinal regimens, and treatment. in a context where aging is stigmatized, these new objects and behaviors sometimes evoked negative emotions and a sense of heading down a road of increasing dependence (wahl and lang 2004) and restricted social life. they could be symbolic reminders of reduced capacities and, often, a feared future that might include increased dependence and institutionalization, which were markers of the end of life. the other side of the bridge many patients and caregivers look forward to discharge from hh. technically, discharge occurs when there is an end to a skilled need, when the specific problem has been resolved, or no further improvement is expected. discharge is a signpost for the end of an ordeal, a closure, a successful refit into environment, and a return to “normal life.”  in practice, vestiges of one’s experience and the mediating role of hh linger. these can be physical, such as in scars from a wound, indentation in a bone from a fall, “glue” stuck on skin from a dressing, or a new wheelchair. or they can be practical, such as adjusting to new devices, technologies, and medication regimes, and dealing with medical bills. they can also be behavioral, as in continued participation in therapeutic exercise or self surveillance. many informants were discharged whilst resetting themselves to a new normal and described a future of a “long down slope” with constant renegotiation of fit with home environment. as 81 year old paul said, “the longer time goes on, the more i realize i’m never gonna get to the point of where i think i used to be.”  during our last meeting, marsha expressed similar sentiments. with a very limited income, some insurance anthropology & aging quarterly 2013: 34 (3) 122 lauren penney uncertain bodies and spaces of aging in place coverage, and her daughters’ help, she had managed to continue physical therapy for about a month after her hh episode. however, she could not continue that and was frustrated to see how her assistive accoutrements and physical difficulties affected her life: “and it’ll never get better, that’s, that’s what really bugs me. if i thought i could have this [oxygen concentrator] on for a month and then it’d be gone, i wouldn’t mind it at all, i wouldn’t mind tripping over it and stuff like that. i’m just now, all this time, i’m just now coming to the (slight pause) realization that i’ll be this way forever. and i think that’s hard.” (marsha, hh patient)  for paul, marsha, and others, their embodiment had shifted in the course of their chronic illnesses and the future provided an unknowable, uncertain, and new landscape. in some cases, the end of hh and the future of aging at home were ambiguous and the sense of uncertainty, reinforced and constructed during hh, persisted. this appeared most commonly among persons with newly identified or problematic chronic illnesses and short episodes of care (e.g., a handful of visits over the course of a couple weeks). discharge could occur abruptly and unexpectedly, either at the behest of insurers, nurses, or patients and their caregivers.  those with access to caregivers (whether informal or paid) might be able to continue care regimes within the home, often on a more limited basis, which provided some assurance and sense of control. in some cases, family members seemed confident in taking up these roles. others seemed more overwhelmed with the tasks at hand, especially when other social supports were lacking. stu, a 90 year old, was discharged under ambiguous circumstances. blanche, his wife and sole caregiver, seemed overwhelmed and confused. she explained that she had liked the nurse very much, but had not been adequately trained in how to care for stu and his breathing machine. she felt that she had cared for their nurse on a personal and material level, and suggested she expected the nurse to reciprocate in kind. this relates more broadly to the emotional and ethical landscape of care. hh occurs within intimate space and the personal-professional lines between patients and hh staff can be blurry.  i saw many informants and family caregivers grappling with their conditions, needs, and available supports. in some cases, hh nurses could help by offering limited social work assistance. however, community resources were scarce and many informants failed to qualify for them. to varying degrees, nurses could also try to help by extending the hh episode if they could document need and the insurer authorized it. while these extra bridges could be helpful, they were not available to everyone or for the long term. this left those with continued long-term needs, with limited economic and social resources in a lurch.  as such, the situation upon exit might be tenuous, at times frustrating, and lead to a cycling between home and facilities with new health crises. such relocations are disruptive and, in part because of poor coordination of services, make management of chronic care difficult and require a negotiation of a web of different service providers (see cartier 2003). several informants contemplated movement into an assisted living facility or nursing home, sometimes at the suggestion of hh nurses. dyck (1995) described residential movement as an active strategy women in her study chose in order to maximize independence and fulfill social roles. often relocation was described as something necessary because of an inability to maintain a larger home and reluctance, or inability, to ask family members for assistance. in a sense, they were choosing a different type of mediated aging experience given a range of possible, usually limited, options.  the policy imperative to age in place in some cases might represent a trap (fairhurst and vilkko 2005), providing for few options and supports outside of the home. as martin (2005) noted, home is often reified as necessarily therapeutic, but that is not always the case. i encountered a handful of cases in which informants described themselves as being stranded, unable to access possible family caregivers who lived in other parts of the country, because their conditions (physical and economic) made movement impossible. in some cases, the amount of care available might be insufficient and around the clock, supportive nursing care in a facility might be a more positive option (bamji 2010; flynn 2007). conclusion this article documents how aging in place is a process that for chronically ill older adults is frequently an uncertain and marked endeavor, often involving physical, behavioral, and social adaptations. hh mediates this experience by helping control risky bodies and environments, while helping maintain person-place integration and quality of life, whilst also taking advantage of the healing qualities of place. however, its introduction is experienced, negotiated, and contested in multiple ways. it works to reinforce and at times introduces a sense of bodily risk, anthropology & aging quarterly 2013: 34 (3) 123 lauren penney uncertain bodies and spaces of aging in place and helps to shift embodiment and daily practice. i discussed how patients were socialized into being the objects of the gaze of health professionals through repeated and varied interactions with the health care system (e.g., doctor’s visits, nursing home stays). i observed and nurses described ways patients attempted to shape how they were evaluated and receive fewer or more interventions. future research could examine these processes in more depth, with focus on the efforts employed, for what purpose, and to what success or failure.  while hh care can assist a person to refit changed body conditions into home practices, the lack of availability of long-term supports for many older adults makes aging at home complex and uncertain, and perhaps marked by multiple hospitalizations and acute health crises. the older adults i met were very worried about the stability of their own financial resources, concerned about burdening adult children (many of whom were unemployed or at risk of becoming so, or embroiled in other health or social issues), and had no idea what services were available or where to go to look for help.  in a time of economic crisis, government cutbacks to programs such as medicaid, and concerns about medicare reforms, despite intentions for older adults to remain in the community, some were concerned they would be forced to be institutionalized in facilities of uncertain quality. while many were not aware of services offered by various agencies, such as meals, transportation, and friendly visiting services, community providers consistently told me these services were restricted and limited. for certain individuals, such as those who expressed feeling isolated and at risk because of lack of physical, social, and economic resources, longer term community supports would make aging in place more easily and reliably attainable.  remaining at home is a complex experience for people and not wholly positive. this does not mean that people, in general, see institutional settings as a better option, but neither are they and their family members satisfied with the limited range of options and opportunities for at home support. however, making home-based long-term care more accessible is only part of the solution. disparities experienced across a lifespan contribute to individual aging experiences. addressing broader political, social, and economic disparities, and exploring how these manifest in peoples attempts to age at home is an area for future research. references angus, jan, pia kontos, isabel dyck, patricia mckeever, and blake poland 2005 the personal significance of home: habitus and the experience of receiving long-term home care. sociology of health & illness 27(2): 161–187. arluke, arnold, and john peterson 1981 accidental medicalization of old age and its social control implications. in dimensions: aging, culture, and health. fry, ed. pp. 271–284. new york: praeger. bamji, andrew n. 2010 long term care. does care at home mean no care? british medical journal 340: c1334. barrett, patrick, beatrice hale, and robin gauld 2011 social inclusion through ageing-in-place with care? ageing and society: 1–18. cabin, william d. 2007 the phantoms of home care: home care nurses’ care decisions for medicare home health alzheimer’s disease patients. home health care management & practice 19(3): 174–183. cartier, carolyn 2003 from home to hospital and back again: economic restructuring, end of life, and the gendered problems of place-switching health services. social science & medicine 53(11): 2289–2301. cutchin, malcolm p. 2003 the process of mediated aging-in-place: a theoretically and empirically based model. social science & medicine 57(6): 1077–1090. dyck, isabel 1995 hidden geographies: the changing lifeworlds of women with multiple sclerosis. social science & medicine 40(3): 307–320. dyck, isabel, pia c. kontos, jan angus, and patricia mckeever 2005 the home as a site for long-term care: meanings and management of bodies and spaces. health & place 11(2): 173–185. anthropology & aging quarterly 2013: 34 (3) 124 lauren penney uncertain bodies and spaces of aging in place estes, carroll l. 1979 the aging enterprise. san francisco, ca: jossey-bass publishers. estes, carroll l., and elizabeth a. binney 1989 the biomedicalization of aging: dangers and dilemmas. the gerontologist 29(5): 587–596. estes, carroll l., and charlene a. harrington 1981 fiscal crisis, deinstitutionalization, and the elderly. american behavioral scientist 24(6): 811–826. exley, catherine, and davina allen 2007 a critical examination of home care: end of life care as an illustrative case. social science & medicine 65(11): 2317–2327. fairhurst, eileen, and anni vilkko 2005 defining risk in the context of home: comparisons from finland and england. in rn ageing in europe, session formal and informal care i, 7th esa conference p. 15. torun, poland. farber, nicholas, douglas shinkle, jana lynott, wendy fox-grage, and rodney harrell 2011 aging in place: a state survey of livability policies and practices. washington, d.c: aarp public policy institute. flynn, linda 2007 managing the care of patients discharged from home health: a quiet threat to patient safety? home health care nurse 25(3): 184–190. hood, francis j. 2001 medicare’s home health prospective payment system. southern medical journal 94(10): 986–989. hugman, richard 1999 embodying old age. in embodied geographies: space bodies and rites of passage. elizabeth kenworthy teather, ed. pp. 193–207. london and new york: routledge. johnson, colleen leahy 1987 the institutional segregation of the aged. in the elderly as modern pioneers. philip silverman, ed. pp. 375–388. bloomington, in: indiana university press. kaufman, sharon r. 1994 old age, disease, and the discourse on risk: geriatric assessment in u.s. health care. medical anthropology quarterly 8(4): 430–447. kearns, robin a, and alun e joseph 1993 space in its place: developing the link in medical geography. social science & medicine 37(6): 711–717. martin, graham p. 2005 places like home? physical, social and psychological aspects in the making of home and other environments in the healthcare of older people. in “doing, thinking, feeling home: the mental geography of residential environments” p. 11. delft, the netherlands. martin, graham p., susan a. nancarrow, hilda parker, kay phelps, and emma l. regen 2005 place, policy and practitioners: on rehabilitation, independence and the therapeutic landscape in the changing geography of care provision to older people in the uk. social science & medicine 61(9): 1893–1904. milligan, christine, and andrew power 2009 the changing geography of care. in a companion to health and medical geography pp. 567–586. west sussex, uk: malden. moss, pamela 1997 negotiating spaces in home environments: older women living with arthritis. social science & medicine 45(1): 23–33. powell, jason l., and charles f. longino 2001 towards the postmodernization of aging: the body and social theory. journal of aging and identity 6(4): 199–207. rosel, natalie 2003 aging in place: knowing where you are. international journal of aging and human development 57(1): 77–90. anthropology & aging quarterly 2013: 34 (3) 125 lauren penney uncertain bodies and spaces of aging in place rowles, graham d. 1993 evolving images of place in aging and `aging in place’. generations 17(2): 65. rubinstein, robert l., sharon nagy, and janet capriotti kilbride 1992 the altered ethos of choice among frail elders. in elders living alone: frailty and the perception of choice pp. 51–78. new brunswick: aldine transaction. sixsmith, andrew, and judith sixsmith 2008 ageing in place in the united kingdom. ageing international 32(3): 219–235. stafford, philip b. 2009 elderburbia: aging with a sense of place in america. santa barbara, ca: praeger. wahl, hans-werner, and frieder r. lang 2004 aging in context across the adult life course: integrating physical and social environmental research perspectives. in aging in context: sociophysical environments. h.-w. wahl, r. j. scheidt, and p. g. windley, eds. pp. 1–33. new york: springer. wiles, janine l. 2005 home as a new site of care provision and consumption. in ageing and place: perspectives, policy, practice pp. 79–97. london: routledge. williams, allison 2002 changing geographies of care: employing the concept of therapeutic landscapes as a framework in examining home space. social science & medicine 55(1): 141–154, williams, gareth h., and philip h. n. wood 1988 coming to terms with chronic illness: the negotiation of autonomy in rheumatoid arthritis. disability and rehabilitation 10(3): 128–133. book review | southam | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.262 http://anthro-age.pitt.edu 115 book review review of amigoni, david and gordon mcmullan, eds. creativity in later life: beyond late style. routledge. 2018. pp 278. price: $99.75 (hardcover); $21.98 (ebook). theresa southam teaching and learning institute selkirk college fielding university school of organizational development and change anthropology & aging, vol 41, no 1 (2020), pp. 116-117 issn 2374-2267 (online) doi 10.5195/aa.2020.262 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ book review | southam | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.262 http://anthro-age.pitt.edu 116 book review review of amigoni, david and gordon mcmullan, eds. creativity in later life: beyond late style. routledge. 2018. pp 278. price: $99.75 (hardcover); $21.98 (ebook). theresa southam teaching and learning institute selkirk college fielding university school of organizational development and change this volume aims to tackle ‘creativity’—what it is, and how it presents itself in late life—on the crossroads of two lenses: cultural gerontology and the arts and humanities. the editors say this is a “provisional” collection, including authors of diverse backgrounds, speaking from a wide area of experiences, “who were likely to approach the subject of late-life creativity from very different, even frankly conflicting, viewpoints” (10). they claim that gerontological contributors tend to be interested in the “effects of creativity on old age [while] arts-and-humanities scholars tend to focus on the effects of old age on creativity” (9). however, it may be oversimplifying, to infer that cultural gerontology interprets creativity as a healing practice, whereas the arts and humanities take a broader sociological view of aging. anthropologists, who span both disciplines, have been major players in cultural gerontology bringing important theoretical insights (climo 1992), while not avoiding the embodied practices of creativity. if anthropologists had been included in the collection, and if the editors had more broadly represented cultural gerontology, their readership might have been widened. for now readers might include older adult artists, policymakers, caregivers, and gerontologists concerned with healthy aging, and professionals from the arts and humanities. the editors, both academics in the arts and humanities, have taken late turns towards the field of aging. david amigoni did so when he became co-investigator for ages and stages: the place of theatre in representations and recollections of aging, and primary investigator for the research network late-life creativity and the new old age. gordon mcmullan, a literary critic and theatre director, has published on the concept of ‘late style’ and its shortcomings ( mcmullan 2007; mcmullan and smiles 2016). as relative newcomers in the field, amigoni and mcmullan question if “late-life creativity” is best confined to a few professionals or is an integral facet of the everyday lives of older adults: “can it encompass both turner prize or pulitzer prize winners and members of a late-life knitting circle?” (196). they don’t settle for any answer in particular, but rather demonstrate a broad spectrum of forms and meanings “late life creativity” can take. the book is divided into five sections including late life creativity’s challenges, rethinking, variety, relationship to dementia, and application to cities. the chapters are a mix of theory, research, and personal perspective, all in the context of the united kingdom. the section on “challenges” has articles authored by two older adults, a gerontologist and singer, as well as art therapists concerned with policy. the chapters in the “rethinking late life creativity” section question whether “late life” connotations are significant and if so, how, including here the music of david bowie, art of william turner, and poetry of derek walcott. the “varieties of late life creativity section,” includes articles on theatre, arts-generated social capital, fashion, everyday life, and creativity through civic engagement. initially, i wondered why the next section was created to focus on just one illness of old age: dementia. however some surprising approaches and results can be found in this section. for example in “the artistry of it all” (chapter 13), liz postlewaite documents how a creative team gives workshops and http://anthro-age.pitt.edu/ book review | southam | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.262 http://anthro-age.pitt.edu 117 then actually moves into a dementia care home for two weeks. she reports how residents recalled and revisited work they cocreated. in the final section of the book authors depict the impacts of late life artists on their cities. overall, an interesting cross cutting theme in the book is what darren henley has called “everyday creativity” (henley 2018). in chapter 10, “visual diaries, creativity, and everyday life,” “everyday creativity” is defined as the “cumulative effect of everyday reflection, decisionand meaning-making, that can contribute to innovative solutions to problems and challenges identified by communities” (amabile, 2017 in martin and pilcher 2018, 223). in an ethnographic style, wendy martin and katy pilcher asked older adults to document their lives and their daily routines across an entire week with photographic diaries. then, through in-depth interviews, the researchers collaborated with the participants to elicit the meaning of these everyday activities through the photos. more visual material, like the photographs in this chapter, would make this a more engaging and enjoyable book. in chapter 11, “self, civic engagement and late-life creativity,” angela glendenning gives an autobiographical account of her everyday creativity, which she understands as an ability to “go the extra mile and support the underdog” (161). glendenning creates the personal challenge just 70—running, walking, swimming, canoeing, cycling, horse riding and climbing tors all within seven weeks—to raise money for a dialysis machine, and builds a second career as a volunteer in race relations. she says: “it seems that when we focus on the needs of others, we also reap benefits ourselves” (163). this collection has a unique aim: to bring together cultural gerontology and the arts and humanities. indeed, twigg and martin (2014) have stated that the “humanities have not been greatly engaged with the topic of age” (354). yet, although the attempt may be laudable, this collection may be too heavily weighted to the arts and humanities. of twelve authors, seven are professors and researchers in health and human sciences, only three specifically mention gerontology in the contributors’ section. it would be interesting to see research on late life creativity that has been co-created by gerontologists and the arts and humanities, conducted within community, and in intergenerational contexts. intentional collaboration of the two disciplines could be combined with community-based action research (cbar), which would allow for a more realist representation. in chapter 8, jackie reynolds, a gerontologist in the collection, calls for research on older adults that accounts for what constitutes successful or effective communities. perhaps in the wake of this book more cultural gerontologists and people from the arts and humanities will enact transdisciplinary practices and shared analyses that result in a future collection. if that collection continues to challenge ageism and unsettle stereotypes, it will be much appreciated. references climo, jacob j. 1992. "the role of anthropology in gerontology: theory." journal of aging studies 6(1):41-55. henley, darren. 2018. creativity: why it matters. london, uk: elliott & thompson. martin, wendy, and katy pilcher. 2018. "visual diaries, creativity, and everyday life." in creativity in later life: beyond late style, edited by david amigoni and gordon mcmullan. new york, ny: routledge. mcmullan, gordon. 2007. shakespeare and the idea of late writing: authorship in the proximity of death. cambridge, uk: cambridge university press. mcmullan, gordon, and sam smiles. 2016. late style and its discontents: essays in art, literature, and music. oxford, uk: oxford university press. twigg, julia, and wendy martin. 2014. "the challenge of cultural gerontology." the gerontologist 55(3):353-359. doi: 10.1093/geront/gnu061. http://anthro-age.pitt.edu/ http://127.0.0.1:9684/inn19ktebz71i5m8mo2h/2kroh0285c9dj1bxyza0.vbk/oebps/chapter11.xhtml microsoft word cattellbrfnov.docx book  review   growing  old  in  cameroon:  gender,  vulnerability,  and  social  capital.  charles  che  fonchingong.  lanham   md:  university  press  of  america.  2013.  isbn  978-­‐‑0-­‐‑7618-­‐‑6125.  247  pp.  $32.99  (paperback)   maria  g.  cattell   research  associate  in  anthropology     the  field  museum  of  natural  history                                                             anthropology & aging, vol 37, no 1 (2016), pp.46-47 issn 2374-2267 (online) doi 10.5195/aa.2016.145 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.145      http://anthro-­‐‑age.pitt.edu       cattell  |  book  review  46     book  review   growing  old  in  cameroon:  gender,  vulnerability,  and  social  capital.  charles  che  fonchingong.  lanham  md:   university  press  of  america.  2013.  isbn  978-­‐‑0-­‐‑7618-­‐‑6125.  247  pp.  $32.99  (paperback)     maria  g.  cattell   research  associate  in  anthropology     the  field  museum  of  natural  history     this  book  delineates  the  lives  of  older  people  in  two  anglophone  regions  of  cameroon,  where   poverty   and   changes   in   family   life   have   made   older   people‒and   their   families‒more   vulnerable   to   the   vicissitudes  of  modern  living.  the  author  gives  detailed  material  from  his  research  on  the  daily  activities   and  social  support  systems  of  these  older  cameroonians  (defined  as  age  60  and  over)  and  the  contributions   of  older  people  to  their  families  and  communities.  as  the  title  suggests,  the  information  is  presented  through   three  lenses:  the  vulnerabilities  of  older  people,  the  effects  of  gender  on  experiences  in  old  age,  and  social   capital  as  theory  and  practice.   the   first   chapter   presents   background   material   on   life   for   aging   africans   in   today'ʹs   world   of   urbanization,   migration   and   globalization   and   states   the   research   problem:   "ʺhow   are   the   elderly   [in   cameroon]   coping,   and   what   policies   could   increase   their   well-­‐‑being?"ʺ   in   the   next   chapter   the   author   discusses   theoretical   considerations,   specifically,   social   capital   theory.   chapters   3   and   4   deal   with   two   meanings  of  social  security:  formal  pensions  and  informal  family-­‐‑  and  village-­‐‑based  arrangements  or  "ʺsocial   protection."ʺ   in   chapter   5   he   discusses   the   gender   dynamics   of   aging   in   africa.   not   surprisingly,   fonchingong,  like  others  before  him‒in  africa  and  globally‒found  women  to  be  more  vulnerable  than  men,   detailing  their  lifetime  cumulative  disadvantage  (though  he  doesn'ʹt  use  that  term)  in  employment,  access   to  pensions  and  home  ownership,  widowhood  and  other  factors.     in  the  next  chapter  the  author  describes  his  research  methods,  which  included  in-­‐‑depth  interviews,   participant   observation   and   focus   group   discussions.   chapters   7   and   8   report   his   findings.   sociodemographic  variables  for  his  sample  of  80  men  and  50  women  are  presented  in  frequency  tables  in   chapter  7.  this  is  followed  with  a  chapter  discussing  various  topics  such  as  coping  mechanisms,  forms  of   reciprocity,  levels  of  care  and  others,  along  with  extensive  quotations  from  his  subjects,  which  bring  the   whole   thing   to   life.   the   details   concern   both   formal   help   (pensions)   and   family   support   and   include   consideration  of  the  many  ways  older  people  are  assets  to  their  families  and  communities  through  activities   such   as   child   care,   income   generation,   advising,   and   leadership   in   community   building   and   economic   development.  chapter  9  details  various  ways  older  people  are  proactive,  building  social  capital  and  social   protection   through   non-­‐‑family   village-­‐‑based   associations   such   as   rotating   credit   societies   and   mutual   support  groups.     finally,   chapter   10   discusses   social   policy   implications   of   the   research   and   makes   policy   recommendations  such  as  government  allowances  for  older  persons  who  do  not  qualify  for  pensions  on  the   basis   of   employment   and   improved   health   care   delivery.   fonchingong   expresses   frustration   at   the   cameroon  government'ʹs  shortcomings  which  will  make  needed  reforms  difficult,  if  not  impossible.  the   state,  he  says,  "ʺis  not  in  tune  with  the  labyrinth  of  problems  plaguing  the  social  security  sector"ʺ  (214),  here   meaning  social  security  in  the  broadest  sense  (not  just  formal  pension  programs).  he  sees  the  need  for  more   "ʺsemi-­‐‑formal"ʺ  support,  involving  ngos  of  all  kinds,  faith-­‐‑based  organizations  and  village-­‐‑based  mutual   societies   and   development   associations.   he   views   these   organizations   as   pivotal   to   providing   services   needed   by   older   cameroonians   as   families'ʹ   abilities   to   provide   for   their   older   members   becomes   increasingly  difficult  and  the  government  fails  to  provide  needed  assistance.               anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.145      http://anthro-­‐‑age.pitt.edu                           cattell  |  book  review  47       fonchingong,   whose   background   is   in   social   policy   and   social   work,   situates   his   work   solidly   in   the   literature  on  formal  social  security  systems,  in  africa  and  globally.  that  is  appropriate  given  that  his     recommendations   are   aimed   at   policy   reform.   however,   he   ignores   ethnographic   research   on   older   africans.   that   is   curious,   since   his   research   has   a   strong   ethnographic   turn   and   he   could   find   in   that   literature  information  on  some  of  the  things  he  laments,  such  as  a  lack  of  consideration  of  older  africans  as   assets  to  their  families  and  communities.  unfortunately,  the  book  is  sometimes  hard  to  read  because  the   writing  is  at  times  awkward  and  even  ungrammatical.  also,  there  is  no  index,  unusual  for  a  scholarly  work.   nevertheless,  despite  these  flaws,  fonchingong'ʹs  research  and  data  analysis  seem  both  sound  and  culturally   grounded,  making  this  book  a  useful  addition  to  contemporary  research  on  aging  in  sub-­‐‑saharan  africa.                             anthropology & aging quarterly 2013: 34 (3) 87 chloé’s story in early october of 2010, r (lead author) arrived in a parking lot at 6:30 am for a hike in the rocky mountains of southwestern canada to meet the group of middle-aged and older adult hiking enthusiasts he had been hiking with once a week since august. on this outing, r was introduced to a new hiking group member, chloé1. her story touched on common themes identified in this ethnographic study and is illustrative of a collective experience. the following is r’s journal entry from that day: it was a very large group today with 26 people. the large number of people, according to one of the hikers, was due to an optimistic forecast of sunny and warm weather, in contrast to the rain and snow we’ve had for the past couple of weeks. also, the hike did not have much in the way of elevation gain or distance; therefore, it was not excessively strenuous for the a r t i c l e s active aging: hiking health and healing physically compromised and promised contrasting views of the mountains to the west and open prairie to the east. chloé was a 58-year-old retired teacher and cancer survivor. a few years ago, when she was diagnosed with breast cancer, she decided to be as proactive as possible and discovered research suggesting that exercise, specifically heavy aerobic exercise, could potentially prevent cancer from returning. she acted quickly and started to walk every morning for a minimum of an hour, searching out challenging, hilly terrain. chloé believed that her active lifestyle contributed to her healing process; the walks eased some of the negative side effects of chemotherapy and improved her overall sense of wellbeing. it also aided in maintaining a healthy body weight vital, she believed, to her recovery from six cancer related surgeries. she did take painkillers after her first surgery – her nurse was a former student and she followed her advice – but suffered “terrible side effects.” she decided not abstract this article examines the illness and recovery experiences and perceptions of physically active middle aged and older adults participating in hiking groups. these perceptions are examined within the local milieu of their group and the larger social context of biomedical norms of healthy older bodies. discourse on the body was viewed through the lens of medical anthropology and data were analyzed using embodied ethnography. there were 15 participants (53 percent female) and all were of european descent. the hiking group served as a liminal space where participants could explore all aspects of their health with the support of others who had undergone similar life experiences. the physical activities they engaged in as a group were therapeutic and transformational for several members. their group activities created a deep sense of community and aided in their healing processes. holistic health programs such as hiking groups could provide an alternative or ancillary treatment options. however, cost, location, opportunities for socialization, and the physical abilities of potential participants should be seriously considered before adopting a hiking program for this demographic. active aging, health, middle-aged, older adult, hiking, embodied ethnography rodney steadman1 candace i.j. nykiforuk2 and helen vallianatos3 1department of anthropology, university of alberta 2centre for health promotion studies, school of public health, university of alberta 3department of anthropology, university of alberta anthropology & aging quarterly 2013: 34 (3) 88 steadman, nykiforuk, vallianatos active aging the association between activity and wellbeing suggests that the quality of social relationships was more highly correlated with wellbeing in israelis over the age of 60 than activity. the authors argue that the failure to address the complexities of successful aging could result in increased marginalization. this study will attempt to address some of the complexities of successful aging through the research method of embodied ethnography.  hiking groups in particular offer unique opportunities for aging populations that can supplement or enhance the benefits of physical activities previously discussed. research on middle-aged and older adults from north america and sweden showed that meaningful activities like hiking provided opportunities for creativity, achievement, nurturing competency, and social interaction (reichstadt et al. 2010:567-575; silverstein and parker 2002:528-547; tang et al. 2010:603-612 ). furthermore, these activities contributed to a positive sense of wellbeing and life satisfaction among participants. research specific to hiking activities for aging populations has provided insight into motivation (sugerman 2001:21-33), perceptions of age and aging (weiss and tomasa 2010:473-475), quality of life (lloyd and little 2005:147-181) and successful aging (boyes 2013:644-665). participation in meaningful activities like hiking allows individuals to display their abilities, explore their potential, and form unique identities (stebbins 1982:251-272; stebbins 1992). it is the formation of unique identities through hiking activities in middle-aged and older adults, as they relate to age, health, and healing, that will be the focus of this study.  the relationship between physical activities and the subjective experiences of the individual have not been extensively explored in the literature on aging. pheonix and grant (2009:362-379) and grant and klug (2007:398414) argue that literature on physical activity and the aging body has been primarily focused on quantitative data collection methods, as indicated by the above literature. the authors suggest that these forms of knowledge do not provide a complete picture of the complex relationships between the aging body and physical activity. qualitative research conducted by laz (2003:503-519) supports this argument. the author found that her sample of adults over the age of 50 (n=15) discussed specific dimensions of embodiment (activity, health, energy, appearance, and illness) when they considered their age (laz 2003:503-519). furthermore, laz’s participants made social comparisons associated with age and ability when interpreting their bodies. laz’s study demonstrates the unique information qualitative research into aging, specifically embodiment, can produce. however, there is a paucity of research investigating how the embodiment of specific physical to take the painkillers after her next and consecutive surgeries and discovered she did not experience a lot of pain and healed quickly. chloé had met other cancer patients who were inactive and overweight and found that they had difficulties healing. she attributed her lack of pain and quick healing to her vigorous morning walks. chloé feels lucky: [i]t came at a nice time, if you can have a nice time for cancer [laughs]. my son was in grade 12…. so that six months that i was off, happened to be his last semester at school. he’d be finished at two. he would come home every day and we would cook supper t o g e t h e r . so, that was five months of extra time that i’d never ever would’ve had otherwise. he also went for walks with me [laughs]. chloé’s story is thick with emotion. she was unwilling to allow her sickness to provide the narrative for her treatment and healing. chloé discovered that the simple act of walking in a natural setting helped her manage her cancer, bond with her family, and opened her up to future adventures and experiences.  some of the psychosocial and physiological benefits chloé experienced through her physical activities (pa) have been well documented in biomedical research. pa, such as hiking and walking, has been shown to decrease the risk or reduce the symptoms of several potentially debilitating health conditions such as coronary heart disease, type 2 diabetes, breast and colon cancer, and depression (paterson and warburton 2010:38; physical activity guidelines advisory committee 2008; world health organization 2010:8-10). there is also ample research that demonstrates the psychosocial and physiological benefits of pa in aging populations (atalay and cavlak 2012:71-79; langlois et al. 2013:400; paterson and warburton 2010:38; teixeira et al. 2013:307). it is clear that aging populations can benefit from pa, but research conducted by katz (2000:135-152), davey and glasgow (2006:21-27), asquith (2009:255-269), and tulle (2008:340347) suggests that the benefits are sometimes overstated to the point where physical activity is depicted as a panacea that can counteract the effects of aging. the authors argue that the buoying up of physical activity as a cure-all fails to recognize the challenges some individuals face later in life that are outside of their control; such as financial insecurity, congenital or genetic conditions, or poor life choices earlier in life (asquith 2009:255-269; davey and glasgow 2006:21-27). asquith also points out that there is a financial cost to social physical activities that not all older adults can afford. transportation to and from a physical activity centre requires money for fuel, public transportation, or a taxi (asquith 2009:255-269). furthermore, research conducted by litwin and shiovitz-ezra (2006:225-242) into anthropology & aging quarterly 2013: 34 (3) 89 steadman, nykiforuk, vallianatos active aging activities, such as hiking and walking, form perceptions of aging, health, and healing.  this article addresses this gap in the literature through the qualitative research method of embodied ethnography. drawing on four months of participant observation by the lead author “r,” we describe how the perceptions of aging, health, and healing are formed, transformed, maintained, and embodied through hiking activities. our analysis provides insight into the individual, social, and political forces influencing how the aging body in this habitus is experienced. finally, our research unpacks the complexities associated with pas, socialization, and the perceptions of aging among older adults. age, health, and healing the youthful, physically active body has become the ideal body image in north american culture (dworkin and wachs 2009). the obsession to obtain this body has undergone intense scrutiny since robert crawford (1980) introduced the concept of healthism. crawford asserts that capitalism co-opts “health” for profit by elevating the ideal and morally superior, “normal,” healthy, youthful body above the undesirable and morally corrupt, “abnormal,” unhealthy, or “old-looking,” body. faircloth (2003) suggests that the dominant forms of visual media in our health, youth, and beauty obsessed culture project constant reminders that a beautiful body is the key to happiness. consumer culture propagates and enforces insecurities created by our self-preservationist culture to promote strategies to counteract the perceived deterioration and decay associated with aging (faircloth 2003). the end result is a consumer obsessed with purchasing the latest products and services for obtaining and maintaining the ideal body (dworkin and wachs 2009; powell and longino 2001:199-207).  biomedical research has increased the divide between young and old bodies. glenda laws (1995) argues that essentialism in biomedical research attempts to assign universal biological causes to the aging body. laws suggests that this single-minded approach rejects the socially constructed intricacies of aging. therefore, the categorical assignment of biological changes creates a negative image of the aging body: it is an unattractive body increasingly susceptible to disease, loss of control, and ultimately, death (vincent 2003:675-684; vincent 2006:681-698). however, there has been pushback against narratives of the aging body involving the medicalization of non-life-threatening health issues associated with aging. wentzell (2013:3-22) investigated mexican men’s resistance to using erectile dysfunction (ed) drugs. the author found that the health narratives supported by medical and pharmaceutical companies stressed the importance of penetrative sex for healthy aging in men. the men’s decision making process on whether or not to begin ed treatment involved discussions with their wives and doctors and they also considered the cost and safety of treatments. wentzell discovered that the men’s decisions were swayed by their doctor’s silence on the issue and their wives’ advice that they should respond to their ed by adopting an age appropriate sexuality. several of the men rejected the ed drugs and adopted a life path valued by their community in which they became more family oriented (wentzell 2013:3-22).  the medicalization of aging did cause us to consider how and if we categorize our participants by age. initially we used statistics canada’s (2007) and the centers for disease control and prevention (2011) definitions of middle-aged as 45-64 years of age and older adult as 65 years or older. we were uncomfortable applying essentialized categories to our participants since experiences of aging are arguably more informative for understanding variations in meanings of an aging body. in other words, universal aging process are arguably not uniform, but vary by sociocultural expectations and individual experiences (featherstone and hepworth 1998:147-175). marshall and katz (2012:222-234) argue that the traditional use of chronological age as a description of the aging process does not provide an accurate description of the aging experience due to changes in traditional roles as a result of increased longevity. however, as laz (2003:503-519) points out, we do have an “age” which is culturally constructed and provides a point of reference for how we experience our bodies as we age. therefore, this study will focus on the dimensions of embodiment (as they relate to age, health, and healing) we discover through our embodied ethnography approach, which is the collection of data through the physical presence, and participation, of a researcher to study the processes at work in the everyday experiences of a group (bourdieu 1977; csordas 1990:5-47; scheper-hughes and lock 1987:6-41; turner 2000:51-60).  participant discourses on health and healing will be analyzed from a medical anthropology perspective where health is viewed as a culturally constructed ideal of wellbeing and healing as both a sufferer and medically defined resolution to a sickness where the sufferer is restored to wholeness (janzen 1981:185-194; janzen 2002; scheperhughes and lock 1987:6-41). in this study, health and healing will be defined by our participants’ ideas, actions, anthropology & aging quarterly 2013: 34 (3) 90 steadman, nykiforuk, vallianatos active aging representations, and the institutions that they view as embodying health (scheper-hughes and lock 1987:6-41). hiking  hiking in the context of this study is defined as walking in a mountain setting. we will use ingold’s (ingold 2004:315-340; ingold 2010:s121-s139) description of walking as a rhythmic activity with a “pattern of lived time and space” where walkers are continually adapting, and fine-tuning, their gait to the environment (332). according to ingold, walking requires a high degree of intelligence that incorporates all the experiences of being human. furthermore, the author argues that it is the landscape that shapes how people experience their environment and not vice versa. ingold suggests that we create a vast network of personalized trails through our nuanced physiological responses to our routes of pedestrian travel in landscapes that change with the seasons and shape our experiences: it is how we explore our world, physical body, and socially constructed self (2004:315-340; 2010:s121-s139). ultimately, walking provides a lens through which to view and interpret our life experiences. it is “a way of thinking and knowing” (ingold 2010:s135) where hikers must be fully engaged with their body to respond to an ever-changing environment and the other hikers around them (csordas 1993:135-156). methodology the data for this study were collected during r’s three month participation (september to november, 2010) in the hiking and walking activities of three different groups from the town of foothill: the women’s walking group, men’s walking group and the foothill hiking club (fhc). this article will focus on the fhc. r used his body as a “tool of inquiry and vector of knowledge” (wacquant 2004:viii) and it served as one mode of data collection. r has been engaged in outdoor activities for over 20 years (he was 41 at the time) and grew up hiking, climbing, and skiing in and around the locations for this study. his experiences of hiking provided r with some cultural capital with participants and insight into the activities of hiking.  r’s data on his own experiences of hiking provide insight into how hiking feels, but he also used ethnographic methods of observation to document how hikers moved over the landscape in field notes, and audio recorded his discussions while engaged in hiking activities (angrosino 2007; o’reilly 2004). interviews were unstructured with a basic outline allowing for reflexivity and lasted between 5 and 50 minutes, depending on the topic (i.e. if r needed a quick clarification on a theme or if he had to conduct a full interview). the interviews included questions about participant’s hiking activities and experiences, relationships with other members and family, work history, health history, and their age. interviews were then transcribed and coded. data collection and analysis proceeded together and were an iterative process. once a theme was identified, it was incorporated into future interviews and validated by re-interviewing participants who preceded the theme’s identification. themes were also compared against the other forms of data collected to ensure their validity.  our research group consisted of seven participants who were middle-aged (75 percent female; female mean age was 58 and male mean age was 61; age range was 51 to 63) and eight older adults (29 percent female; female mean age was 66 and male mean age was 71; age range was 66 to 78). the total number of participants was 15 (53 percent female; mean age 64; age range was 51 to 78). all participants were of european descent with 22 percent at low income level, 56 percent at low-middle income level and 22 percent at upper-middle or higher income levels (statistics canada 2013). participants were chosen using convenience sampling (bernard 2012) where participants are chosen in the field according to availability and willingness to participate as well as their representativeness of the social phenomenon being researched. thus participants were members of the fhc, and actively participated in hiking activities during the ethnographic fieldwork. theoretical sampling (eisenhardt and graebner 2007:25-32) was also used to ensure equal representation from both genders; however, more women than men participated in hikes during the research period.  our findings are organized beginning with a brief description of the town of foothill and history of the fhc. this will be followed by r’s experiences on his first hike. the study is then divided into sections that discuss the dimensions of embodiment through the habitus of hiking: resistance to medicalization and healthy bodies and healing. foothill hiking club  foothill has a population of 13,760 and it is considered a bedroom community of a major city, with approximately 40 percent of the labour force working in areas outside of foothill. thirty-seven percent of foothill’s population are over 45 years of age (approximately18.8 percent female anthropology & aging quarterly 2013: 34 (3) 91 steadman, nykiforuk, vallianatos active aging and 18.6 percent male) and nine percent were older than 64 (five percent female and four percent male). therefore, approximately 46 percent of foothill’s population was over the age of 45. the average household income for the community was in the upper-middle income range for canada ($72, 756 $118, 285) (statistics canada 2010; statistics canada 2013).  the fhc was created in april 2002, after a local doctor approached one of his patients, phil (78 years old), an individual with the determination to see a project through to completion, to create a walking and hiking program in foothill. the doctor was concerned for the health of his aging male patients. phil accepted the challenge and the hard work began. he organized a seminar, attended by 20 men of all ages, and went door to door to introduce the allmale walking group to the community. at the same time, phil created the co-ed fhc. as of september 2010, the fhc had close to 50 members. there is a nominal annual membership fee ($40 cad) for the fhc and participants were expected to help out with fuel costs ($15 cad) if they are car-pooling. there is also a $5 cad drop-in fee for nonmembers. the fhc received financial and administrative assistance from the recreation and culture section of the town of foothill. this allowed the groups to purchase insurance, equipment, and run courses on how to prepare for backcountry travel, general first aid, and wilderness first aid. the courses were mandatory, due to insurance restrictions, for fhc trip leaders. the fhc met at a local park every tuesday and left exactly at 7:00 am.  new members to the fhc are asked to hike with group b because the hikes were less demanding than group a. this allowed for group leaders to assess the fitness and experience level of new members and provided new members with the opportunity to decide if the group was the right fit for them. both groups usually hiked in the same area, but traveled different routes. sometimes the groups hiked to a common area for lunch and then split apart: group b would either return to the parking lot or take a less strenuous route than group a. first day the first day of hiking was a test for r. phil, the trip leader, wanted to r to hike in group b so he could find out if r’s fitness was good enough to go with group a on the next hike. r convinced him that he had done a lot of hiking in the past and ensured him he was fit enough for the group a hike. but phil was still leery. he informed r that there have been people who joined the group in the past who looked fit and capable, but ended up becoming a burden on the group because of their lack of experience, preparedness, and fitness. he stressed that the day is very important to participants and most of them plan their week around the weekly hiking trip, therefore, they do not want to spend their time babysitting someone who should have been prepared. it can be an unpleasant experience for the new member and group. this sentiment was repeated several times throughout r’s time with the group. phil wanted everyone to have a positive experience, so he made sure people were prepared and knew what they were getting into. however, phil did make it clear that accidents do happen and the group leaders have emergency training if anything does go wrong.  while fhc members were gearing up for the hike, two buses pulled into the parking lot. to r’s surprise, both buses were from senior hiking groups. it was a surprise to r because some of the people exiting the buses did not look like they were able to hike the trails in the area. r knew the area well and there were not a lot of easy hikes for the types of bodies he saw exiting the buses. he heard a few of the fhc members voice what he was thinking. immediately r questioned why he and the fhc members, who were in the same age range as the new arrivals, viewed the newcomers differently. r concluded that they did not look physically capable of navigating the rugged terrain. there was a frailty to some of the newcomers that was unsettling. r would like to think that he was immune to the negative stereotypes of aging, but they are so pervasive in western culture that it is difficult not to slip into assumptions about the aging body such as, “these people look old, how can they do what i can do?”  dionigi and o’flynn (2007:359-377) encountered a similar type of ageism in their research on older athletes. the authors found that older athletes held dearly to notions of physical activity improving their physical abilities and prolonging their lives because they feared the opposite and their level of physical activity “reinforced the undesirability of old age” (2007:372). therefore, the juxtaposition of the physical demands of hiking and the rugged mountain setting with what was perceived as frail older bodies, exaggerated the undesirability of old age in r and fhc members. however, their perceptions were proven wrong. although some of the newcomers did need walking aids – almost everyone in both the fhc and the newcomers’ group used walking poles, so the aids were not viewed as something age specific – they did not have any problems with the terrain.  the rest of the hike that day was an illuminating anthropology & aging quarterly 2013: 34 (3) 92 steadman, nykiforuk, vallianatos active aging experience for r. group a did the longer hike which was a 16 km loop with 726 m in elevation gain and group b went to a small alpine lake and returned the same way (approximately the same distance as group a, but not as much elevation gain). group a was a mix of four women and five men. the group embodied distance, elevation, and time to complete hikes. this was exemplified when the groups split up after lunch and group b went back the way they came and group a continued the loop. r went with group a and it was a long slog in rain, sleet and snow to the top of a col (a gap between mountain peaks) that connected two valleys. the group spread out according to fitness level and comfort with the terrain. the easier route was through rock bands in the scree (loose rock), but there was some very minor climbing that could be minimally challenging for some. participants would look after each other and help the ones that needed it through the tricky sections. the scree was less intimidating, but more challenging because the scree would slip so that each step forward was almost half a step on solid ground. everyone waited at the top of the col for the slower members and allowed them to have a rest before the trip down. while waiting for the slower members, phil showed r the altimeter to let him know that they had gained 600 m since their lunch spot and after the hike, phil told r the length of the hike and how long it took them to complete it (approximately 7 hours). he told r, “not bad for a bunch of old guys.” he was right, and r had to remind himself that phil was 78 and the youngest person in group a was 59. they were an extremely fit and capable group to tackle this type of hike. r (41 years old) had also gained the acceptance of the group by not slowing them down. resistance to essentialism  similar to chloé’s experiences with cancer, biomedicine has both figuratively and literally shaped the lives and bodies of some fhc members: surgeries have corrected malfunctioning hearts, removed cancer, and repaired injured joints. pharmaceuticals have allowed members to control chronic health problems, such as heart disease, diabetes, and cancer. however, biomedicine was also viewed with distrust due to concerns about the over prescription of pharmaceuticals and biomedical essentialism associated with their ages. the cartesian dualism of biomedicine has frequently been discussed in anthropological literature (helman 2001; scheper-hughes and lock 1987:6-41; shilling 2012), but for our participants, biomedicine had its own dualism: it was viewed with gratitude and distrust, both a preserver and destroyer of life, something to be avoided and simultaneously embraced.  lou (66 years old) had a dualistic view of biomedicine. he visited his cardiologist three times a year to monitor his hypertension and his cardiologist was always impressed with his good physical condition. lou attributed his good health to staying active and managing his weight, “if your waist line is too big [laughs] and you’re overweight, you’re putting more pressure on your heart and your vessels to supply the blood.” lou’s neighbours – inactive and obese according to lou – frequently told him he was acting like a 20 year old due to his active lifestyle; furthermore, they did not understand why he did not take it easy in his old age. his response to their criticism was that he had a choice to be obese or not. lou’s view of his body coincided with biomedicine’s reductionist view where disease is determined by deviations from measurable somatic norms (engel 1977:129-136). from lou’s perspective, the normal body had a specific weight and size that, when deviated from, resulted in an improperly functioning cardiovascular system. this was a common discourse amongst participants.  lou also had arthritis. in the same way that chloé mitigated her post surgery pain with exercise, lou managed his arthritic pain through physical activity. he believed that the release of endorphins, through exercise, eased his arthritic pain. additionally, lou used acupuncture to control his pain and, like chloé, he was determined to “stay away from medicine as much as possible.” other participants shared lou’s avoidance of pharmaceuticals.  foothill hiking club members attached a moral value to medications they believe could be avoided, or doses reduced, if they remained active: such as medications for pain relief, diabetes, or heart disease. similar to dionigi and o’flynn’s (2007:359-377) and laz’s (2003:503-519) findings, participants considered people who were able to control their illnesses through physical activity as strong-willed, healthy, and of good moral character. furthermore, they did not judge participants who had to take medications due to the severity of their conditions. they considered these individuals to be of good moral character for being proactive and joining their group to improve their health and fitness.  in addition to pharmaceuticals, several key informants had become desensitized to the plethora of potential accidents and illnesses associated with their age group that were endlessly reported in the media. r was told anthropology & aging quarterly 2013: 34 (3) 93 steadman, nykiforuk, vallianatos active aging on several occasions that if they worried about all the potential hazards of life, they would never leave home. it is a reaction to what scheper-hughes and lock identifies as the “medicalization and the overproduction of illness” (1987:27). the medicalization and overproduction of illness is also linked to laws’ essentialism in which specific biological changes and diseases are associated with chronological age. therefore, as experienced by lou being told to act his age, there are specific activities an aging person is not expected to engage in. this also contributed to how they viewed their own age. a frequent response from key informants when asked if they considered themselves healthy was, “for my age.” this response was an acceptance that by a certain age a physiological decline will be experienced (laz 2003:503-519). this was mainly due to biomedical research filtered through media outlets and presented as anti-aging products and recommendations for a youth obsessed culture (cardona 2008:475-483). they were constantly being reminded that an older body was not welcome in western society (cardona 2008:475-483). this was illustrated when a key informant told r that his presence had brought a certain “vitality” and provided the group with a feeling of importance, “now we can puff our chests up and say, ‘we, are being, studied.’” his life before retirement consisted of academic research and teaching. he missed it desperately, resulting in feelings of abandonment: i don’t feel i have a purpose. it’s annoying that people try to attain this [retirement], and when they get there, [as] in my case, i want to be helping. i want to be contributing. i buy into this thing though [that] you should be paying back to society, and now – i can’t go to the university and say, “i’ll do lab work. well our salary, cap… no-no i’ll work as a lab tech or something at half the salary. no-no we can’t because our grid (a union hierarchy of jobs and wages), doesn’t allow it.” it doesn’t make me happy.  hiking provided this informant with something to do with his spare time. he was an avid photographer and would share his photos with other members. it provided an opportunity for him to socialize, be active, and indulge his creativity. therefore, hiking can be viewed as a form of protest against biomedical essentialism. instead of submitting to the aging expectations, group members had taken the privileged position of institutionalized established norms and placed it on par with their ability to consider alternatives when dealing with their health and age (helman 2001:501; scheper-hughes and lock 1987:641). they allowed biomedicine to provide the diagnosis, occasionally the “cure,” but they also had a voice in the decision making process. this form of empowerment created a unique social identity that we explore in the next section. healthy bodies, healing, and age the values of a society can be expressed through symbolic equations and metaphors that delineate individual roles through daily activities (csordas 1990:5-47; geertz 1973; scheper-hughes and lock 1987:6-41). according to csordas and scheper-hughes and lock, these symbolic equations and metaphors can be used to create an idealistic vision of health and reveal how a group views a healthy body in relation to a healthy society and a diseased body in relation to a dysfunctional society (csordas 1990:5-47; scheper-hughes and lock 1987:641). the symbolic structure of the fhc is located in the physical act of bipedal motion (ingold 2004:315-340). our observations and experiences with the group coincide with ingold’s (2004) argument that the routes people walk becomes an expression of their lived time and space. for example, walking for chloé was linked to her overall sense of wellbeing. she endeavoured to walk routes that were difficult enough to ensure she was exercising at a high intensity. she embodied active aging and attributed it to her healing. this also influenced how chloé viewed the inactive body during her cancer treatment. she equated the inactive and obese body to being lethal to a person’s overall health because she saw inactive and overweight patients having difficulties healing, whereas her active body did not experience the same problems healing. however, her perspective on activity does not recognize that these individuals may have faced challenges beyond their control or associated with their diagnosis and treatment regiments (asquith 2009:255-269; davey and glasgow 2006:21-27). chloé thought that someone should help them become more active to improve their conditions. this building of health and healing symbolic equations holds true for fhc members. members shared in the physical experiences of their environments and the changes their activities made to their bodies. these experiences also made them uniquely aware of their age and body parts susceptible to injury.  joint health of the lower body was a major concern for all fhc members. injury to a knee, ankle, or back could severely limit their mobility. fhc members attached meaning to an upright and mobile body in the same way that, as pointed out by scheper-hughes and lock, “old stock” american farmers from the midwest attached meaning to the backbone of their bodies and “upright” anthropology & aging quarterly 2013: 34 (3) 94 steadman, nykiforuk, vallianatos active aging posture (1987:18). when these hard working individuals were bedridden, it was extremely damaging to their ego. their society equated wellbeing with an ability to remain upright and mobile. erwin straus (1966:164-192) in his paper “the upright posture” identified the symbolic importance of an upright posture. according to straus, in western society “to be upright” has literal and metaphorical meanings: the literal meaning is to physically stand up without assistance; the metaphorical or symbolic meaning is linked to a person’s morality (1966:530). an upright person, or as expressed by our participants as “a stand-up guy,” is a person of good moral character. foothill hiking club members attached similar symbolic meanings to the reclining body as midwest farmers by viewing it as lazy or disabled. it represented a loss of independence and a potentially demoralizing, even fatal, situation if an individual was forced to endure long periods of inactivity or lying down.  hal (69 years of age) tore his achilles tendon the summer before he was interviewed. it had been a long recovery for him, but he refused to stop hiking. he believed that hiking would eventually heal his condition. like chloé, hal was a cancer survivor and attributed his recovery to his physical activities. hal had to undergo a six-hour surgery, followed by 12 hours in post operation, to remove a tumour from his brain. he was up and walking within a few days after his surgery to the chagrin of hospital staff. they told him he was a bad patient and his response was, “you want the most efficient sort of patient who lies in bed, but i’m not a patient anymore. i’ve had the operation. i’ve got my own way of getting fit now and i go for walks.” hal allowed biomedicine to treat his cancer, but, like chloé, lou, and others, he was determined to proceed with his healing on his own terms. he fully believed walking had helped his healing process and eight weeks after his surgery he was back at work.  after surviving his cancer, and seeing other members in the group with serious health problems still hiking, hal believed his torn achilles tendon was not enough of a health problem for him to stop hiking. he felt an obligation to his fellow hikers who hiked with more serious health problems than his. therefore, hal had to maintain his upright and mobile body image as a symbolic gesture of solidarity with his fellow hikers. also, hiking just might heal him.  it was not just joints of the lower limbs that were a concern for participants, back problems were another frequently discussed health problem. back pain is a common problem in aging populations. in the united states alone, cases of back pain have increased from 7.8 million to 12.8 million between 2000 and 2007, with chronic back pain accounting for over half the increases (smith et al. 2013:211). during this same time period, the average age of back pain sufferers increased from 46 years to 48 years (smith et al. 2013:2-11). furthermore, over 25 percent of older adults had chronic back pain as they entered retirement (smith et al. 2013:2-11). so it comes as no surprise that back problems were a source of considerable discussion with fhc members. participants would discuss how back pain in aging friends and family members had made it difficult for them to live an independent and mobile life. [s]he [wife] unfortunately can no longer participate [in walks]. she’s got back problems.... she never has a day that she doesn’t have pain... [w]e have some physical problems with my wife at home…. once you are destabilized it’s just incredible how bad it is when you can’t get out and do anything. she’s got a bad back.... when you can’t even walk it’s pretty miserable. their indirect experiences of their spouses’ conditions had given them an appreciation for their bodies and the motivation to maintain an upright, and pain free, posture.  maintaining an upright and mobile body were key symbolic acts by fhc members that demonstrated to others their independence and health status. their attitudes towards the upright body embodied the connection between the individual and the group. hiking with painful injuries or illnesses provided other members with inspiration and enforced the belief that their hiking will heal their injuries or mitigate side effects due to illness. for many, submitting to pain or sickness by reducing their level of activity was equated with a loss of mobility, independence, and overall health.  several participants discussed how their mental pain was also managed or completely eliminated through their hiking experiences; as one key informant suggested, “it gives you the ability to cope with life a lot better when you do physical activities.” it was a mind-body interaction that they were aware of and attributed to their overall sense of wellbeing. they frequently discussed the importance of hiking to improve their mental state, so there was an acknowledgment that the mind and body functioned as a whole: [y]ou keep your body loosened up, like i say you anthropology & aging quarterly 2013: 34 (3) 95 steadman, nykiforuk, vallianatos active aging release endorphins and i really do believe that it helps so you don’t get depressed and people that sit around, feel sorry for themselves rather than get out and exercise, they just seem to go downhill in my opinion. whereas, if you’re out exercising, it just gives you a little lift…  jemma, an fhc member who had been living in a very difficult marriage, found escape and comfort in her fellow hikers who provided her with a coping mechanism for her emotional pain: oh it [hiking] made all the difference, i felt like i was holidays all the time, because one day a week i had a fantastic holiday. i had people i enjoyed outside of the family situation, and the family situation had some conflict, so it was great to get out of that, and it gave me something to look forward to.  the camaraderie that jemma experienced amongst her fellow fhc members was created through the sharing of leadership responsibilities and adventures. leaders were both male and female and treated as equals during our observations. although leadership was an undesirable position due to the extra responsibilities, members felt a duty to lead the group to ensure the continuation of hiking trips. men and women hiked together, helped each other out, and shared in adventures resulting in the formation of deep bonds between participants. these bonds helped them mitigate the occasional negative experience associated with their age.  foothill hiking club members were constantly challenging the stigma attached to age and the aging process. jemma provides a couple of examples of how they used their activities to challenge traditional notions of aging: [t]hey push themselves sometime to the limit and some of them have gone beyond their c o m f o r t level to achieve that and i feel that they’re a good example to anybody who is looking at people who are getting older and see that they don’t sit around [laughs]...i think as you get older – especially if you’re retired – i think it gives you a new lease on life and makes you want more, or not, depending on the individual [laughs]. [w]e went [hiking], and there were two 20 [year old] girls…and they looked at all us ‘old p e o p l e ’ and they said, ‘oh, we should have no trouble with this hike. if these people can do it we can do it’ and i snickered to myself…so, they struggled, and they struggled. they were a little bit behind us, but we kept encouraging and talking to them and some of our group were insulting like they thought, ‘oh this younger generation…’ they had negative comments, but i said, ‘you know what, no. let’s encourage them,’ and so when we got to the ladder [to climb a cliff], they were already going to turn back, but we told them to join us and we helped them up the ladder and told them to watch for us when we left, so we could help them down. i thought that was so good. it probably helped them have a different attitude about aging and maybe helped some of the older people have a different – like, we’ve made a difference in their lives.  for the majority of fhc members, emotional and physical pains were unifying experiences. it defined their experiences of sickness and healing. similar to cholè’s experiences with using walking to mitigate her sickness, group members controlled their pain through hiking. they viewed their hiking activities as liberating experiences that motivated them to continue their active lifestyles and provided them with a sense of control over their lives. however, the production of acute pain was also considered a part of the healing process and a rite of passage.  the physical strain and pain associated with the physical demands of walking and hiking acted as a rite of passage for group members. it was a therapeutic experience important to their healing. hsu (2005:78-96) suggests that acute pain can break down barriers between individuals and create a space for interpersonal connectedness and healing. the sharing of these physically demanding experiences created a bond between group members and provided them with new social identities (hsu 2005:78-96). individuals recovering from sickness or injury were able to change their life narratives to ones where their health issues were not the only experiences that defined them.  embodiment was an important feature to the contextualizing of our participants activities and their experiences of good and bad health and healing; however, it was not the sole focus of our participant interactions with each other and r. of equal importance to their emotional and mental health was their experiences in nature; the feeling of being in a special space or place. boyes (2013:644665) research into successful aging coincides with our findings. boyes found that the natural environment was integral to the experiences of his research group (80 members of an outdoor adventure group ranging in age from 54 to 83 years) and their successful aging. margaret rodman (1992:640-656) observes that the experience of place is unique to each individual and shared amongst members of a group; that is, places are compared, anthropology & aging quarterly 2013: 34 (3) 96 steadman, nykiforuk, vallianatos active aging manipulated, or interpreted to provide an idealized landscape. this was seen in the hiking groups by the taking and sharing of pictures. the pictures represented trophies of hikes completed or their constructed image of an ideal place. it was a way of confirming to each other that their experiences were unique and special, therefore, the group and its members were unique and special: they had a unique level of experience, health, and fitness to traverse long distances, ascend great heights, and navigate the difficult terrain represented by their pictures. conclusions  in this paper we explore how a group of middleaged and older adult hikers embodied their experiences of age, health, and healing. the major themes that identified dimensions of embodiment were: resistance to essentialism, activity, and camaraderie. hiking was considered as an activity that would improve the aging body and make the body less reliant on medications and other forms of medical interventions. it was also a way to maintain a healthy weight and avoid the negative consequences of inactivity and obesity. furthermore, hiking activities allowed middle-aged and older adults to challenge perceptions of the aging body and strengthen bonds between members through the adventures they shared.  the authors acknowledge that their description is not an accurate depiction of all middle-aged and older adult hikers. we are only able to provide evidence of a single group of hikers in a particular time and place. future research on health and healing in this age group would benefit from an analysis of hiking groups that consisted of more diverse ethnic backgrounds. it would also be of value to establish if socioeconomic (ses) status influenced participation in hiking activities and if aging hikers from diverse sess embodied their activities in relation to age, health, and healing in the same way as our participants. furthermore, gender and aging was beyond the scope of this study and could be a source for rich analysis in this population. understanding the role of culture in how groups embody their activities as they relate to age, health, and healing is vital to providing tailored activity programs for specific aging populations (lloyd and little 2005:147181; weiss and tomasa 2010:473-475). the fhc served as a meaningful space where participants could explore all aspects of their health with the support of others who had undergone similar life experiences. the physical activities they engaged in as a group were therapeutic and transformational for many members. it created a deep sense of community and aided in their healing processes. the health benefits of genderand age-based groups have been documented by gleibs and colleagues (2011:456-466; 2011:1361-1377) and others (haslam et al. 2008:671-691; haslam et al. 2010:157-167; haslam et al. 2005:355-370; haslam et al. 2009:1-23). as the global population lives longer (world health organization 2012), healthcare professionals will continue to be challenged with maintaining the health of aging populations. holistic health programs such hiking groups could provide an alternative or ancillary treatment option to aging populations. however, cost, location, opportunities for socialization, and the physical ability of their target demographic should be seriously considered (meisner et al. 2013). notes 1 this is a pseudonym, as will be the case with all names of individuals and places referenced in this article. acknowledgements rodney would like to thank dr. helen vallianatos for all of her help and support during the writing of his graduate thesis – the source material for this manuscript – and this manuscript. he would also like to thank dr. jean debernardi, and dr. pamela willoughby for their valuable comments which helped to improve the quality of this manuscript. finally, we all thank our participants for allowing 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social anthropology 8 (1):51-60. vincent, john a. 2003 what is at stake in the “war” on anti-ageing medicine? ageing & society 23 (05):675684. vincent, john a. 2006 ageing contested: anti-ageing science and the cultural construction of old age. sociology 40 (4):681698. wacquant, loic j. 2004 body & soul: notebooks of an apprentice boxer. oxford: oxford university press. weiss, barry d., and lynne tomasa 2010 hiking on the geriatrics rotation. family medicine 42 (7):473-475. wentzell, emily 2013 aging respectably by rejecting medicalization: mexican men’s reasons for not using erectile dysfunction drugs. medical anthropology quarterly 27 (1):3-22. world health organization. 2013 definition of an older or elderly person. electronic document, http://www.who.int/healthinfo/survey/ ageingdefnolder/en/index.html august 21, 2013. world health organization 2010 global recommendations on physical activity for health. geneva: world health organization:8-10. world health organization 2012 good health adds life to years. global brief for world health day 2012. geneva. anthropology & aging anthropology & aging, vol 40, no 2 (2019), pp. 79-81 issn 2374-2267 (online) doi 10.5195/aa.2019.231 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review review of walsh, katie and lena näre, eds. transnational migration and home in older age. new york: routledge. 2016. pp.268. price: $153.00 (hardcover); $27.00 (e-book). nele wolter max planck institute for the study of religious and ethnic diversity, göttingen. http://www.library.pitt.edu/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ wolter | book review | 79 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.231 http://anthro-age.pitt.edu book review review of walsh, katie and lena näre, eds. transnational migration and home in older age. new york: routledge. 2016. pp.268. price: $153.00 (hardcover); $27.00 (e-book). nele wolter max planck institute for the study of religious and ethnic diversity, göttingen. though lived realities since time immemorial, both ageing and transnational migration have only recently received increased attention from social scientists, as both phenomena impact the world’s population today more intensely than ever before, to converge into new transnational imaginaries of home throughout the life course. as people’s life expectancy increases in an ever more fluid and mobile world, how does this impact their conceptualization of ‘home’? as part of the series routledge research in transnationalism, with the edited volume transnational migration and home in older age, human geographer katie walsh and sociologist lena näre elucidate multiple intersections of ageing, migration and home-making processes. the ethnographic chapters richly document a myriad of dynamics, spaces, practices, movements and imaginaries that crystallize in home-making in older age. the interdisciplinary blend of ethnographic case studies is divided into five sections. although each section takes on a specific perspective on the topic, they all adhere to the same dynamic conception of ageing: not as fixed or static (biological age), but as socio-culturally constructed. thus, notions of ‘home’ are analyzed following a multi-scalar approach and according to their material, emotional and temporal dimensions. the first section, “intergenerational transnational homes”, paves the way for a topos which runs through all the subsequent chapters, by putting a special focus on ongoing relations within transnational families and on the way ageing people negotiate ‘home’ and ‘belonging’: affective spaces that often intertwine with notions and practices of care. tatiana tiaynen-qadir (chapter 2), for example, reflects on transnational grandmothers, so-called babushkas, travelling between russia and finland: they constitute their multi-sited homes not only in response to changes throughout the life course, but also through space by oscillating between their own and their children’s homes in the two countries. in this process, tiaynen-qadir shows, care is mutual, as the aged are not only cared for but also take care of their children and grandchildren that have migrated, particularly in physical copresence. julie vullnetari (chapter 3), on the contrary, focuses on the way parents make and unmake home in the absence of their children in their place of origin. left behind in ‘empty’ houses, these older parents fill their homes with imaginaries and memories of their absent children, thus keeping the acquired homeliness alive. the second part, “home strategies of ageing and mobility”, moves beyond the family as a nucleus for home-making practices. tine buffel and christopher phillipson (chapter 5) for example, illustrate how the process of ‘home’(-making) is not limited to the sphere of family and kin, but intensely interrelates with the (deprived) communities or neighborhoods in urban wolter | book review | 80 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.231 http://anthro-age.pitt.edu contexts, that older migrants in england and belgium live in. here – as many of the ethnographic chapters show – ‘home’ does not only refer to the direct physical environment that is shared by migrants of the same country of origin, but also to the transnational character of tea houses or ethnic shops, that affectively construct a sense of “heimat” (72). alistair hunter (chapter 6) describes the emotional and instrumental attachment by west african labour migrants to their long-term belonging in french hostels, while similarly adhering to their countries of origin. life style migration, as another strategy on the convergence of ageing and mobility, is taken up by stefan kordel (chapter 7) and kate botterill (chapter 8), who write about north european lifestyle migrants that search for a new and ‘idealised home’ in spain and thailand respectively. these elderly are drawn by the promise of growing old in a warmer climate and, thus, by the possibility to increase their health and general quality of life. most often, this desire for a new home goes along with a spatial imaginary of a beautiful scenery or landscape. part 3 deals with a reverse imagination: “returning ‘home’ in older age”. all chapters elucidate migrants’ experiences returning to their country of origin or planning to do so. leslie fesenmyer (chapter 9), for instance, concentrates on kenyan women living as labour migrants in london. although definitely returning ‘home’ these women sway to and fro their “permanent temporariness” (123) and are concerned of struggling with their “old new lives” once they go back to live with their families in kenya. in the tenth chapter, ken chih-yan sun documents the life stories of retirement migrants that return to taiwan after having worked in the us for decades. the “falling leaves returning to their roots” (134) try to dwell comfortably by reshaping different cultural and social realms once back in taiwan (zigon 2014). in the section’s last chapter, katie walsh (chapter 11) sheds light on the life of expatriates growing into old age and constituting ‘home’ after a life of working abroad. the transforming relation to emotional and material belongings, obviates that subjectification is ongoing, and does not end upon return. “ageing in transnational space”, the volume’s fourth section, emphasizes embodied feelings and emotions that come with return. the chapters show that the return after retirement does not come with feelings of pure enchantment, but with difficult, mixed and sometimes contradictory feelings that ask for emotional labour. lars meier (chapter 13), for example, finds that spanish migrants in germany don’t necessarily have a sense of nostalgia when thinking of their homeland. anastasia christou in chapter 14, on the other hand, does describe phantasmagoric narratives of home and the homeland circulating among jewish and cuban migrants in the united states. caroline oliver (chapter 15) closes the fourth section with a realist remark: the often paradoxical embodied feelings surrounding homeliness, are not only ignited by the return but are tied up with the often difficult process of retirement. the volume’s last part makes explicit the relation between “transnationalism”and “elderly care”. angeles escrivá (chapter 16) explores the desire of ageing peruvian and moroccan migrants in spain to be cared for at ‘home’: a place that is familiar to them and where family members live nearby. both, antero olakivi and miira niska and kim england and isabel dyck provide data on the institutional sphere of providing care for the elderly. while the first show how professionals in public care in finland anticipate the development of care in the future, the latter explicitly relate to racialization and power relations at work in the care sector. the afterword by russell king, provides a comprehensive and constructively critical summary of the volume’s chapters. walsh and näre’s edited volume is impressive thanks to the variety of case studies and regions, (re)presented in rich ethnographic detail, using different qualitative methods to provide the reader with a deep insight into the everyday lives of older people across the globe. wolter | book review | 81 anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.231 http://anthro-age.pitt.edu unfortunately, case studies that refer to south-south migration – an area of research that is still marginal within the social sciences – were notably lacking in this volume. nevertheless, transnational migration and home in older age is a must-read for scholars of all disciplines working on the social and cultural construction of ‘home’ among older people, as it consistently combines this process with transnational migration. this book on ageing, transnationalization and belonging should be foundational in future research, to conceptualize a broader understanding of glocal processes of ageing and care. references zigon, jarett. 2014. “attunement and fidelity: two ontological conditions for being-in-the-world.” ethnos 42 (1): 16-30. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 112-120 issn 2374-2267 (online) doi 10.5195/aa.2015.104 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. towards a gerontoludic manifesto bob de schutter1 & vero vanden abeele2 1 miami university contact: b@bobdeschutter.be 2 ku leuven, e-media lab, belgium contact: vero.vandenabeele@kuleuven.be abstract digital games have become an important part of the technoscape, not only for youngsters, but for players of all ages. older adults are a large, currently still largely untapped market for innovative game research and development. however, the current discourse on games and aging can largely be categorized into two themes. the first theme refers to digital games framed as a way for older adults to improve certain skills. the useful, pragmatic qualities, rather than the fun, hedonic aspects of games are emphasized. the second theme identifies the various age-related constraints that prevent older adults from playing. it focuses on the cognitive and physical limitations of older adults. underlying both themes is a reductionist perspective on aging as merely a process of decline and debilitation. in this article, we present a “gerontoludic” manifesto. firstly, games should not be marketed solely as having the purpose of dealing with or mitigating agerelated decline and focus on positive aspects of older age (adagio 1: growth over decline). secondly, agerelated adjustments should never interfere with the actual gameplay of the game (adagio 2: playfulness over usefulness). finally, game researchers and game industry should put more efforts in understanding what differentiates elderly players, rather than seeing them as united in their age-related impairments (adagio 3: heterogeneity over unification). as this manifesto is a first step that needs further abutment by a wider community, we welcome debate and additions from game designers and researchers to further this manifesto and to move beyond agism in games. keywords: aging, gaming, play, gerontoludic, ageism, design http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.104 http://anthro-age.pitt.edu towards a gerontoludic manifesto bob de schutter & vero vanden abeele 1 miami university contact: b@bobdeschutter.be 2 ku leuven, e-media lab, belgium contact: vero.vandenabeele@kuleuven.be digital games have become an important part of the technoscape, not only for youngsters, but for players of all ages. for example, the pew internet & american life project found that 23 percent of those 65 years old and over reported playing games in 2008 (lenhart, jones, and mcgill 2008); the entertainment software association estimated that 27 percent of us gamers were over 50 in 2015 (esa 2015); and the interactive software federation of europe lists that 28percent of males and 27 percent of females between the ages of 55 and 64 are avid gamers (bosmans and maskell 2012). these consistent numbers are not just a prelude of the advent of the silver-haired gamer. they testify that the older player of digital games has already arrived. at the time of this writing (i.e., summer 2015), a 50 year old person was a 7-year-old child when the release of pong breathed life into the video game industry in 1972. there is no reason to assume that people of this age cohort stopped playing digital games when growing older (skalsky brown 2014). in contrary, it is safe to say that older adults are a large, attractive, yet currently still largely untapped market for innovative game research and development. considering the current discourse on games and ageing, we argue it can largely be categorized into two themes: a) the theme of usefulness, and b) the theme of accessibility (de schutter in review). the first theme refers to digital games framed as a way for older adults to improve certain skills (e.g., anguera et al. 2013; goldstein et al. 1997) and their overall quality of life (e.g., jung et al. 2009), or to prevent them from being harmed (e.g., marston and smith 2012). in essence, the useful, pragmatic qualities, rather than the fun, hedonic aspects of games are emphasized. the hidden message is that it is acceptable for older adults to play digital games in order to achieve a higher goal of maintaining health. the second theme (i.e., accessibility) identifies the various age-related constraints that prevent older adults from playing, and focuses on the cognitive and physical limitations of older adults. it emphasizes the challenges that older adults experience with the graphic user interface and input devices of games, the learning curve of playing games, or the motivational barriers that prevent older adults from playing games. next, it identifies solutions to overcome such issues (e.g., gamberini et al. 2006; gerling et al. 2012; ijsselsteijn et al. 2007; ogomori et al. 2011). de schutter & vanden abeele | towards a gerontoludic manifesto anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.104 http://anthro-age.pitt.edu 113 113 while the examples above are academic ones, it should be noted that the game industry has used the same rhetoric of usefulness and accessibility in the few attempts that have been made to target ageing players. most notably, nintendo launched brain training: how old is your brain by marketing its cognitive benefits, and demonstrated in its advertising for the nintendo wii and nintendo ds consoles how they were accessible to older adults and sources for health benefits. the academic literature does offer some exceptions that do not follow the themes above – for example studies on how older adults actively play digital games, studies on the differences between actively playing older and younger cohorts, a study on gender differences among older players, and a discourse analysis of the field (brown 2012; de schutter, brown, and vanden abeele 2014; levy et al. 2012; mosberg iversen 2014). however, these studies are much less prevalent and will often still emphasize the benefits of playing digital games. industry exceptions are even rarer than academic ones. we are unaware of any marketing efforts in which older adults are portrayed as people who are playing without healthoriented ulterior motives, and – excluding casual “granny” games that are seemingly designed for parody (mosberg iversen 2015) –the majority of games that specifically deal with later life are about age-related losses. for example, alz (carter, 2014) is a game that depicts the life of an ageing man whose surroundings become increasingly more distorted as a result of alzheimer’s disease. similarly, forget-me-knot (tarvet, 2015) offers a first person experience during which players explore a home through the eyes of an alzheimer’s patient whose memory is failing to the point where he cannot remember who the people in his family portraits are. as a final example, cahors sunset (locomotivah, 2015) has players weight the potential psycho-emotional benefits and losses of daily activities in an attempt to prolong their character’s life as long as possible. perhaps the only game about later life that is not focused on losses (and that is not meant as parody) is the graveyard, a very short art game by belgian developer tale of tales (2008) that tells the story of an old woman who reminisces on a bench near a church. while it is definitely important to consider the usefulness and accessibility of digital games for older adults, it instills a reductionist perspective on ageing as merely a process of decline and debilitation. this focus on decline which arguably causes a need for cognitive and physical benefits as well as accessible interfaces is a limiting perspective when designing or studying games (or other media) for an ageing population. furthermore, as sara mosberg iverson (2014:1) addresses in her foucauldian discourse analysis, it is can also be a toxic proposition: older adults are seen as a burden on society that needs to be alleviated; therefore researchers/designers transform games into tools to “maintain, correct or tame the ageing citizens.” the same toxicity is found when studying actively playing older adults; participants of our own qualitative research (e.g., de schutter, brown, and vanden abeele 2014; de schutter and malliet 2014) talked about how it was socially unacceptable for them to play games. for example, one 62-year-old female participant told us how she hid her nintendo gameboy when a friend came to visit, and remarked “when i play my gameboy outside of my home i see people looking at me; they think that i have gone crazy.” many older players reported that their gameplay was frowned upon by their non-playing peers, and how this limited their appropriation of games. van leeuwen & westwood (2008) provide an explanation to this finding, as they identify how negative socio-cultural attitudes have undermined the importance of play in later life. adult de schutter & vanden abeele | towards a gerontoludic manifesto anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.104 http://anthro-age.pitt.edu 114 play is often regarded as an inconsequential, shallow deviation from the work ethic. subsequently, this perspective has shaped euphemisms for adult play (e.g., “pastime”, “hobby”, etc.), it has cultivated the social disapproval of older players by their peers, and it has arguably led to a study of adult playfulness that is framed almost exclusively in the context of age-related decline. similarly, traditional games that are typically associated with old age (chess, bridge, boules, golf, etc.) follow the theme of usefulness, as they are considered intellectually or physically stimulating. in conclusion, while market studies show that over one fourth of older adults play video game, the current discourse does not allow older adults to out themselves as game players. we therefore deem it necessary to draft a gerontoludic1 manifesto for game designers and researchers alike, that remediates the stereotypical views on games and ageing presented above. in doing so, we wish to develop a positive and inclusive discourse for games in later life, relying on the following adages: #1 playfulness over usefulness many authors have demonstrated how games and personal development are strongly intertwined or, as crawford (1982:16) put it, “game-playing is a vital educational function for any creature capable of learning.” furthermore, learning that takes place in games spans many domains and can take on a wide range of forms, which can lead to meaningful experiences that are defining for who we are as human beings. murray (1997) sums up this function of play as follows: in games, we therefore have a chance to enact our most basic relationship to the world. (…) like the religious ceremonies of passage by which we mark birth, coming of age, marriage and death, games are ritual actions allowing us to symbolically enact the patterns that give meaning to our lives (murray 1997:143) nonetheless, as van leeuwen & westwood (2008) indicated, it is remarkable how play is deemed essential in early life, but neglected and sometimes even looked down upon in later life. this disconnect could be part of the reason why so many designers and researchers seem to be looking to inject games for older adults with an extrinsic kind of usefulness. for example, fua et al. (2013) specifically introduce their design approach with the following sentences: “with an increase in elder gamers, one important question for game designers and game researchers should be: what purpose should games designed for elders aim to fulfill?” as lantz (2014) explained in his talk at the 2014 game developers conference, games are an aesthetic form. a game is “decoupled from actual purpose, experienced for its own sake, so that we can indulge ourselves in it, understand it, reflect on its myriad of different forms, looking for meaning and beauty.” the answer to fua et al.’s question is therefore simple: games designed for elders do not need a purpose. games for elders need to be played for their own sake, anything else is merely a side effect. one interesting example of this proposition is the red hat society, an international organization of women over the age of 50 who use age as a license to play and act “silly”. a qualitative study by yarnal, chick and kerstetter (2008) examined this playgroup, and found a wide range of self-reported positive outcomes, such as the enhancement of positive coping strategies, positive emotions, stronger social bonds, and general personal growth. for the more than one million ladies of the red hat society, the playfulness that comes with the membership de schutter & vanden abeele | towards a gerontoludic manifesto anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.104 http://anthro-age.pitt.edu 115 115 provides them with ample usefulness, even if – as described on their official website (2015) – they gather “for no other purpose than to play”. considering the above, we conclude that, to advance the field of games and ageing, a change of heart is needed with regards to how we frame games for older players. while serious games – i.e., games with a purpose besides mere entertainment (michael and chen 2005) – might be useful for certain afflictions that are associated with older age, we argue that an exclusive emphasis on the external purpose of ”games for older adults” is detrimental to the very nature of play. our society – including the game industry and game academia – needs to frame play as a valued activity in all stages of human life: successful play is inherently meaningful (salen and zimmerman 2003), and therefore useful. #2. growth over decline. the field of games and ageing should emphasize personal growth over decline in later life. research paradigms on ageing such as the life-span perspective (baltes 1987) have considered ageing to be a process of both growth and decline. while gains are particularly evident in early life and losses are more noticeable in later life, people of all ages can improve skills and cognitive functioning (freund and baltes 2000). for example, older adults devise new strategies in one domain to compensate for losses in another (baltes and baltes 1990), and use media selectively to support personal growth (van der goot 2009). moreover, certain older adults have a richness of experiences and an accumulated wisdom (holliday and chandler 1986) that is commonly ignored whereas small decreases in low level cognitive and attentional processes are enlarged. the field of games and ageing should adopt a life-span perspective in order to become more considerate of the needs of older adults looking to play games. games are supposed to be intellectually cultivating challenges, or to quote lantz’ (2014) elaboration on the intricacies of the aesthetic form of a game, they are defined by thoughts and action formed by a mind that is “making plans and acting on them, observing the world, forming hypotheses, making and updating models, learning, pursuing goals, solving problems, interacting with the world around it.” correspondingly, a game for older adults needs to embrace this quality and not resort to dumbed-down exercises of futility for the sake of accessibility and fear of cognitive decline. furthermore, removing all obstacles in function of accessibility also removes opportunity to devise new strategies to overcome age-related decline (mclaughlin et al. 2013). for these reasons, we argue that growth holds higher importance than decline. older adults want to be challenged and are well-capable of practicing and persevering through difficult ones. older adults can fall back on an accumulated experience. de schutter (2011) demonstrated how challenge was the most important playing motive, and to meet certain side effects of play, it is important to provide them with such challenge. designers therefore might need to adjust the interface to meet needs that are the result of some decline, but the game’s challenge should never be reduced artificially. in fact, as lamb (2014) indicates, coming to terms with one’s decline is arguably a preferred model of successful aging, and potentially an interesting theme for experimental game design aimed at older adults. de schutter & vanden abeele | towards a gerontoludic manifesto anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.104 http://anthro-age.pitt.edu 116 #3 heterogeneity over stereotyping the previous two adages (i.e., “playfulness over usefulness” and “growth over decline”) might lead a reader to conclude that the manifesto assumes an older gaming audience that is in relative good health, and insensitive towards the realities of age-related decline. this is not the case; the manifesto simply considers age-related decline as an irregular phenomenon. while agerelated problems are more prevalent among older than younger populations, they do not occur automatically when someone reaches a certain age. correspondingly, there are 80 year olds who are in better physiological health than certain 60 year olds, and vice versa. the field of games and ageing should therefore emphasize individual differences over unification by decline in later life. considering butler’s definition of ageism (1969) as discrimination and stereotyping of older people, we argue that it is easy for games that target or depict older adults to fall in the trap of ageism: the simplistic generalization of old age as decline typically leads to exaggerated views or conceptions of later life. the presumption that players become more alike as they age is a common, but false presumption (peppard 2013). as with any age group, there is great diversity among older people in physical, intellectual ability and in cultural preferences. moreover, as people age, they become even less like their peers than younger people. as years pass, people have different life experiences, learn different things, face different challenges and respond differently to life’s events. moreover, the actual number of years lived affects people differently as well. people age physically, emotionally and spiritually at different rates. consequently, the longer people live, the more they differ. similar to how games typically have a difficult time being inclusive towards race and gender (dietz 1998), they do not adequately reflect the subgroups within the aging population. as mentioned earlier, games rarely feature non-stereotypical portrayals of aging characters, nor are they marketed directly towards aging players. correspondingly, it is uncommon for games to consider the functional level of older adults, which often leads to accessibility issues. arguably, the only manner in which games address diversity among older populations is through language, which is the result of commercial considerations. considering motivational and thematic diversity, we refer to our own player classification of actively playing older adults (de schutter and malliet 2014). this classification indicates how players who are driven solely by age-related decline to play games are only one of five existing player types. correspondingly, not every older player is eager to play a game that markets itself entirely on a positive side effect, and practically every existing game genre was present among the participants of the study (including “violent” games). to conclude our manifesto, games for older adults should diversify and provide the possibility to accommodate the game in a way that is sensitive to the needs of older adults. the academic literature provides ample recommendations to do so (e.g., ijsselsteijn et al. 2007; miesenberger et al. 2008) and the industry has developed an appropriate educational website (www.gameaccessibilityguidelines.com). however, in line with the second item of the manifesto, accessibility adjustments should never interfere with the actual gameplay of the game. moreover, games should not be marketed solely as having the purpose of mitigating age-related decline. finally, game researchers and game industry should put more efforts in understanding what differentiates older players, rather than seeing them as united in their age-related impairments. de schutter & vanden abeele | towards a gerontoludic manifesto anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.104 http://anthro-age.pitt.edu 117 117 we argue that the current adages are essential to a gerontoludic manifesto, however, we acknowledge that this manifesto is a first step that needs further abutment by a wider community. therefore, we welcome debate and additions from game designers and researchers to further this manifesto and to move beyond ageism in games. notes 1. we coined the term “gerontoludic” as a bridge between two relatively young fields of study, i.e., ludology and gerontechnology. frasca (1999; 2003) originally coined the term “ludology” (from “ludus”, the latin word for “game”) to refer to “a discipline that studies game and play activities”. bouma, fozard, bouwhuis and taipale (2007) describe gerontechnology as “a harmonization of demographic and technological developments, through the direction of technological innovation to the ambitions, purposes, and needs of ageing persons.” references anguera, j. a., j. boccanfuso, j. l. rintoul, o. al-hashimi, f. faraji, j. janowich, e. kong 2013. video game training enhances cognitive control in older adults. nature 501 (7465): 97–101. doi:10.1038/nature12486. baltes, paul b. 1987. theoretical propositions of life-span developmental psychology: on the dynamics between growth and decline. developmental psychology 23 (5): 611–26. baltes, paul b. and margret m. baltes 1990. psychological perspectives on successful aging: the model of selective optimization with compensation. successful aging: perspectives from the behavioral sciences 1: 1–34. bosmans, dirk, and paul maskell 2012. videogames in europe: 2012 consumer study. isfe & ipsos mediact. http://www.isfe.eu/industry-facts/statistics. bouma, herman, james l. fozard, don g. bouwhuis, and v. t. taipale 2007. gerontechnology in perspective. gerontechnology 6 (4): 190–216. brown, julie a 2012. let’s play: understanding the role and meaning of digital 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doi:10.1080/01490400802017456. http://ieeexplore.ieee.org/xpls/abs_all.jsp?arnumber=6031268 http://www.oregon.gov/dhs/apd-dd-training/eqc%20training%20documents/myths%20and%20stereotypes%20of%20aging.pdf http://www.oregon.gov/dhs/apd-dd-training/eqc%20training%20documents/myths%20and%20stereotypes%20of%20aging.pdf http://redhatsociety.com/about http://uknowledge.uky.edu/gerontol_etds/6 https://www.youtube.com/watch?v=v-grreyl-ng http://www.tale-of-tales.com/thegraveyard/ 404 not found schwennesen_finaldoc surveillance entanglements digital data flows and ageing bodies in motion in the danish welfare state nete schwennesen university of copenhagen author contact: ns@anthro.ku.dk abstract in recent years, new forms of self-tracking technologies, advanced algorithms and quantified measurements have increasingly become part of interventions targeting the physical improvement of elderly bodies. this has led authors to argue that the latter are not just ‘busy’ bodies (katz 2000) but ‘busier and smarter bodies,’ as well as being nodes for data collection, monitoring and surveillance designed to promote physical functioning (katz and marshall 2018). the article qualifies the argument by examining concrete encounters in which frail elderly bodies are made to move and transform in digital rehabilitation programs in the danish welfare state. the study mobilizes bennett’s (2009) notion of the ‘vitality of materiality’ as an analytic lens, thus highlighting the agentic capacities of technologies and the fleshy-sensual, lively force of the body itself. drawing on ethnographic material, the article traces how movement is impacted by the links and forces generated by a specific digital rehabilitation assemblage. this emphasizes the fluidity of relational connections between bodies and digital dataflows, meanwhile demonstrating that the vital force of the aging body is expressed through sensory pain when the temporality of the metrics and the rate of bodily recovery are out of alignment. in contrast to studies focusing on surveillance as a pre-given disciplining force, the vital materialism approach invites us to think about surveillance as a vibrant, open-ended and temporally specific process whose outcome is not predetermined. finally, it is argued that, to develop processes leading to bodily restoration rather than disruption, greater attention to sensory expression is needed – among professionals, it workers and the elderly alike – combined with a willingness to adjust the assemblage continually to align metrics with rates of bodily recovery. keywords: self-tracking; algorithm; physical rehabilitation; ageing; surveillance; assemblage; vital materialism anthropology & aging, vol 40, no 2 (2019), pp. 10-22 issn 2374-2267 (online) doi 10.5195/aa.2019.224 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 10 surveillance entanglements digital data flows and ageing bodies in motion in the danish welfare state nete schwennesen university of copenhagen author contact: ns@anthro.ku.dk this article is concerned with the processes whereby frail or impaired elderly bodies are made to move and transform as a result of engagement with digitally arranged physical rehabilitation programs. these are cornerstones in contemporary active aging policy programs in the global north (who 2011) that have become routinized elements in governments’ attempts to activate and improve the physical functionality of aging bodies. physical rehabilitation programs enact a specific progressive vision of bodily improvement, one of advancing currently disabled or impaired bodies to an imagined future stage of bodily recovery (struhkamp, mol, and swierstra 2009). this transformation is effected by enrolling the aging body in a plethora of professional and expert knowledge systems which seek to calibrate and manage bodily movement, ultimately restoring a measure of the body’s past functionality. in recent years, new forms of self-tracking technologies, advanced algorithms and quantified measurements have increasingly become part of these expert systems, constituting a new mode and style of ‘quantified aging’ in which qualitative aspects of aging life are converted into quantitative measures and used for the purpose of improvement (oxlund and whyte 2014; schwennesen 2017). the constitution nature of ‘active aging’ and the ‘doing’ of the aging subject have been recurring themes in critical aging studies. in his influential essay, ‘busy bodies: activity, aging, and the management of everyday life’ (2000), sociologist stephen katz argues that we are witnessing a current ‘neo-liberalization’ of old age which incorporates the ideal of productivity, and conflates ‘successful aging’ with ‘active aging’. commenting, however, on the recent revitalization of the framing of the aging body as ‘busy,’ katz and a colleague argue that successfully aging bodies are no longer just ‘busy bodies’ but ‘busier, smarter bodies,’ as they engage in digital arrangements that seek to monitor and promote physical activity. thus, they note, “the ageng body is emerging as a‘node for data collection, monitoring and surveillance,” processes that seek to promote and improve physical functioning (katz and marshall 2018, 63). this, they argue, reduces aging bodies to “functional, quantifiable, and exercisable molecular entities’’ which “articulate human capacities through the authority of data…linked to the tyranny of health activities” (katz and marshall 2018, 64). in this governmentally inspired analysis of the neo-liberalization of old age, aging bodies are seen as constituted, moved and transformed by the disciplinary forces of neo-liberal surveillance technologies and the authority of digital data which, in subtle ways, shape aging bodies to move and act in compliance with the norms of health and bodily improvement. in the following, i seek to qualify this contemporary notion of elderly bodies as ‘busier and smarter bodies,’ by looking at concrete encounters in which frail elderly bodies are urged to move in accordance with digitally arranged physical rehabilitation programs in the danish welfare state. as katz and marshall point out, little research has so far investigated the ways in which movement data are produced and circulate through webs of technologies, relationships and expertise, impacting in turn on the movement of aging bodies (katz and marshall 2018, 649). this article addresses that gap by focusing on the concrete ways in which frail bodies become entangled with new digital metrics and measurements, and the processes applied to shape their movement. hence, rather than starting from an etic notion of aging bodies as ‘smart and busy’ and ‘surveillance’ as a normative a priori fact, i look at the socio-material relations and procedures whereby aging bodies come to move with and through these digital arrangements. schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 11 my point of departure is an ethnographic study of the danish use of a smartphone application that monitors home training remotely, one designed to assist in the physical rehabilitation of patients who have undergone hip replacement surgery. the technology works through the production and flow of movement data that constitute the aging body as both the object and receiver of data production. this reflects a recent ambition among designers in the field of physical rehabilitation to develop self-tracking sensors and software with the ability to provide ‘intelligent’ digital guidance for patients doing their rehabilitation exercises at home. such digital arrangements are seen as having the potential to provide cost-effective solutions to the expected rise in numbers of frail elderly people in need of physical rehabilitation in the future (danish government 2013), and the so-called ‘problem’ of non-adherence to exercise programs among post-surgery patients after hospitalization (jovanov 2005). thus, the questions i ask of my ethnographic data include the following: what is the epistemology of digital movement data, and what images of the aging body are thus enacted? what are the processes implicated in the flow of movement data through the digital programs, and how do the program configure and interact with aging bodies and the wider arrangement of physical rehabilitation? in my analysis, i draw on the work of post-humanist theorists who have examined the agentic capabilities of non-human actors (barad 2007, bennett 2010, latour 2005), particularly political philosopher jane bennett’s notion of the ‘vitality of materiality’ (bennett 2010, bennett 2005, bennett 2004). this is a useful tool, as it encompasses an understanding of non-humans as potentially lively forces. in relation to the theme of energy in this special issue, it provides a fruitful analytical lens with which to explore how energy and force are produced in digital physical rehabilitation programs in denmark, and the active involvement of non-human agencies in the constitution of bodily movement. whereas contemporary studies of aging and surveillance have until recently mainly focused on the social and discursive construction of the aging body (andrews and duff 2019), bennett’s work allows us to include in our analysis not only artefacts such as technologies, algorithms and measurements, but also the body itself as a fleshy-sensual, lively force. applying bennett’s (2005) notion of vital materialism, i suggest that surveillance operates through a wide assemblage of human and non-human actors, and is better understood as a complex accomplishment than an a priori fact. this understanding invites us to think about surveillance in the context of digital rehabilitation as a specific, vibrant and temporal process through which frail bodies, metrics and technologies are assembled together and produce various bodily sensations. as we shall see, however, such sensations might be articulated as harmful and controlling as well as caring and restoring. indeed, i argue that in the danish practice of digital rehabilitation, more attention should be given to the bodily sensations created by different links between human and non-human actors over time. also called for is a greater capacity for response to such sensations by adjusting and rearranging the assembled components in order to align the temporality of the metrics and technologies with the (non-predictable) temporality of bodily recovery. vital materialism and the surveillance assemblage using the lens of the ‘vitality of materiality’ (bennet 2010, bennett 2005, bennet 2004) to analyze how bodies and digital data are entangled and constituted in digital physical rehabilitation programs, i place the strongest emphasis on two points that i find particularly fruitful. first, bennett develops the concept of ‘thing-power’ to describe the vital capabilities of non-humans, thereby illuminating the sensory and embodied encounters of the lived experience of humans when they engage with non-humans. she describes thing-power as “the curious ability of inanimate things to animate, to act, to produce effects” (bennett 2004, 349). in relation to the digital arrangement of physical rehabilitation, the notion of thing-power draws attention to the agentic capabilities of artefacts and their potentially active role in the generation of bodily movement. moreover, bennett emphasizes that ‘non-human forces’ can operate through objects and nature, as well as the bodily interior, by means of intrinsic elements including hormones, chemicals and micro schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 12 organisms (khan 2009, 95). in this view, the biological body is considered a fleshy-sensual lively force with agentic capacities, rather than a passive entity upon which digital data is inscribed. second, vital materialism has implications for how we understand agency. following deleuze and guattari (1987), bennett suggests that we think of agency as an emergent and dynamic outcome of temporal assemblages of human and non-human actors, in opposition to an understanding of agency as an intrinsic outcome of human intentionality. she defines an assemblage as “an ad hoc grouping of an ontologically diverse range of…vital materialities of various sorts” (khan 2009, 92). hence, an assemblage has no sovereignty in the classical sense. rather, as bennett notes: the effects generated by an assemblage are…emergent properties, emergent in that their ability to make something happen…is distinct from the sum of the vital force of each materiality considered alone. …an assemblage thus not only has a distinctive history of formation but a finite life span” (2010, 24). as an example of an assemblage, bennett suggests the electrical power grid, which comprises both human and non-human elements, such as coal, sweat, electromagnetic fields, computer programs, electron streams, profit motives, heat, lifestyles and so on. despite run-of-the-mill events and the various forms of energy that threaten the grid (damage from animals, trees or wind, human mistakes, electromagnetic fields), it largely functions effectively due to the relational connections between the various elements in the assemblage. hence, the agentic capabilities of the power grid are constituted—not by discrete entities—but through the composite achievement of the fluid system as a whole. applying the frame of vital materialism, we can likewise think of digital rehabilitation as constituted through temporal assemblages of human (bodies, professionals) and non-human actors (smartphones, sensors, exercise programs, algorithms, digital interfaces, imaginaries of aging bodies, visions of automatization and cost-efficiency) that are interlinked by the goal of moving and transforming bodies in order to rebuild their functionality. in this view, bodily movement and processes of recovery must be considered fluid effects of the ways in which the different parts of the assemblage are connected, and the vital energies and affective relations the assemblage creates as a whole. in the following i provide a situated account of the entanglement of aging bodies and digital data in a specific digital rehabilitation assemblage in denmark, viewed through the analytical lens of vital materialism. as we shall see, the relational connections between the various elements in digital rehabilitation programs are assembled, disassembled and reassembled over time, which allows us to think about surveillance as a specific, open-ended and temporal process whose outcome is not predetermined. background and methodology like many countries in the world, denmark faces the challenge of demographic aging due to the increasing longevity of its citizens; consequently, it is expected that the cost of care for the elderly and those with chronic diseases will rise significantly in the future (danish government 2016). as a potential solution to the ‘problem’, the danish government has increasingly invested in the development of innovative public-private partnerships, with the aim of transforming its know-how in the field of care services into the design of innovative welfare technologies. by exploring and investing in the development of such solutions, the intention is not only to render care work more efficient by making the products available for use by the danish welfare state, but also to export them to a global market, thereby providing the basis for an economically sustainable welfare state in the future. this future includes the transformation of denmark, whose welfare provisions were previously ‘fueled’ by its agricultural economy, into a nation sustained by the export of high-tech digital welfare solutions. in this sense, welfare technologies are schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 13 positioned as ‘curators’ of the economic sustainability of the danish welfare state. physical rehabilitation has been mentioned as being particularly well suited to further digitalization, and municipalities have been encouraged to invest in new digital technologies in this field (danish government 2017). following this call, several have complied and the technologies are now being offered to an increasing number of patients who are referred to municipal physical rehabilitation units after hip replacement surgery. the technology is a smartphone application that offers a digital training program with physical exercises and five sensors – two on each leg and one around the stomach, attached with elasticized velcro bands – that monitor bodily movement during home training. based on pre-programmed parameters and algorithms, the sensors translate data on bodily movements into digital feedback and guidance, which is delivered immediately after each exercise by a digital voice correcting the subject’s performance (e.g., “lift your right knee to a higher position”). after each training session, the overall quality of the training is evaluated and visualized on the smartphone interface in the form of stars (between one and three stars) and text messages. the digital movement data are transferred in real time to the physiotherapist through a digital program which color codes the quality of movement (green = well done; red = not well done; yellow = in between). since the beginning of 2016, an increasing number of patients in denmark who are refered to undergo physical rehabilitation after hip replacement surgery have been offered the technology as an element of it, thus reconfiguring such programs in time and space. whereas they were previously organized around an eight-week time span during which patients had to attend group training at a rehabilitation center for an hour twice a week, the technology has legitimated the substitution of one of the weekly training sessions, meaning patients only have to attend a single weekly session at the center. thus, while guided training in previous programs of rehabilitation was located in a clinical setting and articulated through relationships between health professionals and patients, the role of providing guidance in the home of patients through the production of movement data has been delegated to technology. this provides a new distribution of responsibility wherein professional guidance during home training is the province of algorithms and measurements, while patients are expected to engage with and respond to movement data unsupervised. the present work is based on an ethnographic study of the implementation of the technology at two rehabilitation centers in denmark. from spring 2016 to spring 2017, i followed 20 people undergoing physical rehabilitation using the technology, attending weekly one-hour training sessions, observing physiotherapist-patient conversations on the technology and engaging in informal conversations with physiotherapists and patients. i interviewed and observed 15 participants in their homes twice, separated by periods of four to six weeks, and 7 physiotherapists who were primarily responsible for the training sessions at the rehabilitation centers. in addition, i interviewed a health consultant engaged in the development of the technology and an implementation consultant from the municipality. extensive fieldnotes were taken in clinical encounters at the rehabilitation center and during participants’ home sessions with the technology, and they were written up immediately after leaving the sites. interviews were transcribed and general themes were identified across the field notes and the transcripts. as i was specifically concerned with bodily movement and the connections made between professionals, aging bodies and technologies, i traced these themes in particular situations and across the sites. early in my fieldwork, i found that the entanglement between bodies and technologies transformed and co-evolved over time and have, therefore, thematically coded the material to grasp the multifaceted character of the linkages that were made across sites and over time. schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 14 the epistemology of digital movement data and imaginaries of the aging body the constitution of digital data in digital physical rehabilitation programs is the result of a particular way of observing and representing bodily movement. as material feminism scholars argue, vision is always limited, situated and constituted in specific ways (barad 2007; haraway 1988). in this light, the allencompassing vision implied, for example, in the orwellian notion of big brother is unachievable. rather, we must consider data as an apparatus of knowledge production which generates a particular way of seeing and evaluating bodily movement. yet, interestingly, it emerged that the worth of the digital apparatus which is the subject of this study was contested by the health professionals who were engaged in its design. indeed, one health consultant who participated in the process of developing the device told me of the contested nature of the parameters and algorithms that transform digital data on bodily movement into digital feedback. she explained that health professionals were at first invited to identify the parameters that they saw as important in their assessment of whether or not particular exercises were adequately carried out; they were also asked to define their professional vision of bodily movement. she went on to say that the developers then had to prioritize and exclude parameters: we had to sit down and be pretty tough in setting priorities in relation to the kind of parameters feedback should be given on. [… ]i mean, i think we’ve sometimes sat down with 20 to 25 [parameters] and ended with 4 to 5. so, we have actually cut it down quite a bit. this process of exclusion was also defined by the set-up of the digital arrangement itself, as she explains: with the sensor set-up we have – for this target group it’s on the legs – then it’s only the lower extremities that we can say anything about. so, for example, if there were some parameters that dealt with what one does with the arms or something else, then of course, we could say, “the sensors can’t say anything about that.” the digital data and the feedback did not merely stem from the health professionals and their priorities, but also from the materiality of the sensors and their ability to measure some forms of bodily movement but not others. whereas professional assessment of bodily movement would be based on a more holistic approach – taking into consideration the whole body and how different parts of the body moves in relation to the body as a whole – the digital apparatus, by transforming movement data into digital feedback, enacts a particular form of professional vision, focusing only on the movement of the lower extremities of the body. moreover, the thresholds deciding whether or not a movement would be assessed as ‘right’ or ‘wrong,’ and whether the feedback would appear as corrective (in red as corrective feedback) or encouraging (in green as a motivating text message), were also subjects of contestation among the professionals. as another health consultant explained, “every exercise has been designed in three levels, and we have sort of sat around and had these very loud discussions about how many degrees it takes before it’s accepted as a good performance.” by deciding on the particular intervals of angles between what is considered as right and wrong bodily movement, the physiotherapists enact a performative ‘agentic cut’ (barad 2007) whereby bodily movement is evaluated and assessed, ultimately deciding the evaluative digital feedback to the patient. not only the boundaries of evaluative thresholds were decided in the designing process, the speed of bodily recovery and progression in processes of rehabilitation were likewise set and inscribed into the technology. reflecting a vision of efficiency, the digital arrangement is programed to progress automatically with new and more demanding exercises when a number of exercises have been performed correctly. the combined agreed parameters, algorithms and thresholds decide the manner in which the schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 15 exercise program adapts to the movement of bodies, and the speed with which the progression occurs. this adaptability enacts a vision of ‘automated efficiency,’ expressed through the functionality of ‘autoprogression,’ as a physiotherapist explained: we wanted from the outset to design a technology which could replace physical attendance at rehabilitation centers with a digital solution that would promote home training. …clearly, there is this economic rationality to it. …if the main idea is to save time, well then it doesn’t make sense if the professional has to use it to upgrade exercise programs for the patients. so we decided to incorporate auto-progression and we made some templates; so you can easily and quickly push the template button and then you don’t have to spend time on adding to and changing the exercises yourself. this vision of ‘automated efficiency,’ involving digital adaptation of the technology to the user, evinces the imaginary and the desire to fast forward the training and the rehabilitation process towards recovery. digital data in the context of physical rehabilitation are used not only to monitor bodily movement, but also to shape and modify behavior. the design principles of the technology are based on cognitive, behaviorist elements, with the consciousness of the user seen as the primary target of intervention. inscribed in the technology is a rather simple version of human behaviorism, wherein behavior is seen as a response to certain stimuli in the environment: the digital voice correcting a movement provides punishment whereas the three stars and the text messages provide reinforcement. there is clear inspiration for the design of the technology in the growing self-tracking industry, which offers individuals various forms of tracking devices designed to monitor and measure health and behavior (e.g., fitbit, vivofit, endomondo, apple watch, etc.). in her study on self-tracking technologies, anthropologist natasha schull offers a detailed account of how they are designed to govern users through real-time ‘micro-nudging’ (schull 2016). nudging is a strategic method for guiding human behavior and decision-making in a specific direction through positive reinforcement, in contrast with other ways of achieving compliance, such as legislation or enforcement (sunstein and thaler 2008). this new ‘behavioral-informatics mode of regulation’ is designed to ‘hook’ (lomborg, thylstrup and schwartz 2018) the user into complying with the daily training program. similarly, the algorithmic processing of data has its foundations in human anticipations and assumptions about human behavior and how to keep bodies hooked when they are training at home. specific rules were added to regulate the temporal flow of data (at least 15 seconds between corrections; only repeated ‘bad’ movements will trigger a correction; the same correction can only occur twice etc.). these rules reflect an attempt to add sensitivity to the flow of feedback data in order to keep the elderly motivated during training and provide a balance between judgement and re-enforcement. overall, there is a remarkable gap between the conclusive manner in which movement data are presented to elderly during exercises (oral, textual, visual) and the complex and contested processes which created the digital apparatus of movement data. as mentioned earlier, digital data do more than just observe bodily movement, they also transform observations of bodily movement into digital feedback, thereby articulating a particular version of the body being measured. as van den eede argues, technologies operate as ‘epistemology engines’ through which a particular version of the body is articulated (2015, 151). therefore, the digital apparatus must be considered both productive and part of the very phenomenon (the body) it seeks to measure (barad 2007, 115). the aging body articulated through the digital apparatus of knowledge production in this context is a universal and standardized body that moves in predictable ways. it is a body which progresses and recovers with the same speed over time and which makes itself available to the governance rationality of the nudge in its interaction with the digital data. schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 16 encounters between aging bodies and digital data the participants who became part of the digital rehabilitation assemblage described themselves as extremely motivated about doing their exercises at home. after hip replacement surgery, many patients experienced pain and found it physically demanding to move around. most lived in small apartments close to the city center, and traveling to the rehabilitation center would often involve a challenging walk up and down stairs and coordination with public transport. they saw the possibility of training with the technology at home as a welcome opportunity to be released from a demanding weekly trip to the center and the chance to decide for themselves when and where to do their exercises. as one woman said, and i think it was a really great idea, because then, after all, you can do it whenever it suits you; you don’t have to be constantly dealing with, “oh, now i need to be there at 9:30; now i need to be there at this time and that time.” so, i thought that was great, right? moreover, the digital arrangement introduced a sense of proximity and closeness to the rehabilitation center and to physiotherapeutic expertise, in spite of the physical distance. the experience of expert presence in the homes of patients was generated by the expectations that professionals would monitor the movement data, and thus have control over whether or not they were actually doing their daily exercises, from a distance. not unlike jeremy bentham’s prison panopticon, which allows a watcher to observe occupants without the occupants’ knowing whether or not they are being watched (foucault 1973), the digital arrangement theoretically allows health professionals to observe the patients’ physical training, without the patients’ knowing whether or not they are being observed. the vision behind this is one of being better able to monitor and guide behavior from a distance. ethical considerations in relation to remote monitoring of patient data have been debated, and concerns such as privacy loss and the risk of data commodification have been raised, among ethicists and social science scholars alike (brigden et al. 2019; beer 2016). however, patients emphasized that they actually wanted to be controlled and looked after by the physiotherapists. they experienced the professional monitoring of the movement data as a crucial feature in their motivation to follow the exercise program. as one woman said, i think if you went there, and then had to do something at home on your own, you wouldn’t get it done. the fact that it will tell on you ensures that you get more done. it helps you not to think, “nope, he’s not gonna see me skip, is he?” so, it’s a very different level of commitment. many patients explain that the digital arrangement generated a sense of obligation to the health professionals to use the technology and produce data on bodily movement which were based on a shared interest in efficient bodily recovery. in this respect, the technology constituted a relationship of reciprocity between participants and physiotherapists (mauss 2000): patients were expected to deliver movement data, and the physiotherapists were expected to monitor those data and use them for preparation and personal guidance in their weekly training sessions at the center. indeed, the patients used the metaphor of ‘homework’ to describe the relational character of the data, and the sense that those data, like homework, bore witness to the quality and quantity of the ‘work’ (training) they have been doing at home. the patients, therefore, would meet up at the weekly training sessions at the center with the expectation that the physiotherapists had actually seen the data, either proudly looking forward to positive recognition of the training they have been doing at home, or embarrassed about their lack of training and expecting to be corrected. paradoxically, all patients – adherers schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 17 and non-adherers alike – saw the distant surveillance as a positive attribute, something which worked to encourage them to exercise at home and pushed them towards a more efficient recovery process. in concrete encounters with the technology during their exercise programs, patients initially trusted it and saw it as a competent stand-in for the physiotherapist. they willingly engaged in data production, were affected by the data and acted according to the feedback. in this relational process patients animated the technology by describing it as a ‘friend’ that would help them to do their exercises at home and by ascribing a gender to it. moreover, they would at times have little discussions with it, if they did not agree with the feedback they were receiving. kirsten: i mean, i can have a discussion with her and say, listen, i really don’t think she was fair, right? because she kept saying, “stretch your knees, keep your knees stretched,” and i thought that i was stretching and stretching. and then i only got two stars. and then other times, it might say, “that was a good technique, keep doing that,” and then you get a kind of emotional high, right? because you received praise [laughs]. and other times it was just two stars, right? and that was because i wasn’t stretching out my knee, and i just couldn’t stretch it out anymore. ns: did you yell at her? kirsten: i yell at her a lot. she’s not always right. i mean, sometimes when she’s given me just one star i’ll say, “that’s not fair! i know i’ve done that exercise correctly today.” as this encounter indicates, this woman is affected by the different forms of feedback she receives from the technology (oral, textual, visual) and strives to perform her exercises correctly so as to achieve positive feedback. she scolds the technology if it continues to make corrections when she believes she has done an exercise correctly. this ‘squabble’ indicates the affective relationship that emerges as the patient and the technology interact during training. another woman described her connection with the technology as a love and hate relationship, it’s a love-hate relationship, really. it’s great that it reminds you that when you do a certain thing, then remember to straighten your back that’s perfect. but it’s also annoying that it – especially with the step exercise where you need to take a step up. i can’t do that; not once have i been able to do it without it saying, “don’t twist your knees.” so there, at the end, i was honestly really annoyed with it. be quiet! these are examples of the working of ‘thing-power’ that bennett references with the notion of ‘vital materiality.’ as a result of their engagement with the feedback, the patients become entangled in a dynamic flow of data production; subsequently, the digital technology and the governance rationality of nudging become agentive and forceful elements in the surveillance assemblage. when the body strikes back: temporality, friction and pain in pathways to rehabilitation whereas most patients initially trusted the technology and engaged in data flows through the relational workings of affective thing-power, this relationship often changed over time. as the above comments suggest, occasionally patients experienced a gap between how they moved their body and the digital assessment and feedback from the technology. moreover, patients who followed the exercise program schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 18 every day would often experience an increase in bodily pain over time. mary, for example, was very enthusiastic about the technology from the beginning; she followed the program and acted according to the digital feedback on her movements, but nevertheless came to experience serious pain in her body over time. she said, in the beginning i was really excited. it was perfect; i could do my exercises at home, at a time and a place that suited me. i was so enthusiastic. did my exercises every day, i was motivated like never before…but then it started to hurt in my body, and i got anxious…i had so much pain, i could hardly walk, and ended up in my bed for five days. in mary’s case, the standardized training program, the linear temporality of auto-progression and the more cyclical and unpredictable temporality of her body were not aligned. as a health consultant explained, the company and the designers are well aware that patients might be pushed to move too much when they engage in the digital rehabilitation assemblage, and that the elderly might become ‘over-compliant.’ the consultant said, the patients are extremely motivated to do their exercises; they really do train a lot. we have had some who actually trained too much, so clearly there is this risk to it.[…] the patients know that the physiotherapists can see what they are doing at home and they want to live up to that. and they do it as best as they can. while someone who undergoes rehabilitation after hip replacement surgery will most often recover, the time frame and the extent to which this happens is uncertain. we might think of bodily pain as the body’s sensory way of articulating friction and resistance to the relational movement pathway constituted by the digital rehabilitation assemblage. the term friction is derived from descriptions of the physical world, where it refers to the resistance to relative motion between bodies in contact (feynman 1970). anthropologist anna tsing uses the concept of friction to describe the encounter between the image of globalization as a universal flow of movement (of goods, money and people) and the particular ways in which events emerge through specific regional-to-global networks of power, trade and meaning. she suggests that we think about roads as a metaphorical image of how friction works: “roads create pathways that make motion easier and more efficient, but in doing so, they limit where we go. the ease of travel that facilitates movement is also a structure of confinement” (tsing 2011, 5). we can think of the digital rehabilitation assemblage as a prescribed pathway along which bodies are made to move in physical rehabilitation. like roads, the intention of the assemblage is to induce the patient to follow the ordained route to reach its final destination of bodily recovery. yet, as we have seen, the assemblage, like pathways, might also work as a limitation by structuring movement in ways which might effectuate friction and bodily decline. disassembling disparate parts: physiotherapists’ engagement with the digital rehabilitation assemblage so far, i have highlighted the agentic capacities of movement data, the governance rationality of nudging and the affective sensing body in the digital rehabilitation assemblage. in the following i focus on physiotherapists’ engagement, pointing out that, in many situations, they come to detach the patients and the digital technology from the assemblage instead of linking them. as noted, the patients attend a weekly one-hour, group-based training session at the rehabilitation center; this is overseen by two physiotherapists and organized in groups of up to ten. yet, during the program at the center, hardly any connections are schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 19 made with the home training and the various experiences that patients have had at home. patients express disappointment when they realize that the physiotherapists have not consulted their digital movement data or assessed their ‘homework.’ the expected relationship of reciprocity and data flow, with patients delivering movement data and professionals monitoring them, is interrupted because the professionals do not pay much attention to the data. moreover, the physiotherapists explained that they had deliberately decided at the outset not to take an interest in the exercises that the patients do at home, guided by the technology. instead, in order to keep participants motivated, they argue, patients are allowed to exercise on the exercise machines, or they roll a dice to decide the exercises at the center. the physiotherapists emphasize that the new assemblage of physical rehabilitation has changed the patients; they have become more ‘unruly’; they raise numerous questions about their experiences with the technology at home and ask the physiotherapists to assess the exercises, which makes it more difficult for the professionals to plan the one-hour session: they have a lot of questions – “is it wrong, or right?” ‘this part is hurting, what does that mean?” and also a lot of questions in relation to the technology. “that machine is constantly complaining, even though i feel like i’m doing it right.” “am i doing this right?”[… ]sometimes it’s a bit, “whoa!”. it’s a little hard to control. this lack of connection to their training at home and the digital rehabilitation assemblage, however, is frustrating for the patients. as one woman says, “there aren’t any links to the training we do at home because there’s no time. we have some other exercises that we need to complete.” much as the patients experience a lack of connection, so do the physiotherapists, as one explains. “it can be hard to have good contact with every individual participant. there are so many in the group, so there’s so much to deal with during training. it’s harder to pick up on everyone during the instruction – harder than it was when we met twice per week.” this disassembling between the physiotherapists, the patients and their digital movement data occasionally created a sense of being detached from professional proximity, which had previously worked as a motivating force. in addition, when patients complained that the technology kept correcting their movements even though they tried to correct their movements according to the feedback, a common answer from the physiotherapists was that the technology was “not very bright,” “thickheaded” or “not able to deal with detail.” this response further tended to detach the patients from the technology, causing them to start to doubt its competence instead of strengthening links with it. this led many patients to give up training with the technology or simply stop paying any attention to it. mary, one of the most enthusiastic patients, who experienced pain after doing her exercises, came to feel that she was isolated and all alone in her endeavors to recover: there’s no human contact, and then what is it good for? well, you’re over-training, but how can i know that? they are not involved, because i need to do it based on the technology there. you’re all alone, no one is helping you. […] it’s like talking to a machine. now i’ve stopped training completely, i haven’t trained for five days – and they don’t care, no one is monitoring me. there is no contact, there is no connection to what we do at home. potential energy, cyclical movements and adjustment work recalling bennett’s example of the electrical power grid assemblage, we might think of the digital rehabilitation assemblage as a circuit that transfers energy from one form into another. in physics, the law of energy conversion (feynman 1970) states that every object or body has a potential level of energy which is decided by its position relative to its surroundings. in other words, a ball has potential energy when it is held in the hand, but has the capability of producing kinetic energy if these conditions change, if the ball schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 20 drops to the floor, for instance. or, in another example, when an archer works with a bow, drawing the string back, some of the chemical energy of the archer’s body is transformed into elastic potential energy in the bent limbs of the bow. when the string is released, the force between the string and the arrow works on the arrow. in this process, the potential energy in the bow’s limbs is transformed into the kinetic energy of the arrow as it takes flight. likewise, the digital rehabilitation assemblage is directed towards the conversion of the potential energy of frail bodies into the physical movement of the bodies, transforming it into kinetic energy as they are made to move towards recovery. as we have seen, however, the digital rehabilitation assemblage does not always produce bodies that recover. there might be friction between particular patients’ bodies and the anticipated universal body inscribed in the digital arrangement. as noted above, in physics friction refers to the process of two objects moving in relation to each other where resistance to movement occurs (feynman 1970). i suggest, that in the digital rehabilitation assemblage, friction is articulated as the sensory experience of pain. if we understand the digital rehabilitation assemblage as a process of energy conversion, pain can be considered heat, an effect of friction between moving objects. hence, much as a brake in a car that inhibits motion by absorbing energy from a moving system produces heat, physical rehabilitation might produce pain. whereas moderate pain indicates that the training is pushing the body to regenerate over time, ‘severe’ pain weakens a body, in the same sense as brakes can weaken, if the friction produces too much heat. how can we use the analogy of energy conversion and friction in our discussion about moving bodies in a digital rehabilitation assemblage? what are the possibilities for perhaps recomposing the assemblage to make it better able to transform the potential energy of frail bodies into bodies that recover? the digital rehabilitation assemblage invokes a linear temporality in which bodies are anticipated to increase their physical potential steadily over time, placing the body in a particular temporal space on a trajectory towards recovery. as we have seen, however, there might be a misalignment between the linear pathway and temporality inscribed in the technology and the more erratic and cyclical temporality of human bodies. anthropologist stefan helmreich invites us to think through the concept of ‘the body electric’ to learn about the small-scale ‘action potential’ of bodies. he uses the electro-magnetic heartbeat as an example to illustrate how the potential action of the heart and the body is not about grand futures, or ‘teleological’ ‘natural forces,’ but is also at work in the ongoing present, “as a persistent operator at smaller timescales and in iterative, repetitive processes (such as heartbeats)” (helmreich 2013, 139). if we think with helmreich’s notion of the body electric, we might think of bodies in a digital rehabilitation assemblage as evolving through smaller timescales of progression and regression and through a more cyclical time than the linear progressive temporality which is inscribed in the technology and the functionality of ‘autoprogression.’ if we do so, we can think of the digital rehabilitation assemblage as unfolding through the intercalation of two kinds of time: the linear and the cyclical. marxist philosopher henri lefebvre has developed a theory of social action and transformation that is concerned with the relationship between the cyclical and the linear (lefebvre 2004). he suggests that social science analysts should draw attention to the intersection of inner bodily rhythms (respirations, pulses, circulations, assimilations) with those of social life. in the digital rehabilitation assemblage, this would imply a willingness to listen after ‘disruptions,’ places where the body’s recovery processes fall out of step with the temporality of the digital rehabilitation assemblage. this would require joint exploration by health professionals, patients and designers of the bodily sensations that the assemblage creates over time, and the space to try out, adjust and recompose its various elements in order to make a fit between its temporality and the specificity of bodily movement and recovery. schwennesen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.224 http://anthro-age.pitt.edu 21 conclusion in this article, my intention has been to qualify the notion of contemporary elderly bodies as ‘busier and smarter,’ by looking at concrete encounters in which frail elderly bodies are made to move in digital assemblages of physical rehabilitation in the danish welfare wtate. rather than starting from an etic notion of aging bodies as ‘smart and busy,’ and ‘surveillance’ as a normative a priori fact, i have looked at the socio-material relations and processes whereby aging bodies come to move with and through these digital arrangements. drawing on jane bennett’s notion of ‘vital materialism,’ i have traced the relational connections and affective forces that are generated with and through the digital rehabilitation assemblage. as we have seen, the relational connections between the various human and nonhuman actors of the assemblage (bodies, professionals, smartphone, sensors, exercise program, algorithms, digital interface, imaginaries of aging bodies, governance rationale of nudging, visions of automatization and costefficiency) are assembled, disassembled and reassembled over time. as bodies move and transform in nonlinear progression, the digital assemblage may create friction involving processes of bodily degeneration. the vital force of the aging body particularly comes to the fore in the form of sensory expressions of pain when the temporality of the metrics and bodily recovery is not aligned. in contrast to studies focusing on surveillance as a pre-given disciplining force, the analysis of bodily movement in digital assemblages of physical rehabilitation invites us to think about surveillance as a vibrant, open-ended and temporally specific process, whose outcome is not predetermined; the bodily sensations created might be articulated as harmful and controlling as well as caring and restoring. this opens a space for possible action involving the re-composition of the surveillance assemblage, whereby it may be altered and adjusted, possibly reducing bodily pain and suffering. finally, ethical concerns about the remote monitoring of patient data have mainly been discussed in relation to questions such as its commodification and patients’ loss of privacy. i argue, however, that there is also a need for an ethics of ‘response-ability’ (martin et al. 2015; haraway 2013), one directed towards the various sensory expressions of aging bodies as they engage in digital rehabilitation programs. this would require more attention to be paid to the bodily sensations created by different links between human and non-human actors over time, and the capacity to respond to those sensations by professionals, it workers and patients alike. what is needed to encourage bodily restoration rather than weakening is closer collaboration between these groups, along with a willingness to articulate and respond to sensory reactions and disruptions by continually adjusting and recomposing the assemblage to accommodate the temporality of particular bodies. acknowledgements thank you to all the patients and professionals who agreed to be part of this study. i am also grateful to the participants at the seminar “aging-energism: diffracting aging through the prism of energy” who inspired me to write the paper. my two co-editors, henrik hvenegaard mikkelsen and aske juul lassen, provided valuable comments on an earlier version of the paper. two anonymous reviewers provided additional comments which have helped me to frame this version. the 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(www.crackedondementia.ca.) sally chivers trent centre for aging and society, trent university, ontario anthropology & aging, vol 41, no 1 (2020), pp. 114-115 issn 2374-2267 (online) doi 10.5195/aa.2020.253 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ film review | chivers | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.253 http://anthro-age.pitt.edu 114 film review review of collective disruption. cracked: a new light on dementia. playwright & director: julia wright, researchers: sherry dupuis, pia kontos, gail mitchell, christine jonas-simpson. 2017. price: $75. (www.crackedondementia.ca.) sally chivers trent centre for aging and society, trent university, ontario health researchers and artists joined forces to develop the theatre production cracked, which sheds both a refreshing and informative ‘light’ on living with dementia in the twenty-first century. the filmed version of this play offers a unique entry into thinking about and understanding the everyday lives of people who are experiencing dementia, the people who love them, and the people who work in fields that support both them and their families. cracked stages pivotal issues that are recognizable to formal and informal caregivers, to a broader social network, and to researchers across disciplines. it playfully addresses topics as broad as denial of the diagnosis, fear that comes with perceived loss, the practical and symbolic effects of losing one’s driver’s license, difficulties of disclosure, and the unwelcome spectre of institutional care. at the same time, the production also challenges a set of common assumptions by raising less well-known facets of living with dementia: joy, love, music, meaning, hope, activism, and dance. indeed, the experienced researchers who developed this production left no stone unturned in developing a nuanced yet cohesive story about what it means to live with dementia in a westernized context. the medium of theatre offers an apt vantage point from which to create empathy for people involved in the quotidian aspects of navigating health systems as well as the physical, emotional and mental transformations associated with dementia. it offers a rich platform from which to convey a multiplicity of research findings about creating meaning in life with dementia that are otherwise often reduced to ‘chapters’ or well-defined themes in research. rare within scholarship, and even among artistic productions about dementia, this play offers two focused perspectives from characters with dementia, while featuring equally complex additional characters who gather with them in a support group as well as caregivers. the first character introduced to the audience, elaine, lives with her daughter and her daughter’s wife as she navigates the early stages of learning about and living with her diagnosis and with eventually moving into the parkdale nursing home. through folk songs and seemingly throw-away lines, the audience learns that elaine holds lingering embodied memories of coastal work, such as fishing and lobster trapping. elaine meets the challenges of her situation with a surprising humor: what many might expect to be a devastating experience – repeatedly finding out that her husband has died some time ago – she responds to with laughter. this strategy offers the audience a new way to think about the distinctiveness of dementia experiences and also offers a seamless way to offer moments of catharsis. through elaine, the audience meets her former neighbour, vera, who seems to be a relative newcomer to canada. again entering the experience of the disease through the intimacy of everyday relational encounters, the audience witnesses how elaine and vera compare notes about their recent dementia diagnoses. the portrayal of these two women who engage in a growing relationship, learning from each other, strikes a chord because people (and characters) living with dementia so often struggle for agency, even within fictional representations. characters with dementia frequently come across as isolated, except http://anthro-age.pitt.edu/ film review | chivers | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.253 http://anthro-age.pitt.edu 115 maybe for the generous company of family and the odd friend. elaine and vera’s friendship however, gives a genuine space to both of their perspectives, unmediated by the power relations between caregiver and cared for, youth and older adult, male and female, in a way that is often unseen, or unrecognized, but nevertheless hyper-real. staging the friendship of vera and elaine immediately challenges the representativeness of the dyadic or triadic care relationship. cracked’s inventive theatre devices allow a ‘show don’t tell’ evocation of pivotal themes that run through dementia experiences, as can often be found in good ethnography. one such evocative moment occurs when the seven stage actors emulate clocks with their bodies, embodying time. at the beginning of the scene, their arms mark time in unison as they sing in unison, performing institutional time. they then shift to harmonizing musically and physically, playfully and creatively. with their hands marking different times, they remind the audience of the existential multiplicity of space-time experiences and of the way these radically alter how humans occupy infrastructures and situations, showing that perspective affects our experience of time and how humans occupy institutional spaces. for the most part, this piece of drama evokes empathy for the multiple characters on stage, and their different faces and tones. it stops short, however, with the nursing home administrator. while that character does exhibit some development and change, the play could do more to convey how she—like the residents, family members, and other workers—is primarily caught in an inhumane system, a role that disavows her from the right to make a difference. the move into parkdale, for both central characters, comes across as a tragedy in a way that leaves less to the imagination than other sections of the play. on the other hand, whereas indeed the flat character of the administrator adds to the fear people already have of these places, this fear is often also justified, and unites the multiple actors in a structurally confining situation. while vastly entertaining and wildly evocative, the play also offers information about socioeconomic resources available for people with dementia, as well as about the symptoms that come with the disease. it evokes research-based, but less well-known arguments about dementia care, such as that care programmes need to fit people’s past and particularities. as such, it is not only about grim endings or the acceptance of decline, but also actively explores the idea of new beginnings, continuity with past lives and relational transformation. many moments in this play could thus serve as useful conversation starters, among family members figuring out life with dementia, among service providers, and within classrooms. http://anthro-age.pitt.edu/ _kao_report kao | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.269 http://anthro-age.pitt.edu 2 participants and observations dementia and the challenge for anthropology philip kao harvard univeristy philip_kao@fas.harvard.edu anthropology & aging, vol 41, no 1 (2020), pp. 3-6 issn 2374-2267 (online) doi 10.5195/aa.2020.269 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kao | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.269 http://anthro-age.pitt.edu 3 participants and observations dementia and the challenge for anthropology philip kao harvard univeristy philip_kao@fas.harvard.edu roughly forty professional and student anthropologists from around the world gathered together on september 19th and 20th, 2019 to share their research on dementia and dementia care. hosted by the university of copenhagen (denmark), and the second conference-style workshop of a much larger european research council funded project entitled ‘vital: the vitality of disease – quality of life in the making,’ the arts of caring, arts of knowing: dementia and knowledge practices workshop gave anthropologists (and other social scientists) an opportunity to develop and discuss new ways of thinking about alternative imaginaries, discourses, and practices with respect to dementia. on thursday september 19th, 2019, the workshop began with two back to back morning keynote addresses. for the first address, janelle taylor (university of toronto) spoke passionately about the role of the arts in dementia care. she touched upon the concept of the caregiver as a craftsperson and tinkerer, and spoke about the importance of attending to issues of dwelling and attunement in improving the quality of life for those with dementia. following on from this, annette leibing (université de montréal) delivered the second keynote address, which delved into the intellectual history of the pharmacological treatment of dementia. leibing drew case material from her own fieldwork in brazil, and floated the idea of what it might mean if dementia could be taken up epistemologically as a kind of psychotherapy via particular life histories. the rest of the workshop fell into five working groups that provided a chance for more intimate and focused paper presentations and conversations. these working groups were broken down according to the following thematic titles: 1) living with dementia in time: still there or not? 2) crafting, improvising, and playing: creative engagements with dementia 3) care in places, negotiating good life 4) ethics in question: how we respond to (intimate) others and 5) how do we know (about) others with dementia? the discussion emanating from the first working group focused on the experiences of those with dementia, providing a platform for thinking more about the relationship between time and space. participants posited the ‘out of synch’ phenomenon as a heuristic for better understanding the shortcomings of conventional care in various dementia wards. pivoting to the second workshop, a lively discussion ensued about the role of the caregiver in dementia, and how the usage of mobile media technologies and even music therapy open up new opportunities and meanings in the crafting of particular care relationships. the papers from the third working group, which kicked off on the second day of the conference, focused on what is actually done in the name of care, and how ‘care’ empowers particular institutional practices and decision-making at the expense of wellbeing and quality of care for those with dementia. two papers from the fourth working group dealt specifically with the issue of lying in clinical practice. they offered ethnographic instances into how and why particular kinds of lies were being used by caregivers in the context of dementia. by focusing on the linguistics and ethics of lying, these papers showed that even in the adoption of ‘person-centered care,’ clinical untruths were not entirely without function or sympathy. last but not least, the papers in the final working group tackled the deficiencies associated with our dependence on verbal language in conveying how dementia is experienced and interacted in places like residential care homes. by using new forms of data collection such as charting, visual methodology, and even arts-based participatory approaches to ‘dementia expression’, the kao | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.269 http://anthro-age.pitt.edu 4 participants in this workshop invoked cutting edge anthropological theories and research design, offering new perspectives and scopes for future investigations. by taking seriously the multi-perspectives attendant to dementia sufferers and their (in)formal caregivers, this two-day workshop called for creative and innovative solutions for improving our understanding of dementia as well as identifed how to generate better quality of life decisions, deliberations, and engagements. rather than take ‘quality of life’ as just another sound-bite or unit of bureaucratic measurement, workshop participants deliberated on issues relating to the historical dimension of dementia and its various cross-cultural treatment. additionally, participants shared findings and observations relating to the changing nature of knowledge, especially with respect to levels of authority (for example, biomedical knowledge versus caregiver knowledge, and even self-knowledge). attention was also paid to how dementia maps onto the human/social body, and the consequences of particular etiologies. discussions stemming from some of the presented papers also illuminated the evolving interpersonal relationships in the context of dementia and dementia care. there were instances during the workshop where people talked about the ethical and political consequences arising from various conceptualizations of dementia. in the end, all of these themes only go to stress that larger structural forces often shape how those affected by the disease (either directly or indirectly) come to live with and through dementia in particular ways. what has to be dealt is the issue of how we can work to improve these ‘dementia lives.’ fortunately, that is a challenge that anthropologists who conduct research into this area can and should take up critically. anthropologists are trained to conduct research in contexts where ongoing translation is not only necessary but oftentimes approaches a kind of methodological second nature. they are constantly making sense of new terms and categories, cross-checking their understandings with local informants, whilst reevaluating their own taken-for-granted notions of how things in the world are constituted and made relational. they come to ‘hang out’ and even live long-term in places radically different from where they were raised. through the process of ongoing translation, anthropologists not only identify deeper structures of meaning from linguistic and symbolic perspectives, but also in their translational work they compare how different models of culture, personhood, sociality, and illness are dealt with and rendered meaningful in the world. for many anthropologists, especially of the medical sort, dementia, and the cultural context of how that disease is constructed and played out interpersonally in various (micro)systems of care, presents an altogether new sort of challenge. as alzheimer’s and other similar dementia diseases come to grip aging communities around the world, anthropologists do not have to travel far to encounter this most challenging terrain. in many cases, the challenge of the ‘other’ is in their own backyard. culturally-inflected notions of personhood will of course determine how dementia is conceptualized and attended to in various social and institutional settings. research into this area will provide ways for improving how we manage care and stigma. in the context of the west for example, mahnaz hashmi (2011) writes, “alzheimer’s disease resonates in western societies by the simultaneous embodiment of the fear of aging, fear of becoming dependent and fear of losing ourselves” (208). dementia defies our everyday and normative understandings of autonomy, the self, ‘others,’ and the double-sided nature of our reliance on biomedicalization. dementia’s latin roots, dement—or rather without/out of one’s mind—still underpins our discourse about diseases and conditions that deal with declines in memory, language, and cognitive abilities. so much for the advances in our biomedicalized technology; we have not even made progress jettisoning ourselves out of our crude etymologies! nevertheless, anthropologists have been writing about dementia in useful and in some cases quite personal ways (e.g., leibing and cohen 2006; lock 2013; mclean 2007). most recently, arthur kleinman recounts his own caregiving journey with his late wife joan, who suffered from an early-onset of alzheimer’s. in the soul of care, kleinman (2019) reveals that what is at stake in our medical anthropology kao | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.269 http://anthro-age.pitt.edu 5 is not just accommodation to the cultural construction of disease or even what students learn as ‘cultural competency,’ but a greater attunement to theorizing about the social and moral nature of caregiving itself. in a very personal and early passage in his latest book, kleinman (2019) shares with us the following regarding his late wife’s misperceiving of her surroundings and other symptomologies: “as in joan’s case, it most often is episodic, short-lived, and readily forgotten, but for those close to the sufferer, it can be world-shattering—as if a bond that has taken decades to forge can be broken in an instant” (2). another way in which recent approaches to caregiving for those with dementia has taken off positively on the ground in community-based and residential care settings has been linked to anne basting’s timeslips work (see basting 2013). by drawing from creative storytelling, anne basting gets participants to take cues from pictures and other resources in producing and sharing narratives without having those with dementia worrying about remembering the correct ‘facts.’ imagination is leveraged in these instances of personcentered care, so that those with dementia are able to connect with others including family members in meaningful, therapeutic, and fun ways. similarly, the notion of narrative care as promoted by william randall (2009) provides a further refinement. rather than let others voice and characterize the lives of those with dementia, narrative care gets people, regardless of their state of decline, to construct their own lives as lived out and sought out stories. for randall, narrative care is core care because of the medicinal qualities inherent in giving people dignity and agency, continuing the crucial work of narrative development into late life. at the conclusion of the arts of caring, arts of knowing: dementia and knowledge practices workshop, and on the very next day in fact, the world alzheimer report 2019: attitudes to dementia released its latest findings to the public.1 according to the report, which also happens to be the largest worldwide ‘attitudes to dementia’ survey ever conducted, a rising number of people in the world are concerned about getting dementia. unsurprisingly, stigma is still a growing concern. thirty-five percent (35%) of carers across the world said that they have hidden the diagnosis of dementia of a family member from at least one person. clearly, there is still much more work to be done, and anthropologists can play a crucial role not only in reversing negative misperceptions and translating the experience of those with dementia and their caregivers, but more importantly they can engage the larger biomedical community on issues of how to appropriately pathologize aspects of dementia whilst simultaneously integrating approaches to treatment that emphasize mutuality and an emics of care. because dementia adds another layer of complexity to our communicative practices especially in instances of severe memory loss and cognitive impairment, there is work to be done in those situations where ‘normalcy’ seems to be hi-jacked and the ontological tables turned upside down. in times where claims to the truth and experience are at odds, remembering that our work should be towards evaluating persons as human beings will be important. just as those who love and provide the necessary care for those with dementia, anthropologists too must look to situate their work in and across various levels of scale. the challenge for this kind of anthropology is to achieve a critical closeness to theorizing without losing the ideals that resonate so much with our informants, which include sincerity, authenticity and professionalism. notes 1 alzheimer’s disease international. “world alzheimer report 2019: attitudes to dementia.” accessed february 6, 2020, https://www.alz.co.uk/research/world-report-2019 references basting, a. 2013. “timeslips: creativity for people with dementia.” age in action, 28(4), 1-5. hashmi, m. 2009. “dementia: an anthropological perspective.” international journal of geriattric psychiatry 24: 207-212. kao | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.269 http://anthro-age.pitt.edu 6 kleinman, arthur. 2019. the soul of care: the moral education of a husband and a doctor. new york: viking press. leibing, annette and lawrence cohen. 2006. thinking about dementia: culture, loss, and the anthropology of senility. new brunswick, nj: rutgers university press. lock, margaret. 2013. the alzheimer conundrum: entanglements of dementia and aging. princeton, nj: princeton university press. mclean, a. 2007. the person in dementia: a study of nursing home care in the u.s. toronto: broadview press. randall, w.l. 2009. “the anthropology of dementia: a narrative perspective.” international journal of geriatric psychiatry 24: 322-324. 404 not found _loewenthalfinalbr book review andrew irving. review of the art of life and death: radical aesthetics and ethnographic practice. hau books: 2017. pp. 264. price: $35.00. john loewenthal oxford brookes university & new york university anthropology & aging, vol 39, no 1 (2018), pp. 112-114 issn 2374-2267 (online) doi 10.5195/aa.2018.199 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.199 http://anthro-age.pitt.edu loewenthal | book review 112 book review andrew irving. review of the art of life and death: radical aesthetics and ethnographic practice. hau books: 2017. pp. 264. price: $35.00. john loewenthal oxford brookes university & new york university the art of life and death is the second book in hau’s series of malinowski monographs which are aimed at constructing innovative, ethnographically-inspired theory. drawing upon twenty years of fieldwork in new york city, andrew irving traces the imaginative lifeworlds of persons living with hiv/aids as they try to make sense of, and make the most of, what remains of their lives. interestingly, through the advent of antiretroviral medications, many of those whom irving worked with in the late 1990s went on to live a future which they had not expected to see and which some had severed in anticipation of an early demise – from vast financial loans to drug addictions. while a book review could equally examine the themes of urban, visual, or medical anthropology, i here focus on the existential and phenomenological contributions. it is ironic to find such vivacity in a book concerned with (premature) mortality – yet that is the author’s very point: life and death, like many dualisms, give meaning to each other. attitudes towards death are shown to vary “within and between situations: during times of illness, when drunk, when playing music, when walking, when looking at the ocean, or when laughing” (p.11). it is inferred that such elasticity in outlook – to whatever subject matter – is in some ways the case for us all. irving underlines how the course of a single day can entail dramatic undulations in mood, and how equally, the human life course is perpetually subject to the alterity of the future. the book’s most central themes regard the contingency, situatedness, and dynamism of human experience, and the subsequent utility of non-static, phenomenological ethnography. through six theoretically-driven data chapters, framed by a gripping introduction and a politicized conclusion, we are introduced to a series of brave characters whom irving has worked with independently over many years. through an ethnographic-near “face-to-face” methodology we see how the variables affecting individual lives oscillate and intersect, from rhythms of income to fluctuations of health. elsewhere, the anthropological gaze has been oriented towards ever-emergent futures as much as any traditions of the past (appadurai, 2013; salazar, pink, irving, and sjöberg, 2017), and we here see how chance, luck (good or bad), the unforeseeable, and the uncertain distinctively shape life trajectories. from irrevocable events such as contracting a disease to the implications of which way one turns down the road, each refraction of potentiality in these new yorkers’ lives is at the expense of alternative outcomes and the cascades of different consequences these might have produced. in this way, the ethnography aims to partially convey the universal human condition: a mortal life course that is born out of arbitrariness, elaborated through endless overlapping contingencies, and strewn with the counter-factual conditional tense of ‘what if’ various scenarios had panned out a different way. the subheading of the book, “radical aesthetics,” represents the nuances in people’s senses and perceptions which may – dependent on body, health, and context – combine, disaggregate, decline, or disappear. the membrane of the self may be permeated differently, moment-by-moment: anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.199 http://anthro-age.pitt.edu loewenthal | book review 113 “depending on the person, it might be a certain quality of light, turn in the weather, shade of green, or shape of a building that calls to mind his or her regret over a particular word spoken out of turn, a failed dream, or an unfinished conversation” (p. 127). such a sensitivity to what may trigger certain streams of consciousness appears particularly apt in the context of working with the elderly. this point has ethical implications, reminding us that the questions that we ask in the field may recall unwanted fears, repressed memories, or things best left unsaid. yet equally, an attunement to how people react to visual and sensory stimuli can open doors for creative methods magnifying people’s attachments to times and places beyond their immediacies; for instance, in my own work with young people, using a world map to discuss diasporic geographies and perceptions of travel (loewenthal and broughton, 2018). a concomitant dimension of “radical aesthetics” concerns the many striking artworks which feature in color across the text. irving’s participants are artists whose varied compositions provide compelling insights into people’s responses to mortality, reclaimed life, and the meanings that mediate the two. nonetheless, their occupations and abilities do create a bias in the findings towards the ‘radically aesthetic,’ such as might be different for less artistically inclined sufferers. further to irving’s eloquence and empathy describing the relationship between the artists and their work, there is boundless innovation, such as repeatedly bringing artworks from new york to his other field site in uganda to be cross-culturally interpreted. there are two central critiques of traditional anthropology in the book. the first, which there is little space to discuss here, regards the primacy so often ascribed to collective structures and cultural or national frameworks in conceptualizing people’s lives. similar to arguments made by nigel rapport (2012), irving shows how the tendency to compartmentalize people according to their shared upbringing, ethnic group, sexuality, or so on can mask the idiosyncrasies of their biographies, fantasies, and bodies. his second critique concerns the epistemological propensity towards exteriority and observable symbols as forms of evidence. in response, he experiments with collaborative methods to render audible people’s inner speech as they contemplate life situations within everyday settings. in one moving example, a participant re-walks his journey to and from the clinic where he received his hiv+ diagnosis while recounting into a microphone the chronological thoughts that had passed through his head on that day. this journey is repeated three times with modifications to the visual, aural, and interactive methodology. the strengths of such methods regard the elicitation of memory, affect, and experience in situ and through action. limitations include the consciousness of participants towards an imagined audience, and the need to ‘stage’ such encounters – although a similar critique can be levelled at most structured methods. readers interested in the role of space in mediating age and aging will benefit from irving’s critical use of merleau-ponty. throughout the ethnography, human experiences of landscape are shown to be contingent upon people’s unique situations and the associated thoughts which occupy their minds. for instance, manhattan is described as: “… a grid of straight-edged, commerce-lined streets and avenues that continuously enable citizens to look far into the future and work toward an economically productive life and retirement. after diagnosis those same commerce-lined avenues, brandishing their assorted messages of pensions, retirement plans, and medicines promising a long and healthy life, ceased to have much meaning for frank, holly, benjamin, and many others” (p. 64). the meanings which even familiar spaces evoke are hence shown to be susceptible to change over time. the temporal versatility of meaning is further evidenced through senses of foreboding or retrospect ascribed to everyday dialogue. in the context of people living with terminal illness, simple remarks such as “see you later” (p. 53) may carry a mutual unspoken understanding of possibly not meeting again; meanwhile, a casual encounter that does turn out to be the last may only later be inscribed with significance. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.199 http://anthro-age.pitt.edu loewenthal | book review 114 a key strength of this remarkable ethnography comes from the intimate and longitudinal methodology. as people’s circumstances and outlooks dialectically transform, the author’s points about contingency and situated perception speak for themselves. the implications of this are that we should not overly theorize peoples’ lives based upon singular static snapshots from one encounter. indeed, these represent just a moment in time. the degree of rapport and collaboration in this study may, however, be difficult to attain in other contexts. in instances of vulnerability, sickness, and possible death researchers can feel a burden simply ‘hanging around’ or asking for an interview, never mind experimenting with ethnographic methods. a further issue in translating this ethnography elsewhere relates to the methodological individualism which here serves as a strength. befriending singular persons and treating their lives case by case may be fitting for new york, though perhaps not in places where lives are not socially organized or culturally valued so individually. a final issue in extrapolating the theory and methods from this case study of persons living with hiv/aids to other contexts, such as i am suggesting, is that the framework is overly ‘heraclitan’ – from heraclitus, famed for stating that ‘no man ever steps in the same river twice, for it’s not the same river and he’s not the same man.’ though lives are in motion, for many people around the world, the life course is constituted by consistency, ritual, and familiarity. this book would be of interest to anyone looking to explore people’s dynamic, perceptive, and reflective outlook on the world – whether looking to the future, contemplating death, or simply being alive. for those interested in the anthropology of art, illness, time, or urbanism it is also rich. while literature in cognitive or psychological anthropology is not particularly referenced, the work would also be of interest to scholars in those fields. perhaps most of all, the text would be highly instructive to students for demonstrating the extent of complexity and fascination that can be unearthed through lines of inquiry rarely touched upon in traditional syllabuses. as an anthropology undergraduate, i was left alienated by early encounters with lévy-bruhl and radcliffe-brown and as a lecturer, i am still disappointed by the somewhat dated ethnographies that we are told to suggest. no curious anthropology student – or for that matter, person – would be left un-inspired or non-transformed by this text and i implore as wide a readership as possible. references appadurai, a. 2013. the future as cultural fact: essays on the global condition. london: verso. loewenthal, j. & broughton, j. 2018 (forthcoming). travel imaginaries of youth in new york city: history, ethnicity and the politics of mobility. in stahl, g., habib, s., & ward, m. r. m. (eds.), youth, place and theories of belonging. london: routledge. rapport, n. 2012. anyone: towards a cosmopolitan anthropology. oxford & new york, ny: berghahn. salazar, j. f., pink, s., irving, a., & sjöberg, j. (eds.). 2017. anthropologies and futures: researching emerging and uncertain worlds. london & new york, ny: bloomsbury. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 124 issn 2374-2267 (online) doi 10.5195/aa.2015.110 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. response 2 to “toward a gerontoludic manifesto” robert l. rubinstein & michael brazda doctoral program in gerontology, department of sociology and anthropology university of maryland baltimore county (umbc) contact: rrubinst@umbc.edu abstract responses to commentary, “toward a gerontoludic manifesto,” by bob de schutter and vero abeele in anthropology & aging vol36, no.2, the special issue on “aging the technoscape,” followed by a reply by the commentary authors . http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by/3.0/us/ anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.110 http://anthro-age.pitt.edu response 2 to “toward a gerontoludic manifesto” robert l. rubinstein & michael brazda doctoral program in gerontology, department of sociology and anthropology university of maryland baltimore county (umbc) the authors note that there are two themes found in the technoscape of electronic play by the “silver-hair gamer”: usefulness and accessibility. both in some sense are related to the metatheme of skill. some electronic games may be used to improve certain cognitive and physical skills and other games represent reflect age-related inabilities that constrain accessing and using certain electronic games. another point made by this paper is that the gaming industry finds older adults somehow toxic and does not develop games or market specifically to them, reflecting widespread cultural values that stigmatize and denigrate older adults. despite the fact that one–fourth of older adults may utilize electronic games, it is difficult for older adults to “out” themselves as gamers. we can add to this discussion in three ways. first, it is also the case that many older adults who own computers will also use the games that come with the computers or are available for free or little cost through the operating systems’ store and websites like aarp.org. although, by and large, these are likely to be a solitary endeavors, since computers are often used as a quotidian object in solitary ways. the number of older gamers may then be both underestimated and solitary. second, the privacy of gaming and the industry disinterest in this slice of the market may reflect, unfortunately, a condition similar to the public view of sexuality among older adults: that it should not be public or known about and that it is, to the young at least, somehow shameful and stigmatized as inappropriate. third, in our work in assisted living (al) settings (an element of long term care for impaired and infirm older adults in the us), electronic game platforms such as wii are pervasive in al settings that are well heeled enough to afford them. colleagues have observed other electronic games in such settings as well. another avenue of research for older adults may exist in the use of massively multiplayer online gaming and its effects on social isolation. the research on young adults is mixed in nature, suggesting that social isolation in young adults may be helped through their playing of online gaming. participating in these games may negatively affect a person’s degree of social isolation. it is possible, however, that older adults who are already at risk of increasing social isolation could benefit from such games. a more “age-typical” assessment of appropriate games for older adults may be things like chess, checkers and playing cards, although in some settings chess may be too complex for cognitively impaired persons of any age. it would be interesting to know how the use of electronic games layers on, in terms of layers of active memory, to games that were played in the past or older games that continue to be played at the present time. a related question concerns the sheer enjoyment gained from game playing of all sorts and whether there is also a layering effect in these terms of old and new games. finally, it is important to know whether games are better played alone or with others. games may be useful to fill the space that is developed when older adults live alone or are socially isolated. 263-1201-3-ce book review | carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.263 http://anthro-age.pitt.edu 111 book review review of goulding, anna, bruce davenport and andrew newman, eds. resilience and ageing: creativity, culture and community. bristol: policy press. 2018. pp 224. price: $98 (hardcopy); $39 (paperback and ebook). leslie carlin university of toronto anthropology & aging, vol 41, no 1 (2020), pp. 112-113 issn 2374-2267 (online) doi 10.5195/aa.2020.263 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.263 http://anthro-age.pitt.edu 112 book review review of goulding, anna, bruce davenport and andrew newman, eds. resilience and ageing: creativity, culture and community. bristol: policy press. 2018. pp 224. price: $98 (hardcopy); $39 (paperback and ebook). leslie carlin university of toronto caveat: i am slightly suspicious of ‘resilience’, because i worry about the concept’s potential subtly to blame sufferers, for their failure to resist suffering. in the introduction to this edited volume, resilience and ageing, however, the editors allay my concern to a certain extent. “resilience” here, is defined as a “combination of environmental factors and individual traits; a negotiated process,” rather than an intrinsic characteristic that one either can or cannot perform in the face of hardship (1-2). i continued reading with cautious enthusiasm, hoping to understand how this “negotiated process” intersects with creativity and ageing. now we have gathered in the spirit of full disclosure, i can reveal my professional and personal subjectivity: i am myself an ageing anthropologist, who enjoys indulging her creative side. in the introduction, one of the editors, anna goulding, describes the book’s themes as: resilience, creativity, culture, and ageing. the projects covered in the eleven book chapters, show very different approaches to all of these themes, and cover various forms of creative activity, including storytelling, drama, mapping, lace-making and gardening. they converge, however, around a similar participatory methodology: all the projects the chapters describe rely on participatory means of creating, communitybuilding ánd generating and analyzing data, so that both process and product are co-created by investigators and participants, in this case, older adults. six of the eleven papers in this volume, describe projects based in england and wales, and most of those, surprisingly, in the northern parts of those countries. all chapters bar two represent the english-speaking world: canada, the united states, australia, besides chile and poland. the editors grouped the papers into three rough categories that might be glossed as “arts” (goulding; bernard et al.; de medeiros and swinnen; newman et al.), “community” (schmidt et al.; fang et al.; bailey et al.) and “things” (reynolds; sznajder and kosmala; manchester; miller et al.). references and responses to an article by wild et al. (2013), “resilience: thoughts on the value of the concept for critical gerontology,” are a thread through nearly all the chapters. in the “arts” category, goulding discusses a “cultural animation” workshop in northeast england, to gain understanding of older adults’ views of resilience and coping. this method involved workshops, following up on cultural experiences, like a museum visit or participation in a book group. the workshops explored ways in which social engagement in the activities might strengthen participants’ resilience in the face of loss (e.g. of a spouse) or distress (e.g. anxiety). bernard et al. explored resilience among older adults through participatory research, that developed into a theatre performance in the english midlands. de medeiros and swinnen, conducted a poetry intervention for people living with dementia in the united states. they defined resilience as involving “flourishing”’ rather than absence of symptoms, and indeed reported “more laughter and conversation and less boredom” during their intervention phase (80). newman et al., also in england’s northeast, explored the ways in which visual art supported an ongoing “narrative identity” in people with dementia living in care homes. the three papers focusing on the role of “community,” include an action research project conducted by schmidt et al. on “rural-living elders” in central coastal chile, during the episode after a book review | carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.263 http://anthro-age.pitt.edu 113 major earthquake. they used a communal creative project (collage) to spur dialogue and to support coping with anxiety and fear. fang et al. captured the experiences of older adults from western canada, moving into a new, purpose-built housing complex, hereby using participatory methods and a transdisciplinary approach to understand community resilience. bailey et al., in their engaging and well-written article, deploy an arts-based participatory research approach called “world café,” in collaboration with the elders council of newcastle-upon-tyne, england, to foster “honest and messy public conversations” that draw in policy, historic, and community factors (158). they report that the conversations led participants to write and perform a play, and on the heels of that project, to take “small-scale action” in their own neighborhoods in the final group of papers, “things,” reynolds describes crafting activities amongst older adults in a pseudonymous midlands english town. these activities (e.g. making textiles), did not only aim at creating objects, but also at generating social resilience. interestingly, the author here introduces a dimension of class, and thus finds that, while it is popularly supposed that such crafting groups attract the ‘middle class,’ such an assumption may be unwarranted. sznajder and kosmala describe a similar dynamic interaction of the individual, the social, and the material for older adults involved in lace-making in krakow, poland. the authors argue that “resilience provides a framework for reflecting upon the ability of individuals to withstand adversities related to old age through engagement in creative craft activity and told through oral stories” (204). in the penultimate chapter, manchester writes about the “tangible memories”’ project, which follows older adults in the west of england moving into care homes and of necessity shedding belongings. she argues that possessions affect resilience, because they make tangible attachment to memories and stories. finally, miller et al. discuss creativity and happiness generated through gardening in a retirement home near brisbane, australia. they reaffirm that gardening is good for you, and that the productivity, creativity, aesthetics, and sociality that come with gardening promote resilience. while reading resilience and aging, my thoughts were often drawn to meditations on my own resilience and to the older adults i encounter through my work with age-well nce, a canadian network for innovation, technology and ageing. i especially thought of two women i know well, whom i will call grandma a and grandma b. both women raised families; one had a career outside the home, one did not. both enjoyed reading, traveling, walking, theatre, friendships, their grandchildren, maintaining their homes, feeding their husbands. grandma a continued working into her mid-eighties and after retiring continued to travel, visit with friends, attend concerts and ballets, spend time with family. grandma b deteriorated. she received a diagnosis of parkinson’s disease and managed the symptoms with drugs and exercise, but these diminished in effectiveness, leaving her in great difficulties and dependent on carers. goulding, referencing wild et al. (2013), writes: “[t]he notion of resilience comes with an acceptance that older people will face adversity, and that such challenges are a normal part of life” and “cultural participation…can foster psychological, social and cultural resilience” (19). although i fully endorse (and enact) engagement with creativity in older age, and appreciate its benefits, this volume reminds me of the undemocratic character of this philosophy: those who are unable to participate in arts and community-based projects, those who do not model the superpower of resilience, disappear in the margins, of also this edited volume. when i think of grandma a and grandma b, i remain hesitant to label either the cause or the effect of cultural or creative engagement ‘resilience’. i believe i would instead call it ‘luck’. references wild, kirsty, janine l. wiles and ruth e.s. allen. 2013. “resilience: thoughts on the value of the concept for critical gerontology;” aging and society 33(1): 137-158. book review | frank | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.272 http://anthro-age.pitt.edu 117 book review review of lamb, sarah, ed. successful aging as a contemporary obsession: global perspectives. new brunswick: rutgers university press. 2017. pp. 256. price: $37,95 (paperback). jacquelyn b. frank human services and community leadership / aging studies, eastern illinois university anthropology & aging, vol 41, no 1 (2020), pp. 118-120 issn 2374-2267 (online) doi 10.5195/aa.2020.272 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ book review | frank | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.272 http://anthro-age.pitt.edu 118 book review review of lamb, sarah, ed. successful aging as a contemporary obsession: global perspectives. new brunswick: rutgers university press. 2017. pp. 256. price: $37,95 (paperback). jacquelyn b. frank human services and community leadership / aging studies, eastern illinois university anthropologist sarah lamb’s edited volume skillfully highlights ethnographic explorations of what it means to “age successfully” in a variety of cultural contexts. the beauty of this collection is certainly to be found in the contributors’ aim to dismantle commonly held gerontological notions of “successful aging,” while similarly engaging with possible futures. already in the introduction of the volume, lamb, robbins-ruszkowski, and corwin challenge the reader to confront definitions of “successful aging” commonly accepted in the gerontological literature: “the successful aging paradigm…says that you can be the crafter of your own successful aging—through diet, exercise, productive activities, attitude, self-control, and choice” (2). however, as lamb and contributors clarify at length, these hegemonic and hence normative and normalizing assumptions on old age, most frequently contrast sharply with the real opportunities for self-realization for individuals aging in communities across the globe, all the while producing ‘failed’ elderly citizens. decades ago, anthropologist sharon kaufman (1986) already emphasized the importance of including the voices and experiences of elders in gerontological research. it is symptomatic of the persistence of ageism, that over thirty years later, successful aging as a contemporary obsession still needs to re-emphasize this motivation. it does so, successfully, not only by highlighting the diverse experiences of elders from locations such as poland, china, india, brazil and the united states, but also by actively calling into question the successful aging paradigm itself, that has only gained power since kaufman’s publication three decades ago. lamb’s volume is particularly valuable to gerontologists because it probes four strongly held “cultural-historic values upon which the successful aging paradigm rests” (7), namely: individual agency and control (7); the ideal of independence (9); active aging (10) and agelessness and permanent personhood (11). these issues are then again discussed throughout the four sections of the volume, that address different aspects of successful aging, with each of these four sections including stand-out chapters that are particularly thought-provoking. in the first section (“gender, sexuality and the allure of anti-aging”), emily wentzell’s article, “erectile dysfunction as successful aging in mexico,” challenges the values of both “active aging” and “agelessness,” as described in the introduction to the volume. wentzell’s anthropological research reveals that many men in her study found their erectile dysfunction to be a natural element in their lives “signaling that their youth had ended” (75). the respondents also stated that the their ed served as a catalyst for their emotional maturity and progression to being a “better man” (75). counterintuitively within the “successful aging”-paradigm, such changes were not found to represent failure for them as cultural subjects, but instead “helped them to live out good masculinity in older age” (78). the second section of this book shifts to “ideals of independence, interdependence, and intimate sociality in later life.” for example, janelle taylor’s contribution examines the impact of dementia on close http://anthro-age.pitt.edu/ book review | frank | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.272 http://anthro-age.pitt.edu 119 friendships in the u.s., the uk, and the netherlands. taylor’s research critically analyzes commonly held notions of “personhood” which challenge the value of “agelessness and permanent personhood” that is central to many definitions of successful aging. taylor examines the maintenance of friendships when one individual has dementia and finds that, while these friendship may transform over time, cognitively intact individuals find mutual benefit in the maintenance of these relationships. taylor’s study reveals that, when the friend with dementia can no longer maintain his/her pervious sense of self, friends can and do help maintain the personhood of their friend by “holding the person in personhood” creating a cocoon of sorts for a declining friend (132). whereas cognitive impairment is generally not addressed in most models of successful aging, with this chapter taylor powerfully challenges us to acknowledge the fact that “if the discourse of successful aging contributes to nudging people toward disconnecting from friends when they begin to show signs of dementia, then it may do very real harm to real people living among us” (136). the third section of the book shifts to examining individual and collective aspects of aging well through both national policies and collective projects. jane mcintosh’s chapter, “depreciating age, disintegrating ties,” examines cultural shifts in the roles of elders in sub-saharan africa, kenya. previously, elders in kenya were the source of authority and wisdom and intergenerational interdependence was strong. however, as kenya has ‘westernized’ and youth has moved to cities for perceived new opportunities, social structures among various cultural groups have changed. elders have lost many of their previously held roles within their communities. mcintosh sums up the experience for many kenyan elders in her conclusion: “many aging people wish most fervently not to be young again but to be properly treated as elders: revered and desirably interdependent” (197). finally, the last section of this impressive volume focuses on lessons from the end of life. meika loe shares her findings from a 3-year study of older adults age 85+ in upstate new york. her research focuses on the concept of “comfortable” rather than successful aging. the elders in loe’s study “emphasize ease and subjective health, as opposed to external signs of success and functionality” (228). while these values contradict those undergirding models of “successful aging”, her study participants are elders in their 90s and 100s who feel content in their lives against all odds. many studies examining “successful aging” note that the majority of older adults who hold to this model do not readily discuss decline or death (feng and straughan, 2017; kim et al., 2015; lamb, 2014). this indicates the analytical validity of the more realistic concept of “comfortable aging,” which “requires personal acceptance of vulnerability, disability and mortality” as well as “listening to elders and their desires” (229). successful aging as a contemporary obsession, reminds us that the contributions of anthropology to the field of gerontology are invaluable for an international examination of the ideal of “successful aging” and the ageist assumptions that ingenuously hold it together. lamb’s compilation urges us to consider the usefulness of this term, while simultaneously highlighting the need for more studies that give a stronger voice to elders’ lay perceptions of the realities of old age, rather than reconsider the abstract paradigm of what it means to age “successfully.” references feng, qiushi and paulin tay straughan. 2017. “what does successful aging mean? lay perception of successful aging among elderly singaporeans.” the journals of gerontology: series b 72 (2): 204–213. kaufman, sharon. 1993. “reflections on the ageless self.” generations 17 (2): 13-16. kim, boon han, ji eun choi, joon ah cho, jin. ”hui cho, and min su kim. 2015. “death, fear, and readiness as factors associated with successful aging perspectives from the lay definitions of older patients.” journal of hospice & palliative nursing 17 (2): 149-156. http://anthro-age.pitt.edu/ book review | frank | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.272 http://anthro-age.pitt.edu 120 lamb, sarah. 2014 .“permanent personhood or meaningful decline? toward a critical anthropology of successful aging.” journal of aging studies 29: 41-52. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2013: 34 (3) 126 introduction during the night, on september 2004, jina called for an ambulance after sima had trouble breathing and then accompanied her to the hospital. sima was hospitalized and i came to visit them the next morning at 11:30 am in the ward. after an hour, the nurse entered the room and declared that visiting hours were over. while i prepared to take my things i asked jina whether she was planning to stay again that night. she answered without hesitation “yes, of course until ima [mother in hebrew] will get out” the nurse immediately added, “who else will stay here, she [jina] is the only true family she [sima] has”.  while leaving the ward, i thought about these family-like connections and relational terms. sima has five children and jina isn’t one of them yet the nurse considered her the “only true family” sima has. jina is one of the migrant workers from the philippines and employed in israel as a r t i c l e s the familial dyad between aged patients and filipina caregivers in israel: eldercare and bodily-based practices in the jewish home keren mazuz department of sociology hebrew university in jerusalem caregivers for the country’s aged, dying citizens who reside in their patients’ homes and provide them with round-the-clock care. on what basis are these familial terms applied to them? what is their meaning and practical significance? what do they convey about the relationship between the filipina caregiver and the israeli patient who have different cultural modes and conceptions regarding familial behavior? it is precisely against the backdrop of such cultural and language difference that this family-like relationship emerges, unfolding through the social and bodily nature of care practices.  in this article, based on extended fieldwork among the migrant caregivers from the philippines in israel, i describe the family-like relations in order to broaden our understanding of the possible varieties of bodilybased practices and their relational repercussions as interpersonal care engagements. abstract as the population in the us ages, there is increasing need to study aging in this article i describe a familial dyad between the filipina caregiver and the israeli aged patient. i argue that a familial dyad emerges based on bodily forms of care. this familial dyad becomes a mechanism for adaptation to and enduring of the daily and intimate encounter of a foreign caregiver and an aged dying patient. the familial dyad provides insight into the phenomenology of the care experience as a function for re-conceptualizing social relations and intra-family dynamics. this will broaden our understanding of the possible varieties of bodily-based practices and their relational repercussions as interpersonal care engagements. the form of a familial dyad underscores the dynamism and complexity of care practices as intersubjective and corporeal modes through which one body engages the other. these care practices which are based on repetitive physical actions allow immediate first-person access to the other participants’ subjective state. thus, in an era of globalized care, the familial dyad takes form and shape at the most intimate juncture between the subjects, their corporeal and interpersonal being. keywords: bodily-based practices, eldercare, filipina caregivers, empathy, family, dyad anthropology & aging quarterly 2013: 34 (3) 127 keren mazuz the family dyad between aged patients and filipina caregivers in israel  i argue that the family-like relationship creates a familial dyad between the filipina caregiver and the israeli patient based on bodily-based of care practices. this familial dyad becomes a mechanism for adaptation to and enduring of the daily and intimate encounter of a foreign caregiver and an aged dying patient. the kinship terms emerge spontaneously in the course of the interaction between caregivers and patients; their use is not the result of a decision reached in advance between them or with the patient’s family members, nor as a precondition for the employment of caregivers, but as a sudden articulation that emerges through ongoing bodily closeness and intimacy. the term dyad provides insight into the phenomenology of care experience as a possible function for re-conceptualizing social relations and intra-family dynamics. as i will show below through the analysis of two ethnographies, the social and familial dynamics takes form and shape at the most intimate juncture between the subjects, and the fusion of their corporeal and emotional beings into a novel interpersonal entity which will be called here the familial dyad.  the form of a familial dyad underscores the dynamism and complexity of care practices as intersubjective and corporeal modes through which one body engages with the other. the care practices are located in the interactions between the filipina caregiver and their patients. more precisely, in the interface between the intimacy of the aged body and the filipina’s body so the care practices are combined between the two bodies while the filipina becomes an extension of her patient’s body and daily movements. for example, they walk together at the same rhythm and the patients learn to eat according to the way the filipina feeds them.  these care practices which are based on repetitive physical actions allow immediate first-person access to the other participants’ subjective state and intention that could result in empathy. empathy, argues throop (2012, 408), is a multimodal process that not only involves perception, intellection, affect, and imagination but also the bodily, sensory, and tactile aspects of lived experience…it also highlights how particular cultural contexts, including ethnomedical and therapeutic ones, may significantly shape the expression, recognition, value, and experience of empathy as a basic existential human capacity for orienting to, interacting with, and experiencing others. in this sense, the familial dyad emerges in the most basic therapeutic context of care. the repetitive care practices assist the person being cared-for and the caregiver to orient and interact and through that to develop a sense of empathy based on recognition, gratitude, attention and physical closeness. this care practices bringing them close together as a family despite the fact that the israeli patient and the filipina caregiver have disparate language and cultural backgrounds and their current intimate encounters have neither a common past nor a future (in contrast, for example, to a mother-child relationship). this relationship is all the more ephemeral because it is bound in time to the remaining life span of the patient. this temporality is due to the israel’s immigration administration’s policy which determines that after the patient dies, the caregiver is eligible for deportation to the philippines unless she finds employment caring for another patient. accordingly, the caregivers referred to as “daughters” by their dyad-partners are not entitled to remain in the society in which their life-work takes place nor do they have any familial rights after the patient’s death. despite these circumstances, these daily and corporeal encounters, which can extend over months or years, constitute a profoundly familial relationship, with their participants often being described as “true family”. given these circumstances, the familial dyad is not an object that is “good to think with” metaphorically but a matter of practical adjustment for both the patient and the caregiver.  following a brief description regarding the circumstance in which the israeli eldercare system has led to the employment of caregivers from the philippines and an overview of the research methodology, i will describe and analyze the ethnography of care practices to get a better sense of the role of the body in such a familial dyad. the context of eldercare and filipina migrant workers in israel the caregivers from the philippines are mainly young, female, non-jewish and noncitizen temporary workers employed as live-in caregivers for the country’s aged, sick, and dying citizens. the option of recruiting filipina caregivers is delivered through local placement agencies as one of the national social security (nss) system services available for eldercare in israel.  based on the israeli nursing care law of 1988, israeli citizens who cannot care for themselves in at least one out of five activities of daily living (adl) index of bodily practices eating, dressing, walking, bathing or controlling urine or bowel movements are considered in need of a permanent daily attendant partially paid for by state funds. this care can be obtained either in the form of a nursing institution or by home care assistance with migrant caregivers most of whom migrated from anthropology & aging quarterly 2013: 34 (3) 128 keren mazuz the family dyad between aged patients and filipina caregivers in israel the philippines (today it is also possible to recruit foreign caregivers from nepal, india and romania).  in contrast to israeli caregivers who staff a nursing home, the filipina workers provide round-the-clock care while residing in their patients’ homes until the patient passes away. within this cocoon, performing mundane and intimate life activities entails ongoing close physical interactions. before the passing of the law, it was accepted that the family (especially female daughters) acted as the major caretaker of elderly members. however, in the subsequent period this function has been provided by foreign guest workers.  the outflow of caregivers from the philippines to israel not only meets israel’s local need for eldercare, but is also part of a growing globalized economy of domestic services. female caregivers from the philippines are employed worldwide as caretakers for young, healthy children and families or as housecleaners (cf. in malaysia see chin 1998; in kuwait see shan et al., 2011: in los angeles and rome see parreñas 2001; in hong kong see constable 1997; and in taiwan see cheng 2003) transforming the philippines into the contemporary modern “empire of care” (choy 2003).  in israel, female migrant worker from the philippines is known as “filipina”. a “filipina” has become the hebrew generic term used to describe the employment category of in-home, female non-professional caregivers who perform “bodywork” (twigg 2000). they work according to contracts which define their temporary and low-paying conditions. the term “filipina” in hebrew reflects the philippines as the caregivers’ country of origin, as if the ability to provide care is part of filipinas’ natural makeup.1 this term is based on the cultivated reputation of the filipinas as maternal caregivers, which has actively promoted their export in the global market for domestic, geriatric and family care service.  however, in contrast to their worldwide tasks, in israel, only working with patients known in hebrew as se’udi is considered legal. the hebrew term se’udi refers to a patient whose dependent condition requires the attendance of a caregiver to support in meeting the requirements of basic bodily functions. in contrast with the visually or physically challenged, who are defined according to a physical absence, the “se’udi” patient is defined as such due to the necessity of his or her dependence on the care provided by the caregiver (cf. mazuz, 2013b). the term se’udi as used here explicitly conveys the caregivers’ and the patients’ physical proximity and symbiosis. this symbiosis is manifested by the close and often long-term interactions between the patient and the caregiver who, though they are two different people, engage based on bodily and tactile forms that delineate the familial dyad. most of the filipina work migrants i encountered during my fieldwork were not professional medical nurses. this emphasis how the globalization of domestic and care service from the philippines illustrates how the feminization of care is based on the stereotypic notion of women as maternal, sensitive and de-professionalized caregivers. upon arrival in israel, they received a few hours of training at the manpower agencies before beginning their work with their patients. occasionally, they receive further instruction from the physicians and nurses of the health maintenance organization. most of the filipinas’ job description consists of providing basic care such as preparing meals, feeding, bathing, walking, and dressing, assisting with personal hygiene, changing diapers or taking care of toileting and cleaning the house. but over time and in tandem with the patient’s deterioration they perform more responsibilities involving para-professional medical skills including dispensing medicine, installing bags to the feeding tubes or connecting the patient to a dialysis machine.  on one hand, the filipina must develop culturally intuitive sensitivity (e.g., understanding facial and body language, sickness behaviors and gender attitudes) rapidly while caring for the patient body; a body she learns to know better than the patient’s own children. as a result, she will be aware of any deteriorating change in the body which could be a matter of life and death. however, on the other hand, the filipina’s culturally intuitive abilities, which can be lifesaving, are not professionally acknowledged or compensated by the manpower agencies or the medical establishment on par with israeli caregivers. thus, from a bureaucratic point of view, any filipina can be repeatedly replaced by subsequent filipina woman.  although the filipina caregivers occupying the lowest ladder in the formal employment nursing structure, at the home of the patients they have become the exclusive, skillful and authorized caregivers. over time, the filipina foreign homecare has emerged as socially acceptable solution and respected standard of care chosen by israeli families, despite initial fears and suspicions on the part of the patients’ family members (in this aspect see ayalon, 2009) this, notwithstanding that this involves transferring the bulk of family responsibilities to outsiders who become part of familial dyad. anthropology & aging quarterly 2013: 34 (3) 129 keren mazuz the family dyad between aged patients and filipina caregivers in israel methodology this study is based on ethnographic research conducted between the years 2001–2008 among filipina migrant workers in israel. in broad terms, it examines eldercare as a local industry which includes a large number of senior citizens, governmental agencies dealing with them, and the global network of domestic filipina caregivers who tend to the elderly. this study presents an investigation into the particular meanings of care work that expressed in practices emerging from the caregivers’ daily and social lives, such as the swan folding (cf. mazuz, 2013a) and kinship terms (cf. mazuz, 2013b).  the research was based mostly on observation and participant-observation at the homes of thirty israeli patients cared for by filipina caregivers in a town located in the southern region of the country. the majority of the patients were jewish-israeli female citizens, widowed mothers over the age of 68, who had migrated to israel during the mid-1950s from north africa. they were hebrew and arabic speakers, predominantly of middle to low socioeconomic status.  the caregivers had migrated largely from the rural areas in the northern islands of the philippines. the majority of the migrants are uneducated catholic women from a low-socioeconomic level, between the ages of 35-55, both married mothers and singles. all of them supported their families by sending material remittances back to the philippines. the monthly salary of the filipina caregivers is us$500-800, paid partly by the israeli government incentives through the agencies and partly by the families or by nursing insurance coverage. the migration process starts at the local branch of the israeli placement agencies located in the philippines.  the application of observation methods was particularly relevant in studying these encounters because the filipina caregivers and the israeli patients do not share a common language or cultural background and beliefs. in this crosscultural context, they had little verbal communication since the caregivers usually spoke no hebrew or arabic and the patients spoke no english or tagalog. the filipinas knew elementary words of conversational hebrew and they had difficulty reading and writing in that language, particularly with respect to specialized care and treatment terminology. the patients had lack of language proficiency in english and in most of the cases hebrew was their second language. additionally, in cases of physical or mental impairments, the patients had difficulty communicating verbally thereby making this form of communication between the two even more difficult. as a result, speech was not central to communication between the patient and caregiver even though they lived together under the same roof. when i was present and if requested, i would translate the conversations between the two parties from hebrew and arabic into english and back; in some cases this function was conducted by the patients’ grandchild.  surprisingly, this difficulty that was a source of some problems also functioned as a generative source for communication of a different form, that is, the use of the most immediate alternative communicative medium: the body. the body then is the medium and locality of the care practices and ultimately of the familial dyad. consequently, the daily tasks which were based on bodyto-body practices rendered the use of language as a tool of communication unnecessary.  through daily care practices the filipina migrant becomes a part, an extension, of the patient’s body. through care practices such as bathing and dressing the filipina attends to the patient’s body with her body since both constituents of the dyad learn how to use their bodies in a manner that engages and synchronizes the two bodies to perform as one and at once. so the two bodies combine in a symbiotic, mutualistic and bidirectional relationship which at times continues the movements of one’s body and at other times generates them. as the following ethnographies will show, eldercare in this context is a dialogic process between two bodies and as such it is constituted in terms of social and embodied relations. the work of caregiving was exercised through actions that were carried out repeatedly as the most useful and sensual tools of communication and comprehension. observing the practices of caregiving convey the meaning of the familial dyad.  in the following sections, ethnographies regarding the care practices repertoire are described. caring-for jina and sima during three days of hospitalization, sima was cared-for by jina who slept next to her bed. it was not the first time that sima was hospitalized; jina, 36-year-old married woman and a mother of two children in the philippines had cared for sima since 2001 and had become experienced in what hospitalization entailed. sima’s children trusted jina and came to visit the hospital according to their work’s hours but always called jina’s phone to gain further information anthropology & aging quarterly 2013: 34 (3) 130 keren mazuz the family dyad between aged patients and filipina caregivers in israel and updates about their mother’s condition.  during the third day of hospitalization, i came for another visit in the morning. sima was asleep in her bed and jina sat next to her. jina approached sima and started to wash sima’s face and ears with a wet towel while sima’s eyes were still closed. jina continued to dab sima’s lips, wiping her shoulders beneath the hospital’s dress. sima moved slowly calling “jina, jina”. jina bent over sima’s bed and repeated “ima [mother], wake up, the nurse told me you can bathe today.”  jina intuitively stuck to the care habits she employed at home, positioning the pillows behind sima’s back and preparing sima’s breakfast. she fed her slowly, spoon by spoon while encouraging sima to open her eyes by touching sima’s eyes. feeling jina’s hand, sima opens her eyes and began to eat the hot gruel. sima became fully awake and jina approached her bed, held sima’s hand saying in hebrew “ima bohe [mother come]” and continued in english “come to bath, if you bath they will let us go, that’s good, you want to go home, to your bed, to your neighbors”. sima smiled at jina, and though she couldn’t understand her english words she responded to jina’s request to make an effort, sima replied, uttering slowly in arabic “thank you, god will bless you binti [my daughter].”  jina helped sima out of bed and onto the plastic wheelchair, and wheeled her to the bathroom at the end of the room. the nurse came to the room and praised jina’s ability to assist sima in such a gentle way and telling that “we prefer someone from the family to bathe the patient so she can keep her privacy and usual habits, and jina is the right person to do so.”  jina and sima went into the bathroom and closed the door. after completing the bath, jina wheeled her back to the bed, lifted her into the bed while sima banding over jina to assist her, and jina covered her with a blanket saying loudly “well-done, ima [mother]” and sat next to sima’s bed and leaning against while saying loudly and happily “now she looks good, i can see it.”  it is important to note that jina appreciated the familial terms. she told me that she felt honored when the nurse articulates her bonding with sima as “true family,” as it made her feel she belonged and in-place. significantly, neither she nor other caregivers are forced to use familial terms. the caregiver receives emotional meaning through the familial gratification as part of the dyad’s mutuality that goes beyond the financial compensation she receives for work. the dyad validates the importance of the caregiver’s work which became significant in this temporal context. the familial terms were especially significant for caregivers who were first employed as servants or as aupairs in other countries. there, according to their stories, they experienced displacement with no special treatment from the host families (in this aspect see also parreñas, 2001; chin 1998). thus the familial terms are unique to the working conditions in israel as caregivers for the aged and dying citizens.  jina attended sima’s state and needs based on her daily intelligible communication with her which was expressed in kinship terms (ima and binti) and reinforced by the nurse description of their bonding as “true family”. the care practices emerged in a dialogic process between them based on bodily-based practices: jina’s washing, dabbing, wiping, moving is followed by sima’s moving slowly and calling her; jina then replies and continues by feeding, touching and feeling and sima opens her eyes, eats, talks, smiles, makes an effort, and so on in a continuing process. in bidirectional relationships jina generates movements of sima’s body who continues them over and again while paying attention to each touch, blink of the eye and facial gesture. attention in this context creates a mutual bodily familiarity which evidences non-verbalized trust, awareness and interconnectedness: jina knew that sima felt better just by her attending to her appearance. “paying attention” for jina entails her reliance on bodily contact in attempting to understand and empathize with what sima was experiencing. attention, in this context, brings one into being by perceptual consciousness of the other, this is a multisensory engagement. attending “to” and attending “with” the body are processes called “somatic modes of attention” (csordas, 2002 p. 244). somatic attention requires both sensory and tactile engagement as a mode of attending to each other. in this sense, we can refer to the use of familial terms as cultural elaboration of eldercare that accompany daily attention to the bodily form and movements (of the carer and cared-for). lisa and miriam2 lisa cared for miriam from 2002 until miriam passed away in december 2004. at first, it was like a ‘blind-date’ where there was nothing the two had in common, including language and cultural background. but based on day-today practices and interactions, they become familiar and relatively close, over time, despite the fact that they still did not speak the same language.  when miriam was asked to explain her medical anthropology & aging quarterly 2013: 34 (3) 131 keren mazuz the family dyad between aged patients and filipina caregivers in israel condition, she usually described it as “something sweet that eats my body”. miriam suffered from diabetes that caused loss of vision and a problem with pain in her legs. on the morning of sunday, february 2004, i entered miriam’s house, and saw miriam lying down in her bed and lisa sitting next to her, holding her hands. they were still both dressed in pajamas. miriam’s three floor house was narrow, thus they were unable to get their two beds into one room. although lisa had her own room, she put her bed in the living-room next to miriam’s bed in order to watch and attend to miriam’s needs immediately.  lisa whispered to me: “during the night she was in pain and the pills are not effective. i gave her a little glass of arak [mediterranean alcoholic liquor]”. miriam opened her eyes and moaned quietly. lisa touched miriam’s face slowly and gently, whilst holding her hand, until miriam’s eyes closed again and she fell asleep. after ten minutes, lisa released miriam’s hand and went to the kitchen to prepare breakfast. half an hour later, lisa woke miriam up, calling her “ima [mother] wake-up you need to eat”. miriam opened her eyes, moaned, and lisa lifted her over some pillows and began to feed her spoon after spoon. unexpectedly, miriam closed her eyes and bit her lips in pain. lisa held her hand and stopped feeding her, telling her in hebrew again “ima [mother] i am here”. miriam’s voiceless tears began to fall. she held lisa’s hands and told her in arabic, “t’iech binti [thanks, my daughter]”. lisa relaxed miriam by touching her face and reorganizing the pillows and helping her lie down.  when miriam’s pain overshadowed everything, she closed her eyes. lisa responded in touching her, providing her support. miriam’s pain had become a medium for social interaction with lisa who instinctively responded to it through the mode of touch while holding her hands. through touch as a tactile practice they both shared the “‘here and now’” of the pain experience and by doing so they both participated in temporal and spatial immediacy with the same focus of attention.  lisa responded to miriam’s pain by employing a variety of practices which do not treat or cure but show awareness and intentionality towards the painful state. also the use of arak exemplifies the cultural sensitivity of lisa, since it is considered as a method of pain relief among moroccan jews in israel. although some treatments have not been medically proven as effective, their use—along with attending to the patient’s bodily pain with the carer’s body, sensitive attention, deliberate touching corresponding to miriam’s pain—does appear to make a difference in terms of the pain experience. the carer’s touch is not taken for granted; it is part of the mutualistic relationship between them as mother and daughter. the touch, the proximity, the calling, the attention is already embedded in their bodily-based relationship. the body of proof the content of daily care between miriam and lisa as well as between sima and jina is embedded in bodily actions that are carried out repeatedly each day. as these patients’ physical situation declined and their range of bodily movements narrowed, they became increasingly dependent on the filipinas’ care practices. lisa and jina fed, touched, held and bathed their patients. the filipina used her hands -without glovesas the most useful and sensual tools of apprehension and of action. there was intelligible communication between them through bodily practices. within their hushed intervals, silences and fragments of words in three different languages, conversation and discourse were not major tools of communication.  in these encounters, given the lack of a shared verbal and cultural habitus (bourdieu, 1977), between the filipina caregiver and her israeli patient, the tactile aspects of touching and bodily closeness becomes social instruments for communication that can be put to use inter-subjectively. in this context, by placing bodily-based practices at the center, the familial dyad is taking shape and form.  as both ethnographies suggest, the use of familial terms is not idiosyncratic behavior or a cross-cultural metaphor but part of their corporeal daily lived experiences. the ways in which the care practices are put together, the relative proximity between the two bodies, paying attention, the setting of parallel beds at the hospital and at home, the touching of the face, the holding of hands, the use of familiarity as noted by the nurse, are manifested through the care practices throughout they become a mother and a daughter, a single kinship unit. thus, the physicality of the familial dyad has a communicative role that socially organizes their relationships and providing them with sense of meaning.  the familial dyad is marked, then, by the bodily practices that create relatively static, corporeal dimensions of intersubjectivity and sensual continuity. this is especially so in hand holding and touching. in the ethnographies above, the familial terms appear as the most immediate auditory utterance after or during the care practices which are based on and demand corporeal and mutual involvement. another unique aspect of the familial terms is their inherently reciprocal, allowing the one to be a anthropology & aging quarterly 2013: 34 (3) 132 keren mazuz the family dyad between aged patients and filipina caregivers in israel mother and the other to be a daughter at the same time. it is not a unidirectional relation but rather bidirectional. my objective here is not to offer an ethnomedical model of eldercare as a romanticized alternative by suggesting that the familial dyad is built as quid-pro-quo. the familial dyad never exists outside of the specific context of their encounters and it is limited to particular actors (the filipina and patient) in a specific time and place. nonetheless, though it is not pre-negotiated or imposed, it emerges as an integral part of the caregiver/patient relationship and serves to maintain order, respect, and status by elevating their shared experience to that of a dyad characterized by daughterhood and motherhood. care and empathy: beyond words throop(2012) suggests through ethnography of bonesetting practice in the island of yap the term “tactile-based empathy”. the term outline that empathy is not reached only through verbal or visual modalities but as “rooted in alternate embodied and sensory forms of attuning with others” (p. 424). throop suggest this term especially in contexts in which the capacity to gain quasi-first-person access to another’s lived experience is problematic. thus, empathy “is considered a mode of disclosing ongoing embodied forms of intersubjectivity” (p. 425).  accordingly, the care practices that are bodily-based are crucial tools of communication especially given the disparate language and culture as a problem to gain quasifirst-person access. in this context, the care practices are not just technical or “empty” forms but materialization of “tactile-based empathy” (throop 2012). as described above, these caregivers and care receivers used a few words in three languages hebrew, english, and arabic and still none were enough for a correct and complete conversation. at the beginning, those words were meaningless. however, they became gradually loaded with significance not through their translation but rather through the bodily care practices that accompanied them. these care practices require intuition, attention and sensitivity as essential aspects of tactile-based empathy through which the familial dyad emerges.  in their research among indonesian nurses working in japan, alam & wulansari (2010) describe two care practices that emerge between the indonesian nurses and the elderly japanese patients due to the lack of language proficiency: “skinship” and empathetic caring. the term “skinship” is derived from “skin” plus the suffix of “friendship” and has surfaced as the indonesian nurses’ strategy to maintain a close relationship based on skin-to-skin practices in the absence of a shared language. “looking at their patients as they were their own grandparents” (2010, p. 190) strengthens the indonesians’ empathetic caring. thus, in a theoretical manner, the application of care through physical intimacy, bodily proximity (such as skinship) and tactile moods of touching facilitated the caregiver and patient role to extend to the utmost degree of engagement, familial dyad and empathy as the main aspects of eldercare.  the familial dyad which concretely demonstrates empathy is central to our understanding of how bodily attention and practices create identifications and bonding in a reality of sickness and displacement caused by ageing and migration. the familial dyad is entangled in and acts as vectors of sociality and subjectivity; it is a new adjustable way of being-in-the-world for both the caregiver and the patient in which no one could take a part. in this context, empathy is the vehicle for adapting to the changing environment of both the cared-for and the caregiver in an era of globalized care. the familial dyad consequences: the function of the family the familial dyad became a bonding essence created solely between the filipina caregiver and the israeli patient that no one else, including the patient’s children, can take a part in. the nurse at the hospital describes jina as the “true family” acknowledging jina’s irreplaceable position and daily stance of action which is part of eldercare.  this gives rise to the question, what are the familial dyad consequences? the familial dyad, which provides insight into the phenomenology of care experience through implementation of bodily-based practices, reconceptualizes social and intra-family dynamics of both the caregiver and the patient’s family.  the patient’s children do not approach the filipina as a sister but in some cases do refer to her as a “bat michpaha” [family member]. the filipina caregiver frees the children from the routine and dirty, tedious and exhausting work that is considered part of eldercare. the jewish family is reconstituted because there is one filipina who is a noncitizen, who holds no residential or inheritance rights, and yet is essential to the operation of the jewish family especially in the face of the modern labor system (so in sima’s case, her children could continue with their works and came to visit at the hospital). the filipina allows the physical and social functioning of the aged parent as well as of the whole family. consequently, the filipina anthropology & aging quarterly 2013: 34 (3) 133 keren mazuz the family dyad between aged patients and filipina caregivers in israel lubricates the gears of the jewish family system. the filipina enable the children to go on—consciously and practically—with their everyday lives without torments that they neglected their aged parents. moreover, it assists them with encountering their aged parent as they would like to remember them: as one of the children told me with a somber tone “i don’t want to remember my mother being diapered, she is more than that”. the children’s visit often occurs after their mother/father has been treated and cleaned. thus, a filipina foreign homecare became a standard of eldercare that jewish-israeli families choose and maintain as both a moral necessity and a socially acceptable option in the face of the modern labor system. the filipina caregiver enables the children to continue functioning by transferring responsibility for ongoing bodily interactions involved in the decay of the aged body to the filipina who, by necessity, lives and works as one unit with the patient in close physical proximity.  another consequence affects the irreplaceable filipina. the filipina homecare, which shoulders the jewish family, demands a total attendance which only a foreign female body constructed as foreign noncitizen, nonjewish temporary resident displaced in space and time, separated from her language and culture of origin, and deprived of rights and citizenship could carry repeatedly. as i concluded (mazuz 2013, 109): “eldercare in israel has been viewed as temporary work. despite the fact that it shoulders and sustains the jewish family’s burden, it is based on an endless supply of a frequently changing flow of foreign women, and new, refreshed asian bodies, until their supply becomes depleted”.  consequently, the familial dyad is located at the crossroads of global and local economics, the state regulation and bureaucratization of work migration, and cultural conceptions of eldercare. paradoxically, this junction also fosters the most intimate and familial bond between the subjects, their corporeal and interpersonal being. these, in turn, generate an alternative conception of intra-family dynamics and burden, belonging, and empathy which are dependent on bodily-based practices and tactile 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in israel. in sternudd, hans and hinerman, nate (eds), making sense of pain, interanthropology & aging quarterly 2013: 34 (3) 134 keren mazuz the family dyad between aged patients and filipina caregivers in israel disciplinary press. throop, jason, c. 2012. on the varieties of empathic experience: tactility, mental opacity, and pain in yap, medical anthropology quarterly, 26(3): 408-430. twigg, julia 2000. carework as a form of bodywork, ageing and society 20 (4):389-411. food roots & today’s pantry: the multiple meanings of “thrifty know-how” among older african american women kathrine lambert-pennington university of memphis k.lambert-pennington@memphis.edu lyndsey pender lyndsey.pender@theworkscdc.org abstract in this article we put the themes of agency, food tradition, and time, into conversation with research on aging and food security to offer an intersectional analysis of older african american women’s foodways. in particular, we explore the food provisioning practices of a group of older african american women in the u.s. south. we examine the various ways age, resources (monetary and non-monetary), gender, and black food traditions shape everyday practices like shopping, cooking, and eating. additionally, we explore the varied ways particpant’s past experiences, current social and health, and desires for the future contribute to their food choices. this multidimensional approach to understanding the relationship between aging and food moves beyond the point-in-time and income-expenditure frameworks often used in food security research to consider alternative ways of conceptualizing food resources and thrift. we find that participants’ practices of thrift, like couponing, buying in bulk, and food budgeting, are not always or only reflective of economic constraints. rather, we argue that participants’ “thrifty know-how” operates as a form of gendered cultural capital that they draw on to navigate changing social and physical conditions and food goals over time. by using an intersectional lens and paying attention to older african-american women’s agency, food knowledge, and the role of time – past, present, and future – this article makes visible the the complex and dynamic relationship between aging and food. keywords: foodways; cultural capital; intersectionality; limitations of food security measures anthropology & aging, vol 41, no 2 (2020), pp. 93-109 issn 2374-2267 (online) doi 10.5195/aa.2020.265 lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 93 food roots & today’s pantry: the multiple meanings of “thrifty know-how” among older african american women kathrine lambert-pennington university of memphis k.lambert-pennington@memphis.edu lyndsey pender lyndsey.pender@theworkscdc.org introduction much of the existing scholarship on aging and food has assessed food security among older adults (nord 2003; frongillo and horan 2004) or has emphasized the ways that seniors’ present-day food habits and nutritional status impact their overall well-being (wolfe, frongillo, and valois 2003; lee and frongillo 2001; ahmed and haboubi 2010). both food security and health focused research frequently rely on standardized measurements, like calories and nutrients as markers of nourishment, and standardized assessment tools, like household food security survey modules (hfssm). these pointin-time measurements often treat food as separate from bodies, cultural and historical context, and the environment (hayes-conroy 2016). likewise, food security research often focuses on how economic (income and food expenditures) and other social indicators, such as race, age, and gender (dean 2011), operate as risk factors for food insecurity (hall and brown 2005). the result is often a reductionist perspective on food resources that leaves unexplored the ways that life experiences and individual agency intertwine with other factors to shape food practices and preferences (wolfe, frongillo, and valois 2003; jones et al. 2013). in this article, we begin to bridge this gap, by placing the measurements and concerns emphasized in the aging and food security literature in conversation with the themes of food tradition, gendered food labor, and agency to explore the foodways of a group of older african american women in the u.s. south. inspired by calls for intersectional approaches to food studies (avakian and haber 2005; williamsforson and wilkerson 2011) and a bourdieuian attention to everyday practices, we conceptualize the relationship between aging and food in terms of foodways, or “the cultural and social practices that affect food consumption, including how and what communities eat, where and how they shop and what this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 94 motivates their food preferences” (alkon et al. 2013, 127). we suggest that foodways, like habitus, are “shaped by the practical conditions of everyday life,” connected to history, and generative of individual and collective action (bourdieu 1990, 53). they represent an accumulation of food knowledge and practical competence over time and can be used to meet a variety of social, cultural, and economic goals. centering on food provisioning practices, we explore the ways a group of older african-american women accumulate and use food resources (fiscal and non-monetary). in particular, particpants’ grocery shopping strategies provide an everyday entry point for examining the ways age, gender, income, and black food traditions shape food preferences over time. we pay particular attention to practices of thrift (miller 1998), like coupon clipping and shopping at sales, and the different meanings the women in this study attach to these practices as they age. while previous literature on food access and security among older adults often interpret thrift as a cost saving measure, we argue that older african american women’s “thrifty know-how” represents a form of cultural capital (beagan, chapman, and power 2016) that is employed to meet diverse social, cultural, financial, and health goals. this alternative understanding of food resources and thriftiness allows us to see “thrifty know how” as more than a response to economic constraints. importantly, participants’ childhood food memories, aging appetites, and adjustments to food traditions in the name of health shed light on the ways their food choices not only reflect their past and present, but also their orientation toward the future. two assemblages of literature offer touchstones for this paper: studies examining the relationship between aging, health, and food security and research exploring soul food traditions and the genered labor of foodwork. in keeping with the food security literature, we begin by examining the intersections of age and financial resources as they relate to food insecurity and sites of food acquisition. pushing beyond the traditional questions of food security, the second section considers how participants’ food memories and childhood lessons about homecooked (and often homegrown) food link to their contemporary food practices, as revealed through their reflections on changes in the quality of food and their food preferenes over time. we then examine how participants’ shopping strategies, especially practices of thrift, reflect the dynamic intersection of age, income, and gender and point to the ways “thrifty know how” is deployed to navigate changing household dyamics, tastes, and physical conditions. in the final section, we place participants’ changing food practices into conversation with their expressed desires for longevity and health. here, participants’ emphasisis on food as a means of supporting their health and future aspirations, draws attention to an often-omitted time horizon in research on aging. ultimately, our analysis reveals that while financial resources do influence some seniors’ food purchasing and eating habits, their practices are equally shaped by food preferences and values cultivated in childhood, gendered patterns of foodwork (counihan 2009), and age-related health goals. by tracing the overlapping influences of resources, time, and agency on participants’ food provisioning strategies, this article makes visible the complexity of older african american women’s foodways and points to the need for research that examines the relationship between food and aging in terms of both potential contraints and productive possibilities. aging and food through the lens of food tradition and gendered labor scholarly attention to the relationship between food and aging has often examined the relationship between age, food insecurity (nord 2003; frongillo and horan 2004), and health (lee and frongillo http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 95 2001; frongillo and horan 2004). focused primarily on the economic, physical, and social constraints of older age, food security scholars argue that concurrent events, such as, fixed income, limited mobility, and restricted social networks, may increase seniors’ likelihood of food insecurity (nord 2003; quandt and rao 1999). frongillo and horan (2004) found that not only did physical impairment and limited transportation pose challenges to a senior's ability to purchase groceries and prepare meals, but seniors on fixed incomes often rationed and spent money allotted for food provisions on household expenses and health and medical costs, resulting in a lower nutritional intake. while seniors’ income and food expenditures do shape their food security, jones et. al (2013) suggest that such studies overlook the many strategies that seniors use to obtain food. for example, oemichen and smith (2016) found that snap and congregant meals were important forms of food support among low income seniors in minnesota. similarly, other researchers have explored the ways alternative food provisioning strategies, like food rationing, gardens, and social networks serve as “coping skills” (green-lapierre et al. 2012), buffering mechanisms (wellman et al. 1997), and protective factors (goldberg and mawn 2014) against food insecurity. our analysis suggests that seniors’ use of cost-saving measures, like using coupons and buying in bulk or eating at senior centers, is not fully explained by financial constraints, nutritional necessity, or as a safeguard against food insecurity. rather, our participants use thrifty practices for a variety of reasons: to ensure they have the types of foods they prefer, to provide food resources for others, and as a marker of their self-sufficiency. other scholars have taken a life course approach to understanding older adults’ food choices, nutrition patterns, and food security. falk et al. (1996) emphasize the need to understand food choice as a process that includes interactions between seniors’ experiences over the life course, their ideals, food needs and resources (financial and non-financial), and their personal system for negotiating the value of food. green-lapierre et al. (2012), using an ecological systems approach, found that the women in their study did not self-identify as food insecure, despite noting access barriers, like transportation, income limits, and not having access to foods that meet their health needs. the authors suggest that seniors’ experiences of living through and surviving economically difficult periods in the past have shaped their worldview in ways that run counter to current understandings of food insecurity. by considering the ways past experiences influence seniors’ present-day food resourcing strategies, the life course perspective offers a more dynamic view of food resources, acquisition patterns, and preferences. at the same time, it does not account for the future – how and why present-day foodways might change to meet a future goal. in this article, we highlight the ways the women in this study are future-focused, situating their decisions to give up or adjust food traditions or return to a way of eating from their past in context of their pursuit of health and longevity. for many black americans, soul food is synonymous with cultural tradition. sometimes referred to as “down home” or “country food,” adrian miller (2013) argues that soul food signifies shared memory, historical consciousness, and movement of enslaved people and traditions across the atlantic ocean and later within the united states. while enslaved persons’ diets varied based on rations, whether they lived in urban or rural settings, and whether they could plant a garden, they frequently included cabbage, turnips, cucumbers, hull peas, and other vegetables as well as meat, cornmeal, and molasses (2013, 19-23). post-emancipation, many of these vegetable and meat staples continued to be part of http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 96 african american people’s diets and food tradition, particularly as they left the south and relocated throughout the united states during the great migration of the twentieth century. soul food, as it came to be called in the north (poe 1999), has been characterized in diverse ways over time. prior to the 1950s, it was disparaged for its association with southern-ness, preparation strategies, and unhealthiness (poe 1999; opie 2010). by the 19070s, it was heralded as an important symbol of urban, collective black identity (miller 2013; henderson 2007). in the late twentieth and early twenty-first centuries, soul food has been variously portrayed in film and on tv as a source of matriarchal love, an expression of family and cultural strength (williams-forson 2006), as well as a serious health risk (nettles 2007). the multiple representations and meanings of soul food over time not only reveal its complexities as a food tradition, but also suggest the importance of both personal and social history in understanding the roles these foods play in people’s lives. in this article, seniors’ memories of and reflections on the food items and preparation styles associated with a soul food tradition, which they refer to as “country food” or “homegrown” food, provide an important lens for understanding food preferences, changes in diet, and gendered labor over time. moreover, their decisions to adopt or adjust these food traditions echo the complex representations of soul food in both popular and medical discourses. foodways can reveal the intersection of financial resources, race, and gender in important ways, particularly for african american women in the southern united states (liburd 2003; henderson 2007). the reproductive labor of planning and preparing meals often falls on the shoulders of women (williams-forson and wilkerson 2011; counihan 2009) and shapes the ways women maintain their sense of identity and navigate their changing role and status in the household as they age (plastow, atwal, and gilhooly 2015; davidson, arber, and marshall 2009). particularly relevant to this project are studies that have examined women’s agency in resource constrained contexts. counihan (2009) explores how women use food-related skills to meet their personal and household needs. her analysis reveals the complex ways that the kitchen and cooking skills served to both reproduce gendered expectations within the household and create spaces for women to cultivate expertise in particular dishes. counihan argues that such skills offered a site of agency, earning women appreciation at home, as well as social recognition within the community and, in some cases, income to support their families. page-reeves (2014) considers how everyday food acquisition practices are gendered responses to food constraints. she suggests that the hispanic women in her study developed “food access expertise,” including stretching food resources, making do with what was available, and drawing on a mix of social networks and food benefit programs, in order to feed their families. similar to counihan, page-reeves argues that such practices demonstrate personal resilience as well as resistance to structural inequalities (2014, 100). importantly, the author’s attention to agency in relationship to gendered food labor underscores the ways that material resources can be transformed into new forms of value and meaning for women, their families, and communities. for the older african american women in this study, “thrifty know-how” is a form of expertise used in different ways according to resources, age, tastes, and desires. actions associated with gendered food work (counihan 2009), like extending food budgets, feeding friends and family, ensuring their access to cultural food preferences, and reducing food preparation time, are expressions of agency. participants not only employ “thrifty know-how” to accomplish personal, household, and social aims, but interpret their ability to acquire and manage their food resources as evidence of self-reliance (reese 2018). http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 97 methods this paper draws on a study of seniors’ food resources and food security that was conducted during a qualitative program evaluation of a health and wellness curriculum offered in four senior centers in memphis, tn from 2015-2016. we employed a phased, mixed methods approach to learn about seniors’ foodways, including a food resources survey, focus groups, and interviews. the primary research team was composed of a middle-aged white faculty member, katherine lambert-pennington, and an african american research assistant, who was pursuing a master’s degree in applied anthropology, lyndsey pender.1 overall, 93 participants took part in one or more of the research activities. participants ranged in age from 50 to 94 years old; however, the majority (61%; n=42) were in the 60-69 age range at the time of this research. most participants identified as women (91%; n=85), which is consistent with the gendered attendance of senior centers nationally (pardasani, sporre, and thompson 2009, 51) and 74% (n=69) of these women identified as african american. the high rate of african american women’s participation reflects both the geographic location of the four senior centers in neighborhoods with a high percentage of african american residents (84% or greater), and the overall population of memphis.2 in this article we focus on the foodways of older african american women in an effort to address a qualitative gap in the aging and food literature. we draw on data from a food resources survey (n=69), four focus groups (n=38), and one-on-one interviews (n=35). the food resources survey primarily focused on factors considered important to food access and security, such as where respondents shop, modes of transportation, daily food consumption, and participation in the supplemental nutrition assistance program (snap), a federal program that supplements recipients’ food budgets. only 10% (n=7) of participants in this study reported living with children under the age of 18. thus, we modeled the questions related to food security after the fssm second-level screening tool, which was designed to measure moderate food security in households without children (bickel et al. 2000, 8). the research team administered the survey at the end of a class session and were on hand to answer seniors’ questions about the survey and assist anyone requiring help to complete the survey. focus group and interview questions generated animated discussions about seniors’ food-related activities, like shopping and cooking, as well as reflections on food choices and eating preferences and how these may have changed over time. interviews and focus groups were conducted on-site at the four senior centers. focus groups were led by the research team with assistance from note takers, who documented the discussions as they unfolded. these notes were then transcribed. interviews were digitally recorded and transcribed. the overlap of seniors participating in focus groups and interviews worked as an extended conversation about participants’ foodways. we used the qualtrics survey software to analyze the survey data. we coded focus group and interview data manually, using key themes connected with participants’ food provisioning practices, like shopping, couponing, freezing, economic constraints, choice, and health. then, drawing inspiration from devine (2005), we coded for themes related to changes in foodways over time, including eating and cooking habits, food preferences, and childhood food memories. finally, we systematically compared coded data by age and income categories. to access the shifting and nuanced experiences of http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 98 aging in relationship to food, we used four age groups: under 60, 60-69,70-79, and over 80. additionally, we included three income categories: resource restricted (participants with income less than 200% of the poverty line), resource constrained (income of $2,000-3,499 per month) and resource flexible (income $3,500 or greater). these comparisons helped us better understand not only how these material and social identity factors shape participants’ food related practices, but also enabled us to explore diverse meanings participants attribute to them over time. financing food seniors’ food provisioning practices, especially their shopping, preparation, and eating habits, reflect how they negotiate various types of desire and constraint, including income, food availability, and personal preferences. these are all key factors in food security. participants’ financial resources varied widely, ranging from less than $750 a month to over $5,000 a month; however, the majority of survey respondents, 65%, (n=45), are resource restricted, reporting annual earnings under $24,000. twentyeight percent of respondents (n=19) are resource constrained, reporting incomes between and $2,0002,999 a month. resource flexible participants, those earning more than $3,000 per month, make up 7% (n=5) of the survey respondents. notably, approximately 51% (n=23) of resource restricted seniors are aged 60-69 (see figure 1). the high poverty rate among the participants in this age range might be partially explained by the number of women under the age of 65 (n=13; 57%). they are not yet eligible for social security or medicare and thus fall into an age-income gap. figure 1: economic resources by age group http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 99 seniors’ financial resources play an important, but not always predictable, role in food security. although 42% of participants reported incomes below the poverty threshold, traditionally a risk factor for food insecurity, the majority of the women in this study (91%; n=63) are food secure. nine percent (n=6) of respondents, however, reported experiencing two or more characteristics of insecurity during the previous month, including anxiety about running out of food (6%; n=4), skipping meals (7%; n=5); not having enough to eat at some point during the previous 30 days (6%; n=4); and/or weight loss (4%; n=3). these findings can be interpreted as food insecurity without hunger (bickel et al. 2000) and correlate with age and income in interesting ways. while a finding of 9% is slightly higher than the overall national rate of food insecurity, which is almost 8% (coleman-jensen et al. 2018, 18), it is significantly lower than the national rate of food insecurity among low-income households or households headed by african american women, which is 31.6% and 22.5%, respectively (ibid 2018, 13). of the 9% (n=6) of women that reported two or more characteristics of food insecurity, 66% (4 of 6) reported incomes under the poverty line and 50% (n=3) were under the age of 65. this suggests that lack of social security benefits can contribute to food precarity. regardless of food security status, participants across age and income categories emphasized their ability to shop for themselves and to pay for their food without relying on help from family members. the federally funded supplemental nutrition assistance program (snap), often colloquially referred to as food stamps, is an important source of economic assistance for 16% (n=11) of the women in this study. this represents less than half of the total number of participants eligible for the program (42%, n=29), which is determined based on household incomes below the 2015 poverty threshold ($973 and $1,311 for households of 1 or 2, respectively). participants’ low rate of snap usage is not uncommon. nationally, only 43% of eligible senior citizens receive support from snap (u.s. department of agriculture 2015). focus group participants offered several explanations for why they do not use snap. some women said they were ineligible due to their income, while others felt that accessing these benefits carried a stigma. still, others pointed to reasons like transportation challenges and long wait times at the department of human services office. these explanations echo findings by oemichen and smith (2016), guthrie and lin (2002), and page-reeves (2014, 96). additionally, two participants reported receiving snap in the past, but chose not to re-enroll because the monetary benefit was too low (under $10 per month) to make a difference in their overall food budget. these findings suggest that income, snap usage, and other demographic characteristics, like gender, race, and age, are imperfect indicators of food insecurity (jones et al. 2013; wolfe, frongillo, and valois 2003). while financial resources shape the possibilities for our participants’ food provisioning practices, their overall low rate of food insecurity and minimal participation in federal benefits programs suggest a dynamic interplay between age, resources, food provisioning practices, and preferences. at the same time, temporal factors like age-based eligibility for social security highlight the importance of understanding older women’s fiscal status as fluid over time. moreover, these findings call for a broader consideration of food resources. thus, in the next two sections we explore how the intersection of income, non-financial resources, particularly food traditions, personal history, and gendered food know-how, inform participants’ food preferences and shopping strategies. http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 100 food roots & today’s pantry our participants’ contemporary food practices represent accumulated food knowledge drawn from their previous life experiences and food traditions. regardless of income, age or whether or not the women in this study grew up in urban or rural environments, many participants described growing up on “homegrown” foods like mustard greens, corn bread, cabbage, potatoes, chicken, tomatoes, okra, and peppers. in doing so, they often pointed to the specific foods and values they were taught in childhood, and compared them with food today. for example, cat remembered, “my mom’s main vegetable for my dad was like greens and string beans. my father didn't feel like it was a meal if we didn't have greens and string beans. well now, i don't cook greens.” many participants, like rene, pointed to “momma’s kitchen” as the place where they learned how to cook. she recalled growing up in the 1950s “in the country” and said, “i was like 10 and 11 years old in the kitchen watching my momma put meals together. she made sure we had vegetables every day. if it wasn't turnip greens, it was collard greens or pinto beans or black-eyed peas, or baked chicken and stuff like that.” rene was not alone in describing some of the staples associated with soul food. “homegrown” foods were also an important part of betty’s city-based childhood. she explained, “my momma had a garden. i love vegetables. i'm a vegetable person and i still love vegetables. i was raised on vegetables.” these food memories highlight both the importance of vegetables and the gendered labor of food preparation in their childhood households. women, usually mothers and sisters, and sometimes men, often fathers, played important key roles in planting, picking, slaughtering, and preparing the homegrown foods. moreover, “momma’s kitchen” served as a gendered site for both cooking instruction and the preservation of traditions and tastes. in addition to food knowledge and cultural traditions, participants often reflected on the values their parents attached to these practices and compared them with today. for example, elise recalled, “we had a huge garden, we had chickens and eggs. . . . we got milk from the cows. my big sister used to milk the cows. we had everything we needed. the food now is so processed.” other participants like sandra, linked her parents self-reliance to her to decision to prioritize eating unprocessed foods. she explained, “it’s always been a part of my lifestyle to raise my own food and eat healthy foods. i saw my mom and my dad [do that] back in the day. we had to depend on our gardens and canned our own foods and prepared our own foods.” for other women, the shift from fresh to processed food and increased levels of food waste mark the differences between past and present. as lottie, now in her eighties, recalled, “my parents came up in the depression. they taught us the value of fresh foods and not wasting anything.” she contrasted these experiences with the food habits she sees among her grandchildren, which she described as “convenience food, tv, and fast food.” similarly, judy, in her seventies, said “you didn't have to freeze it like we do now, and it was better for us. cornbread, biscuit, we didn't have to get no biscuit out the cans and stuff like that. that's what i enjoyed. i miss that.” these childhood food memories serve as signposts for contemporary food practices. participants’ preference for homegrown foods, emphasis on self-reliance, avoiding waste, and concern about fresh versus processed foods speak to the ways lessons learned in “mamma’s kitchen” cultivated particular values and tastes (bourdieu 1984) and mark changes in the food system and their access to it over time (devine 2005). it also lays the groundwork for understanding why and how participants accumulate and use food resources in particular ways. http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 101 today, the women in this study acquire most of their food from grocery stores and prepare food for themselves at home; however, a small number of participants also noted accessing food from personal gardens, farmers markets, restaurants, and senior centers. they cited fruits and vegetables as their first and second most important foods to have in their households, followed by cereal, bread, and other grains, and then meat, chicken, and fish (see figure 2). although not ranked in the top four, eggs and milk, were frequently noted as important. these rankings mirror the southeastern dietic association’s soul food recommendations, which suggest grains provide the base (6-11 servings), followed by vegetables and fruits (5-9 servings), and milk and meats (4-6 servings) (soul food pyramid 1998 cited in nettles 2007, 110). while most women, regardless of financial resources, preferred fresh fruits and vegetables, they also regularly incorporated frozen vegetables and canned fruits depending on seasonality, affordability, and/or deals they could get at the store. figure 2: important household foods participants placed a similar emphasis on fresh, healthy foods when deciding to eat at senior centers. approximately 22% (n=15) of participants ate lunch at the senior center at least once a week. while senior food programs are often cited as providing a food safety net for older adults, eating at the senior center was not a given, despite the low cost of the meals ($1-4 depending on the senior center). rather, than cost, participants stressed that the healthiness of the food and personal tastes were their primary considerations. for example, portia, who is in her seventies, explained, “they serve lunch at [my] senior center and it's a well-balanced meal. they have meat, two vegetables, we always have milk, and, it is not too salty. we don't ever have any fried foods.” participants’ attention to the homecooked quality of senior center food and the emphasis they place on maintaining a selection of unprocessed childhood staples like vegetables, meat, and dairy in their homes, further suggest the ways taste and values cultivated in childhood shape the foods they eat and assign meaning to in the present. further, 0 10 20 30 1st 2nd 3rd 4th fruits and veggies meat, chicken, and fish cereals, bread, and grains milk and dairy (incl. eggs) ranking of important household foods http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 102 participants’ rankings begin to shed light on the more than cost-saving role of thrifty practices. in the next section, we closely examine participants’ thrifty shopping strategies to further probe the ways financial and non-financial resources, aging, and gender inform their food acquisition strategies. thrifty know how as cultural capital during focus groups, questions about shopping produced lively discussions in which the women compared notes on where to find the freshest vegetables, the best ways to find deals in stores, and which store apps they had on their phones. these exchanges revealed, that participants, like their mothers before them, take an active role in acquiring and preparing food for their households. in doing so, they draw on a repertoire of practices, such as food budgets and lists, as well as couponing, watching sales, and buying in bulk and freezing. the varied ways participants use thrift to acquire and prepare food resources constitutes their “thrifty know how.” these skills, knowledge, and values represent a form of cultural capital (bourdieu 1986) that brings to light the overlapping influences of income, age, and gendered labor on food practices. in what follows as we explore how participants use “thrifty know how” in a variety of ways to navigate social and physical changes that accompany aging. practices of thrift were pervasive among the participants in this study, regardless of income; however, which strategies participants used and how they used them varied by income and age. in particular, budgets and lists were used by both low and high income shoppers. participants with more limited resources employed them as an economic safeguard, while others used lists to organize their shopping. buying in bulk and freezing, not only contributed to savings, but also allowed women across income groups to have ongoing access to preferred foods, reduce their food-related labor, and meet household food needs. resource restricted participants described using a mix of strategies, such as knowing exactly how much items cost or waiting until payday to do grocery shopping, as well as maintaining lists of things that need to be purchased and stocking up when things go on sale. for example, elise tried to strike a balance between having the foods she needs and making sure nothing goes to waste. she explained, “i do have a freezer, but i don’t want to get overstocked. i can’t afford to throw away food. i might have two three things of chicken and fish. i just get enough to carry over for short time. just in case something takes place.” similarly, judy who is in her seventies, explained, “i use coupons, and i shop wisely. i look in my pantry and see what i really need. i look in my deep freezer. . . . now, i'm putting up my food for the winter. i went to the market and got me some peas and stuff like that. . . . frozen food and frozen vegetables. . .” stocking up on particular items when they go on sale and freezing foods allow elise and other resource restricted participants to stretch their food resources if money is tight or they are unable to shop due to illness or schedule conflicts. for these women, avoiding waste, a lesson reinforced in childhood, also translates into saving on food costs. importantly, as judy suggests above, not all resource restricted participants viewed buying in bulk and freezing strictly in terms of financial savings. some participants use this strategy to ensure they have access to seasonal or preferred foods or to prepare several days-worth of food at a time. for example, alice, who is 80, buys in bulk and freezes so she will have snap peas throughout the year. she explained, “. . . i put them in those freezer bags so it can keep. you can freeze your stuff -you can start now and have it up to next year in the summer.” other resource restricted seniors, like byrdie, who is in her http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 103 seventies, use this strategy to feed themselves and others. she said, “i get the big thing of chicken and i cook it, and i freeze enough for me and if somebody comes over -they'll get this other part. and then i fix cornbread and i cut it up. i keep it cooked cause i don't like cooking every day.” similarly, tess, who is in her late sixties and resource constrained, also bought in bulk for both efficiency and of savings. she said, “i usually go to [membership-based food warehouse] and i get what we need. i separate it, because it's only my husband and i. i even season it before i put it in the freezer, if it’s meat. i don't run back and forth to the store.” for tess, buying in bulk results in lower food costs and enables her to scale and season her bulk food purchases for the size and tastes of her two-person household. morover, practices like preparing food ahead of time and freezing it, allows participants to minimize the gendered, reproductive labor of cooking and shopping, waste less food, support social relationships and personal tastes, and potentially avoid overspending or over-buying. notably, participants with more financial resources engaged in some of the same strategies as their peers with greater budgetary constraints, but often to different ends. many resource flexible seniors reported buying in bulk and freezing, but few used lists other than for organizational purposes. for example, cat, who is in her seventies and lives in a multigenerational household, detailed her thrifty shopping strategy, saying, “i’m a coupon queen. i clip coupons all the time… my daughter does the grocery shopping and i do the separating of the food because we buy in abundance – in bulk. i wash and season it, separate it how we gonna cook it, and we freeze it.” her self-description as a “coupon queen” highlights the pride she takes in getting a deal and underscores the gendered labor of food acquisition. cat’s expertise and effort to prepare the food for freezing both deepen the household food resources and shorten the time it takes to prepare these foods in the future. moreover, the motherdaughter team’s division of labor both accommodates cat’s difficulty walking long distances and allows her to maintain a leading (queen) role in the managing the household’s food resources. thus, for households like cat’s that can afford to buy in abundance, these practices are less about economic necessity than about meaningfully contributing to foodwork (counihan 2009) and meeting food preferences and tastes. couponing and buying in bulk were not currently practiced by all participants. seniors who no longer use this shopping strategy cited age, and changes in household size and configuration as reasons for this shift. for instance, anne, who is in her eighties and resource restricted, described how her changing economic circumstances and age have shaped her food provisioning practices over time. she said, “i used to cut coupons, but my daughter said to me one day, ‘mother, stop buying all this food. your closets are full and you don’t have room anymore.’ when i didn’t have enough, i would buy what i wanted and as a result i would have too much and end up giving away most of it... now, i’ve learned to buy what i need and i don’t waste anything.” anne’s conversation with her daughter highlights the way her caretaker role has changed as she has transitioned from household matriarch and cook to living alone and cooking for one. not all seniors have fully transitioned their shopping habits. wanda, who is in her seventies, also described no longer using coupons and trying to curtail her food purchases. she explained, “i don't go to the store that much. seniors don't eat a whole lot and i over-buy when i go. well you know, i'm used to buying for a big family and i'm having a hard time cutting it back.” while coupon clipping and buying in bulk was a helpful strategy an earlier point in their lives, both anne’s http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 104 and wanda’s reflections reveal the ways these habits can lead to over buying and food waste in the present. they further suggest the ways older women’s adjust their foodways to accommodate changes in household size, decreases in appetite, and shifts in income. whether shopping, clipping coupons, or buying in bulk and freezing, participants’ food acquisition activities are a form of gendered labor. moreover, their “thrifty know how” reflects a high level of skill and knowledge of food planning and preparation. it allows the participants to provide for themselves and others in their households, maintain a variety of foods in their homes, particularly vegetables and meats, and take advantage of deals offered by sales and bulk purchases. while the majority of participants experience economic constraints and may use thrifty practices out of necessity, our findings suggest other key factors are also at play. shifts in shopping and eating habits reveal the intersection of age and gender as participants accommodate lifestyle and life changes, particularly transitions in household make up and gender roles, from mother and/or wife to single person and/or grandmother with multi-generational obligations. moreover, their emphasis on not wasting food crossed income categories but had different meanings. for some resource restricted women, not wasting food was a resource saving measure and an act of thriftiness. for those participants whose household size and/or appetite had decreased, not wasting food translated into the absence of thrifty practices. participants’ attention to food waste echoes the lessons of self-sufficiency they learned in their mothers’ kitchens. likewise, seniors’ practices of stocking up on seasonal foods allow them to prioritize the tastes and food traditions they have developed over time. eating (or not) for longevity healthy foods and healthy eating are a part of participants’ past food experiences and shape which foods they buy and keep in their homes, as well as what and where they choose to eat. accordingly, these practices are central to how they plan for the future, a temporal consideration often missing from studies of food and aging. participants from across income and age categories identified food as a means of disease prevention and treatment for of some of the chronic health conditions they face, including hypertension (56%, n=39), high cholesterol (38%, n=26), arthritis or rheumatic disease (36%, n=25), and diabetes (22%, n=19). for some participants eating healthy in the present equates with the ability to be self-reliant in the future. margaret explained “as you get older your body gets smarter and lets you know when things are bad for you. you get more focused on health, since you’re going to be on your own.” mary, who is in her mid-sixties, is similarly future-oriented. she explained, “my health has the biggest influence on my diet. because i want to maintain my health. i want to be healthy. i want to live long. i want to start seeing the oldest grandchildren graduate next year and then they are going to college.” significantly, participants’ awareness of the impact of food on their physical bodies and the links they made between healthy eating and longevity translated into actions like prioritizing or omitting specific foods and eating less. these steps often meant calling on and navigating soul food traditions in a variety of ways. interviewees frequently mentioned cutting back on or omitting salt, sugar, and pork, which they linked to particular health conditions like hypertension, diabetes, and high cholesterol. for participants like eli, who is in her seventies, this meant changing the way she prepares certain foods. although she grew http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 105 up eating her mother’s homegrown cooking, she has adjusted how she prepares these dishes, saying, "my health tells me: watch your salt intake. you can't cook with ham hocks like mama did. you got to get those turkey necks and season your food or get the bouillon cubes and season your food. i miss that part, but i have to adjust and i have adjusted.” eli is not the only senior that has revised a soul food tradition with a healthy future in mind. cat recalled bacon, cooked in her mother’s well-worn skillet, as one of her favorite foods growing up; however, she noted, “we've come off of pork. we don't do pork anymore. at first, i didn't like turkey bacon, now i like turkey bacon.” while eli and cat substituted ingredients, others participants, reduced their intake certain foods. pam described cutting down on pork, saying “i had a smothered pork chops yesterday with gravy. i ate one of them. that was it. . . . pork ain’t too good for you, especially when you got hypertension.” as these examples suggest, participants readily combined their health and food knowledge to adjust, rather than abandon, mothertaught food traditions to meet their present-day health concerns. importantly, these choices are further reflected in the ways participants shop, the foods they prioritize having in their homes, and how they use their “thrifty know how” to secure preferred food resources. for other seniors, healthy eating meant eating lighter and eating less. approximately half of the seniors we interviewed talked about having smaller appetites, eating smaller portions or less often, and cooking less than in previous periods in their life. for example, judy explained, “i don't eat as much as i used to. i'm easy to get full. . . . i get full by just looking at a lot of food and stuff.” other seniors described how their eating habits have shifted toward “lighter” foods that do not require cooking, like sandwiches or salads. mary described her late afternoon meal in the following way, “i just eat a salad -something light, especially if i eat lunch here [at the senior center].” such changes in eating habits are not unusual for aging adults, as decreased food intake due to biological and activity changes, particularly shifts in olfactory and taste sensitivities (morely 2001) as well as changes to the digestive system, hormones, disease, and pain (pilgrim et al. 2015), often lead to changes in appetite. the prevalence of eating less among the older women in this study suggests one of the ways food security data may have limited explanatory power, as standard food security instruments do not distinguish between skipping meals due to declining appetite or to avoid running out of food. participants’ focus on health, whether in the general sense or in relation to a specific health condition, highlights the evolving and temporal condition of foodways. many women linked their desire for longevity to their food practices, specifically quantity, quality, and the types of foods they put in their bodies. their attention to health and healthy eating is also reflected in the foods they choose to purchase and eat and the changes they have made in their eating habits as they have aged. for some participants, eating less is an artifact and affirmation of an aging body. for others, avoiding foods that exacerbate underlying health conditions, like diabetes or high blood pressure, also means adjusting soul food traditions. the choices partcipants make, to alter a family recipe, eat less of a favorite dish, or simply eat less, rely on accumulated knowledge about their bodies, health, and food preparation. these changes not only reveal the intersection of aging, gendered agency, and food traditions, but also highlight the importance of the future for understanding how older african american women position themselves and their foodways in relationship to their physical and social goals for aging. http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 106 time, thrift, tradition food is a past, present, and future phenomenon. foodways are dynamic and the labor of food provisioning is gendered. income changes, downsizing of households, fluctuation in tastes, appetite and food tradition, desires for longevity, as well as decreases in time and energy spent on food preparation all factor in to how and what foods older african american women acquire and consume. yet, few of these dynamics are accounted for in traditional, point-in-time food security measurement tools like the hfssm or in analysis that frames income, race, age, gender, and/or presence of coping mechanisms as risk factors for food insecurity. while these indicators can reveal some things about the relationship between aging and food, they do not offer the complexity or socio-cultural nuance of the intersectional approach offered here. we have put everyday food practices, time, and cultural capital at the center of our analysis and suggested alternative ways to understand how these factors intersect to shape african american women’s foodways, whether they are food secure or not. our analysis reveals that older african american women’s food resources are fluid over time. changing access to age-related benefits, like social security, or use of snap can contribute to or lessen food vulnerability, as can changes in physical mobility, access to transportation, and living arrangements. likewise, standard food security measures, like eating less or skipping meals, can also be accounted for by decreased appetite and changing taste buds, which are part of the physical processes of aging. further, we have reconsidered the meanings and purpose of thrifty practices, looking beyond their economic uses and what they might do as buffering mechanisms against food insecurity. while fiscal constraints can and do factor into many seniors’ thrifty practices and likely contribute to their food security, this is a narrow view. examining “thrifty know-how” as a form of gendered cultural capital, makes visible the ways older african american women employ their food expertise and gendered labor to pursue cultural, social, and personal needs, tastes, and desires. here, understanding the role of past experiences, present conditions, and future goals is key. uses of “thrifty know-how” can be demonstrations of self-reliance and ability to care for self and others, especially as economic, social, and physical circumstances change over time. likewise, specific food knowledge, including black food traditions and healthy food practices cultivated in childhood, serves as a resource that older african american women draw on to manage and mitigate the social and health changes that come with aging, as well as meet present-day tastes, and direct their eyes to the future. acknowledgement we are sincerely grateful to the women who graciously participated in this research. they patiently answered our questions and enthusiastically shared their food stories. their humor, hope, and spiritedness helped us think anew about the relationship between aging and food. thanks also goes to several graduate students who supported the research along the way: alexandria boykins, joyce harris, and amanda miller. finally, a debt of gratitude goes to micah trapp and kathryn hicks who provided insightful comments on various drafts of this article and to the anonymous reviewers whose feedback helped strengthen our argument in important ways. notes 1. several additional graduate students assisted on an ad-hoc basis by taking notes at focus groups. http://anthro-age.pitt.edu/ lambert-pennington and pender | . anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.265 http://anthro-age.pitt.edu 107 2. memphis has a population of approximately 653,000. according to american community survey 1-year estimates for 2016, 64% of residents are black/african-american, 25.4% are white, 7% are hispanic, 1.5% are asian (https://datausa.io/profile/geo/memphis-tn/#demographics). references ahmed, tanvir, and nadim haboubi. 2010. “assessment and management of 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wilkerson. 2011. “intersectionality and food studies.” food, culture & society 14(1): 7-28. wolfe, wendy s., edward a. frongillo, and pascale valois. 2003. “understanding the experience of food insecurity by elders suggests ways to improve its measurement.” the journal of nutrition 133(9): 2762-2769. http://anthro-age.pitt.edu/ https://www.fns.usda.gov/pressrelease/2015/020215 https://aspe.hhs.gov/2015-poverty-guidelines zegarra_chiappori_finaldoc zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 59 growing old in the margins in lima, perú magdalena zegarra chiappori university of michigan author contact: mzegarra@umich.edu keywords: old age; care; abandonment; possibility; positionality anthropology & aging, vol 40, no 2 (2019), pp. 60-66 issn 2374-2267 (online) doi 10.5195/aa.2019.234 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 60 growing old in the margins in lima, perú magdalena zegarra chiappori university of michigan author contact: mzegarra@umich.edu “i no longer have any reason to hold on to life. i have lost everything, everybody. every night i pray for god to take me.” as the beautiful summer afternoon faded, mariela confided to me that she was not afraid of death. she was now feeling at ease with the idea that she would die alone, that somebody would find her in her silent bedroom after noticing her absence. i came across this realization several times while i was conducting dissertation fieldwork in la merced shelter, a geriatric institution for the abandoned elderly located in an urban marginal zone of lima, peru. i traveled to lima to study the processes of intimacy, abandonment, and care that the urban elderly poor experienced at this facility, with the purpose of understanding the subjective dimension of growing old in the midst of family abandonment, economic scarcity, and institutional neglect within the peruvian context. peru’s population is aging rapidly under contexts of extreme poverty and deep social disparities. from the 1960s to 1980s, the country witnessed a rapid process of urban migration that relocated rural settlers from the andes to the outskirts of lima. with lima’s rise in population (lobo 1982; matos mar 1984), many migrants ended up working informally given that the formal job market was unable to keep pace with the demands of a rapidly increasing population. throughout the 1980s and 1990s, social and political crises deepened due to hyperinflation, extreme political violence, and corruption. as in much of the rest of latin america, this fragile socio-political order was intensified by the implementation of neoliberal policies aiming to limit state responsibility for social programs (roberts 2012), trapping migrants and lima’s urban poor in insolvency and with limited or no access to pension and social benefits to support them in their old age. in peru, the elderly comprises 10.4% of the total population (inei 2018). there are approximately 1,100 elderly abandoned citizens—both by their families and the state—in the peruvian capital (ortiz 2013), many of whom live in homes for the aged. currently, demographic transitions in peru pose a challenge to its public institutions, while the state is slowly implementing governmental mechanisms in order to satisfy the urgent demands of the elderly’s population. since 2002, the peruvian government has launched multiple proposals aiming to protect the rights to age with dignity of the elderly women and men who have been neglected by the state and their families. however, even after the implementation of social welfare programs designed to improve the elderly’s living conditions, residents of these homes continue to lack the basic capital (bourdieu 1986) to look after themselves— families, money, and health. located in an impoverished district of lima, la merced currently houses 335 elderly adults, who come from the most marginalized sectors of the city. these 335 residents comprise a significant 34% of the total population of abandoned elderly adults in lima, making this shelter the largest institution in the country that helps men and women experiencing social risk in old age. the majority of people who live here do not have active kin ties, as many never married nor have a family of their own. others still preserve family bonds but reside in the facility because their families cannot or do not want to look after them. the plethora of severed kin ties and poor institutional assistance make la merced an emblematic zone of social abandonment (biehl 2005). moreover, representing the many social microcosms of lima, la merced is a prime example of what goffman (1961) called a “total institution,” a place of residence where a large number of like-situated individuals, cut off from the wider society, conduct all their everyday activities. i conducted 22 months of ethnographic research at this geriatric institution. but as days passed and turned zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 61 into weeks and months, i became aware that to determine the significance of growing old in lima under intensive socio-economic inequality and affective deprivation would not be the only challenge i would face as a researcher. a much bigger challenge would be an emotional one. as an anthropologist, how do i position myself in the face of these people’s sense of being forgotten? understanding care: the logics of a contested practice i personally met saturnino on a summer day. i had seen him before a few months ago, when i helped some members of the staff put him in bed, as he was a bed-ridden resident. on that first encounter, his glance struck me; his silent eyes were asking for something nobody was able to hear. the second time i met him, i had been requested by the staff to feed him, as hands were scarce. as spoonful’s of food came and went, i noticed that his wrists were tied to the bed with some kind of “scarves” or cloth ropes that restrained him from movement. (today, i cannot recall what i thought as i discovered his hands tied under his bed sheets.) later that day, i asked one of the nurse aides why saturnino was tied in this way. she told me that it was a security measure; otherwise, he could fall from the bed, rip out his foley catheter, or play with his feces. the woman finished her explanation with conviction: “it is for his own good. i have to take care of him.” recent anthropological research has turned its attention to the role that processes of care play in the midst of moral and political neglect (stevenson 2014; aulino 2016). furthermore, care has been addressed as a multidimensional concept, ranging from everyday practices (twigg 2000), engagements with bio-politics and biomedicine (livingston 2012), moral obligations with kin (leinaweaver 2013), to an ethical practice of empathy and solidarity (kleinman 2009). these multiple epistemologies of care were, in fact, present in my field site. the residents of la merced shared with me that, often times, their notion of “being cared for” differed from what the nurse aide had told me. for many residents, the act of tying the most fragile elders with these cloth ropes to their beds and wheelchairs exemplified that in this institution, attentiveness was a “delicadeza humana que no existe” (a humane and tactful action that was deeply absent). providing care turned even more complicated as materiality and infrastructure were precarious at this setting. i had many conversations with staff members, who told me that lacking the proper resources made it even more difficult to offer quality care for their patients. nurses could not cope with the large workload, which meant they had to accept the fact that they would have to tie up senile, psychiatric, and fragile residents instead of being by their side to prevent them from falling out of bed or ripping out their feeding tubes. i soon came to understand that, at this institution, care was seen as a practice of biopolitical control that had to guarantee the continuity of these people’s bodies. the staff worked under the imperative to rule out—through the use of improvised resources— residents’ chances of hitting their heads, slipping on the floor, becoming aggressive and hurting themselves and others, and so on. care, as understood by the institution, was a form of management and control of residents’ corporality. in fact, in the name of “providing adequate care,” not only residents’ bodies but their lives as well were managed in the facility, as several men and women were forbidden to leave the institution given that they had come to la merced through inabif—a national social program that seeks to provide assistance to homeless older adults—and yet the terms of their stay were not clearly defined. this prevented them from leaving the facility if they wanted, for example, to spend the day out. metaphorically yet inexorably, these individuals’ subjectivities were also tied to the institution—not through their wrists, but through their restricted independence and autonomy. in the name of care, these men and women’s lives and bodies were dismissed. care relations were power relations that, oftentimes, threatened these people’s rights and citizenship as the institution lacked clear-cut protocols detailing the zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 62 duties and responsibilities the staff had. however, precarity of resources and infrastructure are much more complex issues and play a crucial role in understanding the type of care offered at la merced shelter. what if, one day, the institution lacked diapers and pieces of cloth were used instead? did encountering this situation necessarily mean a deficient type of care was being provided? what if, due to a shortage in the month’s budget, getting the necessary supplies to prepare meals for those diagnosed with diabetes was impossible, thus leaving this group of people with no other choice than to eat the regular menu? did this, by all means, imply that the institution was neglecting these people’s needs? the intricacies of my field site revealed that care at this setting cannot be understood as an absolute concept encompassing necessarily attentiveness, connection, access to resources, and well-being. in an extremely unprivileged social world like la merced, care is rather messy, enmeshed in contradictions, full of dissociation and violence, frustration, and neglect. nevertheless, in such contexts of material deprivation, this kind of care is much better than nothing. staff offered care to the limit of their capacity—which meant it was extremely imperfect and contingent upon the restricting political economic circumstances in which it was provided—while residents told me many times they came to the institution because it was the only way they could avoid dying like “street dogs.” being perfectly aware of the material constraints of the social world that surrounded them, what kind of care were these men and women expecting? was there an ideal of the type of care they wanted to be provided with? actually, i found there was. as my informal conversations with many residents showed me, a group of them felt completely forgotten and abandoned, as if the social world had turned its back on them. for them, there was a deep yearning of cariño—affection, in english. but, authentic affection. most of them—understandably—condemned the fact that when cameras visited the institution, staff and institutional members spent the day hugging and kissing residents—especially those most vulnerable—so these images could circulate on social media. in fact, when important visitors came to the institution, residents were “suggested” or “advised” by staff to let visitors know that in la merced, they were treated “con mucho cariño” (in a very loving way). cameras, later, make sure to capture this circulation of affection. as i witnessed many of these interactions, i could not help but think that care at my field site was politicized. there was a clear mandate of what dimensions of social life in the shelter should be visible, such as nurses staring fixedly at and smiling at residents in wheelchairs, groups of older adults dancing to the latest hits, and people playing with balloons while being entertained, and what should not be visible, such as bed-ridden resident’s stunted feet, dilapidated rooms, and senile men and women tired of monotony and being disoriented. if elders strongly rejected cariño under these premises, what were they really looking for? how did they want to be taken care of? what did cariño mean for them? the answer to this enquiry came from andrés, an 80-year-old man, whose lucidity and wisdom i admired since our initial conversations. “we want affection,” he told me once. he stated, we sure do. but for true affection to take place it is imperative that the staff first respects us. we want affection, but we also want more. we want respeto. we want to be taken care of with respect. they don’t have to love us; we are strangers to them. but they have to respect us because we are persons with rights and dignity. and once you respect somebody, maybe there is a chance that affection can flourish. if you respect somebody and you feel affection for them then you feed your patients with patience, you call them by their name and not by the number of their room, you take care of their wounds with attentiveness, and you provide them with the medication they need if you have access to it. it became clear to me, that at this site, people were eager for a comprehensive kind of care. care encompassed not only an engagement with biomedicine, but also an urge to satisfy material, emotional, and citizenship needs. to be cared for was these people’s right and not a mere act of benevolence and zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 63 compassion that the institution had towards them. to be cared for was to be visible to others, to stop living in the margins, and to regain a voice even in the wake of insufficiency of resources. “todavía podemos”: possibility and the remaining of the self as my fieldwork progressed in la merced, i could not help but ask myself how socially abandoned these people were, by whom and, ultimately, what it meant for them to live on the margins. throughout those 22 months of conversations and observations, i witnessed many occasions in which people were invisible, muted and neglected—although generalizations cannot be made about my field site and a few times people were treated with some level of consideration. during the first months of my work, i witnessed and heard the stories of many individuals who felt banished from the social world. however, as days turned into weeks and weeks into months, i encountered that, in the face of poor institutional assistance and family loss, some elderly women and men continued to defy the contingencies to which their everyday lives were subjected. did they still hold chances to be heard? what sustained their everyday lives while being aware they were growing old and dying surrounded by absence? could they rework their circumstances and feel they could still take refuge in life? in august, i started participating in the cooking workshops occupational therapy offered to the residents. one winter afternoon, i decided to join them in the preparation of causa de papa, a typical peruvian dish. it was three o’clock and people started gathering at the door of the facility. once inside, the others and i were given different responsibilities: mash the potatoes, cut the avocados, peel the eggs, or squeeze the lemons. as i was working silently in my corner of the room, i noticed that the facility was in a great level of material deterioration. peeled walls painted in hospital green, broken tables, improvised chairs, and wrecked floors were part of the dilapidated scenario in which we were trying to pursue, in a way, a kind of miracle. we did not have basic cooking supplies such as, sharp knives, an electronic mixer, scissors, or a strong potato press, and so we were left with no other choice but to improvise with our hands and with what we had at that very moment. i was a bit skeptical we would succeed in cooking the dish successfully. however, i was mistaken. we did not only prepare the causa de papa together, but the dish turned out to be delicious. as the evening was coming to an end, señora juana expressed with wisdom what the task had been about, “es lindo ver que todavía podemos”: it is rewarding to see that we still can. for me, witnessing how these people created and carved out their present in the midst of precarity and in the absence of basic material resources was revealing and comforting. the world in which these people’s everyday lives were taking place had been reinvented as they succeeded in making their will tangible— through laughs, with complicity, and by being a community. their goal was not extraordinary but rather quotidian: to cook together, to have a nice time, and to share the meal. as i recall the experience today, i am still amazed by the fact that these individuals recreated their restricting circumstances, and in that process, they also re-signified their own social world. that day, as we were cooking, possibility opened, just as the sun paved the way later that windy winter afternoon. my fieldwork is full of experiences of people maneuvering and enduring their lives’ circumstances, of people striving for possibility: andrés crafting bijouterie necklaces in order to sell them, so he can provide himself with money to buy the supplies for personal hygiene la merced cannot afford to give him, señor juan struggling to get batteries for his 1980s radio so he can listen to the huaynos of his beloved cajamarca as he cannot return to his hometown, clara’s persistence in sewing her clothes, although she is losing her sight quickly due to limited access to health care in the past. and let us not forget about filomena’s determination—even after being diagnosed with dementia—to clean her mouth as food left zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 64 overs stain her face in a facility where personnel are scarce due to budget cutbacks. all of these acts—vital acts—are subtle ways to remain in the here and now. they are affirmations of the self, processes that, if i am correct, allow these women and men to bear the unbearable—time, death, loneliness, loss, and illness. in small acts like these—maybe trivial at first sight—lies the persistent desire and the powerful will to continue, throughout time and space, being oneself and to find meaning in later life. in places like la merced, i believe people need to hold on to something in the face of an institutional and systematic oblivion that often renders them as invisible, frail, and as ex-humans. the examples of clara, filomena, and many others are a clear metaphor for how people on the margins are resisting political-economic arrangements that limit them in their quest for well-being, health, or quality of life. many of these subtle but vital acts are beyond language. many of these subtle but vital acts do not need language. decrepit bodies, existences commonly thought of as “absent” or “lost” communicate their persistence in the world at this zone of social abandonment, even if this is not intentional. i keep thinking about the fragile corporality of some of these older adults’ bodies, their toes devoured by aggressive nail fungi; numb feet dreadfully tangled with one another; and consumed, cadaverous bodies that, at some point, resemble mummies that obstinately hold on to life. one cannot help to think of these individuals as dead alive, absent, disoriented, and with no possibility of word. bones and flesh. this is what i first thought when i encountered residents in these conditions. although, as i said, bodies in these circumstances continue to hold on to life. as the days went by, i assisted jimena, the physical therapist, in massaging and stretching the limbs of women and men who quietly lied on their beds in a fetal position. smoothly, she started every session by stretching arms and legs. the exercise was repetitive, often with no response. at some point, however, the dynamics of the interaction changed, and these bodies started to respond to the stimuli. jimena stretched, touched, and mobilized their bodies. people groaned, opened their eyes abruptly, and tightened their muscles as a strong rejection to the pain they were experiencing. words were absent but the message was clear: refusal to be touched. anchoring in the present by expressing pain and discomfort happened not through language, but through the body—no words, just gestures. on many occasions, i asked myself if persons commonly thought of as “disconnected” from reality were actually “present” or not. with time, i realized that i will never be certain under the language-centered parameters and the ideals of economic productivity we live in. without spoken language, it is a real challenge to access these people’s subjectivities, thoughts, and feelings. if one does not contribute to capital, it is difficult (or really easy) to determine this person’s worth as a social being. as old people under these circumstances often times appear to be “gone,” what is needed, i believe, is to start thinking in different ways of being in the world that are not only circumscribed to words, to being “aware,” and to generating economic growth. our possibilities of being acknowledged by others cannot rest, fundamentally, on how articulated we think, speak, or sound; on how rooted we are in time and space; and on how much we contribute to capital. recent anthropological studies have shown that aging is a multidimensional phenomenon, rather than a stable experience (kaufman 1986; lock 1993). can we venture to rethink what being in the world and being fully human means in the same fashion? if we try to, what possibilities would we find to better map people’s subjectivities? a note on positionality: emotional challenges of feeling fieldwork fieldwork for me has been an ambivalent experience, which has given me the opportunity to be touched by the lives of others. my field site has been a place where i have found myself immersed in the suffering and pain of the people that i have come to study. because of this, i have felt sad and helpless more than once. how do you position yourself in front of the constraining life circumstances of those you work with? how are you able to grasp what really matters to them and, above all, why they should matter to us? zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 65 how do you do research, observe, analyze, and interpret reality in contexts where people feel loneliness as a heavy burden and even death is seen as a deeply desired outcome? after 22 months of deep ethnographic fieldwork, i do not hold the answer to these questions. i have learned, however, that being with people— even in silence— and that listening to what they urge to say is, probably for now, my best contribution. i believe that relying on emotion and not only on rationality is pivotal when trying to navigate the complicated social worlds others inhabit. today, as i move closer to the end of my field stay, i am more aware of what it means to be moved by others. fieldwork is not only about gathering information about cultural practices or about understanding the meaning of these particular practices (although this is certainly core to our discipline). fieldwork, i believe, is also about being able to feel the other; to empathize with people who are, sometimes, radically different from us. in other words, to be able to put yourself in the shoes of somebody who inhabits the world differently than you do. this entails great challenges. throughout my fieldwork, i have grown attached to different women and men from this institution. i have had the opportunity to be close to them when they have been forced to face deep family crises, loss of autonomy, serious illness, everyday suffering, and even death. it has been overwhelming, it has been difficult, and it has been heartbreaking. frequently, feeling my fieldwork has been emotionally draining and painful. the unfathomable need of many older adults for human affection and touch, some days, felt like a hardship that weighed heavily on me. ultimately, is there anything i can do for them to contribute to their emotional and material well-being? as an anthropologist, am i expected do something? what about as a human being? i have realized that i cannot fight a system that pervasively perpetuates inequality and marginality by myself. the limited quality of life that these people experience is a result of unequal political economic arrangements that constrain their agency, autonomy, and their rights and freedom. i have found that i can listen to people’s troubles and concerns, but i cannot change the system that perpetuates their malaise. people have told me that they are not afraid of death. their ultimate fear, however, is to die in the conditions under which most residents pass away in this institution: alone, abandoned, and in pain and discomfort. i have sat many afternoons with residents listening to how dying in these circumstances troubles them. but at the end of the day, both of us know that their reality is not going to change anytime soon. despite their reluctance to die under these circumstances, of how much this enrages them, and they resist it, they know—and i know—this is the way things will happen. doing fieldwork in these circumstances is debilitating and frustrating. this has been one of the biggest emotional challenges that i have endured in my fieldwork. but, as i said, fieldwork has been an ambivalent experience. although i have felt on many occasions powerless in front of people’s everyday struggles, the relationships i have forged during these months have given me the strength to carry out my work despite encountering limiting situations. as a peruvian, as an anthropologist, and as a human being, my fieldwork has had a transformative effect on me. it has been a decisive encounter with my nation’s social reality outside of my middle class enclave. in the face of these individuals’ inevitable destinies, i have received their life stories as generous and openhearted gifts. i have witnessed how these older adults, despite circumscribed to constraining life circumstances, hold on to their lives by striving to remain human and worthy of engagement even when being divested of everything that society considers makes us count as valuable, productive, and rational individuals: memory, autonomy, independence, economic possibility, social networks, family and affection, etc. the day is approaching when i will leave the field and return to my own comfortable life in an anthropology graduate program in one of the most affluent countries of the globe. the people i have met will stay in la merced. they will age there and will eventually die there. i will probably not be close when they navigate these transitions and this is something that still troubles me. despite the fact that my path and theirs will branch off, i am certain that the care, preoccupation, gratitude, and affection that flourished between us will endure in me through distance and time. and this zegarra chiappori | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.234 http://anthro-age.pitt.edu 66 gratitude, this affection is now shaping as the main motivation that encourages me to actively and politically engage in ways and procedures that can improve their quality of life. the personal stories of endurance and resilience kindly shared with me speak of determined, courageous women and men who, against all odds at 69, 65, 83, even 92 years old, continue to move on, to persist in the world, and to maneuver eventualities. i have learned this from them. and i know i will need time to make sense of it. the challenge now is to make justice of those words, of those conversations, of those ways of being in the world to the best of my ability, never forgetting that i can merely get close to their experience dimly, posing only the option of a narrow interpretation. maybe to do them justice and to unravel their pain, their joy, and their everyday, i have to embrace the position of a vulnerable witness. feeling and understanding: complementary movements in the processes of untwining the life-worlds of others and acknowledging the significance of these people’s lives without romanticizing their vulnerability. references aulino, felicity. 2016. “rituals of care for the elderly in northern thailand: merit, morality, and the everyday of long-term care.” american ethnologist 43 (1): 91-102. biehl, joao. 2005. vita: life in a zone of social abandonment. berkeley: university of california press. bordieu, pierre. 1986. “the forms of capital.” in handbook of theory and research for the sociology of education, edited by john g. richardson. new york: greenwood. goffman, erving. 1961. asylums. essays on the social situation of mental patients and other inmates. new york: anchor books. instituto nacional de estadística e informática (inei). 2018. situación de la población adulta mayor: enero-febrero-marzo 2018. [accessed january 23, 2019]. https://www.inei.gob.pe/media/menurecursivo/boletines/01-informe-tecnico-n02_adulto_enefeb_mar2018.pdf. kaufman, sharon. 1986. the ageless self. sources of meaning in late life. madison: university of wisconsin press. kleinman, arthur. 2009. “caregiving: the odyssey of becoming more human.” the lancet 373(9660): 292-293 leinaweaver, jessaca. 2013. “toward an anthropology of ingratitude: notes from andean kinship.” comparative studies in society and history 55(3): 554-578. livingston, julie. 2012. improvising medicine. an african oncology ward in an emerging cancer epidemic. durham: duke university press. lobo, susan. 1982. a house of my own: social organization in the squatter settlements of lima, perú. tucson: university of arizona press. lock, margaret. 1993. “cultivating the body: anthropology and epistemologies of bodily practices and knowledge”. annual review of anthropology. 22: 133-155. matos mar, josé. 1984. desborde popular y crisis del estado: el nuevo rostro del perú. lima: instituto de estudios peruanos. ortíz, diego. 2013. “a dignified life: getting homeless seniors off the streets of lima.” peru this week. may. [accessed august 13, 2016]. http://www.peruthisweek.com/blogs-dignified-life-getting-homeless-seniorsoff-the-streets-of-lima-60128. roberts, elizabeth. 2012. god´s laboratory: assisted reproduction in the andes. berkeley: university of california press. stevenson, lisa. 2014. life beside itself. imagining care in the canadian artic. berkeley: university of california university press. twigg, julia. 2000. bathing, the body, and community care. new york: routledge. anthropology & aging quarterly 2013: 34 (2) 170 introduction i found just the place for me…even though one doesn’t accomplish great things. but we know what we want. we chose this…we aren’t going to give in to power, staying home. it’s good for us to be out in the street, doing something, awakening the recognition of folks. it’s tied to the solidarity of others with you… it comes from my father and sharing a plate of food, and the neighbours…you are shouting for all that you’ve lived, all that. it’s not disconnected from that. others say that we don’t accomplish anything…. it’s about feeling good doing something. i’m proud to be president of a senior center where today, when it was 3 degrees below zero [celsius], there were seven compañeros collecting signatures… and it’s more than the cold numbers; that’s 450 people [who signed] expressing solidarity. it’s a commitment to solidarity, despite this trashy society we live in. solidarity is the only thing that is going to save us… this morning we were cold, we were standing there… but it’s activist pensioners, a contradiction in terms? argentina’s jubilados lindsay dubois department of sociology and social anthropology dalhousie university comforting. we aren’t too humble to recognize that we have done excellent work. it’s still possible to rebuild solidarity. that’s what we’re hoping. we know we are fighting for human dignity. – hector anzorena, retired waiter, activist pensioner hector anzorena spoke these words in an interview in buenos aires in 2002 by way of explanation. he was trying to convey how and why he came to be so engaged in the work of the activist pensioners (called the jubilados) who are the focus of this article. the surprising thing is that he was not talking about a group of twenty-somethings standing on the street corner collecting signatures, but of older people, in their sixties, seventies and eighties. hector, for example, was born in 1930, so he would have been 72 as he stood in the cold cajoling passers-by to acts of solidarity. abstract why does it seem unlikely that retirees should be political activists? what does that reaction say about our understandings of retirement and of activism? this article examines the experience of a group of older activists who, among other things, rally weekly in front of the national congress in buenos aires, argentina, and have done so for more than two decades. regardless of advanced age and infirmity, these men and women, some in their eighties and nineties, refuse to be defined as passive by their roles as retirees and grandparents. after examining some of the tensions embodied in the idea of activist pensioners, this article proceeds to look at the pensioners’ own understandings of where their activism comes from and what sustains it. situating the pensioners’ struggle in broader historical processes in argentina illuminates their motives and strategies. the article thus also demonstrates that a historical approach provides a productive strategy for analysing elder social movements. key words: activism, ageism, argentina, pensioners, social movements silver linings: older people defying expectations anthropology & aging quarterly 2013: 34 (2) 171 lindsay dubois activist pensioners, a contradiction in terms?  old age is supposed to be a life stage in which the passions of youth have been tempered by time and experience. yet the women and men who are the subjects of this article continue to protest in the street, rallying weekly in front of the argentine congress in downtown buenos aires. this article considers the sense of the unexpected that the phrase “activist pensioners” evokes. why does it have the air of the oxymoron? what does this tension between “activist” and “pensioner” say about the social position of the aged? notwithstanding the particularities of the argentine case, examining the tensions entailed in the idea of activist pensioners illuminates not only the situation of activists but also the place of pensioners and older people more generally in similar societies. the article goes on to consider the pensioners’ own explanations of their activism and its sources. throughout i take a historical approach, reading the personal experiences of particular activists in the context of larger political historical processes.  judging by the literature, one might imagine that old age and activism are indeed contradictory states. general searches under these and related key terms turn up very little.1 among the notable exceptions are roger sanjek’s gray panthers (2009) which describes the history of the american activist organization by that name. the gray panthers and sanjek’s treatment of them provide an interesting point of comparison for the activists i discuss here. they are similarly contentious. they do not see theirs as a service organization, but rather enter political debate from a generational perspective, dealing with senior’s issues – such as nursing homes, mandatory retirement, and health care – but by no means limiting themselves to them.2 another well-known north american group is the raging grannies. the grannies (organized into local gaggles) deploy their age and their gender in critical political street theatre, mainly as peace activists, but they do not take the issues of the elderly as their focus (sawchuk 2013).  the scanty literature raises the question of whether older people are in fact rarely engaged in activism or, alternatively, whether their activism is underappreciated. both phenomena are probably at play. in most times and places activists are surely in the minority. perhaps this is reason enough that studies of activist elders seem to be few and far between. yet the jubilados felt themselves to be not just unusual amongst their peers, but also overlooked. they struggled with the problem of recognition (see fraser 2000). ideas about how older people should (and do) behave shape both what people are likely to do and how their behaviour is understood and reported. a thoughtful reflection by meredith minkler and martha holstein (2008) notes the political impact of the type of engagement deemed suitable for older people. minkler and holstein discuss dominant paradigms about the place of older people in the us, canada and the uk, decrying the shift from “civil rights” to “civic engagement.” interestingly, they describe themselves as having entered the field of gerontology partly because they were drawn by people like gray panthers founder maggie kuhn. as we see it… the vision of civic engagement that proponents put forward is essentially a de-politicized strategy to encourage, facilitate, and normalize community participation in old age. it does not call for analysis, critique, or change in the social and political assumptions and consequent political agendas that now prevail in much of the industrialized west, which have the potential to harm the less advantaged members of this and subsequent cohorts. what then is the resemblance to the heady – and highly politicized – early days of the gray panthers, let alone the townsend movement, civil rights and the women’s movement photo credit: mary gaudet anthropology & aging quarterly 2013: 34 (2) 172 lindsay dubois activist pensioners, a contradiction in terms? to which it is sometimes compared? (minkler and hosltein 2008:197)  in other words, the narrowly conceived civic engagement model fits neatly with the agendas of nation-states seeking to reduce their social welfare roles, placing responsibility on individuals to pick up the slack. the emphasis is on activity, but not activism in its overtly political sense. the political projects of groups like the gray panthers and the jubilados are not what those touting “active aging” have in mind. the research the research discussed here was conducted in buenos aires primarily between september 2001 and june 2002, with supplementary bouts of fieldwork in 2003 and 2006, (and occasional subsequent conversations). the timing is significant. the main fieldwork began at the close of a decade of increasing economic hardship in argentina. the economic crash of 2001 led to a dramatic upsurge in popular mobilization, especially in buenos aires, where pensioners joined crowds of people banging on pots in protest. this context often strongly shaped discussions, interactions and how the pensioners understood their struggle.  conceived as an oral history project, the research centered on life history interviews and a history workshop conducted in one the movement’s allied senior centers. it also involved participation in the weekly pensioner’s protest marches, attendance at talks, and study of the various official statements made by the pensioners’ organization –press releases, flyers, occasional newspapers, and (later) blogs. the life history interviews were conducted with thirty-one people who participated actively in the jubilados’ movement or its allied center.3 these interviews were usually conducted in one or two sessions. they ranged from twenty minutes on a street corner, to seven hours over three meetings. interviews took place in locations preferred by the pensioners, often cafes, but also in people’s apartments, the offices of the retirees’ organization with which i worked, or a senior’s center.  my central concern in these interviews was the question of where activism comes from. yet this question was framed as broadly as possible and placed in the context of life history. for example, interviews usually began with the question, “when and where were you born?” many people answered this question by describing their parents, often noting where their parents came from if they were first generation argentines (as many were). descriptions of childhood often followed. i was interested in how different jubilados framed their lives, noting the ways in which these accounts were structured. i read these differences as saying something about people’s public personas, or perhaps the personas they wanted to present to me in particular. women were more likely than men, for example, to discuss their family obligations, and to structure their accounts around domestic events like marriage and the birth of children. by contrast, for some men, i had to pointedly ask if they had ever been married before i learned anything about their domestic lives. some told their life stories through an account of the different labour unions they had belonged to. luciano,4 for one, portrayed himself as a scrapper by focusing on the different labour conflicts of which he had been a part, with particular emphasis on moments when physical violence was involved, either within unions or between workers and police or military. photo credit: mary gaudet anthropology & aging quarterly 2013: 34 (2) 173 lindsay dubois activist pensioners, a contradiction in terms?  whereas the life histories were narrated to and for the interviewer, the history workshop saw jubilados speaking to each other; different kinds of conversations resulted. when i began this research, i asked people at the main group organizing the seniors, the coordinating committee of argentine retirees and pensioners (the mesa coordinadora de jubilados y pensionados de la república argentina, known as the mesa), if they knew of a senior’s center which might host a history workshop. someone pointed me in hector anzorena’s direction. he invited me to meet people at the abasto-once senior’s center (centro de jubilados y pensionados abasto-once, known simply as abasto-once, after the neighbourhoods near which it is located) where he was then president.5 as the quote from hector at the beginning of this article attests, members of this center tried to engage people in political discussion about the pensioners’ plight. over three months, a small group of between three and seven jubilados met late friday afternoons to drink tea and mate cocido (an argentine beverage, prepared like tea), nibble on cookies, and discuss the past, present and future. some workshop meetings were discussion based; some focused on a life stage such as childhood, others considered the broad historical sweep of the the history through which the jubilados had lived, still others addressed the history of the jubilados’ movement. the workshop attempted to make a video about the jubilados’ struggle. although the video never happened for financial and logistical reasons, the planning process focused the group’s discussion on questions of how the political struggle should be portrayed and to what ends.  before proceeding to describe the jubilados, a note on terminology is in order. i call the elder activists who are the focus of this work “jubilados” using the spanish term for retiree. this is the term most of the people i spoke to used to describe themselves. coming from júbilo meaning joy, the word has a positive connotation noted with a heavy dose of irony by many jubilados. the mesa, as noted above, is formally called the mesa coordinadora de jubilados y pensionados de la república argentina, to cover both the class of people that we think of as “pensioners” in english (that is people who have retirement benefits resulting from their work) and those receiving other kinds of state payments. for example, war veterans and the disabled are two groups of argentines receiving pensions. several individuals i met in the course of this research pointed out that they were not properly jubilados, because they had not retired from a job that paid pension benefits. nonetheless, the common term for the group was the jubilados which was also the title of their semi-regular newspaper. thus i use this term in spanish to refer to the activist pensioners in this article using upper case to refer to the group and lower case to refer to members. note also that “jubilada” is the feminine form. the jubilados and their historical context the elders who are our focus are by no means typical pensioners. for more than 1100 consecutive wednesdays they have protested at 3 p.m. in front of the argentine national congress in downtown buenos aires. these weekly rallies began in 1990, moving to their current location in 1992 and continuing to the time of writing. at the rallies, a series of speakers, mostly from the mesa but including visitors, address the crowd from the back of a small truck. they speak to the issues of central concern to the elderly, especially pensions and health care, but also take up many other questions about which they have strong views, including both national and international political debates. over the last decade the rallies have tended to be relatively small, involving as few as forty jubilados and supporters. at their peak in the 1990s, however, they sometimes included thousands. photographs from that period show aged protesters confronting police in riot gear.  although a social movements approach to the jubilados might focus on their common identity and their common plight in the present and leave it at that, it is instructive to approach the group historically. as the jubilados themselves often argue (and as discussed below), their struggle needs to be understood as a consequence of historical processes. it is very much shaped by the history of argentina in the 20th century. in a chapter on how we should think about individuals, philip abrams (1982) argues that the concept of generation for historical sociology differs from that of common sense. rather than depending on biological reproduction, generation has to do with the historical conditions, especially socialstructural ones, that characterize everyday life.6 thus, just as in certain periods with little social change a generation could last one hundred years or more, in others, where social change is more rapid, generations describe much shorter intervals. the jubilados constitute a generation in this sense, marked by crucial socio-historical processes and arrangements in argentina. most of those i spoke with were working-class people born before 1930, so their historical experience positions them as observers of the rather dizzying argentine political scene stretching from childhoods before the advent of peronism, through the peronist decade, dictatorship, democracy, industrialization and deindustrialization, as well as boom and bust several times over. as one jubilada in the history workshop put it, “it’s a very rich and contradictory history.” jubilados anthropology & aging quarterly 2013: 34 (2) 174 lindsay dubois activist pensioners, a contradiction in terms? note that these political and economic changes have been accompanied by social and cultural ones.  the generation under discussion is the first to have entered the workforce with a reasonable expectation of receiving a pension. before juan domingo perón came to power in 1946 a small number of workers received pensions, but it was peronism, harnessing argentina’s post-war economic boom, that built its modern welfare state.7 perón’s government was also the architect of the peculiar argentine healthcare system, described further below. perón was removed from office in a 1955 coup. much of the rest of the century, one might argue, saw leaders – both military and elected – trying to undo the kind of state which perón had made. this unmaking process was most violent in the last dictatorship (1976-1982), but it was also very much a project of the government of carlos menem (1989-1999) (grugel and riggirozzi 2007). for example, president menem earned special recognition from the world bank and international monetary fund for the effectiveness of structural adjustment policies he was implementing (also widely described as neoliberal policies). menem oversaw the widespread privatization of state enterprises and institutions, cut back state spending, and further opened the country to foreign investment. it was menem who tried to privatize all state pensions. meeting with considerable resistance, this plan was altered to an optional one designed to encourage people to move out of the state pension system.  the dire situation of the pensioners became a public issue in the early 1990s, illustrating the human cost of the economic model. the press reported a wave of suicides, apparently a consequence of the despair seniors felt at the prospect of trying to survive on meagre pensions which had fallen far behind inflation. at that time in the early 1990s, pensions covered about 12% of the cost of living (lloyd-sherlock 1997:65). pensioners could not feed themselves, much less pay for rent or medication. if you mention the jubilados to people old enough to remember the early 1990s, the image that comes to mind is an incident which dramatized the jubilados’ struggle. ailing pensioner norma pla confronted the architect of the neoliberal economic model, minister of the economy domingo cavallo. the cameras were rolling when she brought cavallo to tears by berating him about the plight of the country’s seniors (zommer 1996).8  in addition to the level and timeliness of pension payments, healthcare is the jubilados’ other key issue. in order to understand the particular institutional importance of healthcare to the pensioners, the peculiar structure of the argentine healthcare system – a material legacy of peronism – warrants some explanation. one of the ways perón expanded working class rights, on one hand, and consolidated working class support and control on the other, was through the obras sociales [literally “social works”, actually benefits and services]. a broad range of social services and benefits, including health care, were distributed through the massive labour unions via obras sociales. peronist argentina used unions to organize argentine society by including virtually all workers in unions organized by profession (for example, as a waiter hector was unionized) (rock 1987: 263). the system, though, was designed to incorporate people via their work, including dependent children, but leaving retirees uncovered. pami9 was created to fill the gap, providing health care and other benefits to pensioners and other seniors. pami covers millions of argentines, primarily jubilados, and is the largest health plan in latin america. like the pension funds, pami’s enormous budget which the national government administers presents an attractive way to adjust public accounts in economic hard times.  pami then, although ostensibly available to all pensioners, has not always provided the health care it promises. particularly during the 1990s and the early 2000s, there were periods when pami was in arrears in its payments to doctors, hospitals or pharmacies. as a consequence, health services to seniors were often dramatically reduced or curtailed altogether, sometime for months at a time. likewise, medicines were sometimes available free of charge, while at other times unavailable. a third problem which seniors experience with pami is the elaborate bureaucratic complexity which, to an outsider, almost appears designed to discourage potential users. in order to renew a prescription, for example, a senior often had to go to her general practitioner, to the pami offices and then to the pharmacy, sometimes waiting for hours at one or more of these locations. it was quite common for people to go to hospital clinics at six in the morning in order to be in the queue when staff arrived at 8:30 in order to get an appointment to see a doctor later in the day. one then had to line up again to actually see the doctor. people sometimes joked that you needed to be retired to have the time necessary to receive pami health services. the overall experience was of a health care system that was uneven, unreliable and demanding.  considerable public support led to some material progress for pensioners by 2001, when i began to work with them. however, this was a moment in which the argentine economy was moving towards its spectacular crash. the events of december 2001 included the largest national default in history (up to that time). this, in turn, led to an upsurge in popular mobilization. pensioners joined large protests of people banging pots, and attacking bank offices anthropology & aging quarterly 2013: 34 (2) 175 lindsay dubois activist pensioners, a contradiction in terms? and automatic tellers. there were also widely publicized lootings in december, and massive mobilizations of the unemployed which often blocked major highways (vilas 2006). five interim presidents and two years later, nestor kirchner, a peronist, was elected in 2003. he and cristina fernández de kirchner who succeeded him (she was his political partner and wife) reoriented social and economic policy. since the change in economic models, the state has considerably expanded its welfare functions, extending pensions to large segments of the population. anses, the newly nationalized pension agency, extended pension coverage to an additional 2.3 million argentines bringing the total number of pensioners to 5.6 million in 2010, expanding coverage from 57% of seniors in 2003 to 88% by 2010 (cufré 2010; bossio & boudo 2010). the government has also indexed pensions to inflation. this is another boon to jubilados who have often found gains won through struggle evaporate again as the peso lost value. anecdotal evidence suggests that health care has also improved, although this is harder to measure. the jubilados today although the jubilados say they are pleased with these gains, they also eschew asistencialismo, (welfare-type social assistance) which they believe undermines their rights as former workers. instead, the mesa has insisted that the original terms and conditions of their pension plans be honoured. the organization continues to focus on increasing the pay level of pensions, and specifically on a longstanding demand to set pension scales at 82% of current salaries of the same job and rank, as specified by law. the jubilados contend that they have historically and unfairly been “a variable in structural adjustment” equations [una variable del ajuste] (de la sota 2008) since both their pension plan and their state-administered health care plan are large funds that the state can dip into for other purposes (and scholars agree, see dantz 2012).  a 2008 letter to the editor of la nación, the most elite of the national newspapers, captures the sense of grievance: after all this time i have realized that the pensioners’ problems are only of interest to pensioners, and often not even to them, because they are already defeated, full of suffering; it seems as if they just wait for the only thing that is certain in this life: moving on to eternity. today, as always, they are mistreated, even by their own families. so why should we imagine that journalists would pay attention to us? that the government should help us? we have always been the variable in [structural] adjustment and we never realized that we were pensioners; we always wanted to avoid talking about it. why talk about my pension if i’m still young? and the years pass and those who make it have to suffer the consequences of being “old”. who will pay attention to us? if we are not productive [working], we are only an expense in their budget line. to understand all this you only have to look at our daily lives. who gives a seat to an older person (now very few)? have you seen how they are treated in the lines at the bank? have you seen how they are treated in hospitals? the only moment in which we are more or less important is at election time, where the politicians tear their clothing to fight for our rights. it is very difficult for a country to have a future if it doesn’t respect its elders. is that why we are in the state we’re in? god willing, today’s young people at some point will really think about the future and not forget that then they too will be older people. [de la sota 2008] this writer calls out not just the government and the press, but also argentines in general. for him, the policy problems are an effect of the larger invisibility of the aged. like this letter writer, the jubilados see ageism as one of the underlying causes of their economic plight.  the jubilados are socially positioned so as to make their activism appear unlikely in at least three ways. first, they are not workers. second, and related to the first, they are thought to be passive. third, ageism means they are thought to be different from, even less than, those who are not old. the first of these, that pensioners are not workers, is especially important in the argentine context. as the explanation of obras sociales above suggests, one effect of peronism was to make work a powerful organizing principle for the society as a whole (karush & chamosa 2010). this is partly because peronism mobilized labor, making labor unions key players on the political scene. in addition, the obras sociales further enlarged the role of unions in the everyday lives of working-class people. in argentina, retirees are defined as part of the “passive class” (la clase pasiva), and are explicitly contrasted to those currently working who are described as “en actividad.” in other words, work is closely tied to activity.  in a complex and nuanced analysis of the changing connotations of “dependency” as a key word in political culture in united states, nancy fraser and linda gordon (1994) show how the idea of dependency shifts to become more negative, and to be increasingly read in the “moral/ psychological register” (1994:332) as an individual failing. they connect this process to the stigmatization of welfare recipients, and especially the emblematic recipient of social assistance, the welfare mom. likewise in argentina, receiving social assistance marks one as needy and dependant, which is understood to be negative.10 within this larger constellation of ideas, children and old people are quite often seen as “the deserving poor” (will 1993); anthropology & aging quarterly 2013: 34 (2) 176 lindsay dubois activist pensioners, a contradiction in terms? that is, as legitimately needy. that legitimacy is tied to an understanding that children and the elderly should be protected and cannot be expected to fend for themselves. fraser and gordon note that the problem with this sort of reasoning is not so much that some groups are seen as dependent, but rather, that independence is assumed to be an unmitigated good, a virtue. seeing senior citizens as the deserving poor often goes hand in hand with seeing them as less capable, as recipients rather than agents.  it is this view of senior poverty that norma pla’s exchange with minister cavallo (described above) evoked. it is a view of neediness that presumes passivity.11 given that norma pla was something of a folk hero, i was a bit surprised by the degree to which leaders of the jubilados movement were uncomfortable in talking about norma pla and hesitant to celebrate her. on reflection, it seems their reaction was partly a response to the way her message played up the pathos of pensioner’s situations, pulling on the heart strings, rather than calling for the recognition of rights and entitlements.  it is worth noting that children and the aged have been the focus of the dramatic poverty reduction policies advanced by the kirchners in argentina since the crash. the state’s strategy has effectively reduced extreme poverty in the country. yet the jubilados are not satisfied. the increased spending has focused on incorporating many more people and raising minimum pension payments in the context of inflation. this strategy has the effect of converting the pension system into a form of social assistance. when jubilados criticize asistencialismo, they are making precisely this distinction. the activist jubilados see their pensions as deferred wages. they do not seek hand-outs; they want their due as workers.12 ageism aligns with these notions of neediness and passivity. older people are supposed to lack the energy and imagination for activism.13 they are also thought to be rigid and isolated, except perhaps for family. organizing argentine pensioners as the jubilados i worked with often noted, only a tiny proportion of pensioners participated in their movement, raising questions about the degree to which older argentines are organized and in what forms14. a helpful study (fassio & golpe 1999) surveyed formal seniors’ organizations in buenos aires in 1998. the study underlines the diverse ways in which older people were in fact creating spaces of solidarity and social interaction, notwithstanding “the dense proliferation of contemporary ageism” (1999:73) and alienation which the authors observed in argentine society. for fassio and golpe, the variety of elders’ organizations offer up spaces, “with identity, with history and the possibility of social relations” (1999:73). furthermore such spaces “not only optimize the objective living conditions of the aged, but invigorate their self-organizing capacity in the fight for rights for one of the most vulnerable social groups” (1999:73-4).  of particular interest is their analysis of the type of organizations in which older people are involved (see table 1).  of 854 organizations in the city of buenos aires15 which were registered with either the city or the national governments, the vast majority (84.6%, or 723) were recreational. most of the others were evenly divided between religious (4.6% or 39), political (4.2% or 36) and work related (3.8% or 32)16 (fassio & golpe 1999:81). only eight organizations fall under the category “representative associations.” this would include the mesa as one of the groups which organize and represent local groups such as seniors’ centers.  the mesa was founded in 1968, partly around the health care problem outlined above: the system was organized around labour unions such that workers and their families lost their coverage upon retirement of the unionized worker. the wednesday rallies organized by the mesa have been the public face of the pensioners’ movement since the 1990s. their other activities include: lobbying, table 1: distribution of older people’s organizations in the city of buenos aires by number and percentage (fassio & golpe 1999: 81). type of group number % recreational 723 84.6 religious 39 4.6 political 36 4.2 work related 32 3.8 representative associations 8 0.9 programs 7 0.8 ethnic groups 4 0.5 rights groups 3 0.4 mutual benefit society 1 0.1 unclear 1 0.1 total 854 100.0 anthropology & aging quarterly 2013: 34 (2) 177 lindsay dubois activist pensioners, a contradiction in terms? producing flyers, organizing talks and conferences, and publishing an occasional newspaper (now replaced by a blog), participating in other demonstrations, and working in coalitions. the visibility of the pensioners and their issues has also varied widely across the years, at times making the front pages of the national press, as in the norma pla incident, at others disappearing from public view.  some jubilados argue that media attention was not the main reason for their popularity; there were more concrete and specific reasons for the popular support in the days of the massive mobilizations. for example luís cortadi, a retired railwayman and long one of the central figures in the movement, insisted that there had been more specific and practical actions which explained why people started to show up for the weekly marches. the jubilados’ organization had helped people sue pension funds, lobbied for exemption of property taxes for seniors, and convinced the city to let seniors ride the subways for free, among other things. furthermore, when the government made a move to privatize the pensions in 1994, the mesa mobilized 40,000 protesters and collected one million signatures in opposition.17  at present, amidst a political climate which accepts the legitimacy of pensioners’ claims to a decent living, they seek a minimum equal to the national minimum wage as well as pensions payments which reflect current wage levels for similar jobs as already discussed. they also seek control of pami, for which they argue pensioners pay. the pensioners’ situation, therefore, goes directly to the question of the state and its responsibilities. furthermore, as roger sanjek notes for the american gray panthers, their situation makes the state the obvious target for their activism. with respect to the united states, sanjek argues, “as ‘the key determinants of the standard of living enjoyed or endured by the aged’ became ‘national and economic policies,’ older americans organized to confront the state at their point of exclusion – chronological age – from the working class and its struggles” (quoting estes in sanjek 2009:4). similarly, the jubilados might be seen as a counter-hegemonic group; their struggle is in many ways a direct response to the conditions of their exclusion and subordination. likewise, their overall strategy is an effect of their situation. on one hand, their efforts are directed at making themselves seen and heard through their public demonstrations. on the other, they attempt to shape government policy and legislation. ideally, in their view, congress-people might stop in at their demonstrations on the way to the legislature. although this very rarely happens these days, they hope at least to be noticed as politicians enter the congress. representatives of the jubilados do also lobby congress-people on their issues. in 2010 opposition groups took up some of the jubilados’ demands, incorporating them into proposed new legislation that would have dramatically increased pension payments for many. this legislation did not pass. why activism? in light of the way elder activism is thought to be unlikely and appears to be quite uncommon, one wonders how these elders came to be participating in the jubilados movement in their various forms and to their different degrees. in this section of the article, i turn more fully to jubilados’ explanations of why and how they do the unexpected. these explanations point to the importance of generation in the abrams sense (as discussed above).  one striking characteristic of the activist pensioners was that the vast majority had some kind of history in “the old left” – as communists, socialists and anarchists (tortti 2009). their political experience was quite diverse. some were current members of the communist party or one of the various socialist parties, others had broken with their parties, still others spoke of an identification or sympathy with the old left. this identification was often described as emerging from concrete experiences in some of the institutions the parties sponsored, especially before the advent of peronism. one must recall that argentina is a photo credit: mary gaudet anthropology & aging quarterly 2013: 34 (2) 178 lindsay dubois activist pensioners, a contradiction in terms? country in which the intervention of peronism from 1943 challenged, to a degree incorporated, and eventually all but eliminated leftist traditions from working class life. most working-class people in the interim have been peronist. the non-peronism of these jubilados is therefore striking, in part attributable to their age since they mostly came of age before peronism, but by no means reducible to it.  this connection to the “old left,” though extremely varied, is suggestive. in trying to unpack the link between the activist jubilados and the old left, i have identified several threads. one is institutional: the peronist and radical parties have historically run a plethora of senior’s centers which draw members of those parties. these mainstream party-affiliated centers, although mostly recreational, do sometimes mobilize people on behalf of their parties, but not against the state. it is likely that many of the groups characterized as “recreational” by fassio and golpe (1999) would be of this type. the other threads connecting the jubilados to their left history was articulated clearly by the jubilados in the interviews and the history workshop. one has to do with values and commitments. another is tied to the longer arc of their life stories. values ramón sanchez, 72 when i interviewed him, was retired from skilled-labour in a refrigerator factory, although he still did a little work on the side. ramón is not a leader of the jubilados movement. nevertheless i met him week after week at the demonstrations in front of the congress. occasionally we went for coffee afterwards; burger king had a cheap coffee and pastry combo preferred by ramón and his older anarchist-spaniard friend josé. as in all the interviews i conducted, i asked ramón about his political life and how he came to be protesting at the congress. he told me he had been a socialist in his youth, in large part because of the library the socialists ran in his neighborhood, but did not really consider himself very involved in the party. as he put it: “i voted. i went [to the socialists] because they had a nice library; i spent hours reading in the library. i wasn’t an activist. i wasn’t a hero, not an activist, not a fighter, none of that. i always liked the books.” ramón also described himself as a person with a penchant for lost causes.  like ramón, many of the jubilados point to what i have come to think of as an urban left-working-class milieu as a source of their progressive values. most participated in, or were influenced by socialist, communist and anarchist messages which characterized urban working-class communities in argentina before the advent of peronism in 1943. for ramón this was the socialists and their library. for hector, with whose words i began this article, the values of justice, solidarity and integrity were learned from his anarchist baker father and articulated in the anarchist newspapers read at home. ramón’s friend josé was a veteran of the spanish civil war and continued to be fiercely anarchist. others identified with the communist party. regardless of their particular origins, most jubilados see their engagement as a consequence of values like solidarity, justice, and nationalism. this may be counterintuitive (or even sound self-congratulatory) for a movement expressly built around specific concrete demands like improved pensions and healthcare, but most of the jubilados noted that there were millions of argentine pensioners who might have been involved but were not. they explained the differences between themselves and the many others whose interests they represent in terms of these values.  in addition to these more abstract principles, the jubilados also saw their struggle to defend the rights of the elderly as calling argentine society to task. they worried that elderly people were pushed aside and not taken into account. from my vantage point in middle age, i was often struck by the way these evidently feisty people in their 70s and 80s lamented the poor treatment of people who were truly old and vulnerable – not placing themselves in that category. photo credit: mary gaudet anthropology & aging quarterly 2013: 34 (2) 179 lindsay dubois activist pensioners, a contradiction in terms? trajectories most jubilados asserted that values and commitments alone did not explain why people participated. the values which underwrote participation were accompanied for many by concrete experiences over the span of their long lives. these questions were addressed directly by participants in the history workshop.  as already mentioned, the group dedicated quite a lot of attention to the larger political project of the jubilados. the workshop participants had planned to make a video based on their deliberations; for a variety of reasons that video never came to fruition, nonetheless the discussion and debates about how and why it should be made were illuminating. with respect to this question of their trajectories, participants in the workshop commented, “we have come from a history of struggle. we were born fighters.” they saw themselves as paving the way for the political mobilizations happening all around us as we met in march 2002; they called themselves “pioneers of resistance” and compared themselves to the international human rights heroines the madres de plaza de mayo.18  for example, when i pressed ramón about why he went to weekly protests in front of the congress, he replied: “truthfully, i don’t know… but there is something which people carry until they die. i know i have to be present now because i have to keep fighting. behind every jubilado, you see something. behind each jubilado there is a militancy.” he went on to elaborate: “behind every jubilado there is one who wrote, one who was a shop steward, another [who was] a different sort of union man. we have life stor[ies].” ramón continued by pointing out that his participation and experience is modest compared to some, speaking with respect bordering on awe of fellow jubilados who took big risks, were detained during military regimes, and so on.  certainly the evidence supports ramón’s argument. sanjek notes a strikingly similar process among the gray panthers. “[i]t was not involvement with senior citizen issues that brought most people to the gray panthers. it was rather lifetimes of engagement with labor struggles, civil and human rights, economic justice, health care and peace – from the 1930s onward for the older panthers and during the 1960s and early 1970s for younger members” (2009:5).  a number of the jubilados had long histories in political parties and in organized labour, but as ramón might note, these are often on the losing side of national and local struggles. the left parties have only ever had a small number of elected seats. union politics in argentina are tied quite directly to party politics, meaning that the groups within unions to which most jubilados involved in labour belonged were also usually in the minority. the life experience engaged within unions and labour struggles more generally were formative for many of the men and some of the women with whom i spoke. this connection is unsurprising given the important place of union politics historically in argentina. one of the effects of this, though, was that many felt doubly adrift upon retirement. not only did they leave their working lives behind, but the unions to which they had often devoted much of their political energies, were likewise closed to them. nostalgia for past days fighting the good fight was apparent in many of the life history interviews. these jubilados described joining the activist pensioners as a solution to this problem. the jubilados’ movement offered an opportunity to put their skills and experience to work in a meaningful way. for a few, the connections were more direct. the late antonio fortes, a former shoe-maker born in 1914, and president of the mesa when i interviewed him, built his life within the argentine communist party, meeting his wife there, and joining the jubilados at the party’s request.  although labour union participation was a common precursor to involvement with the jubilados, there were others. ramón, for example, was quite clear that his participation in the jubilados’ protests represented a new, heightened degree of photo credit: mary gaudet anthropology & aging quarterly 2013: 34 (2) 180 lindsay dubois activist pensioners, a contradiction in terms? political involvement. he had never been involved in union activity. women in general were less likely to have held important roles in unions, both because they were less likely to have engaged in unionized work, and because of the sexism of most of the unions at the time. women jubiladas were also more likely to bear the brunt of family reproductive labour, obligations which held their energies and attentions in their middle years. although many of the women i spoke with still had domestic obligations looking after grandchildren part time, the lessening of these responsibilities permitted their participation with the jubilados. interestingly, quite a few of the women were widows, perhaps with greater autonomy than those with husbands to care for. dora garcía, for one, dated her entry into the jubilados’ movement from the marriage of her children. notwithstanding a period of heightened domestic responsibilities, most women could point to an earlier moment in their lives where they had been involved in political activities. the differing trajectories also help to explain why men occupied virtually all of the leadership roles within the mesa, even though women outnumber men in the elderly population.  struggling to explain how people came to the jubilados, ramón told me: “people are like wine. if the wine is good, with the years it will get better. if it’s bad, it’s poison.” he thus underlined the continuities, especially of character, which he felt explained why some people chose to take up the quixotic task which the jubilados embraced. elegantly aged wine is certainly a nice metaphor, but it is interesting that ramón’s explanation also takes up the question of the less-than-virtuous. being old and an activist finally, it is important to acknowledge some of the ways the jubilados’ age shapes their social movement. spending time with the jubilados one can forget their chronological age partly because they resist being defined by it. yet there are moments when it comes to the fore. yolanda, a workshop participant, described a debate that arose at one of the community assemblies [asambleas barriales] that sprung up in the wake of the 2001 economic crash. in a discussion about the video we hoped to make about the jubilados, yolanda told the other workshop participants: last monday i was at the community assembly and the inter-community assembly was there. and i stayed, and people were speaking and the problem of the pensioners came up, and i was allowed to speak. two or three people, a man who was quite old, said to me, “you are focussing [too much on] this topic...” (he was very parochial, this guy) “because the jubilados, you are just another group that protests, you need to ask [more broadly] for justice.” and i said “look, we are one sector, but we are four million and some, who are reclaiming pami, which is pretty representative.” there are people who don’t give the issue priority... but we have a shorter life expectancy... with luck i will be able to live to eighty. i have nine years left. how am i not going to worry about this problem? [mutters of agreement from all.] we don’t have thirty years. there are still people who see us jubilados as a little thing... i don’t disagree with having [the video] present people’s histories, and with giving it a more political tone, but we also have to bring ourselves closer to these sectors, that don’t do anything, but who for ten years have been collecting $220 or $150 pesos [in monthly pension payments].  yolanda’s commentary brought together several themes. she raised the relationship of the pensioners’ issues to a larger set of political demands. she asked the other workshop participants to think strategically about how much to frame the jubilados’ agenda in the language of the old left. yolanda also reminded her audience at the community assembly of the material significance of their age: time is limited.  this last point certainly came to the fore on the occasions when speeches made at the weekly marches paused to note the passing of yet another jubilado, as it was in the concern expressed when a wednesday regular missed a couple of weeks in a row. the fact of the jubilados advanced age was articulated most explicitly in two arguments made repeatedly. it was often noted that pensioners cannot be expected to wait indefinitely for real change if they are to get to see it in their lifetime. sometimes, as for yolanda, this argument was made in the face of competing claims for scarce resources. alternatively, some of the more pessimistic noted that they were not fighting for their own gain – they did not expect to see the fruits of their political labour – but for future retirees.  being activists also protected the jubilados from being subsumed into one of the only roles available to the elderly. as proud as they were of their grandchildren, the jubilados resisted being defined by their grandparenthood. in a conversation at the senior’s center, matilde let loose her outrage at the way argentines refer to older people as “abuela” or “abuelo” (grandmother or grandfather). it is quite common for people to refer to unknown elders in this way, for example, someone on a bus might say, “would you like a seat, abuela?” i had always imagined this as a kind of affectionate respect, but matilde certainly did not. “you don’t know me! i am not your grandmother!” she declared.  for many, there was doubtless a social side to anthropology & aging quarterly 2013: 34 (2) 181 lindsay dubois activist pensioners, a contradiction in terms? participating in the jubilados’ movement. small gatherings of jubilados could be found in coffee shops (or, as with ramón and josé, fast food joints) near the congress every wednesday after the protests. matilde, for one, emphasized how much she enjoyed the company of people her own age. yet company was not reason enough; like many others, she expressed her disdain for seniors who went to centers only to play cards and gossip. she was one of those gathering signatures as described by hector in the opening quote. political debate, weekly protests, flu shot drives and collecting signatures were all more meaningful ways for her to spend her time. conclusions the jubilados are extraordinary. the mere fact that they have managed to sustain weekly protests for not just months or years but decades is in itself a remarkable feat. add to this the advanced age of most members, and they truly defy expectations. the jubilados struggle to practice a different kind of old age. they refuse to be defined as passive by their roles as retirees and grandparents, and they refuse to retire from political life. the jubilados’ movement might be seen as a struggle for recognition in the broadest sense (fraser 2000). indeed, in the quotation at the beginning of this article hector describes them as trying “to awaken the recognition of folks.” they strive to express their points of view and to be heard. they want people to understand the plight of seniors in argentina and to change how they think about and treat the elderly. as history workshop participants asserted: “we want to make our own contributions to the country.”  it may be precisely because older people are apparently unlikely activists that the jubilados have much to teach us. their example demonstrates how activism is more than just an effect of youthful discontent, as sometimes asserted, but comes from somewhere. with the benefit of hindsight, the jubilados are able to articulate some of the ways that they see their life experiences as having led them to their activism with the mesa.19 their example has the potential to act as an important corrective to some of the literature on social movements. this literature has made important advances to thinking about how and why groups win political spaces. yet by focusing on group dynamics and resources, thinking about social movements risks overlooking historical continuities which can be traced through the life-stories of participants. many formulations draw distinctions between ‘old’ and ‘new’ social movements, the former referring to traditional class politics (via parties and labour unions) and new ones, drawn around ‘identities’. yet the jubilados show how people move around among different kinds of political engagements throughout their lives. in a way that resonates with the jubilados’ own views of their particular contributions to the fight for social justice in argentina, we can see how the longer view helps us better understand where activists and their activism come from. they are clearly both the product of their collective and individual histories and makers of history. acknowledgements i gratefully acknowledge the help, openness and insights of the mesa coordinadora de jubilados y pensionados de la república argentina, the centro de jubilados abastoonce and the many jubilados who agreed to speak with me. thanks to mary guadet for her various parts in this, as researcher, research assistant, and photographer. this research was conducted with the financial support of the social sciences and humanities research council of canada, standard research grant. finally, thanks to sarah lamb, liesl gambold, jason danely and two anonymous reviewers for their thoughtful and constructive comments on earlier drafts of this article. notes 1. there is work on voting, which is a qualitatively different form of political participation than that under examination here. see for example, campbell (2003). 2. one distinctive characteristic of the gray panthers is their commitment to building intergenerational solidarity, including young people in their movement and employing the slogan “age and youth in action” (sanjek 2009). 3. people were recruited at the weekly marches, where introductions often led to other interviews. some people who did not participate in the marches were also recruited. most of this group were participants at the abasto-once senior’s center (described below). some of this second group did also attend the marches. for reflection on some of the particular strengths and weaknesses of this methodology see dubois (in press). 4. throughout i use the actual names of jubilados by their choice, following common practice for oral history. luciano asked that i use his “nom de guerre” (as he put it) instead. 5. mary gaudet was a master’s student who worked with me on the project. her work focused on the senior’s center abasto once, of which hector anzorena was president, and which was affiliated with the mesa coordinadora the main group organizing the pensions, see below (see gaudet 2003). 6. for a discussion which compares life-course and generational approaches to politics see braungart & braungart (1986). 7. the evaluation of perón’s motives and practices is still widely and passionately debated and cannot be addressed here. that said, there is little question that many state institutions were either made or dramatically remade in perón’s first two presidencies. his third presidency was short-lived, from 1973 to his death in 1974 (rock 1987). 8. it should be noted that pla was not a member of the mesa, the group whose members i worked with. anthropology & aging quarterly 2013: 34 (2) 182 lindsay dubois activist pensioners, a contradiction in terms? 9. although everyone refers to the obra social as pami, its official name is inssjp for “instituto nacional de servicios sociales para jubilados y pensionados.” 10. a rich feminist literature analyses how women get positioned as recipients of aid, see for example gordon’s edited collection featuring a number of the key authors (1990). 11. linda gordon evokes this notion in the title of her book about welfare in the u.s.: pitied but not entitled (1994). 12. of course, the jubilados also prize social and economic justice and in this sense would never object to the expansion of the social safety net. 13. scholars have noted the peculiar and paradoxical nature of ageism: that it is a prejudice against one’s future self (jönson 2013). jönson makes the interesting observation that this quite often is maintained through a temporal construction in which the non-old imagine old people as qualitatively different from themselves because they are from a different generation (2012). 14.approximately 650,000 people 60 or older lived in the capital of buenos aires in 1998 (encuesta permanente de hogares in fassio and golpe 1999:75). 15. buenos aires is a megacity including gran buenos aires and the city of buenos aires. the latter, also known as la ciudad autonoma de buenos aires is a capital district, analogous to washington d.c. the 2010 census places the population of the capital at 2.89 million. the total population of gran buenos aires, including the capital, was 13.53 million (indec). 16. “work-related” is defined as “connected to the work past of its members” through unions or professional associations (fassio & golpe 1999:80). 17. given that street protests are part of the argentine repertoire, 40,000 is not a huge number, but a respectable one which would have helped get the jubilados’ issues on the table. 18. the madres are a group of mothers of the disappeared who publicly demanded the return of their missing children during the dictatorship, and when almost no one else dared criticize the military regime (bouva rd 1994). 19. this is not accidental. people tell their life stories with a purpose, and these activists tended to narrate their lives in such a way as to explain their current priorities (see dubois n.d.). references braungart, richard b. and margaret m. braungart 1986 life-course and generational politics. annual review of sociology. 12:205-231. bossio, diego and amado boudo 2010 inclusion y prevision social en una argentina responsable. bueno aires: minesterio de economia, republica de argentina; anses. bouvard, marguerite g. 1994 revolutionizing motherhood: the mothers of the plaza de mayo. london: scholarly resources inc. campbell, andrea louise 2003 how policies make citizens: senior political activism and the american welfare system. princeton: princeton university press. cufré, david 2010 con la moratoria se arrimó el bochín. pagina/12, economia. retrieved 6/24/2010. dantz, giselle 2012 the inextricable link between sovereign debt and pensions in argentina, 1993-2010. latin american politics and society 54(1):101-126. de la sota, hugo 2008 carta de lector: ¿a quién le importan los jubilados? la nación (9/3/2008). dubois, lindsay (in press) the romance of reminiscence: problems posed in life histories with activist pensioners in argentina, in s. high, e. little, and t. r. duong (eds.) remembering mass violence: oral history, new media and performance. toronto: university of toronto press. fassio, adriana n. and laura i. golpe 1999 población de edad y organizaciones de la sociedad civil. revista de la escuela de economía y negocios 1(3):73-92. fraser, nancy 2000 rethinking recognition. electronic document, http://www.newleftreview.org/?view=2248. fraser, nancy, and linda gordon 1994 a genealogy of dependency: tracing a keyword of the u.s. welfare state. signs 19(2):pp. 309-336. gaudet, mary 2003 “we are going to fight as long as we have life”: histories and politics of argentine activist pensioners. ma thesis, dalhousie university. gordon, linda  2012 women, the state, and welfare. madison: university of wisconsin pres. gordon, linda  1994 pitied but not entitled: single mothers and the history of welfare. new york: free press. jönson, håkan 2013 we will be different! ageism and the temporal construction of old age. the gerentologist 53(2):198204. karush, matthew b. and oscar chamoso, eds. 2010 the new cultural history of peronism: power and identity in mid-twentieth century argentina. durham, nc: duke university press. http://www.newleftreview.org/?view=2248 anthropology & aging quarterly 2013: 34 (2) 183 lindsay dubois activist pensioners, a contradiction in terms? lloyd-sherlock, peter 1997 old age and urban poverty in the developing world: the shanty towns of buenos aires. houndmills, basingstoke, hampshire; new york, n.y.: macmillan press; st. martin’s press. minkler, meredth and martha b. holstein 2008 from civil rights to... civic engagement? concerns of two older critical gerontologists about a “new social movement” and what it portends. journal of aging studies 22:196-204. rock, david 1987 argentina, 1516-1987: from spanish colonization to alfonsín. berkeley: university of california press. rugel, jean and riggirozzi, maria pia 2007 the return of the state in argentina. international affairs. 83(1):87-107. sanjek, roger 2009 gray panthers. philadelphia: university of pennsylvania press. sawchuk, dana 2013 peace profile: the raging grannies. peace review. 25(1):129-135. tortti, maria c. 2009 el “viejo” partido socialista y los origenes de la “nueva” izquierda (1955-1965). buenos aires: prometeo libros. vilas, carlos m. 2006 neoliberal meltdown and social protest: argentina 2001-2002. critical sociology 34(1):163-186. zommer, laura 1996 falleció norma plá una mujer combativa. la nación. 19 june. retrieved 5/17/2010. “yesterday is history, tomorrow is a mystery”: dying in south african frail care casey golomski university of new hampshire casey.golomski@unh.edu abstract what happens when we die? this article explores answers to this question as posed to staff and residents of a frail care (nursing) home, run by a christian women’s charitable organization in a smalltown in south africa. the religious, cultural, and racial diversity of staff and residents, along with their different medical understandings of declining health and death constellate expansive perceptions of dying and life after death. staff and residents share certainty about the continuity of a soul or spirit after death through a christian god, although precise locations and modes of egress for these spiritual entities are uncertain. heaven and hell are not strongly defined nor taken for granted realities. a presentist, rather than historical, orientation strongly shapes both the rhythms of daily life and the end of life in the nursing home. while residents aim to find meaning in daily life, staff aim to find meaning in aiding residents in the final moments of life by being tenderly co-present. overall, peoples’ perceptions of spatiotemporal transitions from life to the immediate after-life effectively complicate notions of immanence in the anthropology of morality, ethics, and religion. to use one informant’s terms, the end of life is “a mystery” which residents and staff engage in delicate orchestrations of care work. keywords: dying; end-of-life; nursing home; temporality; immanence; south africa anthropology & aging, vol 41, no 2 (2020), pp. 9-23 issn 2374-2267 (online) doi 10.5195/aa.2020.243 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 9 “yesterday is history, tomorrow is a mystery”: dying in south african frail care casey golomski university of new hampshire casey.golomski@unh.edu introduction “yesterday is history, tomorrow is a mystery, but today is a gift, and that is why it’s called the present” is a three-line poetic quip about time, often featured in greeting cards, daily journals, and motivational texts. i learned this saying in 2015 from an 87-year old white afrikaner woman named babsie. she was a “prayer warrior,” according to her roommate tina and the staff of withuis, a small-town south african “frail care” home in which they lived.1 she and tina resided in the wing designated for more independent and ambulatory residents, their room usually bathed in salmon and ochre hues cast by the sun through sheer curtains. when i stopped in to greet them after breakfast one tuesday morning, babsie told me: today i go by the strength of god. he’s helped me out in so many situations. you see, there was a time i was dying. everyone here saw me. tina came in from their small porch to abet babsie’s storytelling. tina said that the nursing staff became concerned when babsie’s breathing deteriorated one afternoon, saying “it wasn’t good.” the nurse on duty rounded up a driver and a staff caregiver, and they took babsie to the nearest public hospital in one of the black-majority townships surrounding the small city that anchors the area. babsie recounted an internal monologue she had at the hospital where she stayed for two days: i asked to die. just finish it. but he didn’t. he had a different plan for me. god has a plan for everything. if it is not your time, it is not your time; we have to go by what god says. when he is ready, then it’s your time. stories like this, ones that i collected from residents like babsie and tina, and the withuis staff, foreground a cultural metaphysics of dying. from their stories we learn how people who live and work in a common institutionalized space, but occupy differently situated demographic and biosocial vantage points, understand and experience the process of dying, the ethics of witnessing that process, and the after lives of death. the quip of “yesterday is history, tomorrow is a mystery,” which others in the home told to me, helpfully conveys what i discerned to be a culturally specific way of experiencing time in the later years. studies in medical anthropology and the anthropology of aging show how experiences of time are shaped by myriad medical, ethical, and technological negotiations surrounding a person’s biosocial death (leibing 2006). despite the well-defined pathways for how life is supposed to end in institutional settings like hospitals or hospice, practical negotiations of treatment, caregiving, and decision-making lead people to experience death as an unsettled process.2 this article considers how residents and staff http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 10 of this frail care home reckon with care and treatment protocols, embodied experiences of frailty, decline and senescence, and religious experiences and symbolism to make sense of this unsettled process. it argues that these factors are mutually influential and significant for each groups’ moral aspirations and experiences of time itself. death was a major and potential event that people faced in the frail care home. it is an event, i argue, that led people to foreground divine mysteries and presences as a primary temporal orientation at the end of their own and others’ lives. immanence and imminence as times of dying my interest in the question “what happens when we die?” focuses on the “when,” or the temporalities that shape perceptions of aging and dying. fassin’s (2013) comparative study of sentiments inspires my approach to delineate these varied perceptions in the home. looking at diverse social groups in the same field site of post-apartheid south africa, as well as france, fassin explores the meanings of “resentment” and its francophone variant of “ressentiment” as ideal types of moral and political sentiments. the latter emerges as a “reaction to historical facts, which generate an anthropological condition [that] victims of genocide, apartheid, or persecutions experience... it implies not primarily revenge but recognition. it signifies the impossibility to forget and the senselessness to forgive” (fassin 2013, 260). in the cases he presents, peoples’ perceptions of violence they experienced in the past are still shaped by their racialized and or alienated subject positions in the present, and these sentiments may coexist or transmute in the present as well. this article explores these transmutations and the ‘impossibility of forgetting’ as memories of a life amid violence change or transform over time, first in aging-related physical or functional processes, and second in the social settings older individuals (and their caretakers) inhabit, such as institutional care facilities (rather than households in their communities). the phonetic resonance among the terms in fassin’s case lead me to similar hermeneutic detective work to clarify the meanings of terms we have for understanding time and temporal experience. i consider how temporal ambiguities surrounding the end of life gray the lines between “immanence” and “imminence,” two concepts that may help explain peoples’ perceptions of dying in this particular south african setting. imminence means something is about to happen or is overhanging. it refers more to an event or phenomenon in potentia rather than a parallel domain or reality. an imminent thing is not inherently negative (canclini 2014), but is often culturally qualified as dangerous, threatening, or something at risk of emerging. fear induced by imminent violence, as in the example of prolonged armed conflict in colombia, can itself become a form of local cultural knowledge (castellanos 2015). in contrast, immanence means something is already existing or inherent within something else. immanence presupposes a separation between objects, realms, or times but that somehow one inhabits the other. for example, the past is immanent in the present. at the conjuncture of memory and history, the present is shaped by and echoes the past in peoples’ experiences of landscapes, material culture, and their social relationships among these (birth 2006). anthropologists of religion show a kind of conflation of imminence and immanence, where evil or millenarian events are understood to be both phenomena existing somewhere and also about to appear in the world, much to humans’ detriment. in their ritual and symbolic actions, humans assure that divinity mitigates the risk of evil from eventually bursting open (kaell and hardin 2016; kravel-tovi and bilu 2008). turner (1982) showed how the religious spaces where symbolic or ritual action occurs is often also experienced by those actors therein as outside of the normal flow of time.2 in contemporary western social life, judeo-christian influences shape perceptions that divinity is already manifest in this world, rather than somehow separate from it; this latter state of being is defined as transcendence. http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 11 taylor (2007, 549) argues that we perceptually behold an “immanent frame” through which we decide to believe (or not) in divinity, noting the frame is “‘spun’ in ways of openness and closure, which are often dominant in certain milieux.” in other words, openness or closure to possibilities for experiencing divinity life depends on cultural and sociopolitical context. taking cue from lambek (2015, 129), understanding how we negotiate movement among varied spatiotemporal frames (including those of death and dying) requires a turn to ethics or morality; ethics, he argues, is “intrinsic” or immanent to all social interaction. this immanence is a “ground” from which ethics emerge in everyday practice and become evaluative cultural criteria for how we should act, especially in uncertain or difficult situations.3 mattingly (2018, 47-8) argues that people’s life narratives about uncertain conditions like illness and dying reveal their urges to overcome these conditions as well as overcoming the force of the ethical demands they face among their family and caregivers. this dynamic is what mattingly calls “immanent transcendence.” for her, ethical negotiations about overcoming these conditions are embedded and play out in narratives about their lives. narrative, then, is what people use in health care settings to existentially and socially move through these conditions and time itself.4 narrative or stories are thus key expressive media for identifying cultural and ethical experiences of time, aging, and dying in late life. they are accessible in the methods of interviewing and conversation that constitute this ethnography. stories like babsie’s are evidence of these experiences and offer a different perspective of older adults and their caregivers than previously focused on. els van dongen was one the last anthropologists to do ethnographic research on south african older adults’ religiosity and meanings of aging. in one of her last, posthumously published chapters, based on time spent with impoverished black older adults living in peri-urban township communities, she argued that “religion and spirituality are not only medicine for the many traumas older persons have had and have to endure in their lives, but also that they are the means for survival”; religion was a “medicine and moral strategy” for abating their historically conditioned “misery,” and it positively impacted their “‘successful ageing’ and well-being” (van dongen 2010, 153). more recently, douglas bafford (2019) finds that older white south african evangelicals’ reflections on their country’s racist past (and their role in antiapartheid struggles) are heightened in retirement and morally converge with their millenarian preparations. these findings open us to expansive visions or evaluative criteria of aging, dying, and temporality that older adults and their caregivers perceive, and how their aging-related and spiritual experiences reflect their historic and institutional setting, taken altogether ethnographically, the diverse vantage points of residents and staff collapse presumed distinctions between past, present, and future, life and after-life, alertness and diminished cognitive functioning, and body and spirit. settling in-between these reveals meanings and experiences of death’s “mysteries” that people often focused on, sometimes more so than the violent history of apartheid that also shaped where and who they are today. following a discussion of methods and the field site, i trace a path through the opening poem that inspired the title of this article to situate the temporalities that devised life in the home. ethnography at the home withuis is near kruger park in the mpumalanga province in the eastern part of south africa. it was established in the 1950s amid strong white nationalist social welfare policymaking and is part of a larger network of facilities run by an afrikaner christian women’s charitable organization. the organization http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 12 itself was founded in the 1900s amid british and afrikaner settler colonists’ encroachment on indigenous african polities and wars among these groups. withuis is racially and demographically comparable to other residential frail care or old age homes nationally (makoni 1998; coetzee 1999; sagner 2000; van dongen and ferreira 2004). administrators and the majority of lead nurses were white women. the staff of nursing aides, caregivers, cooks, and others were almost all black women. at the times of the research, out of the 50 majority women residents, three were black. given such homes are historically white or racially segregated caregiving spaces, people in the home saw this racial arrangement as novel. most people in the home were variably multilingual in english, afrikaans, siswati, or xitsonga. nearly everyone identified as christian of some kind, as evidenced in statements about experiences of divinity and participation in daily prayers and weekly worship service programming. one black caregiver identified as christian and also trained to be a sangoma (diviner).. the majority of residents belonged to an age cohort born roughly between 1930-1940. the nurses were about 20-25 years junior to most residents, and the caregiving staff members were all born between the 1970s-1990s. about two-thirds of the residents had grown up, lived, or raised families within a three hour-drive of the home, and another third were living in the home as a result of their adult children, who had moved to the area and placed them there. many white residents were middle to lower-class when occupationally active, identifying as having been housewives, farmers, or entrepreneurs. a few were party to more extreme activities. for example, one white male resident claimed to have been an officer assisting in state executions, and another white woman operated radios for the former white minority rhodesian security forces. most black residents i met were migrant indigents from neighboring countries of eswatini and mozambique, who were put into the home through the help of local black social workers; one black woman resident was moved there by her adult daughter. nearly all the residents had been living in the home for less than seven years. three human ethics research boards approved interviews and or conversations with staff and residents and participant-observation at the home and others in its network. i conducted 20-30 hours per week of research from february-june 2015 and august-october 2019 and visited for two days in may 2017. also, for two weeks in 2019, i was aided by a young afrikaans-speaking woman research assistant, who fluently interacted with residents who primarily spoke afrikaans. withuis grouped residents into three wings based on their physical and cognitive faculties, including a wing that staff informally called the “alzheimer’s” wing that houses those living with more pronounced dementia, are extremely frail, or are behaviorally unsociable. i also conducted life history interviews with a dozen staff and residents not living with dementia. during participant-observation, i also engaged in ongoing conversation with staff and many residents, including those in the “alzheimer’s” wing. my findings, presented in three sections like the opening poem, show their perceptions of dying as shaped by race, gender, age, and cognitive function, as well as the shared work-life space they inhabited on a daily basis.5 yesterday is history the first part of this poem offers an equivalency of two past times. the recency of the day before today disintegrates into a deeper temporal expanse. what distinguishes each is chronological, one by mere hours and the other a flush of years. yet, each specially shapes how people in the home come to narrate their aging selves into the past (myerhoff 1992). a frail care home, in a postcolonial setting marked by a history of violence, is a complicated place to investigate peoples’ sense of the past. first, for residents, many of whom lived with various stages of http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 13 dementia or frailty, the conjuncture of memory and communicative abilities was sometimes fragile. physically and psychologically, it was difficult to talk, or talk at length about the past, which was a dynamic subject to ongoing negotiation, consent, and assent in the context of research and daily interaction with others in the home. many residents told me they did not remember what had happened the day or week prior, attributing forgetting to the mundanity of everyday life. sitting over a breakfast of maize meal porridge with white women residents jo and vern in 2015, vern told me, “when you get old, you give up more and more.” asking her what it was that one gives up, she replied, “well, memories i think,” elaborating that the older one becomes, the more memories one beholds, and this becomes too much to remember as kind of a cognitive overload. in 2019, my research assistant wrote in her field notes about a conversation with a white woman resident named jess, who “struggled to remember most of the finer details of her experiences with her family; however, she suspected that perhaps she’s ‘too lazy to think.’” in a conversation with three black kitchen staff women in 2015, they noted that many residents grew up during apartheid, and perhaps “do not know what is going on outside [of the home or in the country on national level]; “they might remember things from the past, but not remember what is happening today; they forget recent memories.” indeed, a special narrative element with respect to history were stories some individuals consistently retold about significant past events; this behavioral repetition may also be a sign of dementia or alzheimer’s. for example, then-82 year-old martina, a former housewife who came to live in the home at the end of my research in 2015, told me little about her past other than beholding a transformative divine vision in 1970. trembling near tears each of the four times she recounted it to me over the course of two weeks, the experience left her feeling “like i was a child because he is so awesome. god is so awesome. i asked him to show me a verse and he led me to proverbs 3: 5-6”— “trust in the lord with all your heart, and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight.” after this, martina would then ask me when i myself had come to “know jesus.” “i came to this place by god’s will,” she elaborated once, referring to withuis, “god has a plan for me, just like he has a plan for everyone else.” martina’s narratives show how she derived strength from her historic relation with god and his divine providence. the bible verse about submission may also account for a life trajectory that is not uncommon to many south africans. like other postcolonial societies, the country’s history of colonial atrocities and enduring structural conditions of inequality engender and forcefully shape memories, identities, and relations among social groups. the residents altogether grew up during the start of the most egregious period of segregationist policymaking in the 1940s. they reached young and middle adulthood in the 1960s-70s to see high-apartheid infrastructural development in urban areas and forced segregation in the group areas act, as well as the eventual decay of this system through the mass resistance movements of the late 1970s and 1980s (crapanzano 1985). most were in their 60s-70s at the end of nationalist party rule in 1994 with nelson mandela’s election to the presidency. for those who lived through the violence and paternalism of apartheid, submission, rather than resistance to the state or participation in its policies cultivated a subjugated life, but one in which individuals could remain alive, rather than imprisoned, or worse. the immensity of past violence, which included terrorism and killings, made history and one’s place in it distressing topics of discussion. this was clear in the ways both black and white staff generally avoided talking about historic tumult, believed in present redress for past wrongs, and waxed nostalgic for a past they perceived as more secure than the present. http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 14 for example, the white, head nursing staff often blamed the state of the contemporary public health care sector and society at large as due to (black) politicians’ neglect. the white former head nurse told me in 2015 that (black) public hospital staff “do not care for the patients or their work; it is not like in the past when we would go there.” her perception of poor conditions at these hospitals also factored into decisions to triage patients (or not) like the prayer warrior babsie and upheld a view that apartheid’s (segregated) public health sector was superior. that same year, 2015, south african university students and others were engaging in a mass movement protesting tuition increases and changing educational policies as a mode of decolonization. first called “rhodesmustfall,” the movements involved taking down campus statues of colonialist figures like cecil rhodes. in a conversation with a group of four black women caregivers, one told me, “we don’t like the issue with the statues either; those [statues] make the cities look nice; mandela told us in 1994 that we are one nation; they are being crazy over a statue that means nothing.” i suggested to them the statues were a sore reminder of a violent history, to which one caregiver replied adamantly, “that’s not it because there are lots of other statues of blacks like sara baartman [an infamously enslaved indigenous woman, b. 1789 d. 1815] and chris hani [a black anti-apartheid activist, b. 1942 – d. 1993]; it’s all in their minds.” this is not to say black staff members did not see racism operating in their midst; they did, often in dealing with angry, confused residents who made racist remarks toward them. yet, revisiting the past seemed moot. more broadly, narrating one’s place into the country’s tortuous political past has been an ambivalent project. from 1995-1998, the truth and reconciliation commission, a nationally televised restorative justice forum, tried to usher citizens beyond the violence of apartheid through public testimonies. despite these efforts, many black south africans found this to be inconsequential or incapable of culturally conveying their experiences of suffering in the form of self-referential, individuated narratives (krog, mpolweni, and ratele 2009; makoni 2008). in the few instances where black staff and white residents talked openly among each other about apartheid or the history of colonialism, these quickly transformed into joking situations, sacrificing personal or political standpoints for a necessity to be amicable as part of their role in the caregiving-resident relationship (golomski 2020). the exigencies of caregiving meant there was a lot of work to do. staff did of course get to know the residents by constructing a shorter biopic of their past lives, asking: are or were they married, do they have children, what was their past occupation, and where are they from? these bits of information were crucial for interpersonal connection, but there was often little biographical depth beyond this. staff primarily talked with residents in the context of aiding them with activities of daily living—bathing, feeding, clothing, toileting, transferring—and talked about the caregiving task at hand. in other words, they were not trying to talk about a past beyond yesterday when getting to the toilet; they were talking together about how to get to the toilet safely, comfortably, and with dignity. while a few residents divulged intimate personal histories, which i explore in other writings, the daily, monotonous routines of treatments, meals, and interactions more strongly contoured an overall temporal preoccupation with the present. for residents at least, their varied historical experiences were more silently remembered and increasingly forgotten. or perhaps because the past was so traumatic for some, there was no incentive to disturb anyone by bringing it up in a context of illness, frailty, and bodily intimacy. this is not to be an apologist for the older adults’ racism or explain away some staff members’ ambivalence toward history. life history narratives and popular or historic explanations of violence are more entangled with or constitutive of each other (argenti and schramm 2012). this is rather to acknowledge that biomedical and humanitarian logics of elder care may structure social relations in ways that depoliticize history or dehistoricize livelihoods at the end of life. http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 15 tomorrow is a mystery the most obvious future that residents and staff immediately faced was the residents’ deaths. of course, some residents were more likely than others to succumb to declining health, but the general sentiment was that, in the words of a hospice consultant i met there, withuis was “god’s waiting room.”6 if the next passage in residents’ lives was death, what lie beyond this “room” was a spiritual mystery. many staff members told me about the process of “getting used” to death. this meant both witnessing the moment of death and working socio-culturally and emotionally through the aftermath, as well as learning how to handle death through specific institutional protocols. despite its routine occurrence, staff told me it was impossible to fully overcome the fact of loss or prepare for it. i was incited to learn more about staff and residents’ perspectives on death after the passing of a white woman resident named bea in 2015. bea had stunning blue eyes and was in her 90s. she lived in the alzheimer’s wing and was almost totally silent. i took to feeding her breakfast and lunch almost daily over the course of three months. she ate little. our choreographed feeding relied on an unsettled yet mutual dance of eye-to-eye and peripheral vision and my gentle commands to open and close her mouth after delivery of spoonsful of food. it was sometimes messy and incoherent and sometimes satisfying and smooth. after a two-week getaway from field work, i returned to withuis and found that she had died. a grey-colored tingling fell upon me when ronette, a nursing aide, told me this. bea had died in her sleep. her body was still warm when ronette found her during early morning check-ups. a black woman caregiver named mbali told me in 2015 about the more immediate experience of witnessing the moment of death while on duty: “the person will gasp. do you know what that is? they gasp, and they ask for their daughter or someone else. when they ask for that person, we know they are getting ready to die. then you find that when that one gets here, the person will just die.” have you seen them at the moment they die? i asked. “i’ve seen many people at the moment they die,” she replied, “and it’s mostly the same. sometimes they want us to hold their hand.” in another conversation on this topic, the white head nurse noreen told me: “you know someone is dying. you can tell by the eyes, the skin, the breathing, and their mouth. the eyes begin to cover like a dead goldfish at the store; there is a film. sometimes you can tell they will die, but sometimes you cannot.” in both mbali and noreen’s accounts, visibly discernible physical attributes were evidence of dying and death. these were also the operable grounds for staff interventions, as in the case of babsie’s shallow breathing. nursing staff had formal biomedical training and certifications that qualified them to work in this setting and treat or triage residents. procedurally, the nursing staff on duty convened to call the family first and then the resident’s listed doctor or a consulting doctor from a local public hospital. they also called the on-call nursing staff for reporting purposes. the resident’s preferred morgue was contacted last. touchingly, the staff tried to position bodies in a lying state, shut the eyes, dress them in their clothes, and ceremoniously cover them with a flower and sheets. ronette, who told me about this small ritual, qualified the sheet as “white,” a point i took to be more symbolic than literal since the linen supplies mostly consisted of faded pastels and prints. mbali’s account also shows the social dimensions of biosocial dying. at the brink of physical cessation, the dying person sought a final tie, a touch or presence of another. this phenomenological encounter is ethnographically significant (chatterji 2015). kin of the dying were preferred in these final moments, but staff could otherwise stand in as “fleshy, imperfect specters” of real family members (buch 2013, 643). the day i returned after my getaway, i looked at the visitors’ log. five days before bea’s death, two individuals named brenda and barbara louise were listed as visiting her. brenda came again four http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 16 days before the passing, leaving the comment “please phone.” on the day before bea’s death, someone else wrote “please phone if anything changes.” in their training, staff also learned to forge relationships of simultaneous closeness and detachment with the residents with the stipulation of not getting too close to them. detachment, it was reasoned, was necessary for staff’s psychological and emotional well-being given the frequency of death. staff told me they sometimes felt overwrought by residents’ deaths and buffered the experience by resorting to the home’s procedures and their own nursing training. however, they counteracted detachment by framing their work as more kin-like and unlike care received at public hospitals. noreen said: no. no. i am not used to [death]; you don’t get used to it; there are ways you can handle it, but it is never something that you get used to; there is a bond we have with the people who come here; this place is not like a hospital, where you go to see the person and they are asleep because they’ve taken their medicine, and then you come back later and they are still sleeping and recovering; we see them all the time and this place is their lives; we are their friends, family, everything when they come in here; so when they die that is then over. ayanda, a black woman caregiver, said: they tell us in our training not to get too attached to the patients; this place is not like a hospital where people come and go; they stay here and we see them all the time when they are healthy and well; i don’t get too attached but it is hard sometimes. residents, however, perhaps because of their embodied proximity to death in their advanced age, seemed to accommodate it. ambrose, a white man resident with epilepsy, who smoked and aided staff on shopping trips, told me in 2015, “i am used to death here; it doesn’t get to me, but i help others here because they can’t deal with it.” ambrose’s own life partner, pik died less than a year after they came to the home together in 2014: “i’ve seen it here and in my own life; i’m used to it now. when you’re in a place like this you get used to it.” residents’ and staffs’ moral and emotional experiences of others’ dying suggests that the home as a space of dying was not institutionally cold to them. it was humanely social: “we are their friends, family,” said noreen, “everything when they come in here; so, when they die that is then over.” residents sometimes had close relationships with each other based on rooming situations and daily interactions, but in the context of dementia-near-death these relations were also ambiguous. a week after a resident named tish was taken to a hospital for falling into a coma, i asked her roommates myra and suzane if they had heard how she was doing. suzane first said she did not know who tish was. myra recalled that tish was their roommate but told us that she had died. “no man, that was bea. she had beautiful eyes.” suzane then remembered tish was her roommate in contrast to bea but knew not of tish’s whereabouts. this uncertainty of absence and presence also colored peoples’ ideas about the afterlife. metaphysically, for staff and residents, a human person possessed an embodied phenomenon known as a soul or spirit that somehow continued beyond the moment of death. that a person goes “home” or to “heaven” were the most frequent answers to my question, “what happens when we die?” the egress and locale of these places, however, were often undefined. http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 17 questions about post-mortem phenomena drew many references to popular christian religious knowledge and what was learned from pastoral authorities. sitting on lunch break with ayanda and a black man caregiver mbongi in march 2015, ayanda said, “well, i don’t know what happens to the spirit, i should google that. in our church we say that we die, and we are waiting for the second coming of jesus christ; it is not that the dead will rise again; it will be a spiritual resurrection, but i don’t know what happens to the spirit.” she did not mention hell. i then asked mbongi what happens after death, who suggested that all spirits go to heaven when they die. ayanda quickly said that he was incorrect, arguing that some people clearly cannot go to heaven but not elaborating on why that would be. her curt cut-off of mbongi made me uncomfortable, and i spat out my own suggestion that we simply lose consciousness and life is extinguished like candle flame. to that, they both looked at me incredulously. the next month, to the same question, mbali told me, “hey, that thing, i don’t know.” telling her about the information ayanda learned from her church, mbali went on, “well, sometimes people go to heaven, they say, sometimes the spirit just goes around some place; like it doesn’t go anywhere; it is hanging around but the person is finished.” “do they lahlabantu,” i asked, naming a regionally common nguni rite of sweeping the site of a person’s death with a blessed tree branch. “yes, that thing,” she said. “i grew up learning that some people go to heaven and others go to hell. i’ll probably go to hell,” i said laughingly. “that’s probably right,” mbali said in a way i felt was void of irony. precious, another caregiver joined us. “i don’t know,” she laughingly replied to the same question, “they say you go to heaven or hell. but if you die and it is not your time according to god, your spirit might just go around this place.” “you see what we think in our [black, swazi, african] culture,” mbali said, “but we don’t know.” finally, another month later, precious and i urged one of the black residents, lamatsebula, into giving her own explanation after her breakfast. lamatsebula was a blind woman from eswatini, who constantly talked in the mornings and evenings. she stayed and ate with the residents of the alzheimer’s wing. “god chooses everyone,” she said, “but a soul becomes a spook that moves around here and there. they can be in the woods or the mountains. the body is in the ground and there are ancestors there. the spooks are everywhere, those that have no place. sobhuza (a former king of swaziland, ruling 1921-1982) and other amakosi are all around.” amakosi, is a siswati plural for chiefs, kings, spirits, and in its singular form, god, and spook or ispoki is a creolized afrikaans-siswati cognate for the english word ghost. to recall the regional colonial history of land dispossession and migrancy, many black south africans’ contemporary religious experiences are characterized by mobilities, displacement, and the uncertainty of bodily belonging to a place. according to white (2010), some zulu-speaking peoples’ ancestors call upon them in dreams to create permanent dwelling space for them to reside in and construct small houses in a customary style, as they have otherwise been wandering lost in the afterlife. this cultural articulation converges with contemporary pentecostal christian religious rhetoric in the region, which cites that bodily materiality of the dead is inferior to the needs of a religiously cultivated soul or spirit (golomski 2015). in the many worship services and bible study sessions i attended, pastors and speakers noted that preoccupations with problems of aching or dying bodies and their burial locale were misplaced, because in the greater metaphysical scheme of things, what really mattered was a spirit’s continuity through god’s immanent power in the present world. today is a present http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 18 lettie, a white former farmer, had since moved to a new room when i revisited withuis one morning in may 2017. she was sitting at the edge of her bed and folding facial tissues in her hands. we greeted each other, and i asked her whether she had dreamt about anything that night. sweetly, she told me: “we are already in heaven. when i dream, i dream of beautiful things like the sky and stars and moon.” i replied that the dream sounded serene and asked what it meant that we were “already in heaven” while still here in this small town in south africa. she explained, “in life we must do what god wishes. god has a plan. those dreams show me that god is there.” the final line of the poem inspiring this article is “today is a gift, that is why it is called the present.” it embodies the temporal orientation and meaning that residents and staff attributed to the end of life. with respect to imminent death, babsie’s story of her near-death experience was like several others i heard, that narrated a dynamic of being kept alive or moved from this present life according to god’s preordination. subjective volition in wanting to die made practical but not theological sense to many at withuis, who claimed that death was not ultimately in their hands. divinity suffused staff and residents’ lives because its power was immanent. the borders between heaven and this world seemed to evaporate for some individuals like lettie, reflecting a particular spatio-temporality in the home, one kind of “present” reality shaped by god’s “plan.” withuis and its parent organization were officially non-denominational, but, again, the home was strongly christian. several residents had framed inspiring religious quotes, bibles, crucifixes, and rosaries in their rooms, and these objects were also found in most of the common areas. every week they hosted a bible study run by a volunteer from the nearby town and a worship service run by a pastor of a protestant church. both were well-attended as being the only major events occurring on their respective days. every morning around six o’clock, staff gathered at the nursing station to pass from the overnight to morning shifts. this meeting involved updating each other on residents’ conditions, saying a prayer, and singing a few lines of a hymn. these rituals and the adornment of work-living spaces re-inspired people to go about their daily lives, movement which could be practically and personally difficult. maureen, another white, head nurse, often gave tours of the home to prospective residents’ family members. one afternoon, she returned to the nurses’ station after such a tour with a white woman, whose cascading auburn curls partially covered the remnants of tears on her face. “ack shame we are full now,” said maureen, referring to withuis being at maximum occupancy that month. “there is a long waiting list. but our in-take depends on god’s plan. we will see who goes where. you see some may go from the independent living wing to the alzheimer’s wing. god is great.” “god is good,” the woman replied. maureen concluded, “god’s plan is what i see here every day.” later that month, god’s plan for bed-space took shape when the adult children of a white resident named john removed him from the home after living there for half a year. the staff were relieved in john’s move, as several qualified his unwillingness to eat and general disposition as “naughty.” beyond workplace routines, god was also immanent in staff members’ own daily existential concerns. gladness was a 40-year old caregiver and grandmother who glared a shorn front tooth in her constant laughter. one day i found her in the alzheimer’s wing where she was animatedly telling the other black caregivers about her healthy cd4 count; her “soldiers” (emasotja) were strong these days, and others should go get theirs inspected too.7 “health is good,” she explained, and doctors could easily do such a count at most clinics. to drive her point home, she then cited a sermon she heard in church about a man who lived and faced many challenges but persevered though the holy spirit to overcome them. the caregivers listened encouragingly. going back on her rounds, she took with her a brochure for a local funeral parlor that the other caregivers were reading. mbali, who was also hiv positive and often sent http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 19 me biblical quotes via text message, told me that she knew she would die sometime in the future and that is why she herself took out a policy with the parlor the year before. staff members desired to engender good “quality of life” for residents while they were still alive but took a practical day-to-day approach to residents’ treatment that also reflected their own awareness of material limitations. preserving quality of life sometimes took form in keeping residents out of hospitals amid ongoing illness or injuries and instead treating them in the home. i learned this in noreen’s description of tish: i don’t think she will last longer . . . changing her [diaper] we found a growth in her abdomen. the doctor suggested we take her for a ct scan. but we made a collective decision. we said, ‘what is the point? why must we put her through the pain of driving in the car, being uncomfortable, and lying in a bed in [the nearby public hospital] and then if they find something, then what? what can we do?’ discerning that tish would likely neither survive an operation or the aftercare at the hospital, the staff colluded to palliate her at withuis. a week prior, maureen showed me a large brown file thick with tish’s hospital records which marina said they “borrowed” indefinitely because they perceived it would inevitably be lost or unavailable if they took her back to the hospital. their previous experiences steered them to wait things out for a while in the home instead. this decision offers a contrast to more resourced frail care settings. staff in danish nursing homes, for people with dementia, explicitly call their charges “citizens.” this evinced socio-cultural and political ideas about residents’ progress and futurity, in that under their care, they would “never be too frail for self‐realization” as citizens of the welfare state (svensen et al. 2018, 29). danish staff members’ position hinged on a cultural move of “substituting” aspects of residents’ personhood with respect to time. for these older human beings with diminished capacities, staff re-imagined alternative temporal horizons for them—one of daily “fulfillment” rather than prolongation in successive treatments—as residents would otherwise not strongly articulate this process for themselves.8 in withuis, for staff at least, contemporary (versus past) state health and social welfare institutions in the form of public hospitals are not typically salvific resources. a retreat to a “home” is a more compelling option. also, staff and residents shared cultural scripts about temporality as god’s gift of the present in which they were both variably imbricated, which contrasted with the more unidirectional substitutions based on time in the danish case. despite illustrating a similar orientation of care in denmark, these south african residents and staff’s shared political history, relative poverty, and religiosity shaped and located their sense of the present in the home as a portal to the next life. conclusion the sociopolitical and racial landscape of post-apartheid south africa is in a perpetual state of suspension. radical change was supposed to happen after the 1990s political transition. the old was supposed to converge with the new, seamlessly and colorlessly, according to the much-touted postracial, multiculturalist rainbow nation ideology. the symbolic freight of this promise, however, is continually laid bare in the present. did we witness these changes in this lifetime? if not, where do we instead see ourselves now? narratively re-articulating lived experiences of the past in the present is theorized to be a source of interpersonal or social transformation (mattingly 2018; krog, mpolweni and ratele 2009). still, http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 20 narrative is challenging, especially when we situate practices of storytelling in cultural context and a particular life course phase. the ethnographic specificity of this home and proscriptions for both sociality and research therein perhaps reveal the limits of narrative as a medium of evidence to support theories about immanence as a moral and ethical concept. the enduring structural violence of the (post)colonial political economy is immanent in everyday life in south africa and, for many, already embodied (fassin 2013). racism is pervasive and systemic in the present as the policy-based foundation of apartheid and prior colonial orders. at the level of narrative articulation among interracial and unequal relationships of caregiving and receiving, it can burst in at any moment. it is both immanent and imminent, but it is held in abeyance in the face of frailty and mortality. history as embodied in an older adult and their life stories dissipates in their potential death. for staff, beholding dementia (-near-death or otherwise) also shores up the fact that pasts can be forgotten on one’s own terms or due to senescence. these contradictions, i argue, were reconciled temporally with reference to another pervasive force in the lives and times of staff and residents: god. for people at withuis, both younger caregiving staff members and those who lived through apartheid, foregrounding god’s presence was a way to re-qualify difficult life conditions and transitions they faced as pre-ordained or perhaps something good. this was despite and because of life’s imminent complications related to hiv, poverty, and even death in this care-fully guarded home. mortality as a universally recurring yet shiftily defined event was configured by god. it occurred on his time, and he was its silver lining. he, and death were here all along. this religious orientation turns out to be a temporal one as well, as the present is divined to be a gift from god himself. it reflects aspects of what scholars of aging call gero-transcendence, where older adults may become more self-reflective or meditative and reorient toward cosmic dimensions of existence and an acceptance of death (bohman, van wyk, and ekman 2010) and here, conditioned by local prostestant eschatalogies (bafford 2019). in sharing their understandings of dying under god’s watch, residents and staff did not deny that their lives were physically or emotionally painful. this hurt was indeed immediate. yet, the space within which it was felt was culturally and religiously shaped insofar to engender meaningful, indeed, livable experiences of time itself in the midst of dying. in tracing peoples’ experiences of working through waiting with-in god’s mysteries of death, we see that the sacred is perhaps as immanent in the aftermath of violence as it is usually seen in situations of healing. to wit, an ethnography of aging and dying in a site like this allows for a graying of postcolonial histories and temporal linearities often construed in more “black” and “white” terms. acknowledgements thank you to the residents and staff at withuis for allowing me to witness and document these intimate moments. i received encouraging comments from sarah lamb, susan orpett long, and janelle taylor at the 2017 american anthropological association meeting and insights on the larger project from colleagues at the 2015 north eastern workshop on southern africa, 2017 harvard africa workshop, and 2020 harvard friday morning seminar in culture, psychiatry, and global mental health. emily wentzell, iza kavedžija, and two reviewers for anthropology and aging offered closer readings and careful suggestions to help bring this article to its present form. notes 1. withuis is a pseudonym, like all individuals’ names mentioned in the text. i retain the local vernacular of frail care home (versus nursing) to reiterate the cultural framing or scripts in play about what it means http://anthro-age.pitt.edu/ golomski | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.243 http://anthro-age.pitt.edu 21 to age and what to do about it in south africa, there as it signals accommodating bodily debility (“frail care”) rather than biomedical treatment (“nursing”). 2. social personhood, for example, may be diminished in “dementia-near-death,” where an individual’s ability to move (their own) social life forward in communicative interaction is curtailed despite the continuation of other biological functions (kaufman 2005). 3. lambek’s definition is but one in a robust subfield focused ethics and morality, the breadth of which cannot be covered here. lambek’s approach is widely cited and also critiqued on both methodological and theoretical points (lempert 2015; zigon 2018). 4. for mattingly (2018, 48), “narrative is needed to consider the temporality of the self,” and following the philosopher ricouer, “lived experience is already narratively prefigured.” 5. a caveat regarding the expressive abilities and ideations of death of residents with dementia as arguably (in)comparable with ideations of staff and residents not living with dementia: anthropologically, we know claims about incommensurability inhere a kind of knowledge production that operates on essentializing difference. handler (2009, 627) notes when one claims things are incomparable, it is as if “two phenomena cannot be compared when they mean to rank one decisively above the other,” i.e. that staff’s coherent ideations are somehow more logical or legitimate than ideations of a resident who lives with dementia. this is a cognitivist bias that i try to avoid by taking a culturally relativist mode in acknowledging both groups’ perspectives as biosocially distinct and historically coeval. 6. frail care homes in south africa are not hospice homes. staff members were not aiding the dying process, although they could contract with a local branch of a national hospice network should the client or her or his family desired this option. 7. influenced by decades of public health communication and education for people living with hiv/aids, the surface proteins of t-cell lymphocyte white blood cells are called “soldiers” in southern nguni vernacular languages. 8. to make this argument, the authors interestingly compare cases of people living with dementia-neardeath to neonates and research-lab piglets to investigate the ways temporality is substituted for or applied to forms of life more 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the lives of older persons in the new south african society. cape town: human sciences research council. white, hylton. 2010. “outside the dwelling of culture: estrangement and difference in postcolonial zululand.” anthropological quarterly 83(3): 497-518. zigon, jarrett. 2018. disappointment: toward a critical hermeneutics of worldbuilding. new york: fordham university press. http://anthro-age.pitt.edu/ andersen_finaldoc andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 47 energy, aging, and neurasthenia a historical perspective michael andersen university of copenhagen author contact: michaelchrisandersen@gmail.com abstract that there is an association between energy and aging may seem commonsensical in modern society. nonetheless, the question of how aging came to be associated with energy is less well known. this article explores how the 19th century disease of neurasthenia became related to aging through contemporaneous ideas about productivity, energy surplus and energy dissipation based on an analysis of how a lack of energy was featured as a symptom of the disease. it examines the specific historical intersection where a lack of energy was related to a diagnosis, illustrates how aging and energy have become intrinsically tied to each other and how the focus on the productive uses of energy has antecedents in religion as well as moral economics. as aging continues to be considered a problem in modern society--in large part due to the inherent unproductivity associated with old age caused by a lack of energy--the discourses surrounding neurasthenia demonstrate how the concept of energy manifested itself in contemporaneous consciousness. keywords: aging; disease; neurasthenia; energy anthropology & aging, vol 40, no 2 (2019), pp. 48-59 issn 2374-2267 (online) doi 10.5195/aa.2019.170 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 48 energy, aging, and neurasthenia a historical perspective michael andersen university of copenhagen author contact: michaelchrisandersen@gmail.com introduction an old story often told is that the human body is a phenomenon that inevitably ages. from plato to cicero and hippocrates to galen, the process of aging is presented as a significant characteristic of life. yet, what causes the process of aging and thus what aging has been associated with is a multilayered story. in this article, i present one of these layers by analyzing the association of aging with the disease of neurasthenia. i explore how the representation of energy in this disease of the 19th century--an era marked by heavy industrialization and a focus on productivity--equated a lack of energy with disease, and hence illustrate how aging became part of the discourse on disease. as exemplified in the famous early modern and late modern illustrations of “the ages of man” (burrow 1986), the human body continues to develop physically until it at some point ceases to – this is where the body “as old” enters the picture. that this point of recession will occur at some point is well established in science, ranging from the cartesian view of the body as a machine (descartes 2002 [1619]) to contemporary studies relating old age to mitochondrial function (payne and chinnery 2015). what is common to these approaches is that the recession of the body is demonstrated in terms of available energy. in other words, old age limits energy expenditure. however, defining when old age begins to make itself felt is one of the more debatable questions in science, popular science and in society. although it may seem to be a banal point that old age and energy are closely related, i argue that the specificities of this relationship have not been explored sufficiently. by looking at how energy became an important tool in the classification of a disease (nosology), such as neurasthenia, we get a better sense of what foreshadowed the current discourse on energy in aging. energy, life force, and the disease neurasthenia the term force – or more specifically, life force, crops up continuously when the concept of energy is discussed from a cultural historical point of view. some of the earliest known descriptions of life force present this intangible notion as something that closely corresponds to the air we breathe (taylor 1979). when we are conceived, we begin breathing, and we end our lives when we stop breathing; hence, life force is an element that gives and sustains life. referencing genesis 2:7, “and the lord god formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul,” the physician and psychiatrist frederick kräupl taylor demonstrates the relationship between life, soul, breath and mind. he also notes how this association appeared in greek and roman cultures: psyche was originally a greek word for breath; spirit came from latin spirare (expire), and anima was the original latin word for wind and air (ibid.). when life force is tied to notions of spirit or soul, it is something one can lose, as in the phrase “to lose spirit,” or something one could show, as in the phrase to “show spirit.” hence, we find the opposites of possessing life force and losing life force. however, possessing life force was not always considered a andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 49 good thing if it was associated with a wrongful deployment, e.g., an evil spirit in possession of one’s life force, the sapping one’s life force, or quite often, both at the same time. essentially, life force was seen as multifaceted. it maintained a certain ambiguity in society as both a destructive as well as a productive entity, an approach that is parallel to our contemporary conception of electricity and force in physics. the concept of energy was used interchangeably with life force, which led in part to the sudden appearance of the diagnosis of a nervous disease characterized by a lack of energy—a disease that came to be known as neurasthenia in 1869. in his work the journey of life, thomas r. cole (1992) argues that the prevailing discourses on old age in the 18th century were based on two competing ways that one could become old. one way was, generally speaking, good: becoming old virtuously and experiencing a natural death. the other way was bad: becoming old full of sin and disease and ultimately experiencing premature death. however, cole suggests that these two different ways of approaching old age gradually shifted from the 1870s onward toward looking at old age in the bad way: old age began to be seen as an obstacle to industrial progress. aging in the good thus dissipated, and the recognition of old age as a distinct period of life did not do much to change this. publications by health professionals and physicians at the time primarily represented aging as bodily decay. one of these physicians was neurologist george miller beard, who framed “the disease” of the 18th century as american nervousness or neurasthenia. in his 1869 paper “neurasthenia, or nervous exhaustion” (beard 1869), beard argues that neurasthenia was becoming increasingly prevalent as a disease in modern american society. he later expanded upon this idea in his highly influential book (at the time), american nervousness (beard 1881). according to historian roy porter, beard’s conceptualization of neurasthenia owed something to the brunonian system of medicine developed by scottish physician john brown (brown 2012 [1780], which suggested that diseases could be split into categories of -sthenia and – asthenia. the latter were diseases caused by an inability to react to stimulus, and the former by an overreaction to stimulus (porter 2001). neurasthenia was presented as an overreaction to stimulus, and encompassed a range of symptoms that were before then contained in other diagnoses. symptoms of neurasthenia could be: despair, phobia, insomnia, nightmares, inattention, migraine, palpitations, indigestion, impotence, neuralgia, extreme fatigue, and many more. in effect, neurasthenia was something of an umbrella diagnosis that encapsulated many of the symptoms that were being reported by the upper class of american society. but for beard, neurasthenia was not merely a regular stigmatic disease. instead, he believed that neurasthenia, being particular to american society, was caused by the innovations of american industrialization. innovations included: steam power, the periodical press, the telegraph, the sciences and participation of more women in society, among others (lutz 1991). neurasthenia was seen as a condition related to overuse of nerve force; in that sense, it complemented certain contemporaneous physical theories about the limited amount of energy within systems. historian anson rabinbach (1992) argues that german physicist hermann von helmholtz’s “discovery” of thermodynamics in 1847 contributed to a certain degree to this idea of a universal law regarding the conservation of energy in the human body. in his first thermodynamic law, helmholtz proposed that energy is cosmological; as such, it is a universal force that cannot be added to or destroyed because the cosmos must continuously contain the same amount of energy—an energy that cannot dissipate beyond the cosmos. this thermodynamic law would eventually align the human body with the machine in the sense that the productivity of both was regulated by energy output. however, helmholtz’s second thermodynamic law describes how the transition of energy from one state to another (e.g., from cold to warm) in a closed system always entails the loss of energy. thus, rabinbach argues, the great discoveries of nineteenth-century physics led, therefore, not only to the andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 50 assumption of a universal energy, but also to the inevitability of decline, dissolution, and exhaustion. accompanying the discovery of energy conservation and entropy was the endemic disorder of fatigue – the most evident and persistent reminder of the body’s intractable resistance to unlimited progress and productivity. fatigue became the permanent nemesis of an industrializing europe (1992, 3-4). but as porter shows, what could be considered a forerunner to neurasthenia had already been established before helmholtz’s and beard’s thermodynamic and neurasthenic theories (porter 2001). as noted above, the brunonian idea had touched upon dissipation and excess stimulation to a certain extent, but the idea of overusing nerves and its possible connection to society came to the fore during the georgian era with george cheyne and his diagnosis of the “english malady” (1991 [1733]). cheyne coined the term in the 1730s at a time when an increasingly important question was whether the wealth of nations also gave way for the health of nations (porter 2001). cheyne argues that both the enlightenment and growing wealth among the upper-classes had created a deterioration of health; he proposed (without noting the irony) that those in society who were suffering the most were, in truth, people with the highest education and living standards. unlike laborers, the elite had to constantly use their nerves and would do so for noble purposes that enhanced society—for instance, business, pleasure, ease and fashion (porter 2001). however, this disease of civilization did not mean that cheyne proposed to prevent the progress of civilization that he believed caused the english malady; rather, he wanted to refine civilization to aid the suffering upper classes. a review of various accounts of the english malady indicates that the ailment carried with it something of a mark of honor that was very similar to what was later seen with neurasthenia. yet, compared to neurasthenia and the idea of limiting energy output, the approach to the english malady focused much more on limiting the use of nerves. it was not the substance (i.e., energy) passing through the nerves that was the problem, but rather, the use, and specifically overuse, of the nerves. it was believed that strain on the nerves themselves would eventually render them sluggish. balancing a nervous economy the notion of a “proper” use of one’s nerves went hand-in-hand with the development of the economic metaphor of “nervous economy” (porter 2001). naturally, people in possession of such an economy would have to balance their expenditure of nervous energy while simultaneously ensuring societal progress—in short, it was a question of investment and a strict nervous economy (lutz 1991). hence, to have a proper nervous economy was to use one’s nervous energy for the “right” purposes. this nervous economy was essentially extremely moral. beard argued that masturbation, gambling, and illicit sexual or financial activity were a waste of nervous energy, while productive work and procreation were valuable reinvestments of energy (ibid.). in beard’s construction of a moral incentive for work, one can hear echoes of the protestant work ethic described later by max weber in the protestant ethic and the spirit of capitalism (2002 [1905]). but as seen in several other reviews of diseases, morality and disease were not, and still are not, two separate logics, as they are intertwined.i beard’s protestant moral perspective extended so far that he portrayed catholicism and neurasthenia as incompatible due to the lack of individual religious responsibility in the catholic religious persuasion. when we review the metaphor of a nervous economy, we can see how neurasthenia could offer a medical explanation for the changes that were regularly occurring among individuals in 19th century western society. but the economic perspective by which it was necessary to invest one’s resources wisely was certainly not exclusive to the expenditure of nervous energies. instead, discussions about how to utilise energy and avoid energy dissipation in relation to manual labor became of greater importance. ever since descartes introduced the now-infamous divide between mind and body—the mind being a metaphysical andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 51 substance with its primary location in the pineal gland and the body playing the role of an automaton— the body was increasingly seen as a machine, with the mind as the defining feature that separated man from animals. however, the growth of industrialization and the construction of machinery recognized the body’s mechanical function and also emphasised the human body as a productive force—as labor power. in this way, the actions of the body were not to be seen so much as governed by the mind as by their interrelationship with the machine. according to marx (1976 [1867]), this interrelationship was so skewed that in factory work, the machine makes use of the human worker—something he would later examine in more depth through his concept of alienation. however, marx suggests another understanding of the use of nervous energy when he says: “factory work exhausts the nervous system to the uttermost” (1976 [1867], 548). marx incorporated the idea of nervous energy in his theory of historical materialism. the worker was seen as possessing this energy. whether marx would have called the worker “neurasthenic” is an unanswered question, but the idea of nervous energy—and the management of nervous energy—had become increasingly consolidated in society at the time. and, energy remained janus-faced, becoming a point of fascination for several ideological factions of society, from bolshevism, fascism and liberalism to taylorist capitalism, all of which proposed making progress through the productive use of energy (rabinbach 1992). the physical symptom of the potential depletion of nervous energy was fatigue. however, among the workers in these ideologically diverse factions, a lack of energy could, for instance, in bolshevist terms, also be seen as a product of false consciousness. in the productivity of taylorist capitalism, it might be the processes that were not utilised to their maximum, and so on. as a concept, neurasthenia developed in a number of different directions, often depending on the cultural appropriation of the concept. it moved beyond the borders of american society and became widely known throughout europe (sengoopta 2001). in the preface to the second edition of a practical treaty on nervous exhaustion (neurasthenia), beard writes, “this observation is of value as showing that this malady is not confined to the united states, where it was first systematically described, and where it is certainly far more common than in all the world besides, and that the symptoms, behaviour, and clinical history are the same in both countries” (1971 [1880], 9-10). work conducted on neurasthenia in europe by scholars such as wilhelm erb (beard 1971 [1880]), william playfair (sengoopta 2001) and the pioneer of research in hysterics, jean-martin charcot (goetz 2001), may have convinced beard of the likelihood that the diagnosis could exist in other countries, although he maintained that the diagnosis was primarily applicable to the us. in europe, neurasthenia also came to the attention of sigmund freud, the father of psychoanalysis. in freud’s paper “über die berechtigung, von der neurasthenie einen bestimmten symptomenkomplex als ‘angstneurose’ abzutrennen” (“on the grounds for detaching a particular syndrome from neurasthenia under the description ‘anxiety neuroses’”) (1953 [1895]), he paved the way for the disease to be recognised as a psychoneurosis that could possibly be cured through psychoanalytic treatment. but as tom lutz rightly points out, neurasthenia as a psychoneurosis existed in parallel with the actual organic neuroses in freud’s paper. however, historian edward shorter (1992) argues that this alternative change in cause, from somatic to mental, affected the general status of neurasthenia, absolving it of individual responsibility. in effect, with the introduction of psychoanalysis, neurasthenia—previously the disease of modern civilization— became a different disease. freud later claimed (perhaps in light of events in germany at the time) in his civilization and its discontents in 1929, we are threatened with suffering from three directions: from our own body, which is doomed to decay and dissolution and which cannot even do without pain and anxiety as warning signals; from the external world, which may rage against us with overwhelming andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 52 and merciless forces of destruction; and finally from our relations to other men. the suffering which comes from this last source is perhaps more painful to us than any other (1962 [1929], 24). like beard, freud argued that advancements in civilization put critical demands on the human psychic condition. he claimed that the constant demand for higher and higher rates of production caused severe mental illnesses—not only among the elite, but also among workers (ibid.). but as the above statement suggests, mental illnesses could also be caused by certain kinds of social interactions and (sexual) repressions, whereby the expressions of an individual were manifested in both mental and somatic diseases. as friedrich nietzsche (2006 [1906]) apocalyptically argued, stopping the train of progress was unlikely, and thus the dissipation of energy would continue and accelerate. to a large extent, this dissipation was seen by these scholars and medical professionals as an epidemic caused by progress itself, which threatened, even promised, a social deformation of society. aging and neurasthenia the threat of social deformation through the loss of energy also applied to the concept of aging, which was becoming an increasingly prevalent issue in western society in the late 19th century. beard was of the firm conviction that old age was “an inevitable casualty in the great race of life” (cole 1992, 164). in a graph explaining the relation of age to producing original works that appeared in american nervousness, its causes and consequences (1881), beard argued that mental and physical power declines after the age of 40. in many ways this argument foreshadowed the alliance between american medicine and industrial capitalist efficiency (cole 1992). in effect, beard completely repudiated the features of good old age, which had hitherto been moral courage and happiness, and replaced them with traits such as being conservative and cowardly. he argued that happiness was a feature of middle age, not old age. to that extent, aging was a specific neural decline from age forty onward, and so happiness was not to be found in old age. this corresponded well with the ideas about conserving one’s energy that were current at the time. according to beard, one had to maintain a certain amount of nerve force after the age of 40 to slow the decline. old age was therefore the advent of an inevitable cerebral disease. that the disease was confined to the nerves was an important factor for beard, who noted that very few of his patients suffering from neurasthenia exhibited any outer signs of depleted nerves. thus, cole writes, “beard deserves the dubious distinction of being the first to scientifically legitimate the reduction of human beings to their productive capacities” (1992, 168). adding to beard’s rather unflattering description of old age, the physician william osler contributed to the establishment of a scientific and unsentimental view of the body whereby human value was measured by productivity. even the few who dared to criticize this conception of old age did not argue against the decline of productivity associated with old age. instead, they argued that one came to higher spiritual insights when reaching old age. thus felix adler (1906), the leader of the new york ethical culture society, took an existentialist approach to aging, arguing that while youth and middle age was a time of “doing,” old age was a time of “being,” which seems to accept the economic worthlessness of old age. while adler’s ideas had little popular appeal, they demonstrated how a lack of energy that causes less productivity had become a central concern in an increasingly industrialized world. thus, aging as ultimately resulting in old age presented not only a threat to one’s own body, but also to the modern dream of limitless accumulation of wealth for individuals (cole 1993) and for nations. the overarching element in the descriptions by these 19th and early 20th century physicians is how aging would ultimately result in a decrease of energy, which was set in the context of a decrease in andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 53 productivity. with the increased focus on energy in industrialized societies, several authors suggested that human productivity was one of the essential features of mankind—a productivity that essentially necessitated energy. hence, the body was a vessel facilitating the creative productions of the mind. while this cartesian dualism aligned the human body to that of a vessel, the industrialist-need for rational, calculated and homogenous production focused less on the creative uniqueness of each “vessel” and more on the energy spent on the production of pre-specified products. as for time, the industrial linear time structuring a workday made it possible to measure productivity. industrialization and ideas about the rationalization of the body’s energies moved the possibility of energy expenditure in production from being a question relating to the work ethic of the working man, to a question of a rationalization of possible energies (rabinbach 1992). in other words, because industrialization placed the human body alongside machines, whose efficiency and productivity were directly measurable, measuring overall productivity in relation to supply and demand necessitated certain standardized norms of human labor. this, it can be argued, created a body that was in a constant relation to a quantitative norm of production, which facilitated the increase of pathological conditions, of which lack of energy became central. as georges canguilhem (2008) noted, the normative had and continues to have a tendency in positivist sciences to become the definition of the normal, which creates new conditions of abnormality (2008). yet, one might argue that the mind was not completely eradicated from this rationalization of energy, which could be seen in the prevalence of discourses concerning the moral imperative to use one’s energy in a manner which would add to productivity, or at least, not hurt one’s productive capabilities. in this way, the ultimate responsibility for one’s level of energy for production was not solely related to the industrialist use of energy, but also to the way one chooses to discipline the body. ranging from rationalization of energy in work to individualized disciplinary notions of how to preserve energy, aging was seen as unproductive because it ultimately limited energy output. while beard argued that aging happened with the use of nerve force, others argued that sexual or cellular energy that depleted with age caused the overall loss of energy. among the followers of the latter conviction was charles asbury stephens (1892), who tried to demonstrate how the aging process was found at a cellular level, and that the perfection of cellular nutrition and utilization of vital energy for cellular restoration could possibly be used to ensure endless rejuvenation, or immortality. in relation to sexual energy, masturbation was portrayed in numerous descriptions at this time as draining the body of energy. the development of brown sequard’s elixir of life in the mid-19th century in the wake of this speculation prompted the hope for a rejuvenation of this sexual energy. the elixir was widely sold and although it proved to be to be quackery (cole 1992), the idea that energy could be located in the sex glands continued to be widely believed from the mid-19th century through the beginning of the 20th century. in some cases, this belief that energy is located in the sex glands meant that some went to the extent of surgically redirecting the sexual hormone from the genitalia back into the body (ibid.). in any case, a new disciplinarian regime seemed to gain impetus in the late 19th century with regard to preventing “unnecessary” loss of energy. disciplining one’s eating habits through diet and controlling sleep patterns also provided new methods to foster energy conservation. so, when the kellogg and post cereal companies introduced their cornflakes in 1901, declaring that they would prevent aging, they were part of a larger trend of disciplining the body through consumption. it was in light of “disciplining energy” that microbiologist elie metchnikoff, the 1908 nobel prize winner (with paul ehrlich) for physiology or medicine, suggested that bacteriology could eliminate infectious disease, and thus most causes of death. metchnikoff’s 2004[1908] theory prompted him to andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 54 promulgate a discipline of “civilized morality,” which focused on a rational hygiene that included a strict dietary prescription highlighting sour milk besides regular exercise. according to metchnikoff, the lactic bacilli in sour milk and other products were able to neutralize the toxins produced by harmful bacteria. in this way, applying the dietary measures in combination with exercise would prevent disease and ensure a high energy level throughout one’s life. following metchnikoff’s ideals meant that there would be a difference between dying a natural death and dying a death caused by infectious bacteria, with natural death being the end of “healthy old age.” in light of this, it is noteworthy that metchnikoff was the first person to frame gerontology as a science that was created to specifically address inhibiting the process of aging. some gerontologists have argued that a significant predecessor to geriatrics was the physician carl friedrich canstatt, who on the basis of friedrich wilhelm joseph schelling’s naturphilosophie argued for the existence of a vitality that sustained bodily existence (kirk 1995). canstatt’s (1979[1839]) ideas on aging implied that age was defined by one’s life force, not by one’s age. thus, the question remained: how to maintain this life force? although canstatt was discredited by some of the better-known physicians, such as jean-martin charcot, the idea of life force, and specifically questions about how to maintain this metaphysical presence, was evident in some of the early geriatric works (kirk 1992). in the early 20th century, dr. ignatz nascher (1914), who is commonly known as the father of the discipline of geriatrics, argued that the body contained a vital energy. although he disclaimed theories of the body as a machine that could wear out, he argued that intense psychological and physical energy expenditure could accelerate the aging process. two general discourses concerning aging and energy emerge from this brief review of late 19th-early 20th century research on aging. one discourse outlined the use of energy as facilitating a decrease in overall energy, while the other discourse outlined an expenditure of energy as being beneficial in preventing the process of aging. how one could optimize or preserve this energy or what to do when the lack of energy occurs was a widely debated question at the time; in many cases the discourses were intermingled. however, a common feature in all descriptions was that aging meant a decline in overall energy, which would entail a loss of productivity. as previously noted, with the shift in medical discourse during the 19th century—attributable in part to charcot—the definition of the pathological became juxtaposed with the definition of the normal, and signs and symptoms of disease and health were dependent on these definitions (tiles 1993). this, in turn, would make old age inherently pathological. however, when nascher coined the term “geriatrics,” he presented it as the study of old age as a distinct period of life in which different definitions of the normal and the pathological applied (cohen 2006). by doing so, he attempted to separate old age from disease, but struggled to provide a clear definition of what old age is if it is not solely defined by gradual decline (kaufman 2006). to that extent, old age continues to be defined in the fields of geriatrics, gerontology and the life sciences as biological decline (katz 2011), and concurrently, old age was and is presented as “a problem of the limit” (cohen 2006, 5). popular slogans such as “healthy aging” (fries 1980), “successful aging” (kahn & fries 1987) and “productive aging” (butler and gleason 1985) all express the concern with old age as an unproductive burden on society (lamb 2018). consequently, they promote a compression of morbidity, effectively arguing that morbidity in old age should be as limited as possible (moody 1995). this also means that there are right and wrong ways to age, and to ensure that one ages the right way has been discursively put forth as a life-long endeavor. when considering how neurasthenia was, and aging is, characterized by energy depletion, it is not difficult to see the connection between the contemporaneous concerns around andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 55 neurasthenia and contemporary notions on aging. the cause of the spread of neurasthenia also became its downfall. in addition to being a diagnosis that gradually become more widely used in less-elite circles, neurasthenia had always had the problem of being an umbrella diagnosis that sought to explain nearly everything that could not otherwise be measured. as beard argues in a practical treaty on nervous exhaustion (neurasthenia), first of all, the symptoms of neurasthenia are largely of a subjective character, and to one who does not suffer them, appear trifling and unreal; many of them do not appeal directly to the senses of the scientific observer: the physician can only know of their existence through the statements of the patient, or through his conduct. unlike the existence of surgical and acute inflammatory diseases, the phenomena of which the physician can see and feel, and for the study of which he is little, if at all, dependent on the patient’s intelligence or honesty, they do not appeal directly to the eye or ear or touch, and are in fact quite out of the range of all modern appliances to supplement the defect of the senses, as the ophthalmoscope and laryngoscope, or even the spectroscope (1971 [1880], 26-27). this statement demonstrates that neurasthenia exhibited symptoms that seemed inexplicable to medical professionals at the time. it also provided the elite with a diagnosis that confirmed their positions in society as well as the sacrifice of their nervous energy for the sake of social progress. however, the eventual disappearance of neurasthenia in western medicine is not necessarily related solely to neurasthenia becoming a gesunkenes kulturgut (sunken cultural treasure) that lost favor among the elite medical practitioners, or to its becoming a psychoneurosis with its hypothetical somatic foundation removed (sengoopta 2001). rather, neurasthenia’s “disappearance” should be connected to a change in doctor–patient relations. according to historian mathew thomson (2001), the diagnosis offered medical recognition of the immeasurable ailments that patients experienced as somatic, and this satisfied the elite patients who were paying for a medical consultation. however, when neurasthenia spread down to the lower levels of society, neurasthenia’s former mark of honor was at risk. the diagnosis became especially contested after the first world war, when many of the returning soldiers opting to receive state pensions were suddenly diagnosed with neurasthenia (ibid.). in light of the range of symptoms credited to neurasthenia, it is logical that a number of ailments can be traced back to it. the disease is a prominent feature in the history of diagnoses such as shell-shock and its later version, post-traumatic stress disorder (ptsd) (shephard 2003). another frequently occurring contemporary diagnosis that neurasthenia has become associated with is chronic fatigue syndrome (cfs). the term was first coined in 1988; since then, cfs has undergone something of a baptism of fire. on the one hand, it has been accused of being just another diagnosis invented by medical companies. on the other hand, it has been the battleground for a range of patients who have sought medical recognition for their ailments (straus 1991). in social origins of stress and disease: depression, neurasthenia, and pain in modern china, anthropologist and physician arthur kleinman (1988) notes that neurasthenia is still recognised in china. according to lutz (1991), neurasthenia has been widely accepted in asian countries because it is not associated with any stigma, while kleinman argues that a stigma is inherently present in the diagnosis in china. social anthropologist vieda skultans (1997) presents a very different analysis of neurasthenia in latvia, a post-soviet country. according to skultans, neurasthenia came to denote difficulties related to succumbing to political submission, and was thus an issue of false consciousness. from a psychiatric point of view, history could not provide any consolation because by creating a true consciousness, the timelessness of socialism was ubiquitous. however, neurasthenia became a tool for socialism to translate andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 56 a political threat into a psychiatric language that was dichotomous—the disease exhibited both false and true consciousness (ibid.). the diagnosis of neurasthenia as a matter of dialectics should be obvious. on the one hand, it represented an explanation for paying patients who had symptoms that were hard to integrate into a medical discourse without stigmatization. on the other hand, it allowed doctors to provide a somewhat satisfying diagnosis that was grounded in the energy discourse of the day. in other words, neurasthenia as a disease made sense: it was created through the vocabulary and praxis of the time, and it gave an individual much-desired status in society. but because neurasthenia involved the field of energy, it also became a sign of the limits of progress and the great human costs made in the name of progress that saw energy dissipation and consequently aging as its largest obstacle. a diagnosis of neurasthenia thus highlighted both the moral and pathological nature of energy and aging. conclusion the old dictum that diseases are social is obvious when reviewing the disease of neurasthenia. in general, as medical historian charles rosenberg (1992) argues, nosology facilitates the rationalization, mediation and legitimization of relationships between individuals and institutions. the creation of a diagnosis constitutes a disease as a social phenomenon, which means that while a disease may seem to have a somatic individuality, it is always experienced in a cultural and historical setting (rosenberg 2003). to this extent, neurasthenia as a diagnosis played out in societies where continual increases in production had become tantamount to progress, and where aging as “unproductive” was presented as a limitation. focusing on the diagnosis of neurasthenia, this article demonstrates how energy became closely associated with production during the industrialization of western countries. i argue that this both caused an increased rationalization of bodily energy as well as a disciplining of the body, which ultimately resulted in old age being seen as an unproductive state of depleted energy and hence an obstacle to modern progress. how to renew this energy and ultimately create the conditions under which one could be productive for as long as possible thus became the question of intense discussion, which still continues to this day. thus, aging is presented as a systemic problem in contemporary society—due in part to its threat of creating unproductive and unenergetic bodies that are a burden to society. this is exemplified by numerous socio-economic formulas of which the “dependency ratio” (calasanti 1986, 1229) represents the prime example of the link between productivity and aging. as the dependency ratio presents how productivity in contemporary society is coupled with economy, the decline in productivity with aging has caused aging to become associated with economic dependency. consequently, healthy and active aging continues to be discursively promoted and encouraged in western society, promising the added benefit of a compression of morbidity (lassen and andersen 2016). thus, numerous financial as well as governmental institutions frame aging as an unproductive factor that threatens to cause many of the same societal ills as the diagnosis of neurasthenia was thought to cause when it was initially introduced in 19th century societies. notes i a contemporary example could be hiv or certain types of cancer, where the disease has become associated with a lifestyle that is portrayed as morally corrupt (e.g., promiscuity, obesity, smoking, etc.). andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 57 references adler, felix. the spiritual attitude towards old age. new york: new york society for ethical culture, 1906. beard, george m. 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"geriatric medicine and the categorisation of old age – the historical linkage." ageing & society 12 (1992): 482–497. kirk, henning. da alderen blev en diagnose (when age became a diagnosis). københavn: munksgaard, 1995. andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 58 kräupl taylor, frederick. the concepts of illness, disease, and morbus. cambridge: cambridge university press, 1979. kleinman, arthur. social origins of distress and disease: depression, neurasthenia, and pain in modern china. london: yale university press, 1988. lamb, sarah. "on being (not) old: agency, self-care, and life-course aspirations in the united states." in medical anthropology quarterly 0 (2018): 1-19. lassen, aske j., and michael andersen. 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 sengoopta, chandak. "’a mob of incoherent symptoms’? neurasthenia in british medical discourse, 1860–1920." in cultures of neurasthenia from beard to the first world war, edited by marijke gijswijt-hofstra and roy porter, 97–115. amsterdam: rodopi, 2001. shelley, mary wollstonecraft. frankenstein or the modern prometheus. edited by nora crook. london: w. pickering, 1996 [1818]. shephard, ben. a war of nerves: soldiers and psychiatrists in the twentieth century. new york: harvard university press, 2003. shorter, edward. from paralysis to fatigue: a history of psychosomatic illness in the modern era. new york: free press, 1992. skultans, vieda. "a historical disorder: neurasthenia and the testimony of lives in latvia." anthropology & medicine 4, no. 1 (1997): 7–24. stephens, charles a. pluri-cellular man: whence and what is the intellect, or "soul"? what becomes of the soul? is it possible to save the soul? norway lake: laboratory company, 1892. straus, stephen e. "history of chronic fatigue syndrome." review of infectious diseases 13, no. 1 (1991): 2–7. andersen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.170 http://anthro-age.pitt.edu 59 thomson, mathew. "neurasthenia in britain: an overview." in cultures of neurasthenia from beard to the first world war, edited by roy porter and marijke gijswijt-hofstra, 77–95. amsterdam: rodopi. 2001. tiles, mary. "the normal and pathological: the concept of a scientific medicine." the british journal for the philosophy of science, no. 44 (1993): 729–742. weber, max. the protestant ethic and the spirit of capitalism and other writings. translated by gordon c. wells. london: penguin books, 2002 [1905]. theater review review of the other (2020), a play by megan moodie. leslie carlin university of toronto leslie.carlin@utoronto.ca anthropology & aging, vol 41, no 2 (2020), pp. 257-258 issn 2374-2267 (online) doi 10.5195/aa.2020.289 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. theater review | carlin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.289 http://anthro-age.pitt.edu 257 theater review review of the other (2020), a play by megan moodie. leslie carlin university of toronto leslie.carlin@utoronto.ca what is it to be human? anthropology both asks and answers this question in many ways. megan moodie, an associate professor of anthropology at the university of california, santa cruz, and who suffers from a genetic condition called ehlers-danlos syndrome, has written a brief, semiautobiographical play in which the protagonist, kathleen, asks the question of herself. in fact, within the confines of the play’s reality, kathleen quite literally poses the query to her own, younger self in a surreal situation that finds the two women – older kathleen, younger kathleen – in conversation on a park bench one mild autumn day. the year is either 1994 or 2019, or both, or neither, “somewhere in the northeast or the midwest” of the usa. don’t be mistaken by the indeterminacy of the situation: the atmosphere is not one of weirdness; that is not the point of the play. the play, called the other, is loosely based on the conceit that jorge luis borges used in his short story of the same name (“i just straight-up stole his title,” moodie says cheerfully during a q&a after the show). i watched the performance of the other on may 20, 2020, during the covid-19 pandemic, in the midst of deep lockdown.1 the jersey city theater company (jctc) ingeniously arranged for actors to give dramatic readings from remote locations. all the world’s a stage, with zoom. on this particular evening (local time) the staff of the jctc, four actresses, and three playwrights explored the theme “return to love” in three single scenes, either monologues or physically-distanced dialogues. the audience sat in their homes and watched in two dimensions on their own small silvery screens.2 the event was curated by catalina florina florescu, a professor of drama at pace university, with olga levina as artistic director. moodie’s play, directed by mark cirnigliaro, formed one of the trilogy. it required dialogue between two characters: julia patella played the 17-year-old kathleen while tara westwood depicted the same character in her early forties. young kathleen several times refers to her interlocutor as “old,” spurring playful objections. older kathleen eventually convinces the younger woman to accept her for who she claims to be: her own future self. she proffers at one point a dollar bill with the date ‘2019’ (an idea lifted from the borges story) but her sharp insight into young kathleen’s dreams and fears goes further toward persuading the dubious teen about the elder’s identity, for instance poignantly and accurately describing the pride that young kathleen feels about her recent star ballet performance. in spite of these moments of recognition, both characters acknowledge the evanescence of their encounter and the great probability that neither will remember its occurrence, neatly leaping tedious discussion of the timetravel conundrum. http://anthro-age.pitt.edu/ theater review | carlin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.289 http://anthro-age.pitt.edu 258 with that dubious layer of amnesiac protection in place, older kathleen tells her younger self that she carries (that they carry) faulty genes, a mistake of dna, erroneous chromosomes that affect connective tissue. younger kathleen’s immense flexibility is part of what makes her excel at dancing, but is also a harbinger of the devastating disability lying ahead. it brings to mind the story of achilles’ heel, a fatal flaw; vulnerability. and yet the play forms part of a trilogy about love. the jctc has mounted performances on various themes; that the other is included in “return to love” raises interesting considerations on the emotion attending the intergenerational dialogue in the play. moodie’s older (current?) character reveals to the younger what lies ahead in her life, both the glories and the horrors. is that an act of love? the young kathleen reacts to the information with suspicion and befuddlement, but not, apparently or overtly, grief. she runs away—“i have to go home for dinner”— and then turns back, ambivalent, to hug her(older)self, this intimate stranger, and hangs onto the scarf older kathleen handed her (as in the borges story, in which the younger borges acquires a dollar bill from his future self). meanwhile, we are left to wonder whether either elder or younger kathleen do in fact keep and safeguard a memory of the encounter, or whether only we, the audience, remember. borges, enjoying more leeway and a higher word-count than a fifteen-minute play offers, delves further into this question of memory, self, and continuity. his narrator says, i have thought a great deal about this encounter, which i've never told anyone about. i believe i have discovered the key to it. the encounter was real, but the other man [the younger borges] spoke to me in a dream, which was why he could forget me; i spoke to him while i was awake, and so i am still tormented by the memory. in his version the protagonist is called jorge luis borges. in megan moodie’s, the protagonist is called kathleen. the floating associations of real and imagined, dream and waking, and of different versions of the self—and thus of the other—make both narratives as absorbing as they are universal. the author clarifies in her stage directions that ehlers-danlos syndrome is not linked to a particular population and thus that the actors, while they should look similar to one another, need not be of any one race or ethnicity. what would anyone—with a progressive genetic disorder or without—choose to share with their younger selves? those of us interested in the anthropology of aging and the life course may find reverberations of this question in their research. moodie brings up the point during the q&a: her imagined scenario is not just about illness, she comments: it is about cultivating compassion throughout the life course, and using art to capture this process in a moment, imagining a discrete milestone in maturation. while a progressive illness brings into sharp relief issues such as the aging self and genes that travel beyond the self across generations, it is not only flawed chromosomes that make the aging process a force to be reckoned with. genes act as determinants – but “life intervenes” as well. aging happens to everyone who is lucky enough. in this play, we are invited to ponder whether knowledge that accrues to the older and the wiser is fit to be shared with the young and the raw. notes 1. the full programme of this evening is available on the website of jctc: https://www.jctcenter.org/e/jctc-newplay-festival-return-to-love-103998879448/. 2. this plan and its execution were novel and amazing when i viewed the play; now, seven months later, just prepublication, it is nothing special. http://anthro-age.pitt.edu/ https://www.jctcenter.org/e/jctc-new-play-festival-return-to-love-103998879448/ https://www.jctcenter.org/e/jctc-new-play-festival-return-to-love-103998879448/ editor_note mikkelsen | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.273 http://anthro-age.pitt.edu 0 the editor’s note henrik hvenegaard mikkelsen author contact: henrikhvenegaard@hotmail.com anthropology & aging, vol 41, no 1 (2020), pp. 1-2 issn 2374-2267 (online) doi 10.5195/aa.2020.273 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mikkelsen | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.273 http://anthro-age.pitt.edu 1 the editor’s note henrik hvenegaard mikkelsen author contact: henrikhvenegaard@hotmail.com aging as an anthropological field is evolving and it is critical that it continues to do so. as the way the life course changes—along the way it is perceived—so too must the anthropology of aging continue to morph into new areas. and it is an intriguing time for aging research, which is reflected in the manuscripts that we receive at anthropology & aging. these manuscripts apply aging as an ethnographic lens that shed light on often overlooked domains of societies and provide new entry points into current political debates. this is imperative for multiple reasons. most notably, it is vital that anthropologists continue to provide nuanced perspectives at times where gaps are formed—often enthused by media reports that boil down complex issues to simple antagonisms. think for instance of the internet meme okay boomers, which has attracted an excessive amount of media attention during the last six months. okay boomers has become a catchphrase that signifies the defiance of a young generation who have had enough. it thereby suggests a reversal of the power dynamics between the older boomer generation (those born between 1946 and 1964) and the younger generation of millennials (those born between 1981 and 1996), where the latter is sick and tired of being referred to condescendingly as overprivileged and lazy. okay boomer is the reply to the, supposedly, moralizing elderly when they criticize the youth while the elderly themselves have proved unable to offer viable solutions to the mounting ecological and economic challenges of our times. rather, what they have done, according the millennials’ criticism, is that they have undermined national economies by, for instance, inflating the housing market and thereby making it difficult for future generations to buy a home; as the journalist joseph c. sternberg (2019) recently phrased it, the boomers “stole the millennials’ economic future.” the question here is not only whether this economic analysis is correct, though this is indeed an important question. we need also to explore what historical circumstances have made it possible to conceptualize the boomers as a social whole. if, as it has sometimes been argued, we live in times of monster-making, where gaps can rapidly be formed between groups in society, anthropology should de-monstrate—i.e., insistently inquire into the gaps that are constructed by media and political rhetoric. anthropologists will always need to provide research that show that the world is more complex and while this is, at times, tedious compared to the daily flow of spectacular media-events to which we have grown accustomed, the need to dissolve gaps, to understand other people’s perspectives continues to be crucial. thereby, using john borneman’s term, anthropology could be seen as an academic endeavor aiming to generate not only knowledge of the outer world, but knowledgeability. this term implies a “cultivation of curiosity beyond the usual investments of interest, a critical thinking that is thoroughly mediated by introspection and empathetic communication” (borneman 2015, 74). this effort is also important at a time where the funding agencies who support our research are more often than not interested in topics related to health and care. while these are indeed important areas, we must remain intensely aware of how we as anthropologists decide what accounts for relevant research topics. in my opinion we must think about the extent to which anthropology may come to add to the notion that old age is first and foremost a phenomenon that needs to be understood in relation to physical and mental health. anthropology & aging has for years published research that moves beyond this narrow depiction of what senior life entails. we will continue to publish article that explore the lush and intricate worlds that people inhabit—and that use such insights to enrich the tapestry of the anthropology as a field. we need to explore aging with the same curiosity and theoretical innovation that anthropologists have engaged with mikkelsen | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.273 http://anthro-age.pitt.edu 2 cultures across the globe. it is a great honor for me, as the new editor of anthropology and aging, to be given the opportunity to support this project in the coming years. i hope you will enjoy the current issue of anthropology & aging, 41(1). we are excited to be able to publish the winners of 2018 margaret clark award from the association for anthropology, gerontology, and the life course (aage) in this issue: rose keimig won the graduate award for “chronic living and deleyed death in chinese eldercare institutions” and oliva silva (with ariel cascio and eric racine) won the undergraduate award for “person-oriented research ethics for studies involving elderly participants with dementia.” also, on behalf of the editorial board, i would very much like to thank cortney hughes rinker for her dedication to the journal in the previous years. as she steps down as editor, she will remain part of the editorial board and i am looking very much forward to work with her to develop anthropology & aging in the future. thank you for your continued support of the journal. references borneman, john. 2015. cruel attachments: the ritual rehab of child molesters in germany. chicago: university of chicago press. sternberg, joseph c. 2019. the theft of a decade: how the baby boomers stole the millennials’ economic future. new york: public affairs. book review review of degnen, cathrine. cross-cultural perspectives on personhood and the life course. new york, ny: palgrave macmillan. 2018. pp. 261. price: $119.99 (hardcover); $89.00 (ebook). maria g. cattell the field museum of natural history, chicago mgcattell@aol.com anthropology & aging, vol 41, no 2 (2020), pp. 276-279 issn 2374-2267 (online) doi 10.5195/aa.2020.291 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | cattell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.291 http://anthro-age.pitt.edu 277 book review review of degnen, cathrine. cross-cultural perspectives on personhood and the life course. new york, ny: palgrave macmillan. 2018. pp. 261. price: $119.99 (hardcover); $89.00 (ebook). maria g. cattell the field museum of natural history, chicago mgcattell@aol.com when cathrine degnen’s research on older persons in northern england led her to wonder if personhood is more secure at certain points in the life course than at others, she became “entirely captivated by the question of personhood” (1). pulling together her various research interests ‒ aging selves, intersectionality, relationality, and others ‒ degnen wondered: who and what counts as a person? does personhood shift over the life course? is it for the dead as well as for the living? this book is the result of her exploration of these and other questions pertaining to how and when personhood is acquired, maintained, changed and lost; how some people (e.g., slaves, women) in some times and places are excluded from personhood; the role of place in personhood; and personhood attributed to other-than-human beings. overall, degnen makes a strong case for the view that “personhood is intrinsically connected to ‒ and changes with ‒ the various phases of the life course” (3). chapter 1 is introductory, providing an overview of ideas and practices of personhood worldwide and relevant discussions in anthropology. degnen does not propose a new definition of ‘the person’ or ‘personhood’ ‒ rather, she offers multiple attributes of personhood through her ethnographic examples and through a review of anthropological debates about personhood from mauss and radcliffe-brown to the present. “personhood,” she says, “is not identity . . . [and is] not always equivalent to being human. but personhood does entail a capacity for action in the world of social relations, and it also arguably extends a moral value to persons that non-persons are excluded from” (7). furthermore, personhood matters because it has “deep pertinence . . . to being, experience, and sociality crossculturally” (10). here, and throughout the book, degnen contrasts the normative “western” conception of a person, which emphasizes individuality and valorizes “autonomy, agency, independence, cognition, rationality” (153), with personhood that is brought into being and maintained through reciprocal fields of social interaction, including relations with place and an animated universe. while academic discourse initially differentiated the latter as “dividuals” rather than individuals, current thinking is that people everywhere exist as both dividuals and individuals. the first chapter also deals with degnen’s methodology, qualitative cross-cultural comparison, which usually reveals great cultural variability, as it does in her work. degnen discusses three issues with the method: the “curio-cabinet” effect, using ‘western’ as a touchstone, and problems with time and historical contingency in using material written in the ethnographic present about times which now are http://anthro-age.pitt.edu/ book review | cattell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.291 http://anthro-age.pitt.edu 278 historical. on the whole, her fine-grained summaries of ethnographic materials from others’ research minimize these effects, which probably can’t be entirely eliminated. in some ways the remaining seven chapters are stand-alone pieces, each with its own introduction, discussion and conclusions, with the exception of chapters 2 and 3 on the beginnings of personhood, which need to be considered together. four chapters are organized by broad life stages: the beginning of personhood, older age, and death. these life stages are culturally malleable and historically contingent, as degnen amply demonstrates. childhood, adolescence and adulthood prior to old age are not covered, though surely there are issues of personhood in those life stages as well (e.g., initiation rites or the creation of new categories such as "tweens" in the us). three other chapters discuss place and personhood, other-than-human persons, and threats to personhood. chapters 2 and 3 together deal with the beginning of personhood, which varies cross-culturally across the early life stages of conception, pregnancy and babyhood/early childhood. here degnen takes into consideration the importance of shared substances and practices such as feeding and naming in the articulation of personhood, as well as, in the us, the ways that ultrasound technology contributed to the concept of the fetus as an autonomous individual, a view prominent in current abortion debates. chapters 4 and 5 consider place and other-than-human people in the constitution of human personhood. humans alter places to express social relations and imbue places with meaning, but places also act upon humans and gather humans, other beings, ancestors, experiences, memories, and much else. in many societies animals, plants, spirits and material objects are regarded as persons. this contrasts to western binary modes of thinking that discourage such ideas, though companion animals may move us in that direction, along with the growth in recent years of multispecies anthropology and the ontological turn. readers of this journal likely will find the last three chapters of particular interest. chapter 6 deals with the significance of loss of personhood, with various cultural phases of old age (such as young-old/oldold and healthy/frail), with the tensions between cultural stereotypes and the lived experiences of old people, and with the impacts of gender, socioeconomic status and sexuality on personhood in old age. degnen’s ethnographic examples include explorations of the “frail elder” life stage as a time of diminishing personhood among the people of niue island by judith barker and among the tuareg of niger by susan rasmussen. she discusses elana buch’s study of chicago caregivers’ embodied care practices that help maintain their clients’ personhood and emily wentzell’s work among older mexican men who redefine manliness and personhood as caring for one’s family rather than as sexual conquest. degnen also takes up sarah lamb’s analysis of india’s bengalis, who, as they age, are concerned with loosening maya, the web of attachment with others, by physically moving to the periphery of their household and devolving household responsibilities to younger family members. this processual detachment diminishes personhood and allows the person to age and die well. the final two chapters deal with personhood endangered by such things as brain death and dementia, and the effects of death on personhood and relations of the living with the dead. life course approaches have figured in research on aging for the past half century. early research on age-set societies depicted the life course as a series of culturally defined life stages, though with some flexibility. today it is clear that life course experiences are shaped not only by social settings and cultural expectations, but also by the historical contingencies of rapid political, economic and sociocultural transformations in a globalizing world. what this book adds is a culturally relevant understanding of http://anthro-age.pitt.edu/ book review | cattell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.291 http://anthro-age.pitt.edu 279 personhood across the life course and openness to the fact that persons shape and reshape the life course through their experiences of the world in which they are embedded, and by interactions within and across generations, the latter an idea thoroughly explored in lynch and danely’s transitions and transformations (2013). degnen’s book will be of most value to graduate students and professional anthropologists. readers should appreciate the ethnographic richness of degnen’s discussions, though they tend to be repetitive across the chapters. also, a concluding chapter summarizing the materials and their implications for research would have added to this book’s analytical value. nevertheless, i can’t help but wonder how my understandings about aging and the life course in western kenya might have developed differently had i read degnen’s book before i wrote my dissertation (cattell 1989). i expect it would have inspired me to include a consideration of personhood in my analysis. references cattell, maria g. 1989. old age in rural kenya: gender, the life course and social change. phd diss., bryn mawr college. lynch, caitrin, and jason danely, eds. 2013. transitions and transformations: cultural perspectives on aging and the life course. new york: berghahn. http://anthro-age.pitt.edu/ final_pinesgiles pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 82 dancing while aging a study on benefits of ballet for older women rachyl pines university of california santa barbara author contact: rpines@ucsb.edu howard giles university of california santa barbara author contact: howiegiles@cox.net abstract as people age, experiences of depression, loneliness and loss of physical capabilities can emerge. as with previous work on the benefits of music as an intervention for social belonging and valued social identity, dance may increase similar feelings. although theoretical chapters have been written on dance as it relates to social identity, belonging, and health, little empirical work has been conducted on the benefits of ballet as a recreational activity for older adults. the study reported here is framed by the “communication ecology model of successful aging,” and modestly embellishes this framework based on this study’s findings. using interviews from 24 american female recreational ballet dancers ranging in age from 23-87 in a small west coast town, this study investigates, for the first time, how ballet is incorporated into their self-concept and physical, mental, and social experiences of aging. findings indicate that participating regularly in ballet is a core aspect of most women’s self-concept and means of self-expression. all women discussed how ballet has improved their physical and mental wellness, helping them have a more positive experience of age-related changes. results showed that most women regard ballet as a very social activity, such that it helps them to feel a sense of community or even kin-like relationships with the other people regularly in class. all women interviewed mentioned that ballet is so integrated into who they are that it is something they hope to do for as long as possible. keywords: aging; ballet; communication ecology model of successful aging; identity; social relationships anthropology & aging, vol 41, no 1 (2020), pp. 83-94 issn 2374-2267 (online) doi 10.5195/aa.2020.209 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 83 dancing while aging a study on benefits of ballet for older women rachyl pines university of california santa barbara author contact: rpines@ucsb.edu howard giles university of california santa barbara author contact: howiegiles@cox.net as people age, especially in retirement and assisted living communities, loneliness and depression are increasing health concerns (gonyea et al. 2018; theurer et al. 2015). however, there is strong evidence that recreational activities (e.g., and particularly sporting ones) enhance physical, social, and psychological well-being (human kinetics 2010; leitner and leitner 2012; onishi et al. 2006; tinsley and eldredge 1995). focusing particularly on older adults, many studies have pointed out that leisurely pursuits (e.g., lifelong learning and volunteering) have such benefits, including anxiety and stress reduction, emotional growth, and enjoyment (chang, wray, and yegiang 2014; gasoirek and giles 2013; glendenning 2004). cultural involvements and interests, like music, theaterand art gallery visits are also engaging resources that promote positive affective and outcomes among older people (age uk 2018; goodman, geiger, and wolf 2017; hays and minichiello 2005; jacobs 2014; murray and crummett 2010; pyman and rugg 2006). for example, an intervention study in care homes found that encouraging music-making among residents contributed to increased feelings of social productivity and positive social identities (theurer et al. 2015). among activities like these, dance has received only a modest amount of work as it relates to aging populations (cooper and thomas 2002; eyigor et al. 2009; keogh et al. 2009). dance and ballet dance has been a major focus in much anthropological research (kaeppler 2000; kringelbach and skinner 2012; taylor 1998; ness 2008; reed 1998; sweet 2016, marion 2008). historically, anthropological choreology (i.e., ethnochoreology) research considers the dance—particularly folk dance—to be like a dynamic yet coherent text that can be catalogued for the sake of preservation of the body of movements. however, this cataloguing is not a static representation of the dance, rather, it positions the dance in contexts and considers its cultural history within a community. this approach values how the dance holds, creates and shapes meaning and culture (blacking 1984). for example, some ethnochoreology research, in addition to more contemporary forms of dance (for a review of contemporary ethnochoreology research in serbia, see rakoeeviae 2015) has considered the purpose of traditional or tribal dances particularly in a variety of ways. dancing has been a form of prayer to cure a person’s illness (fergusson 1931), rituals to help a community member grow taller (royce 1977), encouraging good harvests (delgado 2012), and as an attempt to show strength and prowess before battle like in the maori “hakka” (list 1963). in parallel, dance ethnology focuses on social relationships and characteristics, such as gender, age, the body, and identity of the people dancing (kaeppler 2000). this affords an understanding of dancers and their means of expression, functioning within the socio-cultural community. due to the complexity of dance, it is important not only to focus on its artistic dimensions, but also its social ones (giurchesu, anca, and torp 1991). there has been little research to date on the social benefits of dance and, in general, has not focused on ballet (e.g., the social benefits of dance for people with parkinson’s; mcgill, houston, and lee pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 84 2014). most research regarding social benefits of dance has examined adolescent populations and education. research by kreutzmann, zander, and webstert (2018) found that for adolescents with little to no training, dancing a choreographed form together can increase feelings of belonging and actual social ties to other adolescents. similarly, other research has advocated for the inclusion of dance in k-12 education for its benefits for learning, problem solving, synthesizing information, and reinforcing nondance knowledge (hanna 2008). although dance styles, meanings, and levels of formality vary widely, blacking (2010) argues that “the universality and survival of "dance" (89) suggest that it cannot be abandoned without danger to the human species.” dance is a special kind of social activity and, as such, the actors of this activity are of special interest. therefore, he argues, we should be asking the question “who dances?” answering this question in terms of professional ballet dancers, ballerinas are encouraged to begin training as early as possible, and careers end early as well.1 according to a popular dance magazine, dancespirit, ballet dancers are often expected to be career-ready by as early as 16 years old. furthermore, most dance studios allow girls to begin taking ballet as early as three years old in the united states. in fact, female ballet dancers who start in their teens who achieve professional careers are an anomaly (dancespirit 2012). the average age of retirement for a professional ballerina is 35. rarely, some dancers continue into their early forties (dance.net 2009). although the women in this study may seem young for an aging focus, the vast majority of participants are well over the average retirement age of a professional ballet dancer. with these ages in mind, even recreational ballet dance for older people, which is the focus of the current study, has received negligible attention. this lacuna exists, in part, because younger people are surprised to learn that dancing can be a lifelong commitment—even for older women. ballet, as an anthropological area of inquiry, has received attention. some researchers have argued that ballet is a universal movement language. this can be reflected in its inclusion as an academic form of study in academies across the world (kaeppler 2000). although ballet research has distinguished between dancing it and being a spectator of ballet, the focus has mainly been on performance. that said, wullf (1988) conducted an ethnography of dancers at the paris opera ballet and described dancers’ backstage experiences. among other foci, she directed attention to professional ballet dancers’ experience of aging as primarily a negative experience, particularly with respect to how dancers avoid aging as much as possible to preserve their careers. the contrast between professional ballet dancers’ aging experience as negative, and the known benefits of cultural recreational activities such as dance as positive, encourages inquiry into older ballet dancers who are recreational participants. recreational ballet and successful aging clearly, the advantages and values of cultural activities such as dance can be enabling factors in successful aging. definitional debates asides (e.g., cosco et al. 2014), successful aging and allied processes have inspired the work of social scientists across several disciplines (e.g., pruchno, wilson-genderson, and cartwright 2010; heckhausen and schulz 1995, including anthropology (e.g., fujiawar 2012; lamb 2014; lewis 2013; vitols and lynch 2015). recently, the case has been made that older people’s social relationships, specifically how older people communicate, are communicated to and about, have important implications for successful aging (giles et al. 2013) and across the lifespan (e.g., bernhold, 2019; gasiorek and fowler 2016). herein, we invoke the “communication ecology model of successful aging” (cemsa, e.g., fowler, gasiorek, and giles 2015; gasoirek, fowler, and giles 2018) as a framework for our study as dance can be considered vital expressions of intrapersonal, interpersonal, and intergroup communication (see gasoirek, fowler, and giles 2018). pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 85 efficacy positive affect about aging negative affect about aging uncertainty: probability × desirability of age-related experiences communication about aging • self-categorization as old, or attributing behavior to old age • expressing optimism about the aging process • collusion in categorizing and teasing others • resisting mediated images of age and peddlers of anti-aging products • planning for future care needs • successful aging demographics and societal position characteristics environmental chatter • explicit messages about aging • role models for older adulthood • intergenerational communication • mediated images of aging • recreational cultural communication figure 1. the revised communicative ecology model of successful aging (after gasiorek et al. 2016), with shaded boxes and dashed lines representing revised elements of this model over the original. based on the current study, we inserted a fourth and non-italicized bolded component to the environmental chatter box above. pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 82 the essence of cemsa is that communication practices (see practices listed in the “communication about aging” component of figure 1) reduce anxieties about the aging process in that they bolster favorable and diminish negative affective views about it, thereby increasing our perceived efficacy to manage aging successfully. a revised cemsa model (see gasiorek, fowler, and giles 2016) includes facets of so-called “environmental chatter” that refer to how the language and communication people observe from a variety of sources (e.g., role models for how to age well) may also be influential in directly and indirectly predicting people’s aging efficacy. we contend that cultural involvements, such as taking recreational ballet and other forms of dance, are an additional and potent element of “environmental chatter” that can facilitate social relationships and our efficacy in dealing with the uncertainties attending the aging process. the majority of research invoking cemsa has had participants who are white and middle to high ses. the current study has similar demographics, and as such is appropriate for study through this model. however, in light of the lack of research on ballet, social benefits, and successful aging, our study is aimed at understanding how does ballet influence or factor into the experience of adult ballet dancers’ changing identity as they age? how has and does ballet frame ways that these women experience a changing physical body? in terms of social identity, how has and does ballet influence women’s social relationships? research methods and data analysis this study was conducted in a small, affluent coastal town in central california. the local context is one that highly values the performing arts, and has many shows and donors who support bringing professional artists into the community. most participants (n = 21) are regulars at a local professional ballet company’s associated school. another set of participants were recruited from another local dance studio location (n = 4). it is common for dancers to take dance classes at more than one studio. most women had taken at least one class at both studios at one point in their time living in the town. participants regularly take intermediate/advanced level ballet classes, with modifications when necessary to suit their physical abilities. such classes assume that dancers have knowledge of a full repertoire of ballet movements typically included in a ballet class. there is no time spent in these classes explaining how an element is executed, but instead, combinations of dance elements are taught. the instructor teaches the combination of movements quickly, which tend to be novel each class. the dancers then put the movements to music that is chosen by the instructor, requiring the dancers to have musicality. a typical ballet class for participants in this study costs $20, and is 90 minutes. the first half of the class is spent doing a typical sequence of movements with a small break to learn the next exercise between movements (e.g., pliés (bending kneeds with feet flat on the floor), battement tendus (brushing and pointing of feet on the floor), battement glissés, ronds de jambes, fondus, frappés, petits battements, developpés, ronds de jambes en l'air, grands battements, and stretching). this is completed holding onto the barre with one hand. next, dancers come to the center of the room to complete another series of movements often including tendu, adagio and turn combinations as well as some jump combinations. several movements are also completed going across the floor often including a turn combination and completing the class with a grande allegro combination (a series of large jumps travelling across the floor). ballet classes commonly end with a reverence (a bow/curtsy) to thank the teacher. although most of the dancers in this study have performed ballet in the past, the classes that participants take do not include any type of public performance. although no participants perform ballet publicly anymore, several of the younger participants do perform publicly in other forms of dance. those experiences go beyond the scope of this study. a total of 25 participants completed a semi-structured interview with pines who takes ballet classes regularly with most participants, and has prior experience as a professional ballerina.2 at the end of ballet pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 83 class at the two studios, pines announced that she would like to conduct interviews with interested participants in the class. dancers in these two locations volunteered to be interviewed by notifying her of their interest, often very enthusiastically, to complete the interview. participants also happily agreed to having their name, age and photos represented in the research.3 this study included 24 completed interviews with adult female ballet dancers (median age = 50 years; age range = 23-87). seven respondents were under forty years of age and this wide range in ages provides perspective of experiences of ballet from young adulthood to much later in life. the most common experience with ballet was that women started as children, took a break from ballet, and returned as adults with a combined experience of over 40 years of taking ballet classes (n = 17). of these women, eight of them had careers as professional or semi-professional ballerinas either belonging to ballet companies full time for one to ten years, or performed in paid projects. another group of women began ballet as adults (older than age 25) and had between four and 15 years of experience (n = 7). although the women who had professional careers reported stronger ties between ballet and their self-concept, no differences were found in terms of social or physical experiences. in terms of marital status, 12 women were married, nine women were single or in a dating relationship, three women were divorced, and one woman did not reveal her marital status. sixteen of the participants were mothers. the women were well-educated; most of them completed a bachelor’s degree, with two participants holding doctorates. generally, the women were middle to upper-middle class. all participants regularly take ballet classes ranging in frequency from approximately one to six times a week, with the majority reporting taking classes twice a week after approval from the university of california at santa barbara institutional review board, interviews were conducted over a three-month period between february 2017 and may 2017. most interviews were conducted at a local coffee shop, seated at a table, and at a suitable time for the interviewee. a small number of interviews were conducted either at the ballet studio before or after the class, or in the participant’s home. one interview was completed by phone. interviews were semi-structured, ranged in duration from 21 minutes to 53 minutes, and were digitally recorded. each interview began with the question: “can you tell me about why you started taking ballet classes?” this question allowed participants to reflect on their involvement and experience of ballet from the beginning. other questions included: “how has ballet changed your social relationships?” “how has doing ballet been a part of experiencing a body that is aging?” and “would you say that ballet is part of your identity? if so, how?” each question was followed by probing questions for clarity and completeness of information. interviews were transcribed by two undergraduate research assistants (ras), guided by notations from jefferson (2004), and checked for accuracy by a third undergraduate ra. based on braun and clarke (2006), thematic analysis was used to generate themes inductively from the interview transcripts. pines began by listening to all interviews and identifying references to how ballet shaped participants’ identities and generated broad themes relating to aging, particularly aging successfully. the same process was used for all references to ballet as associated with the women’s relationships to friends, family members, and other dancers. using these themes, the two ras coded interview transcripts line by line and this process resulted in the identification and refinement of broad themes and sub-themes. the ras and pines met weekly to reconcile differences and questions, and the ras refined, added or collapsed themes where necessary until sufficient agreement was reached for all interviews. we then returned to the interviews to identify exemplars of the themes. pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 84 findings participants could easily recall their personal experiences and trajectories with ballet that had implications for who they are and for their relationships. most participants described ballet as a core aspect of not only who they are today, but in shaping their self-identities. results demonstrate themes describing how ballet has shaped and is part of the dancer’s changing identity. analysis of the data also indicated ways ballet influenced their social relationships which have implications for successful aging. finally, dancers discussed how they hoped and planned for ballet to be part of their life as they age. ballet as part of a changing social and physical identity when discussing ballet as part of their self-concept, all women mentioned that it played a role (see wylie 1974 for a full description of self-concept theory). the first theme, shaping and showing the self, considers how ballet shaped and shapes their identity, and is self-expression. theme 2: ballet as purpose, describes how ballet has been a piece in shaping the purpose of their life in the past and in the present. theme 3: ballet and the social self, depicts through three sub-themes how ballet factored into the social and romantic relationships the women held through ballet as they aged, many of which contributed to positive aging through identity affirmation and role models. theme 4: ballet and the physical self, shows how ballet has helped the women experience more positive mental, physical and sexual wellbeing as they age. shaping and showing the self in response to how, if at all, ballet was part of their identities, participants explained how ballet acts both as a fundamental shaping experience for these women to varying degrees, and as a key way they express themselves to others. none of the participants said that it did not influence their identity at all. in general, the older the woman was, the more strongly she explained ballet as part of her identity. for example, emily (36), one of the younger women, first responded that ballet was not part of her identity even though she enjoys it very much. she then went on to qualify her answer to include, “if someone said i couldn’t do that anymore, i’d be very sad. so, maybe yes.” by contrast, shawna (53) explained that ballet was so central to her self-concept that it was “in the blood.” respondents similar in age or older echoed these sentiments. lisa l. (51) described the centrality of ballet for her life as “a matter of survival for me. the passion is just too deep. it’s too integral to who i am… it’s a full thing. i can’t separate out myself from all of that.” caitlin (58) said, “i feel like at some core it is who i am.” similarly, sandra (61) says that “it feels like a full integration of who i am as a person… it really taps into every element of who i am as a person.” with ballet being so closely tied to most of their self-concepts, participants also stated that ballet was a fundamental form of self-expression. regardless of age, participants described ballet as a way that the inner emotion goes outward. allison (50) describes the self-expression aspect of ballet as “a form of communication it starts with being an inner-part of your inner voice and so that it really gets, it gets deep inside you in terms of being able to express feelings and emotions in that way, and then the movement of the dance is very external and very much projecting towards an audience so it naturally communicates that inner voice.” similarly, jaime (61) said that doing ballet is like “maybe opening up and inviting you know… well, like, you’re inward and then you kind of be outward.” other participants said that ballet is “like a spoken language, it is a language” (carrie, 58), mentioning that is an entire language form, not insofar as it being in french, but that different movements hold entire meanings for them and for choreographers. not only did participants describe ballet as a form of self-expression, but participants also described how ballet held purpose for them. pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 85 ballet as purpose participants described how ballet was on a continuum from being a career purpose for them to being a meaningful activity that they enjoy regularly. ten of the 24 participants had some level of ballet being part of their profession, such as teaching or performing it. for example, allison describes her experience of dancing with ballet arizona and then transitioning into starting her own ballet studio after retiring as a professional ballet dancer, that she “wanted to be a professional dancer…it has become my profession.” because this has been her path, she said that “almost everything i do is, revolves around dance so i think it kind of shapes my whole life.” in this regard, ballet has always been her profession and integral to her purpose. the women who reported ballet as being part of their career at some stage tended to report ballet as more shaping of their life compared to others. on the other end of the ballet as purpose spectrum, ida (77), who never danced professionally and began ballet as an adult (age 26), said that she has always loved ballet. she said that she loves it so much that the first thing she would do when moving would be to find a studio to take class at: “once we moved around the country i was in missouri and i always, it was my first thing i would was to go find a class. and well uh yeah i just kept that up.” the purpose of finding a class was because “it was so pleasurable.” at times, ballet shifted between these two purposes as the women aged. although it may have started as a professional career or attempt at such goal, it had now transitioned into a valued enjoyable activity age they aged. for example, shawna said, “i decided early on that i was going to be a professional dancer, i was going to make a go of it.” shawna danced in several ballet companies for a number of years after high school until she decided to go back to college. ballet slowly transitioned from being a full-time purpose to a secondary purpose for shawna as she performed a few more times with her university’s “dance repertoire group.” she then “took a little time off” to have children and transitioned back into dance as a social activity that remains purposeful, but in a different way than before. the sense of purpose offered by ballet as a career or meaningful activity is closely tied to the social benefits gained by these women for doing ballet. ballet and the social self although a small minority of the women (n = 3) mentioned they do not see ballet as influencing their social relationships, saying they do not really spend time with anyone they have met at ballet, most women regarded ballet as a major aspect of their social life. many women, especially those older than age 45, have “become good friends with a lot of the people in the class… i’ve gotten to know them pretty well” (jaime). three themes showed how ballet was a core element that shaped their social relationships. participants described dancer versus non-dancer friends, intergenerational social relationships, and ballet in their romantic relationships. dancer versus non-dancer friends respondents, regardless of age, described a level of closeness or qualitative differences between non-dancer friends and dancer friends. kaita (32) described this as “in some ways it has bifurcated our social lives where we have, like, our non-dance friends together and then i have my dancer friends separately.” with “dancer friends,” participants noted that they can share common social activities like “go out and enjoy, you know, enjoy shows.” (chris, 49). shawna described the qualitative difference between those “two worlds” as her dance friends being “like your support group. it’s like a family, where outside of ballet it’s more, like friends.” for example, lisa l. said “there’s the social interaction at the studio, pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 86 which feels like, pretty much home.” this may range from a sense of deep understanding or trust to what holly (60) exemplifies in the following response: i always felt a real kinship with dancers even though i might not be close to them. i feel like we share this gene, that’s a little bit weird and um, i can-i take ballet class wherever i go and i try you know. i took a class in france i mean in paris when i was there a couple summers ago and you know it’s like the catholic church or aa, it’s like the barre is there and you just go for it. so yeah, i’ve just always felt this weird connection that because it is a weird kind of calling. not only did holly feel that she shares relationships with people at her home studio, she also felt some sense of family with dancers across the world who she did not know interpersonally. although many participants highlighted similarities they share with fellow dancer friends, many also mentioned the unique qualities of some of the intergenerational friendships they had made, as below (for a discussion of intergroup friendships, see davies et al. 2011; munniksma et al. 2013). intergenerational social relationships participants highlighted unique intergenerational relationships they have formed, because they share the common social identity of being a ballet dancers. kristal (34), one of the younger women, said, “it doesn’t matter that that person is 50 and i’m 34. like, we share this and so we can talk, we can laugh, and we can go out and have dinner, and we can hang out and yeah, otherwise i probably wouldn’t get to know those people.” for these women, ballet was a way to not only make friends, but to experience deep kin-like relationships. for these women, ballet fostered the forming of intergenerational friendships. familial relationships are another way that ballet had implication for these women’s intergenerational relationships. ballet in romantic relationships a subset of the women discussed how ballet was a part of their romantic relationships that was identity affirming. taylor (54) mentioned how in a dating relationship, one of the things she liked about her partner was his support for her ballet involvement. she recalled fondly that he once told her, “i think it’s really awesome that you love it [ballet] so much and that you continue to do it.” taylor valued that her romantic partner affirmed such an important part of herself. barbara’s (65) husband encouraged her to go to class: “he drives me up here and drives me back and, umm, because he knows how much it means to me.” this helped barbara feel understood and cared for by her partner as she aged. however, not all participants recalled positivity and supportiveness from their romantic partners. lisa l. explained how her ex-husband “completely diminished what [ballet] was for me and the role it played in my life, and what i wanted to do with it, and what i had already done with it.” when women described experiences like this, they described a sense of identity disconfirmation from their partner that was a highly negative experience that left them feeling misunderstood. this demonstrates how deeplyheld, at the core, ballet is for many of the participants. this deeply-held sense of ballet influences these women’s physical and mental wellbeing. ballet and the physical self participants noted how ballet helped their overall wellness on three dimensions, mental health, physical health, and sexual wellbeing. many participants described taking ballet as an activity that helps pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 87 them to keep positive mental health. crystal (23), the youngest respondent, said, “i enjoy doing it for the physical aspect and also, just like mentally. like, i can definitely tell when i haven’t taken for like a couple weeks… i’m way more anxious, i’m way more stressed out, like i’m just not a happy camper and it’s just like cathartic to like take it and everything.” holly echoed this sentiment when she told a story about how when she was younger and raising her daughter, she kept ballet as a special and necessary time for her mental health. she told her daughter “this was for my mental health… you know this is for my sanity. and that was one boundary i drew with her.” this boundary meant that even though her daughter may have wanted to spend time doing something else, holly made sure to go to ballet. in general, younger women mentioned ballet helping with their mental health in terms of managing anxiety and mood. older women explained how the “aspirational component” of ballet kept them challenged and forward thinking mentally. sandra said, “i’ve never felt like, okay i’m never going to get any better so i should quit. i always felt like there was a chance to move and do something better…maybe this tonight or tomorrow i can do a pirouette that i hadn’t done in a while or it’s going to hit or my extension is going to be better.” along with maintaining positive mental health, the women explained how ballet helped them maintain a positive experience physically of a body that was changing and aging. most participants, regardless of age, said that ballet is “a great way to get exercise” (lisa p., 49). what’s more, ida once told one of her ballet teachers, “i felt ballet was the corner stone of my health. that i’ve been as healthy as i am because of ballet because it keeps you moving, it keeps your joints going…you know my energy level has actually sustained.. its sustained itself and i think it’s through ballet that its done that… i think it adds more than 10 years to your life and to your health” many dancers also explain how over time, their ballet ability has decreased and that “you just modify” (jocelyn, 39). even as a younger woman compared to others in the study, jocelyn already has begun experiencing changing abilities in the ballet studio. at times, as this modification increased due to physical capabilities changing, the women explained how this could get them a bit discouraged. caitlin, who quit professional ballet at age 26 and started up again at age 41, describes her experience of an aging body in the following way: because, you know, i have an older body and there are limitations. you know, i can work on my flexibility but i'll never be as flexible as i was when i was 18. i can work on my strength but it's a constant battle because as you're getting older your body is automatically getting less strong. so just maintaining is hard so getting ahead of maintaining is even harder. but when i feel like old and i can’t do anything and what am i doing here, i look at marge! for caitlin, marge served as a positive role model and inspiration. some dancers, viewed the physical experience of taking ballet as inspiring self-awareness in a way that was more than a means of exercise. for danielle (49) and others, ballet helped her have “a sense of their bodies in space” and gain benefits like strength and flexibility. barbara recalled that after multiple injuries, surgeries and even a battle with cancer: “i’ve always come back to ballet to help me get over it.” some of the women even said that ballet was an influential physical experience during their pregnancy(ies). although some women mentioned how it was a positive way for them to return to physical activity postpartum. joanne,3 who was more than 30 weeks pregnant when she was interviewed, mentioned “becoming pregnant because i was, like, am i still going to be able to dance and that was my whole fears, like, will i be able to dance.” clearly, despite her excitement about her pregnancy, dance was so central for joanne that she was conflicted. one special case of physical experience mentioned by many participants is ballet aiding in maintaining a more positive sense of sexuality into older adulthood (for a discussion of sexuality across pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 88 the lifespan, see danulik 2003; nussbaum, miller-day, and fisher 2009).4 participants described how ballet improved their physical fitness and that “it gives you more confidence” (jaime) as a positive influence in their sexuality as they age. for example, taylor said that ballet had “definitely improved it both from a physical standpoint because if you look beautiful, you feel beautiful, and so you portray that to your partner. umm, my partner happens to think it’s really awesome.” amidst the many ways that ballet has shaped and is shaping these women’s lives, they all see ballet in their futures. dancing into the future all women, with varying levels of passion, stated how they hoped to continue dancing for as long as possible. lauren (27), a young woman who was newer to learning ballet said that “i definitely would like to continue taking ballet class. as much as i can.” more strongly demonstrating her commitment to continuing, caitlin pointed out that, “i would try to avoid a change in my life that would keep me from dancing at this point. like moving somewhere where there were no dance classes, that sort of thing.” for the women from the studio where most participants were recruited, participants cited one woman as their inspiration (as caitlin did above). marge was the oldest participant at 87 years of age. she takes ballet approximately once a week, can still do the splits, and works as a seamstress for the associated professional ballet company. marge’s daughter is also now a professional choreographer, and she told stories of ways they share in that passion together. marge said, “i’ll take classes as long as i can… i thought just getting to 85 would be fine, but i’m 87 now, so i don’t know. if i have regular classes and everything in my life goes well.” kristal, a younger woman in the study, said of feeling inspired by marge and others older than her: “i don’t feel like i could stop dancing… i’ve seen people in class like marge and caitlin…and allison who have been dancing and they’re still dancing and they maintain a youth and vitality about the that’s not just oh yeah they can still move but like they’re young, they’re fun, they’re energetic because they are maintaining a physical sense and capability and i don’t want to stop dancing.” theoretical and practical implications of ballet participation findings suggest that for these women who are generally well-educated, affluent and white, recreational ballet as an element of “environmental chatter” in cemsa encouraged positive aging; see figure 1 where this (more generic) element is inserted into the model. ballet, and perhaps dance in other genres and across various cultural activities, is communication and not merely a context where expressive communication happens (gasiorek, fowler, and giles 2018). the acts of observing oneself dancing and dancing with others together are intraand interpersonal (and, maybe, intergroup) communicative elements of environmental chatter. relatedly, recreational ballet provided positive role models for these women. for instance, marge was cited as an inspiration and aspiration of where most the other women hoped to be when they were her age. in addition, because ballet was a core component of identity for many of these women, they did not self-categorize as old but, instead, they categorized as ballet dancers. in this sense, they may align with the profile of those older persons—a profile of ager found in previous studies to be those who perceive they are aging well and have the highest levels of life satisfaction as they age called “engaged agers”—who have been found to be the least stressed and the most successful agers (bernhold, 2019; gasiorek and barile 2017; gasiorek, fowler and giles 2015); although whether older recreational ballet dancers might constitute a unique profile is an interesting question for future research. they also did not forgo continuing ballet even though their physical capabilities may have changed. instead, they focused on their artistry of the movement, and continuing to do ballet despite needing to modify movements to match their changing physical capabilities. taken together, the physical pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 89 and self-categorizing experiences of these women with ballet may nuance arguments about health and age in the united states that often suggest staving off age and findings of people vehemently self-categorizing as “not old” (lamb 2018). however, similar to findings by lamb (2018), cemsa does conceptualize successful aging as being partly within people’s own control such that people exert some agency in the way that they age, through their communication. these women exercised this aging agency by recognizing and adapting to their changing, older bodies and also added identity categories, rather than doing ballet in order to avoid being old. of course and in line with lamb’s findings, the demographic characteristics of the women interviewed here suggest the privilege to even have the option to age with agency by even being able to pay for ballet classes, for example, and mean that the women here are overall more likely to be healthier than other women of lower socioeconomic status. this suggests recreational ballet encourages positive communication about aging for these women, thereby enhancing efficacy and a more positive attitude about the process. other cultural recreational pursuits for other types of populations may encourage the same types of communication that engenders these benefits. findings relating more specifically to social relationships indicated that for most participants, ballet was an important way that they made new friends, suggesting that ballet (or similar recreational or cultural activities for other groups) can help combat the loneliness and depression that older adults can experience (gonyea et al. 2018). in addition, participants described these friendships as qualitatively different from their “non-dancer” friends in terms of shared bonds and feelings of trust. participating in ballet also encouraged more intergenerational social relationships than, arguably, most other people experience (munniksma et al. 2013). this finding supports claims by pines and giles (2017) where they theorized that dance could be a superordinate identity. in context, ballet became a superordinate identity and age became less salient in these intergenerational friendships. similar to dumit’s (2012) concept of objective self-fashioning, these women incorporated ballet into their being, for some, to redefine who they are and what it means to age. other cultural and recreational activities may similarly make salient superordinate identities over age as a social identity. in general, findings suggest positive intergenerational relationships being fostered through recreational participation in ballet in older age as they make friendships with people who are not their age. according to cemsa, having intergenerational communication that tends to be positive as environmental chatter is associated with positive affect toward the aging process and with efficacy to successfully age (gasiorek, fowler, and giles 2018). results support the contention that recreational ballet dancing fosters positive intergenerational communication, thereby enabling positive affect toward aging. this contrasts with the experience of most professional ballet dancers discussed in this article (wullf 1988). limitations of this study suggest three major future research directions. first, several men expressed interest in participating in the study, but were excluded from participating to focus the study on the female experience as the majority of professional ballet dancers are female. in addition, previous research has found that gender can be a salient and central social identity (e.g., steffens and viladot 2015), meaning that studying male ballet dancers would require its own focus. future research could more purposefully examine similarities and differences of experiences between male and female recreational ballet (and other) dancers. second, one participant’s response was excluded for her focus on eastern styles of dance (e.g., belly dancing, bollywood). other genres of dance could be examined to determine if they encourage similar experiences of positive aging. perhaps any style of dance, not only recreational ballet dance, could function as environmental chatter and a component of identity that fosters efficacy and positive affect toward aging. it may also be the case that the true facet of participating in recreational activities that fosters positive aging is the friends that people are otherwise unable to easily make, and the expansion of their network (see nussbaum 1994; rawlins 2004; rook 1998). indeed, previous research has shown that dancing with others leads to an increase in one’s social ties (kreutzmann et al. 2017). third, the pines and giles | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.209 http://anthro-age.pitt.edu 90 data reported here are only self-report interviews from relatively affluent women, from two dance studios in a small town. as such, findings cannot broaden the demographics for which cemsa has been applied to in previous research. future research should observe the actual dance classes across locations to consider societal position more focally (as now has been added to the cemsa model herein), especially lower income areas as previous research has shown that socioeconomic status is a key component to the physical and subjective experience of aging (lamb 2018). examining the discourse that occurs therein, of adult recreational ballet dancers as they take class and interact with their peers and family can help illuminate what ballet talk may look like, and answer questions such as do dancers verbally air ballet proudly as part of their identity with others? conclusion there are many processes that foster successful aging. results from this study provide support for recreational ballet being an activity for this group of women that can foster both a positive social identity and affect that engenders efficacy in managing successful aging. dancers did not self-categorize as “old,” and they enjoyed positive intergenerational relationships. overall, participants described, and discussed fondly, how they hope to continue dancing for as long as they can. this orientation suggested a positive view of the future. participants also explained how recreational ballet encouraged wellness as they have aged in terms of positive mental, physical, and sexual well-being. several participants mentioned how they have always returned to ballet following a physical injury or a negative emotional life experience. this suggests that recreational ballet offered women a sense of efficacy for overcoming trying physical and emotional experiences as they age. these interviews, and previous research (e.g., age uk 2018; goodman et al. 2017) provide support for a modest, but important, addition to the communication ecology model of successful aging. namely, cultural recreational activities, such as ballet, can now be considered a significant element not only for active older adults, but also for those in care facilities (koponen, honkasalo, and rautava 2018) in the process of aging successfully. acknowledgements we are extremely grateful to dr. jessica gasiorek for her careful read of an earlier version of this manuscript and for her cogent observations which have led to an enhanced product. we would also like to thank the dancers in this study for their passion and willingness to share their stories and to the research assistants for their dedication to the project. lastly, we express gratitude to the editor and two anonymous reviewers for their extensive and incisive feedback on earlier drafts of this article. notes 1. there is no record of statistics generally in the united states of how many adults take ballet recreationally. from the first author’s knowledge as a former professional ballerina and now ballet instructor, each studio that teaches ballet has an adult (18+) class weekly, but usually they vary widely in difficulty, in age, and in how many people come each week. 2. one response was not included in this analysis as the participant focused on her experiences with eastern styles of dance including belly dancing, and not her experiences with ballet, despite the first author probing her ballet experiences specifically. 3. all participants, except for joanne, agreed to having their age included in research. pseudonyms used for participants who did not wish to have their name appear in this article. 4. sexuality included in physical health instead of in romantic relationships because participants had a physical focus when discussing sexual identities and activities rather than within their relationships. 5. age is listed in parenthesis following the name/pseudonym of the participant for the first time. pines and giles 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are indispensable to the working of hospitals, schools, prisons, and other institutional environments. drawing on ethnographic fieldwork in three eldercare homes in germany this article suggests that the more permanent care context of institutional homes for the elderly compared to a hospital setting is decisive for people’s interpretation of and engagement with sounds. this is true at multiple levels, such as “monitory listening,” the use of “music as a technology of self,” or sounds as a tool of care. in fact, in this long-term care context even silences prompt action. based on their experience with individual residents, for example, caregivers can direct their monitory listening not only to existing sounds, but also to the silence of expected but absent sounds. throughout the article, additional consideration is given to the role of the technologies that produce the sounds, showing how in their design and functioning they shape, complement or prevent people’s attention to sound and silence. finally, i propose that research is needed that goes beyond an understanding of silence as a healing environment for the vulnerable and sick and instead attends to the complexity of this acoustic event within the context of eldercare homes. keywords: elder institutions; ethnography; sound and silence; technology; sound studies anthropology & aging, vol 41, no 1 (2020), pp. 69-82 issn 2374-2267 (online) doi 10.5195/aa.2020.229 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 69 caring through sound and silence technology and the sound of everyday life in homes for the elderly carla greubel maastricht university author contact: c.s.greubel@uu.nl it will soon be midnight. most residents in the eldercare home are sleeping. silently, caregiver d enters one room after the other to see, smell, listen, and feel whether everyone is doing fine, to adjust a fallen blanket, to hand a glass of water, or to change a stoma pouch. i follow her silently. from time to time she whispers a comment about the resident, on what she observes and what she does. walking along the corridor we can hear radio sounds from behind a closed door. we enter the room. resident e is lying in her bed, sleeping. her radio is playing loudly. caregiver d has a look and decides that everything is fine. on the way out she whispers that she better not turn the volume down yet in order not to wake up the resident. in his ethnographic study on sound in two british hospitals, anthropologist tom rice (2013) noticed how nurses tried to establish a quiet ward during night. they spoke with a softer voice and lifted privacy curtains with more caution than during the day. they exercised what rice calls “aural selfsurveillance” (2013, 29). i made a similar observation in the three nursing homes in germany that i visited as part of an ethnographic study on everyday sounds in eldercare institutions. while nighttime means a time to sleep for residents in the home, it is the time when the nightshift caregivers become active. alignment of these different rhythms takes place partly through self-regulation of the caregiver’s own production of sounds. practices of aural self-surveillance during night often include not knocking on the door when entering a resident’s room, opening doors carefully, walking on tiptoes, and whispering. however, as the instance i recalled at the start of the article highlights, caregivers sometimes decide against the creation of a night-time silence. although resident e was already sleeping, the caregiver preferred not to turn off or lower the volume of the radio. based on my comparative ethnographic fieldwork i argue that caregiver d’s action is one example of a form of soundscape interpretation that is characteristic for the context of residential care homes. just like hospitals, eldercare institutions are dedicated to taking care of the health of their “patients.” one implication of this is that both types of institutions are equipped with various care and non-care related technologies that shape the sonic environment. one example is the help bell system—a key technology for the institution’s organization as well as for studying the role of sounds herein. contrary to hospitals, however, where patients’ sonic experiences are commonly connected to a temporary stay on the ward, elderly homes constitute a more permanent institutional environment for their inhabitants. this article’s goal is to attend to this difference of permanency versus temporary stay by juxtaposing some of the sonic experiences and interactions of residents and caregivers in my fieldwork sites with those of the hospital patients and nurses in rice’s analysis. the findings suggest that, in fact, the knowledge and experience gained in long-term interactions with others in the homes play a decisive role in residents’ and caregivers’ interpretations of and reaction to auditory events. to illustrate this argument, i will lead the reader through three levels of sound interaction in the homes: 1) monitory listening, 2) music as a technology of self and others, and 3) music as a tool of care. these three levels are chosen as exemplars. of course, there are many more aspects of the soundscape of eldercare homes that are shaped by the time people spend living or working on the ward. both caregivers and residents told me how over months they had learned to distinguish people in the home by the sounds greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 70 of their shoes walking down the hallway. everyday sounds like the rolling of meal carts or the rattling of dishes become indicators of specific times of the day, helping residents and staff members to adjust to and orientate themselves within the institutional life. unravelling the multiple ways in which sounds contribute to the structuring of everyday life inside eldercare institutions has been part of my ethnographic study. however, in this article, i will limit the analysis of the empirical material to instances of monitory listening, music as a technology of self and others, and sounds as a tool of care. it is relevant to mention that the implications discussed in the following pages primarily apply to those cases where both caregivers and residents have long tenures in the homes, allowing them to build up the necessary familiarity with each other and with the institutions’ socio-material environment. where this is the case, though, i made the remarkable observation that not only sounds, but even silences, prompt action. based on their long-term experience with individual residents and their use of the help bell system, for example, caregivers can direct their monitory listening not only to existing sounds, but also to the silence of expected sounds. in the discussion of each level, i therefore aim to show how in the three fieldwork sites, listening and reacting to sonic events happens in terms of both knowledge about others and knowledge about the function of the technologies in use. following this introduction, i will first situate the article within scholarly debates in the interdisciplinary field of sound studies and provide background on the theoretical lenses applied. subsequently, i will discuss my methodology. the analysis of the empirical material will be divided following the three exemplary elements of the soundscape of eldercare institutions mentioned above. throughout the article, silence in terms of absent sounds reappears as a crucial element of sonic events inside eldercare homes, prompting attention and care and triggering varied personal feelings. the last section then demonstrates that extending the ethnographic focus from sounds to silence—how it is experienced, sought and avoided—can reveal something about the complexity of sonic needs in these laterlife home environments. sound studies and anthropology this article is situated at the intersection of aging studies, sensory anthropology, and the interdisciplinary field of sound studies which has been deeply informed by science and technology studies (sts) (pinch and bijsterveld 2012; sterne 2012). a core theme of sound studies research is to attend to what sonic anthropologist christine guillebaud (2017) described as the “inherent complexity” of ambient sound (2), that is, to acknowledge and examine both the material as well as the immaterial (the social, cultural and historic) textures and alterations of the sonic worlds that we live in. this point is emphasized by anthropologist jennifer hsieh (2019) who writes that what the study of piano sound as noise in taiwan demonstrates is “the distinctions between noise as a material object and noise that is imbued with meaning” (14). although the concept of “soundscape,” as it was first formulated by murray schafer in the 1970s, has been criticized for focusing primarily on the materiality of sound, neglecting the social and cultural embeddedness of sound and ways of listening (samuels et al. 2010), in later refinements of the soundscape we already find explicitly mentioning of both the material and cultural dimensions. my ethnographic study builds on the work of emily thompson (2002), who defines soundscape as: simultaneously a physical environment and a way of perceiving that environment: it is both a world and a culture constructed to make sense of that world. the physical aspects of a soundscape consist not only of the sounds themselves, the waves of acoustical energy permeating the atmosphere in which people live, but also the material objects that create, and sometimes destroy, those sounds. a soundscape’s cultural aspects incorporate scientific and aesthetic ways of listening, a listener’s relationship to their environment, and the social greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 71 circumstances that dictate who gets to hear what (1). within the broad range of sonic worlds addressed in sound studies literature, most relevant for my research is the emerging debate on sound inside institutions. scholars from anthropological as well as sociological backgrounds have analyzed sound in schools (gallagher 2010, 2011), prisons (rice 2016), hospitals (harris 2015b; rice 2013) and hospices (gunaratman 2009). their work engages with and answers to concerns raised about western ocularcentrism and the bias towards the visual in knowledge making and representation (rice 2013; samuels et al. 2010). often drawing on ethnographic research, these authors vividly illustrate how sounds contribute to the temporal, spatial, and social structuring of everyday life inside various institutions. challenging the focus on vision within foucault’s analytical concept of power relations, michael gallagher suggests the “dominant ocularcentric understandings of surveillance could be enlarged to encompass what might be termed ‘panauralism’” (2010, 271). the management of prisoners, students, patients, and hospital staff members is not confined to the visual realm but takes shape in other sensory modes, such as the production of sounds and forms of monitory listening. examples of acoustic monitoring include a bell and the teacher’s listening ear (gallagher 2010), a key rattling and screaming voices (rice 2016) or monitoring technologies and doctors’ phones (harris 2015a; rice 2013). the concept of “monitory listening” thereby describes one of several modes of listening. its purpose is to detect and attend to possible malfunctions of the object/subject of attention, indicated by a deviation from what the listener expects to hear or by a sound that explicitly warns about malfunctioning (supper and bijsterveld 2015). in his hospital study, rice (2013) notices how monitory listening often happens alongside other activities. it is a form of “listening in readiness” (truax 2001), allowing the listener to engage in other tasks while having one’s attention ready to receive any significant sonic information. in the context of residential care homes, such constant auditory alertness may be considered a form of surveillance or supervision, but in as far as it entails the execution of power and control, it is always directed towards the protection and care of the elderly residents. for a nuanced understanding of the blurring between logics of surveillance and logics of care, peter lutz (2015) suggests complementing care surveillance with the notion of “care-valence” (158-9). developed in an anthropological and sts-inspired study of senior home care, this notion introduces the three dimensions of the term valence—screening, bonding and encouragement—to avoid reducing the complex effects of attention in care to disempowering conceptualizations of surveillance. in fact, it seems helpful to not only examine the sounds of institutions as if these were merely disempowering and outside the control of those immersed in them. rice (2016) himself has shown how even in captive institutions such as prisons, inhabitants actively create and employ sounds for their own purposes. they exercise “acoustical agency.” one form, specified by rice as “musical agency,” is the inhabitants’ use of personal stereos for the purpose of managing their emotions. another form of acoustical agency becomes evident in the prisoners’ attempts to escape the often very noisy environment of banging doors, loud music, screaming, or key rattling by actively looking for more quiet places like a prison’s chapel (ibid.). the concept of acoustical agency then refers to the active use/avoidance of music technologies as well as the active use/avoidance of other forms of sound like those produced by the pushing of chairs or the beeping of the alarm bell system. for questions concerning the use and avoidance of music technologies in residential care homes, i take sociologist tia denora’s (2000) concept of “music as a technology of self” (46) as a starting point since this reflects human agency specifically in the context of music listening. this concept developed out of an exploratory study about private music listening practices of women in the uk and the us. it describes how greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 72 music is put on for the purpose of managing the self, how “music is appropriated by individuals as a resource for the ongoing constitution of themselves and their social psychological, physiological and emotional states” (denora 2000, 47). the concept entails two key points. the first is the private, one-to-one character of human-music interaction. the second is the proposition that these music practices are done in an “aesthetically reflexive” (denora 2000, 48) way, referring to the listener’s awareness about what kind of music she or he necessitates to regulate or maintain the desired or demanded state of self. such use of “music as a technology of self” can also be found in residential care homes. however, the institutional setting implies that the boundaries between private and public, and between self-decided and not self-decided use of sound technologies, blur, as who turns music on and off, for whom, and for what purpose is not only a question of institutional power relations. in an environment of care, differing physical and mental capabilities affect who gets to hear what. moreover, the design and placement of sound technologies co-shapes the possibilities of individuals to exercise acoustical agency. this specific setting of eldercare homes, the mingling of private and public space, and their special temporal context as long-term will be given attention throughout the article. methodology the empirical material stems from a research project in which i studied the role of everyday sounds in three eldercare homes in germany. in the case selection i looked for differences in the institutions’ approaches to eldercare and the role that music and technology played. in the eden-alternative care philosophy, as practiced in home a, both instrumental and electronic music play an important role. a record player on wheels is one example of how in this institution sound technologies are explicitly used to interact with the residents. as a contrast, a second home was included (referred to as home b) where the approach to care and the social and material organization of everyday life is grounded in the ideas and values of anthroposophy, a cosmologic and spiritual-scientific philosophy founded by rudolf steiner. my assumption was that in a nursing home based on this worldview i might come across explicit avoidance of sound technologies (heine 2009). actively making music by singing and playing instruments together, however, seemed to be as important as in the first home. for the third case, i included a more standard german nursing home, one in which the handling of sounds and music did not seem to be as much in the focus as in the other two (referred to as home c). between march and may 2018, i conducted two weeks of ethnographic fieldwork in each home. attentive listening, participant observation, and fifteen semi-structured qualitative interviews with caregivers, care workers, residents, their relatives, and institutional managers were further enriched by sound elicitation. as anthropologist anna harris (2015a) explains, the sound elicitation method uses sonic prompts as a way to interact with interviewees and to “elicit fuller and more detailed responses than might otherwise be possible” (20). in a context where elderly interviewees might suffer from forgetfulness and therefore potentially have difficulties sharing past sonic experiences, sound elicitation can help to trigger sleeping memories. during fieldwork, i used sound elicitation in two different ways. one was to record sounds of the institution’s everyday life (roughly 25 hours in total), play short sections of one to four minutes to my interlocutors and work with the prompted verbal and non-verbal responses. the second way was to elicit the sonic prompt myself. at the end of interviews, i sometimes reproduced typical routine sounds like the knocking at residents’ doors. while the first form proved promising in interviews with caregivers, some residents had difficulties hearing the recorded sounds. reactions then resembled a guessing game. however, the use of knocking as a sonic prompt elicited rich accounts of everyday sound memories which the respondent did not think of during the normal interview. in reaction to such a knocking sound, one greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 73 lady for instance told how this sound is something she looks forward to every morning. she is unable to get out of her bed herself. hearing the knocking is therefore a sign of approaching help, a relief in the situation of a pressing bladder. the sound elicitation method thus indeed supported the remembering and sharing of experiences related to the prompted sound and the subjective meaning it carries for the interviewee, but replication worked better than playing the recordings. one conceptual remark about the delineation of the “everyday sounds” considered shall be added here. when starting the project, i was specifically interested in two questions: first, how the sounds of technology contribute to the structuring of everyday life inside eldercare institutions, and second, how residents, staff members and visiting relatives actively employ or avoid these sounds to create a life that they consider good. technology and its sounds was thereby understood in a broad sense, including the beeping of alarm and monitoring systems or songs and voices played by radio and tv appliances but also the sounds of chairs being moved, of shoes walking down the hallway, of meal carts being pushed into elevators, or of caregivers’ knocking on residents’ rooms. in line with thompson’s soundscape definition, i furthermore payed close attention in my ethnographic observations to the architectural details of the houses and the design of the materials used inside. inspired by an sts understanding of technology as both material artefacts and as practices, denora’s (2000) concept of “music as a technology of self” became an important analytical framework for studying the active use and avoidance of sounds inside elderly homes and an additional factor for the choice of sounds to be studied. when considering sounds from a perspective of “music as a technology of self,” not only music technologies and musical instruments, but also some human vocalization in the form of singing, appeared to play a role and was therefore included in my study of the sounds of and as technology in eldercare homes. although additional forms of human vocalization—communication, expressions of feelings, or the repetitious and distressed sounds coming from some dementia patients— are of course a central feature of the soundscape of eldercare institutions, my ethnographic study thus primarily concentrated on those everyday sounds produced by technologies and those used as a technology of self. during fieldwork, however, i repeatedly noticed how staff members’ decision to put on music or radio sounds was closely related to matters of human vocalizations in the home, especially the silence of a group of residents sitting together without talking. in my attempt to unravel some of the complexity of the absence of sounds in relation to the specific context of elderly homes, i therefore also turn back to (the absence) of human vocalization. monitory listening within empirical research on institutions, michael foucault’s (1977) “panopticism” is an often-used concept for the study of power and supervision. while the panopticon was originally designed for a prison by jeremy bentham, foucault extends this idea of visual surveillance to explain power mechanisms in a variety of disciplinary institutions including factories, schools, army barracks, and also hospitals. in line with foucault’s argument, rice (2013) writes: they [hospitals] are spaces in which power is directed towards the control and organization of people and behavior. hospitals involve the management of large numbers of people. patients must, for instance, be sorted, categorized and spatially arranged according to the nature of their complaints. their freedom to move around the hospital and interact with other patients must be restricted so as to limit contagion. they must be repeatedly checked to ensure the treatment is properly administered and followed, thus becoming subject to practices of monitoring and supervision (22). greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 74 some of these characteristics also apply to eldercare institutions. they too are places where care of sometimes more than 100 residents must be coordinated. in general, residents may move around freely. yet, on wards for patients with high levels of dementia, sometimes entrance doors are locked, located in close proximity of a receptionist’s eyes and ears, or redesigned into a painted bookshelf. in all three research sites, the residents are checked frequently. one of the main reasons mentioned by caregivers is the risk of falling and not being able to call for help. how is this need for a constantly present “help in readiness,” and for the awareness of any distress faced in the three homes? it was interesting to observe that the architecture and material design of each institution show elements that support the idea of a panopticon and others that clearly contradict it. especially in newer buildings (home c plus dementia house in home b) the caregivers’ offices are placed in the middle of the ward and designed with big windows facing group areas. this way caregivers can observe many residents at once while simultaneously having the possibility to close the door and be out of the residents’ auditory horizon. i participated in a group activity in one of the dementia sections of home b which involved piano playing and moments of intense silence. two nurses were sitting in the office, seeing us and being seen, but i did not hear their voices, although i saw that they were talking. nonetheless, visual control is not always a priority in the design of these houses. before the renovation of home c there were long corridors where the gaze could wander all the way from one end to the other. in the course of renovating the home, architects suggested building “eggs” (term used by the care manager to describe them) in both ends of the corridor. these are wide round pillars with wooden lamellas that give the long corridor a more aesthetic character, but limit visual surveillance. yet, sounds can still follow the roundabout around these eggs, being heard by the attentive listener further down the hallway. this is a good example of how visual surveillance can be complemented and replaced by the ear, underlining rice’s (2013) argument about the reinforcing relationship between the visual and the auditory in monitoring patients in healthcare institutions. while i acknowledge the relational dimension of sensory experiences also foregrounded in serematakis’ (1994) discussion of “relative sensory ratios or balances” (126), unravelling the interplay of the senses in acts of care and supervision would go beyond the scope of this article. aware of my drawing of sensory boundaries, i hope that this zooming in on my research participants’ experiences and engagements with auditory aspects of their everyday lives inside the homes will help to clarify the point i want to make: that indeed, the special context of these more permanent care and home environments allows residents and caregivers to interpret, engage with and actively co-shape their sonic environment in ways that differ from those in other more temporary health care institutions. to this end, the rest of this section analyses practices of monitory listening in my fieldwork sites and subsequently compares them to other literature on sound and monitory listening in healthcare institutions. in the homes i studied, the clearest example of mediated monitory listening is the use of the help bell system. typically, there is one help button attached or close to every bed plus another one in the bathroom. once a resident presses the button, a beeping sound goes off at several stations on the ward, including one in a caregiver’s office, one in the ward kitchen and living area, and sometimes in the hall or common bathroom. in addition to these stations, the alarm will go off in every resident room where a caregiver is currently present. whenever they enter a resident’s room, caregivers have to push an attendance button to indicate their presence to their colleagues. an activated attendance button in turn implies that any call issued on the ward will also elicit a beeping in this room. this way it is secured that monitory listening can be done wherever caregivers are and whatever they are doing. greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 75 what is the everyday practice of attending to these calls? in her study, sociologist sabine weishaupt (2006) demonstrated the centrality of experience-based knowledge in care activities in nursing homes. indeed, my ethnographic data confirms that caregivers’ interpretation of and reaction to the bell ringing is informed by multiple senses and tacit knowledge. after hearing the sound, they usually look at the device’s display, see the room number and note who is calling. based on their assumed knowledge about every elderly resident and on the urgency of their current activity, they decide how fast they will react to the sound. occasionally this can take time. rice (2013) made a similar observation in the hospitals where he conducted research. he tells how in very busy moments nurses would sometimes not respond to help calls directly or ignore them entirely. when numerous calls and tasks arose simultaneously, priority decisions had to be taken. weighing between competing tasks and calls is a challenge of monitory listening that caregivers in residential homes also face. yet, i want to argue that the different tempi in answering help calls observed during my fieldwork are not primarily a matter of competing tasks, but also, of the more permanent setting of this healthcare environment. one day in home a, lunch had just been finished and the two caregivers had accompanied each resident to their room for rest. the help bell station in the ward kitchen started beeping. one caregiver looked at the room number shown on the display and made a joke with the resident by imitating a voice mail into the system’s two-way intercom option, hanging up immediately after. she did not go to the resident’s room. later, she commented to me that this resident is one who constantly presses the help button after lunch. thus, the caregiver explained why she did not attend the call. given her experience, she felt confident that this call would be nothing urgent, just one of the resident’s repeated requests for attention long-term experience not only allows caregivers to decide where and how quick to allocate their attention and care, but also, through repeated interactions, they can build an acoustic knowledge of their residents’ daily rhythms. a caregiver illustrates this nicely: for example, in the morning around 7am it is always clear that this and this person will give a call, yes, and then of course i expect their call, or rather that i receive a beeping, have a look and see the room number. and when that is not the case, then at the latest 15 to 20 minutes later i will go into the room, whether she has called or not (interview f). this caregiver has been working for several years in home b. what in the beginning might have appeared as an enigmatic network of help calls has over time and repeated experiences crystallized into some routine morning calls. drawing on the work of anthropologist and ethnomusicologist steven feld (1996), the caregiver’s knowledge about residents’ daily rhythms might be understood as a form of “acoustemology,” mediated by the technological system. originating from feld’s realization of how central rainforest sounds are to the kalulis’ life, knowledge and sense making, “acoustemology” describes a way of knowing through sounds (see also rice 2018). this is not to argue that sound is the most important factor in caregiver’s relationship with and management of patients, but that being familiar with residents’ routine morning calls enables them to coordinate care activities accordingly. there is something additionally interesting to notice in the quote above: the caregiver tells how, when listening to the help bell system, he orients his attention and care not only to incoming calls but also to the silence of expected, yet absent calls. this is an important observation as it illustrates how in this more permanent healthcare environment, caregivers’ acoustemology allows silence to prompt action. for the monitory listening of caregivers, the silence of expected but absent sound can be a sign of danger or greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 76 heightened caution preparing them to go and have a look if everything is fine (bijsterveld 2019). rice (2013) does not mention whether listening to the absence of expected calls was part of monitory listening in the hospitals he visited. however, this phenomenon presupposes routine sound productions on side of the elderly (ringing every morning around 7am) and knowledge about these routines on side of the listener. since residents usually spend a long time in eldercare homes, caregivers can base such expectations on their long-term experiences with every elderly resident. this is likely to be different in a hospital environment. residents are not only the objects of monitory listening. in all three homes i was told stories about how residents come to actively complement the monitory listening of caregivers. one resident in home a, for example, shared such memories: well if i am not listening to music, i hear quite a lot. in the next room ms. g passed away last year in the summer, she suffered greatly from dementia but was a wonderful, lovely woman. and when i was in my bed at night, i usually heard every sound. and then, when i heard something, i knew that ms. g had fallen again. of course, i then immediately pressed the help button myself, the alarm button. (interview h). again, knowing the vulnerable state of the neighbor and the sounds of her falling, the resident was able to quickly call for help. such horizontal monitory listening among residents becomes especially relevant when the “listening in readiness” (truax 2001, 22) of busy caregivers is complicated by everyday background sounds. so far, we have seen how a mutual knowing becomes key to the monitory listening practices inside eldercare institutions. i have shown that in cases where caregivers “know” that most probably it is only a call of being bored, their reaction can take time. this is different, however, when the frequency of the beeping changes. i was “lucky” to experience such a situation once during my sonic walking with a caregiver in home b. we had entered the room of one resident and the caregiver was now preparing the man for the night. suddenly the help bell started beeping but with a different sound, with shorter intervals than usual. without hesitation, the caregiver left everything and rushed to the room where the call had been set off. to understand his reaction, another detail of the help bell system needs to be mentioned. the system does not only provide assistance to residents, but additionally communicates help calls among caregivers. when they are in a resident’s room and an emergency happens, a caregiver can call for a colleague’s help by pressing the same button as the resident. a caregiver’s call can be distinguished from a resident’s based on the higher frequency of the beeping tone. in the situation above, hearing the quick beeping indicated to the caregiver that one of his colleagues is in serious need of help, that there is an emergency, and that he has to run now. thus, it is not only the familiarity with residents and their call routines that is important for the caregivers’ interpretation of the sounds of the alarm bell system. their understanding of the functioning of the technological system also plays a role. they have learned that the fast alarm beeping means urgency with little regard to second thought. music as a technology of self apart from informing care activities, such as the monitory listening discussed so far, sounds and music are often assigned important roles in eldercare homes, negotiated by the residents, their visiting relatives, and the institution with caregivers, care workers and other professionals. this makes nursing homes an interesting place to study sounds from denora’s perspective of “music as a technology of self.” greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 77 in her ethnographic study on private music listening practices among women in the uk and us, denora (2000) shows the various forms in which individuals use music as a way to change or enhance their mood. they draw on music to relax, become active, feel pleasure – all tied to music’s role in the “construction of the self as an aesthetic agent” (46). the use of music in eldercare homes is often attributed a similar role. however, the institutional context implies a very different setting from the one in denora’s study. music listening practices in residential care homes go beyond one-to-one human-music interaction. they take place in group activities such as the dancing described by anthropologist jonathan skinner (2013). in many residential care homes, radio sounds fill public areas like living rooms, ward kitchens or elevators. they are heard in the rooms of residents or offices of employees. sometimes, “glenn miller big band music floats out from behind closed doors” (denzin 2019, 1). even in cases where the act of listening is private, the choice of music as well as the turning on and off may be done by another person. in fact, patterns of musical agency are complex, diffuse, and constantly (re-)negotiated among residents, caregivers, institutional managers and visitors from outside. two examples illustrate how the more permanent character of eldercare institutions also manifests itself in practices of musical agency. it is common in all three homes that caregivers put on music for residents in their rooms. what usually happens is that residents who want to listen to music, but cannot turn on the technologies by themselves, ask caregivers to do so. however, this is not a daily type of communication. a caregiver’s account illustrates how preference statements become integrated into routine behavior: i: ...with one resident i know exactly he wants his radio to run in the morning. that is the first, when i enter the room, i turn on the radio. then i sit him up, drive him into the bathroom, make the bed, but i know exactly that the radio has to be running, yes in fact the residents specify it more or less. r: did he tell you once that he wants to have it every morning? i: right right, and when he isn’t having a good day, he says ‘not today’ (interview f). in this example, the radio is put on by the caregiver following the resident’s personal request. it is put on for the elderly man in his private room, for his state of self. the caregiver thus exercises musical agency in the name of the resident. however, given their everyday interaction, the impulse for the caregiver to turn on the radio shifts from an expressed statement to a knowing of the resident’s wishes. interestingly, then, music listening practices become part of the habits through which caregiver and cared-for know each other and interact. the second example is a phenomenon i only observed in home b. here, each stationary care section is equipped with at least one piano which everybody may use. on one ward, a resident plays piano in the dining room almost every day. after breakfast residents often remain at their tables, waiting for one of the group activities to start or just to pass the time. on this specific ward the break between breakfast and the first program was often filled with the resident’s piano play. occasionally he would improvise, but mainly he played folk songs. what regularly happened was that other residents joined in the singing. the making of and listening to music became a shared activity, not initiated by the institution or staff members, but rather by a group of residents themselves. from the facial expressions and moving fingers one could obviously see its effects on participants’ emotional state. moreover, the folk songs triggered conversations about memories of a shared past. this phenomenon in its entirety suggests a use of music as a technology greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 78 not of self but of the group-self. four elderly ladies at one of the tables, for instance, grew up in the same region a few valleys away from the care home. they told me how they sang in choirs together for many years, where one of them used to play the organ. when the piano player played his songs, she often happened to follow the sound, moving her hands in the air as if it was her organ that filled the room with music. the form of this group activity again shows traces of how the participants have come to know each other in a distant past or during the many mornings spent together in the dining room, singing songs or listening to the piano music. in her recent study on piano sounds in taiwan, hsieh (2019) reminds us that if we are to understand the soundscape of one place, we need to open up the perspective to include those broader sonic expectations that inform social connections and disconnections over auditory events. hsieh (2019) explains how the piano, which was introduced to taiwan as part of western art music, served “as a symbol for upward mobility as well as an instrument for moral refinement” (7). the equipment of several pianos in each institution where i conducted research also hints at a broader understanding of piano sounds as a positive feature of the soundscape of elderly homes. as much as the spontaneous making of music among the residents in home b or the disputes over piano sounds among neighbors in taiwan are emplaced phenomena, they also are embedded in wider expectations within a sonic world. sound and silence as a tool of care shifting the discussion on the use and avoidance of music and sound in the three homes, this section addresses a form of acoustic agency where actively employing sounds and controlling the sound production of oneself and others can be understood as itself an act of care. during one fieldwork day in home b, at around 9pm, an elderly woman issued a call via the help bell system. it was not her first one this evening and according to the caregivers not the only evening that this happened. one reason for her frequent calling seemed to be that she could not fall asleep. the nightshift caregiver looked after the lady, talked with her for a while, and before leaving turned on the tv. back in the hallway she commented that the low background sound would help this resident to fall asleep. in this case, the caregiver’s decision to put on background tv sounds did not follow an expressed wish by the resident. it was the caregiver’s initiative. from what i could observe the elderly woman neither showed a reaction of pleasure nor objection. as in the use of music as a technology of self, the purpose of this practice is to affect a specific physiological and emotional state—to calm down and rest. yet the context and meaning of the situation here is very different from denora’s (2000) concept. rather than as a technology of self, we might conceptualize this use of sounds as a technique. this technique does not focus on the regulation of one’s own, but of another person’s constitution. it is an act of care through the employment of sounds. its basis is the caregiver’s more general expectation about what (positive) impacts the sounds of technology can have combined with her experiences with this resident. the introduction to this paper recounts a related experience from my night fieldwork in home a where a caregiver decided not to turn down the volume of the radio in a resident’s room in order not to wake the sleeping resident. as a one-time observer, i was struck by this active “inaction” of not adjusting the radio volume to the surrounding night-time silence. it seemed counterintuitive to the aim of care and the creation of a “healthy” sonic environment for the night. however, seeing the caregiver’s decision within the context of her overall experience with this resident, makes room for a different perspective. her active inaction might be understood as a form of soundscape interpretation that is characteristic for the special context of residential care homes since it builds on the knowledge emerging from long-term interactions between caregivers and cared-for. greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 79 caregivers’ efforts to care through the regulation of sounds, though, can be offset by disturbing and uncontrollable sounds of the technologies involved. a night-shift caregiver in home c explained: sometimes it is frustrating, when you enter a room you have to push the attendance button, and then if another room calls it beeps just as loudly as here and, in the rooms, you cannot adjust the volume and sometimes people wake up, even if you only have a look and are really quiet (interview i). here, technological design prevents an attention to sound and silence. the caregiver expressed the wish that someday it will be possible to see the call on the phone, to have a light signal instead of a sound. interestingly, home b has resolved this problem in some way. caregivers there cannot control the sound volume of the attendance system either. so, they use a pager, a small portable device connected to the alarm system in which they can adjust the beeping sound. when i accompanied the night-caregiver in home b, i almost did not hear the pager ringing; silent was the lowest volume level. speaking silence when rice (2013) writes about the nurses’ efforts to create a degree of night-time silence in the hospital wards, he relates this to a historical preoccupation with quiet as a healing environment for the sick. the linking of health and silence is also present in current discussions on hospital noise reduction in the field of health services research. adatia, law and haggerty (2014), for instance, argue that the problem of harmful noise levels in technology intensive hospital units is endemic and propose health care decisionmakers implement a daily quiet time on maternity wards (see also johnson and thornhill 2006). in the care environments i studied, by contrast, silence was not primarily sought, but often it was to be avoided. in this last section, i therefore want to share some of the participants’ contrasting and often deep and controversial experiences around silence. the silence i refer to is not one of a complete absence of any auditory event, but rather, it is an expectation of and hope for sounds that for some reason are not there. it is common in these homes that from time to time residents sit together in one room but do not interact at all. they just sit there silently. one therapist in home b described such a moment as her most intense experience with silence in the house. she walks along the hallway, does not hear anything, comes around the corner and sees a group of residents sitting there in complete silence. she called it a “speaking silence.” it felt sad to her and in some sense uncomfortable. you feel like you need to start a conversation, to break the silence. the same urge was expressed by various participants, mainly staff members but also visiting relatives. one morning the son and daughter-in-law of one resident approached me. without me saying anything they told how they had spent breakfast time together with the residents the last few days and how it always had been so silent. “nobody talks. such a freaking silence. couldn’t you ask them to play some background music? that would be nicer for everyone. some elevator music. something calm but nice.” for many in the field, the picture of silently sitting residents triggered feelings of uneasiness and sorrow, urging them to start conversations, animate, or put on music. yet this is a sensitive situation: how do the residents themselves perceive these moments? does the silence feel uncomfortable to them? my empirical data give some indications. first of all, “residents” obviously are not a homogenous group. whereas comments by some of them aligned with experiences described above, others clearly showed a different perspective. some residents confided to me how they enjoyed moments of silence in group areas. especially older residents made statements more about enjoyment of silence in groups than about uncomfortable silences. early in the morning, one woman commented that she likes being among the first greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 80 for breakfast because then there is “silence before the storm.” for her this is a pleasing sonic environment for a first cup of coffee. in clear contrast, another woman suddenly touched upon this topic when telling about her lunchtime experience: i: i am surprised every day. we are sitting there at a big table, silently, more silent it could not be. we are unable to have a conversation. r: and how is that for you? i: (exhales loudly). not easy. because i then cannot either. and small talk, i don’t do that. that would be no life anymore. but it is, i am suffering from it to be honest. we are all sitting at the table waiting for the meal to be served. oh and then i just look at the people, one after the other, that is also interesting, all their faces, right, but having a conversation, impossible. but i guess that is normal among older people unless they are friends. but still it is strange. you are sitting in a room, maybe 10 to 12 people and absolute silence. that is strange. r: could you imagine, if there was music in the background would that be something nice for you or would it be... i: i actually requested that already. that would of course make it much more pleasant, but they forget it from one time to the next. they are busy the ladies who are serving us. but that would of course be a much nicer atmosphere if there was some background music. but i don’t give up, i keep asking for it (interview j). it is striking that the respondent is one of the relatively younger and fitter residents and someone who actively uses music for herself. yet, these experiences tell us something about the complexity of sonic needs in eldercare institutions and the difficulty of aligning them. some of the tragedy of these later-life home environments expresses itself in silence. conclusion the role of sounds inside hospitals, schools, prisons and other institutions has been examined from various angles, focusing on practices of acoustic surveillance, on the sonic experiences of those immersed in the auditory realm, or on people’s active employment or avoidance of sounds (gallagher 2010, 2011; rice 2013, 2016). the preceding article builds on and contributes to this work by investigating what the special context of eldercare institutions as a long-term care and home environment implies for people’s interpretation of and engagement with sounds. i have argued that in cases where residents and caregivers live and work together for an extended period of time, a familiarity with each other and with their sociomaterial environment can develop which supports forms of monitory listening, of music as a technology of self, and of sounds employed as a tool of care, which in more temporary care contexts might not emerge in the same way. caregivers include their experiential knowledge of each resident in decisions about whether to or how quick to answer help calls. moreover, residents themselves become active contributors to horizontal monitory listening as they come to know each other and learn to detect falling sounds out of the acoustic cues coming from the rooms of their neighbor residents. mutual experience with and among caregivers and cared-for also affects matters of acoustic agency: how music is used as a technology of self, of others, and of the group-self, and how sounds become employed as a tool of care. what seems important, greubel | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.229 http://anthro-age.pitt.edu 81 thus, is that the knowledge about each other and about the function of the technologies allows people to integrate sonic experiences and expectations into their everyday interactions. moreover, it seems that as a characteristic of the long-term home and care environment not only sounds but also silences prompt action. in some cases—as the caregiver’s reaction to the absence of an expected morning call—this phenomenon indeed connects to the more permanent care environment. in other cases, however – such as the relatives’ urge to ask for background music when experiencing a silent breakfast, the silence of residents sitting together without interacting – this phenomenon cannot be explained within the argumentation of the present article. participants’ often deep and controversial experiences around the silence of elderly residents’ hint at a central role of silence in my research fields more generally. further research seems needed that addresses (the absence of) human vocalization within elderly homes. research that goes beyond an understanding of silence as a healing environment for the vulnerable and sick and instead attends to the complexity of this acoustic event within the context of eldercare homes. amanda cachia’s (2015) perspective on silence as “a space of richness rather than a void or vacuum where nothing happens” (336) might be a useful starting point. her work responds to work by friedner and helmreich (2012) which sets out to bring together sound studies and deaf studies, arguing that deaf people are not only people of the eyes but do experience both sound and the “unsound” in diverse sensory forms. what these authors share with the present article is an attempt to open up sensory anthropologists’ and sound studies scholars’ focus on sound to also attend to the experiences of the “unsound,” or the richly filled and speaking silence. references adatia, safina, susan law, and jeannie haggerty. 2014. “room for improvement: noise on a maternity ward.” health services research 14: 604. https://doi.org/10.1186/s12913-014-0604-3. bijsterveld, karin. 2019. sonic skills: listening for knowledge in science, medicine and engineering (1920s– present). london: palgrave macmillan. https://doi.org/10.1057/978-1-137-59829-5. cachia, amanda. 2015. “loud silence: turning up the 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 supper, alexandra and karin bijsterveld. 2015. “sounds convincing: modes of listening and sonic skills in knowledge making.” interdisciplinary science reviews 40, no 2: 124-44. https://doi.org/10.1179/0308018815z.000000000109. thompson, emily. 2002. the soundscape of modernity: architectural acoustics and the culture of listening in america, 1900–1933. cambridge, ma: mit press. truax, barry. 2001. acoustic communication. westport, connecticut: ablex publishing. weishaupt, sabine. 2006. “subjektivierendes arbeitshandeln in der altenpflege die interaktion mit dem körper.“ in arbeit in der interaktion interaktion als arbeit, edited by fritz böhle and jürgen glaser, 85-106. wiesbaden: vs verlag für sozialwissenschaften. microsoft word spring2021_kroløkke_in template.docx for whom does the clock tick?1: male repro-temporality in fertility campaigns, scientific literature, and commercial accounts charlotte kroløkke university of southern denmark charlottekro@sdu.dk abstract sperm swimming in circles or a lone sperm cell with two heads—male reproductive aging is increasingly equated with poor sperm quality, the prevalence of learning disabilities, and even schizophrenia in offspring. to discuss the construction of a male biological clock, this article asks two questions: how does the notion of a biological clock seek to regulate male reproductive bodies? and how is male repro-temporality visually and rhetorically invoked in fertility campaigns, in medical literature, and in the commercial marketing material of a sperm-freezing company? situated within an interdisciplinary theoretical framework, the article draws upon biomedicalization theory (e.g., clarke et al. 2003), reproductive masculinity studies (e.g., almeling and waggoner 2013; daniels 2006), critical cultural gerontology (e.g., sandberg and marshall 2017), and feminist theories of time and temporality (e.g., amir 2006; freeman, 2010). this article contributes to the interdisciplinary scholarly agenda on time and temporality by conceptualizing a male biological clock as a type of repro-temporality that, in its discursive and aesthetic framing, portrays male reproductive aging as involving loss and disability. the article concludes that, while the male biological clock derives its temporal force from the logic of decay, it simultaneously cements heteronormative ideals of the nuclear family, re-naturalizes the genetic unit, and situates men as “proactive” and “modern” in their anticipation of future infertility. keywords: biological clock; sperm; men; reproduction; elective sperm freezing; fertility campaigns anthropology & aging, vol 42, no 1 (2021), pp. 81-96 issn 2374-2267 (online) doi 10.5195/aa.2021.257 kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 81 for whom does the clock tick?1: male repro-temporality in fertility campaigns, scientific literature, and commercial accounts charlotte kroløkke university of southern denmark charlottekro@sdu.dk “people lose muscle strength, flexibility and endurance with age, in men, sperm also tend to lose 'fitness' over the life cycle” interview with physician gloria bachmann in the economic times 2019 “the battle of the sexes just got a lot more equalized” (bailey-millado 2019). although this statement from the new york post visually featured an african-american man holding a baby, it highlights the existence of a male biological clock. advanced paternal age is not only a risk to the health of the fetus, the new york post article forewarned its readers, but also plays an active role during gestation and may lead to gestational diabetes, preterm birth, and preeclampsia (bailey-millado 2019). echoing this concern, gloria bachmann, physician and professor in the department of obstetrics, gynecology, and reproductive sciences at rutgers university, noted that—like the body—sperm ages and loses its “fitness” (the economic times 2019). combined with the knowledge that 40-50% of all infertility cases can be attributed to “male factor infertility” (kumar and singh 2015), and that men’s sperm quality appears to be rapidly on the decline (e.g., carlsen et al. 1992; levine et al. 2017; sengupta et al. 2017), scientific attention has thus begun to turn to the role that paternal age plays in conception, gestation, and in the health of offspring (e.g., lambert, masson, and fisch 2006; pasqualotto, borges, and pasqualotto 2008). the scholarly interest in men’s role in reproduction is also emerging in social-scientific research. for example, sociologists rene almeling and miranda r. waggoner (2013) note how men’s reproductive importance in the united states has historically been reduced to conception; specifically, what has been seen as the life-giving qualities of the male ‘seed.’ in the process, men’s reproductive responsibilities with regards to gestation and childrearing have largely been ignored. meanwhile, based on a large interview study of arab men, anthropologist marcia c. inhorn (2012) uses the phrase “emergent masculinities” to conceptualize the ways in which contemporary men negotiate and become entangled this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 82 with both infertility and reproductive technologies. similarly, albeit based on a large interview study with mexican urology patients, anthropologist emily wentzell (2013; this issue) examines what men say and do when they negotiate reproductive aging and erectile dysfunction. social-scientific scholarship has also explored how masculinity and reproduction entangle in ethnographic accounts of sperm donors (e.g., almeling 2011; mohr 2018), during contraceptive decision-making among men in central and south america (e.g., gutmann 2005; wentzell 2013), in historical accounts of eugenic and sterilization practices (e.g., balasubramanian 2018; dyck 2013; shropshire 2014), and in the history of hormonal contraceptives for men (e.g., campo-engelstein et al. 2019; oudshoorn 2003). there are also ethnographic accounts of men’s experiences with infertility and in-vitro fertilization (ivf), including cultural ideals of masculinity (e.g., inhorn 2012; tjørnhøj-thomsen 2009) as well as in cultural analyses that situate sperm as a normatively gendered fluid (martin 1991; moore 2007). to date, however, very little social-scientific attention has been given to the ways in which scientific, commercial, and fertility campaigns related to men’s reproductive aging seek to intervene in men’s reproductive lives. situated within the current social-scientific research on men and reproduction, this article aims to highlight the construction of a biological clock for men. to do this, i rely upon an interdisciplinary theoretical framework—specifically, biomedicalization theory (clarke et al. 2003; clarke et al. 2010) to frame men’s reproductive aging within individualized demands for enhancement and ‘successful’ aging. in addition, i use the concept of “reproductive masculinity” (e.g., daniels 2006) and feminist theories of time and temporality (e.g., amir 2006; freeman 2010) to describe the discursive and aesthetic construction of a male biological clock. based on a review of scientific literature, the marketing of voluntary sperm freezing, and a recent fertility campaign in copenhagen (denmark), i investigate: how does the notion of a biological clock regulate male reproductive bodies, and how is male reprotemporality visually as well as discursively invoked in these accounts? i return to a presentation of my methodology later; in the next section, i briefly discuss the theoretical framework for my analysis. biomedicalized and timed: the emergence of male repro-temporality the idea of a ‘biological clock’ became popularized following an article that journalist richard cohen wrote for the washington post in 1978. his concept of a ‘biological clock’ targeted specifically women with the effects of advanced maternal age while silencing or altogether ignoring the ways that a similar clock may tick for men. in cohen’s framing, the woman who works outside the home (the “composite woman”) is targeted, particularly when he writes: “sometimes the composite woman is married and sometimes she is not. sometimes, horribly, there is no man on the horizon. what there is always, though, is a feeling that the clock is ticking. a decision will have to be made.”2 in this way, the biological clock was, from the outset, a cultural regulatory mechanism—i.e., “regulating forms of living according to heteronormative perceptions” (amir 2006, 51). today, the biological clock continues to be conceptualized as a female clock, and the very notion that the clock ticks for men has only gradually emerged over the past decade (e.g., fisch 2005). in general, as political scientist cynthia r. daniels (2006) notes, little attention has been paid to men’s role in reproduction. she points out that, not only have men been assumed to be secondary to reproduction, but they have also been cast as less vulnerable, always virile, and distant as far as the health problems of their children are concerned (daniels 2006). in the following, i briefly turn to feminist theories regarding a male biological clock, situating it within an increasingly biomedicalized culture, critical understandings of time and temporality, and what i call male repro-temporality. the concept of biomedicalization signals an important shift from the ways that the aging body has historically become entangled with images of illness, disability, and disease. in the biomedicalization paradigm, the body is now re-entangled with a more general cultural requirement to stay healthy— kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 83 even as one gets older. whereas the medicalization framework includes a desire to control the human body, the term biomedicalization signals greater attention to risk and prevention (clarke et al. 2003, 2010). thus, characteristic of processes of biomedicalization are the ways in which technologies and commercial practices jointly provide new understandings of the aging body. notably, it is no longer necessary to have any medical symptoms to be considered ill or ‘at risk’; rather, “everyone is constantly in the process of seeking enhancement in the attempt to avoid eventually becoming ill” (clarke et al. 2003, 172). consequently, biomedicalization refers to how the aging body becomes entangled with societal expectations as well as commercial and emergent technological practices related to contemporary cultural requirements for prevention and optimization: “biomedicalization practices emphasize transformations of medical phenomena and of bodies, largely through sooner-rather-thanlater technoscientific interventions not only for treatment but also increasingly for enhancement” (clarke et al. 2010, 2). as a concept, then, biomedicalization constitutes a useful framework for capturing emergent scientific, clinical, and technological innovations as well as for critically examining the ways in which ‘successful’ aging and reproduction have both become individualized moral responsibilities. thus, the concept of biomedicalization reveals a more general turn towards prevention and risk management in everyday biomedical practices (e.g., adams, murphy, and clarke 2009; clarke et al. 2010). as noted by sociologist adele e. clarke et al. (2010), an optimized and enhanced body has become the norm. some feminist scholars have critiqued the very idea of ‘successful’ aging (e.g., fishman 2010; roberts 2002; sandberg and marshall 2017). for example, in her analysis of the marketing of hormonereplacement therapy to menopausal women, sociologist celia roberts (2002) suggests that the biomedicalization of women’s bodies affirms conventional understandings of heteronormative femininity. in the case of women’s aging, this means situating women as primarily young and, most importantly, attractive (roberts 2002, 39). similarly, in her analysis of the widely prescribed erectiledysfunction drug viagra, bioethicist jennifer r. fishman (2010) debates how “positive” and “successful” aging, as far as men are concerned, collide with normative understandings of male sexuality and virility. according to her: “‘positive aging’ began to emerge, touting scientific developments as the path to successful aging, through ideals of vitality, activity, autonomy, and wellbeing. these ideals still persist in contemporary understandings of erectile dysfunction” (2010, 291). characteristic of this work is the notion that contemporary biological citizens should be able to foresee their likely futures or, as noted by anthropologist vincanne adams, historian michelle murphy, and sociologist adele e. clarke, staying “‘informed’ about possible futures has become mandatory for good citizenship and morality” (2009, 254). in the case of reproduction, citizens must risk-manage their reproductive futures through an anticipation of infertility (e.g., martin 2010), engaging in acts of what could be framed as “responsible” reproduction in the process. responsibility should, of course, be understood here as a rhetorical and temporal strategy akin to the individualizing discourses of selfdetermination. my use emphasizes the normative expectations that individuals employ to manage their present fertility in order to ensure future fertility and the making of what becomes seen as “healthy” new citizens. the notion of ‘successful’ aging has also aptly been critiqued in cultural gerontology (e.g., sandberg and marshall 2017). as gender studies scholar linn sandberg and sociologist barbara marshall (2017) discuss, successful aging is intimately linked to assumptions of happy and heteronormative bodies. however, with a focus on queer aging, sandberg and marshall disrupt “the narrative of heterohappiness,” revealing “alternative ways of thinking and theorizing that might provide space for a great diversity of later lives, including those rendered abject in current models of ‘successful aging’” (2017, 2). interestingly, heteronormativity—along with the cultural imperative to reproduce—come together in the making of the happy and healthy (active) later life. as they write: “success is not just illustrated kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 84 through coupledom, but also portrayed through happy intimacies with grandchildren, pointing to (hetero)kinship as what which makes later life meaningful and positive” (2017, 3). in this manner, the child becomes a cultural trope that contributes to the privileging of heterosexuality and reproductive futurity (edelman 2004). embedded in this feminist critique is a discussion of heterosexual temporality in particular. whereas communication and rhetoric scholar dustin goltz (2013, 68) refers to “heteronormativity’s discursive hijacking of the future and the correctness of straight temporalities,” gender/sexuality/queer studies scholar elizabeth freeman (2010) develops ‘chrononormativity’ as a critical concept. defined as “a mode of implantation, a technique by which institutional forces come to seem like somatic facts,” freeman (2010, 3) suggests that entire populations are synchronized in order for bodies to appear properly temporalized. the somatic temporality of the body (i.e., growing old, becoming infertile) entangles with institutional temporalities (i.e., how society structures procreation in people’s lives), normative temporalities (i.e., when a man is considered too old to procreate), and affective temporalities (i.e., hoping to become a parent or fearing being infertile within a prognostic medicalized reproductive culture). such temporalities can be understood as embedded within temporal techniques (i.e., calendars, clocks, and watches), thereby forming a temporal experience that may appear natural and feel like “my inner clock” that orients people in specific ways. as freeman suggests (2010), in a neoliberal context, time is recalibrated as preferably always productive. these feminist scholars have clearly indicated how the construction of the biological clock has gained cultural significance. offering a genealogical and feminist approach inspired by philosopher michel foucault, cultural and political geographer merav amir (2006) views the construction of the biological clock as a mechanism for naturalizing gender differences. she argues that the linear and goal-oriented biological clock is embedded within a masculine logic. conceptualized as an attempt to “turn back the clock,” amir (2006, 52) proposes that the biological clock seeks to remake a disrupted gendered order. in a similar vein, cultural studies scholar lucy van de wiel (2014a, 2014b) suggests that the biological clock reinstalls fears associated with the aging (infertile) female body. as she discusses in her analysis of british and dutch news media, the biological clock is not an “ordinary” clock; rather, it reappears as “an alarm clock counting down time, referencing a general notion of bodily finitude and an understanding of desired parenthood as a temporal problem” (2014b, 15). such feminist scholarship suggests that the biological clock regulates the gendered reproductive body. amplified as an “alarm clock,” the biological clock has, since the 1970s, been loudly telling women that their reproductive time is running out (amir 2006; van de wiel 2014b). in combination with these ideas, biomedicalization theory helps to position male repro-temporality within an increasingly individualized biomedical culture. here, optimization and enhancement become naturalized while feminist scholarship on time and temporality provides a framework for critically interrogating the ways in which reproductive temporality becomes gendered and puts reproductive masculinity to the test. reproductive aging can be situated in light of the cultural requirement to riskmanage one’s future. for example, building upon anthropologist sarah lochlann jain’s (2007) proposal that we are all living in prognosis, some feminist scholars note how contemporary people become defined as living in relation to statistical risks and probabilities related, e.g., to reproductive futures. jain argues that the prognostic subject is constantly confronted by the fear of a likely future (2007); this has already been seen in the example of social egg freezing. here, visual imageries turn delayed reproduction into a risky affair (van de wiel 2014b). yet, as i discuss in my analysis, it is also increasingly present in the formulation of elective sperm freezing as a response to men’s aging and the fear of lessthan-optimal future reproductive cells and offspring. in both cases, the cryopreservation of one’s own reproductive cells becomes presented as a form of risk management as well as a way to prevent kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 85 reproductive aging—in the case of men, it is a metaphorical viagra for one’s future reproductive chances. it is from within this mix, i argue, that the notion of male repro-temporality emerges. having briefly outlined my theoretical framework, i turn now to my choice of empirical material. methodology: tracking male repro-temporality in fertility campaigns, scientific literature, and commercial accounts akin to science and technology studies (sts) scholar donna haraway’s notion of staying with the trouble (2016), in this article, i view the construction of male repro-temporality as “trouble,” and i pursue the ways in which a contemporary fertility campaign, medical literature on men’s reproductive aging, and commercial endeavors both visually and discursively attempt to regulate and mandate men’s reproduction. throughout the article, fertility campaigns, scientific literature, and commercial accounts are conceptualized as biopolitical interventions that, i argue, manage a set of cultural anxieties associated with the increasingly poor sperm quality of primarily white, western men. similar to earlier anxieties related to male infertility—such as the anti-masturbation campaigns of the 19th and 20th centuries (e.g., garlick 2014; hunt 1998)—cultural anxieties have historically focused on the production of “weak” sperm and thereby concerns about “weak” offspring. however, such concern has clearly been racialized as well as classed. as noted by sociology of law alan hunt (1998, 588) in reference to the anti-masturbation campaigns: “it is a distinctively class discourse; it is young men of the upper and middle classes that arouse concern.” the empirical material for my analysis consists of three sets of data: a copenhagen-based fertility campaign, 29 international scientific articles on men’s reproductive aging, and the marketing of elective sperm-freezing conducted by a new sperm bank in the united states. while the choice of several different geographical sites makes it impossible to generalize about, for example, danish biopolitical attempts to manage men’s repro-temporality, my approach illustrates the ways in which male reprotemporality takes form in different commercial, marketing, and medical accounts. the publicly sponsored danish fertility campaign, “can your spunk do the funk?”3 was launched on billboards in copenhagen and a website in 2018; it was the result of collaboration between the city of copenhagen and rigshospital’s fertility clinic. while both women and men who reside in copenhagen tend to be older than the national average at the birth of their first child, the campaign indicates that infertility is the most common chronic illness among danes aged 25–44. estimating that one in four danish men has poor sperm quality, which only worsens with advanced age, the campaign is primarily directed at young men. however, within this nuclear heteronormative domain, women are also featured in the website imagery. as a result of joint efforts between danish politicians and leading fertility doctors, the campaign exemplifies the state’s attempt to regulate danish men’s repro-temporality. in so doing, it not only ensures the sustainability of a population who can continue to financially support the danish welfare state but, with its visual imagery, the campaign reinforces the specific imagery of white, collegeeducated, and middle-class reproductive future. such public-health campaigns related to reproduction are not new. in her historical account of pronatalism and reproduction in the united states, historian laura lovett traces positive eugenics in public campaigns as exemplified by, e.g., “fitter families contests” (2007). characteristic of the positive eugenics of the 1920s, each family was understood as a genetic unit, and their combination of good ancestry and upbringing became equal to good breeding (lovett 2007, 141). the fitter-family contests were meant to encourage “healthy living” while also institutionalizing particular body norms and scientific measurements. moreover, at a time of increased urban development, these contests effectively celebrated the rural family as an idealized family type. as lovett notes, “the fitter family contests were a campaign of popular education that lent scientific credence to a nostalgic vision of the rural family” kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 86 (2007, 161). while contemporary danish fertility campaigns may bear little immediate resemblance to the fitter-families contests of the 1920s, they do—as i explain in my analysis—reinforce the premise of “good genetic stock” together with the concern and responsibility related to “infant health,” which is now being recalibrated in the face of declining birth rates and new family forms. to further understand how a male biological clock has emerged and is conceptualized, i include contemporary scientific and commercial accounts. a pubmed search using the terms “advanced paternal age” revealed 474 scientific, peer-reviewed articles while a search using the words “male biological clock” resulted in 4,511 articles, and a search on the word “andropause” resulted in 598 articles. all results were then sorted through the pubmed system for “best match,” and the top 60 results from each of the three searches were analyzed for relevance. once sorted through for relevance, my medical archive of scientific, peer-reviewed articles consisted of 29 articles published in medical journals between 1997 and 2019. i argue that scientific articles are important; not only do they discuss scientific terms and negotiate what comes to constitute new biomedical truths, they also have a spillover effect into the increasingly commercial industry of reproductive health. as noted by urologists and reproductive specialists ranjith ramasamy, koji chiba, peter butler, and dolores j. lamb (2015, 1404), scientific findings related to the effect of advanced paternal aging encourage younger men to cryopreserve their sperm. an example of such a commercial endeavor is a us-based elective sperm-freezing company—dadi— which, for a price of $99.99, will send men residing in the continental us an at-home sperm-collection kit. for an annual cryopreservation storage fee of an additional $99.99 and a withdrawal fee of $299.99, men can voluntarily store and withdraw their sperm. whereas scientific articles provide insights into the ways that male repro-temporality has emerged in the medical domain, the ability to zoom in on a contemporary commercial practice enables me to pinpoint the ways that imaginaries related to male repro-temporality slip into—and may gain additional force from—the commercial domain. in this way, “the commodification of health is fundamental to biomedicalization” (clarke et al. 2010b, 48). there may also be links to biocapital; e.g., when emergent technological developments appear to enable “new ways to circuit of capital” (rose 2007, 150). meanwhile, i have chosen to focus on two different national contexts (denmark and the united states) in order to highlight the ways that male repro-temporality is activated differently in different national and empirical contexts. because my interest lies in identifying how the biological clock seeks to regulate the male body and the ways in which male repro-temporality is invoked both visually as well as discursively, i rely upon a grounded-theory approach (strauss and corbin 1997) to analyze the empirical material. using an open coding of themes related to my research focus, i detail how male repro-temporality emerges in this material. two themes were especially dominant: the theme of “unfit sperm”; and the making of the “proactive” and “modern” man. importantly, the notion of “fit” sperm appeared in both the scientific literature and the commercial accounts, while the construction of the proactive and modern man was unique to the fertility campaign as well as the commercial accounts. moreover, whereas the notion of “fit sperm” ties in with positive eugenics and the reinstallation of “good genes,” the imagery of proactive and modern men in the empirical material draws upon new perspectives of men as involved, responsible, and anticipatory partners and fathers. while engaging the empirical material in different ways, both themes suggest that male repro-temporality debunks traditional notions of reproductive masculinity; instead, it repositions men as responsibly oriented towards their reproductive future. kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 87 tick, tock: the emergence of a male biological clock “men have biological clocks that affect their hormone levels, fertility, and the genetic quality of their sperm. women should no longer be viewed as solely responsible for agerelated fertility and genetic problems” lambert, masson, and fisch 2006, 616 what do george clooney, billy joel, elton john, alec baldwin, mick jagger, steve martin, and eddie murphy have in common? joining the list of old dads, these celebrity men have fathered children well past the typical childbearing age. in general, the age of paternity has increased in the west. in the united states, the birth rate among fathers aged 35–39, 40–44, and 45–49 increased 61%, 63%, and 52% respectively in 2014 (eisenberg and meldrum 2016). while this may be attributed to increased life expectancy, an increase in divorces and remarriages as well as access to assisted reproductive technologies (brandt et al. 2019, 81), the trend is similar in other western countries. for example, in denmark, the average age at which a man had his first child was 31.5 in 2020—up from 28.8 years in 1990 (danish statistical yearbook 2020). in the male biological clock, urologist harry fisch (2005) warns that men’s fertility potential declines with age. while fisch popularized the concept of a male biological clock, it is interesting to note that— up until that point—the general western medical community had been slow to investigate the ways in which male fertility and age intertwine; in my pubmed search, most results appeared only after 2004. in most of this scientific literature, advanced paternal aging was recognized and estimated to begin at the age of 40. echoing this, the american society for reproductive medicine puts 40 as the upper age limit for sperm donors (brandt et al. 2019). similarly, the european sperm bank, located in denmark, has age 40 as the upper limit for their sperm donors, and cryos international, the world’s largest sperm bank, has set its limit at age 45. however, some scientists speculate that advanced paternal age may even start at age 35. according to epidemiologists anne-marie nybo andersen and stine urhøj (2017, 312): “most studies denote paternal age of 40 years or more as fathers of advanced age, but the risk increase in indisputable paternal age-related conditions starts around the paternal age of 35 years.” urologists fabio f. pasqualotto, edson borges, and eleonora b. pasqualotto (2008, 198) also point to 35 as a critical age for men: “after controlling for maternal age, couples in which the man is over 35 years old have a 50% lower pregnancy rate than do couples in which the man is not more than 30 years old.” while an age-related decline in testosterone may negatively affect men’s fertility potential, current research indicates that dna fragmentation may potentially put offspring at risk, thus leading some scholars to ask: “is advanced paternal age a health risk for the offspring?” (sigman 2017, 299). while the biological clock has historically been constituted as a gendered ticking time-machine (e.g., amir 2006; friese, becker, and nachtigall 2006), this construction is now invoked in the case of men as well. in biomedical, commercial, and marketing accounts, the emergence of the male clock contributes to an understanding of male reproductive aging as involving the production of “unfit” (decayed and faulty) sperm. contrary to the biological clock for women, which disciplines them from becoming involved in the workforce, men’s biological clock—particularly in the commercial accounts— repositions reproductive masculinity into that of the “proactive” as well as the new “modern” man and engaged father. in the ways in which a biological clock seeks to regulate larger populations, it is thereby always biopolitical. as noted by anthropologist ayo wahlberg (2018) in reference to his ethnographic work in china and that country’s alleged “national sperm crisis,” fertility concerns invariably become linked to concerns about ‘reproducing the nation.’ kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 88 the making of “unfit” sperm from ‘fast and furious’ to ‘decrepit and faulty,’ reproductive aging is put in close proximity to reproductive decay in both the scientific literature as well as in the copenhagen fertility campaign. here, men’s aging bodies become translated into decayed sperm cells. sperm cells appear visually disabled as well as immobile (photo 1). although none of these “old” cells are gendered, they are all visually portrayed as “unfit”; i.e., one of them uses a walker while others appear to have difficulty reading or are even blind and use a cane (photo 1). characteristic of the campaign’s visual portrayals is that the cells reveal a fault—e.g., sperm depicted with two tails. this aesthetic of decay is further documented in the authoritarian male voice-over: “every fourth man has reduced sperm quality,” we learn, and “every fifth man does not become a father.” this information is followed by an image of a white couple walking during an autumn day. whereas leaves falling signals the onset of winter, it also aesthetically highlights the couple’s aging process—and the viewer is told directly: “it doesn’t have to be you.” as if transformed by this message, the couple then joyfully walks with a baby and the video ends, in a happy ending of sorts, with one muscular sperm cell happily displaying a gendered victory through a display of its biceps (photo 2). photo 1 photo 2 the copenhagen campaign: does your spunk do the funk? (translated by the author from the danish title: spiller din sæd?). whereas the decrepit and disabled sperm cells in the copenhagen fertility campaign debunk the myth of masculine reproductive invulnerability (daniels 2006), the campaign simultaneously repositions men as becoming individually responsible for their own reproductive fitness. not only is biomedicalized reproduction characterized by an intensified focus on health and optimization (clarke et al. 2010), but individuals are also increasingly repositioned as having to be in control of their own anticipated future. similarly, with a reference to “vital politics,” the focus is increasingly on the individual’s ability to “control, manage, engineer, reshape, and modulate the very vital capacities of human beings as living creatures” (rose (2007, 3). in the copenhagen campaign, the comment “it doesn’t have to be you” reiterates this understanding of fertility as firmly situated within the confines of the individual. moreover, by combining this statement with a heterosexual couple, successful aging is invariably linked to the reproduction of heteronormative forms of kinship (cf. sandberg and marshall 2017). in the fertility campaign, aging becomes translated into miniature cells. the viewer is initially confronted with a lone, tired (and presumably elderly) sperm cell relying on the assistance of a walker. however, this old and lonely sperm cell is contrasted with the general optimism that the young couple displays. “i would like to have children,” says the young and, presumably, cis-gendered male (i.e., a person whose sense of personal gender identity corresponds to their birth sex), posing together with his kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 89 white female partner. situated in front of the city skyline, this urban, white, heterosexual couple appears optimistic, yet their optimism is temporally disciplined when the authoritarian male voice-over says: “but perhaps you should consider getting started.” physically situated at a table behind two computer screens, the couple’s decision to surround themselves with books, computers, and red wine is called into question. youthfulness and optimism become replaced by the image of this couple’s transformation into an old couple. visually displayed as distraught and tired, this older and slightly overweight couple (perhaps due to too much wine and a sedentary lifestyle) has none of the optimism or energy of their youth. such a representation serves as an aesthetic reminder of the older, miserable, childless couple, and echoes the ways in which heteronormativity, reproduction, and a happy senior life intersect (sandberg and marshall 2017). in the fertility campaign, a desire to have children is replaced with a reminder that reproduction and parenthood “may take some time.” although still visually displayed as a couple, the consequences of infertility are shown to be serious. at this point in the video, the man assumes the aesthetic position of the infertile half of the couple when he is seen carrying not a child but two cats. “you can’t count on your sperm cells doing the funk,” he is told. a large group of happy-golucky (smiling) sperm cells that appear in the middle of a footrace—obviously, fit and healthy, and capable of moving in the “right” direction—immediately become replaced by the immobile, tired, and old-looking cells (photo 1). in this manner, childbearing and heteronormativity become synchronized and linked to happy and fit bodies as well as sperm cells. recalling sociologist carrie friese, medical anthropologist gay becker, and obstetrician-gynecologist robert d. nachtigall’s (2006) and sociologist charis thompson’s (2005) observations that the biological clock has become epitomized as old eggs, men’s reproductive aging is translated into old sperm cells in the copenhagen fertility campaign. however, the “happy ending” in which a muscular sperm cell (photo 2) represents reproductive masculinity also underscores the potential for reproductive optimization translated into the ability to father one’s own genetic children. as echoed in political scientist cynthia daniels’ (2006) construction of reproductive masculinity, infertile men are frequently feminized and emasculated, which the campaign visually displays as decaying cells. similarly, the old sperm cells have none of the strength and forward momentum of the fast-swimming, excitable cells that become present in what appears to be a footrace. as daniels suggests (2006), reproductive masculinity reveals how men’s abilities and desires to reproduce (or not) are always entangled with gendered reproductive as well as nationalist agendas. moreover, in the campaign, fertility becomes reconstituted as a moral obligation. noting the morality related to health in general, clarke et al. (2010, 63) argue that the “focus is no longer on illness, disability, and disease as matters of fate but on health as a matter of ongoing moral self-transformation.” reconceptualized as a form of fertility awareness, then, the copenhagen campaign is a visual and textual reminder that young, white, educated, and urban danish cis-gendered men must take their reproductive abilities seriously. in this campaign, male reprotemporality becomes interwoven with a new moral order that specifically addresses men. in this way, scientific knowledge—along with the markets within which they become embedded—“embody and generate new ethical value. as life itself is penetrated by market relations and becomes productive of wealth, the morality governing some forms of economic exchange is being reconfigured” (rose 2007, 152). the translation of male repro-temporality into the production of “unfit” sperm cells is reiterated in some of the scientific literature i analyzed. however, now re-conceptualized as “dna fragmentation,” andrologists ranjith ramasamy, koji chiba, peter butler, and dolores j. lamb (2015, 1404) echo the notion that aging produces cellular decay: “in men between 60 and 80 years of age, the percentage of dna fragmentation in ejaculated sperm is estimated to be 88%.” similarly, as they link declining reproductive abilities with men’s age, pasqualotto, borges, and pasqualotto (2008, 198) argue: “it has been demonstrated that men over 35 years of age are twice as likely to be infertile (defined as the kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 90 inability to initiate a pregnancy within 12 months) as men under 25 years old.” moreover, entangling aging and reproductive decline with sperm cells as a reproductive unit, they note: “in men, advancing age decreases semen volume, percentage of normal sperm and sperm motility. while these factors adversely affect fertility, the genetic integrity of sperm is at risk” (2008, 198). similarly, in the realm of commercial sperm-freezing endeavors, men are told that “age matters” (dadi 2021). along with the image of a fast-ticking clock, the prospective dadi customer learns that, “after age 40, sperm count decreases, and you become more likely to pass on birth defects, neuro-cognitive disorders, and increase the risk of miscarriage” (dadi 2021). in the making of “unfit” sperm, male infertility is positioned as rampant (50% of infertility is attributed to sperm”; dadi 2021). men are also reminded that the health of their offspring is at stake. in particular, according to pasqualotto, borges, and pasqualotto (2008, 198), the offspring of men aged 40 and above are “5.75 times more likely to have autism spectrum disorder (asd) than were the offspring of men younger than 30 years, after controlling for year of birth, socioeconomic status and maternal age, also older men were at higher risk of fathering a child with schizophrenia. men over 40 years old were more than twice as likely to have a child with schizophrenia as were men in their twenties.” reproductive aging has also been linked to autism (e.g., schubert 2008), and to the development of diabetes and some childhood cancers (e.g., lewis, legato, and fisch 2006). moreover, it now takes longer for men to become fathers. commercial sperm-freezing banks such as dadi claim: “millennials are 50% as fertile as their parents’ generation. there is a 5 times longer time-to-pregnancy at age 40 than at age 25 due to infertility” (dadi 2021). in this empirical material, male repro-temporality is positioned as a “serious problem to the couple seeking to conceive a child” (ramasamy et al. 2015); this reinforces the development of a new moral order in which the ticking reproductive alarm clock, as exemplified by unfit sperm cells, ticks for men too. the making of “proactive” and “modern” men “this report has led younger men to question whether they should bank sperm while young to prevent the risks “associated with advanced paternal age” ramasamy et al. 2015, 1404 the making of “unfit” sperm situates men’s aging within reproductive decay and appears across my empirical material. but i argue that the cultural anxieties associated with male repro-temporality are resolved in the making of “proactive” and “modern” men. reproductive masculinity, while challenged, is also reiterated and strengthened. this is especially true in the cases of the copenhagen fertility campaign and the dadi commercial accounts. in both, the aesthetic and rhetorical construction of men includes that of proactive, fit, and good-looking men who wisely anticipate their potential reproductive futures. similar to rose’s (2007, 7) observation that “securing the best possible futures” is vital, these men actively engage in monitoring and self-evaluation. conceptualizing this as a “regime of the self”, rose (2007) says: “each individual is engaged as a prudent yet enterprising individual, actively shaping his or her life course through acts of choice, activities that extend to the search for health in the face of the fear of illness, and the management of the risks” (154). proactive men seek to actualize “optimal futures” that involve “engagements with regimes of risk and surveillance, extended responsibility for knowledge accumulation and consumption, and taking up new kinds of biomedically-inflected identities” (clarke et al. 2010, 23-24). in the copenhagen campaign, the visual imagery shifts between an optimistic, wine-drinking young couple, a tired-looking older couple, and a couple in which the male partner is carrying a child (contrasted with the image of older-him holding two cats). these shifts aesthetically remind the male viewer of the importance associated with securing his reproductive kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 91 potential through a heteronormative coupling. the young, attractive, fit, and nicely dressed men in the dadi commercial similarly testify to a conventional aesthetic associated with that of the proactive man. anticipation is key in the construction of proactive and modern men. in the case of the dadi marketing material, the prospective customer (and father) learns that voluntary sperm-freezing is about “protecting your future family for a fraction of the cost” (dadi 2021). as noted on the company’s website: “we believe in empowering you by drastically breaking from the norm” (dadi 2021). once the lab receives the customer’s sperm, he is sent an email with the results along with a video of his sperm cells. testing for sperm concentration and volume, the dadi tests attempt to bring men “back on track.” as noted by the company: “the future is full of questions. making sure you’re able to have a family shouldn’t be one of them” (dadi 2021). in this manner, elective sperm-freezing turns into an anticipatory practice akin to elective egg-freezing (carroll and kroløkke 2018; van de wiel 2014b). clarke et al. (2010, 24) theorize this move when they argue that biomedicalization involves a “constant anticipatory orientation toward the future, toward potentialities.” in the context of dadi’s marketing materials, sperm-freezing becomes discursively as well as aesthetically constructed as a modern tool of empowerment that can contribute to the making of the new modern man; e.g., when the company states: “we’re reimagining fertility by providing a modern, accessible option directly to you” (dadi 2021). supportive of the modern, urban, cis-gendered, and heterosexual position, men depicted on the dadi website interact with women as well as with what appears to be their own genetic children. for example, an african-american man in a fully equipped kitchen bakes bread together with an approximately fiveyear old child. supportive of an urban form of reproductive masculinity, the construction of this new modern man is further reinforced by images of an urban apartment, a sports bike, relaxed yet fitted clothes, and a backpack large enough to fit the dadi sperm-collection box (dadi 2021). here, technology and convenience come together, as the company claims (dadi 2021). on the dadi website, there are images of a young, slender, and fit-looking african-american man who receives the sperm-collection kit while situated in a nice, orderly apartment. his bedroom is tastefully decorated: white linen, fluffy pillows, white bedspread, matching black glass lamps, small black bedside tables with books on them. this new york-style apartment (brick walls, windows facing other brownstone apartments) is then replaced by an image of a couple sitting together on the bed. this fully-clothed, caucasian couple appears relaxed; the woman is listening to the man speak, and the blue dadi sperm-collection box is placed at the man’s feet. directed at the urban man and visually exemplified by a racially diverse yet quite heteronormative group, the dadi box closely resembles that of an apple computer box and is always neatly placed either on the bed, by the man’s feet, in his bag, or on the table. like the copenhagen fertility campaign, temporality is embodied in the material by the sperm cells. dadi, for example, promises their customers the security of peace of mind through the act of securing, frezing, and storing so-called “younger” sperm cells: “dadi ensures that couples can use healthy, younger sperm when they’re ready to start a family, putting you in charge of your own future” (dadi 2021). the “younger” cells are here put in proximity to images of men playfully interacting with young, healthylooking children—when combined with images of men on the floor drawing with their children, this further reiterates an understanding of men’s role in gestation and birth as well as imaginaries of involved fatherhood. with the visual imagery of happy and healthy-looking children, sperm-freezing becomes reconstituted as a rescue technology that enables heterosexual and cis-gendered men (like women) to bypass the problems of aging and, in the process, to engage in new understandings of fatherhood. dadi reinforces heteronormative reproductive masculinity through the assistance of cryo-technologies. similar to how egg freezing becomes translated and visually depicted on the clinical websites as a sound, even responsible, kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 92 investment strategy (kroløkke 2019), such technological developments reshape “vitality from the inside” (rose 2007, 20). cryopreservation promises to optimize heterosexual and cis-gendered men’s life chances, thereby synchronizing reproduction with the realities of increased life expectancy and reproductive aging. similar to egg-freezing advertisements directed at women (carroll and kroløkke 2018; van de wiel 2014b), cryo-technologies for sperm seem to ensure the customer his best future odds for becoming a father. in the case of dadi, the biological clock becomes a justification for cryopreservation technologies, and men are reminded that their best years for fertility are “running out.” consequently—and in contrast to both the scientific literature and the copenhagen fertility campaign in which aging is equated with decay and a loss of testosterone—dadi’s sperm-freezing material rejuvenates men in terms of their reproductive abilities, their ability to engage in proactivity, and their new, empowered fatherhood roles. compared to the accounts of women’s biological clock, male repro-temporality is clearly managed as less urgent. in the scientific literature, the notion of a male biological clock makes men co-responsible for the reproduction of healthy offspring. according to urologists sarah m. lambert, puneet masson, and harry fisch (2006, 616), “women should no longer be viewed as solely responsible for age-related fertility and genetic problems.” however, although the scientific literature i studied addresses the existence of a biological clock for men (since 2004), it also suggests that a male biological clock is somewhat more flexible—even reversible—noting that some men become fathers well past their retirement years. it is not possible to stop or reverse women’s biological clocks (van de wiel 2014a, 2014b) but, in the case of men, fatherhood becomes a temporal problem, albeit one not equated with finitude. this is especially evident in the case of anecdotal accounts. for example, ramjit raghav reportedly became the world’s oldest father at age 96, attributing his prowess to a vegetarian lifestyle, and a newspaper report about him claimed: “vegetarians still got it at age 96.”4 rather than exclusively playing into certain cultural anxieties associated with male reproductive failure, the commercial accounts i examined conventionally reactivate reproductive masculinity. specifically, these accounts turn the men who engage in reproductive anticipation—as well as those who can afford these emergent reproductive consumer practices—into new, modern men and involved fathers. in sharp contrast to women’s egg-freezing accounts, men’s reproductive failure and decline are described in narratives of empowerment and modernity. conclusions this article has examined the ways in which the notion of a biological clock seeks to regulate men’s reproductive bodies. feminist scholars have analyzed how the biological clock structures women’s reproductive lives; however, currently, little is known about how the emergence of male reprotemporality influences men. interestingly, at a time when families are becoming increasingly diverse— with women having children with sperm donors, men having children through surrogacy, or the various ‘rainbow,’ adoptive, and step-families—an insistence on genetic families relies on a quite traditional agenda. the copenhagen fertility campaign, the scientific articles related to men’s reproductive aging, and the commercial sperm-freezing accounts in my empirical material provide self-selecting individuals with an opportunity to idealize and synchronize reproductive hetero-time along with their genetic heritage. taking inspiration from feminist scholarship on biomedicalization, time and temporality as well as critical age studies, i have argued that male repro-temporality becomes articulated through individualized forms of self-enhancement and moral responsibility. as i have discussed, there is a moral responsibility associated with reproducing healthy offspring and, in doing so, a heteronormative order of reproduction and the nuclear family becomes reinforced. throughout the empirical material i analyzed, men’s fertility is described in a discourse of decline; nevertheless, it is managed (and overcome) through conventional gendered framing. a nostalgic moral order is reiterated throughout the material. in this discourse, the genetic tie is positioned as central in the kroløkke | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.257 http://anthro-age.pitt.edu 93 construction of “new,” “modern” men who are also “involved” fathers. having children then becomes entangled with the reiteration of an educated middleand upper-class. in this entanglement, imaginaries of proactive and “modern” men reproduce a particular understanding of the nation as well. clearly, more empirical research is needed to illuminate how men become implicated as users of emergent reproductive technologies as well as to investigate their perspectives and practices in relation to male repro-temporality. however, it is interesting to note that, while the construction of a male biological clock calls for a dismantling of the gendered biological clock—including the ways in which clock-based thinking has justified a gendered temporal organization of life—in my empirical material, reproductive masculinity is reiterated through the production of the “proactive” man who secures his seed in the production of his own “better” babies. notes 1. this title is a play on lucy van de wiel’s (2014b) article, “for whom the clock ticks. reproductive ageing and egg freezing in dutch and british news media.” studies in the maternal, 6(1): 1-28. 2. cohen’s chronicle appeared first on march 16, 1978 and can be found in the archive available at: https://www.washingtonpost.com/archive/local/1978/03/16/the-clock-is-ticking-for-the-careerwoman/bd566aa8-fd7d-43da-9be9-ad025759d0a4/ retrieved october 30, 2019. 3. the danish title of the campaign is “spiller din sæd?,” which is a sexualized play on the vitality of sperm. the title is translated, by the author, to “does your spunk do the funk?” another possible translation could be: “is your semen steamin’?” the campaign began in the autumn of 2018 and was displayed on billboards in copenhagen as well as on a website. today, the website is still active: https://xn--spillerdinsd-hdb.dk/ retrieved september 2020. 4. this is according to the article titled “india’s 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retirement can be played out. based on thirty-two months of fieldwork at two of the us’s largest casinos, i argue that these facilities help older adults maintain their personhood by engaging them socially, mentally, and physically through the myriad services and amenities they offer. dominating narratives informed by western economic and medical trends call for ‘active aging,’ ‘productive aging,’ or ‘aging gracefully,’ and these related paradigms emphasize social engagement along with physical and cognitive activities as the keys to thriving in old age. the casino environment simultaneously challenges and facilitates these narratives, providing an age-diverse setting in which seniors can exercise, entertain family, acquire gifts, and earn status. drawing on david graeber’s (2001) framework for theorizing value, i assert that it is participation in the many activities of the casino, rather than the monetary wins and losses, that has constituted them as valuable places to sustain personhood and achieve the ideals of an ‘active’ or ‘successful’ retirement. keywords: personhood; active aging; casinos; gambling; older adults; value; usa anthropology & aging, vol 40, no 1 (2019), pp. 63-76 issn 2374-2267 (online) doi 10.5195/aa.2019.200 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 63 aging and personhood in the landscape of the mega-casino retirement at the tables joy ciofi university of connecticut author contact: joy.ciofi@gmail.com introduction it was an early friday morning in the heat of late august when i joined nick and venus in the long, u-shaped line filling a side entrance lobby in mohegan sun resort and casino. “so how long will you guys usually wait?” i asked, watching the neat queue of mostly seniors creep forward, past the beckoning conveyor belt of freshly glazed donuts behind the windows of krispy kreme. “oh, sometimes a half hour, forty-five minutes even,” venus replied, “but the line is moving fast today.” she recognized a familiar face across the way and waved. soon enough we arrived at a desk where the couple displayed their brightlycolored player’s club cards and were handed an xxl tie-dyed t-shirt with the casino logo emblazoned on the back. i commented at the size for her petite frame, but she explained they are one-size only, adding that she wears them to work in their garden. she tucked the plastic-wrapped shirt into her bag and we set off to a new row of space-maiden themed slot machines around the corner. despite pervasive beliefs that life after paid labor ends is about rest and relaxation, many anthropologists and age scholars have found that ‘successful’ retirement in america is about managing activities rather than embracing idleness (katz 2000; lamb, robbins-ruszkowski, and corwin 2017; weiss 2005). a key component of the active aging narrative is the belief that characteristics of youth can and should be preserved well into later life. those elements that define the person and structure individual identity, such as physical appearance and capabilities, relationships, hobbies or interests, and the maintenance of the home are all, ideally, sustained despite the changes brought by advancing age. successful aging demands a “permanent personhood”, one more or less unmodified through the passage of time (lamb, robbins-ruszkowski, and corwin 2017,11). in this article, i reveal how older adults respond to the deeply felt changes and challenges to personhood through the utilization of the unusual places of american mega-casinos. i argue that these casino customers have found ways to amend the existing structures, spaces, and services of these vast facilities to effectuate the key element of active aging—the activity—and fulfill their desires for a ‘good’ retirement. value, uncertainty, and the making of a person before one can understand why retirees will wait in line for impractical ‘gifts’ or risk limited pension money on slot machines, it is important to contextualize these activities in light of significant changes that have occurred in the institution of work into the 21st century. economic anthropology has undergone considerable theoretical shifts as local economic systems have expanded into international ones and career paths for many workers have become increasingly unpredictable and dynamic. uncertainty has become the new ‘normal’ as international financial speculation, currency exchange, and venture capital continue to dominate global economics. these changes have permeated across wall street and into the everyday economic activities of most americans as they navigate a deliberately perplexing array of financial products to sustain them once formal employment ends. the demands of late capitalism have ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 64 rewritten the life course by requiring frequent career shifts in place of rewarded company loyalty, often resulting in relocations, retraining, or even forays into freelance or contract work (lane 2009). richard sennett reflects on the ways in which this transition impacts notions of personhood and family life: the problem with all this is that a self oriented to the short term, focused on potential ability, willing to abandon past experience is—to put a kindly face on the matter—an unusual sort of human being. most people are not like this; they need a sustaining life narrative, they take pride in being good at something specific, and they value the experiences they’ve lived through. the cultural ideal required in new institutions thus damages many of the people who inhabit them. (sennett 2006,17) uncertainty erodes these three elements of personhooda sustaining life narrative, pride in mastery of specific skillsets, and the importance of experiencesand replaces them with a series of transitions and adjustments that emphasize preparedness for the future and make it increasingly difficult to define a cohesive self. to sit still, then, is antithetical to a system based on constant change and movement, and thus the institution of retirement has also shifted from a period of respite and security to a constant bustle of busyness in an effort to align with expectations about what it means to age actively when paid labor ends. david graeber astutely discerned the importance of action in his influential text on theories of value. rather than aligning with either of the “two equally unsatisfactory poles” of exchange-based value or value from “meaningful difference,” he asserts that both of these models fail to reflect the fluidity and dynamism of relationships, both social and economic (2001,46). “value becomes… the way people represent the importance of their own actions to themselves: normally, as reflected in one or another socially recognized form,” (2001,47). departing from the work of other economic anthropologists, he places primary emphasis on the action or activity itself, but also recognizes the importance of an audience, even an audience of one, to observe the act taking place. sara lamb (1997) lends ethnographic credence to graeber’s theory in her examination of maya, or the emotional and physical ties to kin, among older indian women. she argues that one of the socially recognized practices of aging in north indian villages is the act of gradually severing these ties to others in an effort to ‘unmake’ elements of the person, allowing the transition onward without leaving a lingering (or still socially attached) spirit behind. thus, the value of maya as an element of personhood is sustained from actions that are socially recognized, and, in order for this value to be recycled, it must be deliberately unrecognized in a publicly visible way so the cycle can continue. actions are also fundamental to marcel mauss’s (1985) development of the concept of the person through time. in his classic essay he demonstrates how the idea of the self (moi) was produced historically with actions, beginning first with the acts of giving a name and participation in one’s role in the clan, and following a series of increasingly complex processes from indigenous groups until arriving at the contemporary european understanding of the individual agent. this definition of the person as both a conscious individual but also one constituted through participation in social groups and institutions is derived from actions, and as graeber emphasizes, the importance given to those actions to oneself and others. mauss’s definition is also based upon participatory actions in institutions such as kin, politics, and the like. to extend this to include the institution of work seems wholly fitting, as it is often within this hierarchical setting that ideas about the self are further developed (jiménez 2003). a person can be a father and son (a participant in the reciprocal institution of kin) a husband (a participant in the institution of the house), and an accountant, or pipefitter, or nurse (a participant in the institution of work). the skills and ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 65 relative rank acquired in the workplace can be defining elements of the person that are not easily sustained when careers have reached their end (savishinsky 2000; weiss 2005). traditional employment also provides a somewhat predictable daily routine of necessary tasks, interpersonal interactions, and, importantly, scheduled activities which structure the day and create meaning through achievement or completion (lynch 2009, 2013). when formal work ends, retirees may initially revel in the abundant free time by socializing, traveling, or dabbling in new hobbies. once the excitement gives way to monotony, many older adults are left searching for activities, however mundane, to fill the day (weiss 2005). in this way, the cultural obsession with activity in late life serves as a facilitator of ‘permanent personhood’ for those who are physically and financially able to participate in the sanctioned behaviors that are socially prescribed. guided by the work of graeber and utilizing the construction of personhood developed by mauss, i argue that it is through this active participation that value is created and beliefs about a ‘good’ retirement are actualized, even in the unlikely spaces of mega-casinos. aging-as-activity the process of becoming older is an ongoing activity that begins at birth and ends at death, though we often do not think of it in this way. old age is both relative and specific: it is relative to the perspective of the person assessing it, whether yourself, a child, or someone older than you, but is seen as a specific period of time in the life course: “every image of a human being is effectively an image of aging, given that it provides a representation of the face and body which is of a person at a particular point on a chronological time scale and therefore immediately marked in terms of linear age,” (featherstone and hepworth 2009,136). along with this chronological scale, there are culturally specific activities and behaviors that are associated with particular age sets; in the united states and indeed many other places, childhood is for play and education, young adulthood is for marriage and starting families, and retirement and old age too are accompanied by their own sets of actions. the cultural paradigms shaping the behaviors of old age in the united states have come to be defined by a set of synonymous terms such as active, productive, or successful aging. these buzzwords are of course deliberate and the product of neoliberal ideologies. in his contribution to the cultural context of aging, henry moody (2009) outlines the relationship between our fixation on the medical aspects of aging and the circulation of these terms, which exist as a contrast to feared declines in health. although there are subtle differences between these concepts, they generally emphasize the belief that old age can (and should) be a period of continued social participation and engagement, involvement in new hobbies or interests, and a proactive and preventative attitude towards current and future health problems and their consequences (cardona 2012; estes and associates 2001; vozikaki et al 2017). often, older adults are encouraged to participate in activities that are deemed socially appropriate for their age, regardless of their personal interests. in the united states, this is reflected in the types of activities hosted by senior centers or other community programs, which might center around handicrafts (gendered heavily towards women), puzzles, collectibles, and low-impact exercises. however, despite the positive connotation of terms such as “active aging”, it is presumptuous to assume they are merely the most ‘scientifically validated’ approaches to later life. moody cautions, “taking for granted our individualist, activity-oriented and future-oriented approach to successful aging becomes an uncritical kind of cultural blindness (a kind of ethnocentrism) that will not be overcome by empirical investigation itself” (2009, 70). in other words, successful aging is steeped in cultural meaning and laced with a set of accompanying values that require the nuanced insights of anthropologists in addition (or perhaps in contrast) to the louder voices of the american association of retired persons (aarp), western medical practitioners, and concerned adult children. ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 66 methodology casinos are notoriously difficult sites to conduct academic research for a number of reasons, all of which were encountered in undertaking this project. given the controversial status of legalized gaming, associated cultural vices (smoking, alcohol, sex work), and increasing awareness of gambling pathology, casino management are resistant to allowing outside researchers poke around. however, after several months of polite persistence, i was able to gain access to mohegan sun’s non-gaming retail area for recruitment and participant interviews. the group of seniors i worked with were recruited with a variety of methods. short screening surveys were administered to casino guests voluntarily, and qualified participants (retired adults 65 or older who visited an area casino at least weekly) were contacted for interviews. i also recruited via convenience sampling at area senior centers on bingo day, and used snowball sampling when applicable. fieldwork for this project was conducted from january 2015 to august 2017 in both mohegan sun and foxwoods resort and casino, two tribal mega-casinos situated in rural southeastern connecticut. interviews with seniors were semi-structured and open-ended, with a focus on narratives and anecdotes to generate an integrated understanding of how casinos fit into the post-retirement lives of these older adults. to support these interviews, all casino-going seniors were shadowed for several casino visits in order to document their movements, choices, and social interactions as they utilized the facilities. i also formally interviewed casino employees in various positions and had several informal interviews with casino management, security, and marketing staff. casino employees were interviewed once each with a more structured set of questions regarding casino advertising and outreach targeting older customers, and many employees described their personal (and often long-lasting) relationships with regular senior guests. all members of staff, regardless of position, could think of several seniors with whom they had developed a strong connection and they spoke fondly of these guests during interviews. a total of 13 seniors and 5 casino employees were interviewed for this project. the senior participants ranged in age from 65 to 92 and were diverse in their educational and socioeconomic backgrounds, with careers as hairdressers, chemists, and upper-level management for major corporations, among others. given the importance of financial issues in retirement, i chose my sample with consideration to household income, and my participants ranged from fixed-income and dependent on state support to highly wealthy and generating income from investments. some were married with many children and grandchildren, while others were widowed and childless, with few family members still living. frequency of casino visits was dependent on finances, personal interest, and temporal availability. participants with a little time to fill usually only went once a week, while others with more abundant free time (and fewer competing interests) visited more often, up to four times a week in some cases. trying your luck at active aging: casinos and late life we may now return to the meandering line of retirees waiting for tacky, oversized t-shirts. this image is likely very different from the depictions most of us have in our minds when considering the american casino industry. popular films such as the ocean’s series and fear and loathing in las vegas use casinos as glamorous-yet-distasteful backdrops for stories about handsome young men and accompanying dames dashing about from one illegal activity to another under the catchy anonymity of ‘what happens in vegas, stays in vegas.’ however, the reality of the expansion of casino gambling across the united states is more mundane, and skews demographically much older, with a full 64% of casino visitors being over 50, and 28% over 65 (aga 2013). in addition, casinos have spread outside of their designated hubs of las ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 67 vegas and atlantic city to 40 states due in part to state budget woes and rising public approval of gambling (aga 2017). this increase also reflects shifts in federal recognition of tribal sovereignty, beginning in 1979 with the seminole tribe in central florida, which won the right to operate a small bingo hall on reservation grounds (cattelino 2008). within a few short decades, dozens of other tribes followed suit, including the mashantucket and mohegan, owners of the field sites for this project. cattelino cautions in her ethnographic account of the seminole’s rise to success that only a handful of tribal casinos earn the majority of tribal gaming revenue (2008,4). many other tribes, due to interacting factors such as local governmental regulations, location, and management, fail to see the same successes. regardless, tribal casinos continue to represent a significant portion of the expansion of casino gambling nationally. this spread has not occurred without debate, especially about problem and pathological gambling and the impacts this may have on those with fixed or limited incomes (back, lee, and stinchfield 2011; nichols et al 2002; quinn 2001). the rates of these disorders in the general population, however, are low, with estimates ranging from 1-7% (quinn 2001; shaffer et al 1999). natasha dow schüll critiques such figures in her book addiction by design and argues that these statistics are misleading; gambling addiction is likely much more prevalent among regular casino gamblers, with some studies asserting as high as 20% (schüll 2012, 15; zaranek and lichtenberg 2008). such wide variations in percentages are reflective of significant complexities involved in assessment, such as the reliability of self-reporting, the validity of screening instruments used to diagnose problem/pathological gambling, and the different rates of pathology across types of gambling games (volberg et al. 2001). given these challenges, and in light of my role as ethnographer rather than psychiatrist, it is not my intention to classify the gambling habits and decisions of my participants or assign to them any diagnoses. instead, i focus on mega-casinos as institutions facilitating a variety of activities for senior guests, including, but not restricted to, gambling. occasionally during fieldwork, a participant would meet me looking flustered from having lost more money than anticipated, but none of my interlocutors ever reported self-diagnosing or seeking treatment for gambling addiction. more frequently, i encountered participants using self-limiting strategies to keep spending in check, such as not visiting casino atms and only bringing the amount of cash they felt they could afford to lose. for these reasons, gambling addiction and associated outcomes, while critically important areas for ethnographic research, are not the primary focus of this article. the field sites for this project were two of the largest casinos in the united states. in the early 1990s, they opened as small bingo and slots facilities run by two native american tribes, the mohegan (of mohegan sun resort and casino) and the mashantucket pequot (of foxwoods resort casino). today, these vast facilities have sprawled well beyond their original boundaries and both are all-inclusive, familyfriendly resorts with an abundance of non-gambling entertainment options, ranging from concerts and comedy shows to shopping, ice skating, and golf. that is not to say that gambling is not the primary draw for most regular visitors, including older adults. both facilities house over 3,000 slot machines, hundreds of table games, designated poker rooms, and race books, in addition to selling state lottery tickets in a variety of forms. foxwoods also boasts the largest bingo hall in the united states with 3,600 seats and a minimum of three games daily. senior gamblers enjoy all these games, but generally slot machines and bingo are the most popular, as they are easy to understand, low-pressure, and fast-paced (chapple and nofziger 2000; munro 2003). this was reflected in my participants as well, with three playing poker exclusively, one dedicated to craps, and the remainder spending their time on slots or the occasional bingo game. for each of my participants, regardless of his or her preferred game, the casinos offered valuable opportunities to be busy and make plans. the promotional calendars mailed out by mohegan sun and foxwoods each month provided physical reminders of things to look forward to, and always presented ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 68 another chance to potentially win big next time. casino visits had become a way to ‘get something on the books’ and avoid staying home again, succumbing to the monotony of daily routines. with the variety of events and activities offered, a single facility could be transformed into an entire day’s worth of entertainment, socialization, meals, errands, and even exercise. older adults are keenly aware of the stigma associated with being a ‘shut-in’ and finding oneself cut off from the outside world (buch 2015, 2017). this fear was especially acute for my participants in their eighties and nineties who were less mobile and had experienced the passing of spouses and relocation of children. maintaining a schedule and having upcoming plans helps to stave off loneliness and brighten one’s outlook on the future, but it also reflects the ‘active’ component of the active aging paradigm. activity is a generalized term, and each of my participants interpreted it differently, defining activity in the context of their individual interests, physical abilities, and financial limitations. regardless of how activity was invoked, the underlying importance of doing rather than idling, going rather than staying, and playing rather than watching was frequently reiterated. in the following sections i draw on my observations, field notes, and interviews to situate the mega-casinos as valuable places for older adults to fulfill their desires for busyness, activity, and potential in late life. aging in places many age scholars have observed the ways in which physical places develop or change in significance during late life (rowles and bernard 2013; stafford 2009; vesperi 1985). often these places are valued because of the connections to family or association with memories, or because they are meeting places that allow community interactions and support. in her seminal ethnography on a jewish center, barbara myerhoff (1980) described in moving narrative accounts the way this institution facilitates connections, social life, and a shared sense citizenship for its members. members of the center were united by a sense of mutual history and the cultural, ethnic, and religious identities of judaism. identification with a group, especially a group with a shared sense of place, is becoming critically important in light of economic uncertainty and the increased mobility that accompanies it. in his discussion of ‘lifestyle migrants’ in northern michigan, brian hoey (2010) highlights this desire in workers and retirees who relocate to find a greater feeling of community in contrast to the demands of corporate life: “under current economic conditions and imperatives, people are expected to live in a perpetual state of becoming. this may lead to a crisis of individual identity not easily remedied by jobs in the contingent workforce. relocating to personally meaningful geographic places becomes the basis for defining self-identity within narratives essential to personhood” (238). yet even the most generic of public settings can attain significance, becoming ‘third places’: not home or work but other facilitators of sociability, such as mcdonald’s restaurants or auction houses (stafford 2009). these third places are sites of activity, and often exist within geographic areas of personal meaning. since their opening nearly three decades ago, the two mega-casinos i observed had become, through a combination of marketing strategies and convenience, valuable places in the lives of older adults in the region. the abundance of activities available in one location is ‘too good to pass up,’ as nick and venus explained to me over coffee one morning. “there’s always something going on, something new to try,” venus said excitedly. they enjoyed looking for new machines to play, taking advantage of gifts and coupons, and chatting with other seniors at the food court. the casinos, eager to fill their vast gaming floors during the slow workday hours, view seniors as the ideal demographic solution to this problem. every monday, as part of a seasonal promotion (branded ‘forever young’ mondays by mohegan sun) adults over 60 could get a free coffee and pastry at many casino cafés. this morning gathering was known as the senior coffee club, and i often met participants there. the t-shirt giveaway from the opening vignette was yet ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 69 another seasonal promotion that occurred every friday throughout the summer, generally the slowest time of year. these events acted as ‘filler’ activities, or ways to spend time at the casinos without spending any more money, even if it was just time in line to pick up a gift. over the course of this project i began to see the importance of the casual but meaningful interactions between the older guests coming to take advantage of these promotions, and often the topics discussed were quite personal, such as health concerns or the loss of a spouse. that is not to say that the relationships were particularly intimate, nor did they often result in friendships that extended outside the casino walls, but it is precisely this background neutrality— the shuffle of comings-and-goings, constant cycle of activities, and unwavering functionality of the space— that made the casinos valuable ‘third places’ for seniors outside the home. these facilities are unique, both among other entertainment options as well as in the very nature of their design and construction. they never close, never lose power (despite seasonal snowstorms and hurricanes), are climate-controlled, and, unlike other institutions specifically dedicated to senior activities, one could make a whole day of a casino trip. many participants expressed distaste at the thought of going to a senior center because it is an age-exclusive setting. tim, a retired delivery driver and regular poker player in his sixties, chuckled when i asked him if he ever went to the senior center. “i’m old, but i’m not old-old,” he said. “i could never get into zumba or whatever that is they do over there.” his laughter was accompanied by a dancelike gesture, emphasizing his disinterest. interestingly, his daughter worked with senior services for the state, and would occasionally come play poker with him on her day off. many senior centers even run bus trips to the casinos, though several center employees i spoke to seemed to hold them in poor regard, reflecting media and popular discourse about older visitors overspending on gambling. tim strongly disagreed with this attitude. “yeah, but you know what, they're all bingo players. a lot of them just come up to play bingo, or slots. they’re 70, 75, and they are living now, you know, they got money and they want to spend it and enjoy themselves. i don’t think there's anything wrong with that.” tim’s comments are revealing on several fronts. by noting that these older gamblers are “living now” and have the right to spend their retirement participating in activities they enjoy, he places emphasis on the positive experiences that can be had at the casino, rather than dwelling on potential risks or losses. despite his daughter’s career in senior services, he is situating elder-exclusive settings as undesirable or a ‘last resort’; the casino is, for tim, the less-stigmatized of the two facilities, and he can clearly empathize with people choosing to spend an afternoon at the slots instead of resigning themselves to ‘official’ places of aging. the all-inclusivity of the casino experience actually parallels many of the characteristics of elderfriendly communities. they are accessible to people with physical disabilities, provide an age-diverse environment, are safe and secure, and promote physical and mental stimulation (peace 2013). some of my participants had even experienced medical emergencies at the casino and were appreciative of the rapid ambulance response times and availability of trained personnel. hank and jeannie, regulars for the monday promotions, were playing slots when hank had a heart attack: “thank god we were there, the floor people were so fast to come help. if we were at home who knows how it would’ve turned out,” jeannie recounted. the security staff at mohegan sun and foxwoods (and indeed most other large casinos nationally) are trained to use defibrillators if a cardiac arrest is suspected, and both tribes maintain their own emt services and ambulances in case of emergencies on site. in contrast to pervasive ideals about aging-in-place, for jeannie, home was the worst place to be should a serious medical issue arise. although the couple’s lifelong home was only blocks away from several of their children, the demands of work, grandchildren’s after-school sports, and evening homework meant that their family had become less involved and visits were less frequent. the feeling of being ‘cut-off’ from outside activities intensified when hank gave up driving. jeannie, having never acquired a driver’s license, was now ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 70 completely dependent on other kin to complete errands and keep appointments. during our interviews, they stressed to me the importance of their monday casino trips for their well-being. “what else do we have to do?” she asked me. “it’s something to look forward to each week. without it, our lives would just be the supermarket, doctor’s appointments, and the tv.” she spoke sadly. “it’s some excitement in the week, you know,” added hank. “something to get out of the house and do.” participation in the activities of public and private spaces, such as grocery stores, libraries, shopping malls and sporting events is emphasized as part of ‘successful’ or active aging and helps people feel ‘themselves,’ or a whole person. the ability to carry out these mundane activities independently becomes highly valued during advancing age and thus the settings for these actions are, too, valuable and support feelings of being a whole person in the individualized, western sense. mauss (1985) emphasizes the way that agency became inseparable from the person, and on his path to this conclusion he notes the importance of social roles in the constitution of the self. the role of an actively aging adult in the united states is one that necessitates both the ability to schedule and follow through on the day’s plans and a setting in which they can unfold. in this way, the third-places of aging described by phillip stafford (2009) are key components of the lives of their customers, facilitating personhood through sociability, participation, and action. these casinos have become places to go and be active for area residents in old age. echoes of work: status and skill development most of the seniors i spoke to had dedicated their lives to a particular career, reflecting the patterns of work that, in many ways, defined this generation. nick was an electrician who was employed by regional power plants since leaving the navy in 1966. tim had made a vocation out of delivery, starting out on a paper route and eventually working up to a driver for a major shipping and logistics company. beth anne, another regular for the monday promotions, was a chemist for a local pharmaceutical manufacturing company and returned to the job for another 20 years after raising her six children. then there was sam, a retired financial manager for a prestigious research and technology firm. he left the company somewhat abruptly when new executives came in and began making decisions he felt were unethical. so when this new guy came in, to me, he was ridiculous. i mean he just was all out for himself. he could figure how many ways he was going to screw the company by taking more and more money. he didn’t know anything. wall street liked him, so -you know, so the board liked him. but he brought in his own people who didn’t know anything, and they just really screwed up everything. so i wouldn’t agree with some of the stuff he wanted to do. what i thought he was doing was, if not illegal, immoral. i knew i wasn’t long for the company, but i didn’t care. they gave me a good package. i got 28 months’ full salary and benefits. and i was 55 at the time. so i was eligible for my pension, and i never got another job after that. this meant that sam was suddenly faced with an abundance of free time, with no grandparenting responsibilities or financial concerns, and he and his wife were in good health. for people like sam, retirement can be an opportunity to develop new interests or throw oneself into an existing hobby with renewed fervor, and the pursuit of pleasure and passions is a recurring theme in ethnographic accounts of life after work in the west (liechty, yarnal, and kerstetter 2012; mikkelson 2017; savishinsky 2000; weiss 2005). the ability to develop a new skill at this stage of life is itself somewhat antithetical to cultural tropes about aging, and this belief is reflected in the english expression “can’t teach an old dog new tricks.” ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 71 but sam found that the mathematical and probability skills he had developed over his financial career were useful at the craps tables, where he spent one or two mornings a week shooting dice with other mostly retired older men: “my wife doesn’t understand why i like to gamble. she says it’s because i was a finance major and i know all about finance. and she says ‘you know that the house is going to come out ahead of you.’” he smiles. “yeah. but i just like playing the game.” this sentiment reflects the importance of the activity of ‘playing the game’ over the actual monetary value of what is being wagered. the value of the craps tables, for sam, is about the actions; by the time he takes his spot standing over the green felt of the field, he has participated in multiple actions that have increased the value of the overall experience. he has been greeted and recognized by casino staff as he is extended credit with which to make bets, supporting his identity as a valued (and valuable) player. he engages his mind and mentally prepares himself for the game, tabulating the stacks of the other players, observing the bets and dice, and using his skills to decide how and what to wager. he may lose or win, and this unpredictability adds excitement but also requires him to potentially adjust his strategy. the combination of all of these actions produces an activity that is dynamic, satisfying, and ultimately valuable to sam, supporting graeber’s (2001) argument that value arises from the representation of actions to oneself and others. while money clearly has value to sam, the activity of “playing the game” is a composite of many actions, and its value is only partially derived from the exchanging of money. the social recognition and accumulated status are thus not ancillary to the wins and losses, but they are important components of the entire activity of a casino visit. during the course of a career, mastery of a skill set is often accompanied with its own set of rewards or incentives. capitalism underscores personal agency as the mechanism through which improvement can generate payoffs, and workers are encouraged to put in the time and effort to earn bonuses, raises, or promotions. this system has been staggeringly effective at increasing corporate profits and it is therefore not surprising that casinos have found a way to replicate this in their own internal economies. all major casinos have player’s club programs that use personalized magnetic cards to track customers’ spending and time gambling. at mohegan sun, this comes in the form of the momentum program, which is a tiered system for incentivizing gambling and maintaining customer loyalty. in an almost literal parallel of graeber’s theory of value, the very name momentum is a word indicating sustained action, and the names of the corresponding tiers are also verbs (ignite, leap, ascend, and soar). customers earn points, called momentum dollars, in exchange for their time and money at machines or table games. the dollars can be used to purchase anything (aside from gaming) inside the casino, and there are even travel agencies and local car dealers that will accept the fictitious currency. earning the next status level comes with its own set of rewards in the form of comped meals, tickets, or hotel stays, and in this way even money lost gambling can at least, as one participant put it, “go towards my momentum.” achieving certain status levels also opens up new vip experiences, including a private dining area on the 33rd floor, where i joined sam and his wife for brunch one sunday morning. sam was the only one in the group to have earned the highest status, but due to his generous retirement package and adherence to strict limits and strategies at the craps tables, his spending at the casino did not have a negative impact on their finances. the casino had become a recreational substitute for the things about work sam enjoyed. he could use and perfect his statistical skills, receive acknowledgement for the time and energy he put in, and in exchange for the money lost at the tables he was compensated with concert tickets, high-end vacations, fine dining and the occasional spa day for his wife. of course, not all retirees are so financially secure as to play with thousands of dollars each week. it is inevitably true that player’s club systems do lead to overspending for some, and potentially a serious addiction, as schüll (2012) reveals in las vegas casinos. for my participants, the ‘free’ gifts and promotions ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 72 discussed earlier that are offered to lower-level players became a good reason to get out of the house, and provided something to do besides gamble at the casino. the points system designed to boost corporate profits is actually co-opted by these retirees as a way to sustain important elements of the person and engage in enjoyable activities that add value to their lives. by developing and practicing skills, receiving status through participation, and filling empty days on weekly calendars, older adults who visit casinos are able to live up to the expectations of active aging that might otherwise be out of reach or undesirable. the mega-casino experience differs significantly from person to person, but the diversity of activities available within this single institution contribute to its wide appeal and gives a deeper meaning to participants’ comments that there are ‘so many things to do.’ one-stop shopping and independence having an abundance of activities available is only one arm of the active aging model; having the physical, economic, and social means to participate in them is equally critical. the values of independence and self-sufficiency are defining values of the united states, and these values are evinced in recent policy and fiscal decisions by the government regarding pensions and healthcare. the ongoing reduction of social services for the elderly has led to an emphasis on market solutions that can facilitate self-care and urge personal responsibility rather than dependence on state assistance or support (estes and associates 2001). these products and services are oriented towards adapting the home to changing physical needs, enabling self-administration of routine medical care, and making household tasks and errands more manageable. in her study of home care in chicago, elana buch (2013) reveals that it is through this facilitated sense of independence that personhood can be sustained for elderly residents. the aging population in the united states is preoccupied with losing their independence and becoming a burden on kin, especially adult children (portacolone 2011). this concern was voiced by several of my participants, most notably by beth anne, the retired chemist, and judy, a former hair-dresser who had just turned seventy. both women were widows and had some serious medical issues. beth anne suffered a stroke several years earlier (while at a casino, interestingly) and still had some difficulty reading and remembering words. judy was on dialysis thrice weekly and went to the casino on her free days. she and her late husband never had any children, and she was without family in the area excepting one cousin, whom she hated to bother but sometimes drove her to appointments if she was not well enough to do so herself. beth anne was a mother to six children and many grandchildren, who were, in contrast, often bothering her. she explained to me that one afternoon she had been late returning from some errands and missed one of her daughter’s regular phone calls. when she arrived back home, she found her daughter standing in her entryway, terrified that something serious had happened. beth anne laughed about this story with minor irritation, saying with a sarcastic smile, “i’ve got a dinner this coming monday night, and i’ve got to remember to tell her i won’t be there when she calls this time.” unlike beth anne, judy had to adapt to living alone, and found it a difficult transition. i still live in my own home. i'm still able to take care of the snow, the grass, and stuff like that. other than that i'm fairly self-sufficient. i don't like to bother anybody. i've gotten pretty independent actually. it surprised me, because i've never really been alone. i've been married all my life. and now i've become somewhat of a loner. i was married for almost 37 years, and you had your own circle of friends with your mate, and things change when you’re widowed. they really do. you become the third wheel, and i don't have a lot of the same friends that i used to have. i've made new friends. and you have to go on. but it's different in a way, because i never have been alone, and i didn't know how i was going to fare with it, and it was very scary in the beginning, because my husband took care of all ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 73 the financial things and everything, and i never wanted to be bothered with it. the perceptions of independence for these two women were very distinct from each other, but for each, maintaining self-sufficiency and managing one’s own schedule were crucial priorities and symbols of ‘successful aging.’ both women took it upon themselves to plan outings and activities to keep the week full. judy would visit the local senior center for bingo and a chair yoga class, and beth anne had weekly lunches with her sisters and participated in her homeowner’s association. the casino was also a regular social activity and both women went at least weekly. beth anne came with a couple in her neighborhood for the monday promotions: “getting older is…” she trailed off with a sigh, “you have to fill your time some way. this is one thing i really look forward to once a week. we chat in the car coming up. we don’t see each other from week to week. and we tell stories, it’s just a good time.” the importance of frequent activity is underscored, and the use of the expression ‘fill your time’ reveals beth anne’s framing of time itself as ‘empty’ until given value by ‘filling’ it with important actions of one’s independent choosing. judy, however, had found another way to use the casinos to maintain her independence, by taking advantage of the momentum status program and the dizzying and frankly unusual variety of shopping to be done in one place. mohegan sun contains within it a wide assortment of retail shops. aside from the expected range of luxury goods that are typical for this setting, you can also purchase gasoline, groceries, prepared foods, underwear, household appliances, cell phones, toiletries, and even power tools. some of these items are available at standard mall-type stores, but the casino also has its own stores that sell a hodgepodge of commodities they think customers might need. the purpose of this is to encourage guests to shop with their earned momentum dollars, keeping them in the casino longer and hopefully inciting more gambling, where the real profits are made. for judy, this strategy was not so much a clever marketing move but a real convenience, as her dialysis trips were extremely time-consuming and made it difficult to complete all her necessary errands. since she already came to the casino to gamble on several of her free days, she accumulated momentum dollars and used these to put gas in her car, pick up some aspirin, and stock her freezer with shrimp and steaks, all at the same location. even when money was tight at the end of the month and she refrained from gambling, she would come to the casino just to do her errands. i go into the shops every once in a while, and i've got a lot of points. so i've lately been shopping, and i hate to shop. i'm not a shopper at all. but i lost a lot of weight with my kidney disease. so last year i realized, i don't have any clothes that fit me. and i just can't afford to go out and buy a whole new wardrobe, but i went into the shops here and got one. now i go in there all the time. i didn't have the internet. my friends say, ‘you should get an ipad. you should get a computer.’ so i went into the store here, and i bought my ipad. i bought a couple of vacuums. i also like to get stuff for my cousin who does things for me, and my friends. i take them out to eat up here, and things like that. so the points… you know, i spend money gambling, but at least i’m getting something out of it. because the points add up, and they don’t go away if you don’t spend them. so i have spent a lot in there on things that i normally probably would not have bought otherwise. and i get gas, i haven’t bought gas at a gas station in almost five years now. one could easily critique this tactic by arguing that if she did not spend the money gambling, perhaps she could afford to shop for the things she needed elsewhere. this critique could also be leveraged against any expensive (but socially approved) hobby of retirement, such as exotic travel or golf. but this is beside the point for judy, and indeed for all my participants. they are going to gamble; it is an activity they enjoy, it provides them with mental stimulation, and gives them something to anticipate for the week ahead. the ciofi | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.200 http://anthro-age.pitt.edu 74 mega-casino as a singular institution, even though not explicitly designed for retirees, aligns remarkably well with idealized social constructions of ‘active’ aging. in assessing the role of these facilities in the lives of the older adults who increasingly frequent them, we must also consider the external cultural pressures that emphasize constant activity, recognizable and reciprocated social status, and independence. the active-aging rhetoric pushed by professional organizations, state governments, and the western medical system offers only a template for a ‘good life’ post-retirement; the steps to attain it are more nebulous and determined by factors both within and outside one’s sphere of control. my goal here is neither to praise casinos as perfect solutions to the problems of retirement nor to condemn them as risky financial disasters waiting to happen. instead, i hope i have succeeded in describing the mechanisms by which these unusual facilities acquire value in the lives of older adults and contribute to their sense of self by presenting multiple possibilities that otherwise may have remained inaccessible. conclusions the active-aging paradigm requires that elements of personhood developed over the duration of the life course persist into late life, despite physical or financial changes and limitations. those elements are defined through the participation in systems of particular cultural value and supported by reciprocal recognition (mauss 1985). for retirees in the united states, being busy, staying social, and remaining selfsufficient are simultaneously cast as both indicators of good health and means to stave off feared ‘declines.’ despite their position in a moral grey area for many people, casinos have, for better or worse, become facilitators of these activities of aging. the need to remain constantly busy with socially and personally significant activities has become the gold standard for american retirement. the activities to busy oneself with must also align with a long list of value-laden priorities, from physical exercise to mental engagement to the development of skills and nurturing of passions. being unable to fulfill these purposes is associated, accurately or otherwise, with ‘letting go’ and succumbing to the slow decay of ill health and true old age. reminiscent of de certeau (2011), casino-going retirees have managed to use tactics to secure myriad needs and desires within a single institution, even one that is actively strategizing against them in many respects. the casinos are massively profitable enterprises, and some of those profits are of course made off of local retirees through successful marketing schemes. in exchange, however, these regular customers feel that they receive value beyond their financial expenditure — not literal monetary value but the value produced by activity, as graeber has discerned. if value is created through action, then there is certainly plenty of action at the tables. notes i. participant names have been changed to protect privacy. ii. i wish to thank the management, staff, and tribal gaming council of mohegan sun resort and casino for their assistance in facilitating site access for this research project. i would also like to thank the reviewers for their thoughtful comments and suggestions as 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contact: ccoe@camden.rutgers.edu erdmute alber university of bayreuth author contact: erdmute.alber@uni-bayreuth.de abstract this special issue introduces the concept of age-inscription. it accounts for the ways that transitions, expectations and markers around age and life-course stages are modified in interplay with social change. this new concept is necessary, we argue, because age-inscriptions correspond to more indeterminate and transitional levels of changes in aging trajectories and life stages than the concept of norms. inscriptions lie between rules, laws, and norms on the one hand, and individual feelings, emotions, and actions on the other. they are at least slightly shared between individuals, and, thus, somewhat more standardized than individual behavior, but not as standardized and shared as norms. this introduction lays out the reasons why ageinscriptions happen, as well as the primary ways by which they are formed and generated. we conclude by arguing that contemporary age-inscriptions are fashioned in relation to a longer life course encountered by a new generation, an increasing temporalization and institutionalization of the life course, and high levels of mobility and migration. keywords: aging, life course, migration, age-inscription, institutionalization, social change anthropology & aging, vol 39, no 1 (2018), pp. 1-17 issn 2374-2267 (online) doi 10.5195/aa.2018.172 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 1 age inscriptions and social change cati coe rutgers university author contact: ccoe@camden.rutgers.edu erdmute alber university of bayreuth author contact: erdmute.alber@uni-bayreuth.de introduction because age is a central principle of social organization, aging trajectories—in their temporality, social meaning, and relatedness—are highly sensitive to social change. based on her research on aging in the former east germany (gdr), tatjana thelen (2005) discusses a new aging trajectory: grandfathers provide child care for their grandchildren. within this context, grandfatherly childcare accorded with neither gender norms of male and female roles nor with traditions of care from grandparents, as institutional forms of child care were widely available in the gdr. after german unification, however, the economic collapse in east germany primarily affected the sectors that employed men, who were subject to early retirement and thus had more free time than their female spouses. furthermore, the younger generation faced more precarious work and scarcer state childcare support than previous generations. grandfathers with time on their hands stepped in to take care of their grandchildren while the young and middle-aged generation of parents worked odd and variable shifts. surprisingly, despite the importance of grandfatherly care in allowing mothers and fathers to work, this care was not acknowledged by the men and not a topic of discourse. thelen commented that it was their wives, the grandmothers, who were willing to speak about kin caring arrangements and from whom she learned of the significant role played by grandfathers. the grandfathers were not proud of their new roles; therefore, they refused to expound on them in conversations with the anthropologist. thelen notes, “it is possible that these caring grandfathers are only a transitional model, at a time when the socialist value orientation in favour of wage labour and the model of the working mother still exists” (2005, 185). through this example, along with the articles in this special issue, we introduce a concept that captures this indeterminate and possibly transitional level of social change in culturally prescribed aging trajectories and life stages, which we call age-inscription. in this special issue, we theorize age-inscription as the way that transitions, expectations, and markers around age and stages in the life course shift in practice. these inscriptions are based on individual and familial emotions, experiences, and restrictions, as well as on actions of reflecting on and responding to processes of institutional and societal change. we suggest inscription is positioned in between rules, laws, and norms on the one hand, and individual feelings, emotions, and actions on the other. inscription, always in the making, is more standardized than individual behavior. it emerges when some people are doing, believing, and feeling in similar ways. however, it is not, and often not yet, as standardized and shared within society as a norm. inscription arises out of personal and familial experiences as people quickly respond to situations to which existing norms do not provide adequate answers or provide contradictory answers. there is a gap or a lag between norms and practices. inscription is a response to the practical conflicts and problems caused by conflicting or increasingly irrelevant norms. it has effects on persons in that it can become embodied in anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 2 everyday habits and routines. as in thelen´s example, the age-inscription of caring grandfathers was not dominant and the principals were not eager to articulate it. but it did affect grandfathers’ bodily practice: they overtly expressed affection for their grandchildren, picked them up from school, cooked for them, and put them to bed (thelen 2005). consistent with our understanding of inscription as non-dominant and experimental, we consider age-inscription’s habituation in bodily practices to be flexible and subject to change. furthermore, age-inscription has material effects. inscription falls within the continuum between shared norms, on the one hand, and individual actions, on the other. it is less formal and explicit than a norm. it can emerge when several people do similar things—like the grandfathers who do not see this pattern as a duty. norms, in contrast, are discussed in patterned, formulaic discourse, although usually they are evoked at moments of norm violation. they are shared knowledge about how people should behave. age-inscription, in contrast, is not dominant or hegemonic. it can be contested and negotiated, competing against other understandings and even against social norms, but it is sometimes so invisible and unarticulated as to escape social censure or commentary. processes we call age-inscriptions are happening due to the fact that every society is in motion. they often take place when discrepancies between norms and behavior occur: if there were neither change nor conflicting norms, age-inscriptions would not occur. this is why they always indicate processes of change. conceptualizing inscription as a processual moment in between norms and individual behavior implies possible dynamics in all directions: it could start as individual behavior that is gradually shared by others. if it spreads, it could gradually develop into a social norm. of course, this dynamic could, and does, happen in the other direction, as when shared norms come to contradict one another and become less dominant and less shared inscriptions. what we examine as an inscription today can, in the future, become more articulated and even dominant and hegemonic as a social norm, or it might fade into the background as part of the transition to yet another social norm. the concept of inscription is needed to indicate a level of articulation and practice which is not socially normed and, even more importantly, not necessarily discursively organized. our term age-inscription derives from kin-scripts, which carol stack and linda burton (1993) developed some decades ago to theorize the ways that kin create scripts for the life courses of their members. through this concept, they emphasize the temporality of multiple life courses and the ways that each life course affects the life courses of others, a finding that they frame with the term kin-time. the work that is needed to sustain a kin group over the generations is called, in their terminology, kin-work, and the ways in which various people become recruited to do kin-work they call kin-scription. in their contribution to this special issue, franziska bedorf and julia pauli add the concept of kin-place, or sites such as houses where kinwork occurs, the physical space enabling certain kinds of care and socialities across the generations and serving as a kind of lieu de mémoire (nora 2001) for kin groups. in anthropological and sociological research, including our own work (dossa and coe 2017), the concept of kin-work has been mainly used because it resonates with other feminist literature on the recognition of women’s household labor, and even more specifically, women´s care work (cf. alber and drotbohm 2015, 4). although we draw on stack and burton’s concept of kin scripts, unlike them, we want to emphasize the ways scripts are coming into being, and being made and formed, rather than the ways that existing scripts are being negotiated in practice. as a result, we use the term inscription rather than script, to emphasize the processual quality by which scripts are made in practice. grounded in a praxeological approach, our understanding of inscription does not resonate with the way the term is used in philosophical scholarship inspired by jacques derrida, in which it is part of mimesis anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 3 and the production of the double body (see a summary in irwin 2010). our aim is also not to detect differences between scripts guiding performances and the back-stage in the sense of erving goffman, but to figure out how people´s feelings, actions, and changing assumptions are producing new ways of understanding aging processes. age-scripts and the related process of inscription are not exclusively related to aging but to any phase in the life course. the growing literature on youth provides many examples that could be re-read through the concept of age-inscription. we would even argue that in addition to the age-scripts and the aforementioned kin-scripts stack and burton (1993) have discussed, other kinds of inscriptions could be mentioned, such as for instance gender-inscriptions. however, in this issue, we limit our reflections to ageinscriptions that are happening around the life phases of aging. this allows us to capture and analyze the processes of social change with regard to aging, as people and groups find cultural hegemonies around age stages inadequate, insufficient, or no longer practical. in the discussion below, we elaborate on our concept of age-inscription, highlight the processes by which they occur, and illuminate some of the reasons why they are happening now. age-inscription, social norms, and hegemonies since early debates on age-class societies, anthropologists have documented the variety of norms, rituals, and practices around the stages in the life course and the ways that age-grade related norms are central to the construction of political power and social organization in those societies (bernardi 1985; for an overview of the literature see also alber and häberlein 2010). additionally, mainly focused on euro american societies, sociologists have analyzed changes in normative expectations of different age stages or, more generally, within life-course regimes. these age norms work in hegemonic ways, often implicit in social organization, verbal expressions, and cognitive categories. sometimes they are not even articulated, but rather are what pierre bourdieu called doxa, to refer to what is so taken for granted that it can be assumed without saying, as “common sense.” tabea häberlein (this issue) argues that images of the intergenerational contract, which she sees as a dominant norm all over the world, are often doxic—that is, viewed as taken-forgranted and natural. silence about the norm, as well as its alternatives, can be an indicator as well as a maintainer of doxa. john borneman argues that the inability or refusal to name a practice relates directly to the severity with which it breaches the norm; silence keeps practice in the realm of doxa, defined by bourdieu as “that which is beyond question” (1977, 169). bestowing a name would objectively recognize a practice that is best regulated by keeping it unmentionable; namelessness thus prevents the development of a language for description that might bring individual practices into public discourse. (1992, 295) such norms detail how people should act in the different phases of their life course in order to be recognized as being at a particular stage, as well as the roles and positions they can assume. just a few examples will suffice to illustrate this point. among the zafimaniry in madagascar, older adults are considered like a kind of hard wood, calm, and immobile, in contrast to middle-aged adults who go to farm every day, and young people who are considered flexible and soft (bloch 1998). at different stages of the life course, people speak differently and have different kinds of knowledge at their disposal to perform. in another example, in england the property of a deceased spouse is so expected to be inherited by the surviving spouse that it is anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 4 not even considered inheritance, such that people do not discuss spousal inheritance when asked about property or objects they have inherited (finch and mason 2000). at other times, age norms are articulated in formulaic and conventional discourses, what bourdieu (1977) called orthodoxy. social norms which are articulated as orthodoxy are weaker than doxa, which are taken for granted and not subject to debate. one example of orthodoxy comes from madagascar where older persons monopolize and manipulate knowledge about kinship relations in order to affect decisions about new marital relations (astuti 2000). although their knowledge is articulated as orthodox, it is important to note that there is scope for contestation even using orthodox discourses, as people can present other opinions which are also framed as based on orthodox norms. what is articulated as orthodoxy can also be challenged by alternative constructions, which bourdieu called heterodoxies. these are positions which are not shared by all and not even intended to be legitimized as such, but nevertheless shared by several actors. they could be articulated as positions of minority groups or as emerging, not yet articulated, norms. with regard to bourdieu´s terminology, we would see some age-inscriptions as meeting the criteria of heterodoxy. however, not all emergent inscriptions need to be heterodoxies set in contrast to orthodoxies; some are just emerging without being in direct opposition to other, more dominant norms. our term for this phenomenon is alterodox. age, age norms, and age scripts are critical to social organization, undergirding a particular social order and the domination of particular groups (bourdieu 1977). matilda riley and john riley (1986) note, “age is built into the changing organization of institutions and roles through formal or informal criteria for entry and exit, through expectations of how roles are to be performed, and through sanctions for role performance” (55). because of the way age is constitutive of the social order, including the distribution of power, wealth and property, aging trajectories—in their institutionalization, restrictions and constraints, social meaning and social roles—are highly sensitive to social change. jennifer cole and deborah durham (2007) argue that “periods of pronounced social change have often seen increased concern with age” (6). looking at age-inscriptions therefore provides a lens for understanding broader processes of societal change. triggered by often very small modifications in the social order, alterodox age-inscriptions occur and sometimes rapidly become social norms, as they are shared within social networks and become more coherent and stable, a process which may result in a new dominant codification around age. this increases the process of change. becoming a norm might mean the integration of several inscriptions. for example, for the age-inscription of caring grandfathers to become a new social norm, there might have to be new discourses of masculinity, continued valuation of fertility and the employment of parents, and societal developments which reduce state support for childcare and increase the kin-work of the aged and retired. therefore, age-inscriptions are not only highly sensitive to modifications of the social order, but also cause and accelerate ongoing change. the need for age-inscription when enacted, social norms are put into use in a particular situation, to help interpret what is going on (as in goffman’s notion of “frame” [1986]) and guide subsequent action. they provide people with goals in relation to such action and help them understand their responses to such situations. however, a dominant discourse or social norm may be insufficient to justify or explain a particular response, causing another script to be mobilized (swidler 2001). the friction between a social norm and the “balky world” (sewell 2005, 179) in which it is mobilized is one of the causes of alterodox age-inscriptions. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 5 various theorists have been interested in processes of changing social orders and their relation to changing emotions (as pioneers, see medick and sabean 1984). raymond williams used the term “structures of feelings” to refer to emergent feelings and thoughts, born of lived experience, that do not fit a received worldview or hegemony. because of the patterned ways that experience does not match that worldview, the resulting feelings, thoughts, and actions are also patterned. these can be confused and unarticulated, manifesting themselves as “an unease, stress, a displacement, a latency: the moment of conscious comparison has not yet come, often not yet coming” (williams 1982, 130). jean and john comaroff describe the same process: it is the realm of partial recognition, of inchoate awareness, of ambiguous perception, and, sometimes, of creative tension: that liminal space of human experience in which people discern acts and facts but cannot or do not order them into narrative descriptions or even into articulate conceptions of the world; in which signs and events are observed, but in a hazy, translucent light; in which individuals or groups know that something is happening to them but find it difficult to put their fingers on quite what it is. (1991, 29) it is this transitional, perhaps liminal, period in which people respond to existing social norms about aging with chaotic and inarticulate feelings and thoughts by changing their practices and behavior which we term alterodox age-inscription. it is the moment when new social relations may emerge. although a new vision of society, personhood, and social roles are implicit in these practices, they are not necessarily a kind of resistance in the way hidden transcripts are (scott 1985). in the next stage of organizing the alterodox age-inscription, people may then begin to try to make such “unease” coherent and organized, finding new language to talk about their new patterns of behavior. the types of processes in the formation and generation of age-inscription we highlight several processes by which social change occurs in relation to age-inscriptions, although we will not cover all the possibilities and variants. here, we identify processes based on 1) substituting adjacent relations, 2) mixing of discourses in which heterodoxy becomes orthodoxy, 3) organizing unease discursively, or 4) maintaining a social norm through alterodox age-inscription. 1) substitution of adjacent relations. changes in the organization of caring for the older person can occur through the substitution of similar persons, without discourses reflecting these organizational changes in practice. häberlein’s contribution to this special issue illustrates the ways that neighbors substitute for the daily care of migrant children in northern togo, even as the discourse of care for older adults continues to highlight the significance of children—not neighbors. cati coe (2013a, 2012), in earlier work on conflicts concerning whether children were slaves, pawns, or foster children in the colonial gold coast, similarly argued that care norms could change through the substitutions of adjacent relations. in yet a third example when grandmothers in ecuador take care of their grandchildren whose mothers have migrated abroad, the children tend to normalize this difference by representing their grandmothers as their mothers to their friends, schoolmates, and teachers (rae-espinoza 2011). the slippage between categories of persons seen as similar—whether persons of a certain age, gender, or generation—thus allows people to maintain a discourse which conforms to social norms, even as they enact an alterodox age-inscription in practice and behavior. 2) mix of discourses, in which sometimes heterodoxy becomes orthodoxy. people can mix orthodox and heterodox discourses. laura ahearn (2001a) shows how “newer” ideals of love and personal compatibility co-exist with anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 6 “older” notions that marriage is determined by fate in nepal. for example, a nepalese woman mixes the two idioms of fate and choice in explaining her marriage, “we didn’t dislike each other enough to break up. this is my fate, i said, see?. . . . well, for myself it was written that i would marry; if it hadn’t been, i would have left him, see?” (ahearn 2001a, 110). mixing discourses leads to the emergence of new discourses and the elision of the differences between the new and the old. in these processes, formerly heterodox discourses may also become the dominant or orthodox discourse or practice. erdmute alber, jeannett martin, and tabea häberlein (2010; alber 2011) showed how the trousseau was introduced among peasant lokpa in northwest benin about forty years ago, when some of them saw this practice among neighboring ethnic groups. as these trousseaus of modern consumer goods such as beds, “modern” pots, and other household things were highly attractive, little by little, girls started to leave their home region in order to work in the cities as domestic workers. today, the ongoing norm of living youth is to work in urban households to acquire a trousseau, which almost all girls of the lokpa region fulfill. the heterodoxy, namely the girls themselves acquiring the dowry through migration, has become the new orthodoxy, and a former age-inscription has become a dominant norm, namely that a girl needs to migrate to become an adult. 3) organization of unease discursively through comparisons and hierarchies. when people generate new practices—like caring as a grandfather—they may begin to name, justify, and organize those practices. one strategy by which they can order their experiences is by creating hierarchies, comparisons, and dichotomies: for example, “this was the way of the past, this is now,” or “we do this, they do that” (sewell 2005). in thelen’s work in romania (2015), she noted how romanians tended to criticize germans for putting their older relatives into institutions while the romanians tried to keep them at home. lawrence cohen (1998) similarly noted indian evaluations of the “bad family”—the modernized and western-oriented indian family—which did not take care of their aging parents. these hierarchies are unstable and can be easily inverted: while seemingly intransigent in criticism of an other, they seem to be a step in the process of integrating new ideas and practices. thus, ten years after the original research, thelen (2015) noted that with the out-migration of romanian women to care for germans in their homes, romanians began to place their older relatives in institutions and praised the germans. similarly, two decades after cohen’s research, sarah lamb (2009) showed that indians were far more open to non-familial care environments and had adapted institutional care homes associated with the western family to concepts like the ashram and the joint family household. in her contribution to this special issue, coe discusses ghanaians’ openness to new practices of care for older adults, even though they associate these practices with the west and as antithetical to “the ghanaian traditional family.” thus, although these dichotomies and hierarchies of age trajectories seem rigid and can be articulated quite passionately, they can collapse or be inverted quite rapidly. 4) maintenance of a social norm through alterodox age-inscription. people might maintain a social norm through new practices. häberlein’s and alber’s articles in this volume provide examples: häberlein argues that the intergenerational contract is maintained through migrants sending gifts and foodstuffs to their parents in the villages in order to help those who remain to care for an older person. alber shows that in benin, the old and dominant norm that children should take care of their older parents can be fulfilled in a new way. those who have lived a middle-class life style, including the expectation of living independently, do not always want to move into the households of their children when they age. alber mentions the case of a retired man who was unable to afford finishing the construction of his house. instead of taking him into his own household, as the dominant norm would suggest, his son helped him financially to finish building his own house. with this action, he enabled his father to continue living independently, at the same time as he fulfilled the social norm of caring for the parent. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 7 in our view, these four types—the substitution of adjacent relations, the mixture of discourses in which heterodoxy becomes orthodoxy, the organization of unease discursively, and the maintenance of a social norm through alterodoxy—constitute the main ways by which age-inscription occurs. actors and institutions the making of new age inscriptions can be driven by practices of older people themselves, through their agency or “the socially mediated capacity to act” (ahearn 2001b, 112). there are many examples in the literature. for instance, martine segalen (2016) has noted that grandparents in france feel compelled to invent new terms of address for themselves such as papi and mami, speaking to changes in the values and roles associated with grandparenthood and generating new possibilities for the performance of grandparenting. in china, older, uneducated women are often disparaged as unable to contribute to national wellbeing, unlike younger, well-educated persons “of quality,” but some older people fostering disabled children position themselves as sacrificing for the nation through their care (raffety 2017). similarly, liesl gambold’s contribution to this special issue discusses how the baby boom generation is expected and desires to age in a diy (do-it-yourself) way. this, gambold argues, gives them simultaneously the freedom to develop new paths of aging, but also the pressure of caring for themselves. several articles illustrate a high level of older people’s agency in shaping age-inscription, but in situations constrained by larger structural forces shaped by social norms. however, it is not always older people´s agency alone that create new age-inscriptions. they can also be socially mediated by cohort members (riley and riley 1986). another possibility is that the actions of caring others are key, as coe and häberlein in this issue show. therefore, age-inscription is not always a sign of an older person’s agency. inscriptions also come from institutions, to the extent that institutionalized norms generate unexpected and unsought-for practices. both individuals and states construct narratives, and these exist dynamically and dialogically with each other (borneman 1992, 285). laws and regulations of aging through retirement policies and social security policies directly regulate the social and economic conditions through which aging is framed. we are interested in the interpretations, appropriations, or consequences of these regulations. for instance, the introduction of a pension system for all older people in south africa has led to the emergence of an age-inscription of investing a portion of the pensions of older persons into household food security and the schooling of the children (case and menendez 2007). or, in the united states, the age at which one is eligible to receive social security is not meant to push people into retirement. yet, in her research on ghanaian care workers in the united states, coe (2017b) found that many formulated their retirement around when they would be eligible to receive social security, in part because they were working in physically strenuous jobs. furthermore, the state regulation of aging can generate alterodox ageinscriptions in response. alber (this issue) observes that for many state officials from northern benin working in the capital in the south, starting the phase of retirement is associated with the inscription of moving back to northern benin and thus relocating the household. age-inscriptions emerge from state policies, individuals, kin, and cohorts and are negotiated by older persons and others in everyday contexts and in relation to social norms. these dialogues are sometimes with other age scripts and age-related discourses from the present and the past, including, as we noted above, those of different societies or different levels of societal organization, whether kin networks, the state, or other social organizations such as religious entities. this is especially true in situations where transnational migration and media make such images and knowledge available. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 8 the reconfiguration of aging trajectories through age-inscription is not only a response to social change but also generates social change. changes in one person’s life course affect others. for example, the active rejection of grandmotherhood by some middle-aged and older african-americans had intergenerational ripple effects, as the care burden was shifted to great-grandmothers or the teenage mothers (hagestad and burton 1986). mette line ringstedt (2008) argues similarly, showing that tanzanian teenage mothers try to make their mothers the responsible caregivers. persons, including older persons, affect the social order in which they live, as they pursue their own projects (ortner 2006). this is especially visible in the case of relatively wealthy older people in the global north who are part of the “do-it-yourself generation” (gambold, this issue), but also true in other contexts. if, for instance, older people in south africa decide to invest parts of their pensions into the education of their grandchildren, they are also affecting the social order in which they live (case and menendez 2007). however, as in other matters of social life, power and wealth affect the ability to generate and share ageinscription. thus, an examination of age-inscription is a crucial way to understand otherwise unnoticed and unremarked-upon processes of social change. personal subjectivity, the body, and the material world in age-inscription dominant norms are not simply expressed, but also affect personal subjectivity and embodiment as well as the physical landscape. the term habitus, proposed first by marcel mauss (2006) in 1935 and further developed by pierre bourdieu (1977), seeks to explain the ways that dominant norms become felt and embodied by individuals. habitus, in mauss’s conception, is comprised of the everyday routines or bodily techniques of a person such as habits of brushing one’s teeth or style of walking. inculcated through previous experiences, these habits and routines are embedded in the body, a set of tastes and dispositions perhaps not even available to a person’s consciousness, although bourdieu thinks the habitus may be available to consciousness or undergirded by ideals that are discussed more explicitly within a community (like honor). for bourdieu (1977), the habitus is “the cultivated disposition, inscribed in the body schema and in the schemas of thought,” which disposes a person to act a particular way in a situation (15). the habitus is “a system of lasting, transposable dispositions which, integrating past experiences, functions at every moment as a matrix of perceptions, appreciations, and actions and makes possible the achievement of infinitely diversified tasks, thanks to analogical transfers of schemes, permitting the solution of similarly shaped problems” (bordieu 1977, 82-83, original italics). the habitus disposes people to act in a certain way but is flexible enough to be applied, through analogy, to new situations people face (sewell 2005). we would add to this formulation the significance of the ways that social norms are embodied in the material world and physical landscape, such as through housing, as illustrated by the articles by häberlein, bedorf and pauli, and alber. housing, by functioning as a kin-place, enables certain kinds of personal and kin routines and habits. the past experience which bourdieu attributes as the source of bodily inscription is one’s birth or childhood kin (bourdieu and passeron 1990). however, we think that embodied practice can be re-inscribed through shifting norms or even more transient, liminal age-inscription at any stage in the life course. because bourdieu conceptualized the habitus as formed most strongly in childhood by kin, the habitus seems resistant to historical analysis, or an exploration of how it changes through time, both within the course of a person’s life course and across generations. some theorists, and bourdieu himself, have recognized that the habitus is inscribed through various social contexts. jay macleod, for instance, in his study of adolescent boys growing up in a public housing complex in the united states (1995, 137-138), re-worked the notion of anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 9 the habitus, considering it to be multiply layered, constituted not only through the boys’ family life, but structured through the boys’ subsequent experiences with peers and school. habitus emphasizes bodily and unconscious dispositions, an important point to make, but which slights the moments when such dispositions become visible and discussed. as jean and john comaroff (1991) have argued, the historical moments when something commonsensical becomes the subject of commentary and when topics of debate become naturalized into bodily responses and reactions are important, because they signal change. however, we think that there can be various levels of habitual embodiment also; in other words, embodiment does not simply signal doxa, or what is so dominant as to be commonsensical. instead, some bodily and material practices may be so fragile that they have not yet obtained a discourse with patterned terms and representations; this is our sense of age-inscription. thus, we consider inscription to be more flexible than the ways that the habitus or regimes of the body are normally conceived as reflecting the ways that people inscribe themselves into dominant discourses (bourdieu 1977, foucault 1980). through ageinscription, then, we seek to capture this sense of indeterminacy and possibly liminality, at the level of discourse, in the body, and in the landscape. age-inscriptions in times of global aging, migration and the temporalization of the life course age-inscription is an indicator of pressure points for social change and of the fact that dominant trajectories of aging are not or no longer working. although these processes are continuously occurring in everyday social life, we argue that today three social conditions are particularly generative of ageinscriptions: firstly, the longer life spans of populations around the world, including in large parts of the global south; secondly, migration and mobility, both international and regional, which are affecting the lifeworlds of both migrants and non-migrants alike; and thirdly, processes of the temporalization and institutionalization of the life course. global aging the un’s latest report on world population aging (2013) reports that not only are people living longer around the world, but that there is a shift in populations as a whole, in which the share of older persons has increased as a result of reduced fertility and mortality. the global proportion of older people (aged 60 years or over) increased from 9% in 1990 to 12% in 2013, with the share of older persons aged 80 years or over within the older population at 14 percent (up from 7% in 1950). they predict the proportion of older people to continue to grow, reaching 21% of the world population by 2050. older persons are projected to exceed the number of children for the first time in 2047, mainly due to changes in life expectancy in less developed regions. thus, not only are individuals adjusting to the longer life spans they are experiencing, but so too are societies and states adapting to a larger number of older adults. because of increasingly longer life spans in europe over the past century, peter laslett argued (1980), “our situation remains irreducibly novel; it calls for invention rather than imitation” (181). as people live longer, and with less risk of death at younger ages, they experience more overlap with the lives of their children and grandchildren and more accumulated experiences in general (alber, geissler, and whyte 2004, hagestad 1986, hareven 1982). these characteristics have consequences for the construction and perception of old age but also for intergenerational relations. although frailty and death were once experienced as anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 10 human conditions, their possibility looming at any point in the life course, particularly for women in their childbearing years, it is now more tightly associated with aging. people may experience four generations living simultaneously (hagestad and burton 1986). alterodox age-inscriptions respond to the new experiences and related challenges of these new life-course expectations. mobility, migration and aging migration and mobility are an important aspect of the contemporary world, affecting the lifeworlds of migrants and non-migrants alike, through an expansion of “the global horizon” in which people imagine themselves emplaced (graw and schielke 2012). migration and mobility affect state as well as kin forms of intergenerational support. because of migration, the coordination and synchronization of multiple lifecourses—from the tasks of parenting balanced with work and employment of the middle generation, to the aging and greater leisure of the older generation, to the vulnerability and schooling of the youngest generation—need to be reworked (dossa and coe 2017), because lives are highly interdependent (hagestad 1986; hareven 1982), and lifetimes are intertwined (alber, geissler, and whyte 2004). “new models of both personhood and intergenerational care” may need to be generated (cole and durham 2007, 13). for example, mothers of migrant women may be kin-scripted to fill “the care slot,” provide childcare to grandchildren, and take care of the family house in the hometown (leinaweaver 2010). new financial resources, such as remittances from migrants, may contribute to the outsourcing of the care of older adults to paid caregivers (coe 2017a). and the loss of the migrant’s kin work may result in new fragility and uncertainty for older people, as coe’s contribution to this special issue describes, or in neighbors’ substitution for migrant children, as häberlein’s article argues. finally, migration may change people’s goals in life, as the article by bedorf and pauli suggest, such that the house that they have built over their working years may not seem as attractive when they are ready to retire. the articles illustrate how both migrants and non-migrants are the source of age-inscriptions in response to situations affected by migration. we do not view migrants as more agentive than non-migrants, as is so common in the migration literature. even those who stay at home in the context of ongoing migration adjust, change, and take on new age-scripts, and have their doxa challenged (baldassar and merla 2014, hirsch 2003). thus, we argue that an examination of age-inscriptions is a key window into understanding migration and mobility. the somewhat unformulated, experimental, and tentative practices around aging which we call alterodox age-inscriptions signals the lack of stability of this stage in the life course due to migration. processes of temporalization and institutionalization responding to the longer life span, gerontologists have introduced new periodizations of aging. they divided the old into the young old and the old old, or the young old, middle old, and very old or oldest old. the variations in this terminology are indicative of its lack of normativity. likewise, in ghana, people distinguish between older people, but here on the basis of whether they are “strong” or “weak” physically, in terms of being able to farm or walk (wɔn honam yɛ mmɛrew). these formulations speak to attempts by various groups to make sense of the diversity of the older population who may span thirty years in age and have a wide variety of physical and mental capabilities and social and intergenerational relations. there are other markers of temporality, such as widowhood rites, that exist almost everywhere (goody 1962; lamb 2000). in euro-american societies, celebrations of decennial birthdays (seventy, eighty, ninety, one-hundred) for older people have become quite important. they signal significant age-related anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 11 transitions which have traveled into middle-class families all over the world. however, anthropologists and sociologists have also argued that there are amorphous norms and few rituals for aging in comparison to the transitions of childhood and youth, such as baptisms, confirmations, quinceñeras, graduation ceremonies, or childbirth (rosow 1974). the elaborate rituals for children and youth may be connected to the greater institutionalization of this phase in the life course, because childhood and youth are seen as the preparation phase before adulthood, whereas old age is seen as the relatively free phase after work (kohli 2009).i in the relatively unstructured, somewhat vague (myerhoff 1984) and extensive social phase of aging, new cultural meanings, new lifestyles, and new forms of intergenerational or institutional care arrangements about this life stage can potentially be created. this is why age-inscriptions happen in practice. for example, many older people in the united states use the inability to drive as signaling a major aging transition and a loss of autonomy and independence, just as they, as teenagers, used the acquisition of the driver’s license to signal their adulthood. yet there is often conflict over the timing of “giving up driving,” with adult children taking away the keys of their parents against their will, signaling the lack of normativity over the timing of this important ritual. in coe’s more recent work on aging in the united states, an older woman told her that she had quit driving when she was ninety-five years old, because she thought it was “the appropriate time.” yet her sense of timing did not affect her husband’s sense of the appropriate markers, who continued to drive into his late nineties. thus, while there is a generalized social norm that older adults may lose their ability to drive, she has generated her own alterodox age-inscription related to the timing of giving up driving, and her sense of timing seems to be hers alone, or at least not shared with her husband. furthermore, there is no ritual around the loss of driving or the taking away of car keys, despite its significant social meaning. every aging person encounters the many physiological, emotional, and social changes of aging (brubaker 1986) as if they were new, because they are new to the individuals going through aging processes. cole and durham (2007) elaborate on this point, using karl mannheim’s notion of “fresh contact.” mannheim’s ground-breaking essay was written in 1928, affected by his impression of world war i, rapidly changing societies in europe, and extremely distinct generational experiences. his main argument is that every new generation has a completely different worldview, knowledge, and experience of historical events. he suggests that there is a special historical force to the fresh contact of groups of people who come of age at the same time. cole and durham (2007) expand his concept to suggest that “every individual undergoes ‘fresh contact’ throughout his life” (18), not just in youth, for example through a change of residence or status. gambold’s and alber’s articles clearly show how a generation comes to handle aging anew: gambold in her examination of the aging of baby boomers, who came of age during profound political changes as well as prosperity, and alber in her research among a new generation of middle-class people from northern benin. independent of his or her cohort, each person encounters aging as new to him or her and has to cope with those changes (cole 2013). to the extent that aging is not elaborated institutionally or socially, then they have to generate their own meanings, perhaps with the help of their social networks, in the form of ageinscriptions. this instability makes aging ripe for institutionalization (riley and riley 1986). the transition to modernity in europe was accompanied by a greater attention to chronological age and a standardization of the life course, which also led to greater individualization (kohli 2009). the structuring of the life course was a major factor in structuring industrial and modern society as a whole. we argue that the institutionalization of the life course has created and is creating new rituals and rites de passage for aging, such as retirement or movement to be near children or grandchildren, to live in an area with a lower cost of living, or to return to one’s hometown. the articles by alber and gambold in this issue describe an ongoing anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 12 process of institutionalizing the life phase of aging, indexing a broader process of the temporalization and institutionalization of the life course. thus, we argue that three majors factors result in contemporary alterodox age-inscription and thereby shape actual ways of experiencing old age: the increasing length of the life course and the aging of the population as a whole; migration and mobility which is re-arranging the roles and obligations between the generations; and the temporalization and institutionalization of the life course which is changing the somewhat less structured phase of aging. this process is resulting in the creation of new meanings and temporalities, including the adoption of institutional temporalizations. overview of the special issue the articles in the special issue cover a variety of cases in west africa (benin, togo, and ghana), north america (the united states and mexico) and europe (the united kingdom, france, and spain), and thus cases in the global north as well as in the global south. they illustrate the different effects of internal and international migration, and highlight various ways that the state is involved in setting and changing aging norms. some of the articles are more focused on retirement (alber, bedorf and pauli, and gambold), and others on the care of older persons (häberlein, coe), but they also illustrate how these issues are intertwined. coe examines why older people in ghana are open to a new form of care through care institutions, associated with “the west” and which the orthodoxy generated by the government and ngos considers antithetical to ghanaian culture and forms of kin care. coe argues that ghanaian older people are more open to new ideas than their middle-aged children because they see that the intergenerational contract is fragile. furthermore, they adapt the image of care facilities to their own ideals and goals, thus localizing a foreign social norm and sustaining a heterodox discourse. häberlein’s article examines the question of whether aged persons in three villages in northern togo and benin are cared for well. she shows that the social norm of gerontocracy is upheld. despite a continued discourse about the role adult children play in providing daily care, some older people with migrant children are instead helped by their relatives in the village, with migrants fulfilling their care responsibilities through remittances. although housing is organized by kinship, practices of care are more heterogeneous and not simply place-based. häberlein thus discusses an alterodox age-inscription of care by neighbors which is obscured by a social norm about the role of adult children in providing care for older adults. alber’s article discusses the ways that middle-class people from northern benin living in southern benin are adopting a discourse of “retirement.” they are using this discourse to give coherence and organization to their new life trajectory—new for multiple reasons, including their prosperity in relation to an older generation, their migration to the city, as well as their longer life span. the article by bedorf and pauli explains why retirement houses built by mexican migrants in the united states lie empty. developing the concept of kin-place, they describe the ways that migrants consider housing and kinship to be deeply intertwined and thus devote their resources to building a house in the hometown. at the same time, however, their children and grandchildren tie them increasingly to the united states, creating a different kind of kin-place that makes it difficult to retire to mexico. the houses are an instantiation of a social norm, but their emptiness or even decay signifies that an alterodox age-inscription, for which there is no new language and much ambivalent emotion. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.172 http://anthro-age.pitt.edu coe and alber | 13 gambold discusses a less ambivalent reconstruction of the life course, in which americans and british are retiring to another country (mexico for the americans, and france and spain for the british) because of the costs of retiring in their own country, but also because of the climate and comfort of the new places. this new practice is given legitimacy by a discourse popular among this generation of baby-boomers, the post-war generation born between 1946 and 1964, of making their own choices and managing their own lives. such self-making is supported by neoliberal governance, in which there is little state support for senior citizens, and thus they have to find options through their own social and financial resources. these articles illustrate some of the diverse processes of age-inscription, and the conditions under which they occur. they show some of the ways that older people, their kin, and their wider communities emplot their lives in terms of location and temporality, imagining stages of the life course and the roles of others in providing care. the articles examine different motivations for age-inscription, and illustrate varying levels of repercussions of age-inscriptions on social life and social change, including gender norms, intergenerational reciprocities, and political identifications: from the more fraught and ambivalent emotions expressed by those interviewed by bedorf and pauli, or the hopeful and confident assertions articulated by those interviewed by alber, to the more triumphant narratives of those in gambold’s study. in other cases, like those discussed by häberlein and coe, a more quiet reorganizing of practices occurs. through ethnographically rich case studies, the articles explore the tensions and resolutions generated by ageinscriptions, the impact of age-inscriptions on the lives of older men and women, and their relations with whom their lives are intertwined. conclusion: a need for concepts that illuminate the indeterminacy of social life anthropologists have moved away from grand theories and claims and towards more indeterminate, nuanced conceptualizations of process and variation. we have discarded terms like “culture,” “society,” and “kinship systems” (abu-lughod 1991) replacing them with more processual terms like kinning (howell 2006) or repertoire (coe 2013b). the concept of age-inscription is a similar move, allowing anthropologists to study the emergence of new practices and discourses which are shared by more than one individual but have not attained the status of a social norm. social norms reduce the randomness and uncertainty in life and create expected and predictable roles for the aged and their relations. they allow people to prepare for life changes, so that they are anticipated and internalized, rather than becoming crises, and evaluate themselves against the expected life course. the concept of age-inscription allows us to highlight the indeterminacy and processual nature of social life and relations, which is particularly important in the study of global aging, in which so many people are encountering a longer life course for the first time in their lives within the contexts of increasing migration and greater temporalization of the life course. notes i for example, pamela feldman-savelsberg (2016) shows how cameroonian mothers in 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497-515. ---. 2005. “caring grandfathers: changes in support between generations in east germany.” in generations, kinship, and care: gendered provisions of social security in central eastern europe, edited by haldis haukanes and frances pine, 163-188. bergen: university of bergen. united nations, department of economic and social affairs, population division. 2013. “world population ageing 2013. st/esa/ser.a/348.” accessed 24 july 2016. http://www.un.org/en/development/desa/population/publications/pdf/ageing/worldpopulation ageing2013.pdf. williams, raymond. 1982. the sociology of culture. new york: schocken books. age-inscriptions and social change cati coe erdmute alber age inscriptions and social change cati coe erdmute alber anthropology & aging quarterly 2013: 34 (1) 6 matthew dalstrom mobile midwesterners introduction the united states is in the midst of a demographic transformation as the number of people over the age of 65 has grown to its highest level, accounting for nearly 13 percent of the total population (werner 2011). as the population ages, policy makers, families, and retirees themselves all seek to improve the often isolating process of aging that occurs as mobility decreases, friends die, and family members move away. “aging in place,” as social anthropologist ann bookman (2008) refers to it, is a process that occurs as seniors become more removed from their communities as they age, resulting in a variety of health issues such as depression and decreased mobility. the ‘aging in place’ narrative comes under scrutiny, however, as seniors continue to live longer and healthier lives through access to improved health care, pensions and/or social security insurance. accompanying this a r t i c l e s mobile midwesterners the impact of migration on aging, health, and community matthew dalstrom department of anthropology and sociology rockford college shift is a growing sentiment that retirement should be viewed not as the end of life, but as the reward for a life of working (bartling 2006). this new mentality has lead to the expansion of retirement communities that cater to the notion that retirement should be fun and leisurely while simultaneously addressing the pragmatic concerns of needing more care as one ages. retirement communities vary along a cost, care, and amenities continuum, but they all offer the possibility of aging not alone, but in an atmosphere that provides social activities and fosters friendships, which can improve the social and physical aspects of growing older (bekhet and zauszniewski 2011). selecting the right community in the best location can be challenging, especially when it is far from home, family, and friends. moreover, choosing the wrong place can be detrimental, causing increased stress, (kao, travis, and acton 2004), loneliness, and has been associated with lower self-rated health and depression (rossen 2007). abstract as the population in the us ages, there is increasing need to study aging and its relationship to quality of life, health, and community. quality of life is closely correlated with belonging to a community. unfortunately, as seniors age there is a propensity for them to become increasingly isolated as their mobility decreases and their friends and family members die or move away. as a result, some seniors in the midwest have begun to migrate to rv parks in the lower rio grande valley (“lrgv”) in south texas that function as temporary retirement communities for the winter. while there, they reconnect with friends and family members and engage in a variety of social, civic, and exercise related activities. further, they participate in a variety of health seeking behaviors such as health screenings, trading medications, and using the mexican health care system. this article explores these practices and discusses how winter texans choose the lrgv, how new members become integrated into rv parks, and how life in the parks impacts health and access to health care services. it also highlights the impact that seasonal migration has on community formation, health seeking behaviors, and the diversity of retirement communities. keywords: winter texans, health, migration, rv parks 7 anthropology & aging quarterly 2013: 34 (1) matthew dalstrom mobile midwesterners therefore, the central issues for many seniors are how to counteract the aging in place phenomenon, enjoy their retirement years, mitigate the stress of moving to a retirement community, and still feel connected to their old lives. for those mobile enough, one option is to become a seasonal migrant, blending the benefits of living in their home with those of temporary retirement community living. seasonal migration, takes many forms but it is distinguished from other types of travel during retirement because migrants repeatedly travel to the same destination community and spend at least one month there. another characteristic is that the destination usually improves one’s lifestyle through climate, social activities, and an expanded support network of friends. seasonal migrant communities can consist of a wide variety of retirees, but they are frequently associated with “snowbirds,” northern retirees who migrate to the south during the winter. snowbirds primarily come from canada or the northern us and frequently end up in rv parks scattered throughout florida, arizona and texas. unlike other types of retirement communities, residents only stay for one to six months and most are in good health. parks do not provide year around care or intensive medical support, and people live in rvs. moreover, retirees are not burdened with the stress of permanently leaving their home or the high costs of living in permanent retirement communities. for many, the annual movement south marks a drastic shift in lifestyle as home and apartment living is traded for rvs and friends who lived miles away become close neighbors. the parks vary in size ranging from a few hundred residents to several thousand and the close proximity coupled with the small living space “requires you to know your neighbor and be social,” one resident explained. it also encourages a strong sense of community and provides seniors with access to exercise clubs, health screenings, social clubs, and tourism activities, just like year-round retirement communities. while seasonal migrants can choose a variety of locations, approximately 150,000 midwesterners tend to winter in the southeastern region of texas known as the lower rio grande valley (lrgv).1 locally they are not referred to as snowbirds, but “winter texans,” retirees 55 or older who spend at least one month per year living in texas. while they consist of a very diverse group from around the northern us and canada, the majority (52.3 percent) come from the midwest (ghaddar and simpson 2008). for several decades researchers have explored the seasonal migration of retirees to florida, arizona, and to a lesser degree texas. primarily the research focus has been on how communities form within the parks (fry 1979), demographics (sullivan 1985), social structures and marginality (van den hoonaard and kestin 2002), and impact on the host community (ghaddar and simpson 2008). to a lesser degree, it has explored the relationship people have with their home community (bjelde and sanders 2009), the impact that migration has on health (mchugh and mings 1994; chui, cohen and naumova 2011) and retirees usage of mexican health care (dalstrom 2012). however, the winter texan community is different from the other seasonal migrants because of their historical connection with lrgv, their emphasis on maintaining ties to the midwest, and because access to mexican medical care has had an impact their health and health seeking behaviors. to understand the relationship between seasonal migration, health, and community formation, this article will draw upon roger rouse’s (1992) concept of the transmigration circuit. while his work focuses on the migration decisions of mexican immigrants in the us, his framework for conceptualizing the importance of the connection between the home and destination community is particularly useful. according to rouse, migration is not random, nor is it isolating, or the sole result of economic conditions, but migrant destinations are chosen based on historic, economic, and social conditionals that create a circuit of sending and receiving communities. while these communities are separated by space, the continued return of migrants to the same location (lrgv) and the perpetual interest in the sending community (the midwest) maintains bonds that “form a single community spanning across locales” (162). for winter texans this circuit orients them both to texas and their home communities, and creates their “winter family” which consists of friends and family from the sending community along with other people from the midwest who live together in the lrgv. this article will explore seasonal migration within the context of the transmigration circuit through a) discussing how winter texans choose the lrgv, b) exploring how new members get integrated into the community, and c) discussing how living in the parks impacts health and access to health care services both in the us and mexico. through the transmigration circuit social connections between the midwest and the lrgv are formed and maintained. these close social ties are not only important in choosing a migration destination, but impact health, happiness, and longevity (bjelde and sanders 2009). anthropology & aging quarterly 2013: 34 (1) 8 matthew dalstrom mobile midwesterners moreover, seasonal migration to the lrgv creates unique health care opportunities for retirees such as exercise classes, health screenings, and in some cases access to the mexican medical system. methods research for this article is part of a larger study on health and medical travel along the us/mexico border that was conducted over eleven months in 2008-2009. data for this article is derived from participant observation research, and interviews. participant observation research took place from november 2008 to february 2009 in one mobile home park in the city of mcallen located in the western part of the lrgv. during that time i attended park meetings, health screenings, and parties along with other social events. i also accompanied winter texans on outings (bird watching, dinners, church services) and 15 were accompanied as they traveled into mexico for health care. semi-structured interviews were conducted with 50 winter texans, 15 us medical providers, and 15 mexican medical providers. interviewees were selected using stratified purposeful sampling. inclusion criteria for winter texans was that they lived in a mobile home park. the group was then stratified by the following categories, between the ages of 55-65 and 66-85, new residents (lived for less than five years in the park) and old residents (lived in the park more than five years), and whether or not they used mexican health care. medical providers were included if they treated winter texans and were stratified by physicians, dentists, and pharmacists. interviews were conducted at the locations selected by the participants. data was cleaned and imported into nvivo 9 for analysis. open-ended coding was used to identify themes (bernard 2011) across the data set. the themes were then organized and linked together using memoing to develop a theoretical model (dalstrom 2012). access to the park was obtained through contacting the park president and arranging a presentation during the weekly park meeting. although i was only in my late 20s during the time of the research, the migrants were largely receptive to me because i was from the midwest and also because i was the same age as many of their grandchildren, making it easier to talk. as i spent more time in the parks, many of the residents saw me as a permanent fixture, and in a mock ceremony i was awarded my honorary winter texan nametag. because i was not 55, however, i was not able to live in the park, which restricted my access to activities that occurred in the evening. seasonal migration the practice of migrating to warmer climates for retirement is not new, nor is it limited to the us. it occurs throughout canada (counts and counts 1996), between northern and southern europe (oliver and o’reilly 2010; bozˇic‘ 2006; warens and williams 2006) and throughout the continental us. called, international retirement migration, if it is international (bozˇic’ 2006), retirement migration for permanent domestic migration (warens and williams 2006), and seasonal migration for temporary moves, these practices are characterized by the movement of people to a new community for the purpose of improving their lives. for the most part, in both europe and the us, seasonal migrants are “baby boomers” who are considered to be more healthy, wealthy, and less family oriented than their predecessors (warens and williams 2006), making international and domestic retirement migration possible. since they are believed to be healthier and less tied to a particular place, many are open to the idea of permanently moving to retirement communities in spain, italy, arizona, and florida to name a few. these communities tend to consist of houses, apartments, and condos that enable independent living while restricting access based upon age. many are built by large construction companies that advertise the possibility for seniors to “live in a blissful and perpetual state of mature adulthood” (mchugh 2000: 2) through providing an improved lifestyle. however, recent research by fitzgerald (2000) illustrates that an increasing number of retirees in the us want to be close to family and home during their retirement years and do not want to live in permanent retirement communities in the south. for those people, seasonal migration is the perfect answer because it lets them leave during the cold winter months when their mobility is limited, spend time with their ‘winter family,’ and return in the summer to be with their biological families. a common precursor to seasonal migration in north america is becoming an rver earlier in life. according to counts and counts (1996) there are many types of rvers, ranging from full-timers (who live in their rv all year), snowbirds (who travel south in rv during the winters), serious part-timers (spend at least six months in their rv), and vacation rvers (212). while the practice can be traced matthew dalstrom mobile midwesterners 9 anthropology & aging quarterly 2013: 34 (1) matthew dalstrom mobile midwesterners matthew dalstrom mobile midwesterners back to the 1920s and 1930s the modern rv movement began in the 1950s when it gained a sense of respectability as rv clubs developed to support the practice. these clubs became ways for rvers around the country to meet, share ideas, destinations, and develop a robust sub-culture. as the demographics in the county began to change and more people with disposable income lived longer, rving became a way for retirees to travel, have a sense of adventure, and meet new people at rv parks around the county (34-39). within the lrgv, the practice followed a similar pattern as the number of rv parks grew and became informal locations for retirees to intermingle. by the 1960s, their popularity was entrenched in the lrgv as they evolved from a collection of concrete slabs with electrical hook-ups to established retirement communities. promoting fun, sun, and mexico to midwesterners every fall, as the leaves begin to change, retired midwesterners begin packing up their rvs and cars to head south to the southeast texas border. over 150,000 strong, they gradually descend upon the lrgv, which stretches across cameron, hidalgo, starr, and willacy counties. while winter texans have been migrating to the lrgv since the 1920s, it was not until the late 1970s that they were considered an important research topic and a systematic study of their origins, spending habits, and activities began to be reported. “a survey of winter visitors in the lower rio grande valley” (school of business administration 1976) sampled 1,505 households and found that most winter texans originated from minnesota, iowa and illinois. subsequent surveys found that over thirty years later the origin communities have remained virtually unchanged (ghaddar and simpson 2008). it has been known for a long time that as people age they begin to orient themselves and make decisions to move based upon their social and experiential ties to a place (oldakowski and roseman 1986), which , can be established through friends and relatives living in that place (gober and zonn 1983). this phenomenon is particularly visible among the winter texan population who started traveling south almost a century ago. early midwestern migration began as a result of increased economic opportunities, as wealthy land developers began to recruit farmers from the midwest through advertising cheap labor, land, and a rail system to take produce north. the campaign was very successful and by the early 1900s as some towns in the lrgv like mcallen went from 150 to 5,300 residents within ten years of being founded (mittelstaedt 2013). while railroads allowed for produce to leave the lrgv, they also facilitated travel via the southern pacific railroad and missouri pacific to st. louis and chicago connecting family members and friends. by the 1920s some businessmen in the lrgv wanted to compete with florida for tourism dollars and began marketing the climate to northerners (robinson 2006). the first national campaign was discussed in 1925 by the valley chamber of commerce. for the venture, brownsville, the largest city in the lrgv, provided 10,000 usd and organized a committee to raise an additional 25,000 usd. the money was used to create a booklet that was distributed in 1926 at agricultural conventions throughout the country. the committee also approached the missouri pacific railroad who hired a newspaper man to conduct a local campaign to raise awareness of the tourism opportunities. at the same time, the chicago based gilllock development company produced a pamphlet called “buried treasure” to promote economic development in the area. the cover showed two people peering out of a snow-covered house that was contrasted to a scene of palm trees. the caption reads “come south to the lower rio grande valley of texas from the frozen north to where the sunshine spends the winter.” (robinson 2006: 213). by the 1930s the advertising effort was believed to be largely successful as the lrgv had a “reputation for being a being a leading winter tourist resort area” (mittelstaedt 2013). nevertheless, it wasn’t until the 1960s that another advertising innovation spurred the growth of tourism. in the late 1960s, hank stanley opened fun-n-sun rv park for retirees, which offered more than just an electrical hookup and a concrete platform like the competitors. he believed that rv parks should be more of a community, blending healthy living, tourism, and entertainment. by 1970 his park had grown from 150 to 550 sites that were mainly occupied by “farmers from the midwest. it became a place where people spend the winter,” he said (del valle 2008). fun-n-sun quickly became a template for other parks in the area that advertised exercise programs, dances, live music, and in some cases church services. moreover, the name winter texan was coined by the park minister, c.l. boyle (del valle 2008). the mcallen chamber of commerce quickly latched onto the term starting a billboard campaign to promote its use. by the late 1970s, the name was firmly rooted when the university of texas-pan american began tracking their impact in the community (school of business administration 1976). over the years, lrgv has continued to target the retired population emphasizing the climate, friendly people, anthropology & aging quarterly 2013: 34 (1) 10 matthew dalstrom mobile midwesterners social activates, and proximity to mexico. for example, in highways magazine, with a circulation of 50,000 readers there was advertisement with elderly people golfing, eating, sailing, and walking past the palm trees with the caption “come spend the winter with the folks who are glad to see you…eat drink and be merry in old mexico… the lifestyle is laid back here in the friendly rio grande valley” (vincent 1993: 14). in addition to advertising, word of mouth referrals have played and important role attracting new people to the lrgv. conversations with winter texans about their decisions to visit the lrgv tend to sound like, “my parents used to live here,” “i had friends down here and they told me to come” or “i was in florida and i didn’t like it, people told me about the valley so i came here.” one local businessman described it as such: word of mouth played a big part of getting winter texans here and they would invite friends to come down and when they began to stay as winter texans, they had more friends down here than they knew what to do with. elaborating on that sentiment, a pair of winter texans from iowa said that that they had a conversation with another couple who had told them “how good it was” and that they had strongly urged them to visit. so they did and within one winter they bought an rv. winter texans can also be very passionate about the lrgv and have on occasions taken it upon themselves to promote it to other people. for example, vera, a minnesota resident was concerned because her friends in st. paul, mn were not able to get adequate information about wintering in texas. so she and a few of her winter texans neighbors, took promotional materials from the mcallen chamber of commerce to the minnesota state fair, where they set up a booth to advertise the lrgv. this perpetual migration between the midwest and the lrgv ensures that new migrants have a pre-existing social support network before they travel and that close connections are maintained with the home community. in short, a continuous supply of retirees is maintained through self-selection, selective recruitment, and network recruitment (longino 1994). therefore it is inadequate to see seasonal migration as “movement between distinct environments” (rouse 1992: 162) because of the strong connections that reside at both locations. rather it is a “circuit” that links current and future retirees to both locations and is the template for community formation in the parks. from midwesterner to winter texan: moving into ocean valley ocean valley rv park is like a lot of the mobile home parks built in the fun-n-sun model scattered throughout the lrgv, and the american southwest. located on the outskirts of mcallen the park is enclosed by a five-foot chain-link fence that separates it from the neighboring park on one side and a small residential community on the other. a welcome sign greets new visitors along with a sign for people to check-in. the park is laid out in a gridlike fashion that separates the 427 lots into blocks that are organized into smaller communities. each block is named by the street that it is on and is led by a block captain. block captains are elected leaders who are in charge of promoting social activities on the block, notifying next of kin in case of emergencies, and organizing the neighborhood watch program. while i was there, the block captains reported to the board of directors, who were elected by the entire park and are in charge of running the daily activities of the park. the board met weekly in the recreation hall, located in the center of the park and all residents were expected to attend weekly meetings about the park’s business. most of the park’s activities occurred within the hall, which was large enough to hold 800 people. living in the park is restricted to those of age fifty-five and older, and although the park is in texas, none of the residents are native texans. most of the residents only lived in the park for a few months during the winter, traveling back north during the months of march and april. in october, when they return south, the composition of the park changes from previous years as residents die or are not able to make the journey. those who cannot make the journey back are commonly replaced by other midwesterners who have familial connections and/ or friendships with people who already live in the park. every year, as new residents enter the park, they are taken under the wing of older residents, some who have over twenty years experience living in the park. the bonds that newer residents share with established park families were particularly strong and form the template for the transfer of knowledge about the area. under their guidance, new residents learn about park customs, life in the lrgv, and tourism in mexico. the strong commitment that is shared between residents is epitomized by the common statement, “they are my second family.” matthew dalstrom mobile midwesterners 11 anthropology & aging quarterly 2013: 34 (1) matthew dalstrom mobile midwesterners matthew dalstrom mobile midwesterners during their time at the park, residents lived in trailers, but spent little time there, electing instead to socialize in the communal areas with their neighbors. the center of social life was the recreational hall, located near the main entrance of the park. every time i visited the hall residents were playing games (usually cards or shuffle board), exercising, socializing, or preparing for large gatherings such as dances or the weekly park meetings. for instance, at the weekly park meetings held in the hall, retirees had the opportunity to share announcements with fellow park residents and solicit volunteers for a variety of activities such as quilting, trips to mexico, and intra-park competitions (horse shoes, scuffle board, etc.). life during the winter is structured around multiple social identities, the block, the park, and state residency. each block had its own block captain and every week during the winter had a social function. certain blocks also took on particular characteristics. for example santa rosa street is known as the party block, because they celebrate everything. according to a resident they even had a “christmas tree funeral, when the block’s tree died and four men acted as pall-bearers carrying the tree down the street.” then afterwards everyone drank beer and celebrated. on another occasion, the block rented a keg of beer and carried the keg into the middle of the community pool, where there was a little sitting platform, so they could drink without “getting hot [leaving the pool].” other blocks were known for being quiet, or for the social activities that people engage in. aside from block membership, there was a lot of pride associated with park membership. long term residents tended to have high levels of personal satisfaction with their park and often compared themselves with others, “we are much nicer than the [blank] park,” “unlike others we own our land so you can’t get kicked out,” or “you can walk down the street and talk to almost anybody.” park identity was further reinforced through nametags that residents wore both in and out of the park, which prominently displayed the park’s name and location. furthermore, intra-park competitions in bowling, cards, and singing allow residents to compete with people from other parks. since parks in the area are also segregated along class and regional differences, intra-park competitions enabled residents to engage in both class and national/regional completions through seemingly benign activities. for instance, there were several parks in the area that catered almost exclusively to the upper middle class and were so expensive as to be prohibitive for residents of ocean valley. residents of these upper class parks were ridiculed for being “exclusive,” and for “not having a community spirit,” because they paid people to do the park maintenance jobs instead of relying of volunteers. other parks in the area have regional appeal attracting large numbers of people from one state in the us or province of canada. however, away from the parks, winter texans saw themselves as having more of a collective identity and engaged in the same social activities (volunteering, bird watching, golf, shopping, etc.) regardless of their park identity integration and becoming part of the park community was emphasized within ocean valley, nevertheless, the primary responsibility falls upon the welcoming committee. one former committee member explained, that when new retirees arrived, they would “tell them about the activities” and “just welcome them leaving it open so they can ask us questions and we would answer whatever their concerns were.” then, “they would feel part of the park.” to further support integration, older residents took newer ones under their wing acting as mentors, “showing them where to go,” “fun places,” and what “to avoid.” moreover, the mentors encouraged people to participate in the park activities as emphasized in the welcome packet: all…residents are encouraged to contribute their energy and skills to park activities. this is an ideal way to become acquainted with many neighbors that are part of the “great group” that makes…[ocean valley] the best.2 in both cases, residents of the park prided themselves on being a community and welcoming new residents. volunteers provided all necessary labor within the park. the residents ran the welcome desk, managed the annual dues, planned parties, and arranged trips, making a strong community vital to the functioning of the park. most new residents found out about the park through friends and families since the park hasn’t advertised in decades. in some cases, whole families of siblings live in the park and it is common for friends from the same hometown to move into ocean valley. there are a handful of rental properties that allow new residents to “see if they fit” before they buy into the park. once integrated, they tend to return every year. some of the “original” residents well into their 90s still come to the park if they are healthy enough and have relatives to drive them. in recent years, the amount of widows has grown as it has become more socially acceptable to be alone and as more children have encouraged their parents to “have fun and be with friends.” however, illness is always present and it is a sad time when people are no longer physically able to make the journey. for the first few weeks of every fall, residents anxiously await to see who will be able to make it and who anthropology & aging quarterly 2013: 34 (1) 12 matthew dalstrom mobile midwesterners does not return. news of a person’s deteriorating health spread quickly in the park, and if he/she needs to sell the lot where they park their rv, a retired real-estate agent in the park helps them do so. along with the sadness of the loss there can also be a lot of excitement as new property goes on sale. some lots are highly sought after because they are larger or on a popular block, so as soon as they go on sale residents will enter into a bidding war over them. aside from the potential of having a larger lot, moving enables people to change their block which alters both their political representation (block captain) and social obligations (block parties). when the lots are not bought internally, they are sold to new people who represent the vitality of the park. just as important as socializing, is maintaining connections with their home community. according to bjelde and sanders (2009) seasonal migrants keep in touch with their family and friends through phones, email, home visits, inviting people to stay with them, and having children drive them to the park. while all those are present in ocean valley, residents also organized themselves around their state affiliations. for instance, it was common for individuals to talk about their home state and put signs on their rv that indicated what city or town they were from such as, “the browns, east troy, wi.” in addition, groups of people from the same state organized social events for residents who lived in different parks. one particular event was the state dinner, where residents of a state such as iowa got together. these dinners could be small consisting of one mobile home park, or large with all of the parks in the area invited. for some of the larger dinners, business from the home state, contributed gift cards and other items that were raffled off during the meal. in ocean valley, there was a state dinner for all the major states represented: iowa, illinois, wisconsin, and minnesota and residents were encouraged to sell tickets to people both in and out of the park. during the summer, when they were back home, residents were also tasked with getting businesses to donate to the dinner. the connection to ocean valley does not end during the summer months when people return to the midwest. for instance, those who leave frequently maintain contact with the permanent migrants who are tasked with taking care of the park maintenance during the summer months. furthermore, during the summer, groups of residents will meet at state and national parks in the us and canada to celebrate birthdays, anniversaries, and mourn deaths. through these year-round activities, residents of ocean valley continually reinforce both their midwestern identity and their strong social and community affiliation with the lrgv. this ensures that when they migrate south again, they will go back to the same park, continuing the transmigration circuit. migration and the impact on health appropriate and affordable medical care is a particular concern for the residents of the park. the average winter texan is 69.5 years old (ghaddar and simpson 2008), and many of those interviewed indicated that they were taking multiple prescriptions and required monitoring for a chronic condition (such as high cholesterol, blood pressure, diabetes). while most winter texans have health insurance (67.9 percent have medicare a, 67.2 percent part b, and 55.6 percent private health insurance) (ghaddar and simpson 2008), they still face gaps in coverage, high prices, and long waiting times at hospitals and clinics in the us. some winter texans also mentioned they did not have access to appropriate medical coverage in the midwest because they lived in rural areas and often had to drive hours to get to major medical centers. moreover, some healthy living practices, such as exercise, are challenging during the winter months when seniors tend to be less mobile. consequently, seasonal migration to the lrgv enables seniors to experience a wider range of health promoting activities, including access to the low cost health care in mexico. healthy living the park living in the park impacts seniors’ health by providing exercise options, health screenings, and access to the mexican health care system. it also gives seniors access to a community and support network that has been linked to a higher quality of life (koropeckyj-cox 2002), and increased activity which has been linked to younger age, better self-rated health, and less functional limitations (agahi, ahacic, and parker, 2006). in ocean valley there were daily exercise opportunities such as walking clubs, biking clubs, water aerobics, dancing, weight watchers toning and stretching classes. in addition, there is a small gym that is open seven days a week. the warm climate in the winter also enabled people to be outside more often and be overall more mobile than if they were living in the midwest. exercise programs in the park counteracted the common barriers seniors have exercising in the midwest: cost, transportation, lack of motivation, unfamiliarity with exercise personal, and lack of confidence (wright and hyner 2009). as one women mentioned, “at home i try to walk, but i don’t do any of the other exercises. it matthew dalstrom mobile midwesterners 13 anthropology & aging quarterly 2013: 34 (1) matthew dalstrom mobile midwesterners matthew dalstrom mobile midwesterners is very difficult and hard to exercise by yourself.” some of the residents explained that the activities, “keep them busy,” “happy,” and feeling better than their other counterparts up north. others went as far as to comment that “i wouldn’t still be alive if i didn’t come down here.” however, as seniors age they are less able to participate and eventually they restrict themselves to less physical activities like playing cards, singing, or making quilts for poor mexican children. aside from physical activities, living at the park provided access to medical care at lower prices than in the midwest. at the hall, local hospitals and medical clinics offered flu shots, blood pressure checks, stroke screenings, and wellness screenings that cost half what they would in the midwest. some of the residents even postponed tests in the midwest, preferring the lower costs in the park. frequently, when the results came back a week or so later, the health care organization sent a representative to give a presentation, explain the results and recommend follow-up care. these events were highly attended and are credited by the attendees for saving the lives of several of the residents through early detection. after the presentations, residents mingled with each other, discussing the results and offering anecdotal stories about the medications and treatments that they used or are using. those who were still confused about their test results usually looked for retired medical professionals who lived in the park for additional information. for those identified as needing additional care, the nearest hospital was minutes away. sometimes, after receiving their results and attending the meeting, residents would come to the conclusion that they no longer needed a medication, either because they were cured or decided it was no longer effective. for example after one meeting, a woman sitting next to me handed me her medical results, smiling, and told me that her cholesterol was under control and she no longer needed lipitor (a popular cholesterol lowering medication). happy for her, i asked out loud what people do with all the extra medication. her friend, rita, a twenty-year veteran of the park explained that residents give the medication away or trade it for another that could be more effective. recalling what she recently did after her medication was not working, rita said: people trade a lot of medication at the park . . . the doctor is always prescribing for you, and i have to pay for it and i take it for a week or so and i get a bad reaction to it and i have to throw it out. maybe it cost me $200 and somebody here is taking the same thing, the same strength. what i used to do is put a note on the bulletin board [in the hall] saying, “anybody taking blank?” and put my phone number on it and they would call me and i would give it to them. this enabled residents to mitigate some of the costs that their friends might incur purchasing the medication. it also became the template or basis for a medicine exchange. through the exchange, some people entered into a pharmaceutical giving or trading cycle where they constantly shared, gave, or sampled their friend’s pharmaceuticals. coupled with lower costs, primary and preventative care, and a community support network living in the park provided access to health care that they would not necessarily have if they stayed in the midwest. 3 accessing mexican medical care living in the ocean valley also facilitated access to mexico which offered a variety of cross-border medical services including pharmaceuticals, dental care, physician consultations, unapproved treatments, and surgeries (dalstrom 2012). while there are many locations within the country for potential patients to receive care, the most popular medical destination for retirees in ocean valley was the mexican border city of nuevo progreso, located about 45 minutes southeast of the park. access to the town is relatively simple, and seniors can either walk or drive across the progreso-nuevo progreso international bridge into the town. no identification is needed to walk into mexico, and pedestrians are rarely stopped or searched by mexican customs or the army. nuevo progreso has a thriving tourist district, which is the center of economic activity in the town. it consists of roughly five city blocks stretching south of the international border. like many tourist districts in mexico, nuevo progreso has restaurants, bars, liquor stores, and a plethora of street vendors selling jewelry, dvds, and mexican crafts, but it was the 72 dental clinics, 61 pharmacies, and 8 physicians offices that appealed most to many seniors. the lower costs and easy access to mexican medical care was particularly appealing. for example, according to the winter texan market survey, 51 percent of winter texans bought prescriptions, 36 percent dental care, and 6 percent visited a physician in mexico (ghaddar and simpson 2008). overall though, cost was the primary reason they used the mexican health care system. for instance, some winter texans reported that they saved up to 70 percent on their dental care and pharmaceuticals and more than 50 percent on lasik eye surgery and abdominal surgery (dalstrom 2012). anthropology & aging quarterly 2013: 34 (1) 14 matthew dalstrom mobile midwesterners aside from cost, accessing health care in mexico enabled winter texans to bypass insurance regulations and reluctant primary care physicians. for example, seniors went to mexican pharmacies they were able to purchase the medication that they wanted or needed without a prescription as a result, seniors had the ability to self-medicate. in ocean valley this meant that retirees frequently traded medications purchased in mexico that they no longer needed or wanted and recommended prescription medications to their friends. then, when they found a medication that they liked, they purchased up to a years supply in mexico. as one retiree explained, “i know what i have, i know what i need, so why do i have to pay a doctor to tell me what i know? i can just get it in mexico” some even looked for surgical opportunities such as arlene, a 70-year-old retiree from iowa who was very displeased with her optometrist who repeatedly refused to give her lasik eye surgery. frustrated, she went to mexico and shopped around until she found an optometrist who would perform the surgery. many people are very concerned about the quality of mexican health care especially in terms of whether it is as good as care in the us. for those concerned about the quality, they described it as “haphazard,” “dangerous,” “not as advanced,” and “risky.” their fears were not entirely unwarranted, and the fda (2011), along with numerous doctors and dentists, have discouraged their use (dalstrom 2012). however, for many seniors, the choice was not that easy and the dilemma, as one resident explained, is often between “some care and no care.” the burden of making the decision about care in mexico that could be dangerous, but desperately needed, falls onto the individual. self-treatment can be particularly dangerous within the winter texan community because many believe that they should not tell their primary care doctor or dentist within the us because they are afraid that the doctor will dissuade them or that it will somehow impact their health insurance coverage. recommendations were particularly important to assuage concerns and new residents commonly listened to more seasoned veterans. therefore while there are numerous dentists and pharmacists in nuevo progreso, residents only utilize a few of them. in effect, certain providers become park dentists and pharmacists. for example, four years ago, jerry was suffering from a bunion and a hammertoe, which caused her considerable pain. she saw several doctors in the us about it and they all told her that she needed surgery. unfortunately though, she was hesitant because her deductible of 2500 usd made the prospects of surgery very expensive. one day she was at the flea market where she met another winter texan who had a similar procedure. during the conversation, jerry found out that in mexico the procedure was 1000 usd less than in the us. the catch was that the surgery was not yet approved in the us (but was practiced in europe), and jerry would have to bring her own medicine and foot brace to the hospital. however, because she was told that the doctor was good, she proceeded with the surgery. using patient recommendations does not always work out well, as in the case of paul, who selected a dentist for a root canal based upon a friend’s suggestion. during the procedure, the dentist only gave him an ibuprofen for the pain and used a pair of pliers to remove a few teeth until he vomited and passed out. when he returned to the us he had several cracked teeth and a root canal that had to be redone, costing him an additional 5,000 usd. however paul’s story was a rarity in the park and now no one from the park uses that dentist anymore. more often, residents talked about the good deal they received in mexico and how they had “waited all year to go to mexico” because they could not afford the care in the us. medical decisions that have positive outcomes are lauded as examples of the benefits of consumer choice and resistance to the us medical establishment. they are also used as the basis to connect health care in the midwest to texas. proud of their medical prowess, winter texans spend the summer months telling their family and friends about the savings and benefits of mexico. in response, people will ask winter texans to purchase medication on their behalf and it is not uncommon to see winter texans purchasing mexican medication for their entire family or all their close friends in the midwest. in addition, winter texans will invite their friends and family to visit them at the park so they can easily cross into mexico for dental care and surgeries. this created a very interesting situation where winter texans and their family members were diagnosed in the us and delayed treatment until the winter when they were able to access more affordable care in mexico. for instance, john, a winter texan from iowa was told by his dentist in july that he needed two root canals. distressed by the high cost of the procedure, he waited until october until he could see the park’s mexican dentists, because as said, “why should i pay more for the same care.” the practice of waiting extends past dental care with some of the interviewees postponing knee, lasik, and foot surgery. when asked why they waited most people indicated that it really was not that hard of a choice. either their health matthew dalstrom mobile midwesterners 15 anthropology & aging quarterly 2013: 34 (1) matthew dalstrom mobile midwesterners matthew dalstrom mobile midwesterners insurance did not cover the procedure or the deductible was just too high. since the surgery was not urgent, they would have to save up to afford it either way, so why not get a “better deal” in mexico. therefore, for many winter texans and their families, health care is not something that is situated in the midwest, but is part of, and intimately related to the circuit that connects mexico, the lrgv, and the midwest. just as people move in a predictable pattern, so does medication, patients, and health care information. as new residents are integrated into the park, they are also exposed to and learn about mexican health care. older residents will frequently take them into mexico to show them how the process works and to assure them that it is safe. for those integrated into the system, medical decisions are conceptualized spatially, in terms of the location that can provide them the care that they need, and temporally, depending on when they need care and what they can wait for. when framed within context of mol’s (2008), discussion of the “logic of choice,” a neoliberal notion that the commodification of health care services and choice produce better patients and health outcomes (which many winter texans believe in), it becomes easier to understand why using healthcare in the lrgv is so popular. access and usage of health care in the parks empowers retirees to choose the type and delivery of their health care. moreover through bypassing their primary care providers in the midwest, winter texans shift the burden of medical decision making onto themselves, allowing them to make decisions the same way that they make migration decisions. through the dual benefit of having access to mexican health care and health care within the park, retirees are able in some cases to increase the availability of health care services and decrease the overall cost. coupled with exercise programs, social activities, and living arrangements that cater to older people, winter texans have the possibility of living, happier, healthier lives. as one resident stated, “if i was not here, i would be dead.” conclusion retiring is not what it used to be. for some it marks the opportunity to travel, move, and have adventures-the antithesis of the aging in place model. to meet the growing demand for this lifestyle during retirement, a growing amount of branded retirement developments have emerged to cater to specific retiree desires (fitzgerald 2000; mchugh 2000). however, not all people want to move to fulltime community and instead desire part-time living arrangements. for those individuals, seasonal migration is one solution to meet the desire for living within a community of seniors and maintaining their home. seasonal migration from the midwest to the lrgv began early in the twentieth century through the development of a phenomenon akin to the transmigration circuit. the circuit developed over the past century as midwesterners came to the area to work, then visit, and eventually spend the winter. during that time the lrgv actively advertised to them, eventually developing seasonal rv parks that offered social activates, warm weather, and a strong community. retirees who decided to winter in these parks rarely did so alone, frequently following friends and family. through migrating with friends and family retirees, they are able to mitigate the often stressful and lonely experience of moving to a retirement community. moreover, many indicated that through migrating, their quality of life increased as they were able to be social, exercise, and be outside during the winter months. living in the park also impacted health in some unique ways. first of all, many hospital and clinics in the lrgv provide discount health screenings and services in the parks on a monthly basis. residents are encouraged to take advantage of these opportunities and also to assist newer residents in accessing medical care in the area. sometimes, that care is in the us, but in other circumstances it means using mexican health care. regardless of where the care is received, winter texans have more access to health services that generally cost less than they would in the midwest. moreover, through accessing health care in the parks, mexico, and the midwest, they are able to fashion and utilize an entirely different health care system than their peers in the midwest. with all the opportunities available, winter texans have found a successful way to mitigate the problem of aging in place, feeling separated from their home community, and needing support by seasonally traveling south. when they move to their retirement communities they take their friends and family with them creating a support network that stretches across the county. new residents often are already connected with the park either through social connections or because they are from the same origin community. once there, they form a tight knit community that becomes the basis for a variety of health seeking and social activities which improve the overall aging experience. anthropology & aging quarterly 2013: 34 (1) 16 matthew dalstrom mobile midwesterners acknowledgements this project was funded by the national science foundation doctorial dissertation improvement grant, “motivations for medical migration in the united states/ mexico borderlands” (bcs-0848478). endnotes 1 there are other regions that send retirees to the midwest, however because of space limitations this paper will only address the midwest. 2 the citation for this pamphlet is not given to protect the amenity of the park. 3 the fda (fda 2011). discourages patients from using prescription medication without medical supervision because of the potential health risks. references agahi, neda, kozma ahacic, and marti o. parker 2006 continuity of leisure participation 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persons. research on aging 24(1):50. vincent, vern 1993 advertising for new winter texans: what is the payoff? edinberg: university of texas pan american. warens, anthony, and allan williams 2006 older migrants in europe: a new focus for migration studies. journal of ethnic and migration studies 32(8): 1257-1281. werner, carrie a. 2011 the older population: 2010 . us census bureau. http://www.census.gov/prod/cen2010/briefs/ c2010br-09.pdf (accessed may 5, 2012). wright, tim. j., and gerald hyner 2009 principal barriers to health promotion program participation by older adults. american journal of health studies 24(1), 215-222. apps_layout capitalizing and compensating older adults’ religious and spiritual uses of technology samantha l. c. kang camille g. endacott gabrielle g. gonazales university of california santa barbara vern l. bengston university of southern california author contact: samanthakang@ucsb.edu abstract this study explores how older adults use information and communication technologies (icts) in their spiritual and religious lives. how widespread is their use? what kinds of icts do they use and for what reasons? what impact do they have on their religious and spiritual lives? we explored these questions by collecting interviews with 90 older adults, average age 77, from six major judeo-christian faith traditions. the sample was developed from nominations by pastors, priests, and rabbis in three southern california cities. data were collected through in-depth, semi-structured interviews and analyzed through abductive analysis. many older adults in our sample reported using icts to assist their devotional lives—nine in ten of our participants provided examples, thus dispelling technology as merely a tool for the young to incorporate into their religious lives. an unexpected finding of the research was the wide variety of ict usage mentioned by these elderly participants —over 15 distinct ones were mentioned. the reasons for using icts fell into two primary categories: compensating for age related changes and capitalizing on unique opportunities for growth in later life. the results demonstrate support for carstensen’s socio-emotional selectivity theory and have implications for practitioners working with older adults, such as social workers and clergy, as well as for marketers in industry. keywords: religion; spirituality; information communication technologies; gerotechnology; aging anthropology & aging, vol 40, no 1 (2019), pp. 14-31 issn 2374-2267 (online) doi 10.5195/aa.2019.194 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 14 capitalizing and compensating older adults’ religious and spiritual uses of technology samantha l. c. kang camille g. endacott gabrielle g. gonazales university of california santa barbara vern l. bengston university of southern california author contact: samanthakang@ucsb.edu a persistent stereotype about older people is that they are reluctant, fearful, or incompetent in adapting to the use of digital technologies (mccann and keaton 2013; niemelä-nyrhinen 2007). there is increasing evidence, however, that the use of technology by seniors is growing. a 2017 nationwide survey noted that four out of ten americans over age 65 own smartphones, a number that has more than doubled since 2013. over two-thirds of older adults now use the internet and one-third now own a tablet or e-reader (pew research center 2017). at the same time as seniors’ use of technology is expanding, another trend is continuing: older americans are more actively involved in religious and spiritual pursuits than any other age group (silverstein and bengtson 2017). as they near the end of life, many older adults describe later life as an opportunity to grow in their religious and spiritual development (bengtson, kang, endacott, gonzales, and silverstein 2018). many seniors work to redefine their relationships with themselves, others, and the world (carstensen 1992; tornstam 2005). these changes may prompt spiritual growth through self-examination, the relaxation of defenses, and a more present and attuned experience of life (loder 1998). a body of research exists on older adults’ use of technology (bowen 2012; chappell and zimmer 1999; charness and boot 2009; gatto and tak 2008; ismail and wan mohd isa 2014; marquié, jourdanboddaert, and huet 2002; lee and coughlin 2014). while other areas of research encompass technology and religion (campbell, bellar, and cho 2014; hughes-rinker, et al., 2016) or older adults and their spiritual and religious lives (atchley 2009; bengtson and deliema 2016; bengtson, endacott, kang 2017; bengtson, kang, endacott, gonzales, silverstein 2017), few studies look at older adults’ use of technology for religious and spiritual purposes. this study situates itself within this gap to explore the intersection of aging, religion, spirituality, and technology. individuals whose time would not otherwise be spent earning money, such as retired individuals, have been shown to devote more time to religious activities (azzi and ehrenberg 1975), and may also use their surplus time to utilize technology for religious education and practice. furthermore, technology can also benefit important subgroups of older adults, such as those with limited mobility. because technology can facilitate connections across time and space (bernal 2005 nardi and harris 2009), it could connect these older adults with religious and spiritual communities that they are not able to access in person. in this paper we explore the use of what has alternately been called “gerotechnology” (fozard et al. 2000) or “gerontechnology” (micera, bonato, and tamura 2008), e.g. social networking, smartphones, tablets, internet, skype, podcasts, in the spiritual and religious lives of older adults. how do seniors make use of such technologies? what are the benefits they see and the barriers they face in doing so? in exploring kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 15 these questions, we offer insight into the rich and varied roles that technology plays in the lives of older adults and discuss the theoretical and practical implications of older adults’ use of technology for religious and spiritual purposes. older adults and their use of technology the adoption of information and communication technologies, or icts, appears to be rapidly increasing among older adults ages 65 and above, particularly for those who have attained a college education (pew research center 2017). older adults aged 65 years appear to differ in their technology use than those aged 80 years and above—indeed, a pew research report from 2017 showed that 95% of older adults ages 65-69 owned a cellphone while only 58% of older adults aged 80+ did. a representative study of a regional section of the united states conducted by vroman, arthanat, and lysack (2015) corroborated that those most likely to use icts were between 65 and 70 and also found that they were more likely to live with a spouse. in this study, however, older adults are operationalized as those aged 65 and above. cohort effects among older adults found in previous research are noted when appropriate. while older adults do tend to pursue a narrower range of goals online than their younger counterparts, both groups see the internet as central to their lives (loges and jung 2001). in mitzner et al.’s (2010) study, older adults’ positive attitudes about digital technologies outnumbered their negative attitudes. these findings suggest that older adults’ use of digital technologies tend to defy popular perceptions that they are reluctant to embrace technology and its potential benefits (selywn 2004). older adults may be especially well-poised to benefit from information technologies’ contributions. past research suggest that icts offer means for self-expression, education, and entertainment in the face of physical decline and lack of control (pekkarinen and melkas 2012) as well as for a sense of agency over the monitoring of their own health care (lutz 2015). in an experimental intervention study, white et al. (1999) reported that older adults who used computers saw a decrease in loneliness and an increase in psychological well-being. these older adults used computers primarily to access the internet and to send emails to family and friends. using technology may also help older adults retain their independence and autonomy during the aging process (mynatt and rogers 2001). icts can also foster new forms of social connection and participation. biniok and menke (2015) found that when issued tablets older adults in rural areas used them to engage in existing participation spaces (for example, fostering deeper relationships among older adults and their acquaintances from various clubs or associations) as well as to form new ones (for example, by connecting older adults to past school mates whom they previously had been unable to contact). this work suggests that technology can function as a “social junction” for those who are geographically distant (biniok and menke 2015, 172). anthropologists who study individuals’ technological lives also show that digital technologies afford opportunities for users to form relationships across time and space (nardi and harris, 2009), embody roles in virtual spaces that would be denied them in face-to-face interactions (boellstorff 2011), maintain transnational identities (kim 2017), and construct communities even in the face of geographic dispersion (bernal 2005). for aging adults, who may face social isolation, experience physical and mental changes, and have trouble accessing meaningful communities, technology can provide new ways of participating in social worlds. while icts offer promising avenues for improving older adults’ quality of life, their likelihood to use technology is affected by both individual and social factors (lee and coughlin 2014). for example, the likelihood of older adults’ technology use is affected by its affordability and their prior experience with icts, as well as by the degree of validation and support they receive (ibid.). older adults must also see kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 16 technology as addressing their personal needs. chappell and zimmer (1999) found that seniors’ receptivity to technology was influenced by the level of concern they had for problems that could be solved through its use. as communication technologies provide older adults with connectedness, satisfaction, utility, and positive learning experiences (gatto and tak 2008), they may reformulate habits and practices such that they incorporate icts (schreurs, quan-haase, and martin 2017). however, older adults also face challenges and difficulties in their adoption and use of icts, such as frustration with technology, physical and mental limitations that inhibit their use, and mistrust of technology in general (gatto and tak 2008). older adults are more likely to underestimate their computer knowledge than younger people (marquie, jourdan-boddaert, and huet 2010) and must overcome perceptions of technology as difficult to use (vroman et al. 2015). older adults who were not exposed to computers in the workplace may be less interested in learning how to use them later in life and may lack the sufficient dexterity and vision to operate them (selwyn 2004). however, these limitations can be overcome (charness and boot 2009). in addition to physical and attitudinal limitations, cultural discourses around older adults’ use of technology may pose a challenge. for instance, the american association of retired people (aarp) depicted technology most often as a health and medical tool rather than as a tool for better social and emotional well-being (bowen 2012). compared with these medicinal uses, older adults appear to be far less likely to be presented with opportunities to see technology as a valuable tool for enhanced social relationships or for enhanced quality of life . rarer still is the opportunity to see technology as a useful tool in their religious and spiritual lives. using technology for religious and spiritual purposes technology is now a part of many individuals’ everyday religious and spiritual lives. increased use of technology via smartphones, tablets, and laptops has facilitated the movement of religion from the public sphere into the private sphere (hughes rinker et al. 2016) and the use of technology for religious and spiritual purposes appears to be growing. according to buie and blythe (2013), there are over 6,000 available applications (commonly abbreviated to “apps”) related to prayer, religious trivia and stories, spiritual guidance, and religious education for users to download onto smartphones, tablets, and computers. these apps can be used to aid users in their religious practice or may have religious content embedded within them for users to consume (campbell et al. 2014). icts may also change the scope and reach of institutionalized religious practice. for example, hughes rinker et al. (2016) found that young people often used icts such as devotional apps and religious podcasts to substitute for in-person attendance at religious services. however, bell (2006) points out that some religious leaders have seen technology as an extension of religious institutions, as illustrated in a search for a patron saint of the internet by the catholic church. church leaders may also use technology to accomplish pastoral care over distance (wyche et al. 2006). rising popularity of applications to read the bible and other sacred texts make texts and commentary widely available for users to access and discuss across time and space (hutchings 2015). while mobile spiritual applications and other forms of religious and spiritual technologies (such as bible software or religious blogs and newsletters) are on the rise, the lived experiences of people utilizing these technologies are relatively opaque, especially among older people (ahmad et al. 2015). older adults may draw on these technologies to facilitate their religious and spiritual development in creative ways. for example, elderly muslims have used spiritual apps to remind them to pray throughout the day (ismail, noor, and isa 2014; ahmad and razak 2013). while scholars have outlined the implications of technology for older adults’ health and mobility (plaza et al. 2011), the possibilities of technology use for connecting older adults to local congregations and other collectives, facilitating spiritual practices, and learning more kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 17 about religion and spirituality are ripe for exploration. to more fully understand how older adults make use of technology in their religious and spiritual lives, we address two sets of questions in this article. first, what role does technology play in older adults’ religious and spiritual lives—that is, what technologies do they actually use and what is it that they do with them? where does technology fit in their devotional practices, religious experiences, or spiritual life? second, what do older adults perceive are the benefits of these technologies for their spiritual or religious growth? what possibilities for technology are realized in their lives? to explore these questions, older adults themselves should be asked about how they use technology in their religious and spiritual lives. research methods context and sample to explore the role technology plays in the spiritual and religious lives of older adults, we used data from the larger research project of the religious development in later life study (rdll) (see bengtson, endacott, and kang 2017 for details about the methods and procedures of this research). the data in this article are drawn from this larger study. the sample was drawn from two southern california areas. the first was a coastal community with a wide range of economic levels and a relatively high proportion of retirees. since the original goal of the study was to explore the spiritual lives of religious older adults, we obtained the sample through contacts from pastors, priests, and rabbis. the churches were strategically selected in order to represent a variety of faiths and socio-economic areas. for example, one catholic church was located in a largely working-class suburb of mixed white and racial/ethnic minorities, while another was located in a suburb populated by a majority of middle to upper class white residents, one of the wealthiest communities in the state. however, this strategy did not initially result in sufficient ethnic and racial diversity so a second sample area was chosen, a los angeles suburb. this resulted in an increased number of black and jewish participants. the congregations from which these participants were drawn varied greatly in size, wealth, racial/ethnic makeup, and faith tradition. four participants came from a store-front pentecostal church in which the pastor reported the average sunday attendance as “35 to 40”; four others attended a nondenominational evangelical church meeting which offered four services on saturday and sunday with 1,200 total attendees. one pastor said his church annual budget was “around $10,000” (he said he refused to take a salary); another said that the budget was “somewhere around $2 million.” we limited the scope of our sample to judeo-christian faith traditions: evangelical, mainline protestant (presbyterian, methodist, episcopalian), historically black churches (ame), roman catholic, jewish (reform and conservative), and other (unitarian, unity). this resulted in a sample of 90 older adults: 22 evangelicals, 20 mainline protestants, 13 catholics, 13 black protestants, 13 unitarian/unity, and nine jews. the average age in our sample was 77. fifty-five participants were female and 35 male. this was overall an advantaged sample—participants were in good health, most owned their own homes, and most had attained at least a college education (the sample as a whole had an average of 16.4 years of schooling). in terms of race and ethnicity, 14 participants were identified as african american, one as asian, four as latino, and one as native american. the remaining 70 were white. all names used in this article are pseudonyms. research methods were approved by an institutional review board to ensure adequate human subjects protection. a summary of the descriptive statistics of the sample is shown in table 1. kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 18 religious tradition age (avg). sex education (years) marital status n m f single widowed married divorced black protestant 76 5 8 15 1 3 8 1 13 evangelical 75 9 13 15.7 1 0 16 5 22 mainline protestant 74.5 6 14 17 0 4 11 5 20 jewish 84.5 3 6 17.1 1 2 6 0 9 catholic 78.5 6 7 16 0 4 7 3 13 unitarian/other 77.4 6 7 18 1 0 11 0 13 total 77.7 35 55 16.5 4 13 59 14 90 table 1: sample characteristics data collection to learn more about the spiritual and religious lives of older adults, data were collected through semi-structured, in-depth interviews, each lasting from one to two hours, which were recorded and then transcribed. older adults were often interviewed in their own home, but interviews were also conducted at local parks and retirement communities. these interviews spanned a variety of topics, from the participants’ religious biography to turning points in their spiritual lives. we asked questions such as, “what role does religion and spirituality play in your life today?” and further inquired as to whether they prayed, read scripture, used other spiritual or religious readings, or meditated. we asked whether they had experienced any changes in their spiritual or religious lives during the past 10 years or since they had retired, and why. we concluded by probing their general sense of optimism or pessimism by asking questions about the future of the country and religion more specifically. immediately following the interview, the interviewer wrote a summary of the interaction in field notes. both the field notes and a transcribed version of the recorded interview were uploaded into the data analysis software maxqda. because this study developed out of a larger project on the spiritual and religious lives of older adults, the majority of questions centered on participants’ religious and spiritual development, practices, and beliefs. however, we noticed that many older adults had much to say about the ways they used technology for religious and spiritual purposes. though not intended as a focus of our larger study, we turned to investigating how older adults spoke about technology across the interviews. data analysis to analyze our data, we drew on an abductive analysis approach (reichertz 2007). abductive data analysis combines the inductive process related to grounded theory (glaser and strauss 1967) and kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 19 deductive processes. the deductive process allowed us to ask focused questions of our data (e.g., what is the role of technology in older adults’ religious and spiritual lives?) as informed by previous literature. we began the research with some general questions related to religion, aging, and technology informed by previous work on this topic (strauss and corbin 1990). this process allowed us to flag relevant portions of interviews that could address our research questions. we then drew on a more iterative approach by allowing codes to emerge from the data itself. we divided the interviews equally between three researchers began the process of open coding—a process that allowed us to describe and categorize portions of interviews based on their content. for example, we described activities that older adults did with technology with codes like “listening to a devotional” or “reading the bible on an app.” we could then develop a domain analysis of the types of activities that are relevant for older adults in this context (spradley 1979). we also openly coded what older adults saw as the benefits and capabilities of technology with codes like “learning more about religious history” or “connecting with religious friends.” after each researcher had coded a portion of the interviews, the team came together for weekly meetings to discuss findings and refine the codes further. this process of consensus coding (desantis and ugarriza 2000) allowed the research team to ensure that they were applying codes uniformly. from these open codes, axial codes were developed to categorize these benefits that appeared meaningful from the perspectives of the participants. we developed the axial codes “compensation” and “capitalization” to describe the ways in which older adults used technology to compensate for challenges and capitalize on resources for religious and spiritual purposes, respectively. we then returned to the data to look for patterns and rich exemplars of how older adults used technology to attain these benefits. technology emerged serendipitously from our data. if it had been an original focus, we might have expected to find that the majority of our participants agreed with caleb (72, ame) who reported, “i’m the older generation, i don’t deal with computers that much. the phone, all i do is talk on the phone.” however, while a few individuals shared caleb’s disinterest in technology, an unexpected finding of our study was most of our participants reported that they incorporate technology into their religious and spiritual lives. the next section describes the ways in which older adults used technology for religious and spiritual purposes, how this usage made a difference in their religious and spiritual lives, and the effect it had on their participation in religious and spiritual communities as well as their individual spiritual and religious development. findings among the 77% of participants that stated they use technology within their religious and spiritual lives, we coded 15 distinct religious or spiritual uses of technology. most frequently, these included reading the bible via app, performing internet research on religious topics, watching sermons through streaming or dvds, and receiving emails as members of religious email subscriptions. for example, richard (69, evangelical) said that he used the internet to do research on religious topics: “if i want to know about king solomon or the first temple or something you just google it and you get all kinds of information. also…raystedman.org has got a very strong website with all kinds of his teachings that are recorded there both audio and pdf format.” camille (66, ame) uses religious apps on her phone and tablet. she said, “i bought it from the app store. i bought the book at the bible book store. but it's easier for me to read it on my tablet or my phone, so i bought that.” similarly, marian (78, episcopalian) is a member of an email subscription: “i receive a daily meditation e-mail online every morning written by richard rohr, a catholic priest, franciscan, and i am gaining a broader understanding through some of his writings that lead me to this sense of that god is within us.” it is apparent from these quotes that technology usage potentially furthers our participants’ engagement with religion and spirituality. kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 20 furthermore, the response of jeanette (73, evangelical) suggests the seamless way in which technology has become a part of many seniors’ spiritual and religious lives: “i get up at 5 o’clock in the morning, i make my coffee, i sit down, i plan my day… you know, now it’s my calendar on my phone, and my bible, and my bible study is all on my phone and my kindle.” the older adults in the sample used many different types of technology for a variety of religious and spiritual usages, defying the popular belief that older adults do not engage with it as much as younger generations, if at all. a full list of the 15 uses can be found in table 2. 1. reading the bible via app 2. praying or meditation via guided app 3. performing internet research on religious topics 4. reading online devotionals 5. watching sermons via streaming or dvd 6. keeping up with church events via website or email 7. subscribing to religious emails 8. checking in on other church members via facebook or phone 9. belonging to religious facebook groups 10. playing bible trivia apps 11. taking online classes related to religion 12. making prayer conference calls 13. listening to religious podcasts 14. streaming religious music 15. listening to the bible via app table 2. religious uses of technology compensation in analyzing the statements by our participants, it became clear that older adults are using technology in ways both to compensate for the challenges of aging and to capitalize on the unique opportunities retirement affords—often simultaneously. here we discuss how older adults use technology to compensate for physical challenges in order to maintain aspects of their religious and spiritual practices. compensating for physical challenges perhaps the most obvious compensations technology provided older adults relate to physical challenges. several participants commented that failing eyesight made it difficult to read scripture in hard copy or other religious materials, and technology provided them with a few different solutions. kindles, smartphone apps, and other forms of e-readers allow seniors to increase the font size of any text. audiobooks and text-to-speech apps provide the same benefits, even for individuals who are nearly blind. when asked whether he read the bible on his own, even caleb, the individual who claimed he was from “an older generation” and thus did not use computers, admitted that audiobooks are also helpful to those who have a tendency to misplace reading glasses: “i’ll listen to it, because my eyes are getting bad and i always forget my glasses. even with the bible on the phone, if i don’t have my glasses, i still can’t read it.” without technologies, these older adults may not have been able to participate in religious and spiritual activities that they find important. kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 21 compensating for emotional challenges perhaps even more importantly, our participants also spoke of ways in which technology can compensate for the emotional challenges and social isolation aging can cause. they described ways in which technology enables individuals who are homebound, hospitalized, or otherwise incapable of driving to maintain relationships and remain active members of their faith communities. some of these individuals described informal check-ins with other members of their congregation, and the members of one particular ame church with a large population of seniors described a formally organized system that had a large impact on three of our participants. ellen (76, ame) describes, we have the sick and shut-in list that we all call, everybody on it—or most people on it, some people are non-responsive, so you can’t talk to them. but we call them on a regular basis…people call and want to know, ‘are you okay? i haven’t seen you. we didn’t see you sunday. what happened? do you need a ride?’ a member of a different ame church described “conference call prayers” that allow seniors to pray communally without needing to leave their own homes. kevin (88, evangelical) said, “instead of having a conference call, have conference prayer…people can be in the confines of their home at six o’clock in the morning. they don’t have to get on the freeway or drive.” technologies like conference calls can reduce social isolation by fostering community involvement even when an individual remains in their home or the hospital. more common, ten participants described how live-streamed or recorded services are brought to hospitalized or homebound seniors. some of our participants explained that their churches explicitly frame the practice as a form of inclusion and outreach to older seniors. nia (89, ame) joyously recounted an interaction with a friend who has used it to stay connected and informed: so many people can’t get to church, but if they have a computer, there the services are. in fact, one member was absent and i got up and said something, maybe it was about my birthday, when we recognize birthdays of that month… and i said, ‘oh mr. houston, i didn’t see you sunday, are you okay?’ he said, ‘yes, but i saw you.’ he saw me on streaming, so that’s one nice thing i like about [it]. an evangelical named ken was unique in describing a “viral” facebook post requesting prayers. he credits it for a miraculous healing after having a stroke: and then my whole family was down in the waiting room. my one daughter put it out on facebook, and then that kind of went viral everywhere. so there was literally thousands of people praying. long story short, after about four hours i had fallen asleep when i woke up i could speak and i told my wife, i said, ‘i think i’m going to be okay.’ and, boom, i got checked out of the hospital the next day. another unique compensatory use of technology was described by james, a 74-year-old evangelical whose story can help to illustrate the many benefits technology provides for seniors. james was raised in a non-religious, ethnically chinese home, and was first exposed to christianity while attending boarding school in sydney, australia. in the past he has struggled to reconcile his faith with his training as a scientist, but he has since come to believe, “in a historic christian faith, that he [jesus] is god become man to redeem us back to himself. that he did die, he did rise from the dead and is in heaven today advocating for me and you.” kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 22 like many older adults, james and his wife recently made the transition from independent living to a retirement community several states away from their former home. the move brought a reprieve from harsh winter weather but also the challenge of being separated from their former faith community. in the two years since the move james has become highly involved in his local evangelical church, but skype video-chats have also helped him to maintain a connection with the friends and loved ones he left behind. every tuesday morning james participates in a bible study that takes place 1,500 miles away back in chicago. james explained, “they meet in a conference room that’s set up for video conferencing, so they see me on a big screen. i see them on my laptop.” because of technology, james can maintain spirituallymeaningful relationships across time and space. retirement has also bought james a sudden increase in available time, and technology helps james capitalizes on it for more than golf and other leisure activities. he can now devote far more time to deepening his spiritual life. he said, i get up at 6:15 in the morning, make myself a cup of coffee, assemble a handful of nuts, and i turn on my computer to logos bible software and i will spend an hour reading, studying, contemplating, making notes, praying. so now this has become a much more regular practice at that hour. in the past when i was much more involved in working i would have to find different times during the day or the evening. but i find this much more satisfying. i think that’s the biggest change in my practice. the software james refers to here, logos, has come to replace a physical bible and biblical commentaries for him. james notes that retirement communities have far less storage space than single family homes and appreciates the way in which this software helps him cut down on the volume of physical books and papers for which he needs to find room. available on both his phone and computer, logos allows james to not only pray or meditate but also spend his time diving deeper into biblical history and scriptural interpretation. he describes, it’s set up so that when i turn it on i’ll see the scripture passage that i’ve been reading in revelations, and if i put my pointer on a particular word it will bring up the meaning of the word, it’ll give me the greek word for that english word and tell me some background about the greek meaning. on the other side of the screen there will be tools that allow me to make notes. i can write a note that records my own thoughts as i type it in, and there will be an asterisk placed with that particular verse so whenever sometime in the future i come back and i put my pointer on that asterisk it brings the note up, whether it’s on my laptop where i recorded it or on my phone or on my ipad i see the same note. it’s a very powerful tool for those who want to dig a little deeper. as james mentions, his use of logos and technology in general provoke insight and aid him in deepening his religious faith. capitalization while older adults used technologies to compensate for challenges such that they could maintain their devotional practices or connections to church communities, seniors like james also used technologies to capitalize on the ways that older adulthood afforded opportunities for religious and spiritual development. consequently, older adults in our sample used technologies for religious and spiritual purposes in ways that were new to them. older adults used technology to capitalize on opportunities for kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 23 further spiritual and religious education as well as deeper spiritual engagement. the combination that james describes—of using technology to capitalize on the increased availability of time in retirement by both learning more about his religion and participating in spiritual practices such as prayer and meditation—was very common among our participants. greater free time associated with retirement allowed many to capitalize on longstanding desires to learn more about denominational history, scriptural exegesis, interfaith comparison, and other topics of religious significance. as kevin (88, ame) explained, “this internet is such a wonderful boon for research and finding out information, getting information out there…now you’ve got the time. you’ve got more time than these young people that’s always on these instruments.” kevin directly attributes time as the reason why he now uses the internet. similar sentiments were expressed by daniel, a 66-year-old methodist sunday school superintendent. daniel is a fan of the christian apologist ravi zacharias and his “let my people think” ministry. as explained by daniel, zacharias inspires him “to do more meditation on the word and studying the word, and understanding what this says, not only just the cursory read, but to get down into and understand really what is being said in scripture” and he encourages others to do the same. daniel’s daughters recently bought him a bluetooth speaker and showed him how to stream religious content via smartphone app. as a result, he says, “i think i’ve grown tremendously because of my study time i have now, my listening time.” additional time in old age paired with access to technology are key reasons why daniel has been able to further his religious study. almost half of the older adults who reported that they use technology for religious purposes utilized it to conduct research and deepen their understanding of religious topics outside of formal classes or seminars. when seniors stumble across particularly thorny or especially meaningful passages, apps and internet searches bring them instant guidance. chloe (67, ame) said, “when i’m studying the bible, and i want to delve into something a little deeper, i’ll often go on the internet and i can do some research…get some different opinions on interpretations or even how to pronounce a word, those types of things.” camille, a 66-year-old evangelical, said her smartphone is useful: “i have a lot of bible stuff and i like to do a lot of research.” she even has a bible trivia app to help her gain and retain biblical knowledge. a few of our participants described ways in which the internet helps them stay informed about current events and political causes related to their religious convictions. marilyn (78), a catholic who stands vigil outside of planned parenthood offices, receives several pro-life newsletters in her email. four of our jewish congregants—and a lone episcopalian—mentioned that they regularly use the internet to stay informed about the political situation in israel. herb (78, conservative jewish) became passionate when he spoke about his habit of reading online news about israel, “i read a lot on the internet about israel…the politics of israel, the religious movements in israel...like women are not allowed to pray at the wall. even though the orthodox are a real minority in israel they dominate the political in israel, which is a real source of irritation.” furthermore, five of our episcopal participants—from multiple congregations—are enrolled in the denomination’s four-year education for ministry (efm) program intended to provide lay church members with a theological education. participants noted that the internet provides a quick and easy way to prepare for the seminar or dive deeper into topics that they found intriguing. for example, linda (72, episcopalian) said, “i’ve gone to the internet many times for efm study to look up some specific thing and, you know the internet, you look this up, then you get this whole thing, oh, that looks interesting, that looks interesting.” helen (70, episcopalian) also commented, “i love to just google stuff that i’m interested in finding out about. so, you know, i do that, and that’s interesting. in the education for ministry class if we kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 24 had to read like the book of galatians or something you just look it up online and wikipedia will give you a lovely little summary.” debbie, a retired speech and language therapist who still occasionally substitutes in special education classes, is another efm participant whose story can help illustrate the importance of technology to older adults. even though she was born into a religious family, debbie left religion in her adolescence and returned to the church only after a painful divorce. she attends two sunday services, teaches sunday school, feeds families at a local transition house, and serves as a lay reader. despite this heavy involvement with her church, debbie described herself as “more spiritual than religious” and said, “i’m finding as i get older i’m much more secure with who i am, and it’s okay to be me and a little different than the mainstream.” meditation is central to her religious practice, and she is careful to differentiate it from prayer. she sees prayer as conversational and involving specific requests but notes that when she meditates she is “not asking for anything except for just to be in the presence of the holy spirit.” music is of great importance to debbie, and she stated, “i have some of my very best feelings of closeness with god when i’m listening to meditative music.” debbie finds the music that she listens to while meditating by using the pandora app on her smartphone: “i just plug into that and it gives you this beautiful meditation.” she also pointed out that the research she does online in preparation for her efm seminars often brings new insight and connection to the hymns that she sings in church every week. she explained, “i’m very much into hymns and spiritual music, and so i will go look up stuff like that, and then you see, oh, this [line] came from matthew or this came from whatever and i hadn’t really given that any thought before, you know. so, yeah, i’m making connections there.” when asked more broadly about her religious uses of technology she exclaimed, “there’s so much!” she continued, “i read a lot of richard rohr’s things and i get his weekly newsletter. that is also at the tip of the computer. you just punch a button and there you go.” debbie’s use of rohr’s writings, along with her use of music streaming, point towards an often overlooked benefit technology has for many older adults: the direct facilitation of spiritual or religious experiences. spiritual engagement for participants from catholic or mainline protestant denominations, this religious facilitation took the form of app and website substitutes for traditional prayer books and formal liturgical materials. marilyn (78, catholic) explained, “there’s a morning offering prayer to start the day to dedicate it to god, to dedicate my thoughts, words and actions, everything to god’s glory. it’s on the internet.” convenience was often cited as a benefit over traditional paper versions of these same materials. walter (79), another catholic, elaborated, “both my morning/evening prayers are part of what’s called a liturgy of the hour and i can get that as books. i have four volumes of books that have this, but it turned out it’s more convenient i can get it on the internet so i typically use it on my ipad so i’m using my ipad for my morning and evening prayers.” technology offered participants easy access to spiritually-focused readings and scripture and facilitated the incorporation of these readings into their daily routines. twelve of our senior participants reported that, like debbie, they subscribe to daily or weekly devotional emails sent out by religious institutions or spiritual leaders. sometimes they described these emails as meaningful ways to begin or conclude the day, while other times they were framed as a resource that could be drawn on whenever a moment of respite or reflection was needed. carol (77, catholic) kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 25 receives daily devotionals from her diocesan bishop. chloe (67, ame) receives “positive” daily emails from joel osteen. richard rohr, the theologian mentioned by debbie, was especially popular. charlotte (68, methodist) describes, i’m subscribed to three daily meditations. one is sight psalms which is photographic, very short, and i actually am a contributor to that. and then one called inward/outward, a very short reading every day, and it’s usually a poem of some sort. it’s not biblical. it’s pretty, i would call it, mystical, but that might have too many meanings. and then the one that has really been helpful to me is richard rohr. he has a daily piece that is fairly concise and short. he’s a wonderfully concise writer. the name of rohr’s devotional subscription service—constant contact—is an apt description of what he helps provide for those whom he honorifically calls “elders.” furthermore, one of our participants (jasmine, 75, evangelical) is herself the author of daily devotionals that she publishes on her personal website and distributes via email “to people all over the united states.” another participant from her church mentioned them as being a helpful way to start her day. janet (72, episcopalian) also found helpful reflections on the internet directly from individuals that she knows, “i have a number of contacts on facebook that send either sort of a spiritual thought or a passage from the bible. it doesn't follow liturgy the way the book of common prayer does, but nevertheless there's always something there. so several times a day, i look at things like that and consider how they might apply.” for participants like janet, technology provided a means to engage with others in their social networks about spiritual and religious topics. five of our participants, including debbie, indicated that they use streaming services to access hymns, gospel music, or calming music that they play while praying or meditating. other older adults indicated that technological access to spiritual music provided them with a way of turning ordinary activities into acts of devotion or meditation. daniel (66, methodist) volunteers to sort recycling through his church, which he considers to be a sort of prayer, and uses his phone to listen to christian music as he does so. jasmin (75, evangelical) listens to the messiah while driving and said, “it occurred to me the other day. it keeps me calm while i'm driving. everybody else is running around and acting crazy.” finally, irene (66, baptist) revealed, “well, when i’m writing bills i will turn on hymns.net and just play hymns which is lovely…music is sometimes very, very comforting.” tyrone, a 67 year old former mta bus driver who describes himself as “retired, but working,” provides a helpful illustration of the way in which this sort of technology can facilitate spiritual practices in even the most reluctant of adopters. in his youth, tyrone attended a historically black college for a few years, but never graduated. now, in addition to caring for his ailing wife, tyrone works as an usher at a sports arena (“i get to walk up and down the steps, get my steps in, my exercise”) and as a bus driver for a local senior center (“i take them all to breakfast. i take them to walmart. just take them different places.”). he attends his pentecostal church four times a week and is heavily involved in several ministries. he serves as a deacon, welcomes visitors with the hospitality team, feeds the homeless with the outreach ministry, and teaches children’s church. when questioned about his busy schedule tyrone said, “my job is to be a light.” tyrone is grateful for his job driving the bus at the senior center because he is able to utilize his phone to play gospel music, something he longed for, but was unable to do when he drove city buses: “when i was driving the bus, i always wanted—because people would try to get on and play their other secular music, or worldly music. and i said, ‘man, i sure would love a job that i can play the music that i kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 26 love’ and here i am.” he also takes advantage of the time he spends driving the bus by listening to an audiobook version of the bible on his smart phone: “i have my bible app on my phone and i have my little bluetooth in my ear listening to the thing.” however, tyrone admitted that he was a reluctant adopter. when the researcher points out his impressive utilization of bluetooth headphones and religious apps he responded, “yeah, technology. i didn't like it, but see…” later he added, yeah, you got to do what makes you successful in this walk. just like your career or your skill, you just can't sit down and don't read. you got to stay on top of things. if you don't, you're going to fall behind. i'm constantly listening—like i was out in the backyard, cleaning up this morning, and i had my little box on. just keeping my mind on him. that's the key to victory in this life. you got to stay committed. tyrone thinks that his peers all too often fail to stay committed and continue growing in this way. while he celebrates the wisdom and experience that comes with age, he suggests that older adults sometimes become stagnant and are content to leave learning—and new technology—to the young. as he says, because when you're older, most christians just get comfortable because they have so much knowledge over the years. they don't recognize that you still got to stay busy. you still got to fight, you know? and you still have to allow your mind to expand in the word of god. and they just get settled in tradition, the old ways. but the young people, they're getting exposed to the depthness of god. and then with technology, they have so much that they can see and grasp. tyrone and other participants exhibited attitudes focused on religious and spiritual growth and saw older adulthood as something more than a fight against physical or mental decline. the ways that participants used technology showed that older adulthood can present new opportunities for expanded religious and spiritual growth, as reflected in participants’ use of technology to educate themselves more fully on their religious heritage or beliefs and facilitate deeper spiritual engagement than what they had previously experienced as younger adults. discussion and implications in this research we have explored how older adults use information and communication technologies in their spiritual and religious lives. how widespread is their use? what kinds of icts do they use, and why? contrary to stereotypes of older adults being technophobic, the overwhelming majority of the older adults in our sample, across every denomination, used icts in their everyday lives—particularly to assist in their spiritual and religious devotion. seniors are certainly willing and capable of using technology, especially if given explicit guidance. not only do older adults use technology to compensate for age-related changes, they also use technology to capitalize on new opportunities in later life and purposefully facilitate growth in their religious and spiritual lives. we coded 15 distinct ways that participants were using technology to compensate for physical and emotional challenges (such as decreased mobility, poor eyesight, or social isolation), to capitalize on the increased availability of time to deepen their religious education (via apps or websites), and to directly facilitate spiritual experiences (including emailed devotionals). our findings add to the growing body of research on the relationship between technology and the ever-expanding older population (micera, bonato, and tamura 2008). our findings support previous kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 27 research by loges and jung (2001) that both older and younger populations see the internet as important in their lives, and mitzner et al.’s (2010) study that older adults’ positive attitudes about digital technologies outnumbered their negative attitudes. in highlighting the lived experiences of older adults, our research shows that their technology use is not only a solution to health-related concerns (plaza et al. 2011). instead, the seniors in our study draw on technology as a key part of their religious and spiritual development as well as a means to stay connected with their faith communities. thus, our research also supports bowen’s (2012) observation that the discourse surrounding older adults and technology needs to shift and include the ways in which technology can be used as a tool for better social and emotional well-being as well as a health and medical tool. at the individual level, our findings extend the application of social-psychological theories in gerontology to the realm of older adults’ technology use. for example, selective optimization with compensation (soc) theory (baltes and baltes 1990) accounts for the ways older adults “cope with agerelated losses to manage adaptive (successful) development in later life” (bengtson and deliema 2016, 38). this theory highlights how aging individuals use strategies of selection, optimization, and compensation to maximize increases in resources to minimize the losses they encounter through the aging process. the data in this study illustrate how this theory can apply to older adults’ use of technology for religious and spiritual purposes. older individuals in this study are optimizing use of technology to compensate for age related conditions, such as loss of mobility, and thus allowing them to continue to age successfully (schroots 1996). future research in this area might further examine older adults’ use of technology to cope with changes that would otherwise inhibit their religious and spiritual development. similarly, carstensen’s (1992) theory of socioemotional selectivity (ses) posits that as older adults become increasingly aware of the limited time remaining in their lives, they look to enhance meaningful relationships and affiliations. older adults can adopt technologies and use them to selectively focus and augment their spiritual and belief systems. besides using technology for religious and spiritual purposes, participants in this study mentioned using technology to maintain contact and keep in touch with those important to them—such as “prayer partners” and bible study members. according to ses theory, as individuals age, their interest in material things frequently declines while interests in meaningful relationships increases as they “selectively devote more effort to emotion regulation and bonding with close friends and family than to investing in future relationships and rewards” (bengtson and deliema 2016, 39). our findings support this notion. rather than replacing close relationships or communities, older adults used technology to foster existing bonds that provided them with religious and spiritual support. future research might examine if and how seniors’ use of technology might change even throughout older adulthood. the findings of this study also have important implications for practitioners involved in serving older individuals. clergy have reported that they feel forced to choose between either serving youths and young families or addressing the needs of seniors, especially in regards to incorporating technology into church services (bengtson, endacott, and kang 2017). however, our findings suggest that utilizing technology and serving older adults are not mutually exclusive. energy might be best spent assisting older adults in utilizing their technological devices through educational workshops or intergenerational programs. participants from several of the churches represented in our sample discussed successful programs where youth and young adults teach seniors to use different pieces of technology. one such participant described his church’s “selfie sundays” where millennials are paired with individuals over 50 and teach them to use social media. another participant, ellen (76), reflected upon the importance of a similar program at her ame church: one of the other things that i think is critical—and people may not think it’s a big ministry kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 http://anthro-age.pitt.edu 28 but it is—we have a cell phone ministry that we have it where the young people are teaching the older people how to take selfies, how to use their cell phone...we’re getting them to be more comfortable with technology and i think that helps. these formal programs as well as more informal intergenerational encounters, such as getting help with navigating the internet from a grandchild, show that technology use can foster church communities and connections. in practice, older adults are enthusiastic consumers of technology and should not be overlooked as a formidable potential market segment for technology developers. limitations and areas for future research there are important limitations to this study that should be recognized. the sampling strategy resulted in an unusual group of seniors: older adults who were nominated by pastors, priests, and rabbis and thus who were very much engaged already in spiritual and religious practices. most of the individuals in our sample were older (average age 77) and were also quite educated (16 years) compared to the average for their cohort. moreover, the sample is from just one area, southern california, and results might be different for older adults in regions with differing demographics or sociocultural contexts. such older adults may have different needs than those included in our sample and likely face a different set of barriers to technology use and, consequently, may use technology in different ways. for example, older adults who live in regions with less access to wireless internet or cell service might not own personal technological devices and may consequently use them in different contexts (for example, using computers in public libraries), which may in turn affect how these technologies are used for capitalization or compensation purposes. thus, caution should be exercised when extrapolating the results of this study to other older populations. this study also presents several important areas for future research. first, further research is needed to explore how more diverse groups of older people (including those from other faith traditions and less populated areas), experience the use of icts for religious and spiritual purposes. it is also possible that gender is a component of ict usage and more research is necessary to explore this aspect. second, the nature of older adults’ media literacy in regards to the use of technology for religious and spiritual purposes should be investigated. media literacy has been dubbed the new “digital divide” (müller, sancho, and hernández 2009). though concerns about media literacy often center on young people, particularly adolescents (see flanagin and metzger 2010), older adults may also need to overcome barriers to not only attain access to information, but to interpret and evaluate it skillfully. in light of the plethora of religious and spiritual information available on the internet, understanding how older adults evaluate religious and spiritual information they find online may shed new light into studies of credibility assessment and equip practitioners to help older adults navigate technology for religious and spiritual purposes. acknowledgements this research was supported by grants from the john templeton foundation and the national institute of aging. we are grateful to hannah gruhn-bengtson for her assistance in interviewing, data analysis and editing. we also acknowledge the support of dr. merril silverstein, marjorie cantor distinguished professor of aging studies at syracuse university and principal investigator of the overall project; dr. karen lincoln, associate professor of social work at the university of southern california; and the usc edward r. roybal institute on aging of the suzanne dowark-peck school of social work at usc. we appreciate the consultation and training of dr. summer starling of starling group, inc. in the use of the qualitative analysis software platform maxqda. kang et al. | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.194 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work cscw. doi:10.1145/1180875.1180908. final_keimig chronic living and delayed death in chinese eldercare institutions rose kay keimig author contact:rose.keimig@gmail.com abstract in urban china, demographic shifts, medical interventions, and technological advancements are reshaping how, when, and where elders live and die. within institutions, end-of-life interventions may stave off death, but have little to offer those who are saved but not cured. meanwhile, these end-of-life encounters are unfolding within a larger caregiving landscape that is itself in transition. increased migration, urbanization, women’s employment rates, and access to medical services are radically altering caregiving arrangements. in particular, sharp declines in fertility have sapped family-based caregiving resources and put enormous pressure on medical institutions. although china is just beginning to feel the effects of rapid population aging, demand for end-of-life institutional care has already outstripped supply. the few palliative care wards that exist routinely turn away patients, admitting only those whose end is predictably soon. in the process, dying becomes a diagnosis, complicated by insurance regulations, local bioethics, and limited resources. for those cut off from both curative and palliative care, life itself turns pathological, and they find themselves suspended in a state of “chronic living.” keywords: aging; caregiving; eldercare; end-of-life; dying; china; life course anthropology & aging, vol 41, no 1 (2020), pp. 17-30 issn 2374-2267 (online) doi 10.5195/aa.2020.210 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 17 chronic living and delayed death in chinese eldercare institutions rose kay keimig author contact: rose.keimig@gmail.com “how do i know that delight in life is not a confusion? how do i know that in hating death we are not little ones who have lost our way home?” —zhuangzi the parade of people began filing into building 8 around 2:30pm, shortly after the jade hills nursing home staff passed around afternoon milk. i was one of five squeezed on a long couch in the small common area between the main entrance and the bedrooms. the residents were all bent over steaming metal milk bowls sipping noisily, while i, unable to refuse the insistent generosity of ma li on my right, nibbled a stale biscuit. at first the people walking past seemed to be on a routine visit to a bedridden patient in the dim corner room, but as young mothers carrying toddlers on their hips, businessmen on cell phones, and teenagers in bejeweled tee shirts disappeared into the room, it became clear this was not a normal visit. a man yelled. unfazed, my fellow couch-mates fished for soaked biscuit chunks and strings of congealed milk that had sunk to the bottom of their bowls. after a few short minutes, the visitors left, wearing expressions ranging from anger to impatience to boredom. residents slid empty bowls onto low wooden tables. a group of care workers stretched on blue gloves and entered the corner room while others wheeled a metal table into the open space directly in front of our couch. one care worker emerged from the room carrying a large black garbage bag followed by two more care workers, each barely five feet tall, clutching opposite ends of a faded pink sheet. they shuffled out of the room and heaved their swaying bundle onto the wheeled table with a plop, rattling empty milk bowls. a few residents watched, expressionless, as the gurney bumped around tables and over the uneven floor, its unsecured cargo jouncing unceremoniously to the van waiting outside. in the quiet that followed, i expected some response to the incident, but the only utterances were the usual burps and sighs of a drowsy afternoon. when i asked a resident later how she felt about the death, she replied, “i envy her.” introduction in the beginning, death and decline slithered onto the scene as punishment for wickedness and moral weakness, establishing a separation between god and humans, good and evil. the implications of this narrative have influenced western thought on aging and dying for millennia and continue to shape contemporary bioethics, health initiatives, and global aging models. in social gerontology, there is a recognized tension between conceptions of aging as a lifelong process and old age as a separate, distinct period of life, a tension that informs and is informed by policies and eligibility criteria for age-based services (grenier 2012). on a societal level, chronological age has an assumed significance for dividing the life course into distinct stages while, at the same time, there is a pervasive belief that the “aging self is, ideally, an ageless self” (lamb 2014, 46; marshall and katz 2012). “healthy” aging is “active” and “independent” (who 2016), and the body’s decline is fought, delayed, or avoided in favor of youthful immortality (rowe and kahn 1987; wade 2016). while curative, life-promoting ideals promote positive visions of lifelong potentiality, they also generate dissonance in the face of actual experiences with incurable conditions and failing minds and bodies. in her research in u.s. medical institutions, sharon kaufman (2005) described the “zone of keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 18 indistinction” characteristic of end-of-life medical encounters where diverse understandings and expectations about aging and dying converge with institutional practices that are themselves in constant flux. a “good” death is often at odds with the curative goals of medicine or stymied by limited physical, economic, or human resources. bioethics, medical interventions, and technological advancements work together to defeat aging and delay death, but they offer little guidance for those who are saved but not cured and suddenly thrust into a “gray zone” between life and death (kaufman 2005, 2015). in contemporary urban china, these end-of-life encounters are unfolding within a larger caregiving landscape that is itself in transition. increased migration, urbanization, women’s employment rates, and access to medical services are radically altering caregiving arrangements (broad et al. 2013). sharp declines in fertility have sapped family-based caregiving resources and put enormous pressure on medical institutions (yeoh and huang 2014). although many countries, including china, are just beginning to feel the effects of rapid population aging, demand for end-of-life institutional care has already outstripped supply. the few palliative care wards that exist routinely turn away patients, admitting only those whose end is predictably, certainly, soon. in the process, dying becomes a diagnosis, complicated by insurance regulations, local bioethics, and limited resources. for those cut off from both curative and palliative care, life itself turns pathological, and they find themselves suspended in a state of “chronic living.” as with other chronic illnesses, “chronic living” describes the excess of an otherwise benign condition that becomes pathological only when it crosses the subjective boundary of too much or, more often, too long. life lingers, intractable and incurable. while this condition is not unique to contemporary china, the speed and magnitude of medical advancements and caregiving shifts have made it increasingly visible there. in this article, i examine the ways these end-of-life interventions complicate and compromise both living and dying for today’s institutionalized elders. methodology in order to understand china’s evolving eldercare situation, i conducted ethnographic fieldwork in kunming, china between 2013 and 2015. yale university’s institutional review board approved the research and a local hospital director supervised the project. kunming, with a population of 6.7 million, is the capital of yunnan province in southwestern china. despite its distance from the political and economic centers of the country, yunnan’s temperate climate and rich natural resources make it a top eldercare destination (zhang 2013). during the first phase of the research, from october 2013 through may 2014, i collected data primarily in geriatric and palliative care hospital wards. i lived onsite at a busy city-level hospital and spent nearly every day in the palliative care unit. observations were collected while shadowing doctors and nurses on rounds, during staff meetings, and at palliative care conferences in shanghai and beijing. in the second phase of research, from may to november 2014, i continued to visit the palliative care ward regularly, but shifted my focus from hospitals to residential care facilities. i visited a range of eldercare institutions in the region—high-end and low-end, public and private, urban and rural—for a total of over seventy-five visits to six different facilities. i visited on both weekends and weekdays during visiting hours, which were usually 8am to 8pm. as with the first phase of research, this phase relied heavily on participant observation and open-ended interviews. i conducted formal interviews with thirtythree elders: fifteen men and eighteen women. interviews were recorded with permission. the average age of institutionalized elders was seventy-four years old, and all informants had at least one child. a local keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 19 research assistant helped translate written materials and transcribe interviews. pseudonyms were assigned to participants and institutions. while recorded interviews are the sources of all direct quotes in this article, an estimated 250 hours of participant observation in eldercare facilities provided the foundational data for the research. many chinese elders are wary of signing documents, and some of my closest informants would not or could not participate in formal interviews. nonetheless, through the insights they shared during countless informal interactions, they were still able to contribute to understandings of the everyday experience of living and dying in chinese eldercare institutions. a good death death is one of the few certainties in life. its finality gives existence meaning and form, and shapes the contours of the human experience. it is an inescapable fate yet “irrevocably interwoven” with freedom in life (mbembe 2003). historians, such as philippe aries (1981), have traced past societies’ reactions to death and dying, and psychologists like elisabeth kubler-ross (1969), who developed the “five stages of dying,” continue to influence contemporary experiences and clinical encounters with death. whether feared, tamed, denied, or named, across western sources, death is treated as something deeply meaningful and potentially redemptive (green 2012). in his anthropological study of death and dying, james green attributes this to an “enduring salvational ethos” (2012, 25), which marshall sahlins (1996) observed in christianized cultures sharing the same “peculiar adamic inheritance” (sahlins 1996, 403 quoted in green 2012, 24). despite anthropological accounts demonstrating the relativity of death, there is also an enduring belief that death and life, the body and the spirit, and the dead and the living are separate (lock 2002). however, these epistemological models are not easily applied to the chinese context. classical chinese thought on death and dying, drawn primarily from early confucian and daoist texts, does not emphasize individual salvation or redemptive themes. “based neither on god nor the death of god” (perkins 2015), death is often meaningless, abrupt, and absurd, guided by the same disinterested forces of fate as the weather. chinese philosophies on death also lack the radical life-death dualism found in many western traditions. instead, they stress relationality, reciprocity, equilibrium, and harmony with natural rhythms. death is life’s complement—the states are differentiated, but “a difference is not yet a conflict” (sahlins 1996, 402). rather, death is one half of an unending circle, and the fertile soil from which life emerges. (li 2013; perkins 2015; qin and xia 2015; watson 1988). while complexly interwoven and mutually transformative, daoist, confucian, and buddhist approaches each speak to different facets of death and dying. in line with yin-yang understandings, daoism portrays death and life as the shaded and sunny sides of a mountain, which are not in opposition and cannot be separated. in the zhuangzi, a central daoist text, the sage claims, “whoever knows that life and death, existence and annihilation are all a single body, i will be his friend” (6.4). confucius also saw death and life as intimately connected, but prioritized the practical here-and-now concerns of right living: “if you don't understand what life is, how will you understand death?” (analects, 11.12). the centrality of confucian thought in chinese social life contributes to the observation that chinese people rarely discuss the afterlife or other metaphysical mysteries (guang 2013). however, even within confucianism, death is a concern, but it is approached from the perspective of those still alive, who are expected to maintain proper relationships and continued reciprocity even after death (perkins 2015). buddhism, which has been highly influential in china since the third century, does attend to metaphysical concerns through its teaching of karma and rebirth (desjarlais 2016; guang 2013; li 2013). keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 20 while only 10% of chinese openly affiliate with a religion, and regional, local, and individual religious practices show great diversity (li 2013), the widespread similarity of funeral rites across china in the nineteenth and early twentieth centuries indicate that these shared philosophies have contributed to a standardized chinese “way of death” (watson 1988). prior to 1949, most chinese died and performed funeral rituals at home in order to help ease spirits out of their bodies and into the afterlife (cohen 1988; whyte 1988). after funeral rites were completed, ghosts, ancestral tablets, and tombs continued to have a place in the daily lives of the living since death did not sever bonds of kinship, reciprocity, community, or exchange (cohen 1988). more recently, pressures of urbanization and bureaucratization have encouraged cremation over burial, imbued elaborate funerals with meeting-like efficiency, and moved death out of the home and into institutions, but a “good death” still adheres to the aforementioned values of balance, harmony, and reciprocity (ikels 2004). for the living, this means attending to the proper rites and ceremonies to ensure continous kinship bonds and exchanges between the living and the dead (watson 1988; whyte 1988). for the dead and dying, a good death is a timely one, in which a person has reached their pinnacle of self-cultivation and, surrounded by family, leaves behind a web of social relationships spun so carefully that even death does disrupt its balance (hsu, o’conner and lee 2009). evidence from my thirteen months of ethnographic fieldwork indicated that these ideas about a good death continue to hold true for many contemporary elders and their families today. in formal interviews and casual conversations, participants expressed a deep and enduring need for familial connection and balance regardless of their end-of-life care setting. however, evidence from palliative care wards, nursing homes, and other eldercare settings also revealed that obstacles to achieving a good death, including family disharmony, economic concerns, and disease and disability, are increasing as dying moves out of the home and into institutions. modern dying in urban china the most common popular understanding of ‘the dying process’ is that there will be a relatively long period of stability followed by a short period of physical decline. while this trajectory often characterizes cancers, it does not, in fact, characterize most disease that precedes death. a more common situation is one of long-term disability, with periods of acute symptom exacerbation that may or may not be accompanied by obvious decline. patients, families, and sometimes physicians expect that, given the right medical treatment, patients will survive each exacerbation, and the patient frequently does survive many flare-ups or acute episodes. thus, when death finally occurs, it seems ‘sudden.’ — sharon kaufman …and a time to die sitting in his modest single room at singing meadows nursing home, zhang wei describes the incident six years ago that triggered his heath decline and inspired a recent discussion with nursing home staff about end-of-life directives: just after dinner i was helping [my wife] use the commode when she suddenly collapsed on the bed. i yelled for help and the nurses and doctors rushed in to revive her. the doctor doing cpr asked me, “should i save her?” at that time my mind moved very quickly. what i thought was this: it is useless to try to save her in this situation. but how did i answer the doctor? i said, “save her!” immediately he sent her down to the icu where she was hooked up to a ventilator and other machines. why did i think “don’t save her” and yet tell the doctor “save her!”? i knew trying to save her was futile, but if i didn’t save her, keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 21 if i didn’t say, “save her!” she would have died. my children, my sons and daughters, would not have understood my decision. they could not have possibly understood. they would only demand: “why didn’t you save my mom?!” right? how could i explain myself to them? although zhang wei’s wife survived the incident, she never recovered consciousness and passed away a few days later. now institutionalized and nearing ninety, zhang wei has made clear to family and staff that he does not wish to be “saved” from death: “i have discussed it with my daughter, as well as with the nursing home staff and the doctor. if i fall ill again, it would be best that they don’t say, ‘quick! get him to the hospital!’ if i am admitted to the hospital, i simply cannot afford to pay 10,000rmb ($1660 usd) for 15 days…i am 90 years old. this life is basically finished.” in china, institutions are playing an increasingly larger role in the urban experience of aging and dying. although national surveys show considerable discrepancies in rates of home and institutional deaths, they agree that education level, urban residence, and social position are all strongly correlated with higher rates of institutional death (jing and yuan 2016). in wealthier nations an opposite trend is observed, but the same principle is at work—those with better resources die wherever they can receive the best care (gu et al. 2007). in the chinese context, the demand for institutional care is also being fueled by rising rates of insurance coverage, access to specialized medical services, and bureaucratic pressures (jing and yuan 2016). for example, in 2014 the ministry of public safety issued new end-of-life protocols that mandate signed death certificates for in-home deaths, encouraging some families to transport their imminently dying relatives to hospitals in order to avoid the hassle of paperwork (ibid.). while demand is clearly increasing for institutional end-of-life care services, it is unclear who should or can provide and receive it. china’s official hospice and palliative care institutions are in a comparably early stage of development. the first hospice care institution opened in 1988, and by 2011, there were approximately 200 palliative and hospice care facilities serving an estimated 1% of individuals in need of palliative care in mainland china (li, davis and gamier 2011, 292). due to a lack of nationallevel organization, these services are inconsistently regulated and funded and disproportionately located in larger cities. the imbalances cause such divergent priorities within the practitioner community that one local palliative care doctor, who is a pioneer in the field, described the situation as a “gang war.” at all levels, from policy to training to practice, there is clear disagreement about the goals and scope of palliative care, who should be providing it, and even what it should be called (o’connor, poon, and hsu 2015). despite these inconsistencies, palliative and hospice services are in high demand among patients and families seeking end-of-life care. in the present research, all respondents reported high levels of satisfaction with the care their relatives received while in these units. compared to other hospital wards, palliative care wards tend to be less crowded and exempt from insurance-based inpatient stay limits. furthermore, hospice and palliative care departments are among the few departments where morphine is used regularly and pain control is prioritized (gao 2012). however, providing these services requires first determining that a patient is, in fact, dying, a process complicated by local bioethics, family-based decision making, and taboos discouraging openly speaking about death. in zhang wei’s account above, one can see how the pressures of family-based decision-making converge with available technologies to complicate choice making in the case of sudden decline. his is not a unique case. according to research, only 47% of chinese doctors report ever applying do not resuscitate (dnr) orders, compared to 95% of doctors in europe and hong kong, and more than 70% claim to not feel comfortable discussing limiting life-sustaining therapies with relatives (weng et al. 2011, 659). this is significant because, in line with chinese bioethics, doctors first discuss medical situations with families keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 22 before revealing diagnoses to patients. although policies are changing with regard to informed consent, it is a common practice for physicians to withhold fatal prognoses from patients per the family’s request, as family members fear that speaking about death may cause it to arrive unnaturally soon (bian 2015; fan and li 2004; o’conner, poon and hsu 2015). while it is unclear whether or not avoiding the topic actually staves off death, there is no doubt that it interrupts the dying process. as glaser and strauss (1968) noted in their seminal work, time for dying, one must be recognized as dying in order to be treated as dying. within institutions, death must be “named and expected” (kaufman 2005, 201) before dying can commence. death’s timing is especially complicated with older patients. as new medical technologies extend lifespans, common old age disease trajectories become even harder to predict (kaufman 2015). this also holds true in chinese institutions, and explains why the vast majority of palliative care departments are located within oncology units, and cancer, with its relatively predictable timeline, is almost synonymous with death (dong et al. 2016). yet, as the following exchange with a thirty-year-old palliative care doctor shows, even within these units, “good” care is pro-life: dr. ming: once we had this stroke patient, he was completely unable to take care of himself. after that, he, you could say he was living in extreme suffering. the family members requested to stop all treatment, including tube feeding. so, the patient ultimately, to speak frankly, starved to death. rk: starved to death? dr. ming: we were unwilling to let this situation happen, but the family members said, “if you want to keep feeding him, then take the patient home with you.” this is what they said to us. our nurses and care workers did not have the heart to do it, and they secretly fed him. the family members got very angry, and said, in the end, us doing this just added to his suffering. as a result of these complex institutional processes, even though many chinese elders are frail, declining, and dependent, without a determinable end date or predictable trajectory, few are recognized as “dying.” some, like zhang wei’s wife, die “suddenly” in intensive care units. many others, who have surpassed the inpatient stay limit but are not well enough to return home, spend their final years in longterm care institutions unequipped to provide palliative care. in these institutions, death is ever-present, but few are recognized as dying. in this tenuous, ill-defined space carved out by and for the not-quite-living and the not-quite-dying, many struggle to maintain the familial and social balances necessary for a good death. as one nursing home resident explained, “for those who cannot live and cannot die, life is extremely painful.” chronic living “chronic: of long duration and slow progression. illnesses that are chronic develop slowly over time and do not end. symptoms may be continual or intermittent, but the patient usually has the condition for life.” —gale encyclopedia of medicine one of my closest informants at jade hills nursing home, a private institution with about 300 beds, was wan long. compared to other institutions in kunming, jade hills was average in terms of cost, keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 23 size, and level of care provided, but was older and shabbier than other institutions i visited. it charged a flat fee of about $350 usd per month— comparable to the average pension in the city at the time, and it attracting a larger proportion of high-need residents because of the lower flat fee. wan long often passed the slow afternoon retelling stories of the path that led him to his current state. when did the sickness begin? the first answer that comes to mind is the day he had his stroke, fourteen years ago, at the age of forty-eight. but, as he sifts through layers of memories, wan long traces the symptoms back further. his mother also suffered a stroke. she was in her seventies, and afterwards she lived happily at home in the care of her two sons until she died at eighty-nine. or it could have been when his wife left him and their one-year-old daughter. but no, even after that he was still living well, still healthy, still working. he got into construction at the very beginning of china’s financial boom in the 1980s. he took care of his daughter, gave her everything—probably too much, he admits now with a shake of his head. the money was good, but he worked in the early years of privatization--no pension, no insurance, no security. he took care of his mother, too, but it didn’t feel like a burden: “it was what i was supposed to do. i was her son, right? if i didn’t do it, who would?” his daughter is smart, so smart, but immature. he pulls himself back into the present, shaking his head and wiping the saliva that leaks incessantly from the loose corner of his mouth with a stained handkerchief. it isn’t her fault. he doesn’t blame her. “yes, yes, forget it, just forget it,” xiao mei, a fellow resident, consoles, edging her wheelchair closer after a few minutes of tsk-tsking in the background, “don’t blame her, blame…the government—” “blame this illness!” even wan long is surprised by his angry outburst. he does not shout. or complain. he sits quietly in the shade and naps in his broken wheelchair. he sits quietly in his stinking, unwashed clothes and does not make a fuss even when he has to go to the bathroom and the plastic jug he uses as a makeshift commode is full. once the nursing home director hit wan’s wheelchair with the supply van while making deliveries along the narrow walkway. wan did not say a word, just grunted and glared while a fellow resident helped him straighten his chair. he walks one lap around the courtyard every morning and afternoon, his right arm drawn in like an insect leg and his drop foot rasping in time to the clack of his metal cane. during our visits he lights up as he vividly recounts all-night mahjong games and exotic travels, but when the conversation circles back to his present condition, he has little to say: “nothing changes.” “there is nothing i can do.” “this illness will last until death.” he admits it has gotten much harder to motivate himself, especially now that the headaches have gotten worse. it was not always this bad. the first nursing home was good, but one day his daughter came and told him he had to move. the fees were too high. the government had razed the home he had built, and the money was gone. she packed up his few possessions and they drove away. “i thought we were going home!” he laughs now at his own naiveté, which triggers violent wet coughs and wheezy gasps. when he catches his breath again, he wipes his mouth and continues. he has not seen his daughter in two years. he understands, though. one day she said to him, “dad, when you had your stroke the hospital fees were over 100,000rmb (about $16,600 usd). what could i do?” she left him at jade hills and disappeared. after she stopped paying, the management moved him from his first-floor room to one on the third floor. there are no elevators or ramps at the nursing home, so every morning the nursing assistant maneuvered his wheelchair and two-hundred-pound body down the stairs and every evening she pulled him back up. he stopped reporting the falls to the office once he realized they did not care. one day i arrived at the nursing home to find him with a bandage wrapped around his forehead. he had tipped forward out of his wheelchair while napping and hit his head on the concrete: “i think it would be much keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 24 better if i could die, but that is not my decision.” although the staff had refused to fix his wheelchair’s flat tire for weeks, they did take him to a doctor to patch up his head. the case of wan long is an extreme example of chronic living. like other chronic illnesses, his did not have a clear cause, but all signs indicated that he could expect no relief or improvement. as xiao mei, the resident who had joined our conversation earlier, explained, “there is nothing you can do, nothing you can do, nothing you can do. this is just the situation. the circumstances have led to this place, and you can only obey the circumstances. there is nothing you can do.” pathological pain as a fundamental component of the human condition, pain is present across the life course. however, the physical, cognitive, psychological and social losses associated with late life can be a deep source of suffering for many elders (attig 2015; setterson 2006). in wan long’s case, his personal losses were exacerbated by the larger social and historical context he inhabited. his changing body was inextricably rooted in a world that “ceaselessly assails and beleaguers subjectivity as waves wash round a wreck on the shore” (merleau-ponty 1962, 241). these waves included the privatization and rising costs of health care, life-extending technological advancements, changing family dynamics, and the increasing individualization of risk (yan 2009). the disruptions caused by these larger forces made his end-of-life experiences, both in terms of disease and treatment, painful to a pathological degree (cassell 1991). the subjective nature of pain makes it difficult to measure, but research suggests that nursing home residents report higher levels of pain than their community-dwelling peers (abdulla et al. 2013). however, the typical treatments for pain—opioids and adjuvant drugs like antidepressants—are tightly regulated in chinese hospitals, and virtually nonexistent in nursing home settings (wang 2004). without hope for relief, pain and life merge for many residents. “now everyone says a long life is long suffering,” reported one elder in her eighties. she was relatively healthy, but had witnessed the lingering lives of those around her, including her husband’s, whose dementia was rapidly advancing: “i am not afraid of death. i am only afraid of being unable to die.” however, it is not simply untreated pain that differentiates these cases of chronic living from nonpathological aging in china. pain itself is a symptom of deeper disorder. according to principles of chinese medicine, pathology arises out of disharmony or imbalanced energy. in proper balance, even disability, dependency, pain, and death have a place in the flow of existence. for example, wan long’s mother had also suffered a debilitating stroke, but, by his account, had a positive end-of-life experience and a good death. what differentiated wan long’s case from his mother’s was the series of familial disruptions he experienced and the corresponding dismantling of his family-based safety net. it is this deeper relational disharmony that gives rise to the pathological pain of elders suffering with chronic living. it is difficult to overstate the importance of family bonds in the chinese psyche. the character for filial reverence, xiao (孝), is made up of the symbol for “old” above the symbol for “young.” although this can be interpreted in multiple ways, the two parts are clearly arranged in a relationship of balance (ikels 2004). if the top becomes too heavy or the bottom too weak, the structure will be compromised. increasingly, this is indeed becoming the new image of eldercare in contemporary china: an upside-down pyramid with aging baby boomers at the top and decades of singletons making up the tapering bottom. this imbalance emerges at the intersection of larger social forces and shifting interpersonal relationships, and is a key concern in discussions about eldercare in china. while many focus on the burden this imbalance puts on younger generations, few recognize the disorienting effects it is having on older keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 25 generations. one female nursing home resident in her eighties echoed many of her peers when she asserted, “life is meaningless!” as fertility rates have declined, elders, especially women, have had fewer opportunities to contribute informal labor to the family economy. adult children have also become less dependent on their parents for formal economic support as china’s economy has developed, further eroding elders’ sense of purpose. these factors have also contributed to an ideological shift about intergenerational co-residence (yan 2009). this shift is not simply happening among younger people. the majority of older respondents, both living at home and in nursing homes, expressed that they were not willing to live with their adult children. according to one hospital patient in her seventies, “we older people are accustomed to certain foods and ways of living that are different from younger generations. it is very difficult to bring these into harmony. there is also a generation gap between ways of thinking.” although fewer families are living in intergenerational households, family bonds still persist. for those suffering from chronic living, both the withholding and the demonstration of filial reverence have contributed to their condition. in mr. wang’s case, he suffers now because his daughter has stopped paying and visiting, but the thousands of dollars she did pay for life-saving procedures over the years also contribute greatly to his current state. combined with the rising costs of medical care and caregiving services, elders who suffer from disabling illnesses, and even those who do not, recognize that they are not needed, only needy. as one nursing home resident in her eighties explained, “if i could die now, it would be a relief. no regrets. because now each generation is better off than the one before. seeing they have good lives, good jobs, is great. i don’t worry.” although very few elders i spoke to were living in nursing homes against their will, for many it was exceedingly difficult to maintain the health of relationships that distinguish a good life—and a good death—when physically dislocated from family members. even when the decision was made voluntarily and out of love for one’s family members, it is true that “the most grievous components of human suffering take place in the experience of broken relationships and lost connections to those individuals and contexts that bestow on our lives positive meaning” (wilkinson and kleinman 2016, 9). so, it was for zhang wei, introduced earlier. although he enjoyed keeping up with current events and suffered only minor physical aches and pains, he spoke often about the ache of this separation from family members: “at this [nursing home], what weighs most on my mind? there is just one thing: the absence of family. for people like me, whose minds aren’t yet confused, the biggest lack is family. for example, on saturdays and sundays, kids, grandkids, great-grandkids all come to see you. but they stay for about a half hour and then leave…i never ask them to come. i never make any request like that. but in my heart, the thing i lack most, is family.” despite sharing every meal with hundreds of residents and caregivers, zhang wei felt emotionally isolated. zhang wei was stunningly intelligent, and he feared too much contact with fellow residents would make his brain soft. for zhang wei, and many other institutionalized elders, the physical separation from family members weakened their connections to their social worlds. for the individual, active reciprocal relationships, or guanxi connections, constitute the self, and their disappearance amounts to a social death (kipnis 1997). although weekly visits fulfilled an emotional need, they were not enough to maintain the strong reciprocal bonds necessary for establishing one’s place in the social fabric. as zhang wei’s links to the wider world withered and fell away, his chronic living became chronic dying. he expected to live out the rest of his days in the nursing home, but whether that would be days or years, no one could say. “so now i’m here just, as i like to say, just ‘waiting’,” explained zhang wei, “waiting for what? waiting to die.” resigned to the pain and intractability of their condition of chronic living and chronic dying, many institutionalized elders are nonetheless impatient for a cure: “death hurry up! now is just suffering, death would be better.” keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 26 delayed death in conversations with the adult children of nursing home residents, a main reason cited in their decision to institutionalize was that parents were “safe” there. on the one hand, they meant safe from accidental falls and sudden illnesses, but on the other, they meant safe from themselves. much scholarly attention has been given to the high rates of suicide among chinese elders, which are more than double those found in the us –44% vs. 18%. (wang, chan, and yip 2014, 933). the motivations for elderly suicide range from poverty to family conflict to serious illness, and rural women are especially at risk (fei 2011). institutionalized elders, though they may have similar motivations for self-harm, lacked the means. rooms had bars on the windows, and sleeping pills were locked up. they were supervised at all times. this lack of control, chronic living with no access to a cure, weighed on the minds of many informants. on more than one occasion, elders asked me if i could buy some sleeping pills and sneak them into the institution. suicide and euthanasia were common conversation topics. for example, as i was leaving jade hills one afternoon, i stopped to talk with ma meili, an outgoing resident in her late seventies, who was sitting alone in the shade. “life is meaningless,” she sighed. i asked if she was in pain, but she said no, no pain, but “everything is uncomfortable.” she had no energy and just wished she could die. “it would be so much better if there was euthanasia, just an injection and then you’re done.” life had meaning when she was younger, she explained, but now she can’t do anything. looking out into the overgrown courtyard she cried, “i wish the water in that pond was deeper so i could drown myself in it.” in her work on organ donation in japan, margaret lock (2002) describes the emergence of a biomedically-informed “new death” that is timed and managed. most of the elders in my research had also experienced biomedical interventions, but unlike lock’s comatose patients, my informants were often outside the biomedical sphere as they waited for death, unfit for curative or salvage operations. as ma meili’s story shows, the “new death” they faced was one decidedly unpredictable and unmanageable. ma meili, zhang wei, and wan long all experienced acute pain from being cut off from former social roles and relationships, an “interpersonal social suffering” (kleinman and hall-clifford 2010, 250) characteristic of other chronic illnesses. in ma meili’s and wang long’s cases, suffering stemmed from inhabiting unproductive, consuming bodies in a society geared toward economic dominance, of being toolong in time and too slow to die in an era that put a high value on efficiency and speed. as with zhang wei, these elders experienced social death long before their unmanageable bodies released them (biehl 2005; lock 2002). wang hua, a former schoolteacher, lived at singing meadows with her husband. she was nearing ninety, but her round face was still full and her eyes bright. warm and gregarious, she played piano for the nursing home choir and penned their theme song. although she was glad to bring happiness to others, she admitted she was “very tired.” her husband’s dementia had progressed quickly over the past year, and she spent most of her time keeping an eye on him. her one hope for herself was that she would die quickly, that the phone call to her children would be, “your mom is already gone.” she did not want to linger in the hospital and experience all that comes with a prolonged death. she did not want to be saved from death, wang hua told me, she just wanted someone to hold her hand when it hurt. even relatively healthy residents worried about becoming one of those whose “bodies in time mean far too much” (cohen 1998, 302). one eight-seven-year-old informant, who still lived in his own apartment, candidly told me: “i just wish i could go more quickly. i don’t want to be in pain and suffering. this kind of thinking isn’t like that of religious belief. religions teach that while you are here, think about the next life. i just want a quicker death! ha-ha! a sudden one would be best, but that is not good. for people who keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 27 care about you that is not good.” through death, elders sought to liberate not only themselves, but also their loved ones from the burdens of chronic living. resignation: mei banfa in the face of their intractable conditions, elders’ most common response was resignation. in fact, all those involved in the caregiving situation frequently expressed feelings of resignation. the phrase, mei banfa, which literally translates “there is no way”, has a meaning closer to “there is nothing you can do about it.” for example, when i asked care workers if they found their jobs monotonous or residents if they were used to living at the nursing home, they would frequently answer, “mei banfa.” residents frustrated about their inability to move forward to death or backwards toward life also concluded: “mei banfa.” one nursing home resident summed up the whole nursing home experience as simply a “mei banfa de banfa” or “what you do when there is nothing you can do.” in her recent book resigned activism: living with pollution in rural china, anna lora-wainwright (2017) noted that mei banfa was also the most common response her respondents gave regarding pollution. she saw it as her respondents’ “way to convey their own feelings of powerlessness” and “a means through which they comfort themselves about the limits of their agency” (xxvii). this functions in a similar way in eldercare institutions. even though zhang wei told me “living is a very boring thing,” as with many events in his life, his power to control or change it was limited. conclusion not all nursing home residents suffered from chronic living. some derived great joy from the company of fellow residents and caregivers or busied themselves with games, crafts, and music. others found hope and peace in religious beliefs of heaven or reincarnation. even those who did find themselves suspended between living and dying experienced moments of delight, excitement, and laughter. indeed, ma meili, who often seemed hopelessly hopeless, once surprised me by exclaiming, “what fun this life is! we are constantly learning.” the point of this article is not to create a spectacle of suffering, but rather to portray the full experiences of those whose lives are caught in the eddies of change (kleinman 2010), not out of pity, but out of “respect for great misfortune, for great ugliness, for great failure.” (nietzsche 1977, 378). through the experiences of today’s elders, one can see flows of desire—economic, technological, and individual—moving ever outward and forward, each driven to expansion, to creating better lives for future generations. new possibilities are celebrated and new forms of living realized. today, huge portions of the chinese population can travel freely for work and play, adult children can afford their own homes, and patients can recover from previously incurable diseases. however, this mountain has a dark side as well. demographic changes have transformed the shape of families and increasing life expectancies and rates of chronic illness have extended the period of decline. many who are saved from death but not disability or dependency are left in economic ruin and have to choose from a range of poorly regulated caregiving facilities in which to spend their final days. as a result, growing numbers of elders no longer experience the dying process surrounded by family members. isolated from the primary source of meaning-making and identity-formation, social death occurs long before physical death releases them. as health care practitioners, policy makers, elders, and family members search for new and better ways of extending life, it is necessary to also expand notions of and possibilities for a good death. recognizing and identifying chronic living brings these lives out of the “zone of indistinction” (kaufman keimig | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.210 http://anthro-age.pitt.edu 28 2005) and into serious discussions about quality of life and end-of-life care. for chinese elders in particular, more attention needs to be paid to the role social isolation plays in end-of-life suffering. strategies to maintain meaningful social connections could go a long way in improving quality of life, especially among institutionalized elders. many of the elders i spoke with were adamant in their belief that there should be more public discussions about right-to-die policies in china, and discussions of suffering and death are necessary counterweights to reports of institutional eldercare investments and life-extending technological advancements. out of compassion for our current elders and future selves, our pursuit of life’s creative potential must be balanced with equally brave explorations of aging, dying, and death. references abdulla, aza., nicola adams, margaret bone, alison m. elliott, jean gaffin, derek jones, roger knaggs, denis martin, liz sampson, and pat schofield. 2013. 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"who will care for our parents? changing boundaries of family and public roles in providing care for the aged in urban china." care management journals 8, no. 1: 39. zhuangzi. 2016. translated by robert eno. accessed febuary 2, 2016. https://scholarworks.iu.edu/dspace/bitstream/handle/2022/23427/zhuangzi.pdf?sequence=2&isallowed= y. anthropology & aging quarterly 2013: 34 (1) 18 jonathan skinner social dance for successful aging “you see, the thing is when you retire you don’t have to live the same kind of life you did before. alright, i worked in science all my life, but that doesn’t mean that i can’t change and become a dancer. so it’s a different phase of life. a lot of people they don’t realise that this is the best time of your life.” (bill, sacramento) “they opened a new ice rink in bangor [n. ireland] and my daughters brought me down and said, ‘mum, would you like to go skating?’ and i said, ‘well, i’ve never skated’. but they said, ‘you do roller you did roller skating when you were younger’. it was great then: we had a road to fly down and every hill we went on. well there were no bicycles in those days and not many cars. i could do ballroom dancing so i wanted to see what it was like to do dancing on skates. and i must say i was very impressed and it’s great: flowing and speed! i’ve been doing it for twelve years now. we do rumba, waltz, quickstep, foxtrot, tango. she [ice skating instructor] did want me to compete, but i thought, no, i’d leave it to the younger generation.” (sarah, bangor) a r t i c l e s social dance for successful aging the practice of health, happiness, and social inclusion amongst senior citizens jonathan skinner department of history and anthropology queen’s university belfast introduction bill is sixty-five and has been retired for the past fifteen years. in that time, bill took up social ballroom dancing. he dances two or three times a week around the greater sacramento environs, california, attending the tea dances or social dances in the afternoons, and occasionally the weekly friday or saturday night dance nights when live bands play. healthy, fit and comfortably well-off, bill feels that he is making the most of his retirement. indeed, it is a new lease of life for him. sarah has just celebrated her seventieth birthday in bangor, a seaside resort town outside belfast, northern ireland. since the recent loss of her husband, she has re-entered the local dance world that she was a part of in her teenage and courting years in the 1950s and early 1960s. she started again with the ballroom dancing, added the new salsa dance craze, and is developing her ballroom-on-ice skills that she started in the mid-1990s. this article is about social ballroom dancing amongst senior citizens. it presents the results of a research project exploring social ballroom dancing amongst senior citizens abstract this article presents findings from a qualitative study of social dancing for successful aging amongst senior citizens in three locales: in blackpool (gb), around belfast (ni), and in sacramento (us). social dancers are found to navigate an intense space in society, one of wellbeing accompanied by a beneficial sense of youthfulness. besides such renewal and self-actualisation, findings also attest to the perceived social, psychological and health benefits of social dancing amongst senior citizens. they also articulate three different social dancing practices: social dance as tea dance (sacramento), social dance as practice dance (blackpool), social dance as motility (belfast and environs). keywords: aging, senior citizen, social dance, ballroom, health, nostalgia, leisure 19 anthropology & aging quarterly 2013: 34 (1) jonathan skinner social dance for successful aging in blackpool (england), around belfast (northern ireland), and in sacramento (california) undertaken in 2008. the types of social dance practices found constitute loose ‘models’ that range as follows: daily social practice time on the famous victorian ballroom floor in the blackpool tower; a weekly dance4life programme of dance for senior citizens by a dance studio – the ballroom – in sacramento; and a programme of escorted visits to a church or village hall for social dancing in and around belfast. each of these case studies presents a group of people countering the erosion of social and cultural capital associated with aging as they actively and successfully resist enfeeblement (tulle 2008). as such, this article contributes, then, to the growing ethnography of the body (see turner 1996; waquant 2004; wainwright and turner 2006). research was carried out over 10 months as part of a four year study of social dancing (2004-2008) between belfast and sacramento in which i positioned myself as an ‘observing participant’ rather than participant observer (daniel 1995:21, 22), as an active dancer seeking to understand the meaning of dance by doing it and having it done to me rather than just hearing about it. this embodied fieldwork gave me particular insights and connections with the people i was working with – such as sarah beyond the usual dance connection. dance is non-utilitarian human movement, aesthetic and universal. ‘to dance is human’ states judith hanna (1979); and, indeed, dance may be the ‘mother of cognition’ (sheets-johnstone 1966) as human movements precipitate human thoughts not just in early childhood development. this ‘structured movement system’ (kaeppler 1985) can be analysed within its sociopolitical context (campbell 1988; ranger 1975; skinner 2007; wulff 2007; 1973), and interpreted differently as part of ‘the layered “choreography” underlying lived activity’ (james 2003:91; see also laderman and roseman 1996; cowan 1990; kirtsoglou 2004; román-velázquez 1999; waxer 2002; savigliano 1995; wulff 1998). social ballroom dance, in particular, has its own distinctive history. jonathan marion (2008:20) defines ‘ballroom’ as ‘a formalized style of partnered dancing’, noting that it has both competitive and social aspects to it. whilst the ballroom partner dancing derives in part from fifteenth century french courtly dancing, the modern twentieth and twenty first century ballroom dancing -split between social and competitivefollows national divisions and trends. for example, competitive ballroom dancing typically features standard (or modern) dances such as waltz, tango, viennese waltz, foxtrot and quickstep; and latin dances such as cha cha, samba, rumba, paso doble, and jive. social dancing at ballroom events or in ballrooms or between ballroom dancing competitions can include all the dances above as well as other popular partner dances such as lindy hop, nightclub two step, west coast swing, the hustle, merengue, salsa and argentine tango. indeed, a dance studio will typically teach all of the dances named here, the social as well as the competitive. social ballroom dance events, however, do not have to have regulation or syllabus guidance and can also be found in night-clubs, community centres, church halls and hotels. the ballroom partner dances and locations evolved from dances taught by dancing masters in renaissance european courts to eighteenth century ‘dancing schools’ for deportment and nineteenth century ‘assembly room’ social dances for the leisured class to perform their social skills: take tea, socialize, ‘court’ and, of course, dance (see franks 1963). this report shows that little has in fact changed. in the 1920s, ballroom dancing’s popularity spread to the masses. in britain, popular ‘palais de danse’ were run independently or through chains such as mecca or rank formerly two british multinationals now merged into the rank group and which now concentrate upon bingo and casino gaming, perhaps following their aging clientele. the world war ii years of deprivation, resistance and rationing, and immediately thereafter, are the golden era of the dance halls in britain as dance crazes such as the jitterbug jostled with social ballroom dancing to fill out these cavernous public performance spaces. to give an example, london’s largest venue, the empress hall, catered for some five thousand dancers. victor silvester a ballroom dancing pioneer and champion of the 1920s – rode this modern capitalist bandwagon (hall 1991) with a franchise of over twenty dance studios, and the harnessing of new communication technologies with a bbc dance show (the dancing club 1941-1958) and over 75 million record sales between 1930 and 1980 (silvester 1977). in the us, moses teichmann, a young austro-hungarian immigrant draftsman repackaged himself as arthur murray, an entrepreneur with the idea of mail order ‘dance footsteps’ which by the fifties had grown into a franchise of 3,500 dance studios (now currently 225 [anon. 2008a]) and a hit us television learn-to-dance programme (the arthur murray party). this is another example of twentieth century globalization and transnationalism as cosmopolitans at ease in a new world order (wallerstein 1990; see also hannerz 1996) harness the new communication technologies and emerging mediascapes and finanscapes (appadurai 1990) to their own ends. these cases also show how dance trends and flows are tied to social change as well as economic change. cressey anthropology & aging quarterly 2013: 34 (1) 20 jonathan skinner social dance for successful aging jonathan skinner social dance for successful aging (1968), for example, studied the rise of the ‘dime-a-dance’ taxi-dance hall in chicago in the 1920s, describing them as a consequence of urbanization, the commercialization of recreation, a decline in moral standards, and the growth in immigration levels with a young male social grouping wanting to pay for entertainment with a member of the opposite sex. sociologically, he saw them as an expression of the anomie of large modern city life. more recently, thomas with cooper (2002a; 2002b) have described this urban phenomenon less critically. in a study of older ‘social’ dancers in south-east london and essex, thomas (2003a: 210; see also 2003b; 2004) refers to the social dancing as an opportunity for senior citizens to experience a “strong sense of communitas,” coming together, sharing a common interest, perceiving a common history, moving together with an embodied inter-subjectivity. these observations are reiterated in my more recent study of social dancing amongst senior citizens in three very different locations. three cases of social dancing in the following sections, i present findings from a study of senior social dance in blackpool, in belfast and around northern ireland, and sacramento. rather than compare locations, this report is an examination of different cases of senior social dance. it challenges the stereotype of the actively retiring body and confirms the beneficial effects of social dance amongst senior citizens. the research is in very different locations, with dance organizers, dance teachers, and dancers themselves with variable levels of dance knowledge and mobility. it triangulates on the position of the social dancer via a selection of qualitative mixed-methods (interview, observation-participation, questionnaire). 1. blackpool, england – social dancing as ‘serious leisure’ for this leg of the research, i spent a week in the ballroom in the blackpool tower, dancing, interviewing, observing, and talking with the senior social dancers. blackpool is the mecca of ballroom dancing. it is where the british national dance championships, and the blackpool dance festival are held. typically the adult ballroom dance events take place in the empress ballroom in the winter gardens, a cavernous victorian ballroom which can hold up to three thousand people. the british public, however, will be more familiar with the blackpool tower ballroom from regular come dancing tv broadcasts. it is the blackpool tower with its built-in circus, aquarium, amusement rides and ballroom where you find regular social dancing taking place. there, in the middle of this mass leisure centre structure, is a large ballroom with a capacity of 1,900 people with victorian-like paintings and ceiling decorations and a world-renowned wurlitzer organ. it is a place dating back to 1894 and now billed as ‘the ballroom experience’ where tourists and locals can visit, dance to the organ or circus band, and take tea and cakes. during a winter season week at blackpool, i was able to interview staff, visitors and dancers at the blackpool tower ballroom. the dancing was genteel and proficient but also ‘serious leisure’ (stebbins 2007) for social dancers who train and practice their dancing skills and used the blackpool floor to enjoy the social dancing environment, the live music and organ, their fellow dancers and transient audience. despite the constant movement in and about the room between 10am and 11pm, it had a relaxed atmosphere and a feeling of timeless continuity about it. chris hopkins, one of the ballroom organists, noted that it was only in a new era from 1980 that all-day dancing had been introduced. a veteran organist, chris ‘reads’ the audience and the dancers and tries to tune into their tastes whether ballroom, latin or sequence dancing. during the summer high season, a resident band plays to the visitors. during the winter low season, the organist plays with occasional breaks from the circus band as they move from the circus to the ballroom to play a set. the social dancers appreciate the live music, responding to it and following it just as much as the musician is responding to and following the dancers. román-velázquez (1999) found similar emergent relationships between dancers and musicians in social salsa clubs in london. the social dancing takes on a party atmosphere during the weekends when the retired dancers are joined by the dancers who are at work during the week. then, over the weekend, the social dancers swell from the week-day numbers of between two and thirty to several hundred dancers all dancing and socializing. these reappearances gave it “a cruise ship feel” for hopkins who would talk to them from the stage. the social dance manager in charge of the ballroom also had favourite couples: a “gentleman who’s 96 and his 87-year-old wife” who can only walk with the assistance of sticks, but can dance around the ballroom as soon as the music starts playing. manager: i was shopping one day and that elderly couple – you know in their nineties came walking towards me, both of them with a stick. and i looked and went, 21 anthropology & aging quarterly 2013: 34 (1) jonathan skinner social dance for successful aging “oh it’s you, i recognize from the dancing!” and she said, “oh hello, you work there don’t you?” and i said, “well what’s the sticks for?” “oh we have to walk with a stick in the streets.” i have never seen them walk in here with a stick. all of them are like that even if it’s a bad day sometimes he does bring the stick in. but when he’s on that floor you would never believe that’s he’s a gentleman that has to walk with a stick. so, it’s amazing … and i’m sure a lot of it is mental: these steps, they learn them parrot fashion but you have to have the mental capacity to know that. and it is actually quite physical. he doesn’t dance with a stick. and i’m sure it keeps them going. here, social dancing contributes to the longevity of the dancers, giving them something to enjoy and focus upon to live for. it quite literally fires off the endorphins and takes away the aches, pains and disabilities associated with old age. it is only when the music is over and the moving connection with one’s partner subsides that the arthritis and rheumatism return to haunt the social dancers. i interviewed approximately a dozen dance couples, individuals and groups. in all cases, bar two, i found the employees’ words and sentiments echoed and reiterated. the dancers were all retired and committed to their ballroom dancing. one couple had spent their retirement money buying a flat near to the ballroom so that they could enjoy the social dancing. another couple traveled from london once a month for a weekend of dancing there, and the others seemed to travel within an hour and a half’s driving distance. all attested to the benefits of the dancing whether physical health (weight management, blood pressure, posture, cardiovascular health and suppleness/ mobility) or mental health (social contact, alertness). one couple from huddersfield danced three times a week and spend the weekend visiting the ballroom at blackpool. they have been dancing ballroom for more than fifty years – thirty of those years together as a social dancing couple. in cases such as this, there is a strong togetherness and familiarity in their joint hobby. also, there is nostalgia for the dancer’s past in the sense that they and others were returning to an earlier time, a time of possibilities and a life to lead. this was, especially in the 1950s ballroom dancing and dance hall context, a time when the dancers were courting, looking for a partner to marry and raise a family with. in other words, the ballroom had been a space and activity of potential, possibility and uncertainty, whereas now it was a space for memory, nostalgia and comfort. the social dancers perceived themselves to be “a community with similar interests”: those proactive against the debilitations of old age, fitting in with the ballroom dance scene and knowledgeable about their hobby whether new or not. mary likes to come out dancing at least once a week and to stay in touch with “the personalities on the floor” and to heed her mother’s words: “don’t be a wallflower”. jenny “felt like a lemon” at her twenty-fifth wedding anniversary, sitting watching all the dancing, not knowing how to join in. for jackie, it was watching the dancing on a holiday cruise in the mediterranean that started her interest in ballroom dancing. she and her husband have now been social dancing ballroom for thirteen years. both pairs of dancers enjoy feeling “elegant” in the “nice” surroundings. they have more time for their hobbies now that their children have left home for university, and they wanted an activity that they could do together. currently, dancing suits their lifestyle and life-course. jenny’s husband has prepared for his retirement by carefully phasing down his hours driving a taxi, slowly replacing them with more golf, swimming, choir and dancing. whereas he is less enthusiastic about the dancing than jenny, he is glad that they are doing a very affordable activity: “dancing is fair cheaper than drinking as a hobby,” he declared. he also preferred it for its sociability: it’s one of those social things, dancing. it brings people together and they start talking. you can sit in a pub and just talk with each other but no one speaks to you. then you go into a dancehall and you’re talking to people and dancing and making eye contact. another couple danced for “emotional pleasure” juggling their part-time business shifts so that they could dance together in the middle of the week – “the high-point of the week for us; it got us through it all.” the dancing is a constant in their changing lives. it is their comfort zone that they have been familiar with for decades. in salsa, i have argued for a ‘salsa second skin’ as dancers use the dancing to relocate easily in a modern mobile society (skinner 2007:498). this concept, this physical knowledge, ‘decontextualised’ according to hannerz (1992:257) is not new, nor is it a symptom of a ‘disembedded’ malaise about society as giddens (1991) would lead us to believe. these social dancers have danced through the generations and are intimately grounded with their localities and with their dance compatriots. they jealousy guard their ballroom space at blackpool. children were only briefly tolerated, and were often encouraged to do a hokey-cokey on the dancefloor in the hope that afterwards they would leave. interviews suggested that the social dancing is rooted in the history of the dance, the dance hall, and their lives: js: can i ask, you’ve been at it a while, has it changed over the years? jonathan skinner social dance for successful aging anthropology & aging quarterly 2013: 34 (1) 22 jonathan skinner social dance for successful aging jonathan skinner social dance for successful aging dancer 2: well we have danced to victor silvester music. dancer 1: it’s the speed of the dancing that’s changed. dancer 1: yeah the tempo has changed. victor silvester: he’s very slow where it’s a little bit quicker now. the nostalgia for the dancing and the dancers’ youth was apparent whether the dancers were in high-spirits or even depressed and lonely. a number of dancers were dealing with bereavement on and around the dance floor. they were revisiting the places where they danced with husbands of wives, reliving memories, or breaking the boredom and monotony of old age with a trip to the ballroom. res: when you get to my age, all you’ve got to think about really are the good times and there aren’t many good times you can see in the future. life gets boring when you get older. what are we going to do? like at your age, whatever you’re going to do at your age do it now. you just get up in the morning and just go from one day to the next. in this interview, the dancer, a lone man, was returning to his lost partner’s love for the dance. he watched and relived and replayed memories rather than make new ones. there was a poignancy in his viewing the social dancing, all of the serious leisure taking place around us. 2. belfast, northern ireland – social dancing “for the craic” if the social dancing found in the blackpool tower was one of serious social dancing, part practice for other occasions, then the majority of examples of social dancing in northern ireland follow a more self-entertaining model of social dancing “for the craic.” whilst this study does not claim to be all-comprehensive, it has looked at social dancing amongst senior citizens around northern ireland: in belfast, bangor, hilltown, aldergrove, lurgan and banbridge, a range of dance and performance events and practices where i have used a triangulation of research methods from participant to observer, interviewer and questionnaire sampler. key evenings studied have been public classes and social nights, social dancing between ballroom competitions, and charity and community social service provision with a key reminiscence through dance programme supported through a help the aged grant and facilitated by senior citizen ms philomena gallagher. social dancing in northern ireland has a particular social history and context to it given the history, scars and social traumas of ‘the troubles’ (the ethnopolitical conflict over northern ireland’s constitutional status that manifested itself in violence between the late 1960s and the late 1990s between broadly protestant unionists wanting ni to remain a part of the uk, and catholic nationalists seeking a united ireland). music and marching have, in the past as well as the present, been used as markers to distinguish peoples and to mark out territories (jarman 1997; bryan 2000). ballroom dance – unlike irish folk dance however, has always been an opportunity to bring people together; that is when they are able to (one participant who grew up during the troubles noted that she could not cross town to get to dances [see lysaght 1995]) or allowed to (the 1935 dancehall act banned un-licenced dancing in the republic of ireland and, even recently, former first minister for northern ireland the reverend ian paisley denounced dance as ‘an occasion of sin’ [wulff 2003; 2008]). social ballroom dancing in northern ireland has been shaped and encouraged by an actively aging well programme (2002-2007) that was run between age concern northern ireland and the health promotion agency for northern ireland. this was an initiative to put in place 6-week physical activity introductions for older people ranging from salsa to ballroom dancing, tai chi to walking and swimming (beattie and greer 2006). over sixty community and older groups were supported throughout northern ireland, many of which are still very active. i attended and participated in a sample of the ‘reminiscence through dance’ events. this community development programme about inclusive and successful aging was rolled out across northern ireland, but has a particularly strong base of support around craigavon and banbridge. there, social dancing features in the craigavon and banbridge health and social services trust programme of activities. this means that independent living senior citizens and those needing transport can be catered to. events such as social dances are arranged in the community and parish halls and can range in size from small groups of 30-40 (see figure 1) with a hired dj, to 300+ dancers with a live band and featured artists. for the ‘reminiscence through dance’ programme, facilitated by staff over fifty years old and so accepted by the attendees, band music by the likes of victor silvester was played and a microphone was passed around the room for the participants to describe what they remembered from their dancing youth and from the music. this then prompted dancing in those able to dance with those unable to dance 23 anthropology & aging quarterly 2013: 34 (1) jonathan skinner social dance for successful aging joining in by clapping, singing and tapping their feet as they sat and watched. ms gallagher commented upon the programme as follows: it’s a way of educating them and enjoy starting to take care, better care of yourself, as well as keep physically active but most importantly keep socially active, and one of the ways that they love doing that is through dancing because this would have been the culture. the senior citizens are aware of the physical benefits of dance, less so the social and mental. the companionship with peers is important. the getting ready for a dance reminds them of when they would have dressed up for ‘steppin’ out’ dancing in the 1960s to big marquees in the countryside which would have held several hundred dancers dancing social waltz and irish ceilidh dancing to traveling irish showbands. in many respects the dancing on offer to senior citizens here followed a community care model of church, charity and state provision as opposed to the private serious leisure practice found in blackpool. it too is based upon nostalgia, but nostalgia for a fun past. dancing in these social dancing moments takes the dancers back in time. again, ms gallagher notes: it’s such a great feel-good factor [yeah] and they will just say, “we felt alive”, “we felt young again”, “we felt excited”, “we felt we could take on the world”, and that was all through dance. lewis erenberg (1998) coins the term ‘swingin’ the dream’ when describing the creative transition from jazz to big band swing in the 1930s depression era of postprohibition united states. this movement and the showband movement in northern ireland and eire of the 1950s and 1960s is when dancing became a part of working class and youth culture, occasions when post-world war economic, social and sectarian (religious or colour) differences could be subordinated for the ‘ephebism’ of the dance (gottschild 2000:14). sarah’s experiences of growing up in northern ireland put her at the heart of this leisure explosion. she grew up in a liberal mixed catholic family from the upper falls road, encouraged by her parents to dance as they did. as she recalls, “my mother always thought that it would help me in my life and bring me ... me confidence to be with people and to be able to communicate with people and give them confidence too.” after a day working in a shirt factory, sarah’s evenings were “exhilarating, dancing the night away! […] happy memories!” more poignantly, sarah is now dancing approximately three nights a week with a new, younger crowd of friends, maintaining the routine of life she promised to her dying husband four years ago. she has lost weight from her new-found dancing (“it keeps your body in good repair”), and is experimenting and playing with her balance and weight with the dancing on ice where edges are so critical. she feels uplifted and ”invigorated” from the dancing and meeting new people, and her heart is relaxed and strong from the waltzing in time with the music (cf. belardinelli et al. 2008). finally, sarah attributed her dancing to keeping her safe and not just sound; the dancing made her a more tolerant and cosmopolitan individual. it kept her out of the troubles: well i think that’s why i never was involved with the troubles because the dancing was a mixture of everybody. they come from the shankill road and the falls road. and nobody would ask you what you were or who you were. we just loved dancing full stop. and i had friends ... actually i danced with men, partners that come from the shankill road but we never had any problems like. if you like dancing, you go dancing. you’re not ... it doesn’t matter what people are or who they are really. 3. sacramento, usa ‘dance4life’ social dancing sacramento, california, is the legislative capital of the wealthiest state in the united states. it has a population of approximately 2 million if one includes the metropolitan jonathan skinner social dance for successful aging figure 1 ‘reminiscence through dance’ programme, lurgan – northern ireland (photo by author 2008) anthropology & aging quarterly 2013: 34 (1) 24 jonathan skinner social dance for successful aging jonathan skinner social dance for successful aging districts, and it has expanded some 10-15% since 1990 with in-migration from asia, latin america, the former soviet republics, and considerable resettlement from los angeles and san francisco (anon. 2008b). it is the most integrated and diverse city in the united states (stodghill and bower 2002). this is evinced in the composition of the population: in the city precinct of 400,000 residents, a 2000 census (areaconnect 2000) estimated a population breakdown of 20% latino (88,000 people) and 40% white (165,000 people) with 63,000 african american and 68,000 asian. eleven percent of the population is over 65 years of age. furthermore, whereas belfast has the one main dance studio that has survived the troubles, sacramento has five or six key dance studios, some of which have been in existence since the 1930s. there is, then, more of a tradition to dance and to attend dance studios and dance nights about sacramento, and an affluence to be able to afford to. there are dance programmes of visiting professional teachers teaching the elderly in residential homes; private dances put on for the retired and semi-assisted living communities; and a public dance programme – dance4life, organized bi-weekly in the ballroom of sacramento, sacramento’s largest dance studio at 3,750 square ft, a studio founded in 1996 and supporting some 17 professional teachers. this studio caters to most forms of dance ranging from social hustle and west coast swing to competitive ballroom, argentine tango, zumba fitness (latin dance aerobics), and on tuesday and thursday afternoons it has a popular social ballroom dance for “seniors 55 plus.” james is one of the ballroom organizers and describes the afternoons as “popular, very social times.” they begin with 30 minutes of dance music that acts as a warm up session. this is followed by a short ballroom lesson for another 30 minutes, and then two hours of non-stop ballroom dancing music. attendance is between 30 and 80 people for the afternoons, with over a hundred coming in for the party dance nights on the weekends that are for all ages. the progamme has been running for 12 years and has been deliberately modeled on the tea dance, with refreshments and cake freely available at all times. it has become a regular meeting place, drawing retired dancers from a sixty-mile radius. the clientele is of a similar age span as those dancing in blackpool: the ages range from as young as 55 up to 95. we have people in their late 70s who are very avid and capable dancers. that couple just passing us, they are in their 80s and they have been dancing together for 50 years. it is wonderful exercise for them. they recognise that and they come to be able to socialise as well as practise their dance. it is tremendous exercise and improves their balance, their physical abilities. at the start of this article we heard from bill, a dancer at the ballroom of sacramento. bill is a scientist who took early retirement when he was fifty. the last fifteen years of his retirement have been “the most wonderful fifteen years” in his life. bill’s retirement has enabled him to change his life and to take on the identity of a dancer. he dances in the evenings as well as the afternoons, and finds his thirst for dancing unquenchable: bill: so it’s a different phase of life. a lot of people they don’t realise that this is the best time of your life because you have more from your life, if you have a little bit of pension left, because you get some money so you don’t have to worry about money. you don’t have to worry about competing with anyone. js: how does the dancing make you feel? bill: oh absolutely wonderful. there is nothing in the world like it to me. when you get the right partner that can move with the music you do and synchronise it’s the highest high that you can get! it’s almost like on drugs, almost. but even better. it’s amazing! really great. i come here at 7 o’clock, i leave at 10/11. bill also reflects upon the other dancers around him and how the dancing has been a new – and in many cases improved – lease of life for them bill: the people that you see in here, and they started two to four years ago, most of them they could barely move with the music, they couldn’t dance. they were not … i would say they were not even healthy, they were very timid. but now a few years later they’ve been taking lessons, they move around, they talk to people, they ask you to dance. the social dancing makes the dancers more selfconfident, more agile and mobile, more healthy and more happy. bill’s friend penny has been dancing at the ballroom since the inception of dance4life twelve years ago, and has been social dancing around sacramento for twenty-seven years. she likes to feel herself moving and being moved. it keeps her young and is a part of her weekly timetable of activities: she only dances four times a week now since a knee operation curtailed her daily dancing. now in her seventies, penny has used her dance hobby to transition into retirement. and it continues to help her: “it’s good for your heart and your lungs and your muscles. i don’t know of anything it doesn’t help, even your outlook on life because you see people and see how other people are.” jessica has gone even further and has used her retirement to change employment as “a computer programmer of twenty-five years sitting” to that of trainee 25 anthropology & aging quarterly 2013: 34 (1) jonathan skinner social dance for successful aging dance instructress teaching in a converted room at home and practising, training and recruiting students at the weekly tea dances. now sixty, and dancing since 2000, jessica felt that she burnt out from the demands of her programming job, but that she could never feel the same way about her dancing: my husband and i started dancing in 2000 and we became really addicted to it: i love it. i absolutely love it. we practised every day and then about a year and a half ago i decided to become a dance instructor. it’s very good exercise and as a teacher i also had to learn to lead and i really appreciate what the men have to do because they really have to use their brains. it’s not what step am i doing, but where how does that go, where does the lady go, how do i get her to go there, how do i make sure i don’t run into somebody else. they have to think a lot. the lady’s good, she just has to follow. but she should know. for jessica, penny, bill and many of the other dancers at the dance4life afternoons, they have never been more active, more healthy and more alert. other dancers came for related reasons: the transition into retirement; the physical connection with another person; “an afternoon not wandering around the mall”; a practical form of relaxation and exercise; or to entertain new girlfriends, some of whom could not speak english but could join in by dancing instead. there were two regular characters at the sacramento ballroom dance4life dance afternoons, a retired racehorse jockey and a retired us marine. frankie trained sea biscuit and other horses in the 1940s before getting injured and retiring. now eighty-eight years old and still a ladies man, he dances twice a week to get rid of his arthritis (“i’ve got arthritis, but when i’m dancing, there’s no arthritis pain. it goes away completely”). he is practising for a dance holiday cruise up the west coast to alaska with his new girlfriend. jacob is nicknamed ‘the road runner’ for his speed around the ballroom. he is eighty-four and has been social dancing ballroom for the past 71 years. as a young marine fighting in the pacific during world war two, jacob used his dance skills to get guest passes off base so that the officers’ wives could have a man lead them in their dancing. he met his wife during the war and has been dancing with his “irish feather” ever since. dancing is their self-medication. they are dancing with each other for approximately six hours a week: they try to be on their feet for six hours a day doing weight bearing activities to maintain muscle density; moreover, jacob’s wife has parkinson’s disease and on dance-days jacob loads her up with pro-enzymes to stop her shakes. they find that there is more space and it is safer dancing at the ballroom. there is a dance etiquette and people are careful not to bump into each other, so they are unlikely to injure themselves or fall over. they are able to pace themselves and are even able to use the next-dance signs to work out which dances to sit out on (see figure 2). andy k., the dance programme co-ordinator, has been running the dance programme for the last three years. he sees it as “a sort of low impact aerobics for seniors.” in other words, the dance4life programme targets dance as exercise for the actively retired. the programme started as a tea dance but with a schedule and a lesson, it has become a bi-weekly dance exercise session with tea and cake supplied (including free day-old bread supplied by a ninety-two year old baker and social dancer). because it is an indoor activity, the dancers are not affected by the vagaries of the weather or by the insecurities of the shopping mall. the dancers are “having a good time and have people of their own age to talk to.” finally, andy pointed out – and reiterated the point from other interviews – that the social dancing was especially good at helping offset alzheimer’s disease: jonathan skinner social dance for successful aging figure 2 ‘dance4life’ programme at the sacramento ballroom – sacramento, usa (photo by author 2008) anthropology & aging quarterly 2013: 34 (1) 26 jonathan skinner social dance for successful aging jonathan skinner social dance for successful aging andy: it helps with alzheimer’s disease because it makes you think. especially for the men. because, as they’re men, you have to lead the lady and at the same time you have to basically dance in two directions, you have to dance in the present and the future and that keeps your mind going and it forces you to think. in these three cases of social ballroom amongst senior citizens, dancers come together in a variety of fashions, connecting – mostly with their life partners – for several hours of exercise, enjoyment and practice. at each of these dances, cakes, sandwiches and tea are provided. in the blackpool ballroom, dancers are able to practice their moves and routines on a quality dance floor. there is more socializing on the dance floor in the northern ireland case studies with party dances such as the conga. there is a strong group feel at the dance4life events that begin with dance lessons and cater for bringing on a range of dancers. there is more switching of dance partners there too, though the dancing was the most conventional with no same sex dancing visible (male to male same sex dancing was apparent in blackpool, and female to female dancing was commonplace in northern ireland – largely due to the sex imbalance with a higher male mortality rate than female). except for the blackpool dancing, the social dance events all had a localness to them with the hustle and west coast swing included in the dance programme in sacramento, and some ceilidh set dances in the northern ireland dance programme. dance in-tense whether performing, practicing, or dancing for fun, the senior citizens in blackpool, sacramento and around northern ireland attest to the benefits of social ballroom. the dancing gives them an agility and nimbleness that is both physical and mental. it gives the dancers whether new to the dancing like jessica or a dance veteran like jacob – an enthusiasm for living, a happiness and sense of wellbeing, and releases unrealized or previously dormant levels of motility. it creates communitas. it makes people feel young again, in touch with others for sarah, or even renewed as in jessica’s case. it staves off illness, and even counteracts decline. medical and health studies attest to the qualitative findings presented in this article: dance augments mental, emotional and physical well being and counteracts social isolation (corbin and metal-corbin 1997; young and dinan 1999); the mental challenges of dance decreases dementia (verghese et al. 2003); dance is restorative and recuperative in its marshalling of levels of concentration and release and dissipation of accumulations of energy (lagan 1986); and dance fosters inclusion, understanding, acceptance and tolerance. in fact, lima and vieira (2007:140) conclude their study of ballroom dance as therapy amongst the elderly in brazil by suggesting that through partnered social dance, “the body may change from being a source of oppression to a source of freedom.” one particularly interesting finding from this comparison of social ballroom dancers in blackpool and sacramento, and around belfast, has been the role tense plays in the social dancing, and how the past, the present, and the future all feature in the dance afternoons. nostalgia for ‘days gone by,’ as well as ‘bygone days’, is evident in all three tea dance afternoons. it is in the blackpool venue, the live organ music, reliving dancehall nights from the 1950s in belfast, as well as those moments of pleasure grasped during world war two amongst the sacramento dancers. moreover, in social ballroom dancing, the dancers are rekindling body memories of former movements and intimacies. “dancing precipitates an incredible longing. to recover the pleasure in the imagining and remembering, the connecting again with my limbs, my breath, my body is to ignite desire,” recalls gotfrit (1988:123) during her participatory study in discos of women’s nights out. this is a form of nostalgia not just for the authentic, or for the real of an organic sense of community. it is a sense of nostalgia for one’s former self. gotfrit felt this pull, the “pleasures of memory” in her body, her locating of her self by “interfacing” with others through the dance. this was all triggered in her as soon as she heard the first bars of music and felt a wooden floor beneath her dancing shoes. these nostalgia strings are played upon expressly by the new compilation of victor silvester (2001) tracks traded under the evocative title “you danced to these bands.” th ese senior social dancers are not dancing retrospective mental and physical memories, repeating themselves from their earlier years, replaying poignant memories with the mind and the body. gotfrit (1988:129) claims that the dance floor is where “desire and pleasure are courted and orchestrated,” where its public regulation can be relaxed, especially for women. furthermore, she adds that it is on the dance floor that one experiences “the preamble to other pleasures of the body, in the forms of flirtation, romance, and sex” (126). my experiences participating and observing dancing amongst senior citizens suggest to me that it is generally less predatory than gotfrit’s reported dance environment. the dancers i worked with were either there as couples, or were there for the entertainment and community than finding a new life partner. as such, 27 anthropology & aging quarterly 2013: 34 (1) jonathan skinner social dance for successful aging for all the nostalgia that attracted them to the dance events, and their memories of previous dance nights and dance partners, they are very much dancing in the present. they are concentrating and their bodies are flowing anticlockwise around the dance floor in the “here and now” of the dancing. the stimuli of the music, the ambience, the people brought about their responses. the immediacy of dancing, rather than the prelude to the dancing or the tea or return home after the dancing, resulted in the feelings of happiness, the sudden absence of aches and pains, the release of endorphins, the loss of self-consciousness, and the sudden motility realised. the dancers are also dancing for the future in several senses of the word. the leaders are dancing their moves, leading their partners, and leading into the future as moves fill space ahead of them both physically and temporally. the leader has to think ahead and predict where moves will take the social dancing couple, what will best show them off, how to avoid other couples in their anticlockwise rotation around the dance floor. furthermore, in terms of a future, the dancers are acting out a fantasy of the imagination. they are playing a ‘fred and ginger’ in a new era, creating and dancing-out their proto-narratives. appadurai (1996:3, author’s emphasis) describes “the work of the imagination as a constitutive feature of modern subjectivity.” he argues that we live in a postmodern condition wherein we can realize our fantasies and are no longer curtailed by class, feudalism or slavery. on the dance floor, these twenty-first century social dancers have been able to develop perhaps dormant alter egos, to have motility realized, to become new subjects such as in the case of the new dance instructor jessica, or the new dance addict bill. whether or not there was a disconnect in one’s “body-self relationship” a break between ‘storied bodies and storied selves’ (sparkes 1999:26), between lived body and self and imagined body and self before dancing, or during the period when dancing lapsed in one’s life as with sarah social dancing in ballrooms and community centres is a performance of self-actualisation. renewal can be seen on and around the dance floor in blackpool, around belfast, and across sacramento. in sum, this leisure engagement makes the “youngold” category of senior citizen and can be considered “an egalitarian [people’s] version of the high life as they come together for social dancing” (walsh 1993:118). brown et al. (2008:91) conclude their study of carolina shag dancing amongst the elderly on similar lines to mine: that meaningfulness derived from social dancing leads to a continued engagement with life past, present, and future and holds the “promise for successful aging.” this article has sought to bring social dancing “out of the dark” (ward 1993:29). the study of social dancing amongst senior citizens has hardly been a study of dancing by twilight; it has been one of altered premises, shattered stereotypes, and pleasant memories. acknowledgements research for this article was funded and supported by the atlantic philanthropies, the british academy, department of anthropology at california state university sacramento, the institute of social and cultural anthropology at the university of oxford. references anon. 2008a arthur murray international inc. franchise. http:// www.arthurmurray.com/index.htm, accessed november 12, 2008. anon. 2008b sacramento, california. http://en.wikipedia.org/ wiki/sacramento,_california, accessed december 8, 2008. appadurai, arjun 1996 modernity at large: cultural dimensions of globalization. minneapolis: university of minnesota press. ardener, edwin 2006 belief and the problem of women and the ‘problem’ revisited’. in feminist anthropology: a reader. ellen lewin, ed. pp. 47-65. oxford: blackwell publishing. areaconnect 2000 sacramento california population and demographics resources. http://sacramento.areaconnect.com/statistics. htm, accessed december 9, 2008. beatie, alison, and elma greer 2006 actively ageing well: key achievements. http://www. ageconcernni.org/key_ach_doc_download.htm, accessed december 9, 2008. belardinelli, romualdo, francesca lacalaprice, chiara ventrella, loretta volpe and ernesto faccenda 2008 waltz dancing in patients with chronic heart failure: new form of exercise training. circulation: heart failure 1:107-114. jonathan skinner social dance for successful aging anthropology & aging quarterly 2013: 34 (1) 28 jonathan skinner social dance for successful aging jonathan skinner social dance for successful aging brown, carroll, francis mcguire and judith voelkl 2008 the link between successful aging and serious leisure. international journal of aging and human development 66(1): 73-95. bryan, dominic 2000 orange parades: the politics of ritual, tradition and control. london: pluto press. campbell, susan 1988 carnival, calypso, and class struggle in nineteenth century trinidad. history workshop journal 26(1): 1-28. corbin, david and josie metal-corbin 1997 reach for it: a handbook of health, exercise and dance for older adults. dubuque, ia: eddie bowers publishing company. cowan, jane 1990 dance and the body politic in northern greece. princeton, nj: princeton university press. cressey, paul 1968[1932] the taxi-dance hall: a sociological study in commercialized recreation and city life. new york: greenwood press. daniel, yvonne 1995 rhumba: dance and social change in contemporary cuba. bloomington and indianapolis. erenberg, lewis 1998 swingin’ the dream: big band jazz and the rebirth of american culture. chicago, ill: university of chicago press. franks, arthur 1963 social dance: a short history. london: routledge & kegan paul. giddens, anthony 1991 modernity and self-identity: self and society in latemodernity. cambridge: polity press. gotfrit, leslie 1988 women dancing back: disruption and the politics of pleasure. journal of education 170(3): 122-141. gottschild, brenda 2000 waltzing in the dark: african american vaudeville and race politics in the swing era. new york, ny: st. martin’s press. hall, stuart 1991 the local and the global: globalization and ethnicity. in culture, globalization and the world-system: contemporary conditions for the representation of identity. anthony king, ed. pp. 19-40. london: macmillan. hanna, juduth 1979 to dance is human: a theory of nonverbal communication. chicago, il: university of chicago press. hannerz, ulf 1992 cultural complexity: studies in the social organization of meaning. chichester: columbia university press. hannerz, ulf 1996 transnational connections: culture, people, places. london: routledge. james, wendy 2003 the ceremonial animal: a new portrait of anthropology. oxford: oxford university press. jarman, neil 1997 material conflicts: paraders and visual displays in northern ireland. oxford: berg. kaeppler, adrienne 1985 structured movement systems in tonga. in society and the dance. p. spencer, ed. pp. 92-118. cambridge: cambridge university press. kirtsoglou, elizabeth 2004 for the love of women: gender, identity and same-sex relations in a greek provincial town. london: routledge. laderman, carol, and marina roseman, eds. 1996 the performance of healing. london: routledge. lima, maristela, and alba vieira 2007 ballroom dance as therapy for the elderly in brazil. american journal of dance therapy 29(2): 129-142. lysaght, karen 1995 ”catholics, protestants and office workers from the town”: the experience and negotiation of fear in northern ireland. in mixed emotions: anthropological studies of feeling. maruska svašek and kay milton, eds. pp. 127-144. oxford: berg. marion, jonathan 2008 ballroom: culture and costume in competitive dance. oxford: berg publishers. murray, arthur 1959[1938] how to become a good dancer. new york: simon and schuster. ranger, terence 1975 dance and society in east africa 1880-1970. berkeley, ca: university of california press. 29 anthropology & aging quarterly 2013: 34 (1) jonathan skinner social dance for successful aging román-velázquez, patria 1999 the making of latin london: salsa music, place and identity. aldershot: ashgate. savigliano, marta 1995 tango and the political economy of passion. boulder, co: westview press. sheets-johnstone, maxine 1966 the phenomenology of dance. madison: the university of wisconsin press. silvester, victor 1977 modern ballroom dancing: history and practice. london: barrie & jenkins. silvester, victor 2001 you danced to these bands. cd compilation. london: castle pulse. skinner, jonathan 2007 the salsa class: a complexity of globalization, cosmopolitans and emotions. identities 14(4): 485-506. sparkes, andrew 1999 exploring body narratives. sport, education and society 4(1): 17-30. stebbins, robert 2007 serious leisure: a perspective for our time. piscataway, nj: transaction publishers. stodghill, ron, and amanda bower 2002 where everyone’s a minority. time. http://www.time. com/time/magazine/article/0,9171,1003163-1,00.html, accessed may 6, 2012. thomas, helen 2003a the body, dance and cultural theory. new york: palgrave macmillan. thomas, helen 2003b dancing into the third age: social dance as cultural text. research report, the centre for urban and community research, goldsmiths college, university of london. thomas, helen 2004 mimesis and alterity in the african caribbean quadrille: ethnography meets history. cultural and social history 1:281-302. thomas, helen, with lesley cooper 2002a dancing into the third age: social dance as cultural text: research as process. dance research 20(1): 54-81. thomas, helen, with lesley cooper 2002b growing old gracefully: social dance in the third age. ageing & society 22:689-708. tulle, emmanuelle 2008 the ageing body and the ontology of ageing: athletic competence in later life. body & society 14(3): 1-19. turner, bryan 1996 the body & society: explorations in social theory. london: sage. verghese, joe, richard lipton, and mindy katz 2003 leisure activities and the risk of dementia in the elderly. the new england journal of medicine 348(25): 2508-2516. wacquant, loic 2004 body & soul: notebooks of an apprentice boxer. oxford: oxford university press. wainwright, steven, and bryan turner 2006 ”just crumbling to bits”? an exploration of the body, ageing, injury and career in classical ballet dancers. sociology 40(2): 237-255. wallerstein, immanuel 1990 culture as the ideological battleground of the modern world-system. in global culture: nationalism, globalization and modernity. mike featherstone, ed. pp.3156. london: sage. walsh, david 1993 ‘saturday night fever’: an ethnography of disco dancing. in dance, gender and culture. helen thomas, ed. pp. 112-118. london: palgrave macmillan. waxer, lise 2002 the city of musical memory: salsa, record grooves, and popular culture in cali. columbia. middletown, ct: wesleyan university press. wechsberg, joseph 1973 the waltz emperors. london: weidenfeld. wulff, helena 1998 ballet across borders: career and culture in the world of dancers. oxford: berg. wulff, helena 2007 dancing at the crossroads: memory and mobility in ireland. oxford: berghahn books. young, archie, and susie dinan 1999 active in later life. in abc of sports medicine. mark harries, greg mclatchie, clyde williams and john king, eds. pp.51-66. london: british medical journal publications group. jonathan skinner social dance for successful aging film review review of bonmariage, emmanuelle. manu. brussels: clin d’oeil. karen lok yi wong university of british columbia karenwonglokyi2011@gmail.com anthropology & aging, vol 41, no 2 (2020), pp. 280-282 issn 2374-2267 (online) doi 10.5195/aa.2020.298 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:karenwonglokyi2011@gmail.com film review | wong | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.298 http://anthro-age.pitt.edu 280 film review review of bonmariage, emmanuelle. manu. brussels: clin d’oeil. karen lok yi wong university of british columbia karenwonglokyi2011@gmail.com manu bonmariage (1941) is a well-known belgian film director, who produced more than 80 films, including du beurre dans les tartines (1980), allô police (1987), les amants d’assises (1992), la terre amoureuse (2002), and vivre sa mort (2015). before becoming a director and independent filmmaker, he used to be a cameraman. since he has been gradually losing his memories due to his alzheimer’s disease which he developed in his 70s, he started reviewing and retaining his life, by visiting the different people who he grew up with and worked with. as ever, using his camera as an extension of himself and a medium for interaction, he records what he sees in the process of revisiting his life. his daughter, emmanuelle bonmariage, the director of manu, follows her father on this trip along memory lane and into the future, and records the process. this is a touching film, which provokes deep reflections that, evidently, go way beyond considering the process of living with dementia as an illness trajectory. the first place where manu goes to is chevron, a village near liège in belgium, where he was born and grew up. he shares in this fragment that this is the place where he would like to die/be buried in. when we review our lives, we often think about our roots, that is, where we are from. to many people, the place where they were born and/or grow up, is where their roots are. therefore, it is not uncommon that many people who left the places where they were born or grew up in, express their wishes to return to these places when they are old or after they passed away. when manu was six-years-old, he lost the sight of his left eye through an accident. he has been using only his right eye for almost all of his life. he reflects on this facet of his life by talking to his childhood friends in chevron and feels that losing sight of his left eye is a good thing for him as a cameraman. when cameramen film, they can only use one eye. since manu can only use one eye per se, he can better focus on what he films. he tells his friends, “luckily i lost the left eye. since i don’t have it, i directly see what i have to film.” this remark expresses his positive attitude, that seems unaffected by his age or by the experience of living with dementia. we learn that this is not the only scar on manu’s life: he also had a near-death experience when he was in his 30s after he was poisoned with arsenic. he decided, back then, not to charge the person who intentionally poisoned him, and, while looking back, still would not do so, because this was someone with whom he had a relationship. he even blames himself instead of the person and says, “i had a turbulent life. i wasn’t careful about who i had relationships with.” thus manu is a living example of the concept of relational autonomy: a person may make decisions not based on what is right or wrong or what maximizes their best interest, but on sustaining his or her relationships with other people. http://anthro-age.pitt.edu/ mailto:karenwonglokyi2011@gmail.com film review | wong | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.298 http://anthro-age.pitt.edu 281 this documentary film also shows that manu visits his long-term friend, frans, a soundman, who was in manu’s film crew. they traveled to different places in the world and worked closely together when they were young. they do not live close, and manu takes trains to visit frans. as they are watching their photos together, a lot of memories come up, such as those of their trip to vietnam. when they talk about manu’s near-death experience, frans is teary. he recalls vividly seeing manu in the hospital: manu was naked, sweating all over his body and face, and the room was full of blood. frans thought that manu would die. manu feels how scared frans is simply by recalling this scene, and touches frans’ head. frans sweeps his tears and the two friends hug. the tenderness of that hug makes tangible the depth of their friendship, and how much frans cares for manu as a colleague and a friend. on the train home, manu calls frans and says that he will come and visit again. however, after the call, he says to himself, “we will not see each other again.” manu is in his mid-70s and his alzheimer’s is progressing. it can be the last time that they would ever see each other, and even if they would see each other again in the future, manu may not recognize frans due to his alzheimer’s. his anticipated grief is hyperreal. emmanuelle, the director of this film and the daughter of manu, brilliantly captures manu’s persistent and deep humanity; that is: his connection to and care for people that characterize him throughout his life and work, up to the present. jean, another former colleague of manu from the time at the belgian teleradio, is clear about this: “he (manu) has a heart of gold.” alzheimer’s might keep reconfiguring his memories of a lived past, manu’s humane nature is unattained. i was impressed by a scene in the film where he and emmanuelle watch les amants d’assises, one of the films he produced. the film is about a man who is being betrayed but who still deeply loves the betrayer. when manu watches the film, he is quiet, turns away, closes his eyes, puts his head down, and looks sad. as a spectator, i can feel that he feels connected with the man in the film, feels his love and pain, and cares about him. emmanuelle, who evoked this moment of compassion in the documentary, checks in with him. manu replies to her, “i’m just coming to my senses. it’s gripping.” films and other audiovisuals are powerful mediums for people to experience, share, and co-create emotions and thoughts. this applies – and maybe even more – to people living with alzheimer’s too. although this is not a film about alzheimer’s per se, leaving out most of the tropes (caregiving, loss, apathy) that are commonly mediatized, the film captures manu’s acceptance of his present condition. he even films his dialogue with his doctor about his disease. this dialogue tells that he sees alzheimer’s as a part of him: he describes himself as an “alzheimerian.” he knows that his alzheimer’s will not improve, and his memories will keep fading. “what i’m concerned most about, is whether i will get better,” but also: “i know very well that i won’t.” therefore, he tries to record what he sees and the events that he himself provokes in the present. for example, he runs into a veteran who went to vietnam at the bus stop, and he wants to learn more about this veteran's story, so he asks the man questions, and records their conversation. here, manu shows himself as a person who lives in and treasures the present. living in the present is not an easy thing because people tend to look into the past and future. i was most impressed by the last scene of the film, where manu holds a burning fire torch and walks into the dark. he then leaves the torch on the floor, where, emmanuelle picks it up. the torch powerfully symbolizes manu’s passion for film and film-making, which are significant parts of his life and self. at the moment of the film, manu is still very passionate about the art of filming and holds strong beliefs on what filming should be, that is: capturing reality. for example, emmanuelle, who here is the director of the film wants to film a scene of him coming out of a garage in a way that manu does not think is natural enough. he argues with her and says, “what we‘re doing here should feel natural . . . you have to know that we’re dealing with reality.” another example of the naturalness of the medium in manu’s being-in-the-world, is when emmanuelle asks to what if he would stop filming. he answers: “stop filming? i hope i can film at least my funeral.” however, due to his physical and cognitive decline, his http://anthro-age.pitt.edu/ film review | wong | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.298 http://anthro-age.pitt.edu 282 capacity to produce new work independently is decreasing. emmanuelle, picking up the torch, thus also picks up his passion for filming. this is a very touching film that tells the story of an older person living with alzheimer’s who has a deep passion for his work and deep relationships with people through the camera of his daughter and himself. i believe that it will be of interest to people living with dementia, family caregivers, professionals and researchers working with people living with dementia, and filmmakers. http://anthro-age.pitt.edu/ book review review of dossa, parin and cati coe, eds. transnational aging and reconfigurations of kin work. rutgers university press. 2017. pp. 231. price: $32.95 (paperback). carlos chirinos rovira i virgili university carlosalonso.chirinos@urv.cat anthropology & aging, vol 41, no 2 (2020), pp. 254-256 issn 2374-2267 (online) doi 10.5195/aa.2020.294 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | chirinos | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.294 http://anthro-age.pitt.edu 254 book review review of dossa, parin and cati coe, eds. transnational aging and reconfigurations of kin work. rutgers university press. 2017. pp. 231. price: $32.95 (paperback). carlos chirinos rovira i virgili university carlosalonso.chirinos@urv.cat rarely does a book make every effort to place both the dimensions of kinship in care work and of transnational intergenerational relationships at the heart of its analysis. in this edited volume, dossa and coe have succeeded in this endeavor, and have been able to release the academic potential of the notion of “kin work” to explain the significant contributions of older people in transnational contexts. this book not only focuses on academic issues related to transnational aging and care work, but also highlights the political importance of older women (the main protagonists of this book) as workers, both on the labor market (as producers, e.g., paid work) and in the informal domestic sphere (as reproducers, e.g., unpaid work). the accounts of their lives that take into consideration both their paid care work and their unpaid kin work (as mothers and grandmothers), make visible the leading role that they play in family regeneration. the different ethnographically inspired articles in this volume take us to different socioeconomic ecologies of vulnerable populations in transnational contexts, where the impact of neoliberal policies of migration, structural gender violence, the absence of a welfare system, and precarious systems of care work collide. these articles provide a voice to the older women who proactively deal with these adverse scenarios, while, in turn, often from a distance, work to connect, support, and maintain kinship relations, as well as balance the relations between family, community, and the state. in the introduction, the editors immediately present us to noor, an older woman from iran, who, through her handmade embroideries and their circulation among her family members between nationstates performs impeccable work in transmitting family memories and emotions. through this material practice, she thus connects different generations in the same parental belonging system. dossa and coe borrow stack and burton’s (1993) definition of “kin work” as “the labor and tasks that a family needs to accomplish to survive from generation to generation” (9). this concept will accompany the reader throughout this book. noor and her embroidery are emblematic of kin work: she literally weaves networks of exchange for emotions and family belonging to grow and persist across geographic spaces. the book is further divided into three sections. the first section is reserved for three articles that explore the idea of “kin-scription”: a type of kin work based on cultural scripts that guide family roles based on gender and age. the chapters of this section reveal the peculiarities of a group of older women who, as grandmothers, try to maintain this role and the caregiving related to it, as an inalienable commitment, even if this goes against their well-being. neda deneva (chapter 1) analyzes the case of an older http://anthro-age.pitt.edu/ book review | chirinos | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.294 http://anthro-age.pitt.edu 255 bulgarian woman that makes the transition from paid labor to being a migrant worker, while simultaneously caring for her grandchildren. this transition is what the author describes as the step from welfare to “kinfare.” here, a situation leads to a series of insecurities in the irruption from independent status (as self-employed) to dependent status (as financially dependent on their children). yanqiu rachael zhou (chapter 2) examines how care, aging, migration, and social policies interfere with kin work, with grandparents who travel from china to canada to fulfill their care commitments (filial piety) to their new generations. this ethnographic case shows how strong interdependence between generations persists, and how, simultaneously, tensions arise from being a grandmother in a country to which one does not belong. kristin elizabeth yarris (chapter 3) shows us another face of the conflicts and dilemmas that kin work entails. she discusses the case of two elder women (both grandmothers and mothers) that are caught in the migration processes between guatemala and the united states. these women strive to maintain family cohesion across three generations of women, while enduring the consequences and ambiguities of migration – which is seen as an abandonment of the family – or by staying and sacrificing themselves for the sake of caring for their families. the second section of this book thematically focusses on the reconfigurations of kinship, that are taken up in the title of the volume. these ethnographic cases highlight the transformations in the modalities of care exchanges between generations. erin l. rafetty (chapter 4) explores the “kinnnig” (sacchi and viazzo 2018) that a group of older chinese women perform in their care work as foster mothers, reconfiguring their modes of solitude, their self-esteem, and their relationships with the community and the state. mushira mohsin khan and karen kobayashi (chapter 5) discuss reconfigurations in the intergenerational care contract based on a system of religious values, dharma and karma, between a generation of young women and their indian mothers who migrate to canada. loretta baldassar (chapter 6) emphasizes the emotional and moral support that is transmitted between the different generations of italian migrants in australia during the 20th century, where the technological modes of communication and co-presence become essential for the reinforcement of transnational family values. finally, the last section focuses on ethnographies about migration and aging trajectories, as ways to explore the kin work performed by migrant women. cati coe (chapter 7) examines how two older ghanaian women in the united states recreate a retirement ideal to carry out in their homelands and the dilemmas they face upon arrival, where they must rebuild and reinvent care and family ties in situ. delores v. mullings (chapter 8) explores how a group of older caribbean women reconfigure their retirement through their kin work in the family and community. here, remittances, caring for grandchildren and bonding with the church take on a particular role. in the last chapter, parin dossa (chapter 9) analyzes how kin work is activated among ismaili migrants in canada, constructing epitomizing narratives about daily life, visual memory, and evocations of home, food, and music. transnational aging and reconfigurations of kin work reminds us of the importance of kinship studies in anthropology, making visible the notion of “kin work,” that hitherto remained underexplored in transnational and aging studies. the thickness of the book’s content also surely lies in its ethnographic quality that makes salient the socio-political contexts that impact migration and intergenerational relations in their everyday enactment and negotiation. in sum, this is an essential and accessible book for academics in the social, human, and public policy sciences, as well as for any researcher or student who seeks to deepen their insights into the everyday processes of aging and care in transnational contexts. references sacchi, paola and pier viazzo. 2018. “families and the elderly along the shores of the mediterranean: old and new forms of relatedness.” ethnologie française 3: 427-438. http://anthro-age.pitt.edu/ book review | chirinos | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.294 http://anthro-age.pitt.edu 256 stack, carol and linda burton. 1993. “kinscript.” journal of comparative family studies 24(2): 157-170. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2013: 34 (1) 38 book reviews coughlin, j. & d’ambrosio,l., eds. aging america and transportation: personal choices and public policy. new york: springer. 2012. isbn10: 0826123155.288pp. $65 (hardcover) aging america and transportation is a collection of essays that focus on the growing concerns about mobility and transportation that will be needed to accommodate the aging baby boomer generation. section 1 of the book provides a backdrop to set the reader up for a contextual understanding of the ways is which the baby boomers are currently and will continue to be a generation to age in their own way at their own time. the projected impact of the aging boomers will be more widely felt than in prior generations of older adults. the authors force us to consider the tremendous impact that the boomers will likely have on the shaping of policy, technology, services, and infrastructure. trends will be strongly influenced by the boomers’ statistically high income and education levels; delayed retirement and improved medical care; desire for travel and recreation; and for continued personal independence as they age. projecting ahead, we will see more boomers caring for both children and parents, adding to a picture of continued strong social and economic engagement that will require high levels of mobility. to illustrate the implications, chapter 4 by sandra rosenbloom provides a helpful discussion on land-use, urban design, and projections for residential patterns. the picture that is painted includes the increase of “aging-in-place” trends, where people will demand to “age in place” at homewhether that be in urban, rural, or suburban areas instead of in specialized care facilities. however, rosenbloom argues that policy changes in urban housing and pedestrian planning could lead the way in reversing these trends. section 2 introduces us to emerging technological trends in the automotive industry. this part of the book mainly addresses integrated driver assistive technologies and emergency response systems and increased connectivity. all of these can help accommodate diminished cognitive and physical abilities that may currently prevent older people from driving. this section delves into scenarios for technological advancements between now and 2021. the suburbanization of the landscape has resulted in a near-complete reliance on the automobile for commuting, shopping, and socializing and this is a key concern in looking at the at the boomers’ past, present, and future relationship with the automobile. year 2021 projections are shared through some thoughtful and plausible concepts for innovative integration of technology in automobiles. chapter 6 addresses changes to infrastructure to provide for better safety for older drivers, offering a number of examples of design adjustments that have been made to account for visibility, readability, signaling, and overall sharing of the road. chapter 7 focuses on both private and public transportation, including many useful suggestions to improve services and the transportation experience for older riders. these suggestions range from simple wayfinding design strategies, to car sharing programs, to smart parking (or the use of wireless technology to reserve parking and more seamless trip planning). section 3 moves us beyond the material players of infrastructure and technology to the actual players the drivers themselves. in this section of the book, behaviors and characteristics of future generations of older drivers are projected through charts and graphs that show rising rates across the board from the 2020s through to the 2050s. while it is projected that these older drivers will be healthier and more active than the older drivers of today, it is known that there is greater concern about physical inactivity, obesity, and effects from smoking with the boomer generation. based on these predictions, concern about chronic medical conditions (e.g., cardiovascular disease and obesity) will continue to grow. this section also addresses, through a variety of statistics, the sobering reality that, next to drivers in their 20s, older folks in their 70s and beyond are the most vulnerable to deaths from automobile accidents. to maintain safe roads, licensing and legal policies will have to be adapted to provide for the increasing number of older drivers who will require licenses. one of the authors, bonnie dobbs, argues strongly for increased involvement of the medical community in setting standards for driving ability. the chapters that follow reveal the other side of the coin, discussing the shamefully apparent lack of public transportation options for senior citizens and, aside from a few glimmers of hope, the lack of design for disabilities in much of the public transportation infrastructure that does currently exist. however, projections for 2021 indicate that public and community transit systems will be greatly improved. chapters 11 and 12 review and critique current driver education and training options for older adults. these chapters point out that evidence of the efficacy of these programs is currently inconclusive while offering many suggestions for 39 anthropology & aging quarterly 2013: 34 (1) book reviews improvement of these programs for the future. these suggestions include curriculum changes to existing programs, integration of technology, customized content for individuals, policy change, shifts in service, distribution and overall accessibility to mature drivers, and incentives that would further encourage participation in mature driver education. the book concludes with section 4, which provides ideas for the integration of a variety of services, systems, programs, and policies. all of these strategies could be implemented to address the transportation needs and goals of an aging population including driving and alternatives to driving. ultimately, i found that the discussion of technology and policy in part 2 was a useful section of the book for students in urban planning or design. technology in the form of mobile communication devices, the widespread integration of gps, surveillance devices, sensors, etc. is nothing new or surprising. however, understanding this technology in the context of the needs of the older driver and/or rider (like gps as a tool for people with alzheimer’s) takes a bit more legwork. with this is mind, the rich content of these chapters provides an excellent basis for creative discussion. all of the chapter contributions in the book are well researched and thorough, offering generous statistics, examples, and proposals for improvements for future implementation. although i find this book to be an excellent resource, it was not quite the launch pad for a creative conversation about the future of mobility as i had hoped. the writing is bold yet the projections are still conservative and i feel presents a bit of a one-dimensional picture of the future. the authors consider current technology but do not do a great job of projecting future developments in technology that will provide even more profound changes to our landscape and how we move through space. as a designer, i feel that this volume could use a little bit more futurism in its attempt to visualize and move forward design options nowadays. siobhan gregory, m.f.a. senior lecturer in design wayne state university sanford, j. universal design as a rehabilitation strategy. new york: springer. 2012. isbn10: 0826125522. 304 pp. $55. (hardcover) universal design as a rehabilitation strategy is a comprehensive addition to the literature on the history, approaches, successes, and limitations of universal design. sanford proposes that universal design in the context of rehabilitation strategies can be a “change agent” in fostering social equality of the elderly and people with disabilities. sanford argues that design for rehabilitation is all-too-often specialized. instead he contends that when the concepts and principles of universal design are applied to rehabilitation, the stigma and social segregation associated with disabilities can be diminished or, at best, eliminated. the book sets the stage by dispelling misunderstandings that universal design is a concept that is special to people with disabilities (and the guidelines and codes of the people with disabilities act) and that universal design is more costly and of a low aesthetic quality. this introduction is critical in positioning the text within existing design literature discussing some skepticism about the “universalness of universal design”. for example, one of the most popular books in the field of industrial design is donald norman’s the design of everyday things (1988). it is widely referenced in the area of design education. although a bit dated, norman presents the built environment by providing imagery and narratives that help the reader to begin to critique for themselves how the designed objects of our lives door handles, appliances, technological devices, etc. make us feel enabled or disabled. norman’s work resonates because he forces us to see that it is the built environment, which in essence is simply a series of design decisions (good and bad, sensitive and insensitive), that serves to create inherent categories of ability and disability. beforehand sanford also addresses this idea in his introductory chapter, which critiques the usefulness and limitations of a number of “social construction models.” through his critique of these models, he helps the reader understand universal design as a shift in philosophical design approaches from the intrinsic towards the extrinsic and from the individual towards the social. he also lets us know that these models are still insufficient when it comes to rehabilitation strategies and that clearly there is work to be done. his main critique is that these models are conceptual and do not help in fostering an understanding of the “real and tangible.” it is possible that some social scientists could take issue with this way of looking at things. however, sanford dives more fully into this critique in chapter two. here sanford more clearly illustrates (with the use of many examples including the 2000 presidential election butterfly ballot, countless barriers in anthropology & aging quarterly 2013: 34 (1) 40 book reviews urban infrastructure, and complex menu navigation in electronic kiosks), how everyday design “disables,” leaving room for specialized design to “enable.” sanford prefaces this discussion by presenting the spectrum of established levels of ability to disability and that in reality most humans fall below maximum mental, physical, and communication abilities. chapters three and four offer solutions through an introduction on assistive technology, accessible design, and specialized design. sanford then contrasts these categories with universal design, which rather than being approached as an add-on strategy, is factored in from the very first phases of the design process, considering a better experience for everyone and not just people with disabilities. guiding principles of universal design are discussed including flexibility, simplicity, equality, modes of communication, designing for human error, physical exertion, and consideration to sizing, positioning, and arrangement. stanford also discusses the importance of social and cultural context in this section. lastly, he includes rating systems, which begin to identify the evaluation of successful universal design. part two of the book addresses housing and workplace environments and the need for these environments to work for us at all the points in our lives. in these two chapters lies the strength of the book as a teaching tool for designers and a resource for critical evaluation of design. sanford builds the argument that with rising healthcare costs and the widespread prevalence of chronic conditions, the home is playing an increasing role in health maintenance and health care. in chapters five and six, sanford carries us through the areas of the home, from the point of entrance through the various rooms in a home, and the many activities that are performed in the home, identifying various physical barriers as well as opportunities for the successful integration of a broad range of modification strategies and home healthcare technologies. his suggestions range from the simple use of labels and signs as cognitive reminders, to the integration of color and texture change on flooring to help prevent falls in transition spaces, increasing light levels for better visibility, increasing heights of toilets seats and other seating surfaces, wider doors and entrances, the integration of sensors and forms of electronic monitoring, and much more. the overview on bathing and toileting is especially useful. as a resource for designers and design educators, sanford’s audit of design opportunities provides a variety and breadth of suggestions to begin a robust conversation in the classroom and beyond. additionally, these sections would be useful for industrial designers, interior designers, assistive technology engineers, healthcare professionals, or non-professionals looking for strategic ways to update their interior environments to better serve them as they age. sanford provides a similar analysis of the workplace, arguing further for the social benefits to be had when a workplace is designed for diversity and integration over exclusion. this chapter provides further suggestions not only for design strategies for architecture but also for computing, communicating, and comfort during a variety of workrelated activities. sanford concludes part two of the book with a discussion on policies and the current model of the u.s. healthcare system as the key barriers to widespread and effective implementation of universal design strategies. ultimately, sanford concludes that a greater deal of power is in the hands of the consumer/user. he believes that a greater awareness of universal design strategies and benefits will help bring about positive change in our built environments and our increased capacity to navigate healthily and happily through our lives. when i am teaching design students about universal design, i ask them to imagine a world where the majority of the population are wheelchair-bound, where the use of our legs would be rare and considered a special need. what would the built environment look like? everything we design from cars, planes, buildings, furniture, and appliances would be different. i ask this question because this vision of a flipped reality encourages designers to accept that difference in physical abilities should be reflected through design. universal design, in its most successful examples is not special or specializedit is just better. sanford’s book provides the evidence to help communicate this idea. i will gladly be teaching from this book. siobhan gregory, m.f.a. senior lecturer in design wayne state university goldsmith, j. the long baby boom: an optimistic vision for a graying generation. baltimore: the johns hopkins university press. 2008. isbn-10: 0801888514. 232 pp. $25.95 (hardcover) the long baby boom written by jeff goldsmith, the president of health futures, inc. and an associate professor 41 anthropology & aging quarterly 2013: 34 (1) book reviews of public health sciences at the university of virginia, discusses his view of the continuing positive impact that the baby boomer generation can make on society. this approach is different than the “doom and gloom” attitudes frequently predicted about the impending economic burden that will be caused by baby boomer aging in the us. jeff goldsmith’s book considers at length what the value of this next generation of older adults will be. to frame this discussion, goldsmith reflects on what baby boomers have contributed to this society in a wide-range of important areas such as civil rights and environmental issues. goldsmith talks about the baby boomers, not as a burden on social security and medicare, but in the ways they will continue to be important societal contributors. for example, goldsmith asserts that the baby boomers are likely to be working longer, staying healthier, and having impact on social policy for much longer than earlier generations of retired people. “this is an optimistic book about a generation of optimists.” (goldsmith 2008: xvii) goldsmith uses fictional characters as examples to show how baby boomers are different from past generations, and highlight intragroup variation among the baby boomers too. and while the situations he describes are somewhat predictable, they do prove his point that a single solution to the baby boomers’ aging issues may also be fiction. acknowledging that there is not one simple solution to medicare, social security, and other such programs, is key to finding more innovative ways to solve some of the problems that are facing the baby boomers and american society. goldsmith’s argument that the future is bright and baby boomers will continue to contribute in meaningful and relevant ways is the core of the book. he discusses each topic in detail explaining the positive impact they can continue to have on american culture. in short, the book “explores the baby boomers’ current state: their lives, health, and wealth and how they differ from the generations of older american that preceded them (goldsmith 2008: xv). the book is divided into two basic parts. the first half gives some history and perspective on who the baby boomers really are, since the term is used so often without full understanding of what it means to be a boomer. starting with the prologue, goldsmith tells of three different fictional baby boomer characters all with very different life circumstances who are each approaching retirement age. these different sets of circumstances allow goldsmith to “test” what the impact of the different policy solutions discussed throughout the book would be. it is important to remember how diverse a group the baby boomers are not just culturally, but they cross the spectrum of socio-economic class as well, so the “one size – fits all” solutions will most likely fail to address the needs of this generation. the first half of the long baby boomer explores topics such as music, tv, college, the women’s movement, vietnam, civil rights, how the work place has been redefined, the divorce rate and the “disintegration of the nuclear family,” (goldsmith 2008:15) which influenced the baby boomers. goldsmith discusses why all of the events and culture shifts that have taken place in the baby boomers’ life times directly impacted the way they think of themselves. additionally, he argues that these views will impact the choices that the baby boomers make as they enter retirement. goldsmith also discusses a common perception in american society that– that the baby boomers are a “social burden.” his argument is that as the baby boomers work longer, and stay healthier than their parents their aging will be less of a burden. to illustrate, goldsmith would like to see a way for people who are still working after they turn 65 to defer enrollment in medicare and allow their employer to continue coverage on them, which would create less of an impact on the system and less of a burden on the program (goldsmith 2008: 126). the second half of the book is focused on entitlement programs like medicare and social security; it discusses ways to reform the programs that would be beneficial. in his chapter on medicare aptly named the “mt. everest of entitlements”, goldsmith outlines a four-step plan for positive changes in the program. by simplifying, changing incentives for health care providers, allowing people to buy into medicare starting at 55, and deferring enrollment if they are still working, goldsmith maintains that the medicare system would have the flexibility to serve the baby boomers’ needs without bankrupting the system. his plan is well thought out, and can contribute to the broader national discussion on needed changes to medicare currently going on in washington. goldsmith also dedicates a chapter to social security. he sees the debate over this program’s reform as the bitterest domestic political debate in the last decade. as the centerpiece of roosevelt’s new deal, social security was designed for the past generations of retired workers, but since the baby boomer generation is generally living longer, this demographic reality has put a huge strain on the system. goldsmith discusses several ideas that might help with this problem, but his section regarding raising the age of eligibility really shows the conundrum of the whole system. goldsmith believes in the creation of private accounts, and explains five different sources for the funds. however, he believes that there is too little popular or political will to fully discuss some of these ideas at this time. lastly, goldsmith presents his overall conclusions on the state of the baby anthropology & aging quarterly 2013: 34 (1) 42 book reviews boomer generation and hopes for the future. importantly, goldsmith reiterates how certain kinds of culture change would need to occur for the political machine to correspondingly react with truly innovative new aging policies and programs. the long baby boom is a positive book about one the nation’s most significant issues. goldsmith feels that too many critics want to predict the worst regarding the potential economic burden the baby boomers represent. they fret about will happen when the baby boomers start to retire in larger numbers and collect on the benefits they have come to expect. goldsmith is worried that the inability or the lack of flexibility, on the part of the politicians will thwart making positive and productive changes needed with the large baby boomer population of retirees. this book is a good start to understanding the complexities that are involved in such a shift. the ideas that goldsmith presents are a useful contribution to the meaningful current debate on how the united states needs to think about baby boomers as they enter their golden years. susan ward, m.a. department of history wayne state university manderson, l. surface tensions: surgery, bodily boundaries, and the social self. walnut creek, california: left coast press. 2011. isbn-10: 61132-098-5. 294pp, $ 32.95 (paperback) in this book, manderson uses case studies to explore “catastrophes of the body”. in particular she seeks to understand how people respond to extreme bodily changes in terms of functional ability, personal and social identity, and aesthetics. manderson sets the stage for her approach to this topic by briefly explaining her own experience of “catastrophe” which involved the rupturing of a nerve in her arm resulting in permanently reduced function in her left hand. as part of this altered bodily reality, manderson needed to start regularly wearing a splint. over the years, she has engaged with the split as a functional device and also as a site of artistic expression since she treats it as a piece of jewelry. manderson’s own experience informs her analysis of the other case studies she goes on to present in this book. next manderson provides a moving case study of perdita, a woman whose life was irreversibly altered first by colon cancer and then by breast cancer. perdita’s story which includes both the need for a stoma and a mastectomy gives the reader a glimpse into the complex bodily issues that will be explored in the following chapters. these issues include but are not limited to: experiences of the body and what they mean, the relationship between the body and mind, identity development, and cultural beliefs about the body. in chapter one, manderson draws on the theoretical work of scholars from multiple disciplines who have written extensively about the body. she uses these ideas to understand the complex processes that individuals undergo as “they seek to make sense of the necessary, yet often undesirable embodied changes” (manderson 2011: 24). she begins with a discussion of descartes, in particular his views on the distinction of the body and mind. further, manderson draws on the work of leder, canguilhem, and striker for understanding ideas about identity and what are often categorized as bodily abnormalities. as part of this discussion, it is noted that throughout much of our lives we pay very little attention to our bodies. however, as we experience bodily changes resulting from illness or accident, we are confronted with the physiological challenges as well as the socially and culturally constructed views of the body. importantly, manderson describes her rationale for including the conditions/experiences discussed in subsequent chapters. this rationale involves choosing cases where there “appeared to be surface tension for individuals, usually above the surface, although in the case of transplants, the discordance is largely below the surface” (p. 46). lastly, she provides an explanation of the ethnographic methods used to collect data on functional loss, living with a stoma, what it means to be feminine after breast cancer, and organ transplantation. in chapter two, manderson explores “our cyborg selves”. in particular, she reflects on the role of science and technology that enhance lives through the use of advanced surgical techniques, implanted devices, and adaptive equipment, many of which are now viewed as commonplace. she notes that enhancements in surgical technology has allowed for increasingly more innovative and effective treatment for skeletal/muscular conditions as well as opportunities to minimize hearing and sight loss (e.g., cochlear implants and laser eye surgery). as one example, she uses her mother’s aging experience and resulting bodily changes to demonstrate how as we age we often move into the realm of the cyborg (e.g., hip replacement, cataract surgery and lens replacement, dental crowns, use of walkers and pick up reachers for activities of daily living). manderson takes the discussion further by moving into the realm 43 anthropology & aging quarterly 2013: 34 (1) book reviews of more controversial areas such as radical transplantations (e.g., face, hand) as well as cloning. one of the most significant points articulated in this chapter is the notion that as we age we are more likely to fall into the category of cyborg (e.g., hip, knee, and other joint replacement, pacemakers, adaptive equipment/technology, etc.) and yet the cultural representations of the cyborg are young, beautiful, stronger, faster, and smarter. for example, consider here many of the cultural examples are taken from popular television shows and films including but not limited to the bionic woman, the six million dollar man, and the terminator. while manderson does not address it, it may be inferred that these representations of the young super-able cyborg is possibly due to ageism. importantly, manderson acknowledges that universal access to such “high tech” medical techniques and adaptive equipment does not exist. noted barriers include health care infrastructures and resources to pay. in chapter three manderson explores how people cope with loss, whether it be loss due to amputation, stroke, or traumatic injury. throughout the discussion, manderson provides insightful commentary on many of the challenges that individuals face as they rehabituate themselves in their everyday lives. as part of this process, individuals need to both learn to care for the “sites of trauma” as well as reinvent their ways of being and doing. a challenge to this effort is dealing with the cultural and social expectations which often involve inclusion/exclusion and stigma/ acceptance. a significant amount of this chapter’s discussion is related to the construct of masculinity and how it is impacted by amputation and other forms of loss. manderson describes how men experiencing loss use sports to “use their bodies as vehicles of agency and control.” she describes similar concerns among women regarding femininity and their efforts to restore feeling feminine in chapter five as she explores life postmastectomy. manderson begins chapter four, “body basics: living with a stoma” with data documenting the numbers of individuals dealing with issues of incontinence, bladder and colorectal cancer both in the united states and australia. importantly, she notes that often individuals do not seek medical care until their symptoms are severe and their medical condition is advanced. many of the stories in this chapter illustrate the challenges one experiences when his/her body is permanently altered by the need for a stoma. manderson acknowledges that stoma surgery never results from uncomplicated medical histories; therefore there are many factors that come into play as individuals seek to understand “the stoma in relation to their sense of self and being in the world” (manderson 2011: 148). manderson revisits the point that when no physiological symptoms are present, we go through our daily lives with little if any thought to our internal bodily processes. however, bodily change as significant as the need for a stoma brings these bodily processes to the center requiring new ways of doing (e.g. toileting and care of stoma site) as well as managing the cultural perceptions about adult hygiene and intimacy. chapter five explores what manderson refers to as “the feminine in question.” this chapter addresses the importance of breasts in how women identify as “being women” as well as “being feminine”. all of the women interviewed for this chapter, except one, reported not feeling “normal” after their mastectomy. moreover, they described feeling incomplete or no longer the woman they were prior to the surgery. throughout the discussion manderson focuses on the “meaning of the presence or absence of breasts” (manderson 2011: 184). she notes the contrast in male/ female experiences of loss especially as women tend to tie notions of self -worth to both their perception of appearance and others perceptions of appearance. she addresses the aspects of embodiment that women have difficulty adapting to (e.g., scarring, lack of symmetry). to overcome these negative feelings many women chose reconstructive surgery to restore them to what they perceived as their “normal” selves. chapter six, “replaceable parts: the end of natural life” explores the notion of embodiment as it relates to organ transplantation. she begins by contrasting the visible embodied changes that result from amputation to the “under the surface” changes that come with organ transplantation. she argues that when we notice the limb loss of others we react based on preconceived notions about the potential cause of this loss. this response is not the case in response to those who have undergone organ transplantation as the visible signs on the body can be concealed from the casual observer. manderson goes on to note that embodiment for organ recipients is equally complex because of the number of bodies involved in the transplant process (e.g., donor, recipient, family members). included in the discussion is how cultural values impact notions of living donors, the reality that in many cases that someone had to die in order for another to live, and what connections if any exist between the donated organ, the donor, and the recipient. in the concluding chapter, manderson reiterates many of the key points presented in previous chapters. she reiterates the notion that “bodies are gendered, and gender does not anthropology & aging quarterly 2013: 34 (1) 44 book reviews dissolve with disability or illness; rather, it provides one way of both receiving and doing disability” (manderson 2011: 262). overall, i found the ideas throughout the book to be well articulated and thought provoking. i highly recommend it for anthropologists interested in notions of embodiment and how these notions change as we experience disability and bodily change at different moments in the life course. the ideas presented in this book may be used to inform how notions of embodiment and social identity change as one ages, and in light of bodily changes. amy paul-ward, ph.d. department of occupational therapy florida international university if you are interested in writing a book, film, journal or exhibit review for anthropology & aging quarterly, please contact the book reviews editor, joann kovacich jkovacich@ rochester.rr.com. include your name, areas of expertise, current ation (research, professor, graduate student, e.g.) and any titles you would be interested in reviewing from the last three years. aaq does not accept unsolicited reviews. mailto:jkovacich%40rochester.rr.com?subject= mailto:jkovacich%40rochester.rr.com?subject= final_zhang zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 51 debating “good” care the challenges of dementia care in shanghai, china yan zhang case western reserve university author contact: yxz764@case.edu abstract the increasing number of dementia sufferers in china has transformed dementia care from a private issue to a public concern. nationwide dementia-friendly campaigns have intensified debates about what constitutes “good” care. in response to these campaigns, the shanghai government proposes a systematic care model, which stresses the need for dementia-care units and professionalization. nonstate actors, however, focus on the relational care model, which integrates western humanitarian ethics with confucian values. this article employs cultural and structural frameworks to examine why and how a specific form of “good” care is constructed in china. the debates about the establishment of dementia-care units and the professionalization of eldercare enable us to understand how politics shape certain forms of care. keywords: dementia care; state-society relations; forms of life; china; humanitarian ethics; confucian values anthropology & aging, vol 41, no 1 (2020), pp. 52-68 issn 2374-2267 (online) doi 10.5195/aa.2020.266 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 52 debating “good” care the challenges of dementia care in shanghai, china yan zhang case western reserve university author contact: yxz764@case.edu during periods of rapid social transformation, contending values and moralities often take center stage. china is a rapidly changing nation, having experienced five thousand years of imperial rule; about a hundred years of foreign invasion and exploitation; decades of maoist-socialist domination; and finally, in 1978, a “socialist market economy.” each transition produced fears of instability and debates about traditional practices, especially as they related to confucian values. the practice of eldercare, for a long time, was considered a domestic issue. there was no need to talk about it in public settings. recently, this has begun to change. first, numerous studies have revealed intergenerational conflicts and eroding family practices of filial piety during rapid social change (ikels 2004, 2006; yan 2003b). second, the social impact of the one-child policy and the expansion of empty-nesters in urban china are raising concerns about the adequacy of eldercare services to support family caregiving (liu et al. 2015; zhang 2006, 2009, 2017a). lastly, while the eldercare industry is growing, it attracts public attention due to the preexisting institutional mistreatment of elders (dong et al. 2008; wang et al. 2018; zhang 2017b). all of these factors lead to new debates about what constitutes “good” care for the aging population in china. the increasing number of elders with dementia intensifies debates around “good” care. medicalization, which unfortunately reinforces the stigma surrounding dementia in china (ramsay 2013; zhang 2018), transforms the care for this groups of people. previously, dementia was considered as a sign of normal aging, and seniors with dementia symptoms were cared by their family members (ikels 1998). since the medicalization, services are organized in a way that people with dementia passively receive care mainly from medical institutions, which directly threatens their identity (zhang 2018). in order to avoid stigma, domestic settings become the primary sphere for dementia sufferers. however, social services, such as nursing homes and community-based programs supporting patients and their families, are underdeveloped. dementia-friendly campaigns recently initiated by different stakeholders (e.g., non-governmental organization campaigners, nursing home managers, government officials, intellectuals, and social media producers) are changing the landscape of eldercare in china (zhang, forthcoming). for a variety of reasons, advocates on behalf of dementia sufferers and their families frame their arguments about “good” care within the context of western humanitarian ethics. they propose that elders with dementia should have equal access to institutional, community-based, and in-home care. family caregivers, who are the primary resources for dementia sufferers, should be supported by the state and society. however, the conceptualizations of “good” dementia care and the ways to achieve it are controversial among the multiple stakeholders. in this article, i introduce two constructions of “good” dementia care in shanghai. on the one hand, there is the governmental construction of systematic care, which emphasizes affordability, accessibility, and efficiency. systematic care invests in infrastructure, professionalizes services, enforces top-down governmental projects, and, often, ignores local contexts. on the other hand, non-state actors focus on the relational dimensions of care in their conceptualizations of “good” care. barnes (2012) has theorized care as a way of conceptualizing personal and social relations in western societies and, humanitarian care ethics for dementia sufferers is built upon this notion. in this article, i expand the concept of relational care in east asian societies where confucian ethics, such as ren, construct the practice of relational care. ren, which means benevolence and humaneness, is zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 53 the fundamental human virtue that binds people together first in appropriate familial relations and then directs other social relations by the model of familial relations (bell 2007; confucius 1971). this overlaps with the concept proposed by barnes. but, the difference is that relational care—with an emphasis on ren in china—is more about a paradigm than simply relationships between caregivers and recipients. building on both confucian ethics and western humanitarian care ethics, this type of care values social inclusiveness, genuine respect and support for elders, and the family-like culture in institutions. in practice, systematic care and relational care often coexist in eldercare facilities, which can create conflicts and resistance between state and non-state actors regarding how to provide “good” care. based on my fieldwork, i contend that both chinese government and non-state actors value “good” care for dementia sufferers. that is, both the state and non-state actors believe it is urgent to take actions to support elders with dementia and their families. however, due to different responsibilities and expectations, each stakeholder exhibits variations in conceptualization and practice of “good” care. i put good care in scare quotes to highlight the ongoing debates among stakeholders. i argue that debates between state and non-state actors are inextricably related to the conceptualization and practice of “good” care. in examining these debates and tensions, i pay attention to the underlying cultural and structural contexts that make each version of “good” care favorable. because “good” care is related to the notion of “good” life that is debated by scholars, in the following section, i bring together different conceptualizations to contextualize what is at stake in pursuing the desired life. i analyze how governmentality studies in china and global humanitarianism contribute to the debates about “good” dementia care. after discussing my research methods, i introduce the eldercare system in shanghai to explain why the state adopts a systematic approach in dealing with dementia sufferers. after that, i introduce the moral worlds of people with dementia to highlight the stigma issues that a systematic care approach often fails to address, but a relational care framework can add value to. in the following sections, i attend to two specific debates regarding dementia care. these debates have coincided with china’s introduction of long-term care insurance, the western humanitarian ethics, and dementia-friendly projects. meanwhile, cultural practices such as the adoption of family-like culture in eldercare facilities and public discrimination against nursing aides remain important in these debates. governmentality and the good life in china ethnography has documented the transformation of governmental rationality from ideological security during maoist china to pragmatic security in capitalist china (greenhalgh and winckler 2005; hua and guo 2007; jeffreys 2009; zhang et al. 2011). as chen (2007) argues, recent political reforms are characterized by the state making a strategic adjustment from a politics of efficiency to a politics of equity, in order to address the social issues resulting from economic development. social issues related to the wellbeing of the population include: hiv/aids (shao 2006; uretsky 2015), environmental health (lora-wainwright 2017; tilt 2010), eldercare (farquhar and zhang 2005; zhang 2017), rural education (harwood 2009; yan 2003a), moral challenges (kleinman et al. 2011; wu 2010), and spiritual wellbeing (cooke 2009; gao and qian 2019). the shift from maoist ideology of tight population control to post-mao governmentality indicates the changing governance of human life in china. the purpose is to push life beyond just the survival of living beings to a level of affluency and human flourishing (zhang et al. 2011). what constitutes a good life varies from context to context, from issue to issue, and from place to place. kleinman explores the moral dimensions of human life, such as “how to live a moral life” (2006:72), “moral as an experience” (1999: 373) and “what really matters” (2006:1). tu (1985, 1989) responds to this question from the philosophical perspective, emphasizing the differences between western and eastern understandings of human flourishing. rose and novas (2005) address this issue by employing the concept of “biological citizenship,” zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 54 which means not only the right to health, but also the duty to be well. in other words, the emphasis on the good life indicates the shift in concern from survival to human development, and from mortality to vitality. this concept is further elaborated by zhang and colleagues (2011), who analyze the changing state-society relationship that plays a crucial role in what constitutes the good life. anthropologists have mainly used these approaches to describe the historical and cross-cultural dynamics of good life and the obstacles to achieving it. i shift my attention from what constitutes a good life to why and how a specific form of good life is constructed locally—namely, the cultural and structural contexts that make it favorable. anthropologists have emphasized forms of life and their association with cultural norms and structural factors regarding life and death, health and illness, and care relations and personhoods (chua 2014; danely 2019; lee 2019; traphagan 2000). for instance, a specific regime of life fostered by world “disorders” and global non-governmental organizations (ngos) is humanitarianism (fassin 2011; feldman 2018; redfield 2013; ticktin 2011), which concerns the wellbeing of life, but with particular agendas. no matter how nonpolitical humanitarian actors are, the challenges of serving older adults—such as service gap between the structure of the aid system and the demands of senior recipients—often shape how people experience their own lives (feldman 2018). in the face of the increasing number of dementia sufferers globally, moral concerns have provided a powerful ground for international ngos and local governments to adopt western humanitarian ethics in place of local policies. the dementia-friendly initiatives, which advocate for equal human rights for dementia sufferers, have been advertised by alzheimer’s disease international globally. as a result, many nations have engaged with this project (adi 2017). despite its global humanitarian aspiration, local responses to this project may transform this nonpolitical project to a political one. the localization of the dementia-friendly projects is inevitably related to the conceptualization of good life for dementia sufferers. i argue that social reconfigurations between global humanitarian aspiration and local transformations not only shape certain forms of good life, but also create new tensions that hinder the efforts to achieve it. these new tensions, i suggest, are closely related to cultural and structural complexities. the utility of the cultural and structural framework to understand how and why a specific form of good life is constructed in china is twofold. first, this approach encourages an examination of a specific form of good life. for example, farquhar and zhang (2005) introduced the neo-confucian tradition of self-cultivation and nurturing life as an alternative approach for elders in beijing. this form of life is characterized by a totalistic “health moralism”—a physical culture related to maoism (e.g., strong bodies, endurance, and willpower). second, the cultural and structural framework suggests useful debates among various constructions of good life. initiation of a certain form of good life, for instance, has often been linked to exercises of social power. the power might come from the state, such as “authoritative paternalism” (rose 2011), or from everyday institutions or non-state actors with aspirations, struggles, and dilemmas (zhang 2010). theories of governmentality have examined the manifold ways that wellbeing and social power can be entangled. for instance, a growing body of literature sheds light on the fine line between sociopolitical powers that are repressive and controlling and those that are caring, productive, and supportive (cooper 2008; zhan 2011; zhang 2014). instead of placing productive and repressive power in contrast to one another (greenhalgh 2008; kligman 1998), zhang and ong (2008) challenge the oppositional relationship between state and society and argue that these two forms of power can engage in the co-production of practice, values, and solutions. my intention in this article, however, is to examine conflicts that arise from different constructions of “good” care by state and non-state actors, even though each aims to create and promote better social services in china. in this article, i propose to understand the debates about “good” care in china as a historically contingent formation that emerges from the continual interface between the state and society. rather than drawing a clear line between generative power and repressive power, i trace each form of “good” care within a specific historical, cultural, and structural context, in which both the state and society aim to generate, craft, and zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 55 enhance the wellbeing of human life. the debates about “good” dementia care gives us a different perspective to examine the co-constructive relationship between the state and society, in which the state takes a benevolent role in responding to popular demands and various social groups call for this potential to advance their interests. the uncertainty, distress, and insecurity that arise from these debates also highlight the relationship among certain forms of care and politics. methods my exploration of dementia care in shanghai, china started when i was a project manager for a local ngo between 2010 and 2013. at that time, my colleagues and i tried to introduce the western humanitarian care model for dementia sufferers into a community called the bund. the bund, or waitan community, is located at the center of shanghai. according to the sixth population census in china, there were 64,896 people whose hukou1 were registered in the bund. the exact number of people living there was unknown because of the migrants from outside of shanghai and people migrating out of the community. more than one third of the total population were seniors aged 60 and above in 2017 (srca 2017). therefore, social services for elders are a key topic in the domain of civil affairs. due to the severe stigma, however, no official social services were developed to support family caregivers for people living with dementia by 2010. family caregivers often hided dementia sufferers from outsiders because of the associated dementia (goffman 1963). dementia sufferers, who were often undiagnosed and untreated, became invisible. introducing western humanitarian care model is a response to the limited social support for family dementia caregivers. during this project, i was able to participate in community activities and conduct interviews with various stakeholders, especially family caregivers about their daily struggles. when i started my doctoral program in the united states in 2013, i visited this community each year until 2017. data presented in this article were mainly collected during ethnographic research on governance and dementia care between 2014 and 2017 (20 months of fieldwork total). the months i spent in shanghai included annual shorter visits, mostly in the summer, between 2014 and 2016, and the entire year of 2017. in addition to continuing my research in the bund, i also visited three senior centers specialized in dementia care and five mini-nursing homes.2 these facilities were located in six neighborhoods. moreover, i conducted in-depth interviews with nine nursing home managers and four directors of ngos about their understandings and practices of dementia care. in order to gain a comprehensive understanding of dementia care policies, i interviewed six government officials at different administrative levels. i also spoke to a wide variety of people in several neighborhoods, including family caregivers, volunteers, and eldercare service providers. i conducted archival research on aging policies and collected secondary data including publications in chinese related to eldercare. i examined public debates on dementia care through websites, tv programs, newspapers, and the like. lastly, i attended two national conferences, two municipal conferences, and several small-scale meetings about dementia care. these various sources of information enabled me to systematically study the shanghai government agenda regarding dementia care and the struggles and complaints of non-state actors. creating a systematic eldercare model in shanghai shanghai has been the “oldest” city in china since 1979 when 10.2% of the total population (about 1.16 million) was aged 60 and above. in 2017, those over the age of 60 reached 33.2% of the total population of shanghai, with 3.18 million of these individuals above the age of 65 (srca 2017). there is also an increasing rate of dementia, with more than 150,000 people with dementia in shanghai, or about 5% of elders aged 65 and above (zhang et al. 1990) suffering from the disease.3 zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 56 the government is primarily responsible for building systematic care that is efficient, affordable, and accessible for seniors. in practice, this systematic care model is administration-oriented and enforced from the top. governmental efficiency is evaluated by the number of eldercare facilities, the allocation of financial resources, and the organization of social services. consequently, local governments often pursue quantity rather than quality of services. eldercare programs, which include nursing home care, community-based care, and inhome care, are often implemented from the perspective of service providers, instead of users. nursing home care is one type of eldercare services in which the shanghai government has invested. as of 2017, there were 703 nursing homes with 140,000 million beds total (srca 2017). these nursing homes primarily focus on daily needs and offer basic medical care services by themselves or by outsourcing to collaborating medical institutions. there are also hospital-style nursing homes that have doctors, nurses, nursing aides, and basic equipment, such as a laboratory, ct scanners, and that for rehabilitation. by 2017, there were 39 hospital-style nursing homes in shanghai. these two types of nursing homes are either public or private, or a hybrid of the two. of the nine nursing homes in which i conducted fieldwork, three were public, four were private, and two were hybrids. two of nursing homes focused on healthcare and the rest mainly provided support for daily life. even though nursing home care is an important social service, community-based eldercare programs have attracted the attention of seniors due to lower prices and easier access. unlike nursing homes, which may be located far away from downtown shanghai, these institutions are often located within the more urban neighborhoods. there are two types of community-based eldercare programs. the first is senior centers, which enroll independent elders or elders who need minor assistance. there were 560 senior centers in 2017 (srca 2017). the second type is mini-nursing homes. i call this type of facilities mini-nursing homes because they are small in size, with each providing between ten and 49 beds. these facilities provide respite care for family caregivers, enrolling elders with mild functional disabilities or cognitive impairment, those in need of rehabilitation services, and elders waiting for nursing-home beds. because of its community-embedded nature, family caregivers can easily visit seniors. because mini-nursing homes successfully combine professional services with traditional family caregiving, the shanghai government has invested a lot to promote this type of care model since 2015. when i conducted my fieldwork in 2017, 127 mini-nursing homes were functional, and more were under construction (ibid.). these two types of community-based eldercare programs are typically hybrid in nature (i.e., cross between public and private). the three senior centers and five mini nursing homes i visited were run by local ngos, with five specialized in dementia care, two for general eldercare, and one offer care that was a mix of the two. besides the two types of nursing homes discussed here, home eldercare is the third component of the systematic care model in shanghai. historically, home care was only limited to those living without relatives, independent living abilities, and financial resources. yet, as the life expectancy and potential eldercare burden among families continues to increase, since 2018, home care has been expanded to include all seniors who meet certain criteria (discussed below). home care for seniors includes daily support activities, such as chores and meal delivery. some municipal eldercare programs provide regular home visits (e.g., the senior partner project) and housing maintenance for elders with low incomes or living alone. these services are usually outsourced to local ngos or other governmental organizations, depending on each community’s infrastructure. these services are subsidized by the government for elders who qualify due to their economic standing. the long-term care (ltc) project, which ensures the affordability of social eldercare services, is another significant mark in the development of dementia care in china. this project had an initial trial in qingdao (north of shanghai) in 2012, and later expanded to a national trial in 2017. in shanghai, three districts were experimental sites: xuhui, putuo, and jinshan. in practice, ltc was a multi-agency program: the shanghai municipal human resources and social security department took charge of financing, the shanghai civil affairs bureau oversaw zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 57 the service organization, and the shanghai municipal health commission provided necessary training and evaluation. in-home care and institutional care were both provided by the ltc. these services mainly focused on daily support and basic medical care. to be eligible for ltc services, citizens have to be 60 years or above and have been evaluated at the second level of disability or above.4 three to seven hours of in-home care services were organized weekly for recipients based on their disability levels. ltc covered 90% of the cost, and individuals paid the rest. for institutionalized care, ltc covered 85% and individuals paid 15%. the pricing strategies were 45 rmb/hour [$6.30 usd/hour] for daily life support and 85 rmb/hour [$11.90 usd/hour] for medical care in 2017. considering the potential benefits for older population, the shanghai government has expanded this policy to all neighborhoods since january 2018. however, as a fundamentally new social policy in china, controversies and obstacles are not uncommon in practice. as part of the systematic care approach, the shanghai government aims to professionalize dementia care. nursing homes, community-based senior centers, in-home care, and long-term care insurance are common in western societies, but these concepts and institutions remain relatively new in china. note that eldercare is traditionally a family-based practice, and china still mandates that family has the responsibility for eldercare (zhang 2017a). the government’s eldercare system has indeed laid the foundation for the development of additional social services, but the public is often disappointed by the quality of care provided (dong et al. 2008; wang et al. 2018; zhang 2017b). particularly, dementia sufferers were previously excluded from the preliminary care system. therefore, to build a sustainable and systematic care system for those with dementia is both seen as an indicator of a modern society and as a sociopolitical achievement by the chinese government. moral worlds: stigma, dementia, and caregiving before the dementia-friendly initiative, family caregivers and those with dementia inhabited moral worlds that were to a considerable degree constructed by stigma. based on my work as a project manager in charge of dementia care services from 2010 to 2013 and my fieldwork from 2014 to 2017, i found stigma made both dementia sufferers and their family caregivers susceptible to loneliness and isolation. strategies used to fight against stigma include denial and keeping the diagnosis secret. at times, family caregivers rejected any kind of social support. in order to schedule a family visit, i often had to turn to the neighborhood committee for help. otherwise, it was difficult to enter into the households of those with dementia. i found when visiting patients at home, family caregivers tended to avoid the label of dementia by using courtesy terms to describe their loved ones’ conditions, such as poor memory, brain atrophy, and even “too old.”5 family caregivers had to care for the entire household. often, i could see only two family members: the person with dementia and the caregiver. other family members and friends often shied away. after several times visiting and showing my genuine understanding of their suffering, family caregivers led me into their moral worlds. in the summer of 2016 when i did my pilot study, i stayed with two host families that had elders with dementia. mrs. mo’s mother, aged 80, was diagnosed with dementia about two years ago. during my twomonth stay with this family, a topic we consistently discussed was how to help elders with dementia since most of them refused to take medication or receive any outside support. when i talked to mrs. mo’s mother about dementia, she often said, “i am fine. i don’t have dementia. why do you always talk to me about it?” the paradoxical form of living with dementia, but rejecting the diagnosis, has also been captured by lee (2019). she found that due to the stigma, many people with dementia in south korea are not told directly about their diagnosis by both physicians and their family members. in china, a diagnosis with dementia means a social deprivation of one’s moral status. therefore, the denial of dementia is a rejection of unworthiness and uselessness in later-life, which is often associated with power asymmetry between caregivers and care recipients. even though mrs. mo’s mother experienced cognitive decline, one thing she was consciously aware of was the conversion from a life-long caregiver to a receiver of care. when mrs. mo was absent, her mother often lamented, “i have taken good care of my children and grandchildren for my whole life. now i am useless and have to zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 58 check their face to survive. no face anymore!” the medicalized notion of dementia establishes a new framework in which the relationship between one’s cognitive ability and being recognized by surrounding people enacts one’s right as a person (taylor 2008). in china, loss of face means the loss of one’s moral status and personhood, which also indicates a loss of respect and trust that one feels one deserves. similarly, when i stayed with mrs. zhuang, who was a 70-year-old single woman, she also expressed her anxieties about potential mistreatment by others if she revealed her diagnosis: i haven’t told my neighbors about my diagnosis because i do not want to be looked down upon. when they know that i have dementia, they will cheat me and treat me like a child. will that be good for my illness? no! i only told some of my close friends who can understand my difficulties and are willing to help me. i do not even want to tell my two brothers in fuzhou. they have their own family issues and they would not understand, anyway. i am also worrying about my future. i can take care of myself now. what about ten years later? what should i do to prepare? when i am thinking about these difficulties, i am too anxious to sleep. the dehumanizing effects of the dementia label are the main reasons that most dementia sufferers refused to see doctors and/or acknowledge their diagnosis (kaufman 2006; lock 2013; traphagan 2000). family caregivers also internalize the stigma surrounding dementia. in order to avoid stigma, some family caregivers relocate their kin to other communities. when i asked a service provider about her experience of the dementia care program in the bund, she told me that two of her visiting families moved out of the neighborhood. family caregivers are frequently ambivalent about seeking social support due to associated stigma (goffman 1963). on the one hand, seeking support for dementia sufferers means that someone in the family has a mental disorder that is not socially accepted. on the other hand, family caregivers are the ones who have been worn out emotionally, psychologically, and physically due to the long-term care they provide. the capacity for traditional family support is also tenuous. this is not only due to the rapid social transformation of chinese society, in which the emphasis on the extended family has transitioned to the nuclear family (yan 2003b), but also because of the associated stigma. during my fieldwork, i encountered family caregivers who experienced broken family ties— such as estranged siblings, divorce late in life, and unfilial children—because of the dementia-related stigma. without effective social and family support, most family caregivers experience depression, and some even commit suicide.6 an increasing number of people living with dementia transforms family dementia caregiving from a private problem to a public concern. dementia matters only recently has dementia care become a public issue in china. in 2010, when i started working in an ngo, my colleagues and i initiated the first project of social support for family dementia caregivers in shanghai. before that, no official support was provided to these caregivers, and only one municipal nursing home enrolled elders with dementia. most nursing homes rejected these individuals because of the liability. this was not a problem exclusively in shanghai; only a limited number of social organizations focusing on dementia care existed nationwide.7 in 2017, when i started fieldwork, there had been a dramatic change. there were four ngos specialized in dementia care and family support. many nursing homes listed dementia care as one of their services. organizations advocating on behalf of people with dementia and their families had sprouted everywhere in china. the rapid change in attitudes about dementia was due to the public portrayal of dementia care as an overwhelming burden on families, the increasing number of people living with dementia, as well as the increasing number of people advocating on behalf of dementia sufferers and family caregivers (zhang, forthcoming). zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 59 state and non-state actors respond to dementia issues differently. the dementia-friendly initiative, led by the shanghai government, employs the systematic care approach. this approach deals with elders with dementia through effective management. the government views dementia sufferers as a special group of individuals whose needs can be met by building dementia-care units within existing eldercare facilities. moreover, the state actively promotes ltc insurance to help dementia patients gain access to eldercare facilities. the shanghai government believes that dementia care, like other social services, can be enhanced through improving the care workers’ skills. consequently, the state mandates the professionalization of dementia services in the ltc project and also introduces the project of building dementia-friendly communities to ameliorate the stigma around dementia sufferers. at the grassroots level, non-state actors conceptualize “good” care differently. building upon western humanitarian ethics and confucian ethics, non-state actors focus on improving the relational dimensions of dementia care, e.g., social inclusiveness, person-centered care, stigma reduction, and family-like institutional cultures. the integration of western humanitarian care ethics with traditional chinese values, such as filial piety and ren, attempts to improve dementia services. these key elements contribute to a new vision of “good” care— relational care—which is valuable, but yet, inadequate in china. within this framework, non-state actors seek to strengthen the relational dimensions of human life, which have been waning during the past four decades of reform in china. the pursuit of relational care signals a massive shift from the state’s administration-oriented care to one that is bottom-up and quality-oriented. this form of care highlights a new public culture with regards to dementia. while acknowledging the co-constructive relationship between the two versions of “good” care for the professionalization of dementia services, conflicts still arise when each stakeholder operationalizes different theories of “good” care. one conflict concerns the investment of constrained resources. should we invest in dementia-care units or family-like institutional culture when there are limited resources? another conflict concerns service professionalization. should eldercare institutions follow the state’s rigid standards or do they have the authority to decide how to practice “good” care? although these debates do not give an exhaustive portrayal of the features of “good” care, they demonstrate why the application of certain forms of dementia care can be read as a site of power struggle between various stakeholders with contending values. investment debates since the shanghai government initiated the dementia-friendly project, one significant change in eldercare facilities has been the establishment of dementia-care units. according to the official standards, requirements for dementia-care units include location, space, layout, decoration, and care ratio. these elements are easy to quantify and evaluate. once facilities meet these requirements, the shanghai government subsidizes 10,000 rmb [$1,400 usd] for each dementia-care bed and another 10,000 rmb [$1,400 usd] to the general facility. while acknowledging that dementia-care units are necessary for “good” care, in practice, most facilities pay more attention to infrastructure than to services. several factors contribute to this phenomenon. first, investing in infrastructure is much easier than investing in services. when facilities apply dementia-care models from other societies to shanghai, they assume the most important thing is to build a physical space and configure necessary equipment to make it look like a “high-quality” dementia-care unit. second, paying attention to infrastructure is also an easy way for eldercare facilities to benefit from the state policies. as a result, an increasing number of eldercare institutions have started to build dementia-care units in order to receive the governmental subsidies. lastly, the appearance of eldercare facilities serves as the first impression to the public. therefore, many nursing home managers pay attention to their infrastructure. among the nine nursing homes i visited, three had dementia-care units, and four were planning to create them. yet, the rationale behind the dementia-care units was not directly related to providing better care zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 60 for seniors with dementia, but more about keeping those cognitively intact from unnecessary interruptions. mr. xu, who was a nursing home manager, expressed the importance of risk avoidance in managing elders with dementia: if you place a cognitively intact senior with a dementia sufferer in one room, it will be dangerous. the x nursing home, which often had such an arrangement, had a disaster in 2005. an elder with dementia killed his roommate without any punishment. the responsibility was fallen completely on the nursing home. if your institution has such a disaster, you are doomed. from the administrative perspective, you cannot guarantee that they [dementia sufferers] will not affect other people around…therefore, it’s better to separate them from others. separating dementia sufferers from cognitively-intact residents also could provide an equal division of workload among nursing aides. ms. liu was in charge of a large nursing home that could accommodate about 400 seniors. when i visited the nursing home in 2013, they had just opened with fewer than ten seniors with dementia. in 2017, there were about 80 clients with severe dementia symptoms. with so many elders with dementia, a key strategy of management was, according to ms. liu, to separate them from other seniors. when i asked about their dementia-care units, she frankly told me that they had three floors hosting dementia sufferers. each floor represented a different level of care: the higher the floor, the more intensive the care needed. a senior couple i encountered during my visit to this nursing home were both diagnosed with dementia. however, due to the intensive care needed for the husband, this couple had to stay on separate floors. this was to equally distribute workload among care providers. the over-investment in dementia-care units and infrastructure has led to a public culture in shanghai that evaluates the quality of care based on facilities and equipment. during my fieldwork, many cutting-edge eldercare nursing homes were established, most of which focused on wealthy citizens. these nursing homes were private, and often boasted about their high-tech instruments. therefore, fees for service were much higher than that of average nursing homes. for average ones, monthly fees were about 5,000 10,000 rmb [$700-1,400 usd] based on care levels. however, upscale nursing homes charged about 20,000 35,000 rmb [$2,8004,900 usd] per month or even more, which was far beyond the average monthly pension (4,200 rmb or $588 usd in 2016) in shanghai (srca 2017). many clients judge the institutional care based on equipment, instead of services. when i visited a nursing home specialized in late-stage dementia, a young man who was visiting his grandma complained about the poor infrastructure to the nursing home director. after discussing with the man that his grandma had been bedridden for 14 years without any issues in this nursing home, the director said, “if you send your grandma into a presidential suite, will your grandma get better? she cannot get better, right? it’s not our infrastructure that sustains your grandma’s life, but our service!” infrastructure for nursing homes is necessary, but the over-reliance on technology could lead to a substandard care. instead of paying attention to the infrastructure, some nursing homes focus on the link between the needs of dementia sufferers and institutional cultures, such as inclusiveness and person-centered care. these elements derive from western humanitarian ethics, but are transformed by non-state actors during the process of localization, which includes bringing them together with confucian values. the first characteristic of relational care in the chinese context is a family-like institutional culture. inclusiveness and person-centered care are based on western conceptions of human rights, but these norms in an institutional culture that values collectivism have a different meaning. according to nursing home directors i interviewed, dementia sufferers should be included in all activities, and should not be treated as a stigmatized group by constructing a separate dementia-care unit. among the nursing homes i visited, two managers maintained a critical attitude toward dementia-care units. one nursing home had 70 clients in total, 32 of whom were dementia sufferers. the reason for rejecting a dementia-care unit was their commitment to building a family-like institution. mrs. pan, the nursing home director, said, “we are a big family, and we should mutually zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 61 support each other within this family, especially when some members are in need of more care.” when i conducted observations in this nursing home, all staff and nursing aides would call each client “grandpa” or “grandma.” this is a culturally appropriate way to shorten the distance between caregivers and patients and to show respect. caregivers are treating their clients as family members, rather than consumers. while the marketbased care undermines the motives essential to care, the appropriate combinations of market and family care (e.g., treating clients as family members) strategically solve the ethical dilemma of commercialization of care. the second characteristic of relational-care is the expectation of involving families after their kin are institutionalized. this differs some nursing homes in the west where patients are seen as only consumers (kane and west 2005) and from the dementia-care-unit approach in shanghai. based on my observations and interviews, many seniors still had the expectation of family affection, even after they were enrolled into nursing homes. “they do not want to be abandoned by their families,” said mr. xue, another nursing home director. from mr. xue’s perspective, doctors, nurses, nursing aides, and other staff helped families, rather than replacing them. at mr. xue’s nursing home, when he enrolled elders, he would ask families to come and visit them. he believed that, no matter how professional the services were, their goal was supporting families. in traditional chinese culture, as in other parts of the world, parents raise their children, and when they are old, it is adult children’s responsibility to take care of their parents. rapid modernization and the competitiveness of the job market have reduced the ability of children to devote themselves to eldercare. however, mr. xue stated, sending parents to institutions does not mean that their children’s responsibility is over…many seniors complained that their children did not come and visit them. when i told them that their children would come, they were very happy. the happiness that children brought to their parents cannot be replaced by professional care. thus, family love cannot be replaced; it can only be supplemented. nursing homes have different ways to make sure that families visit their elders. for example, some nursing homes make it a rule that adult children have to visit their parents once or twice a week to make sure that family affection is available to their clients. one nursing home i visited required families to help nursing aides bathe elders. if family members did not show up, the nursing home would call them. in some extreme cases, elders suffered from poor hygiene because adult children failed to come. then, there would be a public discussion about these unfilial children. other nursing homes used modern social media (e.g., wechat) to help seniors to get in touch with their families daily or weekly. the involvement of family members in institutional care not only characterizes the chinese version of “good” care, but also challenges the dementia-care-unit model, which often isolates elders from the community. the last action that non-state actors promote is creating a stigma-free environment. famous nationwide campaigns include the yellow bracelet project, which aims to prevent people with dementia getting lost, and the dementia friends project, which tries to redress the public stigma associated with dementia. in 2018, the shanghai civil affairs bureau responded to these campaigns by mandating that discriminatory words such as, chidai (dementia), laonian jingshenbing (senior psychosis), and shizhizheng (loss of wisdom), should not be used in eldercare facilities. this official statement is an attempt to destigmatize the condition. however, its effect is limited to eldercare facilities. therefore, non-state actors appeal for more public education with the hope of changing attitudes toward dementia. mrs. pan stated, “we should let citizens know what dementia is, why these seniors behave in such a way, and we also need to train our children to know what we should do when we meet dementia sufferers on the street.” changing the public attitude toward dementia not only corresponds to the essential element of social inclusion, but also casts family-like institutional care culture into the larger society. the relational care paradigm has transformed both traditional chinese culture that stigmatizes dementia sufferers, and western humanitarian care ethics, which may ignore local context. zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 62 in china, confucian values such as filial piety and the ethical code, ren, have been successfully integrated with global practices by non-state actors. the state, which also endorses western humanitarian care ethics, adopts the systematic care approach to deal with dementia care challenges. this approach is valuable in terms of building infrastructures, such as dementia-care units. its limitations include not fully creating culturally-appropriate services, which generate more constraints when the state intends to professionalize how care should be practiced. service professionalization debates coupled with the project of building dementia-care units is the professionalization of services. government officials, who emphasize quality control along with the systematic care model. according to policy makers, nursing aides should receive certain course hours of training, pass the national exam, and obtain the state issued license. this enforcement often overlooks the concrete practices of eldercare and the social and economic background of nursing aides. nursing home directors argue for relational care that takes both nursing aides and care practices into account. according to them, eldercare should be outcome oriented. the prerequisite for nursing aides is to be kind-hearted and express loving compassion, rather than being qualified enough to obtain a license. therefore, debates about the professionalization of dementia care mainly center on the rigidity of state administration and the competency of nursing aides. the introduction of the ltc insurance intensified the conflicts between the governmental understanding of professionalism and non-state actors’ practices of “good” care. this conflict arises because the shanghai quality and technique supervision bureau monitors the quality of care in nursing homes. instead of checking the services provided to elders, this bureau requests that each nursing aide completes a form to record their work every day. this form is complex and nursing aides spend a great deal of time completing it. in turn, this reduces their work hours and affects the quality of services provided to elders. when i visited nursing homes, the government officials present that day checked these forms in cursory manner. some public nursing homes hired someone to deal with the supervision; however, private nursing homes did not want to comply with governmental supervision for fear of sacrificing the quality of care provided to their clients. therefore, many private nursing home directors complained about this rigid supervision. mrs. bai explained, “filling these forms are superficial work, not only meaningless for us, but also a waste of social resources. our government does not understand what eldercare is.” another rigid and formalized requirement to ensure “good” care is to take pictures when delivering services. for example, a nursing aide has to take pictures when he/she feeds, moves, or changes a senior’s diaper. this regulation, however, has nothing to do with “good” care; instead, it increases the workload for nursing aides. many nursing home directors complained about this requirement. even the public nursing home i visited, which specialized in dementia care and had a high care ratio (1:4), could not meet this requirement. private nursing homes that often had a lower care ratio (e.g., 1:6-1:8),8 felt even more frustrated. a nursing home director, mrs. yu stated, “i do not think our government understands how eldercare is practiced in nursing homes. if you want to see whether a senior has enough food and water, can you only tell that from pictures? now, the officials only check pictures. without taking pictures, they will blame us for failing to do this and that.” the policy change regarding the competency of nursing aides further complicates debates about professional care. previously, nursing aides had to obtain either medical or eldercare licenses to enter into the workforce. these two types of licenses indicated their professional levels and authorized them to work in particular domains, and thus also determined their salaries. in order to control cost, many nursing homes preferred to hire those who held eldercare licenses instead of medical licenses. but, since the introduction of ltc, the shanghai government requires that all nursing aides have to obtain medical licenses, which does not cut costs for nursing homes. zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 63 this change has challenged the development of social care in shanghai. first, it increases the cost of institutional services. according to mr. xu, hiring a nursing aide with an eldercare license before the change cost about 7500 rmb [$1,050 usd] per month. they now have to pay more than 10,000 rmb [$1,400 usd] to hire a qualified nursing aide with a medical license. second, the transition from a loose policy whereby a nursing home could hire nursing aides with or without medical care licenses to a tightly controlled policy has reduced the number of nursing aides on the job market. people might think this can be solved by raising salaries, but this challenge will not be easily solved. on the one hand, rapid population aging in shanghai will continue due to extended life expectancy, the consequences of the one-child policy, and the relatively low birth rate and mortality rate (srca 2017). on the other hand, it takes a certain period of time to improve the educational background of nursing aides. research has showed that most nursing aides in china are from remote areas and have limited education (chu and chi 2008; dong et al. 2017; song et al. 2014). according to a survey in shanghai, less than 5% of nursing aides had a college degree (wang and yuan 2018). when i did my fieldwork, almost all nursing aides in shanghai were from rural areas and had limited education. moreover, not all nursing aides had obtained a license to legally work in an institution. according to mrs. yu, “they are doing this work only because their children are in college and they have to support them.” in her institution, there were eighteen nursing aides: only two were less than fifty years old, one was sixty, and the rest were in between. all were from rural areas and three were illiterate without any licenses. i found such situations in other nursing homes too. when i interviewed nursing home directors, they told me that, because of the rigid governmental policy, those who had not passed the exam and obtained the medical care license would be laid off by the end of 2017. the question is whether the next age cohort is able and willing to be nursing aides to make up for this shortage. the computer-based exam presents additional challenges. although an exam is necessary to select well-trained aides, the computer-based exam requires a candidate to have computer skills. therefore, this exam excludes many qualified nursing aides simply because of their limited knowledge of computers. this is to be expected, however, since most nursing aides are from rural areas and have limited access to computers. in mrs. yu’s nursing home, she and other staff had trained their nursing aides to use computers to pass the exam, nonetheless only twelve passed the exam; the other six failed. mrs. yu expressed her sadness, “training for nursing aides is helpful because eldercare is practical; but a license is meaningless for us. these licenses are for administration. if illiterate nursing aides have to get licenses, i don’t think we will have enough people to do this work.” the next age cohort who were born in the 1970s or early 1980s, might not be willing to do a job that is considered as “dirty” and “unproductive” (jervis 2001). some of them are the only-child. with higher educational levels, they are socialized to become part of the elite. the only-child generations are viewed as being spoiled and refusing to do dirty and hard work (fong 2006). therefore, this policy change has created more struggles and dilemmas for the development of eldercare in china. public discrimination against nursing aides poses another challenge to the professionalization of eldercare. being a nursing aide has a very low professional reputation in china (wang and yuan 2018). in domestic settings, skeptical family caregivers often treat nursing aides as domestic helpers, regardless of their license status. they assign nursing aides to carry out household chores, rather than providing professional care to seniors. the public, and family caregivers in particular, do not trust nursing aides because of their assumed “lower quality” (yan 2003a). many family caregivers that i interviewed, often doubted the professionalism of nursing aides. one family caregiver said, “these nursing aides are low-quality. they are doing this job only for money, rather than truly care about my father. when he soils the bed, it is me and my sisters who take turns caring for him. i cannot believe that a nursing aide can perform like my family.” this distrust is intensified in the case of dementia sufferers since these patients often do not like “strangers” in their homes. in such situations, most family caregivers only ask nursing aides to do household chores, rather than deal directly with their kin. zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 64 the lack of trust between nursing aides and family caregivers further challenges the state’s systematic care. the ltc project, which ensures systematic care, provides more subsidies to family-based eldercare than institutional-based care. because of the lack of trust, most family caregivers said that if they could not handle the burden of caregiving, they would send their kin into professional nursing homes rather than seeking domestic support. because of the unpleasant interactions with family members in the home, some nursing aides prefer to work in institutions. consequently, most family caregivers have to take on the majority of care tasks, even though the ltc project aims to provide effective social support to them. many stakeholders have realized that a trusting relationship requires the public to respect the work of nursing aides. according to mrs. li, the director of a nursing school, “the further development of eldercare is not a financial investment; rather, it should be social and cultural change. if our society continues to discriminate against nursing aides, no one will join in this cause, no matter how much money we offer.” conclusion this article has traced debates between two forms of “good” care for dementia sufferers in shanghai, china. while acknowledging these debates are historically contingent in order to address the urgency of social support for elders, they equally reveal interactions between state and society—two forms of power in constructing modes of care. the relationship between these two forms is opposing yet co-constructive. in the systematic care model, the state possesses the authority to establish social policies and laws. this form of care has been implemented through the construction of dementia-care units and the professionalization of dementia care services, especially the standardized training of nursing aides. non-state actors, especially nursing home directors, exercise their agency by embracing relational care, which integrates western humanitarian ethics with confucian values. some nursing home directors have generated grassroots strategies for creating a family-like institutional culture to negotiate the state care regime. moreover, these directors advocate for nursing aides, who are primarily from rural areas and have limited training. while acknowledging the significance of professionalization of eldercare, nursing home directors are consciously aware of the potential challenges of these rapid policy changes. condemning public discrimination against nursing aides, non-state actors claim that “good” care cannot be achieved without taking the social rights of formal caregivers into account. no matter how apolitical relational care seems, it mobilizes an ethical code that systematic care often ignores, which makes these two forms of care seem oppositional. yet, in the real world, these two forces can be mutually constructive. for instance, developing culturally appropriate dementia care becomes necessary when there is already an eldercare infrastructure, and to further professionalize dementia care requires governmental guidelines and standards. the seemingly opposing relationship between state and non-state actors actually supplements each other to produce better outcomes. systematic care should constitute the backbone of relational care—both are essential to better dementia care. debates highlight the uncertainty, distress, and insecurity when two forms of power interface with each other in practice. the emphasis on professionalization of services without taking the experience of nursing aides into consideration creates uncertainty as to how to develop sustainable, accessible, and affordable social eldercare. similarly, inappropriate regulations, even with a benevolent purpose, to some extent, place additional anxieties and distresses on nursing home directors who have already been struggled with “good” care. the speed and the scale of these policy changes will continue to intensify the insecurity of institutional care. too rigid state requirements reduce the attention nursing homes can give to their clients. therefore, it requires both state and non-state actors to craft, adjust, and remodify these policies. cultural factors, such as stigma further, complicate these debates. the systematic care approach, which intends to reduce the stigma, reinforces it because dementia-care units separate dementia sufferers from others. the relational care model, however, emphasizes family-like institutional cultures, which could mitigate zhang | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.266 http://anthro-age.pitt.edu 65 dementia-related stigma. these two approaches exemplify the role of cultural elements in promoting better dementia care. in order to generate culturally appropriate programs for dementia sufferers, state and non-state actors must work together to maximize social benefits. a sociopolitical and cultural transition to a more favorable environment for elders with dementia is needed in china. these debates about “good” care serve as a platform for policy makers to learn useful information from practitioners and service users, and thus improve dementia care policies and administration in shanghai and beyond. acknowledgements this research was funded by the wenner gren foundation for anthropological research (#9361). i am grateful for comments on early versions of this article from two anonymous reviewers, dr. andrea milne, and dr. lihong shi. i also want to thank dr. cortney hughes rinker and dr. henrik mikkelsen for their comments and edits on the last version of this article. notes 1 china’s hukou is a family registration program that serves as a domestic passport, regulating population distribution and rural-to-urban migration. 2 i call this type of eldercare institution as “mini-nursing homes” because of its smaller size than general nursing homes. more details see the following section. 3 comprehensive statistics about the current dementia sufferers in shanghai or in the bund may not exist, owing to rapid modernization, migration, and the separation of the site of one’s hukou registration and one’s residence. dr. zhang mingyuan is a prominent psychiatrist. his epidemiological research on the prevalence of dementia in 1990 in another neighborhood of shanghai is still valuable due to the inclusion of almost all residents at that 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danely, ph.d. department of anthropology rhode island college jdanely@ric.edu aaq volume 33 has represented a revitalized effort on the part of aage to create a high-quality venue for work of scholars and researche rs of aging in anthropology. despite our rigorous peer review standards, the number of published articles in aaq over the last year alone matches the number for the previous four years combined. this feat could not have been accomplished without the hard work and dedication of the aaq editorial board and the many reviewers who generously donated their time and expertise. likewise, aaq is grateful to all of the contributors for their excellent work, helping to make aaq an important resource for scholars, students and researchers around the world the articles in this issue serve as an excellent example of the kind of work aaq strives to showcase. each of them explores the ways that “care” reshapes the embodied meanings of the social life course and the felt experience of old age. anna corwin (121) examines the dynamics of care in a catholic convent infirmary in the midwest us, where the domains of spiritual and profane, faith and practice, become entangled with age in a setting where even everyday social interactions and experiences take on aspects of the sacred. susan rasmussen (131), too, is concerned with a religious and symbolic world that lends meaning to the care of elders. among the tuareg, the seclusion of frail elders coexists with beliefs of enhanced spiritual power, a source of meaning that links them to small children. mary alice scott’s article on mexican grandmothers caring for grandchildren shows how economies of care extend far beyond local communities, and offers an intimate portrayal of the hard decisions and harder consequences faced by families of migrants. as aging grandparents become exploited bodies, care can quickly create other burdens, what was a source of value becomes a form of structural violence. this issue also features the first aaq “portfolio” section, a visual commentary on issues related to anthropology and aging. these photos, taken by malik alymkulov for helpage international, are powerful images of the intimate spaces of elder abuse in central asia. the signboards displaying the words of perpetrators are not “hidden transcripts,” but signal the all too visible failure of care in the everyday world. they are potent reminders that our work is not done, but we are in the right place. thank you to everyone in aage for a wonderful year. rebecca berman elizabeth briody sherylyn briller maria catell sarah e. chard wonjee cho charles choi janelle christensen anna i. corwin alex costley edward drott mary durocher jenny elliot carla fisher tom fritsch kuniko fujiwara christopher hajek helpage international ellen idler brenda robb jenike lori jervis philip kao tom klassen megumi kondo jung kwak denise lewis susan orpett long terri ann liller susan mcfadden athena mclean nadva malhotra eppu mikkonen-jeanneret caroline oliver ota hiroshi susan rasmussen mary alice scott jay sokolovsky samantha solimeo philip stafford suzuki hikaru suzuki nanami ayumi takenaka yoko taniguchi ruth toulson thang leng leng wayne warry emily wentzell thank you to the aaq editorial board, the reviewers, and all of the contributors to volume 33 mailto:jdanely@ric.edu anthropology & aging quarterly 2013: 34 (3) 143 book reviews whitfield, keith e., ed. annual review of gerontology and geriatrics: focus on biobehavioral perspectives on health in late life. springer publishing company. volume 30: 2010. isbn 978-0-8261-0613-1, pp. 296. price $90.00 (hardcover) the annual reviews of gerontology and geriatrics (argg) have been in existence for almost three decades. the focus in this volume is on how biobehavioral perspectives impact health and aging and is edited by keith e. whitfield, ph.d. of duke university who brings a wealth of knowledge and experience to the editor position. together with twenty-nine interdisciplinary expert contributors, the authors present approaches and conceptualizations on how complex biological, behavioral, and social systems interact to create and impact aging health. chapters take in to consideration the life span and life course approach to aging as a process. the content is organized in three distinct sections with the goal of “stimulating thinking about how biobehavioral perspectives help to accurately account for complex phenomena relative to aging” (2). whitfield explains the broad conceptualization of biobehavioral as the descriptor of choice when referring to interdisciplinary research that encompasses the biological and social foundation of behavior. this approach accentuates the expanding interest in exploring the aging process by determining complex connections between social and behavioral factors that impact all other processes and may help to explain the etiology, symptomatology, and life course of chronic disease states in late life. szanton and colleagues offer a society-to-cells resiliency theory that represents theoretical synthesis but highlights the impact the social environment can have on aging resilience. this proposed theory “posits that resilience can be manifest in resistance, recovery, or rebound processes, viewing resilience as a process in which all individuals engage as they progress in life” (7). this approach seems logical when thinking about aging baby boomers and their desire to maintain physical, mental, and social function for as long as possible – their need and desire to be resilient. in chapter 3, authors present an overview of biobehavioral methodology including implications, strengths, and weaknesses. more integration of theory-driven explanatory models needs to occur in education and research training. analysis of data from biobehavioral aging research is difficult given the complexity and lack of formal training in biobehavioral design; something to think about when designing undergraduate and graduate research courses for future leaders in aging research. cells to homeostatic systems: chapters 4 through 8 cover an interesting range of topics: the roles of oxidative damage, exercise and caloric restriction to late life health; genetic and environmental contributions to cognitive decline in aging and alzheimer’s disease; hypertension and neurocognitive function; vascular depression and the cardiovascular implications for mental health; and, stress and aging. interesting and current aging topics that give the reader pause when thinking about crossing the behavioral, psychological, social, organ systems and molecular levels. or perhaps the mind-body connection within a social context would be the take home message. the study of psychoneuroimmunology the interactions among emotions, neural, endocrine, and immune functions exists. what might we term the study of environment, social, behavioral, psychological, genetic, cellular and molecular levels? optimageresilientology? another point to ponder in our quest for understanding the process of aging so we can make an impact on the quality of aging. person to society: the final 6 chapter topics include: religious involvement; personality; an ethnographic treatise on poverty and health; breast cancer biology and behavior; the socioeconomic gradient in healthy life expectancy; and, neighborhoods and health in later life. in chapter 9, hill presents his model of how religious involvement impacts health and longevity. social and psychological resources, health behaviors and biological markers are identified from a biopsychosocial perspective. generally, religious involvement impacts aging in a positive manner. however, hill does include the “dark side” of religious involvement which was insightful as i am sure many clinicians working with older adults have witnessed the negative as well as positive aspect. i would have liked to seen an exploration of spirituality, especially since the importance of religion is currently being defined differently by the aging boomers. hooker and colleagues remind us of how important knowing the lifelong personality of the older adult assists us to understand their health issues of today. gaps exist and further research is essential. burton and bromell report on the cumulative health disadvantage of being born in to poverty by using an ethnographic approach. the reader is reminded that “cancer in the older adult is increasing and regarded by anthropology & aging quarterly 2013: 34 (3) 144 some as a geriatric syndrome” (295). the work by harden and colleagues reminds us that with advancing life expectancy and cancer treatment advances, we have an obligation to treat older adults past the typical end dates of 70 years and work toward updating current evidence-based guidelines for health prevention. and lastly, crimmins and hagedorn tell us that “estimating healthy and unhealthy life is an attempt to estimate life of varying quality” (p. 317). using and understanding how socioeconomic factors impact aging can help us to change health policy and determine appropriate resources for leveling the playing field regarding quality. this book is a relevant resource for researchers and educators in many disciplines as well as clinicians and health care profession students. traversing levels of analysis helps us to think about aging as a process impacted from birth by external and internal factors that combine to formulate health and longevity for all aging individuals. understanding the impact of life on living is essential in healthy aging. linda j. keilman, dnp, gnp-bc michigan state university college of nursing peggye dilworth-anderson and mary h. palmer, eds. annual review of gerontology and geriatrics, volume 31, 2011: pathways through the transitions of care for older adults. new york: springer publishing company. 2011. isbn #978-0-82610793-0. pp. 270, $95 (hardcover) this installment of the annual review of gerontology and geriatrics is organized as an answer to the complex question of what is needed to improve the quality of care adults aged 65 and older during their transitions from one health care setting to another. pathways focuses on care transitions because this is where things are most likely to go horribly wrong for the patient, and the overarching goal is to improve patient outcomes, which in turn will reduce spending. the complications facing older adults who are experiencing care transitions are broadly contextualized within the recent public policy issue of health care reform, and even more broadly in the rapidly shifting age demographics of the u.s. that is slated to exacerbate an already strained system. while the many factors contributing to poor health outcomes during transitions are not unique to older adults, comorbidities like dementia do occur at higher rates in this population, further complicating their care. pathways (and specifically “coming full circle”) casts transitional care as a way of reorienting how health care is provided in the u.s. because transitional care as the authors frame it focuses on the patient, with care providers and family members coordinating the patient’s care in symphonic harmony, transitional care is held up as a site for the catalysts that could systematically increase the quality of care provided while reducing its overall cost. the health care system’s current state of disarray can be located in the five thematic “pathways” that this volume treats as the current health care system’s greatest weaknesses as well as its areas of greatest hope: family involvement, education and retention of the health care workforce, patient care quality and outcomes, reimbursement policies, and the fundamental fragmentation of the system. taken together, these themes have the power to make or break continuity of care as patients transition from one health care setting to the next. several solutions also recur thematically throughout the volume. among the most popular are patient-centric care models, interdisciplinary team (idt) coordinated care, multi-directional and ongoing communication, judicious use of technology, tying reimbursement rates to care quality, including family and direct care workers in decisionmaking, and holding health care providers and institutions accountable via standard performance measures. a few chapters, notably “public policy implications” (reinhard and lind) and “educating direct care workers on transitions of care” (stone and bryant), highlight the models and best practices that currently exist, and what promising programs the recently-passed patient protection and affordable care act (ppaca) and other public policies may facilitate. but these same chapters also note the particular barriers that exist to further implementation of these best practices. all of the authors admit there are quite a few stakeholders who are not exactly eager to see things shift to a patientcentric model. in response, “coming anthropology & aging quarterly 2013: 34 (3) 145 book reviews full circle” advocates that we consider stakeholders “in relation to each other” so that common interests can be identified and leveraged for the improved health of the system and the people it affects (252). and the contributors also hold up the potential of ppaca as a way to implement systematic changes. but knowing what we do now about the potentially dire straights the ppaca is in given the current political climate, how do we read the contributors’ optimistic suggestion that this federal policy is something we will be able to leverage to change the system for the better? despite this shadow of doubt, the pathways is thoughtfully written, its sections building easily upon one another. the recurring themes are interwoven throughout to create a consistent whole, allowing the volume to logically reach its conclusions and policy recommendations of the final chapter. the research herein has obvious widespread implications not just in the arena of public health, but also for our society as a whole. after all, as the authors point out, this crisis in health care is part of a larger socio-economic crisis. and while this volume focuses on the impact the system’s shortcomings is having and will continue to have on older adults, the authors consistently stress that it is not only patients who experience their health crises, but also their families and friends. the authors employ a variety of research methods, statistical sources, and ethnography to build their cases. a broad spectrum of people contributed to the solid scholarship in this volume, giving pathways a rich, interdisciplinary scope that bolsters its insightful suggestions for future research and policy. many of the contributors hail from the medical field, and there is representation of the health policy, social work, and psychiatric fields, as well. these are researchers who may actually have the influence necessary to change the lives of the people they have so meticulously studied. like all the volumes in this annual review series, pathways is intended for students, researchers and clinicians in the fields of gerontology and geriatrics. but this volume contributes useful knowledge not only to the field of aging studies, but to multiple disciplines and public policy. anyone interested in aging studies or health care would find this volume useful and enlightening. after reading this book, it seems that by improving care during transitions using the various suggestions the authors put forth, the impending health care and socio-economic crisis that the influx of older adults poses could be averted. however, the disconnect that all the authors identify as so dangerous during transitions of care mirrors the disconnects that tend to occur during the transitions of knowledge from research to policy and from policy to implementation. pathways is undeniably successful in what it aims to do: providing tools to think through ways of improving the quality of transitional care for older adults in america. and the contributors do an admirable job of discussing the underlying, systematic barriers to the application of its important and well-researched conclusions. i simply wish its contributors had provided clearer pathways through the transition from research to practice. rachel sona reed the pasadena village hayslip, bert, jr.; smith, gregory (eds.), annual review of gerontology and geriatrics, volume 32 2012: emerging perspectives on resilience in adulthood and later life. springer. 2012. isbn# 978-0-8261-0874-6, 299 pp, $99 (hardcover) this collection is a timely and excellent contribution to the study of resilience and the field of gerontology. recognizing that resilience as a construct is complex and lacks a unified and agreed upon definition, the editors conceptualize resilience as multifaceted and multidimensional, while demanding “attention to a virtually unlimited array of interacting biological, psychological, and environmental variables that must be truly viewed from an interdisciplinary and life span perspective” (p.24). as a result, the volume is organized in two parts: the first (chapters 1 through 7) addressing domains (physiological, biopsychosocial, and environmental aspects) of resilience and the second (chapters 8 through 14) discussing application (intervention and value of resilience in specific age-related contexts). contributors to this volume address the multidimensional nature of resilience while considering how the research has evolved and developed given its historical context. additionally, contributors present the most pertinent issues related to the measurement and application while advising and encouraging scholars to explore the complex and unanswered questions as they investigate and develop programs of resilience research. this volume showcases prominent scientists studying resilience. additionally, contributors review the current state of the literature and articulate trends in the frontier of resilience research at large. the content in almost every chapter is accessible, compelling, and anthropology & aging quarterly 2013: 34 (3) 146 stimulating. the collection is intended for both lay and expert readers wishing to understand the state of resilience research as it pertains to later adulthood, and would be an excellent text for graduate courses allied with aging and adult development. part i of this volume details various domains and contexts for which resilience is important. key themes are: defining and conceptualizing resilience, resilience as it pertains to major issues related to aging (immunity, cognition, stress and coping, environment, and spirituality), and the call for future research that better measures and models resilience in later life i.e., research that deals with the temporal nature of resilience as a process. in chapter 1, smith and hayslip provide a comprehensive discussion of resilience as a construct and adequately define and situate resilience in relation to protective factors, risk and adversity. fagundes, gillie, derry, bennett, and kiecoltglaser in chapter 2 examine the biophysiological aspects of resilience in the context of immunological functioning. in chapter 3, lavresky explores the relationship between stress, resilience, and mood disorders such as depression and anxiety. in chapter 4, ryff, freidman, morozink, and tsenkova deal with resilience in the context of emotional expression and regulation. stine-morrow and chui in chapter 5 explore the need for maintaining and coping with cognitive functioning in later life as a way to enhance resilience. aldwin and igarashi in chapter 6 treat resilience as the key factor enabling older adults to successfully manage poor personenvironment fit. in chapter 7, ramsey discusses the role resilience plays in promoting spirituality as a resource and component of successful aging. part ii of this volume “focuses on the application and value of resilience to a variety of issues key to successful development” (p.151). key themes are: translating resilience into the lives of older adults and best practices for doing intervention based work in the context of resilience. in chapter 8, walsh applies key components of resilience to later life families using a family systems perspective. in chapter 9, rybarcyzk, emery, guequierre, sharmaskin, and bethel look at indicators of resilience of individuals in rehabilitation following a stroke, fall, or onset of a chronic condition. bonanno, westphal, and mancini in chapter 10 discuss resilience in the context of individual differences in adaptive coping. in chapter 11, sterns and dawson consider resilience in the workplace and how it relates to the older worker. coon in chapter 12 explores the resilience of caregivers. in chapter 13, diehl, hay, and chui discuss the role stress plays in the process of recovery and resilience in the everyday lives older adults. lerner, schmid, weiner, arbeit, chase, agans, and warren in chapter 14, using person-environment interactions, consider the constructs of biological and psychological resilience in the context of a lifespan developmental perspective. traversing the life course promises that individuals will encounter a multitude of life events, and for some these events will be sources of hardship, adversity, and trauma. what determines whether people thrive or survive when encountering these events? what circumstances increase the likelihood of having resilience, or the capacity to maneuver through adversity in a manner that protects health and wellbeing? is it simply inner strength, self-regulation, or innate human capacity? why is it important that we investigate resilience in the later decades of life? how do we translate the underpinnings of resilience into interventions and policies that benefit older adults and society at large? if you are a looking for a volume that addresses these questions and more while offering new and exciting ways to fill existing gaps in resilience research, reading this volume is a worthy investment of your time and energy. lydia k. manning, phd associate professor of gerontology concordia university chicago jean-marie robine, carol jagger, and eileen m. crimmins, eds., review of annual review of gerontology and geriatrics. v 33, 2013. healthy longevity: a global approach. springer publications. new york: 2013. isbn-10: 0826109942 $95.49 (hardcopy) this volume is part of the series of reviews of research in aging. as the subtitle specifies, it addresses research on living longer. the sixteen chapters, each by different sets of authors, included have a consistent conclusion: with appropriate medical care, older people will live longer with less destructive effects from debilitating conditions. more people will live to be the older elderly and men will live longer than before. the effect of this older elderly aging has significant policy and fiscal implications, because appropriate treatment and monies will need to be applied to them. the chapters address different issues that are of interest to students of gerontology, geriatrics, and especially the members of aag. chapter 2, book reviews anthropology & aging quarterly 2013: 34 (3) 147 book reviews for example, by mikael thinggard, matt mcgue, and kaare christensen, “age trajectory of high cognitive functioning,” notes that: “it is reassuring that exceptional longevity does not necessarily lead to high levels of cognitive disability in the 1905 cohort. (p.45.)” the authors ask that this finding be tested in later born danish cohorts as well as cohorts in other countries. they go on to suggest appropriate statistical methodologies be used to make certain any missing data be addressed these findings are further confirmation of earlier results. zarit and zarit, in their review of aging disorders, explore cognitive functioning longitudinally and across cohorts. they note data drawn from the seattle longitudinal study that show stability in most areas as people reach older ages (2011:25.) of course, both medical and psychological factors can detrimentally affect cognitive skills. this is reassuring as we find ways to diagnose both sets of factors. from this example, and others to follow, it is clear that except for japan, the volume focuses on european and north american studies. the editors and chapter writers note that comparable studies should be done elsewhere and continue to be done throughout the first world, with particular reference to appropriate statistical methods that connect both longitudinal and cohort studies. several of the chapters focus on biological factors in health aging. in chapter 7, “optimizing human health span and life span,” bradley j. wilcox et al. look at the phenotypes that define human aging. they conclude from a number of studies: “…the phenotypes of ‘healthy’ or “successful’ aging or ‘health span’ are complex and ill defined. it is difficult to assess predictors or correlates of these phenotypes and even more difficult to replicate findings if the phenotypes are unclear and differ from study to study. (p.156.)” they suggest continued use of autopsy studies, especially given the advances in micro-technology that allow more accurate study of organs to determine aging issues. others focus on medical service, education, and self-care factors. chapter 13, for example, in karine peres, et al., “recent trends in disability free life expectancy in the french elderly,” follows the general theme of the chapter reviews and studies in this book. the authors suggest that “…the health of older people has significantly improved over the last two decades concurrent with a rise in le [life expectancy]…” they go on to note that healthier life styles—e.g., better diets, more exercise, decreased consumption of nicotine— have helped as well. furthermore, they note that some of the gender differences of the past seem to be changing outcomes: “men and women may have developed some competency in areas traditionally dominated by the other gender in previous cohorts, such as doing the shopping or preparing meals among men and driving a car or handling finances among women. (p.306.)” some alternative research suggests that women may report more disability than men: http://www.ncbi.nlm.nih.gov/pmc/ articles/pmc1448463/ consequently, in this reviewer’s experience as an anthropologist and psychologist treating the elderly, researchers and therapists should be sensitive when doing assessments and treatment to this possibility when working with the elderly. as this chapter and other chapters throughout the volume suggest, there are policy implications for this healthier aging. in simple terms, as the later chapters portray, more elderly are living longer. the readings suggest that appropriate medical and psychological care, with suitable funding, can help the elderly achieve a more successful and fruitful experience during these years. the various authors do note the limitations in the research they do and suggest further research in the first world should be done to address uncertainties in their findings. meanwhile, those of us concerned with issues of aging will find this collection welcome in terms of enhancing positive outcomes for the elderly. 2011 zarit, steven h. and judy m. zarit. mental disorders in older adults: fundamentals of assessment and treatment. 2nd. edition. the guilford press. new york. 2004 http://www.ncbi.nlm.nih.gov/pmc/ articles/pmc1448463/ richard zimmer sonoma state university anthropology & aging quarterly 2013: 34 (3) 148 levine madori, linda. transcending dementia through the ttap method: a new psychology of art, brain, and cognition. baltimore, md: health professions press. 2012. isbn 9781-932529-72-2, 243 pp. price $42.95 (paper) dr. linda levine madori has developed an approach to enhance the quality of life for people with dementia. the twelve-step therapeutic thematic arts programing (ttap) offers a way for administrators to implement person-centered dementia care for residents of nursing homes and assisted living facilities. the ttap embraces finding out what animates a person and taps into what levine madori refers to as the mind’s eye throughout the book. ttap allows the individual to reminisce, reflect, and share with others in a group setting by utilizing a variety of communication and self-expression forms. ttap focuses on the arts which include painting, music, dance, sculpture, and writing. the resident is empowered by their ability to choose colors, media, word choices, and music styles. the resident is further empowered to plan social events celebrating their accomplishments by planning events such as themed meals for other residents, staff or family members. finally, the most important opportunity to engage in empowerment and self-advocacy is when the individual is asked to evaluate their experiences and offer suggestions for improvement and options for future ttap experiences. upon first impression, i felt that this book was directed towards therapeutic recreation and activities professionals. the text provides an overview of alzheimer’s disease and dementia, an overview of the ttap, basic brain anatomy and physiology, and details of neurophysiological responses in clients engaging in the ttap. upon further reflection, this book is meant for everyone. culture change within a care center, regardless of the method chosen, can only happen with support from administration. once administration has chosen the method of culture change there must be education and acceptance by all stakeholders, particularly the nursing assistants. in the final chapters there is discussion about the replication of levine madori’s ttap at multiple care facilities. as an administrator, the part that caught my attention was that one facility claimed an estimated cost savings of over $160,000 in one year (170). as an educator, i could see this text being utilized in gerontology, activities, and recreation courses. of further interest to the academicians is the chapter that highlights how the ttap is grounded in interdisciplinary research with foundations from theories in developmental, life span, recreation, psychology, life review, neurodevelopmental, object relations, and gerotranscendance. i found the appendixes to be a great strength of the book and helpful to me as an administrator. in appendix a, levine madori provides sample protocols for the ttap which details the treatment protocol, the materials needed for the session, the rationale for the session, how clients are referred to the sessions, risk management, the structure of the session, time allotment, outcome and evaluation gathering as well as personnel needed for implementation. appendix b provides sample assessment tools. appendix c provides ideas for programming using affordable, everyday supplies that are budget friendly. appendix d provides samples of graphic visual organizing tools to help clients to develop themes for the session. appendix e provides a list of suggested themes to initiate the session. a weakness for me is that i personally would have liked to have seen more detail in appendix a as well as more information on actual implementation. however, upon further research at www. levinemadoripdd.com i found that the author has written other companion books that may provide the additional information i am seeking. as my interest was piqued by the cost savings at one facility, i would have like more information in this area. as facilities and those who regulate them struggle to meet the changing demands of the industry and their clients, i find this book to provide an excellent opportunity to begin or advance current progress on implementing person-centered care. finding the method that meets your facilities personality and culture can be a challenge. whether the ttap is the right one for a particular facility, only the staff and residents can tell. regardless of the method adopted, there are definitely lessons to be learned and incorporated into any activity or recreational program. jennifer a. wagner, mph, lnha bowling green state university instructor, gerontology program karen l. fingerman, cynthia a. berg, jacqui smith & toni c. antonucci, eds. handbook of life-span development. springer publishing company, new york, 2011. isbn 9780-8261-1079-4. pp881. e-book isbn: 978-0-8261-1080-0. price $125.00 (hardcover) book reviews anthropology & aging quarterly 2013: 34 (3) 149 book reviews (karen l. fingerman et al. continued) karen fingerman, phd is professor of developmental and family studies at purdue university; cynthia berg, phd is professor of psychology at the university of utah; jacqui smith, phd is professor of psychology at the university of michigan; toni antonucci, phd is professor of psychology and research professor of the institute of social research at the university of michigan. the handbook is an impressive collection of research studies and theories provided by knowledgeable contributors on life-span development from conception to old age. the 32 chapters are organized within four major thematic sections: 1) theory and overviews; 2) physical and cognitive; 3) socio-emotional; and 4) contexts of development. exemplars from each section are selected to demonstrate related content. relationships, the environment and socialization threads are interwoven throughout the text. study findings of population and generational groups are discussed; however, the uniqueness of the individual is addressed. theory and overviews (8 chapters)several theories and models used by scientists and their study approaches are included in this first section of the book. attention is given to biological and cultural processes involved in the human complex development system. heredity accounts for only a portion of variance in human development, for from the moment of birth, a child’s experiences and behaviors are shaped by the culture and customs of the environment. the parent-child attachment has a great influence— whether positive or negative—on the child’s socialization processes. socialization continues through interaction with important others that make up the immediate and social environments. the environment shapes a person’s interpretation of self, relationships with others, social networks, and aids the individual in finding a sense of meaning in the past, present, and future life. socialization represents stability and is composed of many discrete and related acts over an extended period of time. the authors present an overview of the early research that influences the current work about human development. erik erikson (1950/1963 and 1968) based his psychosocial theory of task development on the work of the early 19th century scientists, charles darwin and sigmund freud. according to erikson the success of completing an age specific task before moving to the next task, or failure to do so, is measured by sociocultural expectations. robert havinghurst, whose work was influenced by erikson, stated that task development is accomplished through biological maturation, sociocultural pressures, and the values and goals of the individual. many theorists have selected these theories as the basis for cross-sectional and longitudinal studies in education, sociology, anthropology, psychology and other sciences. life-span developmental theory emphasizes that human development continues from birth to death; therefore, this theory can open new paths for examining the tasks of adulthood that have not been fully explored. the convoys of social relationships: past, present and future model can be an excellent tool for an individual as the central person to identify the people that make up a support system in three concentric circles in the order of most importance. the scientist and the individual can, then, explore the type of support these people provide, and how the circles constrict and expand throughout the individual’s life span. each life cycle has its own challenges and rewards. the model can, also, help to explain how the individual adapts to these gains and losses. to date there is scant research on the transitional phases of life. recommendations for future research include frequent observations of a cohort group and individuals to discover the subtle changes that occur over a life time. physical and cognitive (9 chapters)-the authors in this section provide an overview of neurological anatomy and the structural changes in the developing brain. study findings revealed that neurogenesis occurs prenatally and that the majority of brain growth volume occurs in infancy and the toddler years. axons and new synapses are formed throughout life, yet some are eliminated as the person becomes more efficient in processing information. additional studies were conducted to understand individual differences in behavior and cognition. other research designs were used to study the effects of maturation on sensory, motor, cognitive, linguistic and social processing through childhood and adolescence. magnetic resonance imaging (mri), positive emission tomography (pet) scans and other technologies have permitted scientists to begin mapping the brain structures. technological advances have also assisted neuroscience researchers in examining and identifying the changes in the aging mind and brain. researchers have learned that long term memory in older adults varies, and some people use different brain areas to preserve their cognitive abilities. research on these areas is relatively new. there is evidence that the brain is particularly sensitive to anthropology & aging quarterly 2013: 34 (3) 150 book reviews social stimuli. theories derived from these studies may provide key insights in ways to combat adverse effects of aging on cognition such as perception attention, working memory, executive control functions and long-term memory. the aging population is ripe for studying brain disorders like dementia which is not part of normal aging; however, the risk increases with age and the etiology is still not understood. socio-emotional (8 chapters)the control of emotions is not an easy task for the very young. researchers usually observe the mother as the principal care provider who serves as the external regulator of the behavior of the infant and young child. personality and temperament are, also, frequently associated with emotional responses to environmental stimuli. emotion control is particularly difficult for teenagers due to the changes in hormone levels and the effects on rapid changes in moods. studies have found that the most dramatic increase in clinical depression rates peak during the ages of 15 and 18 years. however, maturity and the pressure of social behavior expectations have a great impact on the person’s control over emotional responses and coping mechanisms. narratives have been important methods for centuries to convey historical facts to generations of people. children enjoy listening to stories, and frequently create their own life stories about their identity and who they want to be. during the middle years, individuals focus their narratives on their memories of a specific life event or happenings over an extended time frame. their accounts depict the “high and low points, turning points, and other emotionally charged events” (p. 596). reflecting on these events may build social relationships, strengthen connections with family, and can substantiate the person’s identity. story telling can, also, be therapeutic in coping with losses and other negative life events. research with older adults has revealed that narratives are a means for discovering the various strengths as survivors over their personal life challenges. researchers have discovered that intergenerational story telling can affect the development of people of all ages. the narrative can be a legacy to leave for the next generation. contexts of development (7 chapters)the authors comment that research on cognition, emotions, and motivation development can be dependent upon the changes or consistency of social environments for individuals and groups. the context should be used to develop the research questions. researchers are concerned about the inequalities that include race, ethnicity, gender, sexual orientation, class, age, and geographic location. additional factors include citizenship, and the concentration of living in affluent or in high poverty neighborhoods. the neighborhood environment is of particular interest to researchers in public health, sociology, developmental psychology, economics, and epidemiology. residents often describe their neighborhood as an expansion of the family. socialization that begins in the home moves on to the schools and into the neighborhood. many researchers have examined neighborhoods from ecological and sociological perspectives. several theories are needed to adequately explore the many variables involved. however, due to the inevitable changes and instability in neighborhood environments, researchers have difficulty in conducting longitudinal studies. the authors suggest that interdisciplinary collaboration and different methods of inquiry including interand intragenerational studies are required in order to capture all concepts that are involved. there is a need for additional theoretical guided empirical studies related to racial and ethnic inequalities associated with neighborhoods where there is disproportionate allocation of economic and social services. poverty neighborhoods can be dangerous living environments. research has revealed that infant and pregnancy mortality rates are greater, unemployment is prevalent, and poor healthy lifestyles contribute to poorer outcomes including acute and chronic illnesses. reflecting back and looking forward to the futureour world is changing rapidly. the turbulent nature of post-modern society has resulted in many social roles that did not exist for older adults when they were young. today’s family roles have different responsibilities and realignment of activities than a few decades ago. technology has a major impact on the lives of everyone, and will continue to do so. one often wonders what our world will be like in 2025, 2050 and beyond. my review was conducted within the health care perspective. i can envision many possibilities for research in the future. perhaps a legacy for this book is being the first edition of handbooks that will follow. ruth n. grendell, dnsc, r.n. certified advanced facilitator university of phoenix. professor of nursing, emeritus point loma nazarene university anthropology & aging quarterly 2013: 34 (3) 151 book reviews aldwin, caolyn m. and gilmer fox, diane. health, illness, and optimal aging: biological and psychosocial perspectives second edition. new york, ny: springer publishing company. 2013. isbn 978-0-82619346-9, 416 pp. e-book isbn 978-08261-9347-6 price $90 (soft cover) the rising number of aging adults has increased exponentially both within the united states and abroad. this increase warrants a critical examination of the ways in which these adults can obtain and maintain optimal health and address illnesses throughout the aging process. drs. carolyn aldwin and diane gilmer explore, address, and articulate ways in which optimal aging is understood. they revisit their earlier work with regards to optimal aging in the second edition of health, illness, and optimal aging: biological psychosocial perspectives with the intent of expanding their current arguments, providing a useful toolkit for researchers, scholars, caregivers and health providers, to use in continued gerontological studies. aldwin and gilmer have written a text that is accessible to senior level and honors undergraduates as well as graduate students across disciplines and orientations. this book also will appeal to researchers across the social, biological, and psychological sciences. it serves as an excellent medium for fostering and engaging in interdisciplinary research. clinicians and care providers will find this text to be a useful tool in exploring integrated health care of the aging. the authors are very explicit in stating that one of the primary goals of this expanded text is to advance and be a facilitator of knowledge as it relates to optimal aging. throughout the text the authors intricately weave a multi-dimensional tapestry for late life studies. each chapter critically examines emergent gerontological themes across disciplines. they posit that late life research and scholarship cannot be understood through a singular theoretical model; however, these areas of study would greatly benefit from an integrated and holistic approach. aldwin and gilmer argue that “gerontology is not yet at a stage in which a unified theory can be proposed. the book is organized so that it illustrates the various ways in which multiple theories can be used to advance research and scholarship. the authors indicate that their overall goal in this edition was “to examine the biological and psychosocial aging literatures to determine whether they can be organized using the aging accelerators and decelerators model, in order to enhance understanding of the many facets of aging and to promote optimal aging and to create a bridge for understanding across disciplinary boundaries (3,6).” the book is organized into four very distinct sections: 1) demographic, theoretical, and methodological issues; 2) aging of biological systems; 3) psychosocial factors affecting physical health; and 4) practical and clinical aspects of aging. each section is underpinned with the theme of accelerators and decelerators that factor into the ways in which individuals participate in aging. these sections serve as a backdrop for the anthropologist, psychologist, medical practitioner, and lay person to glean important interrelated components of aging. like the ways in which an individual progresses through various life stages, the strengths of the sections and chapters in this text follow similar trajectory. one of the many strengths of this book begins in the introduction, is followed by chapter 4, and concludes with chapter 14. in the introduction, aldwin and gilmer carefully outline the basic concepts in aging. they provide the reader with a set of definitions that puts aging and identity into context as well as delineates the notions of health and illness. in chapter four they walk the reader through the processes of aging research. this is a particularly useful section for the senior level or honors undergraduate student that desires to engage in aging research. chapter fourteen defines and articulates the notion of optimal aging. of interest in this chapter, are the sections on wisdom and optimal aging, religiousness, spirituality, and optimal aging, and ars moriendi-the art of dying. these sections portend a literary artful finality to the text. finally, the primary strength of this book is the implicit optimistic tone of the text. aldwin and gilmer illustrate that an individual has the ability to age gracefully they need not take “the lay down and die approach” to aging. the aging adult is equipped with different ways of aging well (6). they are able to live sustainable healthy physical and mental lives. aldwin and gilmer have supplied an interesting textual model for examining health, illness, and aging. their homogenized approach to aging research is refreshing and insightful. elisha r. oliver, ma phd student in anthropology university of oklahoma anthropology & aging quarterly 2013: 34 (3) 152 book reviews van den hoonaard, deborah k. by himself: the older man’s experience of widowhood. university of toronto press. 2010. isbn #978-1-44264109-9. 198 pp. $45.00 (hardcover) deborah k. van den hoonaard is a sociologist, professor and qualitative research chair at st. thomas university in canada. her recent book, by himself, provides a revealing look at the lived experience of widowhood for older adult men. the book is divided into four parts. part one introduces the conceptual basis for van den hoonaard’s research, with parts two, three and four containing in-depth chapters that explore various aspects of widowhood for these men. part one orients the reader by describing the theoretical and methodological issues of van den hoonaard’s study. chapter 1 situates her research within the wider body of literature on widowhood that is often based on the perspectives of women or younger widowed men. van den hoonaard’s work is distinct in this area of research given its focus on older adult male widowers, a group that is relatively unknown in the literature. grounding her study in a symbolic interactionism framework, van den hoonaard interviewed older adult men living in rural atlantic canada and florida retirement communities to explore how widowhood is conceptualized from their perspective. the author began recruiting for her study exclusively in rural atlantic canada. yet she notes that “widowers were not easy to find” (van den hoonaard 2010: 13), and expanded her recruitment to include widowers living in florida. although this geographic expansion of her research was not anticipated, the author felt the more diverse sample provided deeper analytical insights. in chapter 2, van den hoonaard discusses how widowhood is inherently a gendered experience and consequently emerged as a key theoretical issue that she effectively integrates throughout subsequent chapters. she notes how the men never considered widowhood a possibility in their lives, operating under the assumption that their spouses would outlive them. when the men became widowers, they felt disoriented and “did not know where they belonged in the foreign country which they had entered when their wives died” (van den hoonaard 2010: 21). their sense of masculinity, already threatened by age, also became threatened by widowhood, a status that deprived these men of “visible heterosexuality” (van den hoonaard 2010: 20). part two focuses on the men’s experiences coping with their wives’ illnesses and deaths. in chapter 3, van den hoonaard provides a compassionate account of the widowers’ experiences interacting with and caring for their wives once they became ill. the author analyzed the widowers’ discourse, which revealed speech patterns that “emphasize their masculinity” (van den hoonaard 2010: 31). for example, when describing their caring presence at their wives bedside, the men’s discourse revealed how they embodied the gendered role of the committed husband. the period immediately after their wives’ deaths, the subject of chapter 4, brought a range of emotions from “shock” to stoicism (van den hoonaard 2010: 49) for the widowers. the men described various forms of social support from friends, family and religious affiliations that provided a needed sense of comfort during this difficult time. the men also took comfort in how well their wives were thought of, symbolically represented in high number of funeral attendees. yet the harsh realities of widowhood existed beyond these comforting social networks as some men had to settle financial affairs that included continuously furnishing death certificates, which acted as a stark reminder of their profound loss. part three describes the widowers’ various social relationships. chapter 5 focuses on how the widowers interact with their children, and provides numerous ethnographic examples illustrating the multidimensionality of these relationships as well as boundary issues. some of van den hoonaard’s findings about these relationships are not unexpected, such as daughters fulfilling some of their mother’s gendered roles like cooking or maintaining traditional family events. interestingly though, the author also discovered that some of the widowers used the interview as an opportunity to openly discuss their children’s “flaws” and that “the men tended to blame their wives” for these issues (van den hoonaard 2010: 76). chapter 6 focuses on female companionship and begins with the author acknowledging that her data “reinforced the commonly held belief that finding a new woman is an intrinsic part of widowhood for men” (van den hoonaard 2010: 84). van den hoonaard draws cultural contrasts between the men in atlantic canada and those in florida regarding how each interprets their relationships with women. for instance, the atlantic canadian men describe a great sense of discomfort if women are too forceful when vying for their attention. chapter 7 provides another viewpoint into the men’s social networks through examining their friendships. the closing of one’s social network after the death of a spouse is a common experience of many widowers, both male and female, according to the author. the men in van den hoonaard’s study anthropology & aging quarterly 2013: 34 (3) 153 book reviews are no exception. for example, some of the men found that their widower status made them “the odd man out” (van den hoonaard 2010: 109) when socializing with their married friends. yet van den hoonaard’s method of qualitative inquiry reveals that the closing of one’s social network is not experienced by all widowers. one of her participants, a widower living in a florida retirement community, discussed how his friends rallied to his side after his wife’s death and continued their friendships with him thereafter. part four describes how the widowers conceptualize “everyday life” (van den hoonaard 2010: 121), which includes “keeping busy” (van den hoonaard 2010: 123), the focus of chapter 8. to stay busy, the men describe volunteering, doing “odd jobs” (van den hoonaard 2010: 133) and informal socializing as opportunities for them to leave their home and engage in activities that reinforce their masculinity (such as fishing). leaving the home is highly important for these men, as an empty home is a significant symbolic reminder of the loneliness associated with widowhood. interestingly, van den hoonaard notes that the men preferred spur-of-themoment over pre-planned activities as it asserted their independence. cleaning the home and cooking is the subject of chapter 9, and the men perceived these tasks traditionally female oriented. as a result, they had no desire to “to master” (van den hoonaard 2010: 159) this domain; rather they preferred doing just enough cooking and cleaning to get by on a daily basis. when the widowers did clean or cook, they spoke about their experiences using very masculine language to justify engaging in these feminine tasks. in the following chapter, chapter 10, van den hoonaard concludes her book with an overview of key themes, and provides some insights for future inquiry. overall i found myself immediately engaged by van den hoonaard’s book that paints a poignant ethnographic picture of these men’s lives as widowers. what makes this book so engaging is her ability to iterate detailed ethnographic examples with theory to provide a robust analysis of this experience, yet one that is firmly grounded in the men’s experiences. this book showcases her skill as a qualitative researcher and storyteller, and provides a significant contribution to the gerontological theory on widowhood. this is a highly readable text that would be appropriate for both undergraduate and graduate courses in gerontology, sociology, anthropology and aging studies. researchers interested in conducting qualitative studies with populations that are more difficult to access will also find this book a valuable resource. van den hoonaard includes her interview guide at the end of the text. the views expressed in this review are those of the author and do not necessarily represent the views of the department of veterans affairs. lindsey ann martin, ph.d. michael e. debakey va medical center houston hsr&d center of excellence feil, naomi and de klerk-rubin, vicki. the validation breakthrough: simple techniques for communicating with people with alzheimer’s and other dementias. 3rd edition. baltimore, md: health profession press. 2012. isbn 978-1-932529-93-7, 304pp. $34.95 (paper). nearly five decades have passed since naomi feil originally developed validation as a therapeutic tool and in this time, organizations and families throughout the world have experienced and attested to its benefits. in this most recent edition of the validation breakthrough (3rd ed.), ms. feil, along with co-author and master-teacher vicki de klerk-rubin, continue to refine the terminology, concepts, theoretical underpinnings, and techniques of validation. the authors have expanded the number of case studies and testimonials from certified validation teachers, and updated resources for readers who seek additional training and information. stated simply, validation is a method of empathetically communicating with and caring for disoriented older adults who have alzheimer’s disease or other types of dementia. it is intended to benefit very old persons who are disoriented and who frequently exhibit challenging behaviors, as well as the persons caring for them. the authors contend that challenging behaviors often arise from a person’s struggle to resolve unfinished business during their last stage of life. as the disoriented person progresses through phases of resolution, caregivers can employ the validation techniques to connect with the person and assist them with expressing repressed emotions. as with previous editions, the book anthropology & aging quarterly 2013: 34 (3) 154 book reviews is organized into three parts. part one begins with descriptions of the theoretical underpinnings, concepts, assumptions, benefits, limitations, target populations, and techniques of validation. a substantive chapter is then devoted to each of the four phases of resolution (i.e., maloriented, time confused, repetitive movers, vegetation) and one brief chapter is devoted to people with early-onset alzheimer’s disease. although the authors attempt to review some of the literature about the efficacy of validation (ch. 8), this is by far one of the weakest chapters in the book. the authors conclude this section with a useful albeit brief discussion of how validation compares to other therapies commonly used with disoriented older adults who have dementia (ch. 9). part two of the book focuses on case studies and testimonials from certified validation teachers. it features stories of older adults in each of the four phases of resolution and how validation benefited them and their caregivers. part three provides a detailed description of how an organization can set up a validation group. unquestionably, the greatest strength of this publication is the large number of real-life examples that portray the challenging behaviors commonly exhibited by the target population and how validation techniques were, or could be, applied to the situations. these cases make the book easy and enjoyable to read, while also providing an accurate portrayal of challenges constantly faced by professional and informal caregivers. testimonials from validation teachers and authorized organizations throughout the world appear at the end of each chapter and also in the appendix, providing compelling stories about how validation has helped their residents and staff. this book has broad appeal to a variety of audiences, but is especially appropriate for health professionals and other caregivers who interact frequently with the alzheimer’s and dementia population. it is a useful guide for activity directors and nurses working in long-term care facilities and adult day centers. students seeking an introduction to this particular method of care or seeking insight into the disoriented, dementia population will also benefit. the content is particularly germane to the fields of interpersonal communication, nursing, gerontology, rehabilitation therapies, psychology, and anthropology. professional caregivers who are already familiar with validation and researchers seeking a thorough discussion of the scientific merits of this method, may not gain much additional insight from this new edition. it is an essential read, however, for persons considering validation certification as well as facilities that are considering becoming an authorized validation organization. family members and other informal caregivers struggling to understand and communicate with a disoriented older adult may experience greater empathy and may be able to more frequently connect with the person after reading this book and implementing the recommended techniques. students, health professionals, and family members alike will most likely enjoy reading this book due to the numerous cases and examples of application. while validation is not intended for all disoriented elderly populations, it is an important therapeutic tool for caregivers to have in their tool box. stacy l. barnes, mgs director, wisconsin geriatric education center marquette university film review grandma, a thousand times (teta, alf marra). 48 minutes. 2010. uae/qatar/lebanon: veritas film. (mahmoud kaabour). ‘grandma, a thousand times’ is a sweet and poignant documentary about an aging and spirited lebanese matriarch in a memory-inducing neighbourhood of beirut. writer and director, mahmoud kaabour, pours his heart out in this measured yet never over-sentimentalized film about his grandmother teta kaabour (a.k.a. hajjieh fatima). mahmoud, who has been living abroad, is haunted by an audiotape of his grandfather’s violin playing. the seven taqsims (melodic improvisations) on the tape bring the filmmaker back to his home, to the house of teta. there, we are treated to acts of love; love of a supra-motherly kind that only a grandmother knows how to impart. mahmoud and teta reconnect on the screen, and we are witnesses to acts of intimate kinship. we see teta peeling an orange with a small knife expertly, and then feeding mahmoud with her clean bare hands. part of the charm in this documentary rests with the fact that mahmoud not only looks like his grandfather, but also bears his first name. in an intricate weaving of intergenerational ties and the annoyances for teta surrounding mahmoud’s uncanny resemblance to his grandfather, grandma is once again ignited in her anguish and longing for her deceased husband. this is compounded when mahmoud takes teta down the street in the morning dressed up in fine clothes, donning a red fez hat before he gets married to eva star sayre. for most moviegoers, this short anthropology & aging quarterly 2013: 34 (3) 155 book reviews film will function as a window into a family, largely kept together by teta, and what she means to them and their memories of beirut. they may also empathize with mahmoud and his siblings’ desires to keep their snapshot of beirut and teta alive and unchanged for as long as possible, even if that means turning a blind eye to teta’s hobby of arguileh smoking. what i came away with, however, were some other aspects that captured my attention. to begin with, the documentary showcases a very ethnographic account of what old age is like. grandma realizes that she needs to exert herself intermittently, probably because of her lack of regular exercise and stamina. this amounts to getting out of the chair and taking a few more steps to fetch something instead relying on hasna the hired caregiver to do so, and haggling on the phone with a desirous feistiness for the freshest and leanest cuts of meat from the butcher. her feet are old and swollen, and we see them juxtaposed against the newly laid out winter ajami rugs. teta tells her grandson, that she also likes gum, but she only puts it in her mouth; she is unable to chew it fully. we see how she moves, and waves deliberately and methodically without wasting energy or flexing unnecessary muscles. she inhabits her empty house, but for her children (and their children) she is the warden of their ‘home’. furthermore, teta is not a boastful matriarch. she is a survivor thrust into her position by the people around her who invest their memories with and in her. teta inherits and negotiates this role with a mixture of good humor and good politics. we are often told that the elderly need to tell their stories, that reaching back is a way of providing continuity and narrative therapy. in this film, it is apparent that it is mahmoud and his siblings that need the narrative as a reminder and a lodestone for their own history making and ontologies. we may need narratives of our elders, but for the aging, they need real time commentary, commentary on their lives as things change around and with them. teta has perfected her daily rituals of smoking arguileh, of sitting outside on the balcony, and of providing her own life commentary. it is this subtle and dual commentary: of us talking about our elders and our elders reflecting on themselves that merges the past, present and future. even though this documentary is all too brief, there are beautiful images that lace seamlessly with spiritual solo violin, lingering on well after the film’s ending. in one gorgeous scene, a marble gravestone is being cut with a wet saw, and we can’t help but feel the intensity and sorrow associated with the bleeding white tears of the marble slab. teta is called upon by her family a thousand times, and insha’allāh she will remain teta for thousand and one more nights. philip kao postdoctoral fellow university of pittsburgh if you are interested in writing a book, film, journal or exhibit review for anthropology & aging quarterly, please contact: book reviews editor joann kovacich jkovacich@ rochester.rr.com. include your name, areas of expertise, current ation (research, professor, graduate student, e.g.) and any titles you would be interested in reviewing from the last three years. aaq does not accept unsolicited reviews at this time. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 127-134 issn 2374-2267 (online) doi 10.5195/aa.2015.108 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. design for aging perspectives on technology, older adults, and educating engineers caitrin lynch olin college of engineering contact: caitrin.lynch@olin.edu excerpt in lieu of abstract does the development of new technologies invariably contribute positively to the daily lives of older adults in the contemporary united states and elsewhere? eleven years into teaching anthropology to engineers, and five years into co-teaching a course on design for aging called “engineering for humanity,” my answer is: not always, but we can make it so. keywords: design, technology, older adults, education, ethnography. http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by/3.0/us/ anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.108 http://anthro-age.pitt.edu design for aging perspectives on technology, older adults, and educating engineers caitrin lynch olin college of engineering does the development of new technologies invariably contribute positively to the daily lives of older adults in the contemporary united states and elsewhere? eleven years into teaching anthropology to engineers, and five years into co-teaching a course on design for aging called “engineering for humanity,” my answer is: not always, but we can make it so. my colleagues and i have had numerous conversations about how engineering can contribute to human flourishing, and these dialogues have solidified our conviction that we must train our students to understand that empathy and context are essential for effective innovative design. the following notes toward a point of view on design for aging emerged from my work and discussions at olin college of engineering, and especially from collaborations with ela ben-ur, mel chua, sara hendren, and lynn andrea stein. here i want to describe what we have learned about empathy in design practice, and how the pedagogical approach in the engineering for humanity class helps students develop technological innovations that contribute positively to the lives of older adults. why empathetic design? in order to get students out of their own shoes, challenge their assumptions, and help them be attentive to values, meanings, and aspirations of those they are designing for, we teach our engineering students how to use anthropological methods for understanding people. following bronislaw malinowski’s now-famous description of the how and why of ethnography, we aim to train our students to “grasp the native’s point of view, his relation to life, and to realize his vision of his world” (1922:25, emphasis and pronoun use in original). unexamined assumptions held by designers and engineers can lead to inappropriate technology, overdesign, or the right solution to the wrong problem. for example, consider the following story from my colleague mel chua, who is deaf. for her nineteenth birthday, mel’s engineering college roommates built a direction-signaling box for her car, so they, as passengers, could tell her where to turn. they mounted buttons to activate lights that would blink to tell mel to turn left or right, go straight, stop, etc. mel and her friends were excited to get out and test the system… until they got in the car and realized that hand signals worked more effectively. hand signals utilized peripheral vision, could communicate a wider range of turn options, and required no batteries. the artifact ended up spurring a discussion of how to redesign communications protocols in mel’s car, but the ultimate solution ended up being to not use a device at all. lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195 aa.2015.108 http://anthro-age.pitt.edu 128 in terms of innovations regarding aging in particular, let me provide a positive example of mobilizing empathy to accurately frame the problem, and ultimately to generate better solutions. (i borrow this example from the writer and surgeon atul gawande [2014a].) dr. bill thomas has led a movement for rethinking institutional elder care in the united states. when thomas worked at a nursing home in the early 1990s, unhappy, unengaged, agitated, and depressed patients were treated with medication because the problem was assumed to be with the patients themselves. thomas arrived and reframed the problem. attributing the same behaviors to “the three plagues of nursing home existence” (boredom, loneliness, and helplessness), the design problem or opportunity shifted to addressing those plagues, not the person. so thomas brought animals, plants, and children to the nursing home to “bring in some life.” thomas described the impact to gawande: people who we had believed weren’t able to speak started speaking…. people who had been completely withdrawn and nonambulatory started coming to the nurses’ station and saying, “i’ll take the dog for a walk.” all the parakeets were adopted and named by the residents. the lights turned back on in people’s eyes. (gawande 2014a: n.p.) and, gawande adds, thomas’s team found that the use of medication, such as psychotropic drugs for agitation, dramatically decreased (gawande 2014a; cf. 2014b). several years ago i had the following facebook exchange with an engineer named steve.1 ever since i have used this exchange in classes to generate discussion about this very phenomenon of reframing the problem. steve invokes amazon fresh, a service in which a customer receives home-delivered groceries by placing orders online: caitrin: …i have 2 students working on a project this semester about making the grocery shopping experience easier for older adults. please let me know if you know anyone willing to have students accompany them on a shopping trip to observe/discuss. thanks. steve: amazon fresh. http://fresh.amazon.com/ caitrin: might that high-tech solution inadvertently remove some of the pleasures of shopping for older adults (such as socializing, dressing up, getting out of the house, feeling in control, seeing friends, making choices on the fly in response to things s/he sees, pinching cute babies on the cheek, etc. etc.)? steve: nope. worth noting that i don’t see it necessarily as a tech solution to that problem. it frees you up to engage in alternative baby-pinching socializing controlling friendly activities that don’t have a sense of suck. i use this exchange to prompt students to understand the context and meaning of activities for people they are designing for. what would ordering groceries online for home delivery enable and disable for older adults? how might a design solution solve some problems but ignore or create other problems? lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.108 http://anthro-age.pitt.edu 129 129 i invite students to consider what shopping in a store might enable for older adults, beyond the instrumental purpose of acquiring food for sustenance. i do not suggest that tech solutions are always inappropriate for these same grocery shoppers who might want to get into the store to exercise choice, enact independence, and be social. i prompt my students to consider how we might redesign aspects of the experience to enable people to shop even as some abilities might decline. in addition to improved product design, consider these possible systems-level solutions, some already available in select elder-friendly grocery stores: attractive benches strategically placed for resting; magnifying glasses hanging from shelves for reading labels; store staff trained to be sensitive to confusion that may result when items are relocated to new spots in the store; bargain pricing for other than “family size” servings. but i also caution students that just because the solution for some older adults may not be amazon fresh, for some people, safety, comfort, and engagement at home might be more desirable. i share with students a discussion i had more recently with greg, a designer at a personal emergency response system (pers) company. this is a system that centers on a button worn as jewelry. a press of the button in an emergency triggers a call center worker to summon the required help. these systems can be an important aid for many older adults who want to age in place and independently. greg was proud of a project he had led to design a box that could be shipped to a customer with the entire system inside; the customer could set up the system without the need for a visit from an installer. when i first heard of his work, i categorized it with the amazon fresh example: a naïve engineer ignorant of the loneliness felt by some older adults, removing the human interaction just to save on labor costs. but then greg described to me why he and his team did this work and i realized it was i who was naïve. after months of interviewing older adults, greg accumulated numerous examples of how the interview and feedback process itself was problematic for the customers. so worried that he would arrive when she was in the bathroom, one woman didn’t eat for the 24 hours before greg came. so anxious about a stranger’s impending arrival, one man forgot to take medicine that morning and greg had to get medical help for him. with these observations and insights, greg focused on how to prevent these disruptions in daily self-care routines. he designed the box, the instructions, and the devices to be usable by people who not only might have vision loss and limited dexterity or cognitive capacity, but also might be intimidated by new technological systems. he focused on the mastery experiences that an 80-year-old new customer might feel after independently doing all the work to activate the system. in this installation box example, we find an engineer deeply attuned to the people he was designing for. rather than narrowly focused on a product, he considered the wider context for the product in a person’s life. we hope to train our engineers to be so empathetic and appreciative of context. one opportunity comes through the engineering for humanity course i co-teach at olin college. as my colleague sara hendren has noted, the what and the how of engineering have long been emphasized in traditional curricula. but adding the questions who, when and why invites students of engineering to a much bigger, fundamentally human set of questions. why do we build what we build? why this choice and not another? who is asking for a new product or system? when might we invert or alter the traditional questions, to get better answers?2 with these humanistic questions in turn, let’s turn to the engineering for humanity course. lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195 aa.2015.108 http://anthro-age.pitt.edu 130 engineering for humanity growing out of a commitment to introducing students to interdisciplinary opportunities to make a difference in the lives of older adults, lynn andrea stein and i created engineering for humanity, which we first offered in 2011.3 lynn and i found complementary perspectives and expertise in lynn’s background in engineering, design, computer science, and cognitive science and mine in anthropology and aging. engineering for humanity, which earns the students credits in both anthropology and engineering, engages older adults in the local community. the course is an elective for students from three colleges, olin college of engineering, babson college (a business college) and wellesley college (a women’s liberal arts college). the majority of students are olin engineering students in the second semester of their first year; cross-registered students from a wide range of majors at wellesley, undergraduate and mba students from babson, and foreign exchange students have also participated in the class. we recruit older adults from the surrounding communities to participate in a series of design and community-building activities. students also do contextual work to understand broader issues about aging in the united states and elsewhere. students focus in on working with one person (or domestic partners) and then identify a problem or opportunity, find an appropriate and acceptable solution, and build that solution within the space of one semester. this is a complete start-tofinish process of learning to design for a single user (design-for-one). past student projects have included the following (among others): a gardening stool for a woman who cannot kneel due to knee surgeries; a cutting board to enable cooking for a woman with macular degeneration and glaucoma; a laundry-carrying bag for negotiating steep new england basement stairs; domestic organizers for keeping track of frequently lost items and grocery needs; videos and other aids for using and learning english for recent immigrants; foot massagers to relieve diabetes-related foot neuropathy and prevent sleep disruptions for both members of a household, only one of whom has neuropathy. to attract new students into design for aging, we presume no engineering or design background. to expose students to an entire design and build process (from identifying values, opportunities, and problems, to building solutions), we anticipate projects modest in scope and relatively low tech. this pedagogical approach to early student exposure and design-for-one also has helped us to develop a point of view on effective design for aging. designing for one and in the low-tech space allows students to develop close relationships with community members, to make an immediate and meaningful difference in someone’s life, and to understand how engineers can contribute to needs and opportunities around aging. students come to reframe engineering as not only the technically complex, hightech work they hear about in theoretical lecture classes. instead, they learn from experience that elegantly simple solutions to everyday problems can have transformative impact on people and address more than they might have anticipated in their initial framing.4 allow me to describe a few such transformations. at the final event for the class in 2014, students gave podium-style presentations followed by science-fair style hands-on demonstrations. i watched one student, toward the end of her team’s powerpoint presentation, look directly at her community partner and, in front of the roughly 100 college and community members assembled, thank her for working with the team. she said, in essence, “you are kind, lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.108 http://anthro-age.pitt.edu 131 131 smart, fun, interesting, a great cook, and we learned so much from you. we will miss working with you.” i observed another student introduce his parents to his 90-year-old community partner. the elder woman gave the student’s mother an embrace from her wheelchair height and lauded the son as her “angel.” the next day i received an effusive phone call from another community partner, who experienced a teary goodbye when he had left the event, to tell me that his team deserved an a+. and then i read my students’ reflection papers, and came across comments such as this, in response to a prompt on how (if at all) has the class changed student understandings about aging: this course changed my relationship with aging. getting to know senior citizens was the most meaningful for me and influenced my perceptions the most. it has changed my perception of my grandpa. i used to associate aging with failing health and inability to do things. growing up, my grandpa would go on hikes and go camping with my dad and me. as he got older, he stopped hiking. i attributed it to his body failing. i thought it was too difficult for him to do physical activities. this made me dread aging because i want to be able to do the things i love when i’m older, and my grandpa used to love hiking. taking this class made me realize that he didn’t stop doing what he loved, but rather adapted to his limitations. he started canoeing more when he began hiking less. he enjoys being outdoors and is still able to experience that. what i like in this response is how the student has been able to reframe his own life. the class has led to self-reflection and a newfound respect for and understanding of his grandfather. the student also has come to new ways of thinking about needs and values as he reframes canoeing and hiking as similar in what they both enable, rather than an earlier interpretation that canoeing was an abandonment of hiking. another year, i was heartened to read this in a student’s final refection paper: any good design is secondary to what’s really important—rebuilding the broken bridges between the elderly and the rest of society. we can make the elderly more independent and therefore gain more liberties, but we must also change the attitude of the non-elderly to create a complete community. i am struck by this student’s articulation of where the design opportunity is. it is not just in aiding an individual. we have a responsibility to make positive differences in the community at large, which will then have a positive impact on individuals. our teams do strong work each year, some of which results in a product the community partner takes away to use at home. but even when it does not, the class has generated among students more sophisticated understandings about experiences of aging and changed definitions of design. the product designed by students is not of central importance in this class. for the students, what really matters is the reframing of what engineering is and how it is done, as well as exposure to the world of design opportunity around aging. the older adults greatly value their interactions with young students and we have found positive impacts in terms of decreased isolation, increased meaning and purpose, and improved feelings of wellbeing (lynch et al. 2014). in a boston globe article about the class, one community partner described the co-design process with students regarding her experience carrying items while using a walker: lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195 aa.2015.108 http://anthro-age.pitt.edu 132 these kids are the top of the top. they have very willingly and openly wanted me to contribute to the project, and it’s been a joy to get the [brain] cells going again…. it’s changed my whole outlook. before, i thought whatever you’re given is what you have to use. now i think, let’s see what else we can do. i feel so much richer for the program. it gives us seniors not only the chance to have a voice, but have it be listened to. (cantrell 2013, n.p.) positive practices in design for aging elsewhere in this volume, my colleague maruta vitols and i refer to ideo designer josé colucci’s principles for design for aging: respect the individual; ease the transition; do not help more than is required; promote empathy; encourage fresh thinking; promote connection.5 these principles urge designers to be sensitive to the range of ways of aging rather than assume a universality of experiences, to avoid over-designing or over-interpreting the role of the designer, and to think beyond the obvious. with these principles in mind, i can certainly further admire the pers box solution, and i can frame the ways in which amazon fresh might work for some people, but not for the reason imagined by steve, the engineer who wrote that technology in this case “frees you up to engage in alternative baby-pinching socializing controlling friendly activities that don’t have a sense of suck.” very few older adults who i know in the united states are able to organize their time to find activities that are intentionally baby-pinching, socializing, controlling, and friendly. instead, many older adults look forward to doing an instrumental activity such as acquiring food because it also gives them a chance to talk to people, observe children and young parents, find new products on the shelves, make choices about purchases based on sales and what looks good, and engage in a routine activity such as taking money out of a wallet and exchanging it for something of value. all this contributes to a feeling of still being part of society for people who often feel marginalized and invisible. in the space of design for aging, but also accessibility more generally, my olin colleagues and i hope to lead students to understand the importance of accounting for context to make a positive difference in people’s lives. we expose students to examples of technologies and systems that presume very different questions of the design opportunity. here i would like to provide an example from my colleague sara hendren, who teaches a course on assistive and adaptive design. in the course, “investigating normal,” sara invites her students to think about design approaches to deafness. cochlear implants are a high-tech, precise, and refined engineering solution to grant hearing to people who cannot hear. but sara also shows her students the architectural innovations at gallaudet university, an all-deaf campus in washington, d.c.. gallaudet provides what is referred to as deaf space: a built environment that is engineered to accommodate deafness. many classrooms at educational institutions have walls that separate spaces and make visual communication localized. but in a campus center example that sara provides, sight lines of the room extend its whole length, making it possible to communicate in the visuality of sign language across distances. there are no walls to interrupt the vision of people well across the room. as sara notes, it is possible to be interested in both of these solutions to deafness. but cochlear implants proceed fundamentally from a logic of technology as cure, whereas deaf space lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.108 http://anthro-age.pitt.edu 133 133 is a technology of accommodation. these are forking paths at some point, and an interesting conundrum for young engineers and designers when thinking about how to make things for people with atypical bodies and minds.6 at an engineering conference in spain in 2015, sara, lynn, mel and i led a workshop on the politics and practices of assistive and adaptive design.7 as we described there, these two points of view are known as the medical model and the social model of disability, respectively. the medical model focuses on the disabled individual. it labels disabled people as broken and in need of fixing, usually through drugs or surgery, medicine, or technology. it also labels them as “other”—not one of “us,” but one of “them.” as anthropologists well know, this process of othering sends a message about who rightly belongs, and who does not. in the medical model, the message can come across that the problem belongs to the disabled person, so the fix has to be applied to the disabled person, as in a cochlear implant, or psychotropic drugs in a nursing home. but with deaf space at gallaudet, and dr. bill thomas’s parakeets, we see the social model of disability. with the social model, the problem of disability belongs to society, and so the fix has to be applied to society and by society. the social model recognizes that members of society define what “normal” is, and who is inside or outside that boundary. the social model includes a perspective that people are disabled by the interactions and environments that we design—as formal designers but also as participants in society. we decide as members of a society what our design constraints will be, and what assumptions we will make about people who participate in the world we create. some aging examples: how high are our tables in a coffee shop and how does that work for people who use a wheelchair? how low to the ground do we stock items in a grocery store? do you need both hands to open a jug of milk? does a timer on a stove emit a beep that cannot be heard by many older adults? do we have ample job opportunities for people who might prefer part-time work? at olin college we train our students to examine their assumptions and understand the context of the lives they hope to impact. our world would be even better if we can all become designers who notice and act on the barriers to flourishing that exist all around us. acknowledgments thanks to mel chua, sara hendren, lynn stein, and jason danely for their collegiality and for comments on earlier drafts of this essay. the engineering for humanity course has been funded by a grant from the metrowest health foundation. notes 1. steve is a pseudonym, as is the name greg in the second example below. 2. for more on sara hendren’s articulation of these questions, see https://vimeo.com/channels/eyeo2015/134764010 3. i taught the course with lynn andrea stein for the first two years and with ela ben-ur for the next three. 4. pullin 2009: 83-85, on simplicity and accessibility. https://vimeo.com/channels/eyeo2015/134764010 lynch | design for aging anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195 aa.2015.108 http://anthro-age.pitt.edu 134 5. as presented in the engineering for humanity class at olin college, february 2015. quoted with permission. 6. for more on sara hendren’s articulation of these questions, see https://vimeo.com/channels/eyeo2015/134764010. see also the concept of deaf gain (as opposed to “hearing loss”) in bauman and murray 2014. 7. lynch et al. 2015. references bauman, h-dirksen l. and joseph j. murray, eds. 2014 deaf gain: raising the stakes for human diversity. minneapolis: university of minnesota press. cantrell, cindy 2013 “olin program combines engineering, humanity.” boston globe, 24 march. gawande, atul 2014a “can life in a nursing home be made uplifting and purposeful?” the telegraph, 4 october. 2014b being mortal: medicine and what matters in the end. new york: metropolitan books. lynch, caitrin, lynn andrea stein, sharon grimshaw, elizabeth doyle, lois camberg, and ela ben-ur 2014 “the impacts of service learning on students and community members: lessons from design projects for older adults.” paper presented at frontiers in education conference [fie], madrid. 24 october. lynch, caitrin, sara hendren, mel chua and lynn andrea stein 2015 “designing for atypical bodies and minds: politics and practices.” workshop run at joint conference, mondragon spain: 13th active learning in engineering education workshop (ale); international symposium on project approaches in engineering education (paee); 5th international research symposium on pbl (irspbl). 6 july. malinowski, bronislaw 1922 argonauts of the western pacific: an account of native enterprise and adventure in the archipelagoes of melanesian new guinea. london: routledge and kegan paul. pullin, graham 2009 design meets disability. cambridge: mit press. https://vimeo.com/channels/eyeo2015/134764010 http://www.boston.com/news/local/massachusetts/2013/03/23/engineering-for-humanity-needham-olin-college-olin-program-teams-students-seniors-solve-problems-olin-course-teams-students-seniors-solve-problems/jspkkyazfzom6ky9hntqpo/story.html http://www.telegraph.co.uk/culture/books/11139446/can-life-in-a-nursing-home-be-made-uplifting-and-purposeful.html microsoft word salazarfinal3.docx social contract on elderly caregiving in contemporary chile perspectives of a group of social scientists carola salazar university of florida author contact: salazar.norambuena@gmail.com abstract this paper explores the definitions of social contract on elderly caregiving among a group of seven chilean aging experts. the data show that for chileans, family remains a strong institution that should provide care of its members, with daughters or daughters-in-law being the preferred person to provide care. also, age segregation, along with the gradual privatization of services such as health care and the pension system, promotes individuality: this can become a problem for future generations because they are no longer concerned with helping others. keywords: social contract, elderly caregiving, informal caregiving, social scientists, chile, latin america. anthropology & aging, vol 38, no 1 (2017), pp. 60-79 issn 2374-2267 (online) doi 10.5195/aa.2017.134 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 60 social contract on elderly caregiving in contemporary chile perspectives of a group of social scientists carola salazar university of florida author contact: csalazar@ufl.edu introduction over the past 20 years, it has become clear that the life expectancy at age 60 has improved worldwide (cotlear 2011). additional research (un 2002) suggests that the actual aging patterns are unprecedented and will have different implications in the population. for this reason, the perceptions about the aging population have been changing gradually, from a reflection of social success (roughan, kaiser and morley 1993) to a complex issue, mainly based on the potential implications to the society (restrepo and rozental 1994). in fact, as a consequence of speculation on possible implications, aging has become part of the so-called “apocalyptic demography” (gee and gutman 2000), which focuses on the potential burden that a larger aged population can generate on the rest of the society. following this line of thought, leeson (2013) suggests that an aging population –or any age combinationis not a threat; instead, the challenge resides on the ability of local and regional structures to adapt to the new demographic profile. one way to debunk the myths around an increasing aging population is through the understanding of the diversity of aging experiences. this article documents the perspectives of a group of chilean social scientists regarding the different ways in which post-dictatorship chile is addressing elderly caregiving when older citizens require some kind of assistance. the research is based on interviews conducted with chilean aging experts during june and august, 2013. however, it’s important to mention that this sample is not representative of all chilean social scientists, although it constitutes an effort to contribute to studies on aging. the article is structured as follows: first, i address the definitions of social contracts for elderly caregiving. then, because of the rapid demographic transition along with the cultural and political changes experienced during the last forty years, i describe how present-day chile is a case study for elderly caregiving. finally, i provide the analysis of the interviews conducted with aging experts which focused on four categories: diagnosis of the aging phenomenon in chile, social policies, social contract, and research on aging and future implications. social contracts for elderly caregiving even though most the elderly population is autonomous, at some point older citizens will need some kind of assistance, either due to a health problem related to a disease, or just some consequence of aging (sulbrandt, pino and oyarzún 2012). anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 61 since the resources to provide elderly caregiving are limited, bengtson and achenbaum (1993) suggest that to determine the organization of a care structure requires an implicit agreement between generations, which dictates who deserves care and who is the adequate person to act as the caregiver. this symbolic understanding is known as social contract, and provides a set of norms concerning what it is expected from each participant. because the assumptions regarding what constitutes support differ across cultures, this social contract will be unique from one culture to another (hashimoto 1996). there are two kinds of support available: family caregiving, and formal caregiving. the first is also known as informal caregiving, and refers to kin and non-kin relationships (tessler and gamache 2000). the other option is formal caregiving, which can be provided by the state or a private institution (walker et al 1995). however, both options are not exclusive, and can be used simultaneously, since formal caregiving should not be considered as a substitution: “formal services do not encourage families to reduce or withdraw the amount of care that they provide, nor does home care substitute for nursing home care” (kane and penrod 1995:16). accordingly, it is important to consider both options as complementary rather than exclusive, because elderly caregiving should be a shared responsibility between the family, the state, and the society (huenchuán 2010). although the current demographic transition implies some challenges to the family (hareven 2000), this does not necessarily lead to family decline (gee and gutman 2000). as popenoe (1988) suggests, the family has always been subject to change, and this plasticity has allowed the family to survive as an entity. presently, family caregiving is one of the multiple responses to demographic shifts, and can be considered an example of familiar solidarity and the fortitude of family ties (abellán, garcía and esparza catalán 2009). however, the consequences for family caregiving have become a concern, especially when the number of people aged 65 and over increases. in addition to the economic costs, there is an academic interest on the health of caregivers and their elderly care-receivers (van durme et al. 2012:491), with evaluations focused on caregiver burden and mental health (mosquera et al. 2016). these consequences are attributed to the notions of individualist personhood, such as independence, productivity and self-maintenance, that are prevalent in western cultures and have been “exported” to other cultures (lamb, 2014). in fact, most of the contemporary welfare policies are conceived on the basis that “to be dependent is bad and to be independent is good” (robertson 1997: 435), although no one is completely independent. these notions about independence can also influence well-being in senior citizens. although is possible to find some cases where the elderly parents expect to receive attention from their adult children, most of them do not want to become a burden and desire to stay active as much as their physical and mental health allows them. (beyene, becker, and mayen 2002; zhang and goza 2006; sokolovsky, 2009). in summary, due to the cultural context in which these relationships are embedded, the notions about elderly caregiving, and the consequences for both parties involved, will vary from one culture to another. diverse perspectives can be found even within the same family. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 62 chilean identities chile is a unique latin american country due to its geography, political history, actual economic rise, and its multicultural essence (gitlin and fuentes 2012). the sum of these aspects has shaped individual chilean identities, because one of the characteristics of the country itself is that it has no single identity. bengoa (2004) explains that one of the underlying reasons is the cultural diversity that chile has had from the beginning; there is anthropological evidence that suggests that at least thirteen different ethnic groups existed in the geographic zone of what it is known today as chile. throughout history indigenous people have always been regarded as an extension of the country “the chronology of the indigenous history of chile is not necessarily the same as the history of chile” (pp.14). for this reason, the relationship between the indigenous people and the chilean state has historically been regarded as problematic because it is a story of meetings and disagreements. larraín (2001) describes the chilean identity as fluctuant, because it is subject to constant changes. for this reason, it is has become difficult to identify which aspects constitute the chilean identity. despite this, in a recent study, mayol, azócar & azócar (2013) identified two main layers that constitute the chilean identity. the first, which is predominant, it that it is based on the hacienda1 model, which was established during the spanish colonial era in latin america, and was characterized by the hegemonic relationship between the spanish and the indigenous/mestizo population. the second layer is composed of the value system associated to the neoliberal model, which was imposed during the military dictatorship. the result is that the elite group responsible for the socioeconomic reforms during pinochet’s rule is deeply conservative in matters of morality, religion, and democracy, but simultaneously advocates for total freedom in the economic sphere. also, montecino (1991) describes that among the first spanish who arrived in latin america during the conquista, most were men; therefore, relationships between spanish men and indigenous women were facilitated, resulting in a large group of "illegitimate" children, which later would be known as mestizos. these hegemonic relationships created an imbalance between men and women, in which men enjoy a better social status than women because they are associated with the public sphere, while women develop in the domestic sphere, the family care environment. even though the factors mentioned above come from different historical contexts, the sum of them “promote, explain, justify and legitimize existing inequalities [in chile]” (mayol, azócar and azócar 2013:20) an aging demographic profile despite those characteristics mentioned above, chile shares many factors that transform it into a good case study of the different processes related to aging. aged populations are characterized by a higher number of people over 60, and a lower number of young people. this is mainly a product of low fertility rates and higher life expectancy (leeson 2013). the following table shows selected demographic indicators for chile as compared to the world averages: anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 63 selected demographic indicators, chile and world averages category chile world averages total fertility rate 1.8 births per woman 2.4 births per woman life expectancy at birth 81 years 71 years population aged 65 and above (% of total population) 11% 8.27% source: (world bank 2014) considering these numbers, it is evident that chile is experiencing an advanced aging of its population (cepal 2015). to understand these changes, it is necessary to consider the proximate determinants of fertility (wood 1994), which recognizes the set of factors that play an important role in human fertility, such as socioeconomic status, religious beliefs, and nutritional status, among others. in chile, there was an increase in fertility rates especially within the period of 1950-1959; however, there have been several changes that have affected the fertility rates. for example, since 1960, the appearance of contraceptive methods, the incorporation of women into the workforce, and economic development initiated a decline in these rates. in fact, during 1961 chile reached its highest fertility rate of 5 children per woman. during the period from 1970 to 1979 this rate declined by half, and since then the rates have been declining progressively (ine, 2013). the following graphic shows how the total fertility rate has changed during the last 60 years: anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 64 source: ine (2013) the current total fertility rate for chile, 1.9 children per woman, is a number that the economic commission for latin america and the caribbean (eclac) predicted chile would reach in 2020 (donoso 2007). families/households the demographic transition, along with cultural and political changes during the last 50 years, have produced several changes in family patterns, resulting in a diversification in the types of families and households (cerc and icheh 1992). for instance, the ministry of health describes the current demographic situation as characterized by small families in which couples decide to postpone pregnancies2 (minsal 2011). in general terms, these changes altered the composition and size of the household which moved from 5.4 people on average in 1960, to 3.6 in 2002 (ine 2010). also, the head of the household has changed.: in 2000, 76.8% of the households were headed by men, whereas only 23.2% were women; thirteen years later, the number of households headed by women increased to 37.9%, higher than the 33% average for latin america (cepal 2015). in addition, the household composition has changed as the number of singleperson households has increased, and many couples have chosen to delay parenthood or simply prefer to remain childless (mideplan 2001). also, nuptuality rates have decreased. in 1980 it remained stable at around 8.0 marriages per 1000 habitants, but today the rate has been reduced to 3.7 (ine 2014). in addition, the average age of marriage has changed for both genders. in 2000, men married at age 28 and women at 26; eleven years later, the average age increased to 32.3 for women and 35.1 for men (ine 2013). 0 1 2 3 4 5 6 1950 1960 1970 1980 1990 2000 2010 total fertility rate, chile: 1950-2010 total fecundity rate anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 65 because many couples prefer to live together without being married (salinas 2011), in april 2015 the senate approved the law of civil union, which is a contract between two people who share a household (ministerio secretaría general de gobierno 2015). only a year has passed since the enactment of the law, so there are currently no studies that describe the characteristics and motivations of those who choose this type of union over marriage. these changes have occurred because women have higher access to education, and they have been gradually incorporated into the workforce. however, this does not mean that men and women live on equal terms. the report “women in chile and the labor market: women's labor participation and wage gaps” was conducted by the instituto nacional de estadísticas (ine 2015), and found that the female participation rate rises with increasing educational level. for people who only attended middle school, there are still gender differences, as reflected in employment rates that are currently 35.5 for women and 64.8 for men. in contrast, for people with graduate studies, employment rates are 88.5 for women and 91.1 for men. additionally, the wage gap resulting from extreme differences in educational level is larger: with a primary education, women receive 42.0% less income than their male counterparts, while women with graduate studies receive on average 36.8% less income than men with the same educational level. this illustrates that in chile, women are “punished” if they have few or many years of schooling. there is unequal access to the labor market for women and men, which results in significant differences in labor force participation rates for both groups. it is important to note that over time, the tendency is towards a significant change in gender roles: men have been incorporated into household chores, and women have joined the workforce. because of this, both men and women have been in conflict over how to combine their work and domestic spheres: although women are working outside the home, this does not mean that they are delegating all domestic chores to men. on the other hand, men are also trying to divide their roles. historically, the main role of a man was to be the family provider, and today they must continue to fulfill that role, but simultaneously they wish to spend more quality time with their children, and to help in parenting (olavarría 2001). chilean senior citizens as mentioned above, 11% of the chilean population are people aged 65 and over, and 55.5% are women (ministerio de desarrollo social 2015). the country has an aging index of 80, which means that for every 100 people under age 15, there are 80 people over 60 (celade, 2008). as a result, chile is classified as a country with advanced aging. life expectancy at birth for both genders has increased during the last 30 years. in 1990 it was 73 years; and for 2012 it was 80, higher than the average for latin america and the caribbean, which was 74.7 (huenchuan, 2013). and in chile, when people reach age 60 their life expectancy is 24 years for both sexes. although chile was considered as the best latin american country in which to age (helpage 2013), was the second latin american country to become a member of oecd (oecd 2010), and the gpd during the period 2009-2013 was relatively stable (world bank 2014), chilean academics, especially from the social sciences, have criticized these achievements. montecino (2004) for example, explains that many of these achievements are measured in indexes but not in quality; therefore, these ‘successful numbers’ may be missing the real impact that each one of these achievements has on the chilean population. in fact, the country has a gini index of 50.2, which defines chile as the most unequal country of the oecd (world bank 2014). anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 66 privatization of services: its impacts on the elderly population for the last forty years, chile has faced several cultural and political changes. the most important agent of change was the military dictatorship, which started with the coup led by augusto pinochet against the socialist government of salvador allende on september 11th 1973, and ended when patricio aylwin assumed the presidency after the first democratic election in almost eighteen years (bitar 1990). the military regime left 1,209 individuals detained/disappeared, 8,259 tortured political prisoners, and 342,298 deceased (indh, 2011). in addition, the regime facilitated the transition to a neoliberal country. this change was achieved mainly through the reforms imposed on seven sectors, which per the military junta were the most vulnerable: social security, education, workplace, regional decentralization, agriculture, judiciary and health sector (danus, silva & de la cuadra 1982). these reforms were executed through the reorganization of the government functions: instead of investing in social policies, the state favored the creation of funds for private resources, imposing a perception that public services were inefficient, and that only through free choice of private services could chileans access quality services (tetelboin 2003). there are two reforms made during the dictatorship that affected directly the elderly population: the privatization of the pension system and the health care system. in 1980, the military regime privatized the previous pay-as-you-go (payg) scheme to a defined contributions (dc) scheme that was based on individual capital accounts, which were managed by private companies, or pension fund managers (afp) (oecd 1998). therefore, chile was the first country to privatize the pension system (quintanilla 2011). the payg system was based on “social solidarity”., since each pension was financed in part by the contributions made by the active workers and the state, the money collected went to a common fund. furthermore, pensions were determined on the taxable remunerations registered by the worker in the last years before retirement, and included allowances for maternity and widowhood, hard labor, and work in toxic environments (arellano 1985). however, this system was criticized for the lack of uniformity, because of the “series of parallel systems for different groups of workers, with broad heterogeneity of eligibility rules and benefits” (fajnzylber and paraje 2014: 130). in the current system, each worker has a personal account where their contributions are deposited, and they will earn the profitability of the investments that the afp made with those funds (superintendencia de pensiones 2014). under this system women are at a disadvantage: most of the older ones didn’t have a paid job during their adulthood, or if they did, they possibly got maternity leave, or constant absences due to childbearing or taking care of another family member, resulting in less investment in an afp, and therefore, obtaining a lower pension. considering the above, in 2008, the government of michele bachelet undertook a reform of the dc system to introduce a solidarity pension system designed to promote gender equity and reduce the inequities that the individual capitalization system was generating (larrañaga, huepe and rodriguez 2014). despite these efforts, the average old-age pensions are lower than the minimum wage, and there is still a gap between genders. in december 2015, the minimum wage was usd$389 for adults aged 18 to 65 years (dirección del trabajo 2015), and the average pension for men was usd$284, and for women usd$ 174 (superintendencia de pensiones, 2016b). the following chart shows the difference of income between men and women: anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 67 source: (dirección del trabajo 2015; superintendencia de pensiones 2016) the financial situation is even harder for the retirees who have a basic solidary pension (pensión básica solidaria-pbs). only people aged 65 and over who belong to the poorest 60% of the population can gain access this benefit. in december 2015, the amount was usd $136 monthly (ips 2015), which is equivalent to 35% of the minimum wage, and 45% of the total of retirees received this benefit (superintendencia de pensiones 2016a). also, the national socioeconomic profile (casen) surveys showed that within the 65-75 age group, at least one in five adults is still working; which shows that the actual pension system “does not allow adults over 65 to retire from the job market” (fajnzylber and paraje, 2014:129). during the dictatorship, the healthcare system also was privatized. in the early seventies, before the coup, the chilean healthcare system comprised four agencies: health ministry (ministerio de salud, minsal), national health service (servicio nacional de salud, sns), national employees’ health service (servicio medico nacional de empleados, sermena), and the private sector (aedo, 2000). then, in 1973, the reforms to the healthcare system began, and concluded with the creation of the new health system in 1981. health reforms consisted of several phases: elimination of staff linked to the previous government, separation of the agents who developed the main functions, and finally, a change in the axis of power in the health sector (tetelboin 2003). the actual healthcare system can be defined as a mixed one, consisting of the public and private subsystems. the public system is called fonasa (fondo nacional de salud), which is funded through state contributions, mandatory contributions from workers (7% of taxable income), and co-payments. fonasa beneficiaries are divided into 4 groups according to their income, from category a: indigents, vulnerable people and basic solidarity pension beneficiaries, to category d: people who receive a monthly taxable income higher than usd$ 495 (superintendencia de salud 2015). the private system, isapre is funded using the same 7% of taxable income, plus an additional amount which will depend on the plan of each beneficiary (arteaga 2008). 389 284 174 0 50 100 150 200 250 300 350 400 450 minimum wage average pension men average pension woman minimum wage and average pension, both genders, december 2015 (in usd) anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 68 today a worker must earn at least usd$ 565 to enroll the isapre system if they don’t have dependents; otherwise, the baseline will rise (superintendencia de salud 2015). considering the current minimum wage, this means that only a small group of the population can afford healthcare services through the private sector, and some age groups, such as senior citizens are discriminated against, because as stated above, the average pension and basic solidary pensions are below the minimum wage. methods this is an exploratory research whose main purpose is to provide a description, through interviews with aging experts, of how contemporary chile is facing the aging of its population. however, it is important to note that this study is not representative of the opinions of the whole community of chilean social scientists. the project was approved by the university of florida institutional review board 02 (irb), protocol #2013u-0728. to participate in the project, the participants had to fulfil at least two of the following requirements: • have received a degree in social sciences • conducted research on aging in chile at least during the last five years • taught an aging-related class • worked at the senama, the ministry of the elderly (servicio nacional del adulto mayor), as member of the aging research institute or as part of the advisory council. using the snowball method, a total of seven experts were considered to participate. the seven experts belong to three different disciplines: sociology, social work and public health. the data was collected through semi structured interviews conducted during june and august, 2013 in three cities: santiago, curicó and chillán. the interviews were conducted in person, in spanish, during one session of one hour. later, the interviews were transcribed and analyzed in spanish. only relevant passages were translated to english. analysis i conducted an issue-focused analysis which, as the name implies, is focused on specific issues; this is also known in the spanish literature as “análisis temático”. the analytical process requires the reading of the transcripts of the interviews to make them familiar to the analyst, and then identification of thematic clusters to later organize data according to the relationships that can be established between these concepts (kornblit, 2007). this analysis was conducted through four steps: coding, sorting, local integration, and inclusive integration (weiss 1994). the first step, coding, consisted of linking the responses from the interviews with concepts and categories that will arise based on the interview material. secondly, the categories were sorted into folders. the third phase was the local integration stage, in which the interview material was integrated with the observations that were made. during the final step, inclusive integration, the results from the local integration were used to create general conclusions. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 69 the final analysis of the interviews was focused on four elements: diagnosis of the aging phenomenon in chile; public policies; social contract; and research on aging and future implications. results the following section contains the analysis of the interviews conducted with aging experts, based on the four categories previously mentioned. 1. diagnosis of the aging phenomenon in chile the participants were asked to provide their vision regarding the current situation of the chilean elderly population. within this theme, two subtopics emerged: heterogeneity of aging experiences and inclusion/exclusion of senior citizens. a) heterogeneity of aging experiences the seven experts agreed that the first topic to be addressed was the heterogeneity of the aging phenomenon in chile, especially in terms of socioeconomic differences: “it is an extremely heterogeneous reality, considering socioeconomic and educational terms (…) education is a factor that affects every area, not just the living conditions, but also how they see themselves” (informant 1) additional research conducted in other cultures (cohen, 1999 harper, 2006; sokolovsky, 2009) also suggests that a key aspect of studying aging is to recognize the variety of experiences, even within a country. since chile is a centralized country (oecd, 2009), in which most the resources stay in its capital, santiago, it was expected that most of the differences would manifest between santiago and other regions; instead, all seven experts agreed that the biggest differences are found within cities, rather than between cities: “the place where do you live is extremely important in chile…that place will shape everything: your education, your acquaintances and your job. for example, here in santiago, there is a huge difference between living in vitacura [a high-income sector] and living in cerro navia [a low-income sector]. people from vitacura will have a better quality of life just because they were born in a better place” (informant 6) the main reason behind these inequalities is the unequal distribution of income. although chile is considered as an upper middle-income country (gitlin and fuentes, 2012), the problem is that economic growth has benefited only a small portion of the population, the already high-income sector, and as mentioned before, chile has one of the highest gini indices of the countries participating in the oecd (world bank 2015). b) inclusion/exclusion of senior citizens in addition, the experts addressed the ageist vision of the chilean population. ageism is understood as “a process of systematic discrimination against people because they are old” (cohen 2001: 576). in the case of chile, this is measured through the surveys and studies that senama -the ministry of the elderly conducts regularly at a national level. the latest “national survey of social inclusion and exclusion of the elderly in chile” and “national survey about quality of life of the elderly in chile” showed that 73% of the the respondents perceive the elderly as a frail and dependent group. however, the statistics show that only 25% of the elderly have some degree anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 70 of dependency (senama and facso 2015; puc 2013). this kind of opinion leads to ageism: there is discrimination against the elderly because the population in general, think that they can’t do things on their own. this opinion is not only present in the general population, but also in people who are in the parliament: “people just deny their age. for example, look at the senators…you can see that most of them are relatively older, they are at least 60 years…but they do not want to assume that they are aging; because if they did it, that means that they would have to assume this huge ‘backpack’ full of prejudice against the elderly” (informant 2) the main problem with opinions like this is that they are less likely to address the issues and concerns that emerge with an aged population because they do not ascribe to this group. even though the demographic change is evident in chile, some sectors do not address the whole spectrum of aging experiences. chile, being a highly age segregated country, offers few instances in which the elderly can interact with younger generations, especially outside the family context. for example, one of the main stereotypes of the elderly population presented in media and books is the “grandparent” (in spanish: abuelito or abuelita). a study conducted by jorquera (2010) showed that in the official textbooks provided by the ministry of education, the predominant conceptions about the old age and aging are: aging as a biological phenomenon and isolated from other life stages; senior citizen as a synonym of grandparent; and the elderly as a passive citizen, retired from work. 2. public policies in chile, the elderly was not a target population for social policies (except pensions) until the military dictatorship. during previous decades, there were two kinds of institutions that cared for the elderly: stateowned, and faith-based organizations, such as anipsa, a conglomerate of catholic institutions which includes international partners such as caritas (aldunate and gutierrez, 1985). then, in 1995 the national committee for older adults (conama) was created to make a diagnosis of the current situation of the elderly population and suggest ideas to address issues and concerns related with aging. in 2003, the current ministry of the elderly, senama, was created. currently, senama is the institution in charge of encouraging active aging4 and the development of social services for the elderly (senama 2014). the last major policy implemented by senama is the "integral policy for positive aging in chile", a policy created in conjunction with the advisory committee, regional teams, and the regional advisory councils (which represents organizations from their different regions of the country). this policy is based on a multi-sectorial perspective because it involves different ministries: ministry of labor, ministry of transport and telecommunications, ministry of women (sernam), ministry of social development, and ministry of education (senama 2014). in general, senama offers several programs for the elderly population. for example, long-term care centers called eleam (in spanish, establecimientos de larga estadía). these facilities are distributed throughout the country, and provide shelter to senior citizens with low socioeconomic status (senama, 2015a). senama also offers a program called "senior advisors", in which retired teachers can volunteer to teach the poorest children in the country. in addition, there are some programs directed to empower the elderly, such as the "schools for elderly leaders” program, and the national fund for the elderly that provides funding to organizations of senior citizens. although senama provides tools and funding for organizations conformed by senior citizens, these programs are not enough in terms of public policies. for example, one interviewee mentioned that the problem lies in the separation between health and social policies: anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 71 “i think that we are lacking a debate between ministries, and because of that, we only provide below-average policies to our elders. and well, it’s important to add that senama has made great efforts, especially in terms of housing policies. however, as a modern society we need better policies: for health, pension and well-being” (informant 4) the problem is that even though there is a ministry for the elderly in chile, this ministry does not have the power to create holistic policies that incorporate all the aspects that affect the quality of life of the elderly. the present-day healthcare system was “designed to meets the needs of a younger, more homogenous population rather than those of the emerging group of older adults” (glantz 2009: 270). and the lack of geriatricians in chile is an example of this: “there are only 39 certified geriatricians in the country. in addition, 40 doctors work as geriatricians but they do not have the certification. so, we have about 80 geriatricians available to take care a total of 2 million of elderly (...) the problem is that almost all of them are in santiago, and only a few live and work in other regions. the universities do not show geriatrics as an option in medical schools”. (informant 7) the lack of interest in teaching geriatrics medical schools it is related to the ageist vision that some sectors show in chile. for instance, a study conducted by arnold-cathalifaud and colleagues (2008) explored the perceptions about old age among 682 college students, and found that the younger generations have a negative perspective about age: most of them think of the elderly as a conservative, frail, and marginalized group. 3. social contract: from family support towards social support regarding the contract between generations, experts generally agreed that the family is still a strong institution which provides care of their elderly when needed. the preferred caregiver is a woman, usually a daughter: “i would say that before, the caregiver by-default was the unmarried daughter. today we know that wives, daughters or even daughters-in-law take care of their elders. however, this means a really big burden for them and for the family ...because they do it without any kind of help”. (informant 3) the opinions of the experts match with additional research done in chile: 44% of elderly caregivers are their adult children, and 83.7% of them are women (senama 2014). the average woman caregiver is between 40-60 years old (jofré and sanhueza 2010), is of a lower socioeconomic status, has poor social networks and does not possess or have access to any caregiving training (jofré and mendoza 2005). as discussed in the families/household section, even though gender dynamics are shifting, the traditional gender roles still prevail, therefore, women are socialized to develop specific skills and abilities to help others (herrera and kornfeld 2008). so, because it is considered as a “duty” that women should provide care, the role of women as caregivers is taken for granted and not appreciated (vaquiro and stiepovich 2010). some statistics show that in chile there is reciprocity between parents and their adult children, which is expressed in the exchange of resources throughout the entire life cycle, and with a greater emphasis on times of greatest need (herrera and fernandez 2013). simultaneously, additional data from the national survey on elderly’s quality of life suggest that ideas about filial obligation are slowly changing: in 2010, 45.9% of the participants believed that it is always mandatory for adult children to take care of their parents when they can’t be independent any longer, and in 2013, only 41.9% believed so (puc 2010, 2013). usually, studies about intergenerational relationships highlight the benefits to the elderly, instead of the other way around. the seven experts also mentioned that it’s is important to address the significant role of the elderly in their families: anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 72 “today the grandparents are strong pillars in their families from an economic point of view, because they help taking care of their grandchildren, so their daughters or daughters-in-law can work. but it is like we take it for granted; we do not thank our elders for their help”. (informant 5) to generate positive intergenerational relationships, it’s necessary to address the dependency between generations in positive terms (lamb, 2014). for instance, for the chilean elderly, the family is very important in terms of their quality of life. a study conducted in antofagasta, one of the largest cities in the northern part of chile, found that social support provided by their families was the first item that older adults mentioned in a survey about quality of life (urzúa et al 2011). this is because chileans, just like other latin americans, consider it necessary to “count” with potentially available people who will provide material, instrumental, emotional support, companionship, and advice when needed (montes de oca 2001). in summary, the seven experts agree that there is intergenerational solidarity within the chilean families; however, the problem extrapolation of this solidarity to the rest of the elderly population, the ones who are not “our grandparents”. one of the experts argues that the privatization of services contributes to individualism: “the current elderly population has better conditions than the ones that we will have in the future. i think it is because their pension system was supportive/solidary. however, nowadays we have a different system, of individual savings…so we are not contributing to other’s pensions…if you think about it, the 2008 pension reform was targeted to the younger generations, because with their income, their resources we can fund the pensions of current older citizens”. (informant 6) the privatization of services, such as the pension system, can, in fact, contribute to individualism. as the interviewee suggests, in the current pension system which is based on defined contributions (dc), everyone funds their own pension. instead, in the previous system (contributive), the pensions were financed with the funds provided by the active workers. simultaneously, the latest “national survey of social inclusion and exclusion of the elderly in chile” showed that 54.1% of the respondents would be willing to pay specific taxes for old age if it is guaranteed (senama and facso 2015). therefore, even though the privatization of services can facilitate individualism, the fact that the aging population is increasing in chile it seems to contribute to a deep reflection on the role each has in an aging society. 4. research on aging and future implications because the seven participants defined themselves as social scientists, they were asked to provide a diagnosis about the current state of aging research on social sciences, and the future implications. most of them mentioned the difficulties associated with conducting social research in chile because of the lack of proper funding for social sciences, and especially for aging research. they also argue that even though the population is more conscious about the increase of the aging population, there is not a niche for aging research: in our department we really wanted to create a master in gerontology…but we could not do it because a market study showed that even though people were interested in aging, they would not enroll the program, because they do not feel that the state or the universities are demanding professionals with gerontological skills”. (informant 2). even though aging was considered for priority research by fondap, the national fund for research centers in priority areas (fondap 2014), the funding usually goes to biomedical research instead of social anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 73 research, making it harder to conduct research because of the lack of appropriate funding. another challenge that the chilean experts faced, is the need for a local aging perspective, because most of the theories and research come from europe and the united states. and even though chile and latin america share some of the characteristics of the demographic transition, data shows that in latin america the process has been faster in relation to other places (cotlear 2011). this lack of aging research in the country creates a gap of information, and most of the time, chilean experts are working with theories adopted from other places, different to chile: “i feel that we -as social scientistsjust replicate foreign theories (from the us and europe) and from biology, biomedicine, psychology…or from international organizations: who, eclac, united nations, world bank (…) as a sociologist i really think that we need to empower our elders, providing a territorial vision of their aging” (informant 7) even though cross-cultural research is also useful to engage debate, the problem is that every country also needs to know about their own situation to create solutions to problems and improve the quality of life of its citizens. to conclude, is important to note that despite the challenges, the experts also agree that in general terms, chileans age aging well because the living conditions have improved during the last decade, and the following cohort of older citizens will live a better old age. in words of one of the experts: “the educational level of the chilean population is increasing, so future older adults also will have a better aging…because they will get the knowledge to take care of themselves, to be more active, to cultivate friendships during their life course (…) also, the fact that women also are working outside the home will get them more social networks, and a better quality of life. i think that we have ahead a bright future: not only for ourselves, but also for the future generations” (informant 3). conclusions in chile, most of the elderly population is independent; however, when they need some kind of assistance, family is the primary source for social support. within the families, women, especially daughters or daughters-in-law, are the preferred person to provide care, and this role is taken for granted because of the traditional gender roles. even though the latest surveys have shown that the sense of filial responsibility is decreasing among the chileans, there is still a sense of intergenerational solidarity within the families. the problem is how to extrapolate that solidarity to the rest of the elderly population, because the existence of stereotypes of the elderly as a frail and dependent group, and the privatizations of services are leading some sectors of the chilean population toward individualism. however, some data also showed that other sectors will be willing to pay an extra tax to guarantee adequate care in old age. information is the best way to debunk myths, and for this reason it’s necessary to engage in more aging research in chile. even though today the population aged 60 and over is 2,2679,910, and it’s expected that in 2020 this number will increase to 3,271,990 (ine 2014); there aren’t enough studies about the elderly population in chile. we need more multigenerational studies, and longitudinal studies, to understand generational ties, instead of conducting studies of each generation in separated, which has been the common practice. salazar | 74 anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 74 although there are some groups in latin america focused on the study of old age and aging, there is not a real articulation between those groups. to have a “latin american perspective on aging”, it is necessary to engage the debate between researchers from different countries and different disciplines. even though the group of social scientists interviewed is not representative of the chilean community, this paper was an effort to bring together perspectives of different social scientists, to understand one piece of the bigger (and complex) picture that is population aging. references abellán garcía, antonio and cecilia esparza catalán 2009 solidaridad familiar y dependencia entre las personas mayores. informes portal mayores 99: 1-19. aedo, cristian 2000 las reformas en la salud en chile. in la transformación económica de chile, edited by felipe larraín and rodrigo vergara, 605-640. santiago: centro de estudios públicos. aldunate b., adolfo and 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accessed november 15, 2014, http://www.senama.cl/filesapp/chileysusmayores_encuestacalidaddevida.pdf 2013 tercera encuesta nacional de calidad de vida, chile y sus mayores, accessed november 15,2014, http://www.senama.cl/filesapp/chile%20y%20sus%20mayores%202013,%20encuesta%20de%20calidad%20de% 20vida.pdf quintanilla, ximena 2011 did chileans maximize pensions when choosing between payg and dc?. santiago: superintendencia de fondos de pensiones. restrepo, helena e. and manuel rozental 1994 the social impact of aging populations: some major issues. social science & medicine 39 (9): 1323-1338. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 78 robertson, ann 1997 beyond apocalyptic demography: towards a moral economy of interdependence. ageing and society 17: 425-446. roughan, p. a., f. e. kaiser, and j. e. morley 1993 sexuality and the older woman." clinics in geriatric medicine 9 (1): 87. salinas, viviana 2011. socioeconomic differences according to family arrangements in chile. population research and policy review 30 (5): 677-699. senama 2014 nuestros inicios, accessed april 22, 2014, http://www.senama.cl/nuestrosinicios.html 2015a catastro establecimientos de larga estadía (eleam), accessed august 13, 2015, http://catastroeleam.senama.cl/. 2015b envejecimiento activo, accessed august 14, 2015, http://www.senama.cl/envejecimientoactivo.html senama and facso 2015 inclusión y exclusión social de las personas mayores en chile. santiago: senama. sokolovsky, jay 2009 the cultural context of aging: worldwide perspectives. westport: praeger. sulbrandt, josé, paulina pino, and manuel oyarzún 2012 envejecimiento activo y saludable: investigación y políticas para el envejecimiento poblacional. revista chilena de enfermedades respiratorias 28 (4): 269-271. superintendencia de pensiones 2014 ¿cuál es la diferencia entre el sistema de capitalización individual y el sistema de reparto?, accessed september 12, 2014, http://www.spensiones.cl/portal/orientacion/580/w3-article-2818.html. superintendencia de pensiones 2016a centro de estadísticas, accessed january 25, 2016, http://www.spensiones.cl/safpstats/stats/pageccee.php?menu=sps&item=nbmpm 2016b número y monto promedio, en uf de las pensiones pagadas en el mes por modalidad., accessed january 25, 2016, http://www.spensiones.cl/safpstats/stats/.si.php?id=inf_estadistica/afipen/mensual/2015/12/m00.html superintendencia de salud 2015 ¿cómo se clasifican los beneficiarios de fonasa según su tramo?, accessed july 15, 2015, http://www.supersalud.gob.cl/consultas/570/w3-article-6304.html tessler, richard c. and gail gamache 2000 family experiences with mental illness. westport: auburn house. tetelboin, carolina 2003 la transformación neoliberal del sistema de salud, chile: 1973-1990: reformas de primera generación. méxico, d.f: universidad autónoma metropolitana. un 2002 world population ageing, 1950-2050, accessed september 22, 2015, http://www.un.org/esa/population/publications/worldageing19502050/ urzúa, alfonso, miguel bravo, mario ogalde, and carolina vargas 2001 factores vinculados a la calidad de vida en la adultez mayor. revista médica de chile 139: 1006-1014. van durme, t., j. macq, c. jeanmart, and m. gobert 2012 tools for measuring the impact of informal caregiving of the elderly: a literature review." international journal of nursing studies 49 (4): 490-504. vaquiro, sandra and jasna stiepovich 2010 cuidado informal, un reto asumido por la mujer. ciencia y enfermería revista iberoamericana de investigación 16 (2). walker, alexis j., clara pratt, and linda eddy 1995 informal caregiving to aging family members: a critical review. family relations 44 (4, helping contemporary families): 402-411 anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.134 http://anthro-age.pitt.edu salazar | 79 weiss, robert 1994 learning from strangers: the art and method of qualitative interview studies. new york: free press wood, james w. 1994 dynamics of human reproduction: biology, biometry, demography. new york: aldine de gruyer. world bank 2014 chile, world development indicators, accessed december 18, 2014, http://data.worldbank.org/country/chile zhang, yuanting and franklin w. goza 2006 who will care for the elderly in china? a review of the problems caused by china's one-child policy and their potential solutions. journal of aging studies 20 (2): 151-164. notes i haciendas were large landed estates located on the countryside in most of latin american countries. “peasant workers lived and worked on these estates in serf-like conditions” (lyons, 2006: 3). ii additionally, is important to mention that abortion, in any way is still illegal in chile (gobierno de chile 2016). however, during 2015, the government presented a bill to decriminalize abortion in three causals: lifetime risk of woman, unviable fetus and pregnancy resulting from rape. in march, 2016, the house of representatives approved the bill and now is awaiting discussion in the senate (cámara de diputados 2016). iii this index measures the distribution of income among individuals. the values go from 0, which means that is an equal country; and the highest value is 100, which means that is the most unequal country (world bank 2015). iv even though in their webpage they do not address specifically how they define active aging, because of the description of their program, it could be deducted that they refer to citizens who stay healthy in their own context, considering the physical limitations that some elderly can present (senama 2015). book review review of gullette, margaret morganroth. ending ageism or how not to shoot old people. rutgers university press. 2017. pp 265. price: $120 (hardcover); $28.95 (paperback). aaron guest arizona state university aaron.guest@asu.edu anthropology & aging, vol 41, no 2 (2020), pp. 252-253 issn 2374-2267 (online) doi 10.5195/aa.2020.292 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | guest | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.292 http://anthro-age.pitt.edu 252 book review review of gullette, margaret morganroth. ending ageism or how not to shoot old people. rutgers university press. 2017. pp 265. price: $120 (hardcover); $28.95 (paperback). aaron guest arizona state university aaron.guest@asu.edu the time allocated to cross the street; the presence (or, rather, absence) of accessible walkways; the portrayal of ‘happy’ and ‘energetic’ elders – all forty-years old – in the media: in ending ageism or how not to shoot old people, cultural critic and age studies scholar margaret morganroth gullette challenges us to examine these subtle – and less subtle – ways in which ageism penetrates our lives. gullette examines western culture in detail, pulling from the nascent field of aging studies, to provide an alluring examination of how culture continues to dehumanize and other older age. ending ageism is gullette's third direct examination of ageism in society, following aged by culture (2004) and agewise: fighting the new ageism in america (2011). this is not a surprise, since her entire career has been focused on examining age-related issues, with her work moving with her from mid-life to older age. the book opens with an introduction to the crone-goddess senexa, whose motto 'end ageism' gullette wants to ring from the heavens. the book is divided into three sections: introductions (preface and chapter 1), five special sessions (chapters 2-6), and conclusions/redress (chapters 7-8). in chapter 1, gullette lays the foundations for the rest of the book. she also provides an excellent summary of the age studies movement and the underpinnings of her philosophical approach of aging as a cultural construct. here, she provides the reader with the basic insights, to grasp the critical and subtle role ageism plays in society and how, consecutively, we are often powerless to push back. i largely disagree with her overall assessment of how gerontological scholars have approached ageism. clearly, we have worked to address ageism much longer than only starting in the 2010s. chapter 1 also explains the unique layout of the text: the book is organized as a lecture series. chapters 2 through 6 provide five ‘special sessions’ on ageism in culture and society, with the readers being the students educated on this issue. chapters 7 and 8 provide a space for reflection and for articulating ways to move forward. chapter 2, where the book's secondary and evocative title (how not to shoot old people) comes from, is dedicated to the visual depictions of older adults through art, advertisements and other media. it examines how the visual representation of older adults has shaped our cultural dialogue and vice-versa. for example, why is it we avoid wrinkles in visual art? what is it about the nude, older body that is so provocative compared to a younger body? chapter 3 focuses on our intergenerational connections. it mainly stresses how we must work to alter the perception that younger generations have of older age. chapter 4 is dedicated to how people and cultures (don’t) understand our relationship with labor, identity, and the environment – particularly how changing demographics, and our lack of attention to http://anthro-age.pitt.edu/ book review | guest | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.292 http://anthro-age.pitt.edu 253 them, will result in wide-gaps in our agricultural supply chains. unique to this volume is chapter 5, which provides an innovative analysis of how alzheimer's disease has been legalized and has become the ultimate defense strategy of individuals in their old age – whether they have the condition or not. gullette argues that dementia has become an ‘out’ for past misdeeds. an individual claiming dementia is viewed as untouchable, regardless of when their actions occurred. chapter 6 aptly reconnects two distinct topics: it pairs how we talk about older adults in terms of death/dying and our preferences for a shorter life span with less ‘superfluous’ dependency, with our reluctance to embrace euthanasia as a viable medical treatment. beyond the topics discussed, the chapters also touch on how our perceptions of aging and aging bodies are shaped throughout our lives from high school (chapter 4), to college (chapter 3), to mid-life (chapter 2) and even into older adulthood (chapter 5 and 6). the concluding section of the book first provides, in chapter 7, a discussion of how many of the aforementioned ageist attitudes are internalized and how we – even those of us with anti-ageism approaches – may find ourselves engaging in ageist tropes. chapter 8 aims to tie the book together, connecting what may have seemed like loose threads. it ends, in an epilogue, with a “declaration of grievances,” modeled after the declaration of rights and sentiments, as a starting point for our demands on ending ageism, and as a call for others to contribute. overall, ending ageism feels rushed, unfinished, and the message feels muddled. while following a unique structure – one that inevitably leads the book to provide nine weeks of course content – the reliance on hypothetical discussions and artificially constructed situations, distracts from the overall argument. in a similar vein, the mixture of facts, opinions and hypotheticals, makes it challenging to discern what is objective and subjective. i imagine those who come to gullette through ending ageism will not necessarily be disappointed. the book is enlightening in multiple aspects, with chapter 5, “the alzheimer's defense” (“‘faking bad’ in international atrocity trials”), being particularly noteworthy. however, for those who have followed her trajectory since she first named ageism in her work, ending ageism may be a letdown. in some ways, it does not seem to be the next step in the intellectual development of the field of age studies but rather a repetition or reflection of where the field stands. perhaps, however, that is exactly the point. two connected statements bookend the text. first, “everyone should be concerned about ending ageism” (4), and second “the end of ageism is the goal. it is not close” (192). of course, we are invited to ask: if we should all be concerned, why are we not even close to our goal? it is this ambivalence i believe ending ageism is trying to address more so than anything else. yet, in trying to be a book, anyone can relate to, i fear it has become one that is difficult to relate to for many who are already concerned. readers of gullette will find this book a noteworthy – but not necessary – review of her philosophical approach to anti-ageism and the cultural development of ageism. graduate students and researchers in cultural studies will find it interesting, due to the inclusion of social media in an ageist society. i would recommend that those in the visual arts (chapter 2), law (chapter 5), higher education (chapter 3), and gerontological fields (chapters 5 and 6) consider adopting chapters and sections of the book. in the future, i hope that gullette will continue to critique our age-based cultural systems, but will also move the field ahead in a cohesive manner. unfortunately, much of the book seems to be regurgitated ideas, albeit with new examples, that echo her previous volumes. references gullette, margaret morganroth. 2004. aged by culture. chicago: university of chicago press. gullette, margaret morganroth. 2011. agewise: fighting the new ageism in america. chicago: university of chicago press. http://anthro-age.pitt.edu/ microsoft word spring2021_wentzell.in template.docx time and collective biology: relationships between individual and societal life course ideologies in mexican men’s sexual health treatment emily wentzell university of iowa emily-wentzell@uiowa.edu abstract people may seek to embody cultural ideals of the life course through their use or rejection of medical interventions, including but not limited to anti-aging treatments. here, i analyze this phenomenon via interviews with men engaging with two different forms of sexual health medicine in urban mexico: erectile-dysfunction treatment and testing for sexually transmitted infections (stis). i argue that, in contrast to the biomedical understanding of patients as individuals who change during their lives, my interlocutors understood themselves as components in broader “collective biologies” that change on a longer timeline. these are culturally-defined groups that people understand to be comprised of interrelated members whose behaviors concretely affect the group’s physical and social well-being over time. in both medical arenas discussed here, men used or rejected sexual health interventions in response to local narratives about the nature of the mexican population as a collective biology, including ideas about how it should change over time away from its roots in the colonial past. they characterized predispositions to machismo and disinterest in preventative health care as embodied inheritances that the mexican population should reject in order to achieve healthpromoting modernity in the future. my analysis describes how these interlocutors sought to live out desirably modern forms of race and gender through their medical decisions in a way that they hoped would contribute to positive, embodied change in the mexican social body over time. these findings show that, despite the assumptions of individualism generally naturalized in anti-aging treatment and biomedicine, people may make medical decisions in an effort to aid collective change over population-level timescales. keywords: life course; temporality; masculinity; sexual health; anti-aging medicine; mexico anthropology & aging, vol 42, no 1 (2021), pp. 66-80 issn 2374-2267 (online) doi 10.5195/aa.2021.232 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 66 time and collective biology: relationships between individual and societal life course ideologies in mexican men’s sexual health treatment emily wentzell university of iowa emily-wentzell@uiowa.edu anthropologists have long investigated how people’s experiences of time reflect ongoing relationships between individual and group-level experiences. these experiences include people’s understandings of the relationships between themselves and their societies in light of shared ideas about groups’ origins, pasts, and desired futures (munn 1992; tamarkin 2018). such studies have been particularly useful for understanding how cultural expectations for change over time relate to ideals and experiences of gendered personhood. for example, some scholars have analyzed how body-modification practices help people embody gendered social expectations associated with particular rites of passage or expected forms of change over the life course (cf. boddy 1989). since western biomedicine plays a key role in many people’s everyday lives, anthropologists have studied the use of biomedical technologies to assess bodily change over time, and to attempt to align those changes with medical norms and cultural ideals (e.g., jain 2007; manderson and smith-morris 2010). as other articles in this volume discuss (kroløkke, this issue; sievert et al., this issue), this phenomenon is especially apparent in reproductive and sexual health medicine. in that arena, health practitioners and patients use medical interventions in efforts to align bodies with norms of gender and modernity, and by assisting or preventing reproduction,1 they aim to pursue individuals,’ families,’ and societies’ hopes for the future. for instance, anthropologist tine gammeltoft’s (2013) work analyzes the relationship between vietnamese women’s experiences of gestational time as mediated by ultrasonography as well as the future-altering, traumatic, and teratogenic past of war. studies of such relationships further highlight that expectations for change over time are social constructs that people attempt to naturalize and live out through both medical and social interventions (johnson-hanks 2002). this approach also highlights the non-linearity and contingency of people’s embodiments of expected life courses, as in anthropologist caroline bledsoe’s examination of gambian women’s use of hormonal birth control to promote reproductive healing rather than prevention (bledsoe 2002). the globalization of biomedical interventions, often encoded with western cultural norms of gender, personhood, and the life course, creates a situation in which people may experience competing local versus imported norms for change over time in their bodies and behaviors. disjunctions between these norms are growing more apparent as people worldwide are living longer lives that are increasingly shaped by biomedical interventions. popular, globalized discourses of ‘successful aging’ highlight these possible disjunctions. promoting healthy or successful aging is often framed by health and socialsupport professionals as supporting older people’s rights and well-being. however, what counts as “healthy” or “successful” usually means “ideal to contemporary euro-americans,” i.e., numeric aging coupled with ongoing physical and behavioral youthfulness, activeness, and independence (lamb 2014, 2017). wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 67 promoting these culturally-specific ideals as “healthy” has the consequence of pathologizing other ideals of how bodies and behavior should change over time; it also risks stigmatizing people who depart from those norms (estes and binney 1989). moreover, it has fueled, and been fueled by, the development of the “anti-aging” medical industry (fishman, binstock, and lambrix 2008). anti-aging medicine both naturalizes western ideals of eternal youth and frames medical practice itself as modern and even futuristic (mykytyn 2006). this field overlaps significantly with sexual and reproductive health medicine in that it provides ways to perform reproductive and sexual functions—once socially and/or biologically limited to earlier phases of life—for extended periods of time. medicalizing these aspects of biology has meant defining gender stereotypes as biologically “natural” (riska 2013). this is exemplified by foci on extending the “biological clock,” which reduces women’s personhood over time to a race to reproduce before senescence (friese, becker, and nachtigall 2006) and extending men’s ability to maintain virile and vigorous masculinity as expressed through unceasing penetrative sexuality (marshall 2009).2 yet, while many embrace medical technologies as a way to live out ideals for gender, personhood, and the life course, others may find these norms undesirable or inappropriate (cf. potts et al. 2004). furthermore, while anti-aging medicine is a particularly clear-cut case of culturally-specific life-course norms becoming naturalized in medical practice, such norms reverberate even through healthcare spheres seemingly unrelated to age. for example, the area of preventing and testing for sexuallytransmitted infections (stis) features debates about the appropriate age to vaccinate for human papillomavirus (hpv) as well as critiques of under-screening for stis in older populations assumed not to be sexually active (despite increasing and conflicting pressure to be ‘sexy seniors’) (casper and carpenter 2009; marshall 2010, 211; minichiello et al. 2012). as i discuss below, people’s attitudes towards sti testing are also intimately related to their perceived role in societal changes over time, such as the adoption of “modern” self-care and sexual self-determination (adkins 2001; biehl, coutinho, and outeiro 2001). in this article, i map some specific points of disjunction between the ideals and assumptions regarding masculinity, the male life course, and male biology encoded in two arenas of mexican men’s sexual health medicine. specifically, i analyze data from a study of older, working-class men who were experiencing decreased erectile function but rejected treatments for erectile dysfunction (ed) and from a study of heterosexual, middle-class couples participating in medical research on the occurrence of hpv in men. i discuss how, in both cases, people understood their intimate medical decisions, sex lives, and health behaviors as influenced by—and capable of further influencing—generational change over time in the broader mexican social body. participants attributed characteristics like machismo and a lack of interest in preventative health care to a shared biological and cultural mexican nature rooted in the nation’s history. as such, they intended for their own sexual and health behaviors to make embodied contributions to hoped-for change on the population level. i describe how their health decisions drew implicitly on cultural understandings of people’s individual bodies and behaviors as innately influenced by a population-level past, and as capable of altering its future. i argue that their individual decisions, explanations of their changing behavior, and hopes for those behaviors’ long-term positive effects for others drew upon a shared notion of the mexican population as what i call a “collective biology.” collective biologies are culturally-defined groups that people understand to be comprised of interrelated members whose behaviors concretely affect the group’s nature and well-being on a time scale beyond the individual life course. this concept is meant to serve as an umbrella term for locallyspecific ways in which people understand some individuals’ actions to have embodied consequences for a specific group of others. wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 68 in the following, i discuss the specific ideology of collective biology that influenced people’s actions in the two ethnographic arenas i studied. i then focus on findings from each setting in order to discuss how this ideology informed people’s varied understandings of the ways their embodied sexual and health behaviors reflected a shared, bio-social mexican past and might contribute to its future. i conclude by discussing how people’s hopes that their embodied actions and changes in their individual life courses might contribute to positive generational change on a collective level directly conflicted with the teleologies that have been naturalized in anti-aging and sexual health medicine. gender, health, and time in mexican notions of collective biology popular cultural notions of “mexicanness” suggest that individual sexual and health behaviors concretely affect the health and well-being of the national populace as a biologically and culturally interrelated whole. it is important to note that anthropologists understand racial categories to be cultural ideas about human difference—which then profoundly influence peoples’ lives, opportunities, and health—rather than scientifically valid biological distinctions (ackermann et al. 2019). thus, i am discussing context-specific ideologies and not biological facts when i discuss race, mexicanness, or mestizaje, which is the mix of conquistador forefathers and indigenous foremothers popularly understood as the origin of a uniquely mexican population. the idea that contemporary mexicans do or should comprise a homogenous, mestizo racial group has been promoted since the revolution of 1910 for key political reasons, e.g., unifying the population to enable its governance, promoting the enculturation and absorption of indigenous peoples, and justifying the marginalization of groups who do not conform to this homogenization project (alonso 2004; manrique 2017). this ideology has been used to promote a specific kind of unity—conformity to the health, gender, and other behaviors associated with contemporary visions of modernity. intellectuals and politicians have promoted the belief that mixing of people of indigenous and spanish heritage would eventually lead to an ideal race (e.g., vasconcelos [1925] 1997). for instance, physicians expected women’s pelvises to reach an ideal midpoint between presumptively too-narrow european and too-wide indigenous forms (cházaro 2005). the notion of the mexican or mestizo population as a collective biology—with a shared biological and cultural essence—has thereby been naturalized through these discourses. such attitudes and interventions have further fostered the idea that individuals can advance this mestizo racial whole, and thus the mexican nation, by performing modern health and gender behavior. postrevolutionary public-health campaigns have tasked women with the role of mothers who should reproduce modern ideas of health and hygiene as they planned families and raised children (soto laveaga 2007; stern 1999), and mestizo-identified healthcare workers continue to critique patient behavior and self-presentation that they consider to be anti-modern, unhygienic, or problematically indigenous (smith-oka 2012). thus, ideas of embodied teleology are central to the ideology of mexicanness. this ideology positions contemporary mexicans, whoand whenever they are, as mestizos carrying innate and often negative inheritances from an indigenous and colonial past. they are expected to contribute to biological and behavioral population improvement over time by acting in modern ways. the eugenic and antiindigenous elements of this ideology have become implicit rather than explicit over time; the open discussions about how to create evolution within la raza (the race), which were commonplace in the early half of the 1900s, have since faded away (manrique 2016; stepan 1991). yet, these ideas continue to echo in certain arenas, such as the continuing marginalization of indigenous people in healthcare as discussed above, in national scientific projects built on the assumption of a homogenous, mestizo wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 69 populace (garcía-deister and lópez-beltrán 2015; nieves delgado 2020), and especially in discussions of gender. discussions of mexican machismo exemplify this ideology. the notion of mexican men as inherently macho—emotionally closed and obsessed with power, invulnerability, and virility—became popular in the 1950s and consequently became identified with what it meant to be a mexican man. this conceptualization stems from the idea that the mexican populace is a coherent racial group, formed by the reproductive mixing of spanish conquistador forefathers and indigenous foremothers. innate machismo is seen as men’s biological and cultural inheritance from the violent and coercive character of that reproduction (see paz [1961] 1985). like the broader ideology of race from which it stems, this characterization of “natural” masculinity is a cultural concept rather than a biological fact (lópez-beltrán and deister 2013; moreno figueroa and saldívar 2015). machismo has always been a stereotype obscuring more complex lived realities and gender (as well as racial/ethnic) diversity (gutmann 1996). nevertheless, it has been central to mexican men’s understandings of themselves for the past 70 years. this remains true today, although the ways in which people relate to the concept have changed dramatically in the past several decades. the participants in the studies i discuss below have lived through major changes in cultural ideals of gender and masculinity. this generation of men had been raised with the belief that good men marry, father children, and provide economically for their families—while engaging in frequent extramarital sexual encounters and locating their leisure lives outside the domestic sphere. many were raised to see machismo as a normative attribute of men who met these societal expectations. however, they have lived through increasingly strong and influential calls to enhance gender equity in the domestic and public spheres, as well as widespread adoption of the idea that such a change would represent a way to live out desirable modernity on the population level (garcía and de oliveira 2004). ideals of love and marriage have also changed with the widespread idealization of “companionate marriage,” in which people seek out monogamous relationships intended to provide emotional fulfillment and intimacy, in addition to the more traditional marital goals of economic stability and reproduction (hirsch 2003; wardlow and hirsch 2006).3 current ideals of masculinity combine responsible provision with emotional support for one’s family and monogamous, intimate marriage; these are often explicitly framed as anti-macho (ramirez 2009; wentzell and inhorn 2014). nevertheless, people in mexico continue to keep the concept of machismo alive by framing it as a problematic bio-cultural inheritance against which good men must struggle, rather than simply an inaccurate description or outmoded form of masculinity (amuchástegui herrera 2008; amuchástegui and szasz 2007; brandes 2002; ramirez 2009). critiques of the persistence of machismo and articulations of hope for a more egalitarian future are now central to popular cultural discussions of the ideal life course of the mexican social body. below, i discuss how individuals expressed ideas about mexican collective biology and its past and possible change over time in relationship to their own experiences with sexual health medicine. changing erectile function and ideal masculinities in mexico viagra and other ed medications have been the blockbusters of the overlapping fields of anti-aging and sexual medicine. in the late 1990s, age-related decrease in erectile function and emotionor relationshiprelated “impotence” were redefined as ed, a problem of individual biology that could be treated pharmaceutically (tiefer 2006). in the years since, global marketing and prescription of ed drugs have widely distributed the euro-american cultural assumptions that shaped the inception of ed as a disease wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 70 category. while individual peoples’ and health practitioners’ ideas about ed and how to treat it vary, the global marketing of and media discussion about ed have been remarkably consistent. its key features include metaphors of bodies as machines and age-related changes as breakdowns to be fixed; phallocentric and individualistic ideas of male sexuality as an individual trait rather than a relational experience; and understandings of “healthy” aging as necessarily including the unceasing performance of youthful-style sexuality (grace et al. 2006; mamo and fishman 2001; marshall and katz 2002; tiefer 1994). in short, ed drugs have come to serve as “masculinity pills” that enable men to align their bodies with culturally-specific ideals of gender and aging (loe 2004, 58). the pharmaceutically-mediated promise of never ending virility despite aging or illness would seem to resonate with stereotypes of mexican masculinity. ed drugs have been available in mexico since their emergence on the global scene. they quickly became pop culture mainstays, frequently featuring in television-comedy punchlines. there was even an advertisement on the “viagra”-printed mints i received after dinner at a seafood restaurant (a joking riff on the idea of seafood as an aphrodisiac, the owner explained). as is clear in the names of herbal copycat treatments such as “powersex” and “mforce,” understandings of ed drugs as ‘masculinity pills’ aligned with notions of mexican men’s predisposition to machismo. study 1: men’s experiences of decreased erectile function i found that men’s relationships to the notion of machismo and its critiques—especially the idea of temporality and development over time in a collective mexican racial group—fundamentally influenced their understandings of changing erectile function as they aged. in 2007–8, i interviewed over 250 male urology patients, most in their 50s and 60s, in a government-run, hospital-based clinic in the central mexican city of cuernavaca. i held interviews in spanish and transcribed then translated the portions quoted here into english. patients tended to be working-class and older and were usually seeking treatment for urological complaints other than ed. our open-ended, ethnographic interviews ranged widely but focused on the men’s health problems, life histories, changes in sexual functionality, and their experiences of medical treatment. a detailed discussion of the study and methods can be found elsewhere (wentzell 2013), and this research was approved by the university of michigan and imss institutional review boards. almost 70 percent of the men i interviewed reported decreases in erectile function. however, only 11 percent considered medical treatment for this bodily change, and only a few had tried ed drugs. although ed drugs offered the promise of aligning their bodies with youthful or macho sexuality despite aging and illness, my interlocutors’ narratives revealed this to be precisely why they rejected those interventions. instead, most participants understood age-related changes in sexual function as opportunities to align their bodies and behavior with the emergent, anti-macho ideals of masculinity. many study participants saw a decrease in sexual function as a lessening of their innate, biological urges towards infidelity that had aligned them with outmoded machismo rather than currently ideal forms of masculinity. for instance, a retired laundry worker who identified himself as, in his words, a former “womanizer,” believed that he had recently become a better husband because, “the truth is, now i don’t have the same [erectile] capacity.” he continued to explain that a physical inability to cheat had enabled him to begin cultivating mutual respect in his marriage: “i’m 55, i know what i am. i don’t want problems with my wife. like i deserve respect from her, she deserves it from me as well.” for men like him, biologically-induced fidelity became an aid for living out contemporary ideals of masculinity and marriage. some men understood this shift as also reflecting the increased wisdom they associated with wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 71 proper aging. for example, an appliance repairman discussed his newfound fidelity by noting mental as well as physical changes. he said, “with age, you start to think more.” thus, decreased erectile function and the fidelity these men believed it to facilitate enabled their performance of both desirably modern and age-appropriate masculinities. participants expected respectable older men to focus on the home and family rather than chasing sex. discussing the absurdity of old men chasing women, a barber laughed and said, “here in mexico, we have a saying: ‘after old age, chickenpox.’ it means that some things become silly when one is older.” my interlocutors further understood the pursuit of youthfully vigorous sexuality in older age not only as socially inappropriate but also as physically harmful. several said that they expected their bodies to slow down following lifetimes of hard work. thus, they feared that pharmaceutically ‘accelerating’ their bodies with ed drugs could cause damage and even death. reflecting this common idea, one retiree stated that, “viagra scares me.” this is especially notable since participants did not voice similar fears about drugs taken to treat other conditions, such as high blood pressure. thus, in contrast to the pathologization of aging encoded in ed drugs, these men overwhelmingly saw a decrease in age-related sexual function as normal. they naturalized the idea discussed above that demanding, and thus appropriately masculine, work lives led to general and sexual slowing in later life. for instance, a delivery-truck driver explained, “my work is a little rough, heavy. i carry a lot, so i feel a little tiredness. now, i can’t have as much sex as before. this is normal. now it’s not the same— when i was young, more potency. now with my age, not anymore.” the men’s wives often promoted this normalization of change when their husbands first began to experience decreased erectile function. one construction worker was initially concerned about this change. however, he said that his wife told him that she would rather spend time together than have sex. he became “dedicated to the home” instead of “wander[ing] the streets,” and both his marriage and remaining sex life underwent a “beautiful change.” free of what he characterized as the “sick mind” that had led him into a youth of infidelity, he reported that decreased erectile function had engendered the development of a more companionate marriage. overall, many of my interlocutors had little interest in ed drugs because they saw decreasing erectile function as a bodily reprieve from the innately macho tendencies that they considered to be both culturally outmoded and inappropriate for respectable older men. 4 many articulated that they expected to begin a “second stage” or “another level” of life that would focus on new priorities like being a “role model” for their grandchildren—a life that did not feature penetrative sex. a retired factory worker summed up this valorization of change with the comment, “erectile dysfunction isn’t important. when i was young, it would have been, but not now.” these urology patients understood their male bodies and behaviors to be fundamentally influenced by an innately mexican impulse to machismo; however, they embraced age-related physical “slowing” as an aid for the adoption of currently valorized masculinities. they felt that bodily aging had freed them from their macho urges, enabling them to behave in ways that are consistent with an emerging societal future. their discussions of machismo drew implicitly yet powerfully on culturally-specific ideas of collective biology and its past and future change over time. their explanations rooted their own past behavior in a trait inherited from their imagined spanish conquistador forefathers. they further linked men’s own later-life cessation of stereotypically macho sexuality to future-oriented calls for “modern” rather than macho masculinities. treating collective biologies in men’s sexual health research participation people participating in a quite different sexual-health arena similarly drew upon implicit ideas of mexican mestizaje amid changing gender norms in order to make sense of men’s medical experiences. wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 72 this was the case for the heterosexual male participants in the mexican sub-study of the multinational “human papillomavirus in men,” or “him,” study. this longitudinal, observational study aimed to reveal the ‘natural history’ of hpv in men by testing large groups of men in various sites and then to track their acquisition and clearance of the virus in relation to other health factors, such as smoking. twice annually for four or more years, him study participants underwent genital swabbing to determine the presence of hpv dna; at the same time, they also provided other samples for sti testing, completed sexualand health-history questionnaires, and were informed about prior test results. the mexican him study was administered by the cuernavaca research unit of a federal health organization, and researchers recruited participants mainly from that health system (both workers and patients) as well as from large local businesses with employees who could access the system by virtue of their employment. this created a participant pool that skewed towards middleand working-class men with relatively high levels of education and job stability compared to the local population. from 2010–13, i conducted a series of annual interviews with 31 of these male participants together with their wives as well as with comparison groups of 10 male participants and 12 female partners individually. him staff recruited these participants from the pool of men who suggested their female partners for inclusion in a planned (but never executed) study of hpv in women. these interviews were intended to capture the ways in which spouses jointly constructed understandings of men’s medicalresearch experiences. the interviews were structured according to best practices for talking with couples together. they included open-ended questions that addressed people’s relationship and life histories, medical experiences, decision-making and experiences relating to him enrollment and hpv test results, as well as change over time from year to year. i discuss study methods in detail elsewhere (wentzell 2015, 2021); this research was approved by the university of iowa and imss institutional review boards. study 2: participants’ experiences of the human papillomavirus in men study in contrast to the men discussed in the previous section, who hoped to embody societal change by behaving differently in later life, him study participants of all ages generally saw themselves as consistently embodying modern gender and health behavior through their involvement in medical research. they often conceptualized the potentially embarrassing, intimate testing required by the him study as proof that they were not machos, but instead modern men whose efforts to be healthy were not hamstrung by problematically traditional gender ideologies. for instance, a hospital clerical worker said that, while “in our culture it’s not a given that the mexican man understands health, because there’s a lot of machismo,” he himself was willing to participate because, “i’m mexican but not macho.” participants thus subscribed to the common notion that machismo was a racially innate trait that modern mexican men should ideally reject, and they sometimes considered the frequent sti testing that him participation required as support for doing so. for instance, another hospital clerical worker explained how his negative hpv test results helped him to remain faithful. he recalled, “i thought, ‘good, i’ll keep sticking to one partner.’ you see the consequences that having many partners could have. it’s better to be safe. all the tests are negative, so it’s better that i keep myself that way.” thus, the men’s participation in the sexual-health research was temporally marked, serving as an area and an aid for aligning themselves with modern versions of masculinity and male sexuality. they also used the him study to live out their visions of modern, companionate marriage. wives participating in interviews often characterized their husbands’ participation in this medical research as direct care for themselves—in both the biological and social sense. since they saw spouses’ bodies as intimately interlinked, participants expected that the men’s hpv test results would reveal the female partners’ status as well. for example, a male imss facilities worker believed that if he tested negative wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 73 for hpv, “then as a consequence, she’ll also be ok, it seems to me, right? that’s a really interesting point that helped me become a study subject.” in this way, the men’s willingness to submit to potentially embarrassing genital sampling served as an act of marital care. the men’s willingness to disclose their test results to their wives was a similarly meaningful expression of intimacy. since testing positive for an sti was often perceived as a sign of infidelity—and positive sti status is often stigmatizing—sharing results was a clear statement of trust and vulnerability. couples thus performed companionate marriage by engaging jointly with the him study and its results. a male engineer diagnosed with hpv explained that, since “we’ve taken [the diagnosis] maturely, it really hasn’t affected us.” he recounted that his wife “was there with me when they gave me the results . . . it wasn’t hard because we’ve always kept everything open.” they were thus able to frame potentially distressing sti results as an opportunity to live out a form of marriage associated with desired modernity. spouses similarly incorporated the men’s him participation into their efforts to raise modern families and inculcate their children with anti-macho gender ideologies. a nurse who stated that “gender equity is very important” to her family had suggested that her bartender husband join the study when she heard about it at work. he said, “normally here [in mexico,] a man finds it very difficult to let [any health professional] touch his intimate parts, and well, i got accustomed to it, now i see it as something normal . . . and like that, between jokes, we’re transmitting all that to our sons.” in this comment, he linked his own experience over time to the ongoing task of raising anti-macho sons, and thus the longerterm, societal-level project of moving towards what many mexicans view as modern gender and health norms. for some men, transmitting health-promoting gender ideologies went hand-in-hand with the goal of supporting future scientific advances. for instance, a physician said that his participation in the medical research enabled him and his wife to “hope that, for them [future generations,] there will be fewer problems with aggressive diseases.” overall, many participants in the him study hoped to support the development of medical advances that would protect future generations, while also transmitting the social predilection to use such advances. some participants’ hopes relied on specifically collective visions of modernity, the mexican populace, and the family units that comprise it. a health service worker explained this perspective by saying, “i tell my wife that now i don’t just think of myself, but of what i bring with me, which is her and my children.” his wife, a homemaker, added, “my father had a saying he would tell us, that when one marries, your life no longer belongs to you, it belongs to your husband or your wife.” she added, “when you have children, then again your life isn’t yours, it’s your children’s.” this ethos of living for others extends the impact of one’s actions—such as the men’s him participation—beyond the individual body and life course, framing people as components of broader bio-social entities rather than as detached individuals. this ethos also encourages people to understand their own bodily health as a collective resource. for instance, a male hospital facilities worker explained, “if i’m in good health, i know that in a given moment if there’s any emergency, i know that i can take care of my people.” from this perspective, engaging in modern self-care through sti testing enables participants to care for the health of those intimately related to them in the present moment. it also allows them to model health and gender behaviors that, when taken up by their children and others, will enhance the health and wellbeing of broader collective biologies in the future. this includes modernizing the mexican populace from within by performing anti-macho masculinities and health-promoting self-care. him participants and their partners tended to see themselves as a middle-class vanguard, educated enough to embrace modern comportment but not elite enough to be tempted into the ruling-class corruption, which they universally saw as moving their country backward. wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 74 from this position, they sought to advance the mestizo collective biology. for instance, many explicitly discussed their goal to promote a “culture of prevention.” in a typical statement, a hospital clerical worker mused that the him study “is good because we [in mexico] don’t really have the culture of, of prevention, right?” as such, he thought that more people getting tested before they develop health problems could promote such a culture. along similar lines, some him participants hoped they would serve as models for both their peers and their children. for instance, a retired utility worker explained, “i think that our case can serve as an example for the people around us, because they observe us also.” this promotion of preventative care was fundamentally interconnected with the promotion of modern masculinities. as a medical office worker noted, “in our culture, it’s not a given that the mexican man” understands or cares for his health, “because a lot of machismo exists.” he hoped to model difference from this “lack of culture.” such hopes incorporate a cultural notion of teleology, as they focus on moving mexican men away from the problematic past embedded in their biology and toward a future of modern behavior that will also enable better health. him participants and their partners hoped that these health behaviors could protect the future population against a range of ills with both cultural and biological components. parents frequently looked to the him study as a source of health information that they could share with their children as they taught them more broadly about modern and protective behaviors. a business executive critiqued the “traditional” parenting she had received and said that, in contrast, she cultivated emotional intimacy with her children. this included sharing sti-related knowledge gleaned from her interactions with the him study. she said, “i talk with them all the time . . . [even though] sometimes we start touching on things that embarrass me. . . . they’re growing and developing, and they have more contact with sexual issues, drugs, the security problems in our country.” overall, my interlocutors often framed themselves as agents of change whose behavior could help to heal the ills of their broader collective biologies. they saw actions like participation in the him study as a way to enhance the interlinked health of couples and families. through modeling progressive, antimacho action and contributing to future medical advances, it was also a way to promote health and gender behavior that would enhance the well-being of the mexican populace as a bio-social whole. this collectivist understanding of men’s participation in medical research was revealed through the metaphors participants often used to discuss it. the physician quoted above hoped to be a “positive statistic” in a hypothetical quantitative assessment of mexican health behavior, while a driver described his participation as a “little grain of sand” that would contribute to all of the other actions by his fellow grains of sand on the metaphorical mexican beach. similarly, the bartender quoted earlier hoped his participation in him could “start a snowball effect” of healthy masculinity; this metaphor in particular seems to capture people’s understanding of themselves as components of collective bio-social wholes that could be pushed forward along the long timeline to modernity by the actions of individuals enmeshed in the mexican societal aggregate. conclusion: treating individual versus collective bodies and temporalities the examples i have described here demonstrate how people may relate bodily changes and biomedical experiences into raced and gendered expectations for change over time that diverge from the norms embedded in western biomedicine. in mexico, and in context-specific ways elsewhere, men have articulated that changing their health and sexual practices is a desirable but difficult way to perform modern masculinity and personhood (de keijzer 2016; de keijzer and rodriguez 2007; escobar latapí 2003; sandberg 2011; van der geest 2001). in my research, decreased erectile function emerged as a wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 75 facilitator of this change. similarly, sti testing and diagnosis may function as a threat to or as an aid in the performance of idealized masculinities, depending on patients’ positionality, gender ideology, and expectations of behavior and embodiment across the life course (cf. shoveller et al. 2010). for example, many him participants used hpv surveillance as an arena for performing gendered modernity, responsibility, and marital care. divergences between expectations of natural and healthy male change over time were quite clear in my research on erectile function; here, mexican men rejected the opportunity to embody ‘successful aging’ and become ‘sexy seniors’ with ed drugs. the disjunctures in assumptions about men’s fundamental biology were equally important but more subtle in the him study in which health researchers sought to understand the “natural history” of hpv. while the medical study was framed longitudinally, it tracked changes over time in individual bodies and in a population conceived of as an aggregate of individuals. in contrast, participants understood their involvement primarily in relation to their aim of fostering change in collective biologies—including their own family and the general mexican populace—on a generational timeline. in both cases, the local racial ideology of mestizaje profoundly influenced men’s experiences of bodily change and medical intervention. their understandings were influenced by the idea of mestizo mexicans as components of a broader racial whole, biologically and culturally interconnected and moving slowly from colonial and indigenous backwardness towards health-enhancing modernity. this notion meant that, in different but related ways, both working-class men experiencing decreased erectile function and middle-class men being tested for hpv understood their own bodily experiences as contributing to the enhancement of a collective mestizo biology over time. men in the ed study sought to align their bodies with changing societal values, as aging freed them from embodying a collective past, while those in the him study sought to embody the healthy future they desired for the mexican populace. my analysis suggests that—beyond the problem of western biomedicine naturalizing reductive understandings of masculinity as unceasing virility—men’s sexual-health medicine also encodes assumptions about biology and the life course as fundamentally individual, which may not match the patients’ own embodied understandings. a western emphasis on individuality is present in this medical arena—from understandings of sex as an individual rather than a relational activity (tiefer 1994) to the public-health understanding of populations as collections of individuals rather than largerthan-individual bio-social entities. this leads to a set of conflicting life course ideologies and norms for aging. biomedical interventions and research tend to focus on tracking and minimizing individual biological change over time, while people might instead understand that their own bodily experiences reflect and contribute to collective change on a generational rather than an individual time scale. given this state of affairs, interventions like ed medications which, from one perspective, can appear to promote modern and healthful aging may, from another perspective, seem like impediments to ageappropriate change and a contribution to societal modernization. the examples discussed here highlight the need to attend to collective ideas of biology—and people’s own expected life courses or temporalities—in both research on and the practice of sexual and reproductive medicine. endnotes 1. of course, the confluence of gender, time, and technology goes beyond medical technology as well. while writing this paragraph, i received a #womencrushwednesday bitmoji from a friend who explained that she had learned about this hashtag on social media; it was apparently a response to #mencrushmonday. wentzell | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.232 http://anthro-age.pitt.edu 76 2. virility medicine has its own fascinating teleology, coming in and out of vogue in biomedicine and other healing systems in response to varying cultural and structural changes. it is often used to support wide-ranging conceptions of ‘normal’ and ‘healthy’ masculinity and male sexual function (e.g., mclaren 2007; oudshorn 1994; watkins 2008; wentzell 2008; zhang 2015). the current iteration of this trend took off with the 1998 introduction of the blockbuster ed medication viagra. it was followed by several other brands as well as pharmaceutical treatments for other bodily experiences or changes over time that had previously been considered ‘normal’ or simply caused by life experience or emotion. this includes the burgeoning trend of diagnosing men with ‘low testosterone’ and treating them with hormone supplements as well as the use of selective serotonin reuptake inhibitors (ssris) to treat premature ejaculation (tiefer 2006; vitry and mintzes 2012). 3. research indicates that younger men have also used reproductive health related-changes, like vasectomy, as ways to live out masculine responsibility (gutmann 2007; huerta rojas 2007). 4. additional factors, like men’s economic status and healthcare access, also played key roles in relation to their changing erectile function; see wentzell 2013. references ackermann, rebecca, sheela athreya, deborah bolnick, agustín fuentes, tina lasisi, sang-hee lee, shay-akil mclean, and robin nelson. 2019. “aapa statement on race and racism.” american association of 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(6): 691-705. doi: 10.1080/17441692.2014.917690. zhang, everett yuehong. 2015. the impotence epidemic: men's medicine and sexual desire in contemporary china. durham: duke university press. microsoft word marshallfnov.docx “what  doraemon,  the  earless  blue  robot  cat  from  the  22nd  century,   can  teach  us  about  how  japan’s  elderly  and  their  human   caregivers  might  live  with  emotional  care  robots.”   robert  c.  marshall   western  washington  university   author contact: robert.marshall@wwu.edu abstract structural  analysis  of  the  phenomenally  popular  and  enduring  japanese  anime  doraemon  helps  us  think  about   what  we  might  hope  to  see  in  the  not  too  distant  future  from  japan’s  promised  surge  in  development  of   socially  assistive  robots  (sars)  designed  for  the  care  of  the  elderly.    doraemon,  the  earless  blue  robot  cat  from   the  22nd  century,  is  assigned  the  conjoined  tasks  of  caring  for  the  10-­‐‑year-­‐‑old  boy  nobi  nobita  as  his  constant   companion,  which  he  does  by  reproducing  the  ideal  caregiving  characteristic  of  japanese  expectations  for   mothers,  endlessly  affectionate  indulgence;  and  of  improving  nobita’s  character,  at  which  he  is  unsuccessful   because  he  perpetually  indulges  nobita’s  immature  demands  for  technology  from  the  future  to  solve  his   problems  with  no  effort  of  his  own.    one  might  suspect  a  moral  lies  hidden  here  for  us  all.    oddly  and   surprisingly  enough,  however,  notwithstanding  doraemon’s  failure  as  a  robot  to  reform  the  child  nobita’s   character  because  he  can’t  say  ‘no’,  exactly  because  the  elderly  require  not  reformation,  but  rather   preservation,  of  the  characters  they  have  spent  a  lifetime  honing,  the  unceasing  affectionate  indulgence   doraemon  extends  to  nobita  (even  if  to  nobita’s  lasting  detriment)  could  augment  the  diminishing  physical   and  emotional  care  resources  available  to  the  elderly  from  their  real  caregivers,  fundamentally  middle-­‐‑aged   women  who  must  see  first  to  the  needs  of  their  children  and  husbands  as  their  essential  duty  to  the  futures  of   their  families.   keywords:    japan,  aging,  robotics,  caregiving,  doraemon,  mothering,  anime       anthropology & aging, vol 37, no 1 (2016), pp. 27-40 issn 2374-2267 (online) doi 10.5195/aa.2016.124   this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           27   “what  doraemon,  the  earless  blue  robot  cat  from  the  22nd  century,   can  teach  us  about  how  japan’s  elderly  and  their  human  caregivers   might  live  with  emotional  care  robots.”   robert  c.  marshall   western  washington  university   author contact: robert.marshall@wwu.edu introduction     while   immense   literatures   examine   aging   and   robots   in   japan   separately,   reality   has   not   yet   reached   the   point   where   care   for   the   elderly   by   a   socially   assistive   robot   (sar)   can   be   examined   comprehensively  (bemelmans,  et  al.  2012;  jenike  n.d;  sabelli  n.d.).    disciplining  conjecture  with  method,   structural  analysis  of  contemporary  japan’s  most  endearing  and  enduring  work  of  the  imagination,  the   children’s  anime  doraemon,  in  which  a  slightly  defective  blue  robot  cat  sent  from  the  22nd  century  becomes   the   helper   and   companion   to   a   similarly   slightly   defective   ten-­‐‑year-­‐‑old   boy,   lets   us   peer   into   one   foreseeable  future  of  this  nexus.     doraemon’s  relationship  to  his  charge  nobita  plays  out  the  pattern  of  persevering  care  founded   in  affectionate  indulgence  (amae)  that  reproduces  the  japanese  cultural  ideal  of  care  of  a  mother  for  her   child,  her  husband,  his  parents,  but  which  care  is  becoming  increasingly  unavailable  in  practice,  at  least   to  the  elderly.    the  phenomenal  popularity  of  the  anime  doraemon  warrants  opening  a  window  onto  what   tens  of  millions  of  japanese  evidently  think  a  robot  good  with  children  might  be  like.    from  this  vantage   point,  we  can  reflect  further  on  whether  or  how  a  realized  doraemon  might  be  good  with  people  in  that   second  childhood  we  never  outgrow.    when  japan’s  robotics  engineers  come  to  consider  the  relationship   binding  doraemon  and  nobita  as  a  plausible  template  for  sar  performance  for  eldercare,  the  result  of   their  effort  might  assuage  today’s  fraught  and  frequently  infantilizing,  even  neglectful  relationships  with   youthful,  attentive  elder-­‐‑focused  relationships.       not   a   sensei,   not   a   father,   definitely   not   another   child   nor   yet   a   mythical   hero   or   trickster,   doraemon  is  a  mother,  a  japanese  mother  (capitalized  to  indicate  the  symbol  ‘mother’,  not  the  observable   behavior  of  any  particular  mother),  which  makes  all  the  difference  in  japan.    doraemon  does  not  demand   or  insist  or  discipline,  he  indulges,  he  supports,  he  encourages,  he  puts  up  with,  he  whines,  he  weeps,  he   even  mildly  chides.    with  true  devotion  doraemon  carries  out  his  assignment  to  care  for  nobita  as  his   constant  companion  and  helper  in  order  to  improve  nobita’s  character,  but  his  help  does  not  refashion   nobita  into  anything  like  a  modern  momotarō,  japan’s  traditional  child  folk  hero,  which  is  the  robot’s   ultimate  task.              mothers,  in  one  aspect  or  another,  are  japan’s  intimate  caregivers.    what  doraemon  has  now  led   me  to  think  about  social  and  emotional  robots  in  japan’s  future,  care  given  the  elderly  rather  than  children   and  husbands,  and  the  middle-­‐‑aged  children  who  have  become  caregivers  to  their  own  parents,  leaves  me   somewhat  unsettled.    considering  the  coming  transition  to  sar  eldercare,  i  have  begun  to  wonder  with   mit  robotics  researcher  sherry  turkle  (2011:  107),  is  the  performance  of  care,  care  enough?  turkle  points   out  how  the  caring  robots  presently  being  developed  in  japan  can  “take  care  of  us,”  but  they  would  not   “care   about   us”   (italics   in   original).     but   elderly   japanese,   especially   elderly   women   -­‐‑-­‐‑   all   mothers   anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           28 themselves   -­‐‑-­‐‑   dread   imposing   on   their   children.     and   these   elders’   adult   children   -­‐‑-­‐‑   the   “sandwich   generation”  of  women  who  must  care  for  children,  husbands,  elders,  and  work  at  least  part  time  outside   the  home  -­‐‑-­‐‑  are  at  best  ambivalent;  and  many  feel  distinctly  burdened  (yamashita  and  soma  2014).           through   discussions   of   eldercare   in   japan,   sars,   doraemon,   and   japanese   mothers,   the   remainder  of  the  present  article  ponders  this  quandary  step  by  step:  as  inevitable  as  well-­‐‑designed  sars   are,  can  they  ever  become  a  sufficient  solution  to  the  care  of  the  world’s  rapidly  growing  population  of   elderly?  this  much  is  clear:  the  social  and  emotional  care  robots  that  emerge  from  japan  in  the  next  few   decades  will  lead  the  way  in  sar  development  for  the  rest  of  the  world  as  well.     elder-­‐‑care  in  japan   twenty-­‐‑five  years  ago  margaret  lock  (1993:  46-­‐‑47)  captured  the  perspective  on  aging  and  elder-­‐‑ care  in  japan  that  largely  prevails  there  to  this  day.  in  contrast  to  the  50  years  of  prewar  japan,  men  can   now  expect  to  live  80  years,  and  women,  a  world-­‐‑leading  87  years  or  more.    if  a  tempered  blessing  for   citizens,  planners,  politicians,  and  bureaucrats  see  in  an  image  of  16  per  cent  or  more  of  the  population   over  65  the  approach  of  disaster,  a  tsunami.  the  "ʺgreying  of  the  nation,"ʺ  which  took  130  years  in  france,   85  years  in  sweden,  and  70  years  in  the  united  states,  has  taken  japan  just  25  years.    if  present  trends  of   both  low  fertility  and  mortality  continue,  by  the  year  2025  people  65  and  over  may  make  up  a  full  quarter   of  the  japanese  population.     the  most  dramatic  demographic  changes  will  occur  during  the  first  quarter  of  this  century  as  the   postwar  baby  boomers  reach  old  age.  this  change  in  the  structure  of  the  population  will  not  only  produce   a  rapidly  aging  labor  force  and  a  major  increase  in  expenditures  of  all  kinds  for  the  elderly,  but  forecasts   widely  assume  it  will  all  be  accompanied  by  a  decline  in  economic  growth.    ogawa  (1988)  had  already   estimated  in  the  late  1980s  that  by  the  year  2020,  close  to  55  per  cent  of  medical  expenditures  will  result   from  care  given  to  the  elderly,  that  actual  costs  will  increase  10-­‐‑fold,  and  that  the  greatest  proportion  of   this  money  will  come  largely  from  the  pockets  of  the  shrinking  younger  population  of  taxpayers.  ogawa   went  on  to  point  out  that,  should  present  trends  continue,  more  than  14  million  japanese  will  suffer  from   senile  dementia  by  2025,  of  whom  66  per  cent  will  be  women,  and  more  than  two  million  people  will  be   bedridden  (netakiri,  referring  to  all  sick  and  disabled  elderly,  not  necessarily  entirely  immobilized),  of   whom   62   per   cent   will   be   women.     the   combination   of   a   high   incidence   of   stroke,   the   cultural   reinforcement   of   dependent   elderly,   a   shortage   of   institutionalized   facilities   for   the   care   of   the   aging   population,  and  current  government  policies  means,  therefore,  that  many  women  from  about  the  age  of   50  or  55  can  expect  to  devote  a  good  deal  of  time  to  the  care  of  the  older  generation,  most  often  their   parents-­‐‑in-­‐‑law.            the  tradition  of  extended  family  care  of  the  aged  in  japan  continues  into  the  present.    at  the   time  japan’s  long  term  care  insurance  (ltci)  system  kaigo  hoken  was  introduced  in  2000,  just  over  half   (50.3%)  of  japan’s  elderly  were  living  with  or  cared  for  by  their  children  or  other  close  family  members   (hashimoto  2000:  3).    however,  as  women  continue  to  join  the  paid  labor  force,  as  in-­‐‑home  care-­‐‑givers   age,  as  households  of  one  and  two  elderly  member  increase,  as  fewer  children  are  born,  families  lose  their   capacity  to  care  for  their  infirm  elderly  members.                kaigo  hoken  was  specifically  targeted  to  reduce  the  caregiving  burden  on  families,  especially   women  in  the  labor  force,  while  at  the  same  time  was  designed  to  help  the  elderly  remain  in  their  own   homes  as  long  as  possible.    yet  families  do  not  necessarily  give  the  best  care  available,  nor  does  caregiving   best  support  the  integrity  of  families  (sugiura  et  al.  2009;  nakano  et  al.  2002).      many  women  and  even   some  men  do  want  to  be  qualified  care  givers  and  even  go  through  a  recognized  course  of  training,  but   anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           29 those  who  do  not  do  so  are  not  penalized  in  this  new  system.    on  the  contrary,  the  frail  elderly  of  the   household  are  entitled  to  all  the  care  they  are  determined  to  need  by  a  qualified  care  manager,  itself  a   novel  position  created  by  kaigo  hoken  (yamada  et  al.  2009).       in  this  way,  the  introduction  of  kaigo  hoken  dramatically  increased  demand  for  trained  home  care   attendants  (tsutsui  and  muramatsu  2005:  225).    and  so,  as  demand  for  home  helper  services  exploded,   what  was  expected  was  in  fact  discovered:    “home-­‐‑visit  care  is  the  service  clients  complain  most  about.   the  complaints  are  mostly  about  the  quality  of  the  services  and  attitudes  of  the  care  workers.    the  root   causes  of  the  problem  are  related  to  inadequate  training  of  home-­‐‑helpers”  (nakane  2003:  19).      does  this   situation  identify  and  create  a  place  for  sars  in  japan’s  system  of  care  for  the  elderly?    maybe  not,  but   japan  will  certainly  try  to  find  out.           socially  assistive  robots  and  elder-­‐‑care   japan  leads  the  world  in  robotics,  both  production  and  socially  assistive  robots  (sars).  more  and   better  sars  are  evidently  on  their  way,  but  views  on  their  prospects  vary.    media  reportage  uniformly   smiles   on   pilot   projects   (e.g.,   the   debut   of   softbank’s   “human-­‐‑like”   robot   pepper   (http://www.bbc.com/news/technology-­‐‑27709828))  while  sherry  turkle  (2011)  has  now  come  to  expect   only  disappointing  simulacra  of  intimacy  from  intelligent  personal  technology.     can  we  glimpse  possibilities  for  the  use  of  and  reaction  to  sars  for  the  elderly  in  japan  before   this  nascent  technology  becomes  “rapidly  mundane”  (horst  and  miller  2012)?  japan’s  ambitious  national   robot  strategy  was  unveiled  on  january  23,  2015  (dewit  2015).    it  was  developed  by  the  “committee  for   the  implementation  of  the  robot  revolution,”  which  had  its  first  meeting  on  september  11,  2014.  its   membership  included  heavyweights  straddling  business  and  government.    at  its  final  meeting  on  january   23,  it  formally  presented  its  report  to  japanese  prime  minister  abe  shinzo.    abe  then  declared  2015  to  be   “year  one  (gannen)  of  moving  towards  a  “robot  society”.”  the  strategy  outlined  by  the  committee’s  report   aims  to  quadruple  the  current  domestic  robot  market  from  ¥600  billion  at  present  to  ¥2.4  trillion  in  2020.   japanese  authorities  want  to  expand  the  use  of  robots  in  such  spheres  as  services,  construction,  disaster   resilience,  farming  and  elderly  care.              the  robot  strategy  aims  to  alleviate  problems  both  of  using  robotic  assistance  to  displace  labor   demand  and  to  eliminate  the  current  high  risk  of  injury  to  care  givers  from  handling  the  sheer  weight  of   the  elderly.  thus  robotics  will  be  used  to  help  in  moving  the  elderly  from  beds,  in  assisted  walking,  in   bathing  and  use  of  the  toilet,  as  well  as  in  care  of  those  with  dementia.  survey  data  indicate  that  60%  of   caregivers  would  like  to  use  robots  in  elderly  care.  moreover,  among  recipients  of  care,  the  desire  to  be   assisted  by  robots  is  already  higher,  at  65%.  the  national  robot  strategy  aims  to  raise  both  these  figures   to  80%  by  2020.       interviews  with  females  between  55  and  75  who  work  as  caregivers  for  the  elderly  in  japan  show   a  mixed  response.  many  do  find  the  physical  work  more  demanding  than  they  want,  but  almost  equally,   they  find  the  emotional  element  either  valuable  or  deeply  distressing  (marshall  2013:30-­‐‑31).    a  significant   body   of   research   examines   the   emotional   capacity   of   workers   and   how   employers   try   to   harness   it   (england  2005).  lopez  (2006)  reviews  this  literature  within  the  framework  of  the  organization  of  emotional   care  in  order  to  understand  care  work  performed  in  nursing  homes.  existing  evidence  suggests  that  there   might  be  a  place  in  this  constellation  of  home  and  nursing  home  care  for  the  right  sars,  but  does  not   suggest  that  empathetic  robots  are  even  on  the  horizon  (asada  2015).         anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           30 indeed,   the   right   robots   may   never   arrive,   whatever   robots   in   addition   to   paro   become   commercially  available  in  japan  or  elsewhere.    bemelmans  and  his  colleagues  undertook  an  exhaustive   search  of  the  english  language  literature  on  sars,  “…robots  designed  to  give  assistance  through  social   interaction  to  achieve  progress  in,  for  example,  convalescence,  rehabilitation,  and  learning”  (bemelmans,   et  al.  2012:  115).    their  first  cut  found  2891  articles  which,  through  exhaustively  detailed  methods,  they   boiled  down  to  “41  publications  reporting  on  17  studies  involving  four  robot  systems  and  one  undefined   robot,”  almost  all  discussing  research  done  in  japan.            so   far,   the   effects   and   effectiveness   of   sars   in   elderly   care   have   not   been   demonstrated   comprehensively.  most  of  this  research  is  done  in  japan,  with  a  limited  set  of  robots  (mostly  paro  and   aibo,  now  obsolete),  and  not  yet  fully  embedded  in  care-­‐‑need  driven  interventions.  although  obvious   positive  effects  are  reported,  the  scientific  quality  of  the  evidence  is  limited  methodologically  (e.g.,  small   sample  sets,  short  durations,  no  control  group,  no  randomization).    the  exploratory  nature  of  this  research   emphasizes  the  pioneer  work  of  the  researchers  and  caregivers  involved  in  this  relatively  young  field   (bemelmans,  et  al.  2012:  117).    the  present  would  seem,  then,  a  moment  ripe  for  thinking  deeply  about   the  qualities  that  would  make  a  sar  good  with  the  elderly.     wu   and   colleagues’   (wu,   et   al.   2012)   french   focus   groups   unwittingly   invite   us   to   consider   doraemon  in  all  his  aspects  as  a  candidate.    during  discussions  of  humanoid  robots,  one  theme  concerned   the  non-­‐‑genuineness  of  expressions  of  humanoid  robots  and  of  human–robot  interaction.  when  looking   at  the  robot  kobian,  a  participant  said:  “it  has  an  expressive  face.”  another  participant  answered:  “an   expressive  face  is  not  an  expression.”  along  this  same  line,  most  participants  expressed  at  first  glance  a   positive   attitude   toward   paro.     most   of   them   found   it   charming   and   attractive.     however,   when   the   moderator   told   them   about   its   interaction   capacities,   a   participant   said:   “but   this   is   not   a   genuine   interaction,”  and  later  concluded:  “to  communicate  with  paro  is  to  communicate  with  nothing”  (wu,  et   al.  2012:  127).         doraemon  cares   while  sparrow  and  sparrow  (2006:  141)  find  it  “not  only  misguided,  but  actually  unethical,  to   attempt  to  substitute  robot  simulacra  for  genuine  social  interaction,”  sharkey  and  sharkey  (2012:  27)  locate   “three  main  ways  in  which  robots  could,  if  introduced  appropriately,  solve  a  number  of  the  problems  that   elderly  care  might  face:  (1)  to  assist  the  elderly,  and/or  their  caregivers  in  daily  tasks;  (2)  to  help  monitor   their   behavior   and   health;   and   (3)   to   provide   companionship.”   ethical   or   otherwise,   doraemon,   is   definitely  “not  a  pet,”  odel  and  lablanc  (2013:  70)  assure  us,  “but  a  helper  and  companion.”    it  seems   worth  asking,  then,  if  a  realized  doraemon  couldn’t  assist  someone  in  japan  at  the  other  end  of  life  just  as   well,   someone   perhaps   at   the   edge   of   increasing   senility.   to   do   so   we   need   first   to   understand   the   relationship  between  doraemon  and  nobita  as  doraemon  presents  it  to  us.   in   march   2008   japan'ʹs   foreign   ministry   appointed   doraemon   the   nation'ʹs   first   "ʺanime   ambassador."ʺ    2014  was  the  35th  anniversary  of  the  doraemon  animated  tv  series,  first  broadcast  in  1979   and  based  on  a  cartoon  introduced  in  manga  form  in  1969.      since  1979  one  15  minute  episode  has  been   broadcast  nightly  at  6:45,  just  before  the  evening  news.    fifty-­‐‑plus  full  length  movies,  thousands  of  comic   books  and  1500-­‐‑plus  tv  episodes  have  been  created  since  doraemon  was  first  introduced  in  1969.  one   saturday  evening  while  living  in  japan  in  2004,  i  surfed  into  the  doraemon  25th  anniversary  tv  special  and   ended  up  watching  four  continuous  hours  of  doraemon  cartoons,  16  in  all.  for  the  analysis  here  i  use  the   16  episodes  of  the  doraemon  television  collection,  part  1,  vol.  1-­‐‑3  (2001).  by  a  fate  mysterious  and  deep,   doraemon  and  i  will  share  a  common  birth  month  and  day,  september  3,  in  the  year  2112  for  him,  the   suitably  palindromic  date  of  his  manufacture.       anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           31 episode  plots,  the  syntagmatic  structures  of  structural  analysis,  are  formulaic.    nobi  nobita,  a  ten-­‐‑ year-­‐‑old  boy  and  the  central  character  of  the  cartoon,  is  an  utter  mediocrity  or  less  in  everything  he  does.     the  children  in  his  neighborhood  –  the  big  bully  gian,  the  sneaky  nerd  suneo  and  the  cute  girl  shizuka  -­‐‑ -­‐‑  are  his  friends  and  figure  prominently  in  his  adventures  with  doraemon.    in  the  words  of  young  fan   mijea,  “so  many  hundreds  of  stories  start  off  with  nobita  running  home  in  tears,  crying  "ʺdoraemon!  do   something!"ʺ.”    nobita  tries  to  get  doraemon  to  fish  a  gadget  from  the  future  out  of  his  pouch  to  solve  his   problem.    doraemon  resists  but  finally  yields.    the  gadget  performs  as  required,  but  then  unintended  and   unforeseen  consequences  ensue,  making  matters  worse,  but  funny.    nobita  seems  to  have  learned  his   lesson  by  the  end,  but  tomorrow’s  episode  reveals  that  he  has  not.    wash,  rinse,  repeat  as  needed.    suitable   for  daily  use  with  children.       fujimoto  hiroshi,  creator  of  doraemon,  and  claude  levi-­‐‑strauss,  author  of  “the  structural  study   of  myth”  (which  celebrated  its  60th  anniversary  in  2015),  two  giants  of  20th  century  mythology,  form  a   gestalt.    “when  a  manga  hero  becomes  a  success,   the  manga  suddenly  stops  being  interesting,”  said   fujimoto.    “so  the  hero  has  to  be  like  the  stripes  on  a  barber  pole;  he  seems  to  keep  moving  upward,  but   actually  he  stays  in  the  same  place”  (schilling  1997:43).    from  levi-­‐‑strauss  we  learn  that     …a  myth  exhibits  a  “slated”  structure  which  seeps  to  the  surface,  if  one  may  say  so,  through  the   repetition  process.    however,  the  slates  are  not  identical.    and  since  the  purpose  of  myth  is  to  provide  a   logical  model  capable  of  overcoming  a  contradiction  (an  impossible  achievement  if,  as  it  happens,  the   contradiction  is  real),  a  theoretically  infinite  number  of  slates  will  be  generated,  each  one  slightly  different   from  the  others.    thus,  myth  grows  spiral-­‐‑wise  until  the  intellectual  impulse  which  has  originated  it  is   exhausted  (1955:  105).       the  1500  fifteen-­‐‑minute  tv  episode  “slates”  and  50-­‐‑plus  full-­‐‑length  movies  have  evidently  not   exhausted  the  impulse  that  moves  japanese  children  and  now  their  parents,  some  of  whom  are  robotics   engineers  who  themselves  once  watched  as  children,  to  cease  attending  to  doraemon  and  nobita’s  barber   pole.       analysis  of  artifacts  of  pop  culture  and  their  place  in  daily  life  requires  both  a  reliable  method   and  a  reliable  technique.    pfadenhauer  and  dukat  (2015)  argue  convincingly  that  we  cannot  understand   what  sars  actually  are  until  we  understand  their  relations  with  the  humans  to  whom  they  are  connected.     to  consider  whether  the  anime  doraemon  could  prove  a  model  for  a  valuable  sar,  we  must  have  an   accurate  understanding  of  doraemon  in  his  relation  to  nobita.  structural  analysis  offers  a  means  to  control   our  understanding  of  complex  cultural  objects  beyond  the  simple  associations  symbols  evoke  in  us  as  we   encounter  them.       the  method  of  structural  analysis  takes  symbols  as  public  patterns  for  action  based  on  structured   and  interested  local  knowledge,  rather  than  as  embodied  loci  of  encoded,  disinterested  meanings.    this   method  allows  us  to  identify  enduring  and  reliable  connections  among  the  operating  categories  of  daily   life   and   their   relationships   to   each,   the   paradigmatic   structure,   which   underlay   the   activities   of   the   narrative,  the  syntagmatic  structure.    ouwehand’s  (1964)  structural  analysis  of  the  late  edo  era  cartoons   that  immediately  flooded  the  city  following  the  great  tokyo  earthquake  of  1855,  links  earlier  to  recent   creators  and  consumers  of  japanese  popular  culture  in  a  centuries-­‐‑old  continuous  cultural  tradition.    this   late  edo  tsunami  of  cheap  cartoons  portrays  the  traditional  child  folk  hero  momotarō  (peach  boy)  and  his   animal  companions  (a  talking  dog,  a  monkey  and  a  pheasant)  descending  into  the  bowels  of  the  earth  to   quell  with  just  a  drinking  gourd  the  writhing  of  the  giant  catfish  (namazu)  which  caused  earthquakes  in   japan  in  those  days.    in  one  of  the  doraemon  franchise’s  earliest  theatrical  movies,  “boku,  momotarō  no  nan   na  no,  sa”  (doraemon:  what  i  am  for  momotarō),  released  in  1981  just  two  years  after  the  inauguration  of   anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           32 the  television  series,  nobita  pops  out  of  the  peach  and  doraemon  bears  momotarō’s  iconic  banner  “nihon   ichi”  (“japan  number  1”),  self-­‐‑consciously  connecting  doraemon  to  momotarō  lore.    doraemon  plays  to   mythic  rather  than  modernist  sensibilities,  to  emotional  more  than  intellectual  life,  to  the  needs  of  children   and  to  the  needs  of  adults  for  their  children,  rather  for  adults  themselves.       ouwehand’s  results  justify  at  least  trying  to  analyze  the  structure  of  this  vast  body  of  connected   cultural  material,  even  if  it  is  not  produced  collectively  and  anonymously,  but  within  the  conventional   bounds  of  japan’s  current  commercial  entertainment  industry  by  a  small  number  of  known,  indeed  now   famous,  cartoon  artists  (condry  2013).    that  momotarō  and  his  animal  companions  re-­‐‑establish  the  axis   mundi  with  just  a  drinking  gourd  and  so  calm  the  rumblings  of  the  earth,  jostles  evocatively  with  nobita,   doraemon,  and  the  rest  of  his  pals,  and  the  tasks  they  fail  to  accomplish,  for  anyone  who  knows  both   narratives,  which  in  japan  is  everyone  above  age  three.    nobita  is  not  momotarō,  who  is  a  culture  hero   even  though  a  child.    who  cannot  be  interested  in  the  question,  then,  of  how  a  child  can  build  a  sound   character  and  what  adults  can  do  to  help?   at  a  first  pass,  structural  analysis  of  this  sample  of  doraemon  episodes  yields  results  within  the   range  of  available  interpretations.    at  one  extreme,  shiraishi  (2000:  293)  approvingly  quotes  shilling’s   (1997:  44-­‐‑45)  cotton  candy  characterization  cited  previously,  “a  breath  of  freedom  and  a  glimpse  of  a   funnier,   friendlier   world   where   all   dreams,   even   foolish   ones,   can   come   true.”     at   the   other,   in   the   dyspeptic  view  of  the  anime  encyclopedia’s  unattributed  “doraemon”  entry  (clements  and  mccarthy   2006:  158),  “…the  cat’s  techno  assistance  causes  more  trouble  than  it  is  worth.”    my  analysis  generated  a   more  moderate  syntagmatic  structure  overall,  that  the  futuristic  gadgets  doraemon  produces  from  his   pouch  offer  a  constant  temptation  to  take  the  easy  way  out  which,  once  viewers  are  exposed  to  their   unintended  and  unforeseen,  if  amusing  consequences,  help  us  see  once  again  that  only  genuine  effort  and   ningen  kankei  (human  relations)  can  be  ultimately  and  intimately  satisfying.    but  would  the  approving   parents  of  doraemon’s  child  fans  want  doraemon  for  their  own  aging  parents?    what  price,  then,  reality?   a   second   pass,   however,   precipitated   a   more   intractable   and   sobering   question   from   the   paradigmatic   structure  doraemon’s  gadgets   :  nobita’s  problems   ::  doraemon   :    nobita.    doraemon   structures  these  hundreds  of  brief  narratives  around  the  assertion  that  technology  is  no  more  likely  to   solve  our  fundamental  problem  of  how  to  live  together  as  humans  beings,  than  children  are  able  to  build   self-­‐‑reliant  adult  personalities  with  only  their  mothers  to  guide  them,  even  when  both  do  as  well  as  anyone   can   expect   of   them.   the   minor   contradiction   of   the   paradigmatic   structure,   the   left   side   relationship,   focuses  the  way  the  gadgetry  doraemon  pulls  from  his  pouch  both  solves  and  fails  to  solve  the  endless   minor  childhood  problems  nobita  suffers.    the  minor  contradiction  these  cartoons  model,  as  doraemon   pulls  one  gadget  after  another  from  his  fourth-­‐‑dimension  stomach  pouch,  tells  us  that  especially  when   technology  performs  as  it  is  designed  to,  even  the  ever  more  wonderful  technology  that  awaits  us  in  the   future,  it  cannot  improve  upon  or  replace  the  dedicated  tenacity,  ganbari,  japanese  know  they  must  all   exert   to   develop   a   character   that   can   support   genuine   human   relations,   ningen   kankei.     the   major   contradiction,  the  right  side  relationship,  however,  has  been  built  into  the  syntagmatic  structure  of  the   stories  in  a  less  obvious  way.  doraemon  has  been  sent  back  to  the  present  from  the  22nd  century  by   nobita’s  dissatisfied  descendant  sewashi  (like  nobita  also  a  child)  to  improve  nobita’s  future,  which  can   only  result  from  improvements  in  nobita’s  character,  turning  him  from  a  non-­‐‑entity  into  a  20th  century   success,  rather  than  altering  any  specific  event,  against  which  time  travelers  are  of  course  always  warned.   in  a  similar  but  not  identical  way,  doraemon  cannot  reform  nobita’s  character  for  him,  because  even  as   human  rather  than  cat  or  robot  as  he  seems,  he  is  himself  merely  more  not-­‐‑quite-­‐‑marvelous  technology   from  the  future.     anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           33 the  major  contradiction,  the  constant  relationship  that  runs  through  each  episode,  recognizes   how  doraemon,  the  robot  who  does  not  look  or  act  like  a  robot,  does  and  does  not  help  nobita  build  a   capable,  self-­‐‑reliant  character  that  will  be  able  to  support  genuine  adult  human  relationships.      like  his   own  gadgets,  doraemon  is  not  quite  right  for  the  job  he  has  been  assigned.    because  doraemon  perpetually   fails  to  resist  nobita’s  persistent  importunity  for  a  solution  to  his  problems  from  the  technology  of  the   future,  nobita  never  learns  to  rely  on  and  develop  his  own  capacities  in  the  here  and  now.       we  are  told  doraemon’s  own  flawed  technology  prevents  him  from  straightening  nobita  out,  but   it  actually  looks  as  if  he  simply  won’t.    in  any  event,  he  doesn’t.    doraemon  first  presents  himself  as  having   come  to  save  nobita  from  a  horrible  fate,  but  later  we  learn  that  nobita’s  distant  descendant  actually   brought  doraemon  back  to  the  past  “to  whip  the  disappointing  boy  into  shape”  (orbaugh  2002:  113).    this   never  happens.    technology  appears  to  give  nobita’s  descendant  sewashi  the  capacity  to  (re)form  the   child  nobita’s  character,  as  an  adult  might.  this  appearance  is  illusory.    in  the  united  states  our  parents   are  the  most  important  choice  we  make  in  our  lives,  but  in  japan  the  perpetuity  of  the  ie  (corporate  stem   family)  evidently  requires  people  to  go  back  even  farther  to  fix  fundamental  family  flaws.   the  structural  analysis  presented  here  recognizes  doraemon  as  the  negation  of  the  technological   part  of  present  and  future  reality,  a  reducto  ad  absurdum   through  laughter.    the  technology  works  as   advertised,   but   only   mechanically,   not   socially,   for   each   specific   gadget   explicitly   and   for   doraemon   himself  implicitly.    the  anime  never,  of  course,  refers  at  all  to  the  invention  of  technologies  of  any  sort,   including  robots,  as  a  way  for  large  companies  to  earn  large  profits,  the  entry  point  of  technology  into  our   world  where  invention  is  the  mother  of  necessity.the  self-­‐‑referentially  paradoxical  irony  underlying  the   overnight  reset  button  is  that  doraemon  fails  to  change  nobita  at  all.    even  as  the  content  of  the  episodes   shifts  to  include  more  topics  of  the  day,  such  as  environmental  issues,  nobita  and  doraemon  remain  the   same.    even  the  earliest  episodes,  now  over  30  years  old,  remain  phenomenally  popular  in  japan.  stand   by  me  doraemon  ,  a  full-­‐‑length  movie  released  in  2014,  pulls  together  in  one  continuous  narrative  the  main   story  threads  from  the  beginning  through  the  first  seven  years  of  the  television  anime  series.    the  film  was   a  major  commercial  success  in  japan.  it  ranked  number  1  on  the  box  office  charts  for  5  consecutive  weeks   and  was  the  second  highest-­‐‑grossing  japanese  film  for  2014  in  japan,  with  a  box  office  total  of  ¥8.38   billion.  in  february,  2015,  it  won  the  japan  academy  prize  for  animation  of  the  year  at  the  38th  japan   academy  prize.        far  from  realizing  time  travel,  doraemon’s  creator  has  made  time  stand  still.    from  the  point  of   view  of  social  relations  versus  the  inevitable  changes  brought  on  by  spreading  technologies,  once  called   ‘progress’,  doraemon  is  utterly  conservative  if  not  actively  luddite  in  its  sentiments:  even  if  technology   does  no  harm,  it  is  still  merely  the  preferred  solution  of  an  immature  outlook  and  cannot  be  the  foundation   of  an  adult  character  and  adult  social  relations.    no  future  will  experience  the  effects  of  nobita’s  adult  life   while  time  stands  still  in  his  childhood  life.    a  living  nobi  nobita  is  57  years  old  in  2016.  his  wife  cares   for  his  aged  parents.   doing   the   same   thing   over   and   over,   expecting   different   results,   is   one   casual   definition   of   neurosis.    takeo  doi’s  (1973)  path-­‐‑breaking  work  on  neurosis  and  amae,  the  “need  for  human  affection”   (johnson   1993:   ix),   opens   the   way   to   deeper   understanding   here.     while   nothing   at   all   depends   on   doraemon’s  gadgetry,  nobita  and  doraemon  depend  deeply  and  constantly  on  each  other  for  affection   despite  the  failures  of  doraemon’s  technology  to  solve  nobita’s  problems  and  doraemon’s  (and  nobita’s   own)  failure  to  improve  nobita’s  character  along  any  timeline.    where  can  we  look  among  japanese  life   models  for  this  relationship  of  interdependence  based  on  enduring  affection  and  support,  and  yet  which   evidently  fails  to  develop  the  dependent  child’s  character  in  a  way  that  will  help  the  child  enter  into  and   participate  in  society,  effectively  to  grow  up?     anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           34   japanese  mothers,  burdens  and  affection   nobita’s  mama,  like  papa,  is  an  unimportant,  two-­‐‑dimensional  figure  in  the  stories,  whose  only   task   is   to   give   nobita   an   unexceptionable   family   to   be   part   of.     doraemon,   future   relative   sewashi’s   defective  technology  sent  back  to  correct  nobita’s  character,  is  the  japanese  mother  of  the  narrative.  that   mothers  do  and  do  not  build  their  children’s  character  remains  tacit  in  the  narrative  and  in  japanese  life.   how  can  mothers,  so  utterly  selfless,  so  self-­‐‑sacrificing,  be  thought  to  have  shortcomings  precisely  as   mothers,  when  they  suffer  so  to  indulge  their  dependents  and  thus  add  their  support  to  help  the  next   generation  prosper  and  succeed?    all  japanese  know  in  some  way  that  mothers  do  not  precisely  create  (or   reform)  character  in  a  child  (or  husband)  in  the  first  place.  sensei  (teacher)  does  this;  father  would  if  he   was  ever  home;  the  gang  of  neighborhood  children  (nakama)  relish  the  chance;  public  officials  and  police   officers  are  mother’s  standby  threat;  and  indeed  the  whole  rest  of  the  world  (seken,  soto)  requires  it.       this  japanese  mother  disguised  as  an  earless  blue  male  robot  cat  sent  from  the  future  to  (re)build   nobita’s  character  is  deeply  underdetermined  in  relation  to  nobita’s  equally  overdetermined  childish   child.    the  character  mother  in  the  japanese  domestic  drama  indulges  (amayakasu),  but  is  not  understood   to  build  character  directly  or  explicitly.    as  a  superordinate,  she  is  not  authoritarian  but  an  enabler.    only   later  in  life,  when  they  recall  her  long-­‐‑ago  sacrifices  for  them,  can  her  grown  children  draw  on  these   emotion-­‐‑laden  memories  to  help  them  persevere  (ganbaru,  a  deeply  revered  japanese  value)  through  life’s   hardships   (kondo   1990:   83-­‐‑89).     memories   of   mother   reduce   the   hardest   japanese   heart   to   tears.     so   sending  a  significantly  flawed  doraemon  is  not  exactly  a  mistake  by  sewashi,  but  no  one  can  have  any   interest  in  clarifying  this  situation.    the  story  asserts  that  doraemon  is  the  best  impoverished  sewashi,  in   his  limited  childhood  situation,  could  manage.    structurally,  making  doraemon  a  mother  in  an  earless   blue  cat  costume  is  how  fujimoto  keeps  nobita  from  growing  up.    he  keeps  the  barber  pole  turning  by   stimulating  his  audience’s  affectionate  attachment  and  sense  of  humor,  rather  than  its  critical  awareness.   viewers   do   not   see   doraemon’s   affectionate   indulgence   of   nobita’s   demands   as   one   of   doraemon’s   characteristic  defects,  such  as  his  fear  of  mice  because  a  mouse  ate  his  ears.    mothers  indulge  their  children   and  their  husbands.    the  question  for  the  present  article  is,  what  expectations  do  japanese  have  that   mothers  will  indulge  their  parents  and  parents-­‐‑in-­‐‑law?    how?    and  do  they?   while  mothers  everywhere  are  caregivers,  they  care  differently  from  culture  to  culture.    here  i   draw  on  three  widely  familiar  accounts  of  japanese  mothering  relationships  from  the  extensive  literature   on  motherhood  in  japan.  peak  (1991)  contrasts  mothers  with  pre-­‐‑school  teachers;  kondo  (1990)  describes   women  of  a  certain  age  who  work  part-­‐‑time  in  a  confectionary;  and  iwao  (1993)  observes  mothers  as   wives.       mothers  and  preschool  teachers  appear  identical  because,  after  all,  they  are;  but  their  behavior  is   night  and  day  to  the  children  in  their  charge.  in  the  popular  wisdom  of  japanese  mothers  and  teachers,   the  home  and  the  outside  world  are  so  different  that  the  family  cannot  teach  the  fundamental  rules  of   social  interaction  governing  life  in  the  outside  world.    the  home  is  the  home,  preschool  is  the  outside   world,  and  the  two  settings  require  different  styles  of  behavior  and  habits  of  self-­‐‑presentation  for  success.   this  discrepancy  between  the  public  and  the  private,  soto  and  uchi,  has  frequently  been  described   by  observers  of  japanese  society.    the  japanese  language  institutionalizes  it  and  ritualizes  it  in  indigenous   discourse  on  the  social  world  (bachnik  and  quinn  1994).    the  home,  or  uchi,  is  the  private,  intimate  arena   in  which  one  can  relax,  let  all  of  one’s  feelings  show,  and  expect  indulgence  and  sympathy  from  other   members  of  the  family.    within  the  uchi  a  healthy  amount  of  self-­‐‑indulgence,  regressive  behavior,  and   mild  aggression  are  not  only  cheerfully  tolerated,  but  also  encouraged  as  the  indication  of  intimacy  and   anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           35 trust.    however,  in  the  soto,  the  outside  world,  one  must  learn  to  assume  a  genial  and  cooperative  public   persona,  in  which  individual  feelings  and  desires  must  be  subjugated  to  the  harmony  and  activities  of  the   group  (peak  1991:  7).   the  family  (uchi)  is  not  the  group  (shudan).  neither  style  of  personal  interaction  trumps  the  other   in  the  abstract;  in  a  healthy  personality  each  should  be  exhibited  in  the  appropriate  situation.    japanese   mothers  desire  to  maintain  a  certain  degree  of  amae  in  their  child’s  behavior  toward  themselves  and  other   family  members  while  expecting  that  the  child  will  learn  to  display  enryo  (self-­‐‑restraint)  from  and  toward   peers,  neighbors,  and  others  outside  the  family.    the  first  day  of  preschool  presents  this  expectation  to   most  japanese  children  for  the  first  time  (peak  1991:  16).    americans  are  routinely  stunned  to  find  that   japanese  preschool  teachers,  far  from  considering  hitting  a  matter  requiring  their  intervention,  see  a  child   routinely  playing  alone  quietly  as  an  extremely  serious  behavioral  problem  (peak  1991:  165).   this  pattern  of  mothering  becomes  a  significant  means  of  creating  intimacy  and  trust  in  other   settings  such  as  work  as  well,  making  them  feel  “homey.”    at  the  confectionary  factory,  women  were   instrumental  in  defining  the  tone  of  the  work  culture  on  the  shop  floor,  the  informal  social  relations  on   the  job.    “they  did  so  primarily  vis-­‐‑à-­‐‑vis  the  younger  artisans,  in  their  roles  as  surrogate  mothers”  (kondo   1990:  294).  most  of  the  younger  male  artisans  were  in  their  late  teens  or  early  twenties,  while  the  part-­‐‑ timers  tended  to  be  women  in  their  forties  and  fifties.     kondo   catalogues   the   ways   these   women   provide   the   young   men   with   a   humanized   work   atmosphere,  a  source  of  support  and  care,  fostering  feelings  of  togetherness,  of  “company  as  family,”  of   work  groups  which,  like  the  household,  become  the  locus  of  emotional  attachment.    “this  position  is  a   contradictory  one,  for  it  replays  on  the  shop  floor  the  notion  that  women  are  emotional  workers,  care-­‐‑ givers  and  creators  of  an  uchi  (homey)  feeling”  (kondo  1990:  295)  and  so  continually  set  themselves  apart   from  the  central  story  of  maturity  through  apprenticeship  and  masculine  toughness  and  skill:  while  they   are  acting  like  mothers  toward  these  young  artisans,  they  are  not  improving  these  young  men’s  characters   as  disciplined  workers.   at  the  same  time,  however,  their  position  as  mothers  puts  them  in  a  position  of  advantage  over  the   male  artisans  and  serves  to  make  them  important,  though  formally  marginal,  members  of  the  company.       in  japan,  kondo  carefully  records,  the  position  of  care-­‐‑giver  or  the  one  who  indulges  the  selfish  whims  of   another  (the  amayakasu  position)  is  actually  a  superordinate  one  associated  with  parents  or  bosses.    by   asking  favors  of  the  part-­‐‑timer  women  or  by  acting  childish,  the  young  artisans  are  placing  themselves  in   the  amaeru  position  of  a  child  or  a  subordinate  seeking  indulgence  (kondo  1990:  295-­‐‑296).   iwao  describes  how  this  pattern  of  indulgence  based  in  the  need  for  human  affection,  as  something   that  can  be  at  least  wheedled  if  not  demanded,  carries  over  into  married  life  and  the  relation  between   wives  and  husbands.      the  domestically  helpless  husband  –  and  some  women  do  call  their  husbands  “my   big  baby”  or  “eldest  son”  –  is  a  prime  target  for  caring  patterns  shifted  from  the  young.    japanese  women   give  greater  priority  to  their  role  as  mother  than  wife,  but  the  two  do  overlap  considerably      as  well,  this   role  tends  to  keep  husbands  acting  like  children  at  home,  “as  they  shift  adeptly  from  the  indulged  son  to   the  indulged  husband”  (iwao  1993,    88-­‐‑89).    as  elders,  men  more  easily  amaeru  than  women,  a  buddhist   priest  explained  when  discussing  care  and  loss  in  late  life:  “strength  is  easier  for  women  to  achieve.    men   can  cry  ‘mommy’!”  (danely  2014:  177).    nobita  cries  “doraemon!”   in   commenting   on   japan’s   large   numbers   of   bedridden   elderly,   kiefer   (1987)   points   out   that   allowing  oneself  to  be  dependent  on  the  family  is  culturally  "ʺavailable"ʺ  (particularly  for  the  very  young   and  the  old)  and  hence,  in  contrast  to  north  america,  japanese  culture  indirectly  encourages  the  infirm     anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           36 to  stay  dependent.    and  yet,  as  iwao  (1993:  56)  counters,  “the  care  of  both  infants  and  the  elderly  rests   almost   solely   on   the   shoulders   of   women.”   so,   “availability”   of   culturally   space   for   “dependency”   contrasts  with  the  variable  occupation  of  that  space.    the  similarities  and  differences  in  the  relationship  of   care-­‐‑givers  and  their  dependents  at  the  two  ends  of  the  age  spectrum  do  not  meet  to  close  the  circle.    a   growing  social  movement  in  japan  urges  a  deeper  examination  of  the  state  of  the  elderly  bedridden  in   japan  (ōkuma  2000;  sakuma  1998),  insisting  that  infantilization  (“netakiri-­‐‑ni-­‐‑saserareru,”  to  be  made  to   become  bedridden)  is  not  the  simple  application  of  standard  mothering  technique  in  the  same  way  to  both   the  very  young  and  the  very  old,  but  is  rather  a  means  of  reducing  the  demands  of  the  elderly,  to  make   the  elderly  become  bedridden  for  the  care-­‐‑giver’s  own  convenience  in  the  way  that  doraemon  was  sent   to  improve  nobita’s  character  by  his  great,  great,  great  grandson,  in  the  way  us  nursing  homes  have  been   accused  of  over-­‐‑use  of  sleep  medication.    all  this  is  the  emotional  opposite  of  amayakasu,  affectionately   indulging  a  dependent’s  need  for  affection,  even  at  some  trouble  to  oneself.   yet  here  too  we  find  not  a  one-­‐‑way  street,  but  a  relationship.    consider  the  extent  to  which  the   elderly,  women  especially,  are  determined  not  to  depend  on  their  middle-­‐‑aged  children  when  their  roles   and  authorities  reverse.    traphagan  (2000:  151)  considers  lebra’s  (1976:  55)  discussion  of  dependence  and   indulgence   to   reveal   patterns   of   interdependence,   each   contributing   as   they   can,   that   dependency   in   japanese  society  should  not  be  viewed  as  either  a  wholly  positive  nor  negative  concept.    people  strongly   feel  “the  need  to  avoid  imposing  on  others’  comfort  and  freedom”  (kinoshita  and  keifer  1992:  177)  even   when  the  bond  of  family  allows  some  degree  of  dependence  and  even  indulgence.    however,  even  within   the  family  there  are  limits  on  how  much  a  member  can  cause  a  burden  and  on  how  much  one  is  willing   to  be  a  burden  to  others  (traphagan  2000:  153).    either  way,  whether  any  daughters  (-­‐‑in-­‐‑law)  do  indulge   their   parents   (-­‐‑in-­‐‑law)   or   not,   it   seems   that   1)   dependent   elders   still   need   affection   demonstrated   by   indulgence,  and  so  might  amaeru;  and  2)  it  becomes  harder  and  harder  to  indulge  them  as  senile  dementia   advances.         the  conclusion  is  hard  to  avoid  that  while  this  notion  of  amayakasu  and  turkle’s  conception  of   “care  about”  must  be  very  close,  and  perhaps  even  includes  “care  for”  as  well,  a  third  term  too  must  be   considered:  meiwaku,  trouble,  a  burden.    a  person  might  well  not  ask  for  affectionate  emotional  indulgence   because  they  do  not  wish  to  be  a  bother.    “in  one  survey  conducted  on  reasons  worshipers  attend  sudden   death  temples  (pokkuri-­‐‑dera),  93  percent  stated  that  it  was  because  they  did  not  wish  to  become  bedridden   and  a  burden  on  other  people.    the  second  most  common  response  (18  percent)  was  that  people  did  not   want  to  suffer  with  a  prolonged  illness  like  cancer  (woss  1993:  195)”  (traphagan  2004:  26).    long  observes   that  “death  in  japan  is  feared  more  often  than  calmly  accepted,  but  as  high  suicide  rates  for  the  elderly   suggest,  perhaps  it  is  not  feared  as  much  as  becoming  a  burden  on  others”  (long  2000:  7).    suicide  rates   for  elderly  japanese  women,  higher  than  for  elderly  japanese  men  and  for  both  elderly  men  and  women   in  the  us,  are  “often  interpreted  in  japan  as  an  indication  of  their  unwillingness  to  burden  daughters-­‐‑in-­‐‑ law  with  their  care”  (lock  1993:  13).   amaeru  and  meiwaku  emerge  as  one  relationship  looked  at  in  the  different  light  of  the  degree  of   affection   of   the   person   being   caused   trouble   by   the   person   making   himself   a   burden.     children   and   husbands  seem  not  hesitate  to  amaeru  their  mothers  and  wives,  since  that  is  mother’s  (and  wife’s)  role,   to  take  up  that  burden  cheerfully.    but  this  relationship  does  not  appear  to  extend  uniformly  or  routinely   from  the  same  woman  in  her  role  as  care-­‐‑giver  to  a  dependent  parent  or  parent-­‐‑in-­‐‑law.    or  at  least  the   elderly,  especially  women,  do  not  shed  their  enryo  (self-­‐‑restraint)  in  a  way  that  would  easily  let  them   impose  on  their  caregiver,  when  they  feel  their  request  for  indulgence  could  seem  to  be  a  burden  to  their   caregiver.       japan  has  now  come  to  recognize  explicitly  that  caregiver  resources  are  increasingly  limited.    it  is   anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           37 less  explicitly  recognized  how  asymmetrically  these  resources  are  allocated:  care  for  children  requires   infinite  patience,  even  a  willingness  for  the  socially  superior  adult  to  absorb  physical  aggression  from  the   child.  child  care  is  the  mother’s  fundamental  duty.    care  for  husbands  plays  out  in  similar  ways,  if  with   less  devotion,  but  the  question  emerges  explicitly  in  japan  whether  the  wife  playing  the  role  of  the  one   who   indulges   (amayakasu)   makes   her   the   husband’s   social   superior,   and   generalizing,   whether   that   means  that  women  have  more  power  than  men  as  a  general  proposition  in  japan  (ogasawara  1998).    this   matter  is  treated  as  something  for  open  debate  in  a  society  that  routinely  ranks  near  the  bottom  of  the  list   for  gender  equality  among  developed  nations:  here  is  one  subtle  way  japan  polices  gender  role  inequality.     and   finally,   all   japanese   are   familiar   with   the   legend   of   obasuteyama,   grandmother   abandonment   mountain,  which  tells  us  that,  while  the  elderly  merit  all  the  care  they  require,  they  sometimes  absorb   resources  that  could  be  better  used  in  furthering  the  prosperity  of  the  family,  which  is  the  fundamental   duty  of  all  family  members.    indeed,  as  the  household’s  future  looks  more  and  more  bleak,  grandmother   informs  her  son  that  it  is  time  for  him  to  take  her  to  obasuteyama.    he  resists  as  long  as  he  can,  but   ultimately  relents,  ultimately  indulges  her,  because  he  too  must  do  all  he  can  for  the  family,  although  this   is  the  hardest  thing  he  will  ever  have  to  do.   how  true  is  it  then  that  “one  also  cannot  incur  meiwaku  (burden)  with  a  robot”  (sabelli  n.d.)?    this   assessment  is  too  ambiguous.    is  it  because  robots  cannot  be  programed,  ever,  to  feel  burdened  or  anything   else;  or  is  it  that  nothing  one  might  ask  of  them  could  strike  a  robot  as  a  burden,  like  a  bodhisattva  at  last   entirely  free  of  desire  and  remaining  on  earth  only  to  relieve  others’  suffering?    from  the  other  direction,   can  we  move  beyond  simulacra  to  robots  that  can  display  emotion  as  humans  recognize  it?    and  should   we?    at  this  point  i  have  not  found  evidence  that  intimate  japanese  caregivers  do  indulge  their  elderly   dependents  in  ways  that  parallel  or  extend  their  relations  with  children  and  husbands,  although  cultural   space  is  available  and  the  possibility  widely  valorized  if  only  in  the  ideal.    but  given  the  care  resources   available  to  mothers,  whose  ultimate  responsibility  is  to  manage  those  resources  her  husband  provides   her  for  the  good  of  the  ie,  the  senior  generation  must  come  third  after  children  and  husband.     discussion  and  conclusion   japanese  mothers  do  not  build  character  directly  through  their  immediate  behavior,  they  indulge   children  and  husbands  in  their  need  for  affection  and  support,  which  has  its  positive  effects  on  those  who   depend  on  them  in  the  long  term.    although  the  evidence  is  not  clear  that  women  affectionately  indulge   the  elderly  in  this  same  way  routinely,  the  culture  would  allow  them  to  do  so,  just  as  it  would  allow  the   elderly  to  press  for  affectionate  indulgence  if  they  could  bring  themselves  to  overcome  their  inhibitions  in   this  area.    but  duty  requires  all  members  to  push  resources  toward  the  young  of  their  household.   so,  would  the  elderly  and  their  intimate  caregivers  want  to  have  doraemon  in  their  lives?    yes,   they  would.    it  feels  odd  to  me  to  say  so,  but  an  imperfect  anime  robot  that  acts  toward  his  charge  as  a   mother  should  act  toward  her  imperfect  child,  realized,  might  be  an  ideal  sar  for  the  elderly  who  require   monitoring,  assistance  and  companionship  as  they  become  less  and  less  able  to  rely  on  whatever  human   resources,  their  own  and  of  others,  remain  available  to  them.  elders  reluctant  to  press  daughters-­‐‑in-­‐‑law   for  the  affectionate  indulgence  those  daughters-­‐‑in-­‐‑law  (now  the  superordinates)  are  reluctant  to  give  or   perhaps   even   feel,   would   develop   a   youthful   rather   than   infantilized   or   neglectful   relationship   with   doraemon.    is  it  possible  that  japan’s  robotics  engineers  will  build  doraemon  before  2112,  albeit  without   the  gadget  pouch?    whether  they  have  thought  by  now  of  doraemon  as  a  model  robotic  caregiver  for  the   elderly,  they  all  know  him  inside  and  out.  and  yet  judging  by  the  anime  doraemon  we  have  at  present,   it  seems  unlikely  anyone  supposes  he  would  make  a  real  or  lasting  difference  in  peoples’  lives,  if  not   ultimately  make  matters  worse.    no  one  would  ever  think  this  of  a  mother.       anthropology  &  aging   vol  37,  no  1  (2016)        issn  2374-­‐‑2267  (online)        doi  10.5195/aa.2016.124    http://anthro-­‐‑age.pitt.edu   marshall  |  what  doraemon           38   while  i  am  not  japanese,  it  does  not  seem  to  me  at  least  that  inventing  sars  to  care  for  increasingly   incapable  seniors  is  “taking  the  easy  way  out”  as  care  resources  become  less  and  less  available  to  families.     the  elderly  do  not  require  having  their  characters  rebuilt,  but  on  the  contrary  dread  as  much  as  anything   losing  the  personalities  they  have  spent  a  lifetime  developing.    companionship  and  personal  assistance   in  old  age  are  a  different  matter  than  for  a  ten  year-­‐‑old.    but  if  a  realized  doraemon  could  allow  the  elderly   to  enjoy  life  at  least  as  much  as  nobita  does  with  the  anime  doraemon,  i  think  no  one  can  ask  for  or  expect   more  from  any  robot,  and  would  rarely  get  as  much  from  human  caregivers.   references     asada, minoru. 2015. “towards artificial empathy: how can artificial empathy follow the developmental pathway of natural empathy?” international journal of social robotics 7:19–33. bachnik, jane and c quinn, eds. 1994. situated meaning: inside and outside in japanese self, society and language. princeton university press: princeton bbc news: technology. 2014. “softbank unveils ‘human-like’ robot pepper.” http://www.bbc.com/news/technology27709828. bemelmans, 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“double responsibilities of care: emerging new social risks of women providing both elderly care and childcare in japan.” paper presented at the third international conference on evidence-based policy in long-term care. london, 31 august 3rd september. _borochfinalbr book review review of vania vigolo. older tourist behavior and marketing tools. springer: 2017. pp. 176. price $129. robert boroch university of warsaw, poland anthropology & aging, vol 39, no 1 (2018), pp. 119-120 issn 2374-2267 (online) doi 10.5195/aa.2018.196 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.196 http://anthro-age.pitt.edu boroch | book review 119 book review review of vania vigolo. older tourist behavior and marketing tools. springer: 2017. pp. 176. price $129. robert boroch university of warsaw, poland the issues vigolo raises in his monograph concerning the tourist activities of seniors are part of one of the most important trends of basic research in the social sciences. the issue of tourist activity of seniors ‒ particularly in an economic context, in terms of market potential ‒ has not been extensively discussed in the literature on the subject. vigolo’s work partly fills this gap. the monograph consists of three parts: (i) defining the older tourist market; (ii) older tourist behavior: the demand-side perspective; (iii) marketing to older tourists: the supply-side perspective. in the first part, the researcher focuses on epistemological considerations regarding the definition of the concept of an elderly person, presenting the abundant literature on the subject and refuting the stereotypes inherent in common business opinions concerning the ‘market behaviour and expectations’ of seniors. the researcher points out that, in fact, seniors constitute a significant percentage of the tourism industry’s customers. in the second part, the decision-making processes regarding travel planning by/for seniors are discussed. the researcher draws attention to factors motivating seniors to travel which play an important role in these processes: personal motivation (nostalgia, self-confidence, desire to learn new things) and motivation deriving from the social environment (acceptance). in the third part, the researcher discusses so-called case studies illustrating various strategies adopted in the tourism industry, on the basis of specific examples. the subject of the analysis comprised three tourism firms: (i) viaggi floreali (slovenia), specialising in tourism for small groups of seniors; (ii) eldertreks (canada), specialising in tourism for individual seniors; (iii) algarve senior living (great britain), specialising in the rental of tourist facilities. the qualitative research carried out by vigolo is based on the following methodology: (1) determination of how the company began to target older people; (2) description of the target and its characteristics; (3) description of the company’s distinctive elements; (4) description of the marketing mix (product, price, place, and promotion strategies); (5) analysis of the market context, with a focus on active aging and on challenges for the tourism industry (vigolo 2017, 129). analysis of qualitative data enabled the context to be expanded so as to: ‘(a) […] provide an original perspective of older tourists’ characteristics from a supply-side point of view; (b) […] offer useful insights into companies’ marketing strategies and practices regarding older tourists; (c) […] widen the field of analysis from single case studies to the broader market context […]’ (vigolo 2017, 154). undoubtedly, vigolo’s study will meet with the interest of social anthropologists, cultural animators, and social psychologists, for whom it may become basic research material in the practical as well as the theoretical realm, especially the first part. furthermore, the material presented in the monograph will increase awareness of the epistemic complexity of research problems concerning social structures involving seniors, especially those operating in different cultural traditions (e.g. outside the english-speaking world), inclining its readers to deep reflection and persuading them that that research in the field of tourism for seniors should be conducted with regard to historical and cultural differences to which vigolo did not call attention. thus, the inherent differences between cultural areas, e.g. between anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.196 http://anthro-age.pitt.edu boroch | book review 120 western and central/eastern europe, preclude universality in research results. however, this creates other epistemic opportunities ‒ e.g. for developing interdisciplinary comparative projects, which might aim at attempting to show social stratifications and the potential for eliminating them. in this aspect as well, the work in question is an invaluable resource for researchers dealing with the problem of geriatrics in both practical (applied anthropology) and ethical (applied ethics) aspects. no one needs to be convinced that research in this area will help in great measure to stimulate sociological awareness of societies with divergent historical and cultural backgrounds and to contribute to the expansion of cultural integration diverging from the principle that youth is a collective phenomenon, whereas old age is an individual phenomenon which, basically, will never affect us. anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 145-163 issn 2374-2267 (online) doi 10.5195/aa.2015.105 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. multivalent moves in senior home care from surveillance to care-valence peter a. lutz uppsala university contact: peter.lutz@antro.uu.se abstract recent studies of care argue that it is a relational phenomenon, whereby human and nonhuman entities enter into transformative relations. in this light, different entities of care potentially mediate one another in practice, sometimes with surprising and unforeseen effects. in this article, i trace a similar argument. drawing on ethnographic material from sweden and the united states, i proffer that careful attentions to older people at home produce multivalent moves with transformative effects. increasingly, such attentions encompass new technologies to monitor and observe aging bodies. on this topic, the healthcare literature often invokes the idea of care surveillance. certainly, surveillance can offer a valuable analytical purchase in the study of care. yet, care attentions are not always straightforward. rather, the moving around of aging bodies with technologies can obstruct and transform care and its attentions. at the same time, care attentions can also obstruct and transform aging bodies and their technologies. i argue that the existence of these multivalent, somatechnic moves challenges the notion of surveillance in care. to strengthen this argument, i draw on sts-inspired anthropological studies of care. in turn, i also develop the heuristic term “care-valence”. the key advantage with this term, i proffer, is that it offers an analytical compliment to the notion of care surveillance and helps refocus the analysis on multivalent moves in care. keywords: aging bodies, care technologies, home care, surveillance, sweden, united states http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu multivalent moves in senior home care from surveillance to care-valence peter a. lutz uppsala university introduction the gerontological literature indicates that many seniors prefer to live at home in familiar surroundings to avoid long-term institutionalized senior care. home-based care for seniors and related notions like “aging in place” have intrinsic appeal for seniors, professionals, policy makers and the public at large (ball et al. 2004; boldy et al. 2011; vasunilashorn et al. 2012). the prominence of home care for older people links to a range of interrelated issues. scholars point to the desire for independence among seniors, healthcare staff shortages, escalating healthcare costs, pressures to improve healthcare systems, user-centered services, changing family structures, urbanization as well as the rise in noncommunicable diseases including diabetes and dementia (tarricone and tsouros 2009). a web search confirms a plethora of private and public sponsored services, policies and programs. undoubtedly, home care is big business. one recent estimate puts the annual home care expenditures in the united states alone at 72 billion dollars (national association for home care & hospice 2010). these political and economic trends have also spurred the development of new technologies for senior home care. a who director has equated the interest in home care technology as a return “back to the future” with the aim to “explore, exploit and implement an old idea with today’s knowledge and new means” (bariçs, in tarricone and tsouros 2009: vi). here, “new means” refers to the research and development, as well as the implementation of home care technologies, and coupled with the reconfiguration of healthcare coordination and delivery. a key interest is how new and emerging technologies can augment existing home care situations. nevertheless, home care remains a complex phenomenon, which entails multiple medical and social challenges. as tarricone and tsouros argue, “[…] clearly attributing defined outcomes to a given intervention or technology is difficult, even when it is isolated from all the other delivered services and external factors are controlled for” (2009:30). in practice, the use of technology can produce new and multivalent effects that may also diverge from the design intentions and motivations for such use. some anthropological and sts-inspired scholars discuss these effects as a process of mediation and where the implications of technology are not always clear. for instance, ianculescu and parvan (2011:183) point out that new forms of information and communication technology (ict) situate new opportunities to assist and empower seniors. yet, they also argue that icts paradoxically risk the increase of exclusion among seniors, in terms of how this technology can transform traditional forms of information access—for instance, seeking medical advice. in another study, wigg (wigg 2010; in mort, roberts, and callén 2013) shows how technology used to monitor wandering seniors with dementia can lend a sense of safety and security in one arrangement, but in another context can dehumanize seniors. mort and colleagues lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 146 (2013) also demonstrate how “surveillance technology”—namely telecare systems—in the uk and spain can produce dependence, insecurity and coercion. such findings contradict the assumption that technologies for care consistently enhance independence, security and empowerment. this evidence clearly shows that technologies for care may introduce ambiguous or multivalent effects. in this article, i trace several ethnographic vignettes that concern how attentions in senior home care relate to the multivalent mediations of aging bodies with technology. i am particularly interested in the multivalent effects that emerge with visual and hands on attentions to aging bodies with technology. secondly, i suggest that these effects have direct implications for the idea of surveillance in care. surveillance is a deep-seated and often a broadly employed concept, particularly when technology is in focus. here, for instance, one finds the use of labels like “surveillance technology” (e.g. niemeijer et al. 2010; milligan, mort, and roberts 2010). however, in contrast, i suggest that the idea of care as mediation challenges the idea of surveillance in care. as an analytical compliment to the notion of care surveillance, i propose the notion of “carevalence”. this heuristic term, i suggest, adds another way to think through the multivalent somatechnic effects that often emerge with care attentions. my analysis draws on several stints of ethnographic fieldwork in the united states and sweden, which i carried out intermittently during 2007-2008 and 2010-2012. this work includes semi-structured interviews and participant-observations in situations of senior home care. initially, i conducted ethnographic interviews with approximately twenty seniors in each country. follow-up visits with key informants offered opportunities for further, in-depth participant-observation on repeated occasions—roughly a dozen in total, six in each country. the senior participants typically lived alone but with some form of home care assistance. when available, i traced interactions between home care workers and family members. in addition, i joined participants in activities outside the home, including shopping trips and medical appointments. a european research project with the aim to support the future design and development of “ambient intelligent” telecare technology for senior home care framed this fieldwork and my research interests. ambient intelligence is a term for the artificial capacity to sense and respond to environmental cues and human expectations without direct human intervention. for instance, ambient intelligent lighting is designed to adjust automatically to different human events like a party, meal, bedtime, or home emergency. the project required ethnography to determine how ambient intelligent technologies might augment daily practices in senior home care. it also aimed to inform design assumptions about such practices. thus, an entry point for my fieldwork was the use of new technology for care, including telecare. eventually, in later fieldwork, i shifted my focus from technology design to anthropological concerns about social-technical interactions as they relate to care and its movements. care as somatechnic mediation1 if the [research programme] seeks to provide contextualisation in order to understand the “social and human dimensions” of the new technologies, it has to be because the electronic technologies themselves are already depicted as “decontextualized”. in other words they are imagined as having the power to communicate and convey information lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 147 147 stripped of the encumbrances of social relations, and physical limitation on travel. – marilyn strathern2 [the body is] an interface that becomes more and more describable as it learns to be affected by more and more elements. the body is thus not a provisional residence of something superior—an immortal soul, the universal or thought—but what leaves a dynamic trajectory by which we learn to register and become sensitive to what the world is made of. such is the great virtue of this definition: there is no sense in defining the body directly, but only in rendering the body sensitive to what these other elements are. by focusing on the body, one is immediately—or rather, mediately—directed to what the body has become aware of. – bruno latour3 these two quotes consider the ontological becoming of different entities. strathern writes about technology and how assumptions about its use and purpose tend to go unquestioned. she urges us to consider how technology simultaneously is mediated by and mediates contextual practices. similarly, rather than a stable or well-defined thing, latour suggests that the body is a fluid and sensitive entity open to effects and affects in its world. in other words, if we make analytical assumptions about categories like the body and technology we risk missing the mediated ontological possibilities that emerge with movements in practice. the distinction between the body and technology may not be as fixed as we might like to think. such ideas inspire this article. it represents my efforts to think through how care attentions might produce somatechnic differences. to proceed, allow me to start with an ethnographic passage from my fieldwork in senior home care. this cconcerns the difficulties that emerge when care attentions focus moving aging bodies with technology. robert is in his early nineties, and beth, his adult daughter, is in her early sixties. they live in a mid-sized us city, with about 200,000 inhabitants. it is a hot summer day. the fan is blowing from a corner of the room as we sip on glasses of iced-tea. robert and beth are on good terms and beth speaks frankly about her dad’s situation. beth explains that she wants to support her dad’s independence and his own decision-making, but sometimes she does not agree with his choices. one of his favorite activities is a walk to the store, about a mile away. he uses a wheeled walker but his telecare system does not function beyond the confines of his house. robert knows this but persists. beth: dad is still very independent and capable of taking care of himself. i want him to continue his independence and make his own decisions but his walks to the store concern me because his [telecare] emergency bracelet… if he falls… robert: it’s no good. beth: right. it only works in the house. that sort of independence is worrisome to me. dad is capable of walking with his [wheeled] walker but it would just be nice to have some way of knowing where he is. sometimes when dad takes the bus to the city he’ll let me know. he’s even gone to the beer festival! if he calls me and says i am taking the bus over, then i always ask him to please call me when he gets there so at least i know where he is. at least with his bracelet on at home i feel a lot safer, but when he leaves and goes other places i worry about him falling. i get nervous if i’ve called him two or lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 148 three times and don’t reach him. if it’s a nice day and it’s not too hot he might be outside. i’ll try to call him again in an hour. when he finally answers i’ll say, “i am glad you finally answered the phone because i was on my way over to check on you!” he goes up and down those basement steps all the time. robert: it’s good exercise. robert fractured his hip the year before, when he fell trying to maneuver his wheeled walker up the back steps to his house. initially he ignored the pain and kept his planned meeting with the local grange, a us-based agricultural advocacy organization, where he is a longstanding member. the next day, when the pain became unbearable, he told beth about the incident. she promptly took him to the hospital where he was treated. robert then moved into a local assisted living facility. he wanted to move back home but his condition demanded institutional care. he lived in the senior housing facility for several months before returning home. once home, he revisited his old patterns. although robert knew the risks, he continued to walk to the grocery store. on the way, he negotiated heavy traffic, several busy intersections and occasional bad weather. beth worried about what could happen to him and wondered if her dad always used the best judgment: “sometimes i think he thinks he’s still 50 or 60 years old!” for his part, robert had agreed to call beth before he left and again when he returned, but beth noted that sometimes he forgot. this ethnographic passage offers one example of how attentions to bodies with technology in senior home care can mediate multiple effects. for instance, with the walker’s support, robert could attend to his desire for exercise. yet, while this device enhanced his mobility, it also produced several dangers and negative outcomes. the walker played a part in robert’s fall, and thus his hospitalization and transfer into assisted living. in addition, although the telecare system was installed to enable attentions to robert’s daily condition and the ability to respond to emergencies, outside robert’s house it offered no help. this added to beth’s sense of discouragement about knowing her father’s whereabouts and daily health condition. robert did have a phone that he could use to check in with beth, but occasionally he forgot or simply did not wish to inform her. on closer analysis, however, it is not “the technology” alone—independent from its connections with “the body” that produce these multivalent moves in robert’s care. rather, it was the body-walker or somatechnic arrangements that intervened. these somatechnic combinations did not simply produce positive outcomes. they also added to beth’s anxiety and played a central role in robert’s transfer from his home into assisted living. in other words, the somatechnic effects that emerge with care attentions are multivalent in their implications. here i wish to turn to another discussion with one of my informants to nuance this idea further. meet evelyn, in her late 70s. she is an articulate, us american woman who lives alone in a two-story house which is increasingly difficult for her to maintain. she cannot afford formal home care so she does the best she can on her own with what she calls her “equipment” as well as the occasional help from friends. she suffers from a number of chronic ailments, including type ii diabetes. to help control the diabetes she must test her blood sugar level regularly for inconsistencies: lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 149 149 evelyn: when i get up in the morning, unless it’s to pick up the phone to check on my bank balance, i always test my blood sugar. then i test my blood pressure level with my sphygmomanometer. then i know whether or when or how much medication that i have to take. then i may eat a morning meal. that is a rather complex decision for me because i have to balance my blood sugar reading of the morning and my limited budget for food. if the morning reading is within the so called target level range, which is another way to say “normal” even if you don’t have diabetes. then depending on how much i feel i know about the glycemic index of what i’ve eaten and the fiber and all those things, i might test it after my first meal. i might not test it again until later depending on whether i feel odd or have done something weird about whether i did or didn’t eat or i haven’t had any exercise, which is frequently good. here we see how this device interrelates with her efforts to sustain her life at home and so-called independence, despite her difficult situation. however, sometimes things do not go as planned. evelyn also gives an example of what happens when this technology does not produce the anticipated effect: evelyn: i have three of these blood-testing kits. i keep one upstairs, one downstairs, and one in my purse. last weekend i got these extraordinary elevated readings. that was after i had a visit from my niece and my nephew and they wanted to go to a fancy restaurant. i couldn’t just sit there and say, “well no, i can’t eat this. i can’t eat that” you know. so at first i wasn’t surprised to have a slightly elevated reading. but then i took my oral anti-diabetics and that’s a problem because you’re supposed to take them with food otherwise they nauseate you. what you’re trying to do is reduce the effects of food. there are a lot of times when i am just nauseated all the time. but anyway, instead of going lower they went higher. i thought, oh my god, i guess i my diabetes has gone terribly advanced and i am about to have to go on insulin and the whole thing, you know. while this is an example of what happens with device failure, it also offers an illustration of how technology used for care can generate multivalent experiences and perceptions of the body. evelyn had never had a device fail. initially she trusted its elevated reading. had she not eaten correctly? was her diabetes entering a more advanced stage? then it dawned on her that perhaps the machine was not working right. when she realized it may have failed she compared her levels by testing her blood with another machine, which produced a reading within the target range. however, she remained anxious until she could confirm her glucose levels in person with her doctor. as mol (2000) points out, these diagnostic or “self-monitoring” devices do not simply register facts about the body in a passive manor. they also achieve agency in use. what does this agency look like? mol argues that self-monitoring devices do not necessarily erode corporeal sensations but rather they augment or mediate them, and thereby alter the body’s ontology or what the body is in the process of care. she explains, “[s]ome patients with diabetes don’t feel (e.g.) ‘dizzy’ or ‘light in their head’—they feel ‘hypoglycemic’” (2000:16). in addition, mol suggests that the use of these devices “does” the body as a set of measuring practices which amounts to self-disciplining or regulation (2000:18). in addition, i suggest that care attentions entail a degree of discipline, so monitoring devices further add to the somatic disciplining or lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 150 regulating already present in care. in other words, such technological effects pronounce a given dimension(s) or frequency of the body, which then becomes available for the focusing of care attention. following mol, together with the blood glucose tester, evelyn’s attention to her bodily sensations were mediated as an act of measuring. this accentuation or intensification is similar to martin’s (1992) argument of a “stretching” or “wrenching” of the body into a particular form and akin to mol’s (2002) thesis on the “body multiple.” how such devices determine normality in care is an additional point to consider. mol (2000) argues that such devices not only help users achieve normal glucose levels but they also adjust what matters as “normal” in the first place. evelyn, for instance, became concerned when her reading was above normal after eating out with her relatives, which was already a special event. in this case, medical knowledge hedges what counts as a normal body. yet, achieving normality is not as straightforward or common as designers of healthcare devices or medical practitioners might assume. for instance, at one point in our conversation, evelyn rejected the notion of a “normal” day. normality for her was an obscure and tentative issue: evelyn: there is no normalcy. i mean there really isn’t. it depends. like when i was preparing for our appointment today. last night was fourth of july and i knew that there would be bombs bursting in air and i wouldn’t get to sleep very early. once upon a time, i would have disciplined myself to stay in bed for as close to eight hours as possible but the sun rises at five o’clock now. i was probably asleep by midnight. with my diabetes, i frequently have to get up during the night to urinate. then it’s hard to get back to sleep again and then soon i feel the need to get up again. by that time, i am so tired trying to figure out whether to sleep or if i can that i have to decide. i have to take in all these factors. here we see how evelyn, her disease, the time of day, a national holiday, the need and difficulties of sleep, et cetera, all come together to create an evolving arrangement or collective that mediates unexpected multivalent effects. these, in turn, require additional and ongoing attentions and adjustments. a related point here is also how this challenges the idea of “self” care. evelyn is not fully in self-control of her attempts to negotiate care attentions. rather, they amount to tinkering or experimentation with her arrangement. this involves the negotiation of attention to her diseased and aging body—as she explains in response to my follow up question about sleeping patterns: evelyn: today i thought i would stop going by the old rules of how many hours you’re supposed to sleep a night. instead i should realize how different the energies are if the sun is up at five o’clock in the morning and doesn’t set until nine at night. then it's easier to understand from the atmospheric experiences when there’s no sun at all. […] so there really is no normal it depends. it depends because sometimes us old people have to take a nap or lie down for a little while in the afternoon. but then we’re up later than we would be otherwise. so i think of sleep in chunks of time. if i manage to get to bed at what once would have been a reasonable hour, anywhere from 9:30 to 11:00, and if it took me a half hour to sleep then i would hope to sleep until 7:30. i very seldom accomplish that but i try. when things get sufficiently interrupted i try to balance what i do by responding to those interruptions to keep things as level as possible. lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 151 151 above evelyn defines her care attentions as a process of “balancing” home care arrangements. this is akin to what i have already discussed as tinkering and adjustment. later in the interview, she develops this point: evelyn: i’ve had diabetes for 18 years. type ii noninsulin-dependent. my maternal grandmother had diabetes and she had a terrible time with it but they know more about it now. so i am very conscious about that. […] i’ve been studying diabetes at length for almost two decades and the theories change, and the marketing pressures change, and the places to buy food change. i enjoy the study but then again it’s a lot of balancing. balance with what the nutritional guidelines seem to be and what the prices are and how much gasoline you have and how far can you go to buy the food. now my microwave is also broken and i have no money to fix it. so part of the difficulty is that all my equipment has been breaking down and that relates back to the poverty thing. for evelyn then, her care is not simply a matter of injecting insulin or sleeping a certain number of hours. rather, it amounts to an on-going attempt to balance a range of entities, all of which are in a constant moving relation to one another. these include her diseased body but also the changing medical perspectives on diabetes, her location, her economic situation, and even seasons of the year. here care attentions mix with somatechnic relations that include her equipment and her body—both of which have a tendency to break down. to focus care attentions in this way is to relate to the on-going collaborative arrangements of care. this section has illustrated how moves for attending to aging bodies with technology create collective human and nonhuman care arrangements. in these collective movements of care, the body does not emerge a passive entity. evelyn’s diabetic body acquired different agential potentials. this emphasis is akin to latour’s argument that being in a body is to understand how it is “‘effectuated’, moved, put into motion by other entities, humans or non-humans” (2004:205). by the same token, nor does technology emerge as an entity with straightforward effects. like robert’s walker, evelyn’s use of her self-monitoring device mediated her bodily attentions and produced an array of different effects. thus, in the movements of care attention bodies and their technologies emerge as categorically and ontologically unstable. together they enter into tensions that require tinkering, experimentation and balancing. the next section explores what this tinkering of multivalent somatechnic relations though collective attentions might imply for the idea of surveillance in care. care surveillance? in discussions about the dynamics of care and its attention, especially monitoring and observation, some scholars appropriate the concept of “care surveillance”. this concept also figures in discussions about the adoption of new information technologies, including telecare and the “smart” home. nevertheless, the relation between care and surveillance can seem oxymoronic (mcintosh et al. 2010). care conventionally denotes a sense of respectful attentiveness and concern for the wellbeing of others. surveillance, on the other hand, can evoke the dystopian imagery of an orwellian society where privacy and wellbeing are undermined. surveillance may suggest a view from afar, while care focuses attentions up close. moreover, surveillance typically occupies an objective and removed stance, while the notion of care resonates with a subjective, close-up view. in this section, i touch on some of these inherent conceptual challenges between lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 152 care and surveillance. this will help establish the ground for an additional way to think through the empirical-conceptual play of multivalent somatechnic moves with attentions in care. michel foucault’s work is an important influence in surveillance studies and the notion of care surveillance in particular. foucault was interested in how surveillance extends authoritarian controls in hospitals and other institutional settings including schools and prisons. he argued that the surveillant gaze can “discipline” and “normalize” power and knowledge relations in a wide range of settings. for instance, foucault remarked: “is it surprising that prisons resemble factories, schools, barracks, hospitals, which all resemble prisons?” (1995:228). along these lines, foucault developed the idea of the “panopticon,” based on jeremy bentham’s architectural design for surveillance in prisons and other institutions. foucault employed the panopticon as a social-material metaphor for analyzing the potentials of perpetual surveillance with technology. he also linked this to effects on things like bodily conditioning and the construction of subjectivity. while foucault’s ideas are still influential in surveillance studies, some scholars critique the notion of panopticism for insufficiently characterizing the complexities of contemporary surveillance practices (dubbeld 2006). contemporary or post-panoptic surveillance studies are rich with new terms and concepts, which aim to compliment or correct panoptic notions of surveillance, especially its more dystopian versions. bruno latour’s “oligopticon” is one example. latour describes the oligopticon as a site or arrangement that generates narrow and discrete views, rather than a complete, panoptic view of everything. in his words, oligoptica “do exactly the opposite of panoptica: they see much too little to feed the megalomania of the inspector or the paranoia of the inspected, but what they see, they see it well […]. from oligoptica, sturdy but extremely narrow views of the (connected) whole are made possible—as long as connections hold” (2005:181). stemming from the critique of panopticism and revised conceptions of surveillance, interest in the overlap of surveillance and care has offered additional avenues for exploration. for instance, david lyon, a leading scholar of surveillance, argues that surveillance is best understood as a dynamic process that intertwines the logic of care and the logic of control (in walsh 2010). christopher gad and peter lauritsen (2009) echo this view in their study of danish fisheries inspection. they explain, for instance, how fishing inspectors invoke a sense of care in their work. this includes concern about the wellbeing of fish and the environment, but also the fishermen when they need help. the authors conclude that control and care do indeed overlap in practices labeled as surveillance. some scholars of care make similar claims. for instance, in her study of telecare in swedish senior home care, anna essén (2008) proffers that surveillance and control are both inherent to care. at the same time, essén acknowledges that these categories are empirically and conceptually difficult to distinguish in practice. in their study of telecare in uk senior home care, christine milligan et al. (2010) make an analogous point. they argue that all types of care involve surveillance, whether technologically mediated or not. yet, milligan et al. also stress that the context of use, including the agency of care subjects, makes the view of surveillance contingent (2010:27). in other words, the notion of surveillance is relative and depends on how various entities relate and move together, from one moment to the next. allow me turn to an ethnographic passage from my fieldwork to develop this point further. lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 153 153 it is early. the smell of coffee fills the air. i have joined a group of swedish senior home care workers as they prepare for their daily rounds. the care workers service older people living in two adjacent villages and those living in the in-between rural areas. before starting out in teams of two, they reserve a few minutes to sit down to chat. four of them sit around a wooden dining table, drinking coffee. one of the care workers keeps a transparent plastic folder beside her on the table, with the schedule of all the allotted home care tasks. the folder remains closed during their discussion, yet nevertheless present. out of interest, i ask how they divide the work between themselves and decide who goes where. the care worker with the folder notes that they check the client schedules before their rounds, but that they rarely consult the schedule otherwise. “we know all our clients,” one worker adds. they have worked with them many times. in addition, they explain how they alternate their rounds every week between the two different villages. “otherwise” they remark, “we have no real perspective.” this makes their work less monotonous, but it also supports their collective decision-making about the ongoing efforts to adjust attentions to the changing needs of their clients. in this passage, there are certainly examples of monitoring and observation that could pull the analysis towards the notion of care surveillance. yet, when it comes to the actual doing of hands on care, i suggest that something else happens. for instance, the care workers suggest that without the moving around to adjust their attentions they would lose perspective on what they actually need to do. this is similar to beth’s efforts to shift her attentions on her father’s constant travel. here i think it is clear that the notion of surveillance in this specific situation gives way to a more nuanced or multivalent dynamic once we shift the analytical focus to what actually happens in the movements of care—when the practitioners attempt direct contact with seniors and their aging bodies in and around the home. how might we explore this multivalence further? how does it emerge in practice through the hands-on movements of care? one analytical possibility is to turn to the question of perspective. perspective in medical and healthcare research generally comes in two varieties: the professional / medical perspective and the lay / patient perspective. the mainstream medical perspective typically focuses scientific or biomedical concerns on disease and the human body. here the body is stabilized as the primary object of inquiry but separate from patient concerns. at best, the patient appears in the form of statistical categories or behavioral labels. to address such issues, medical anthropology and other related disciplines have for some time promoted the patient perspective. jeanette pols (2005) suggests that the patient perspective—which she also points out is a topic of inquiry in its own right—has largely served to compliment medical knowledge, particularly the relation between illness and disease. a critique of this contrast would be that the medical perspective figures patients (and their bodies) as objects for knowledge, while the patient perspective approaches patients as knowledgeable subjects. yet, a more significant outcome, according to pols, is the acknowledgement of multiple and even ambiguous or multivalent realities that emerge in practice. in this light, pols questions the relevance of searching for unified perspectives. in particular, she argues that this search tends to overlook the performativity (she also employs the terms co-production and enactments) of people and things as they come together in different care situations. the passage with the swedish care workers resonates with such arguments. consider the use of client schedules. healthcare administrators produce these schedules in an attempt to match client needs with the formalized spatial, temporal, and financial constraints of healthcare. as a care technology, these schedules should guide the care workers’ attentions in the lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 154 performance of their tasks and routines. in this way, the schedules could be understood as an extension of a healthcare or medical perspective, situated by medical knowledge and the political-economic regime (e.g. new public management). yet, the client schedules do not offer the exclusive view on how senior home care gets done in practice. we can also find perspectives aligned with the care subjects or clients. for instance, the care workers discuss their attempts to move around to locate perspectives of their clients’ needs, which they must also balance with their scheduled care tasks. yet, these attempts to gain a patient or client perspective are not the same as achieving one. at best the care workers’ efforts amount to an ongoing work-in-progress. their work may draw on different so-called patient perspectives but their views do not amount to a distinct perspective. it is certainly not the distant view of panoptic surveillance. their attentive views are negotiated, limited, ephemeral, and closer to what latour defines as oligoptic. the same point also holds for the so-called patient perspective itself. for instance, evelyn explains how she struggles on a daily basis to negotiate attentions to her body, which she must balance with a full range of other entities including her equipment. there are also examples of how care attentions mediate the medical perspective. for example, if we include the care schedules as a technological extension of the medical perspective, we can see how care attentions also mediate this perspective.4 moreover, these movements of care have mediated my own analytical perspective. initially, in the early stages of writing this article, i retained the notions of perspective and surveillance. yet, in the careful analysis of care and its attentions such notions have become less tenable or useful. in their place are mediated and emergent kaleidoscopic views, surfacing and submerging with the doing of care. notions of perspective and surveillance remain important, but my point is that we require additional terms that can better attend to the transformative multivalent moves of care. the handful of studies i present above relate to care in surveillance but, equally, surveillance in care. a few general points emerge. for one, these studies suggest that care and surveillance overlap on the issue of control. yet, while this is certainly a valuable insight, i question whether the topic of control invites a focus on the multivalent effects that i find in my material. perhaps the study of control in care surveillance is more concerned with foucauldian arguments about panoptic surveillance rather than care itself. in other words, rather than show how surveillance and care mix with the issue of control, i propose it is worth considering situations where control is less evident. these same studies also proffer that care and surveillance tend to blend to the point of indiscernibility in practice, thereby making it difficult to analytically distinguish such terms as distinct categories. nevertheless, i assert that it remains worthwhile to pursue the study of care, as annemarie mol (2008) suggests, in and on its own terms. while i will not deny that surveillance or control exist in practices of care, i propose we can consider additional terms that remain faithful to the logic of care itself. as i see it, a productive approach is to trace how human and nonhuman elements mutually mediate or “tinker” (mol 2008) one another in practice. this entails analytical attention to what evelyn describes as the “balancing” of different entities. in addition, rather than a adopt a more static perspective or surveillant view that assumes a singular static quality of things, we can shift the analytical focus into how movements of care attention in practice perform or enact subjects and objects. this approach is spearheaded by scholars, like mol, who study the emergence of ontological difference. she writes: lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 155 155 if practices are foregrounded there is no longer a single passive object in the middle, waiting to be seen from the point of view of seemingly endless series of perspectives. instead, objects come into being—and disappear—with the practices in which they are manipulated. and since the object of manipulation tends to differ from one practice to another, reality multiplies. (2002:5) if one endorses this idea of ontological multiplicity—that the reality of a thing is different in different practices—then i suggest room opens up to reconsider assumptions about attentions in care, including notions like surveillance and perspective. for one, the idea of an unobstructed view on a singular reality becomes dubious. in other words, once we establish that the reality of a given entity such as a body or technology can become multiple in different practices, i maintain that all forms of care attention—visual or otherwise—relate to the doing of ontological difference which in turn challenges notions like perspective and surveillance. in the next section, i pursue this line of argument to further ground my proposal of care-valence. towards care-valence to further explore care attentions and how they mix with somatechnic relations i wish to return to robert and his use of telecare. one day robert and i sat down for a chat in his kitchen. however, as he sat he misjudged the distance from the chair, slipped off, and fell backwards onto the floor. surprised and concerned, i quickly asked about his condition and tried to help him back into his chair. laughing from embarrassment he said: “just take my hands!” concerned that his hands and wrists might be too weak, i took him in my arms instead and lifted him back up into the chair. once we had both calmed down, i asked him what he would have done if i had not been there to help him. he explained, with some hesitation, that he could have called someone like his daughter. then i asked him about his telecare pendent. he admitted that he was not wearing it: robert: my daughter would get after me because she wants me to wear it all the time. but when i’m out in public like i was this morning i don’t like to bother with it. sometimes it gets in the way. but i usually wear it. honestly though, i’m too independent to call anybody. i can inch my way over from the kitchen to that recliner chair over there and then inch my up by putting my shoulders against it and pushing myself up. or if i’m in the bedroom i can get the rocker up against the bed and inch my way up to the bed. i want to do that by myself because i don’t want to everybody to know i’m falling. as i noted above, my interest in the relation between surveillance and care stemmed initially from my fieldwork on the use of telecare emergency response systems in senior home care. these systems—which some scholars define as surveillance technology—are installed to enable more effective emergency response and reduce the risks of living at home like falling. it typically consists of a wearable alarm button, in the form of a wristband, necklace or pendant, connected wirelessly to a radio intercom, and wired into the landline telephone. this wireless design has a limited radius that effectively encompasses the home living areas and the immediate outdoor surroundings. if the client experiences an accident or stress, he or she may push the button to contact the emergency responder. the responder first attempts to establish verbal communication with the client via the intercom in order to inquire about the severity of the call. lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 156 these devices have been in use for several decades in both countries. technically, they comprise similar components and design. given these similarities, one would typically expect similarities in their effects and use. however, i found a stark contrast in their use between the us and sweden. like robert, some us participants questioned the use of telecare. they noted concerns about becoming a burden to their family or friends, disturbance of their privacy, as well as the additional costs of the telecare system. a key example is robert’s disuse of his device due to his concerns about privacy and becoming a burden his family. however, i did not come across such hesitations among my swedish participants. this difference, i proffer, relates to the different ways connect these telecare devices connect into the existing local care arrangements. in the us, older people typically become customers and pay monthly fees for their telecare emergency response system. moreover, their calls route to a national emergency call center located many miles away. the call responder determines the severity of the call and attempts to contact the family member or friend previously established in the customer’s profile. it also happens that the responders contact the appropriate local emergency services. in sweden, public healthcare providers typically include telecare as a part of the home care services. in this arrangement, seniors become connected as clients rather than customers. some of my swedish participants even cited that it was their right as citizens of the national welfare system to access good healthcare and new technologies such as telecare. in addition, unlike in the us where emergency calls route to a call center potentially hundreds or thousands of miles away, the local swedish care workers are the first to respond to client calls. thus, swedish seniors are often familiar with the person or persons who answer their calls, which i think helps explain what i perceive as the acceptance of this technology. with this comparison, differences in terms of the use and effectiveness of technology for care emerge. in sweden, some senior participants linked the adoption of telecare to notions about citizen rights to good healthcare. however, among my us participants i did not find these kinds of associations. instead, i found how seniors use (or rather disuse) telecare to veil or screen their body as a stable (rather than unstable) entity. admittedly, this is anecdotal evidence but my aim is not to quantify this comparison. nevertheless, i suggest it supports the argument for the emergence of different multivalent somatechnic mediations in care. it also lays open conceptual assumptions both about technology and surveillance. for instance, if technology produces one set care attentions in one situation, but a different set in another, is it correct to generalize such devices as surveillance technology? i will return to this point below. first, i wish to present one additional example which further illustrates how collective care attentions can mediate technology and vice versa. again, i draw on my work with robert and beth. beth: we just don’t always have time to read the paper and when we do read it we spend too much time reading it. one day we just asked if we could borrow my dad’s. the paper became a really good way to check in on him. it offers an excuse to get over there. i hate to spend money for the paper if it’s not going to be used, so it works really well. peter: and you suggested it? he was already getting a paper? beth: yes, he likes to read it. it’s a part of his afternoon. peter: and the decision to share it with the neighbors—how did that come about? lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 157 157 beth: we just offered it to them. we knew they weren’t getting it and wondered if they’d like it. peter: what is your relationship with them? beth: oh it’s good. we have great neighbors. we have close relationships with a lot of them. in the above passage, beth explains how a daily newspaper became a way to negotiate or mediate care attentions. robert pays for the paper, which he has delivered in the morning. then, later in the day, beth retrieves the paper but uses the opportunity to check in on her dad in an unobtrusive way. in this way, she is able to respect her father’s daily routine. on the other hand, because robert buys the paper, it offers him one way to assert his sense of independence. it becomes a gift to beth, which she then passes on to her neighbor. obviously, there are multiple issues one could explore here. for instance, it shows how the senior home care collective is distributed beyond the home and augments community relations. the most important point for my argument, however, is how an object—the newspaper—becomes transformed as a “technology” for care attention. however, this form of care technology does not provide the unobstructed view of surveillance. rather, it mediates and tinkers with care attentions. certainly, beth could check in on her father in more deliberate ways. yet, the beauty and simplicity of this mediated homegrown care technology is in how it resonates with the mutual respect found in other aspects of their relation. this example also challenges the assumption about care as a one-way flow from giver to receiver. here care is a negotiated and mutual affair, with multiple frequencies of giving-taking. moreover, this multivalent mediation does not only concern technology. it also concerns how and when care attentions to the aging body occur. this observation resonates with the other ethnographic passages including evelyn’s blood glucose monitor, robert’s use of the telecare device, and his wheeled walker. depending on how care attentions are situated, robert’s bodywalker arrangement could emerge strong or weak, mobile or immobile, stable or unstable. certainly, these situations challenge the potentials for a care surveillance—panoptic, oligoptic, or otherwise. instead, i suggest what occurs in my examples are somatechnic effects of care attention, which mediate its entities in multivalent ways. these entities include both technology and the body. recent years have seen in a significant increase in the anthropological and sociological literature on the body (e.g. lock and farquhar 2007; hoeyer 2013). while this literature focuses the body in relation to issues like subjectivity, selfhood or embodiment—with both poststructuralist and phenomenological approaches—the category of the body itself (and the aging body even more so) typically remains untouched or implicit (hoeyer 2013). offering a similar critique, janelle taylor suggests that there is a prevalent “tendency to presume, rather than ask, what a body is and where its significant boundaries are located” (2005:749). in this light, mol and law (2004) proposes that analytical attention to the body we do or enact in practice offers a means to cut through the objective/subjective dichotomy between the body we have (as an object of medical knowledge) and the body we are (part of the fleshy subjectivity that make us persons). lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 158 these observations help refocus analytical attention on how bodily realities—but also other preconceived categories such as technology—emerge in different ways through situated relations. the so-called “ontological turn” in anthropology and other social sciences offers another source of inspiration. a prime example is mol’s (2002; 1999) focus on what she terms “ontological politics.” mol explains: “if the term ‘ontology’ is combined with that of ‘politics’ then this suggests that the conditions of possibility are not given. that reality does not precede the mundane practices in which we interact with it, but is rather shaped within these practices” (1999: 75). to take a “politicized” ontological turn in the study of the body or technology is to question how these preconceived entities “matter” in practice, as fluid or contested categories. attending to the different ways care attentions mediate or materialize its arrangements offers an approach on somatechnic relations as an ontologically multiple affair, with multivalent objectivesubjective combinations or versions. in other words, to take an ontological turn in questions about the body and technology in care is to focus on how such boundaries become (re)done, through the movement of care attention. this is a different concern than the study of surveillance in care, which i suggest tends to fix ontological boundaries between observer and the observed, or subject and object. to better focus analytical interest on the multivalent somatechnic effects produced with care attentions, i develop the concept of care-valence as a compliment to studies of surveillance in care in the remainder of this section. the oed offers several meanings for the term “valence”. first, it can imply an extraction, for instance an herbal extract used in medicine. similarly, it refers to a veil or screen—such as a thinly woven fabric or drapery attached lengthways to a canopy, altar-cloth, or the like (cf. valance). second, it means a bond or bonding force, such as chemical or psychological / emotional attraction and repulsion. third, it indicates valor and courage; including valency, which relates to strength, power, vigor, capacity, significance and importance. hence, the term valence is itself multivalent. these three differences (or valences) in the term valence—namely screening, bonding, and encouraging—offer inspiration for my concept of care-valence. care-valence as “screening” concerns the double-sided ontological filtering-extraction of somatechnic difference that can emerge with care attention.5 of course, in an explicit way, digital screens are used frequently in senior home care and healthcare more generally. evelyn’s monitor, for example, comprised a digital display screen. yet, rather than simply an invisible bystander or innocent conveyer of knowledge, we also saw how her monitor played an active role in guiding eveyln’s bodily attentions. it actively participated by shaping her diabetic body in particular ways, for instance as in a measurable and numeric entity. in this way, screens can organize care attentions but they also cut away particular attentions or views while creating and connecting others. care-valence as screening, then, offers a conceptual or metaphorical extension of this process. it helps to depict the coming into being of different relations and how these can mutually and ontologically “tinker” aging bodies with technologies in ways that produce but also limit their presence as entities for care. robert’s non-use of his telecare device offers another example of screening as a subtractive process. in this situation, the telecare device helped to screen out or veil his fall, which displaced care attention that might otherwise focus on his condition. evidence here also suggests how the telecare device itself became screened out as a care technology. again, my point is that care-valence as screening is a way to think through the mediating and transformative somatechnic relations that can surface with care attentions. in other words, it emphasizes the cutting away and filtering of care arrangements. lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 159 159 while care-valence as screening emphases the filtering-extractive process, care-valence as “bonding” stresses the gathering together or “becoming with” (haraway 2008, see also strathern 1996) of somatechnic relations through care attentions, which amount to different ontological effects. the somatechnic relations explored in this article all suggest instances of bonding. for example, robert’s somatechnic body-walker arrangement is a bond that was created through care attentions, and in turn generated multiple somatechnic effects. another example is how robert and beth’s newspaper bonded not only their own care attentions but also extended this relation into the wider community. lastly, care-valence as “encouragement” concerns the bravery, courage, or capacity in care that nudges, coaxes, urges, and otherwise tinkers or adjusts attentions. thus, this third form of care-valence is closely akin to what mol and others argue is inherent in the logic of care, in contrast to the logic of surveillance or control. care-valance as encouraging is also a way to emphasize the “affective” (cf. massumi 2002) dimension in care. as puig de la bellacasa argues, “[u]ltimately thinking with the notion of care does illuminate the affective aspects of knowledge politics. the tensions of care are present in its very etymology that includes notions of both ‘anxiety, sorrow and grief’ and of ‘serious mental attention’” (2012:212). in other words, care attentions comprise and effect somatechnic relations filled with tension, and these also match with attempts to encourage. in other words, to think of care-valence in purely material or visual terms would be to overlook the deeper affective structures that underlie and inevitably sustain care and its attentions. concluding remarks this article opens by noting the significance of new technology development for senior home care. at the same time, it also stresses how the relationship between technology adoption and care for older people at home remains a complex affair. to better understand this complexity i propose the need for more nuanced conceptual tools. in this light, the article takes up the case of surveillance in care, which is also often used to label technologies for care including telecare. some scholars proffer that control and surveillance are integral to care. at the same time, scholars of both care and surveillance acknowledge that these terms are conceptually and empirically difficult to distinguish. there is evidence, for example, that surveillance gives patients a sense of comfort and empowerment, rather than simply disempowerment or worry. idioms like “watching over” or “looking after” also illustrate this blur between care and surveillance. given this complexity, i proffer that this distinction does not fully express the complexities that emerge in practice. while surveillance remains an important concept, i question if it accounts for the full range of multivalent effects that emerge with care. an analytical focus on attentions to aging bodies with technology offers a provisional starting point for rethinking this distinction. this includes a focus on tinkering and adjustment in practice, which mol relates specifically to the logic of care itself. the logic of care entails thinking through how attentive movements in care mediate or tinker its relations, including between bodies and technology. it rests on a symmetrical understanding of technology and humans. this symmetrical view approaches technology as a deeply social phenomenon and one that is fundamentally entangled with humans. this view is prominent among scholars in sts-inspired anthropology and post-feminist philosophy of technology including scholars like karen barad, donna haraway, bruno latour, john law, lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 160 annemarie mol and marilyn strathern. this is distinct from the standard or literal view, which frames technology as a predominately material category consisting of artifacts, objects, systems, techniques and machines that are well removed from the social sphere. popular and scientific accounts generally adopt this standard view. this article clearly represents an effort to challenge this standard view and contribute to a symmetrical analysis of how senior home care attentions mediate human and nonhuman relations—in other words, bodies and technologies. to better focus the multivalent somatechic effects that can emerge between the logics of surveillance, control and care i proffer the heuristic term care-valence. this is an attempt to better situate the analysis of care in and on its own terms or logic, distinct from the logic of surveillant control. i develop this term by considering its different multivalent dimensions—screening, bonding and encouragement—which i argue offers a more integrated understanding of the mediating capacities of care attentions. as such, i intend care-valence as a compliment to the notion of care surveillance. the key advantage with this term is that it helps refocus analytical interest onto the mediating, generative or performative effects and affects of care. acknowledgements i am grateful to the following people. casper bruun jensen, randi markussen and antonia walford offered valuable comments on early drafts of this article. a departmental seminar at the university of california santa cruz was also instrumental, and included jason alley, mark anderson, don brenneis, nancy chen, susan harding, andrew mathews, heather swanson, anna tsing and matthew wolf-meyer. a special note of thanks goes to don brenneis for suggesting the term valence. in sweden, annika capelán and mats utas gave constructive input on the final draft. the european commission’s marie curie actions programme (grants 14360 and 249322) provided the financial support for fieldwork. notes 1. here i use this term to reference the emergent relations between bodies and technologies that come about with care attentions. i draw on sullivan’s and murray’s term, which they explain serves “to highlight the inextricability of soma and techné, of ‘the body’ (as a culturally intelligible construct) and the techniques (dispositifs and ‘hard technologies’) in and through which corporealities are formed and transformed. this term, derived from the greek sôma (body) and τέχνη (craftsmanship), supplants the logic of the ‘and’, suggesting that technés are not something we add or apply to the body, nor are they tools the embodied self employs to its own ends. rather, technés are the dynamic means in and through which corporealities are crafted, that is, continuously engendered in relation to others and to a world” (2009, 3). sullivan and murray are thus heavily indebted to scholars like donna haraway, teresa de lauretis, michel foucault, judith butler and martin heidegger. lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 161 161 2. strathern continues: “the idea that human artefacts may be abstracted from human life can only point to the missing “context”—it cannot specify or describe it. and when one comes to describe the missing dimensions (so to speak) one will realise of course that the technologies have also created their own” (2000, 53-54, original emphasis, references omitted). 3. with reference to the philosopher william james, latour continues: “this is my way of interpreting james’s sentence: ‘our body itself is the palmary instance of the ambiguous’” (latour 2004, 206, original emphasis, references omitted). 4. see lutz (2013) for further discussion of care scheduling and its mediations. 5. see winthereik et al. 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2010 basic statistics about home care. http://www.nahc.org/assets/1/7/10hc_stats.pdf, accessed july 28, 2015. niemeijer, alistair r., brenda j. m. frederiks, ingrid i. riphagen, johan legemaate, jan a. eefsting and cees m. p. m. hertogh 2010 ethical and practical concerns of surveillance technologies in residential care for people with dementia or intellectual disabilities: an overview of the literature.” international psychogeriatrics 22(07): 1129–42. pols, jeannette 2005 enacting appreciations: beyond the patient perspective. health care analysis 13(3):203–21. puig de la bellacasa, maría 2012 “nothing comes without its world”: thinking with care. the sociological review 60(2): 197–216. strathern, marilyn 1996 cutting the network. journal of the royal anthropological institute 2(3): 517–35. http://www.nahc.org/assets/1/7/10hc_stats.pdf. http://www.nahc.org/assets/1/7/10hc_stats.pdf lutz | multivalent moves in senior home care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.105 http://anthro-age.pitt.edu 163 163 2000 virtual society? get real! ashridge 4–5 may 2000: conference of the “virtual society?: the social science of electronic technologies” programme: abstraction and decontextualisation: an anthropological comment.” cambridge anthropology 22 (1): 52–66. sullivan, nikki, and samantha murray, eds. 2009 somatechnics: queering the technologisation of bodies. queer interventions. farnham, surrey; burlington, vt: ashgate. tarricone, rosanna, and agis d. tsouros 2009 home care in europe: the solid facts. world health organization. taylor, janelle s. 2005 surfacing the body interior. annual review of anthropology 34(1): 741–56. vasunilashorn, sarinnapha, bernard a. steinman, phoebe s. liebig, and jon pynoos 2012 aging in place: evolution of a research topic whose time has come. journal of aging research 2012: 1–6. walsh, james p. 2010 from border control to border care: the political and ethical potential of surveillance. surveillance & society 8(2): 113–30. wigg, johanna m. 2010 liberating the wanderers: using technology to unlock doors for those living with dementia. sociology of health & illness 32(2): 288–303. winance, myriam 2010 care and disability practices of experimenting, tinkering with, and arranging people and technical aids. in care in practice : on tinkering in clinics, homes and farms, annemarie mol, ingunn moser, and jeannette pols eds., pp 93–117. bielefeld: transcript verlag winthereik, brit ross, peter a. lutz, lucy a. suchman, and helen verran, eds. 2011 attending to screens and screenness; guest editorial for special issue of encounters. sts encounters, 4(2): 1-6. http://www.euro.who.int/document/e91884.pdf book review review of bahna, miloslav and martina sekulová, eds. crossborder care: lessons from central europe. london: palgrave macmillan. 2019. pp 149. price: $70 (ebook). zhe yan university of würzburg yanzhe0705@gmail.com anthropology & aging, vol 41, no 2 (2020), pp. 265-267 issn 2374-2267 (online) doi 10.5195/aa.2020.299 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | yan | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.299 http://anthro-age.pitt.edu 265 book review review of bahna, miloslav and martina sekulová. crossborder care: lessons from central europe. london: palgrave macmillan. 2019. pp 149. price: $70 (ebook). zhe yan university of würzburg yanzhe0705@gmail.com in crossborder care: lessons from central europe, sociologist miloslav bahna and anthropologist martina sekulová offer a refreshing approach to the lives of slovakian migrant care workers in austria. they hold that care workers should be seen as active, purposeful agents, positively constructing their own life projects. this argument derives from current analyses of migrant care work, that commonly focus on global care chains and care regimes, neither of which give prominence to the agency of care workers. by conceptualizing care workers as labor and economic migrants, the authors are able to examine care workers’ agency which derives from their day to day care work. in the introductory chapter, the authors outline the particularities of their approach: they identify care workers as active agents in labor migration; they utilize evidence collected from slovakia and austria; and they employ a mixed methods approach. questions such as what determines whether someone decides to become a care worker, what explains work satisfaction within the income levels of a given labor market, or what happens after leaving care work (4) are addressed in the remainder of the whole book. chapter 2 provides some background information on slovak care workers in austria. of particular importance here are the legalization of live-in 24-hour home care in austria on the one hand, and the high unemployment rates in slovakia on the other. this chapter also introduces in more detail the data used for the authors’ analyses, including available official surveys and interviews with care workers in 2011 and 2017. chapter 3 identifies the motivational factors for slovak care workers through both survey analysis and interviews. unsurprisingly, the levels of income and the labor market in the sending country impact individuals’ choices for emigrant labor, and this particularly during and after the 2008/2009 global financial crisis, which induced a rise in the unemployment rate in slovakia. in chapter 4, departing from oft referenced global care drain literature – which tends to accentuate the negative consequences on the left-behind family members as a result of care workers’ transnational migration – the authors find that commodification of care does not necessarily induce alienation of the care workers’ relationships with their families. especially the many middle-aged care workers, who have neither younger children nor heavy eldercare responsibilities at home, reported gaining satisfaction from working in austria as their experience enabled them to both escape domestic unemployment and to gain tangential opportunities which fluency in german can bring. this contributes to a sense of independence among these slovakian care workers, and a concomitant sense of self-worth. finally, cross-border proximity between the two countries permits fortnightly commuting, and with it, the http://anthro-age.pitt.edu/ book review | yan | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.299 http://anthro-age.pitt.edu 266 ability to stay in touch with family members and social activities in slovakia, thus having the best of both worlds. although care work in austria engenders self-realization for many care workers, it is still challenging for workers to find a healthy balance between providing paid care services in austria and simultaneously meeting care needs within their own homes. for instance, within dominant constructions of motherhood and gender roles with regard to women, female care workers are expected to secure delivery of their own home care prior to departure for austria, and then to “catch up” on all that was missed after the return (105). this is illustrated in chapter 5 through an intersectional lens of aging, gender, and circularity. paradoxically, the dynamics of circular and temporary care migrations observed in europe both facilitate care workers’ self-realization and simultaneously, reinforce traditional care expectations placed on care workers in both austria and slovakia. in other words, care workers do escape unemployment, but they cannot escape their caregiving roles as women in both countries. chapter 6 focuses on life of the care workers after they have ended their work in austria and return to slovakia. care workers’ working life once they return to their home country, is negatively affected by their care work in austria, in the sense that it does not increase their employment chances in slovakia. finally, the authors argue in the concluding chapter that new insights can be gained by focusing on questions of who the care workers are and why they do this type of work (136). these questions help to examine the mechanisms of labor migration from the bottom up. one aspect of this book which particularly draws my attention is the diachronic pattern of care migration. the book delineates the geographic ‘movement’ of source regions which provide care workers for wealthier western european countries. within slovakia, few care workers are from the affluent area bordering austria, the majority hailing from the eastern regions of the country. furthermore, there is a noticeable decrease of slovakian care workers entering the market for the first time. indications are that romania will replace slovakia as the largest source country of future care workers. this pinpoints a crucial question for care migration scholars and policymakers: how stable are current care regimes? this book provides fresh insights for delving into this important question by accentuating the economic, gendered, and kinship realities of sending countries such as slovakia. several questions emerge in reading the book. despite the authors’ research methods in combining quantitative and qualitative approaches, the external validity of the data on life experiences of twelve female care workers (34) is not convincing. additionally, since care work is highly relational, it would be interesting to further explore how care workers interact with care recipients, and how they mutually negotiate care tasks to draw personal and professional boundaries, as well as how they both experience and process emotions in those private homes. presumably, relational bonds can have an impact on care workers’ commitments to remain in eldercare beyond merely economic incentives. lastly, since gender has a direct impact on care migration, adding the voice of male migrant care workers would have complemented the conventional gender component in co-determining the motivations and experiences of care. these questions might however be too ambitious an agenda to achieve within one book. that said, crossborder care addresses an important research gap in care migration studies and shall be of interest to those who work on issues of care and migration, both domestically and transnationally. it is a timely contribution to the study of care work and migration within europe and offers unique insights on how care workers exercise agency in their circuitous paths to care. the current ongoing pandemic cuts short the mobility of peoples and poses unanticipated challenges and burdens for the transnational delivery of care. in this sense, care workers are made increasingly vulnerable. however, this book convincingly furthers the discussion of multiple conditions for self-realization among http://anthro-age.pitt.edu/ book review | yan | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.299 http://anthro-age.pitt.edu 267 transnational care workers, which lays the ground for creating a more sustainable care infrastructure for the increasingly silver population. http://anthro-age.pitt.edu/ microsoft word spring2021_sparre & rytter_in template.docx between care and contract: aging muslim immigrants, self-appointed helpers and ambiguous belonging in the danish welfare state sara lei sparre mikkel rytter aarhus university aarhus university saraleisparre@cas.au.dk mikkel.rytter@cas.au.dk abstract in europe, a growing population of older adults are immigrants from outside europe and the anglo-saxon countries. often, elderly care arrangements in these families are different from those of the majority populations. in denmark, a growing number of immigrant families utilize an option in the social service act, under which municipalities can employ a relative to take care of an older family member at home. due to the special construction of this ‘self-appointed helper arrangement,’ the caregiver is both a professional care worker, formally employed by the municipality, and a close relative. as such, the arrangement provides a unique opportunity to examine ideas and practices of care at the intersection between the immigrant family and the state. based on data from interviews and observations among immigrant families (primarily the older adult and the self-appointed helper) and municipal care managers, we explore the consequences of this care scheme for the families, especially the self-appointed helpers. drawing on the concept of ‘lenticular subject positions,’ we show how self-appointed helpers in immigrant families and municipal care managers each adopt two different, often contradictory, perspectives or subject positions simultaneously. we argue that the self-appointed helper arrangement constitutes a gray zone in the danish public health care system, since both care managers and helpers seem to neglect the national legislation and standard procedures concerning public elderly care and care work environment. the consequences are most severe for the self-appointed helpers who end up being in the precarious margins of the danish labor market. keywords: : care, aging, welfare state, lenticular subject position, immigrant family, care manager, denmark. anthropology & aging, vol 42, no 1 (2021), pp. 112-128 issn 2374-2267 (online) doi 10.5195/aa.2021.279 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 112 between care and contract: aging muslim immigrants, self-appointed helpers and ambiguous belonging in the danish welfare state1 sara lei sparre mikkel rytter aarhus university aarhus university saraleisparre@cas.au.dk mikkel.rytter@cas.au.dk shirin2 is a 39-year-old woman employed by the municipality to take care of her sick 78-year-old mother, minal. together with the rest of their family, minal and shirin came to denmark as refugees from the middle east decades ago. due to a brain hemorrhage in 2012, minal is partly paralyzed, unable to speak, and needs care around the clock. shirin was a student when her mother fell seriously ill. divorced with no children, she decided to move into her mother’s apartment to be available to help her at all times. a municipal caseworker suggested that she could be employed as her mother’s self-appointed helper. since then, minal’s health has deteriorated. shirin currently works 21 hours a week all year round. apart from cleaning, her tasks include changing minal’s diapers, attending to her personal hygiene and nutrition, and lifting and moving her around the apartment. when shirin is not carrying out the duties prescribed in her job contract, she remains an affectionate daughter who cares for her ailing mother. in this article, we examine care arrangements like the one between shirin and minal. these “selfappointed helper arrangements” (in danish, selvudpeget hjælperordninger) are set out in section 94 of the social services act, under which an older adult in need of care can “appoint” a family member who is then employed by the municipality to take care of the person at home (serviceloven 2019). originally added in the late 1990s, section 94 was intended for the few older adults who had difficulties cooperating with local homecare units.3 however, our data shows that in major cities, the self-appointed helper arrangement is now used primarily by older immigrants, and their helpers tend to be women, such as wives, daughters, or daughters-in-law. the number of older immigrants who have been in denmark for decades is increasing dramatically. in 1990, the number of immigrants in denmark from outside europe and the anglo-saxon countries above the age of 60 was 4,500 (ældreforum 2013). as of april 2021, it is approximately 45,400 and according to prognoses, the number of older immigrants are expected to reach approximately 90,000 in 2030 and 132,000 in 2040 (statistics denmark 2021). many, like the families in our study, are refugees and labour migrants from muslim majority countries, such as pakistan, turkey, somalia, iraq and lebanon. like minal, older immigrants often do not make use of homecare services or nursing homes provided by the danish welfare state (mølgaard and lindblad 1995; mian 2007; wivel 2012). instead, cultural traditions and religious obligations encourage most families to take care of their older family members at home. many older immigrants, especially women, may have problems speaking and understanding danish, and in general, they often find it embarrassing and consider it a failure if their adult children do not take care of them (ismail 2021; rytter et al. 2021). the self-appointed helper arrangement thus provides an option for elderly care in these families as well as a unique opportunity for researchers to examine ideas and practices of care at the intersection of the immigrant family and the state. in order to understand the arrangement in its complexity, including sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 113 consequences on users’ care relations, we include the perspectives of both the self-appointed helpers in the families and the care managers (visitatorer) in the municipal elderly care administration. overall, we argue that self-appointed helpers and care managers each adopt two different, often contradictory, perspectives or subject positions simultaneously. as the short introduction of shirin and minal suggests, it is far from easy to navigate the roles and expectations of being both the caring daughter and the self-appointed helper employed by the municipality, and between the private domain of the family and the public domain of the welfare state. but also care managers sometimes struggle to balance their roles and responsibilities. while most care managers have a background as nurses, their primarily responsibility as care managers is to assess older citizens’ needs and make decisions about what specific services they can receive. hence, just as the self-appointed helpers are both family members and employees at the municipality, care managers are both representatives of the municipal administration subjected to legislation and organizational prerequisites, and trained as caregivers in the health sector. inspired by ghassan hage’s discussion of ‘lenticularity’ (hage 2015; sparre and galal 2018), we suggest the concept of ‘lenticular subject positions’ to capture the complex subject positions of self-appointed helpers and care managers. hage (2015) introduced the concept of lenticularity as a way to understand the ways that migrants embedded in transnational social fields often inhabit and are engaged in a ‘here’ and a ‘there’ (levitt and glick schiller 2004). like for hage (2015), our use of the concept is also inspired by the lenticular printing method, which makes it possible to show a set of alternate images that may appear to transform into each other. to grasp ‘lenticularity,’ you may think of the kind of rulers with colorful pictures sold in many tourist shops: when you move it up and down, you will see a picture in motion, e.g., a dolphin jumping above the water surface or the queen of england waving at you (just to give two random examples). the figure-ground of the picture changes depending on how the viewer is holding the ruler. by introducing the idea of ‘lenticular subject positions,’ we suggest a way to understand how both self-appointed helpers and care managers can (and have to) step in and out of different, and to some extent contradictory, frameworks that offer specific rationalities, logics, plots, and perspectives. the self-appointed helper is both a caring family member and an employed care worker, and the care manager is both a bureaucrat who insists on following the rules and someone who looks for pragmatic solutions to support care arrangements in immigrant families. as we will show, the lenticular subject positions of both the self-appointed helpers and the care managers are at the same time a result of and a precondition for making the care arrangement work. however, the arrangement also creates a situation where both care managers and helpers end up disregarding rules and legislations. in practice, the arrangement is a gray zone in public health care and welfare administration in denmark. care managers and helpers often enter into a kind of ‘silence agreement,’ where they overlook legislation and standard procedures. the consequences are most severe for self-appointed helpers who are subjected to a particular kind of ‘precarious inclusion’ in the labor market. for example, they receive very little further training, are not entitled to retirement benefits, and have no job security. this is similar to what has also been identified and discussed concerning undocumented migrants in the health sector (karlsen 2015) and refugees in contemporary integration programs (jørgensen and shapiro 2019; rytter and ghandchi 2020). the helpers are promised inclusion in the form of formal contracts with the municipality, but in practice, the care arrangement tends to result in further exclusion, vulnerability, and marginalization within the danish welfare state. sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 114 data collection and research strategies this article is based on data from our research project, aging immigrants and self-appointed helpers arrangement (aisha, 2017-2021), which explores implications of the self-appointed helper arrangement from the perspective of both immigrant families and danish municipalities.4 the study is designed as a collaboration between a group of researchers and two danish municipalities. the authors and the rest of the research group have conducted ethnographic interviews and participant observations among care managers in the municipal elderly care sector and in immigrant families with a self-appointed helper. the focus is on turkish and pakistani immigrant families that, for the most part, came to denmark as labor migrants in the late 1960s and 1970s and arab families that came as refugees in the 1990s and 2000s (cf. rytter 2013; liversage and jakobsen 2016; pedersen 2014). the data sample consists of interviews with 30 older adults and their self-appointed helpers. in this paper, we focus primarily on two cases: the case of 39-year-old shirin and her 78-year-old mother, minal, and the case of 55-year-old fatima and her 92-year-old husband, emin. we focus on these two cases because they are diverse among our family studies. specifically, with their different care relationships (daughter-mother and wife-husband, respectively) and the differences in the needs and abilities of the older family members. our data on these two families was governed by the health status of the older adult and the care resources. in many cases, as in the case of fatima and emin, we visited and interviewed both the older adult and the helper several times over a period of approximately six months; while in others, such as the case of shirin and minal, we only had access to the helper. in addition, we talked to and interviewed over 40 care managers in different danish municipalities, and we followed some of them in their work as ‘street-level bureaucrats’ (lipsky 1980) in their encounters with immigrant families. below, we meet vibeke, anna, and lene, who are among the care managers we followed for the duration of our fieldwork and conducted several interviews and observations of their work practice. finally, the data set includes a series of workshops in copenhagen and aarhus where we invited care managers and self-appointed helpers across danish municipalities to discuss our initial findings and possible solutions to improve the section 94 arrangement. focusing on everyday care routines, we explore the lenticular subject positions of the self-appointed helpers and how they navigate between being caring daughters or wives and employed care workers. along the way, we introduce the ambiguous position of care managers and how they do their best to administer the section 94 arrangement in a way that is meaningful to them. we end by discussing the implications of precarious inclusion and ambiguous belonging of self-appointed helpers in immigrant families in the danish welfare state. care and belonging across state-kinship relations anthropological studies of care tend to focus either on the dyadic relation between state and citizen (mol 2008; rinker, bataille, and ortiz 2020), or on kinship and practices within families, more or less detached from discussions of the state (thelen and alber 2018; thelen and coe 2019). care has been discussed as particular forms of work and as an aspect of unfolding life trajectories (alber and drotbohm 2015) or as an integral part of the ongoing production of relatedness, kin-work, and mutuality (buch 2015; zelizer 2005). other studies have discussed care as an aspect of intergenerational obligations in transnational family networks (baldassar 2014; coe 2011) or have critically observed that women from ‘the global south’ are filling in the care deficit of ‘the global north’ (hochchild 1995), e.g., in the guise of domestic workers (coe 2017), nurses (olwig 2015) or au pairs (dalgas and olwig 2015). when care and the state are discussed in relation to the family, it is often in the context of more or less creative state-based arrangements where care is sub-contracted to family members (forssell 2013; lan sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 115 2002; thelen, thiemann, and roth 2014) or from the perspective of the older adults themselves (ludvigsen 2016; mikkelsen 2017). however, it is important to pay more attention to how care practices and state regulations intersect and shape each other. thelen and alber argue for bringing the state back into the equation in discussions around family care, because “untangling this separation is fundamental to understanding contemporary processes of social organization, including boundary making that leads to diverse forms of marginalization” (2018, 1). we build on this body of work and examine how domains of the family and the state merge, with selfappointed helpers being forced to navigate between them. the helper, in a sense, comes to embody and personify the state in the midst of the family and thus, as we suggest, comes to inhabit a lenticular subject position. on the one hand, she is subject to ‘care scripts’ (coe 2017; oxlund 2018) that emphasize the cultural and religious rights and obligations of reciprocating care between generations within the family (moen 2008). the families in the study follow islam and hence care scripts are influenced by the quranic teachings and sunnah practices (see qureshi 2013; ismail 2021). almost all older adults and caregivers referred to islam when explaining why they preferred a self-appointed helper rather than using the municipal homecare service. a number of quranic verses (surahs) as well as accounts of the prophet muhammad’s words and actions (ahadith, singular: hadith) dictate the care responsibility that children have towards their parents. according to a famous hadith, “paradise is beneath her [the mother’s] feet” (sunan an-nasa'i 3104). muslims are asked to treat older family members, especially parents, with iḥsān, which implies “that priority must be given to the satisfaction of one’s parents over personal satisfaction and that of one’s spouse, children, and others” and that “obeying one’s parents unconditionally unless they command sinfulness” (ismael 2021). thus, islam understood as a ‘discursive tradition’ (asad 2009) provides a number of concrete instructions about elderly care, which taken together can be viewed as a ‘care script.’ on the other hand, the self-appointed helper is employed by the municipality and thereby subjected to current trends in elderly care such as a new public management time regime and documentation demands (vaaben and plotnikof 2019), workplace risk assessments, and expectations associated with active and healthy aging (hansen and kamp 2016; lamb 2017; lassen and andersen 2016; sparre and rytter 2019; rytter et al. 2021). in municipal homecare, the focus is very much on physical activity, and care workers are now expected to function more as trainers than carers (hansen and kamp 2016). thus, self-appointed helpers like shirin and fatima have to balance demands and expectations from both their family and state institutions (i.e. the municipality). similarly, state actors’ practices are shaped in a relational setting (thelen, vetters, and benda-beckmann 2014, 6) with several, sometimes conflicting, roles or demands (forssell 2013, 91). care managers are responsible for assessing needs and making sure that older people get the help that they need and are entitled to receive. on the one hand, they are “administrators, information officers and gatekeepers to the welfare state” (forssell, torres, and olaison 2015, 578) expected to follow legislation and objective standards as any other caseworker. on the other, they are trained health professionals who as (former) caregivers sometimes also express care and concern for the older citizens and their helpers.5 in this way, they also adopt an ambiguous position, where they either make standardized decisions with reference to legislation, formal rules, and procedures, or they accept solutions which tend to go against regulations in order to secure care for older adults at home. in addition, care managers have to straddle an ambivalent politicized field where kinship relations and care responsibilities in muslim immigrant families are sometimes presented as premodern and fundamentally ‘alien’ to danish practices and ways of life (andreassen 2007; hervik 2011; rytter 2019). sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 116 at the same time, policies all over scandinavia increasingly call for more involvement of family members in order to meet the demands of an aging population in need of care (ungerson 2003). self-appointed helpers and public elderly care in denmark, social services for older people are provided mainly by the 98 municipalities that are fully responsible for governance, provision, delivery, and financing of care (rostgaard 2012). people over the age of 65 who legally reside in denmark, temporarily or permanently, and are in need of help and support in daily life can apply for assistance (europa-kommisionen 2018). thus, like other nordic countries (forssell 2013), the overall responsibility of caring for older citizens rests with the state and not the family. citizens have the choice between municipal homecare, care provided by a private supplier financed by the state, or appointing a family member or friend as a personal helper, the selfappointed helper arrangement. self-appointed helpers are employed by the municipality. they are paid a monthly salary depending on the services they provide for their family members. these services are measured according to the regular homecare system: their time allocation equals what it would take a trained care worker to carry out similar tasks. services not provided by the homecare and services offered through external partners (such as laundry and grocery shopping) do not result in working hours for the helpers. consequently, most helpers are employed for 5-15 hours weekly. they are not entitled to retirement benefits, and, if the ageing family member recovers, is hospitalised or dies, helpers find themselves unemployed. in many municipalities, their salary stops immediately or within a few days. they also have to sign a contract saying that they are obliged to report their own sick days and holiday as well as any changes in the citizen’s health situation to the municipality. in return, municipalities are responsible for the helpers’ working environment and wellbeing. in the social service act (serviceloven), services are divided into “personal help and care” (personlig hjælp og pleje), “help or assistance for necessary practical domestic tasks” (hjælp eller støtte til nødvendige praktiske opgaver i hjemmet) and “food service” (madservice) (serviceloven 2019).6 care managers decide care services provided upon routinized systems of care, combining assessments of the citizen’s physical and mental abilities with set times allocated for each activity according to the municipality’s service catalogue, although they are also obliged to make each assessment individual. furthermore, in their calculations they have to consider the older citizen’s potential for regaining abilities as well as available human resources in the citizen’s own network (aspanil et al. 2016; hansen 2016; lassen and andersen 2016). thus, the final allocation also depends on whether or not the citizen and the helper live in the same household. if they do, the self-appointed helper is expected to do most of the cooking and cleaning as a family member and not as an employed care worker. as previously mentioned, shirin made the choice to take care of her mother, minal. she has been taking care of and living with minal since 2012. they share a social housing apartment at the outskirts of aarhus, denmark’s second largest city. minal does not speak danish, and following her brain hemorrhage, she has lost the ability to talk. she is unable to dress, shower, move around, clean, cook, or eat and drink. in short, she needs help with every part of daily life. shirin is employed by the municipality 21 hours a week to help minal. according to a detailed time-management scheme, time is allocated to her for tasks related to practical help and personal assistance and hygiene. however, shirin is not obliged to report her actual working hours, because her monthly salary is fixed, unless minal’s care gets reassessed. her seven days a week are structured in the following way: sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 117 time of day activities time allocated (minutes) morning mobility (getting up, moving from bed to wheelchair, etc.) personal hygiene (bathing, changing diaper, dressing, etc.) preparing food nutrition (feeding) 20 40 20 10 daytime mobility (moving around in the apartment etc.) excretion (changing diaper etc.) preparing food nutrition (feeding) 13 15 5 10 evening preparing food nutrition (feeding) personal hygiene mobility (moving from wheelchair to bed) 10 4 10 3 night excretion (changing etc.) 16 every 2nd week cleaning (mother’s bedroom and bathroom) 48 daily average 179.43 min. = 2.99 hrs. the way shirin’s days and weeks are divided into small bits and pieces of care work and practical tasks reflects a more general trend of new public management and time regulation among care workers in the public sector (vaaben and plotnikof 2019). in homecare units, tasks are organized into what is referred to as ‘point visits’ (punktbesøg), which are the number of visits that older people receive during the day from different care workers during eight-hour shifts. care workers from the homecare would thus have to come to minal’s house three to four times a day for between 16 minutes and 90 minutes. yet, minal is too ill to be left alone. if she had been the responsibility of the homecare unit, the municipality would probably have referred her to a nursing home. shirin, however, obliges minal’s wish to not be left to strangers with whom she is unable to communicate. shirin does not think of her time with her mother as split between family care and contracted care work. nevertheless, there are time slots during the day (and night) when she is formally at work. not only is her time divided between work and spare time, but the physical space of the apartment is also divided. the toilet and her mother’s bedroom are included in shirin’s work contract and have to be cleaned for 48 minutes biweekly, while the rest of the apartment is cleaned by shirin as a family member, when she is not ‘at work.’ but how are the system and the rules understood and practiced among self-appointed helpers and their families? and how do care managers administer and follow up on care provision and the work environment in immigrant families with a section 94 arrangement? in the following, we examine shirin and fatima’s care work in relation to food and personal hygiene and how it is approached and administered by care managers. food and feeding: contradicting demands and expectations care managers allocate services according to the older adult’s mental and physical abilities, and they are obliged to look into potentials for improvement in these abilities.7 in activities related to food and nutrition, tasks are divided into “personal assistance and care,” on the one hand, and “practical assistance,” on the other. serving food is a practical task, but the consumption of food (e.g., feeding) is classified as personal assistance. if the helper and the older adult live together, the helper only receives payment for personal assistance tasks. vibeke, one of the care managers, admitted that “the distinction sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 118 between the two is a bit vague because some might eat some meals themselves, while they need help for others.” the case of 92-year-old emin and his wife and helper, fatima, illustrates how some meals are the responsibility of his self-appointed helper, while others are not. it also illustrates the challenge of applying the logic of regular homecare in families with a self-appointed helper. like other labor migrants from turkey, emin came to denmark in the late 1960s (liversage and jakobsen 2016). a couple of years later, his first wife and two sons came to denmark on family reunification. their two daughters were already married and therefore remained in turkey. however, in the late 1980s, emin’s first wife suddenly passed away, and instead he married fatima, who was in her late 20s when she in 1992 came to denmark. fatima is illiterate and from a poor family in the same district in turkey as emin. in turkey, she was married and divorced at a young age, so a second marriage in denmark was a good opportunity despite the age difference between her and her new husband. today, fatima is in her 50s and employed as emin’s helper nine hours a week. emin suffers from kidney disease and has to go to the hospital for dialysis three times a week. he also needs to be careful about his diet. on top of this, he is affected by dementia, has impaired hearing, and limited balance and walking abilities. he needs assistance during meals and in almost all activities related to dressing and personal hygiene. fatima has never learned to speak danish properly, and emin and fatima have no children together. officially, she has been employed as his helper for about two years, but she has been assisting emin for more than four years, during and in between her shorter and longer periods of factory work, cleaning jobs, and job training. while emin is a respected man who sometimes provide financial help to poor families in his village of origin, emin and fatima live in a social housing apartment and are sometimes struggling to make ends meet, especially if they want to afford summer vacation in turkey. their only steady income is his public pension and her part-time salary. when fatima was still working, different municipal care workers (hjemmehjælpere) came to the house to assist emin, but after a few visits, he cancelled the arrangement. emin did not want anyone but his wife to see him naked (a reservation among immigrant families informed by specific moral-cultural codes that we discuss in a subsequent section in this paper). he also had bad experiences with the food: “some arab [care worker] made stupid food . . . bread with cream cheese and unfried sausage!” after that, fatima started preparing his food, and two years ago, she became his helper. in fact, it was her caseworker (sagsbehandler) at the job center who suggested the arrangement. fatima was unemployed and had difficulties holding on to jobs outside of the house due to her care responsibilities. recently, fatima asked for a reassessment because the care work demanded more of her. many of the other helpers we followed pointed out that the municipal time allocation signaled the lack of recognition of the huge amount of care work they carried out. anahita, another self-appointed helper with immigrant background who cares for her blind husband said: “the responsibility you have as a selfappointed helper is really huge, and the municipality allocates far too few hours taking into consideration the kind of work we actually carry out and the hours we spend on this.” some helpers, like fatima, tried to get a reassessment, but most other helpers accepted the conditions. in fact, many are happy that this kind of arrangement exists. it gives them some kind of financial compensation and an opportunity to meet the expectations of their older family members who wish to have them carry out the care work themselves. while fatima does get some rest and time for herself when one of emin’s sons takes him to the hospital for dialysis, the nine hours she is employed a week do not come close to covering the time she spends sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 119 assisting her husband. during the reassessment meeting at the couple’s apartment, the care manager, anna, asked about the meals. fatima answered that she prepares all her husband’s meals and sometimes even feeds him. she also gets up at night if emin is thirsty. fatima seemed to be aware that emin is supposed to do as much as possible himself. anna stressed that it is very important for emin to help himself if he wants to maintain his physical abilities. at some point during the meeting, emin’s daughter-in-law, who was also present, served tea. immediately, fatima poured tea for emin, added sugar and stirred. anna, the care manager, stopped her: “we just talked about you doing less for him, and yet, now you are stirring his tea!” as this incident illustrates, it can be a challenge to think and work in a supportive (støttende) but not compensatory (kompenserende) way. in general, care managers often see that rehabilitation of older adults is a problem in families with a self-appointed helper and even more so in immigrant families. according to care manager helle, “the focus on rehabilitation is almost non-existent. there are very few. i might have met a couple [of helpers] where i sensed that the daughter had a focus on this, but no, it is virtually non-existent.” thus, despite the fact that all state-funded elderly care is expected to be provided according to the current paradigm of healthy aging where the caregivers help older adults help themselves (lamb 2017; ludvigsen 2016; mikkelsen 2017), this is often not the case in families with a self-appointed helper, and care managers have very limited ways to ensure this. many muslim immigrants, e.g. from the middle east, are raised in a context where getting old means that you are entitled to care and support from your children (cf. moen 2008; ismail 2021; liversage and jakobsen 2016). while many older ethnic majority danes are motivated for rehabilitation by prospects of maintaining their abilities and retaining their independence, especially independence from their own family (christensen 2020; hansen et al. 2015), emin and many of the other older immigrants in our study do not have the same aspirations of independence and mobility. care managers do comment on this during reassessments, but they also quietly accept that this is how care is provided in many of the immigrant families.8 only the appointed helper must provide the care according to section 94, only the person employed and approved as self-appointed helper by the municipality is allowed to carry out the tasks. minal is paralyzed and rarely leaves her bed. she also needs special food. shirin is allocated a certain number of hours for “the practical task” of preparing the food and “the personal assistance task” of feeding her mother – a total of 59 minutes per day. however, the bureaucratic logic makes very little sense for shirin as she rarely leaves her mother. when shirin needs to go to the grocery store or has an appointment outside the home, she asks her sister or brother to look after their mother. her sister lives with her husband and children in a town one hour away and often visits her mother and shirin on weekends. her brother lives close by and visits them on a regular basis. although the siblings, according to shirin, have difficulties understanding minal, who is unable to speak, they do prepare food and feed her if shirin is not there. they also sometimes carry out other assigned tasks. this, however, violates shirin’s contract with the municipality. only the person employed and approved by the municipality is allowed to carry out services paid for by the state. thus, even though shirin’s siblings are not paid for their help, they cannot provide assistance if it relates to the tasks assigned to shirin. however, in cases such as minal’s, where the tasks are many and have to be performed in the morning, during the day, in the evening, and at night seven days a week, most helpers only manage the tasks with help from other relatives (cf. ismail 2021; rytter et al. 2021). the care managers suspect that tasks are sometimes distributed between family members, and even though this violates the contract, they seem to quietly accept this. as vibeke explained: “well, we do not go to the homes of older citizens to observe what is going on without making a prior appointment – so we don’t really know whether it is ahmed who takes care of his mother or if it is his wife. there is no control.” sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 120 nurses from the municipality have suggested that minal should be given a tube-feeding formula because she cannot swallow food correctly. yet, she has refused the offer, and despite the risk of choking, shirin continues to feed her mother. from one perspective, this situation could be viewed as neglect of care. however, instead of dismissing shirin as a self-appointed helper because the municipality cannot guarantee minal’s safety, the care manager has accepted the family’s decision without further objections. the only alternative would be to lose contact with minal altogether. the care manager, lene, said this about this general dilemma: “we have had many immigrant families where we’ve thought that the older citizen would actually have benefited from living at a nursing home. but they don’t do that, even though the task of caring is in fact too comprehensive, right?” naked bodies and personal hygiene: differing care scripts muslims in general attach great importance to filial piety, and it is often considered shameful to assign elderly care to professionals outside the family (ismail 2021). in addition, many older muslim immigrants prefer the caregiver to be a close family member because they do not want ‘strangers’ to see them naked. according to dominant religious and cultural moralities, a person’s awra (intimate parts of the body) are considered private and to be revealed only to close kin such as spouses, sons, daughters, and daughters-in-law (ismail 2021). as we have observed in our study, different families have different priorities. some older men prefer their sons to help them, while older women often ask their daughters. it is also common that daughters-in-law provide this kind of care in the patrilocal household. older muslims might also have specific requests regarding washing and intimate hygiene such as daily showers and washing before prayer. emin and minal have similar requests, and neither of them wants strangers to see them naked. these ideas, however, go against the logic of state policies. unlike activities related to food and cleaning, the personal hygiene of older adults with reduced abilities is the responsibility of the state and not the family. according to care managers, you cannot expect family members to take responsibility for such intimate tasks. “that is exactly why we [the municipality] offer help, so that husband and wife can continue to be husband and wife,” as another care manager explained. in contrast to many other nationalities (both european and non-european), most ethnic majority danes prefer a professional care worker to assist them with intimate hygiene, because they do not want to burden their children (christensen 2020; oxlund, grøn, and bregnbæk 2019). as such, the ideals and norms originating in what can be termed an islamic care script differ significantly from the care script prescribed by the danish welfare state and common practice in many ethnic majority families. here, the more intimate parts of an older person in need of care becomes the domain of the state. in families with a section 94 arrangement, the helper thus receives payment for all activities related to personal hygiene, and the state has the overall responsibility for the provision and quality of the care. for this reason, the municipality is also responsible for the work environment of self-appointed helpers who carry out such tasks. of the 184 minutes shirin is employed daily, 117 minutes are spent on physical demanding “personal help and care”, including relocating her mother from the bed to the wheelchair, helping her move around in the apartment, changing her diapers, and assisting her with personal hygiene. most of the nine hours fatima is employed are assigned for similar tasks. it is therefore crucial that helpers are physically capable of supporting and relocating older family members. care managers must ensure that they do not have physical problems or limitations when they are employed as selfappointed helpers. they take this responsibility very seriously, both for the sake of the helpers and because the municipality might risk extra expenses due to compensation and sick leave if the helpers hurt their knees, shoulders, or back. sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 121 care managers, along with physiotherapists and occupational therapists, do their best to teach newly employed self-appointed helpers how to assist their older family members in an ergonomically correct way so they can protect their own bodies. however, the older adult might already be used to and might expect a certain way of receiving care. emin’s immediate answer to the care manager’s question of how much his family does to help him is clearly illustrative: “my family brings me sandwiches and other things, and if i ask them to stir my tea, they do so!” some helpers do try to assist in a supportive and non-compensatory way, but their attempts are often not appreciated by their older family members. unlike among older citizens born and raised in denmark (christensen 2020, 156), these older immigrant adults are not to the same extent concerned to become a burden to especially younger family members. in contrast to majority danes, older immigrants do not seem to connect notions of personal dignity with independence and “fending for oneself” (christensen 2020, 31). thus, in order treat their older family members with iḥsān and thus live up to the islamic care script, fatima and other self-appointed helpers in muslim immigrant families often end up providing help and care which conflict with the municipality’s approach of active aging and help to self-help. again, the care managers are aware of the problem: “sometimes they get squeezed between what the citizen (borgeren) would like them to do and what they are actually contracted to do,” as lene expressed it. however, care managers also do not have the time and resources to regularly follow up on work environment matters. as vibeke explained: one of the things we discuss a lot is work environment. and i must say that we’re not doing it properly. […] we need to make other rules for these things, how we do it – follow-up meetings and further instructions if we sense that something is not right. i have, for example, been in a turkish family where the daughter injured her back. even though we instructed her not to do this and instead do that, she just lifted! and in principle, she is employed by us, right, as to insurance and things like that. it’s difficult. care managers provide follow-up assessments of the care received by the older person but usually only once a year.9 such meetings allow just a glimpse of the actual practices in the home. most care managers interviewed for this research admitted to be pragmatic in this regard. despite their worries and concerns about the wellbeing of the self-appointed helper, lene, among others, admitted that sometimes she “compromises [on the safety of the self-appointed helper] although this is not the right thing to do.” of course, not all helpers ignore the advice they are given, and many do take care of their bodies. however, in practice the municipality does not have the resources and organizational structures to control this. unfortunately, work accidents can happen, but the self-appointed helpers rarely inform their care manager about their injuries and physical problems. many of the helpers we talked to complained about pain in their neck, back, and arms. fatima, for example, at some point sustained a slipped disc in her back. but none of those we talked to ever reported work-related injuries to the municipality. thus, although self-appointed helpers must abide by the standard rules and procedures for the physical work environment and the municipality must ensure that this is also the case, the reality in many families with this arrangement is different. many helpers employ inexpedient work postures due to both entrenched habits and apartments not designed for older people in need of heavy and physically demanding care work. the self-appointed helpers do not complain about their working conditions to their employers – maybe because they essentially see their care work as a private matter and task for the family rather than as a job for the municipality. since no one complains, there are no incentives for the care managers to make further inquiries. sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 122 conclusion in this article, we have presented and discussed the self-appointed helper arrangement in danish municipalities from the perspective of both self-appointed helpers and municipal care managers. the arrangement provides an option for elderly care among older immigrants who do not want to make use of public homecare services or nursing homes. within the field of anthropology and aging, it provides a unique opportunity to examine ideas and practices of care at the intersection of the immigrant family and the state. we have primarily focused on two immigrant families: shirin, who is self-appointed helper of her mother, minal, and fatima, who is the helper of her much older husband, emin. their experiences and perspectives have been discussed in relation to the understanding of the three municipal care managers. we utilized the concept of ‘lenticular subject positions’ (hage, 2015) to capture situations in which selfappointed helpers as well as care managers step in and out of different and to some extent contradictory frameworks that offer specific rationalities, logics, plots and perspectives. positioned at the intersection of family and state, we find that the self-appointed helper is often forced to balance different demands and expectations in her care work. she is split between being employed care worker and a caring family member (spouse, daughter, and daughter-in-law) that help her aging relative out of love, respect and care. similarly, the care manager find herself caught in the push and pull of the legislative frameworks, economic restraints, and municipal decisions, as well as the care and empathy that she as health professional have towards both the older citizens and their caregivers. the care manager alternate between being a health administrator who insists on following the rules, and someone who looks for pragmatic solutions to support care arrangements in immigrant families. due to increasingly stricter laws and regulations regarding homecare assistance and work environment, the requirements of the arrangement have become impossible to live up to for both care managers and self-appointed helpers. consequently, care managers often end up disregarding rules because they have no other solution at hand. they observe and assess care work, which does not comply with the legislative guidelines, and in many cases, they turn a blind eye to it. some justified this by saying that the self-appointed helper arrangement is the only way to provide some kind of care assistance to families who otherwise refrain from using public facilities for elderly care. others talked about aging immigrants as having less need for state resources because they “‘still’ have kin support” (thelen and coe 2019, 290). also, the self-appointed helpers more or less deliberately disregard the rules. they hand over tasks to other family members, and few live up to the demands of rehabilitation and ergonomically correct working positions. just like the care managers, they end up breaking the rules because they are impossible to live up to. we maintain that the notion of lenticular subject position allows us to acknowledge the tensions associated with care work under the current care regimes. as discussed in this paper, we show that both self-appointed helpers as well as care managers are caught up in a lenticular subject position as both a caring family member and an employed care worker with simultaneously different, often conflicting demands and expectations. thus, in practice, care managers and self-appointed helpers enter into a form of ‘silence agreement’ where both parties refrain from asking questions that they do not want to know the answer to. another, more structural, dimension of the lenticular subject positions is the general relationship between the self-appointed helper and the state. the arrangement promotes a particular kind of precarious inclusion of the helpers in the danish labor market. anthropologist, marry-anne karlsen (2015) introduced the concept “precarious inclusion” to discuss how undocumented migrants in sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 123 norway, despite their legal status, have access to different kinds of health care services. the undocumented migrants are legally placed outside the scope of welfare legislation, while at the same time humanitarian exceptions are built into the system to relieve tensions between the welfare state’s commitment to basic security and immigration law enforcement. similarly, mikkel rytter and narges ghandchi (2020) demonstrate how afghan refugees in mandatory three-year integration programs in danish municipalities are sent into internships at private companies, only to regretfully realize that at the end of one internship the next one awaits. their inclusion in the labor market is at best insecure and precarious. in this article, we show how immigrant women who, like shirin and fatima, become self-appointed helpers are subject to a similar kind of precarious inclusion in the labor market and thus are subject to an ambiguous belonging in the welfare state in general. several years of employment have heavily impacted their lives, wellbeing, and future prospects. as self-appointed helpers, they are included in the labor market as a (special kind of) care worker, but at the same time, they are not really included. they are required to be available around the clock seven days a week, but they never meet any colleagues, and they have little (if any) contact with the municipality. they are not required to have any formal qualifications and, apart from instructions in basic hygiene and lifting techniques, they do not receive any further education or training. this means that they have no new formal qualifications to put on a resume when their contract ends. if the aging family member recovers (an occurrence that is highly unlikely), is hospitalized, or dies, the self-appointed helper is often left without a job. in fact, in many municipalities, the self-appointed helper stops receiving salary immediately or within a few days. given that these helpers have no economic insurance and no or limited formal education, their employment opportunities remain stifled. however, the helpers are to some extent complicit, since they rarely complain about their situation. this lack of willingness or inability “to make claims to reciprocal exchanges” is both an indication and a precondition of their ambiguous belonging to the welfare state (thelen and coe 2017, 287). still, in the near future, the danish welfare state will have to come up with new models of welfare innovation to secure equal access to “care with dignity”10 like that of the danish majority citizen for the growing number of older immigrants and refugees. these models might build on a reconfigured arrangement involving the self-appointed helper, yet an arrangement where employment conditions and working environment are comparable to that of care workers in the municipal home care. overall, we suggest that municipalities take their employer responsibility more seriously by offering e.g. yearly staff development interviews and formal skill development courses, and that they take steps to improve physical and social working environments for self-appointed helpers in private homes.11 notes 1 this work is supported by the velux foundation’s humpraxis programme under funding number 13472. the first draft of the paper was presented at the 2018 imiscoe annual conference, 2-4 july 2018 in barcelona, in the panel “older migrants, segmented life courses and social welfare” organized by marion repetti and ruxandra oana ciobanu. we were grateful for this opportunity to discuss our work. we also want to thank anika liversage and abir m. ismail and two anonymous reviewers for input and constructive comments and suggestions. 2 all names have been changed in order to protect the right to anonymity of our interlocutors. 3 personal communication, danish ministry of health, may 2018. sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 124 4 in denmark, public elderly care is regularly subject to changes. for example, new recommendations by the independent state appeals board (ankestyrelsen) have recently resulted in adjustments of the procedures for assessing needs and allocating time for older citizens with a section 94 arrangement. this article is based on data on how the arrangement was practiced and administered by danish municipalities in 2017-2019. 5 in another paper, sparre (2021) demonstrates how care managers slip in and out of their roles as health professionals, administrators and morally concerned citizens in encounters with young female caregivers with an immigrant background in particular. she shows how female health professionals and ethnic majority women tend to care for young self-appointed helpers as ‘sisters’ or ‘daughters’ in the nation and thus sometimes taking drastic decisions to protect and ‘save’ them from care work in the family. 6 https://www.retsinformation.dk/eli/lta/2019/798, accessed 22 february 2021. 7 the process is usually termed ‘reablement’ (rehabiliteringsforløb) and is a form of rehabilitation, more specifically – “a time-limited, person-centred, home-based intervention for older people who are at risk of functional decline” (aspiral et al. 2016: 574). reablement is very much in line with the paradigm of active and healthy aging. in denmark, it is regulated by section 83a (‘et korterevarende og tidsafgrænset rehabiliteringsforløb’) in the social service act. care managers in danish municipalities are obliged to consider reablement for all older citizens, including those with a self-appointed helper. 8 municipalities are obliged to follow up on section 94 arrangements once a year. a new assessment might result in an adjustment of the time allocation due to change in the abilities of the older citizen concerned. we only heard of very few cases in which a care manager, after a follow-up meeting, decided to dismiss a self-appointed helper due to neglect of care or deliberate violations of the employment contract with the municipality. 9 usually, care managers have case responsibility and follow the same older citizens and self-appointed helpers as long as these arrangements last. however, their managers and colleagues are often involved in major decisions regarding the services that are offered or declined. 10 danish ministry of health, https://www.sst.dk/da/opgaver/videnscenter-for-vaerdig-aeldrepleje, accessed 19 april 2021. 11 based on the insights from the aisha project, we recommend the following improvements of the section 94 arrangement: 1) municipalities should treat self-appointed helpers like any other employee group in the organization, for example by offering yearly staff development interviews. helpers would then have an opportunity to review their tasks and work-life balance as well as a chance to discuss possibilities for further training and work opportunities in the municipality once their older family member has passed away. 2) it would benefit both the helper and the municipality if the self-appointed helpers attended mandatory, formal skill development courses in e.g. lifting and moving people, first aid, and signs of pressure sores and infection, and if they received a certificate on completion of such courses. this would ensure that older citizens received a care standard closer to that required in regular homecare, and the helpers would have proof of their skills and experience if they wish to continue working within the health and care sector. 3) self-appointed helpers would also benefit greatly from improved physical and social working environments in private homes. in order to ensure that helpers assist older citizens in an ergonomically correct way, prescribed tools and facilities should be an indispensable rule and not something the helper should have to discuss with the older citizen or any other family member. furthermore, municipalities should support self-appointed helpers in their need to take time off on a regular basis by employing two rather than one helper. the two helpers might sparre & rytter | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.279 http://anthro-age.pitt.edu 125 share the tasks, or the second helper could be an 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minoriteter i københavns kommunes ældrepleje.’ tidsskriftet gerontologi 28 (1): 8-11. zelizer, viviana z. 2005. the purchase of intimacy. princeton university press princeton, nj. ældreforum 2013. ældre med anden etnisk baggrund – viden og inspiration til indsats. ældreforum, odense. intro_finaldoc energy and aging in the danish welfare state ethnographic explorations of an omnipresent but forgotten concept henrik hvenegaard mikkelsen, nete schwennesen, and aske juul lassen university of copenhagen keywords: policy; old age; energy; conversion; welfare state anthropology & aging, vol 40, no 2 (2019), pp. 1-9 issn 2374-2267 (online) doi 10.5195/aa.2019.235 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 1 energy and aging in the danish welfare state ethnographic explorations of an omnipresent but forgotten concept henrik hvenegaard mikkelsen, nete schwennesen, and aske juul lassen university of copenhagen in what ways can the concept of energy stimulate anthropological research on the relationship between aging and the state? this is the key question addressed by this special issue of anthropology & aging. during the last twenty years, the relationship between “the state” and its older citizens in the global north has radically changed. whereas the relationship was previously characterized by a paternalistic state, responsible for delivering care to its older citizens in need, the state today encompasses the vision of molding and transforming its older citizens through “active aging” policy programs (lassen and moreira 2014). while the programs addressed in this issue are specific to the danish welfare state, the overall idea of empowering qualifiers of the aging process (successful, healthy, positive, creative, productive), and policies addressing them, is global, but with many different local adaptations (see lamb 2017). this overall shift in policy is characterized by a movement from a “needs-based” approach, which assumes that older people are passive targets, towards a “rights-based” approach, which encourages choice, individual responsibility, and participation (who 2002). while this change has led to a plethora of initiatives and policies focused on empowerment, participation, and independency, it has also reinforced new understandings of aging and old age (lassen and andersen 2016; otto 2013). amongst these, old age is no longer understood solely as a period of life wherein energy fades. rather, through the proliferation of programs grounded in neoliberal policy, old age is constructed optimistically as a phase of life where citizens are encouraged to realize their potentials (mikkelsen 2017): it is a period potentially bursting with energy, which can be activated through government interventions. meanwhile, critics have argued that such a “neoliberalization” extends ideals of productivity into old age and invokes a positive/negative binarism with activity and social engagement as “positive” and dependency and illness and loneliness as “negative” (katz 2013; macnicol 2015; minkler and holstein 2008). in this way, the complex relationship between dependency and independency is neglected, while at the same time passivity and stagnation is pathologized (katz 2000; mikkelsen 2016). in this image of the neoliberalization of old age, the state is portrayed as a disciplining force, which—although in subtle ways— shapes its citizens to act in particular ways. with this background, our goal with this special issue is two-fold. first, we wish to shed light on the way ideas of energy permeate the everyday lives of older people in denmark and the policy discourses and practices surrounding them. this focus enables us to tell a story of the scandinavian welfare states, based on their endeavor to energize their populations. our aim is to explore the underlying conditions within the danish welfare state where energy emerges as a meaningful emic concept. as a conceptual device, energy enables people to talk about or imagine the invisible forces that govern and prompt action. but, it also indexes the relationship between distinct material agents such as food, the body, technologies, or other material entities and non-substantial phenomena such as sleep and notions of well-being. yet, the aim of the special issue extends well beyond the danish context. our second objective is to develop energy as an analytical device. energy, we believe, offers us a novel framework for moving beyond the dualistic images of “old age” and “the state,” since using energy as an analytic lens allows us to explore mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 2 the dynamic relationship between the two. we suggest that states, like heat or waves, can be considered as phenomena that may transfer energy from one form to another. just as heat energy is decided by the difference in temperature between two interacting objects, the transformation of aging bodies emerges as an ongoing and shifting form of movement and interaction in governmental interventions. by using energy as our analytical lens, we become able to shift attention from static and discrete entities such as “aging bodies” or “the state,” to “analogue interrelations” (hastrup 2014) between entangled phenomena. we argue that the concept of energy is well suited to understanding the transformative relationship between “old age” and “the state” without dichotomizing them, and without presupposing that the force of transformation can be located in one of the entities. moreover, the concept of energy allows us to study processes of transformation as constituted by a multitude of factors, such as inner bodily experience, bodily intake of food, relational encounters, or interaction with material or environmental surroundings. our ambition is to offer a more dynamic and nuanced analysis of the relation between elderly people and the state, as it plays out in the current paradigm of “active aging”—an analysis that does not entail a dualism between activity and passivity, and dependency and interdependency or a simultaneous moralizing judgment on how to age well. we suggest that anthropologists should engage with the concept of energy as it serves as a central, yet unexplored, concept in public health interventions, medical practices, the antiaging industry, everyday life, and in the life sciences. energy among disciplinary fields as a conceptual apparatus, energy does complex work. first, the concept of energy can slide across different registers and circulate among everyday lives, industry, media, politics, and scientific disciplines. it is a source of power, heating our houses, fueling our cars, and powering our laptops. it is also a source of power generated in mitochondria within our bodies, which enables us to function. it is in the food we eat and it is something that we share, give to each other, and/or receive from divine agencies. it is also something we can experience—typically as a lack in early mornings, after lunch, or when we age, or as plenty when we are in love or when we do something we enjoy. energy is all these things, and more, and its meanings tend to shift from situation to situation. sometimes it is something we can store, at other times it is ephemeral and on the move. it slides, shifts, and transforms. thus, as a concept, energy is “slippery” (lien and law 2012) in the sense that it refers to a wide array of both intersecting and disparate phenomena. even within specialized fields such as physics, one may encounter kinetic energy (stuff moving), thermal energy (warm stuff), potential energy, and so on. and if we broaden the scope we quickly realize the extent to which energy has come to dominate a variety of discourses beyond the academic disciplines. within the social sciences the concept of energy has the double character of being both greatly undertheorized, while simultaneously figuring within much writing. in fields such as public health and social gerontology, energy permeates invisible powers such as vitality, vigor, or life force. however, it appears that the theoretical engagements with the concept have, largely, been left to other disciplines. yet, energy extends far beyond the realm of physics and may be found to describe both elementary molecular relationships and the structure of the cosmos, passing by way of therapeutic concepts of the body and cultural concepts of the soul. this is a metaphysics of movement and order that can be traced through all cosmic levels. judging from the multitudes of contexts in which the concept of energy emerges, it appears as if energy saturates every aspect of our lives. and it would, then, make sense that the human and social sciences picked up the concept—as we do in this special issue. the textbook understanding of energy states that energy cannot be created or destroyed but only transformed. in such transformation heat is the end product. energy is thereby related to a particular mode mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 3 in which something exists or is experienced or expressed. however, even within the field of physics, scientists disagree on whether energy should be considered a real and objective trait of reality or mainly an analytically useful mathematical fiction (cf. mcginn 2011, 174). even in the famous equation of relativity, e=mc2, proposed by einstein, it is not clear what energy is. while the laws of its manifestations are well known, there exists no positive descriptive conception of energy. thus, physicists have struggled with answering the following question: when an object possesses a supposed quantity of energy, how does it differ from another that lacks that energy? in other words, when energy is attributed to a system, then what exactly is it that is attributed? the answer seems to be that rather than seeing energy as a substance, it should be regarded as a conceptual and methodological tool that may be used to, among other things, account mathematically for the relations between distant objects (ibid., 166) and to study the ways things convert or transform (coelho 2009). based on such discussions of energy as an ontological vis-à-vis an epistemological category, it is useful to follow the concept’s trajectory into other discourses. for instance, the concept of energy figured prominently within early psychoanalysis. sigmund freud stated that the libido was the driving force of all behavior—the libido described the surplus energy created by human instincts (zupančič 2008, 21). this was later rejected by jacques lacan who believed that energy as a scientific concept could not be transmitted to the area of the human psyche: because energy is not a substance, which, for example, improves or goes sour with age; it is a numerical constant that a physicist has to find in his [sic] calculations, so as to be able to work [...] each and every physicist knows clearly, that is to say, in a readily articulated manner, that energy is nothing other than the numerical value of a constant. now what freud articulates as a primary process in the unconscious [...] isn't something to be numerically expressed [...] (1990, 18). yet, in spite of lacan’s critical comment about the misuse of the concept of energy beyond the realm of physics, it seems clear that there has been an ongoing exchange of ideas between western scientific discourse and numerous other fields—an exchange which, from an ethnographic perspective, should not be ignored. for instance, the influential japanese zen buddhist d.t. suzuki (1870-1966) applied the concept of energy in his promotion of zen in europe. through his lectures, journals, and translations of zen texts, he presented zen as a core wisdom disembodied from the religious framework in which it had originally been developed. thereby he caught the attention of the prominent figures within the psychoanalytic movement, such as jung and erich fromm, whose ideas resonated with suzuki’s statement: “zen liberates all energies properly and naturally stored in each of us, which are in ordinary circumstances cramped and distorted so that they find no adequate channel for activity” (1956, 3, emphasis added). within the field of anthropology, the attention to energy can be traced back to leslie white who saw energy as a critical element in understanding cultural evolution. he believed that paying attention to how societies become progressively more effiencient in controlling energy would offer a scientific standard for measuring the progress towards increasing social and cultural complexity. this led him to formulate his famous dictum: “[culture] evolves as the amount of energy harnessed per capita per year is increased, or as the efficiency of the instrumental means of putting the energy to work is increased” (white 1959, 56). while the concept has been largely abandoned for decades within the discipline, it has recently resurfaced as anthropologists have attempted to understand the influence of culture and social organization in relation to energy use and production, responses to energy crises, cultural ideas of progress and equity, and struggles for natural resources (strauss, rupp, and love 2013). mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 4 in contrast to such approaches, which attempt to adopt a “scientific” notion of energy, the underlying idea that guides our approach is that while the scientific energy paradigm accounts for physical phenomena such as electricity and heat transfer, it dismisses other less tangible ones, that is, those that are not quantifiable or measurable according to the standards of western science. we consider it crucial to recognize that energy has come to form a relationship between scientific and popular consciousness. this relationship is bilateral in the sense that while scientific discourse today permeates the everyday vocabulary beyond university, the layperson’s understanding of energy also feeds back into academia and may affect the ways in which scientific researchers talk about energy. this insight is important since it makes us aware of the fact that energy cannot be isolated as a stable, analytical concept. rather, as an invisible force, energy becomes meaningful to people within the immediate social and cultural context of their lives and is often understood and explained through a multitude of coexistent, overlapping theories and ideas (rupp 2013). being constantly applied to new contexts, energy as a concept undergoes an evolution of meaning. arguably, this elusiveness of the concept in combination with people’s subjective, bodily familiarity with (especially a lack of) energy has enabled the concept to traverse a broad range of fields, including the danish welfare state, as we discuss in the following section. the danish context the contributions to this special issue derive from research conducted in the danish research institution center for healthy aging. as such, the closely-knit danish welfare state is the broader frame of the aging lives and the interventions explored. this ethnographic context is particular in terms of the close relations and trust between citizen and state and the public funding used to form processes of aging (lassen and jespersen 2017; nørtoft 2013). but the insights generated from this specific national context tell a more general tale about the “new old age” as a period of life with immense moral, political and economic, interests attached to it and how “energizing old age” is both a political ambition and a subjective endeavor of the older citizens. said to be the happiest country on earth in a range of quasi-scientific international happiness surveys, denmark is a welfare state in the scandinavian tradition. this entails high taxes on income and trade on the one hand, and universal welfare services such as public school, public education, social services, unemployment benefits, retirement benefits, and healthcare on the other (jöhncke 2007). this relation between state and citizen also entails that very few older people live with their children, and that home care is provided by the municipalities rather than by the family, but that the family is still generally involved in the lives of their older relatives (stuart and hansen 2009). the rise of the danish welfare state can be seen as a response to the international politics and specific conditions of mid-20th-century europe. when europe was re-constructed after the second world war, the welfare state was enabled by both international economic aid (the marshall plan) and two decades of economic boom in europe, as well as a national endeavor to defend itself from potential outside forces through a coherent society. a part of this endeavor is the idea that the state needs to intervene actively in the lives of its citizens, specifically in the social, health, and educational spheres, in order to promote the collective interests of all social groups. one of the key ideals promoted by the welfare state is equality, economic as well as social, ensured by universal rights (busck and poulsen, 2002). as such, the welfare state developed a closely-knit society, which enabled a high level of education and security, and through this, maintained the larger part of the workers’ movement as supporters of the social democratic party and the welfare state model. in this way, the welfare state was also a defence against the communists and the revolutionary ideas coming from the east. as part of this development through the latter half of the 20th century, the state became omnipresent in the provision of services for its aging workers and citizens. mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 5 in line with other western european health and welfare systems, the danish health system has been undergoing a continuous reform process since the 1980s, going towards decentralization and a simultaneous process of recentralization through increased use of economic incentives and privatization— a process often labeled as “new public management” (andersen and jensen 2010). denmark is inhabited by 6 million persons and divided into 5 regions, which are mainly responsible for hospital management (secondary and tertiary care) and into 98 smaller municipalities, which are mainly responsible for health promotion and primary care. in response to the challenges of an increasing aging population and the need to control rising costs, a radical local government reform in 2007 gave the municipalities extended tasks in care and in the fields of prevention and health promotion. in the last decade, therefore, we have seen a rise of municipal initiatives designed to promote a revitalization of the everyday lives of older people, this is done through various initiatives, such as preventive home visits (ludvigsen 2014; otto 2013), physical rehabilitation programs (schwennesen 2017), everyday re-ablement programs (christensen 2017a, 2017b), municipal activity centers (lassen 2017, 2014a, 2014b), and the design and implementation of welfare technologies (ertner 2015; schwennesen 2016). hence, the municipality is the administrative body receiving most attention in this special issue. this development towards decentralization of care and the emphasis of prevention and health promotion as a core municipal task has reconfigured the link between everyday life and the danish welfare state and enacts a particular form of bio-politics. biopolitics refers to a change in the political apparatus that occurred during the 18th and 19th centuries. whereas territory was previously the primary concern of the state, the primary concern now became the population’s discipline and welfare. to create a strong population was to create a strong state, and this was done through a meticulous interest in, and measurement of, the biological and pathological traits of the population (foucault 1994, 71). this entailed a focus on the conducts of life, and the shaping of the population through disciplines such as statistics, medicine, and education. the rise of the welfare states during the 20th century can be seen as an elaboration of biopolitics, which is closely connected to the idea of disease as an “unfolding, long, continuous event” (moreira 2009, 33). when the etiologies of diseases change into a long unfolding process, the need for prediction and prevention arises, and hence, the need for a closely-knit welfare state with branches of healthcare and prevention programs alongside research techniques, such as longitudinal studies enabling an understanding of how to intervene in this unfolding over time. hence, while prevention programs have, historically, been based on specific risk groups and their statistical risk for developing a disease, today many initiatives are also concerned with facilitating energetic everyday lives. this is a facilitation of a specific version of a good old age, in which the danish welfare state goes to great lengths to create energy in places you would not expect to find energy—nor would you normally consider such initiatives a task for the state outside of the scandinavian context. background and contributions each in their own way, the contributions in this issue explore the concept of energy in old age, both as an emic concept we draw from multiple ethnographic field sites in denmark, and as an analytical toolset consisting of various figures and models of energy used to dissect interventions attempting to energize old age. indeed, judging from the multitudes of situations in which the concept of energy emerges in our ethnographic material, it appears as if energy saturates every aspect of old age and the aging process. it is this omnipresence that the special issue analyses empirically, theoretically and historically; thereby providing a conceptual framework for the “new old age” in the realm of 21st century welfare states. mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 6 our interest in the concept of energy was prompted by a series of group interviews conducted with researchers from a wide range of disciplines within the center for healthy aging (ceha) at the university of copenhagen in 2013. that project was spurred by a perceived need to explore how energy was is in fact conceptualized by scientists within ceha considering the prominent role the concept played in the research application for the center to the nordea foundation . it had been decided from the outset that “energy” should be a guiding concept for the center, as it was believed that this concept was easily translatable across disciplines and thus provided a shared conceptual framework among the social sciences, the humanities, and the medical sciences. the application stipulated that the objective of the research center was “to obtain greater insights into energy creation and transmission and into how various factors affect the level of energy.” it was thereby assumed that a consensus existed about what various individual researchers meant by the term energy across the various fields within ceha. but rather than consensus, the group interviews at ceha revealed an overwhelming richness of different conceptions. each group consisted of three to five participants, and the interviewer would ask the participants to explain and discuss their understandings of energy. what became clear was that the participants were inclined to make use of various “folk-theories” and apply hybrid frameworks when discussing what energy is. they combined specialized, scientific notions of energy with lay ideas, and this switching back and forth between various registers enabled a form of interdisciplinary conversation to take place. while a few participants attempted to define energy in bio-chemical terms, they soon after switched to almost existential terms by, for instance, talking about the importance of having the energy to deal with one’s life. thus, an oscillation took place between an understanding of energy as “what takes place within a cell” and energy as something almost mystical. the interviewed thereby switched between what has been termed formalist and substantivist models (rupp 2013, 80). the formalist model refers to quantifiable, technical systems of energy, while the substantivist model, which was by far most prevalent in the interviews, implies a reflection on energy as a qualitative, socially embedded force that is mediated by people’s relationships and with the conditions of their daily lives. thus, in articulating what they considered energy to be—or not to be—the scientists at ceha reached for a palette of images that worked as rhetorical devices and that sought to create a common language across disciplines. as our interdisciplinary work in ceha continued, a group of researchers from anthropology, ethnology, and public health decided to use the opportunity to scrutinize energy further. together with bjarke oxlund, kamilla nørtoft, malene bødker and marie ertner, the authors organized a seminar in september 2016 for ceha-researchers from anthropology, ethnology, and public health, titled “ageingenergism: diffracting ageing through the prism of energy.” besides the researchers in ceha, ayo wahlberg, chris gilleard, elana buch, and tiago moreira participated as experienced scholars guiding the young research group at ceha in issues of aging research and/or the analytical frameworks used to scrutinize energy. over two days, the researchers were presented with a range of different conceptualizations of energy through presentations from a physicist, an engineer, a molecular scientist, a healer, and a qi-gong instructor, as well as discussing their papers about energy, which have been transformed into the articles for this special issue. we are grateful for the contributions of the scholars, energy specialists, and ceha-researchers, as well as the funding from the nordea-foundation, which all have contributed to putting this special issue together. this special issue brings together four papers that illustrate how anthropological explorations of aging can be enriched through a focus on energy as a conceptual vehicle. nete schwennesen examines how bodies are made to move in remote monitored physical rehabilitation. on the basis of ethnographic material, she investigates how bodies, algorithms and technologies are assembled, disassembled and reassembled over time. by mobilizing jane bennets figure of ‘vital materialism’, she directs attention to the agentic capacities of artefacts such as technologies, algorithms and measurements, and the body itself, as a mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 7 fleshy-sensual lively force. she argues that attention to bodily sensory expressions and a willingness to adjust and align the temporality of metrics with the temporality of bodily recovery, is needed in order to compose processes that produce bodily restoration and not bodily disruptions. aske juul lassen explores how the danish municipalities endeavor to reanimate old age through initiatives engaging civil society and older people as volunteers. by analyzing a choir for copd-patients and an initiative promoting bike trips for older people, he argues that this ‘agencement of reanimation’ combines ideals of active ageing and new forms of governance promoting active citizenship. henrik hvenegaard mikkelsen studies the category of the “passive citizen,” which has become the object of concerted political and media attention in recent years. he offers the argument that the attempt to activate such citizens in fact “energizes” the welfare state. in the fourth article, michael andersen provides a medical historical explanation as to why aging and energy have become intrinsically connected. by exploring the case of the 19th century disease, neurasthenia, he argues that the link between aging and energy can be found in the contemporaneous views of a dissipation of energy with old age, and that this had consequences for the views of the aging body as a productive entity. all authors turned to the concept of energy at a late stage of their research process; none went into the field thinking critically or analytically about energy, but all have found significant conceptual inspiration in, retroactively, approaching their ethnographic material through the lens of energy. the articles show how energy can offer fruitful analytical avenues for anthropological work. while the papers approach energy in different ways, they revolve around the notion that to understand contemporary meanings and practices associated with energy, we must integrate an awareness of our own anthropological assumptions about energy with critical scrutiny of how the concept operates in the lives of the people we study. we take this as our outset by proposing that “energy” as a concept with pertinence to the social sciences, should be considered a conceptual vehicle that allows us to explore the idea of movement and transformation as well as reformulating the critical questions in relation to health, aging, and the dynamics of the modern welfare state. we thereby apply the concept both ethnographically as an analytical heuristic and as an emic concept. we suggest that energy may both be developed as an analytic concept in social sciences as well as being regarded as an object of study in need of further attention. furthermore, “energy” seems to offer a conceptual vehicle for establishing conversation across disciplines. interdisciplinary collaborations have become the reality in academic research and it seems clear that if we want to ensure dialogue across disciplines, we must develop a vocabulary that allows such dialogue to take place. in this sense, it is important that we do not simply assume dialogue, but that we, rather, challenge and reflect on the concepts that we apply, and that we intentionally and openly discuss the overlaps of meaning embedded in such concepts. this will in itself offer a critical form of knowledge production. on this basis, energy may be useful as a concept across scientific disciplines, to generate dialogue, and to frame research projects and scientific results. as one of the most famously abstract quantities within physics as well as a comprehensive common term in everyday speech, energy has the ability to traverse and fundamentally structure our way of imagining areas of research and understanding the world. as will be visible throughout this special issue, energy is a concept that enables us to bridge seemingly distant phenomena, account for their relations, and explore how they convert and transform through these relations—be it scientific disciplines in interdisciplinary projects, the interrelations between state forms and old age, or other anthropological endeavors to explore the relationships among forms of governance and their subjects. mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 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edited by s. lamb, 141-53. new bruncwick: rutgers university press. lassen, aske j., and tiago moreira. 2014. “unmaking old age: political and cognitive formats of active aging.” journal of aging studies 30:33-46. lien, marianne e. and law, john. 2012. “slippery: field notes on empirical ontology.” [accessed july 18, 2019] http://sss.sagepub.com/content/early/2012/09/13/0306312712456947.full.pdf+html. ludvigsen, bodil hedegaard. 2014. “medborgerskab og tilpasning: ældre mennesker med hjemmesygepleje: perspektiver på sociale relationer, forebyggelse, medicin og døden.” phd diss. university of copenhagen. macnicol, john. 2015. neoliberalising old age. place: cambridge university press. mcginn, colin. 2011. basic structures of reality: essays in meta-physics. new york: oxford university press. mikkelsen, schwennesen, and lassen | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.235 http://anthro-age.pitt.edu 9 mikkelsen, henrik h. 2016. “unthinkable solitude: successful aging in denmark through the lacanian real.” ethos, 44(4): 448-463. ---. 2017. “never too late for pleasure: aging, neoliberalism and the politics of potentiality in denmark.” american ethnologist, 44(4): 646-656. minkler, meredith, and martha b. holstein. 2008. “from civil rights to ... civic engagement? concerns of two older critical gerontologists about a ‘new social movement’ and what it portends.” journal of aging studies 22:196-204. moreira, tiago. 2009, “prologue: preventing alzheimers disease: health, ageing and justice.” in health, promotion and prevention programmes in practice, edited by t. mathar, and y. janssen, 29-52. berlin: transcript verlag. nørtoft, kamilla. 2013. “‘did you imagine older people could be like this?’ a kaleidoscope of ageing, health and processes of identity in an urban danish context.” phd diss., aarhus university, denmark. otto, lene. 2013, “negotiating a healthy body in old age: preventive home visits and biopolitics.” international journal of aging in later life 8:111-35. rupp, stephanie. 2013. “considering energy: e = mc2 = (magic ×culture)2.” in cultures of energy: power, practices, technologies, edited by sarah strauss, stephanie rupp, s., and thomas love, 79-95. walnut creek, ca: left coast press. schwennesen, nete. 2016. “et omsorgsfuldt selvbedrag: om brug af robotter der imiterer mennesker i ældreplejen.” gerontologi, 32(1): 28-33. ---. 2017. “when self-tracking enters physical rehabilitation: from ‘pushed’ self-tracking to ongoing affective encounters in arrangements of care” digital health 3: 1-8. doi: 10.1177/2055207617725231. book review review of hess, linda m. queer aging in north american fiction. new york, ny: palgrave macmillan. 2019. pp 232. price: $84.99 (hardcover); $64.99 (ebook). celeste pang university of toronto celeste.pang@mail.utoronto.ca anthropology & aging, vol 41, no 2 (2020), pp. 283-285 issn 2374-2267 (online) doi 10.5195/aa.2020.296 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | pang | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.296 http://anthro-age.pitt.edu 283 book review review of hess, linda m. queer aging in north american fiction. new york, ny: palgrave macmillan. 2019. pp 232. price: $84.99 (hardcover); $64.99 (ebook). celeste pang university of toronto celeste.pang@mail.utoronto.ca in queer aging in north american fiction, linda m. hess examines representations of queer aging in six novels and two films released between 1943 and 2011. centering core themes of temporality, productivity, and success and failure, hess situates these texts in relation to key cultural moments in lgbtq history, and points to further potentials – academic, and worldly – of thinking ‘queer’ and ‘aging’ together. explicitly not a comprehensive overview, hess works with the idea of “spotlights” to highlight intersections of aging and non-normative sexuality across the works and the different historical moments in which they emerged (21). her use of spotlights is highly effective, as it allows close reading and analysis of representations of queer protagonists and the narrative use of aging and age relations in selected works. in the introduction, hess tells the story of her emerging realization that representations of aging lgbtq persons seemed to be missing from both narratives about aging, and in works of queer fiction. this “missing,” the author came to understand, is more an occlusion: it was not that such representations did not exist, but rather that they had received little attention (2). the primary task of this book (an outgrowth of hess’ dissertation), and one that is achieved in wide-ranging detail, is to attend to this occlusion. picking up well-worn critiques in aging studies of the “decline narrative” (gullette 2004) and limitations of the normative paradigm of “successful aging” (e.g., katz and calasanti 2015), hess weaves in queer critiques of heteronormative visions of the life course (e.g., freeman 2010; halberstam 2011) to frame her overarching analysis of the significance of representations of queer aging in expressing and shaping social realities. the body of the book is divided into five parts. part i, “the confines of straight time,” includes two chapters, which trace the trope of the “older lesbian as predator” and the “menace of gay aging,” respectively. here hess examines the predominance of the heteronormative timeline in representations of lesbian aging, and situates the narrativization of gay aging in the cultural climate of the cold war era. in this section, the author sets up a loosely comparative approach, contrasting representations of lesbian and gay aging across historical chunks of time. she also introduces a critical focus on tropes of gays, lesbians, and age relations, and gay and lesbian aging. for example, in her analysis of trio: a novel, by dorothy baker (1943), hess astutely examines how age was used as a narrative element to solidify a trope of older predator/younger victim, a frequent move in lesbian narratives of that time (36). http://anthro-age.pitt.edu/ book review | pang | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.296 http://anthro-age.pitt.edu 284 part ii focuses on novels produced “in an era of liberation,” in the context of gay liberation and feminism. here the texts centered are june arnold’s sister gin (from 1975), and andrew holleran’s dancer from the dance (1978). treating sister gin through a lens of lesbian-feminist aging, hess explores topics ranging from “menopause as a new beginning,” “defying stereotypes of asexuality” to “anger as politics” (82-93). examining dancer from the dance as part of “gay times in nyc,” hess situates it in the wake of the stonewall riots, discussing “the economy of the body,” “failing the heteronormative future,” and “the margins of the cultural screen” (103-117). the breadth of contributions in part ii is exceptional, and shows what i consider the main strength of hess’ work: not necessarily the grand argumentative arc or overarching key findings, but the detailed, provocative insights. part iii leads the reader through “transitions of the 1990s,” where we witness the increasing visibility of narratives of aging in the context of the aids crisis and a novel lesbian ‘hypervisibility’ in postmodern canadian literature. part iv moves to “queer aging in the young twenty-first century,” and to film. here hess turns her attention to mike mills’ beginners (from 2010), and thom fitzgerald’s cloudburst (2011). the cultural work of tropes and the political ramifications of storytelling are brought to the fore particularly strongly in discussion of the latter film. cloudburst is a story of an older couple who seek to escape manipulative family members and nursing home confinement in the united states to the safety of same-sex marriage in canada. it is a plot that hess situates as a “road movie,” anchored “in a tradition of rebellion” and social and cultural critique (201). the image of the butch lesbian hero embodied by the character stella is pronounced here, as are, hess points to, tropes of aging as disability and immobility (206-207), and tropes of the “tragic queer” (216). further surfaced are questions of normativity and inclusion, as hess reveals how the film skirts close to a script valorizing a particular vision of ideal familial relations. as she writes, cloudburst “walks a thin line between highlighting the necessity of having available secure structures, such as equal marriage rights, in order for individuals to retain agency in old age, and challenging heteronormative values of marriage, longevity, and consanguine kinship, at a time when these ideals become more and more attainable for lgbtq persons and invite participation in the linear life course” (23). in this book each chapter is anchored “in a significant cultural moment of lgbtq history” (10). in this way, the reader is simultaneously walked through hess’ analysis of the texts, and through a (select) history of lgbtq people in the united states and canada. hess states that a chronological approach, despite its linearity, “serves well to provide a historical framework for the presently emerging visibility of queer aging” (10). yet one limitation, perhaps related to this approach, is that the author relies upon dominant landmarks in a white-washed and largely gay and lesbian history. hess’ treatment of the stonewall riots is one example of a missed opportunity in this regard: hess does not here recognize the fraught history of the riots, and reiterates this event as a momentous cultural landmark within a history of gay rights liberation which opened up new dimensions of visibility for gay men. such historicization is one that has been thoroughly critiqued for its occlusion of the leadership and participation of trans women of colour, and hess’ failure to acknowledge this is a significant occlusion in turn. while hess is, of course, not responsible for the content of the texts under analysis, a more nuanced historicization could have contributed to a more expansive analysis of ‘queer aging.’ furthermore, visibility is also taken as an implicit good throughout the work, a value which also may benefit from further problematization. narratives of queer aging have fairly recently emerged across the social sciences and humanities (for example through first-person accounts of aging in qualitative research). this book provides a novel depth and breadth of analysis of representations not only in canadian and american fiction, but in narratives of queer aging in scholarship writ large. in this way, queer aging in north american fiction is a novel and critical intervention into studies of aging across disciplines. it will be of interest to scholars http://anthro-age.pitt.edu/ book review | pang | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.296 http://anthro-age.pitt.edu 285 working through questions of gender, sexuality, and aging, including but not only for those with a literary bent. the book avoids jargon and follows a repeated reader-friendly format in each chapter, each of which includes many nuggets of generative discussion, and could be assigned individually or together as an anchoring textbook in undergraduate and graduate courses. in the conclusion, hess points to important new developments in representations of queer aging, such as the visibility of a trans protagonist in the hbo series transparent. while wary of tracking a narrative of queer progress, i am interested to read how hess and other scholars will continue to engage with emergent works of fiction in which diverse narratives of queer aging may be read, and in how queer reading practices in aging studies will develop beyond lgbtq subjects. queer narratives do critical work in helping to open up points of reference and spaces for people to form senses of self and belonging, and to imagine alternative futures. representations of queer aging, as hess contends, “have the power to crack open heteronormative concepts of time and future that still limit the available perceptions and representations of aging significantly,” by surfacing restrictive norms, and “by calling for transgressions of these norms as well as for the invention of alternative narratives” (8-9). this book stands as an important precedent in looking towards both writing and reading practices of queer aging of the future. references freeman, elizabeth. 2010. time binds: queer temporalities: queer histories. durham: duke university press. gullette, margaret. 2004. aged by culture. chicago: university of chicago press. halberstam, jack. 2011. the queer art of failure. durham: duke university press. katz, stephen and toni calasanti. 2015. “critical perspectives on successful aging: does it ‘appeal more than it illuminates?’” the gerontologist 55(1): 26-33. http://anthro-age.pitt.edu/ microsoft word parkfinal3.doc the social context of collective physical training among chinese elderly an anthropological case study in a park in beijingiii yeori park department of anthropology, seoul national university, seoul, south korea author contact: yeoripark@gmail.com abstract this study analyzes the social context in china where the elderly participate in collective physical training, a cultural activity specific to the country. for this study, senior citizens aged 60 or above who participated in collective physical training in a park in beijing were observed for five months. research results found that collective physical training enables formation of social networks providing mutual caring and support. on the other hand, the participants conform to the self-disciplined modern discourse to survive in the post-mao society. they do collective physical training due to their social conditions, such as the poorly established welfare system for the aged, severance pay that is too low to cover medical expenses. although the participants seem to autonomously choose collective physical training based on their own preferences, the context of chinese society, including hidden government intentions, leads the elderly to participate in training activities. keywords: aging, discourse, self-discipline, public dancing, guang chang wu, physical training, park, china anthropology & aging, vol 38, no 1 (2017), pp. 30-43 issn 2374-2267 (online) doi 10.5195/aa.2017.140 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 30 the social context of collective physical training among chinese elderly an anthropological case study in a park in beijing yeori park department of anthropology, seoul national university, seoul, south korea author contact: yeoripark@gmail.com introduction this study aims to reveal the current lives of the chinese elderly through delineating the social context that induces participants to participate in collective physical training. people in many squares, including those in beijing, perform various activities, such as taichiquan and disco dancing (disike). collective physical training in parks or squares is perceived as an example of the “distinctive culture of china.” since most of the participants in collective physical training are elderly adults (哀丽 2014), collective physical training has been associated with the social problems of aging. the government tries to hide the elderly in society, defining them as nonproductive support receivers (powell 2012). on the other hand, participants try to thwart that government strategy by engaging in collective physical training in public spaces as capable self-disciplined subjects. however, being selfdisciplined subjects means that they conform to the government's hidden intention of making modern subjects. to survive the reality that marginalizes them as relics of the pre-modern period and does not recognize them as social beings, chinese elderly conform to the self-disciplined modern discourse created by the government rather than fully resisting the government that has left them to an uncertain future. in the context of china, the study of the collective physical training of the elderly shows how the modernity of china appears differently through the body at different times in history. collective physical training is a way of training productive agents who are in different generations (morris 2004). when mao zedong declared the people’s republic of china on october 1, 1949, mass gymnastics (jituantiyu) became an important daily task for the public (renmin) following the introduction of the work unit system (danwei). the communist party of china (cpc) proclaimed, “[w]e officially promote mass gymnastics for the demand of physical training to intensify the progress of productivity and the labor force” (金欽昌 1994). thus, mass gymnastics was implemented to help create a solid foundation of productivity, promoted as a method of living a modernized life dedicated to the nation and escaping the pre-modern life dedicated to oneself. from the chinese economic reform by deng xiaoping in 1978, however, the cpc dismissed most of the mao period policies as pre-modern and imposed fresh modern policies that fit the market economy system. at that time, the government exploited the collective physical training strategy to shift the responsibility of welfare from the government to individuals after the collapse of the work unit system (farquhar and zhang 2012). the cpc encouraged physical training not only to unite the people but also to lead them to consider self-management as a natural process. unlike the mao period, collective physical training has been advertised for individuals’ health, rather than for the nation. thus, collective physical training in the mao period was promoted to foster modern subjects who worked for the nation. in the post-mao period, it has been promoted to foster modern subjects who can manage themselves without the help of the government. in the same context, considering that the main participants in collective physical training are elderly adults, collective physical training shows how old age has been defined in the modernity discourse of china. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 31 theoretical framework foucault (2007) argued that modern individuals always manage their own action for themselves by internalizing discipline without external control. foucault called the governing strategy of imprinting self-discipline on the body of individuals “biopolitics.” as zhang (2011) insists, we could find out the field of managing body as a governing strategy in china in what foucault states as body politics. body politics based on self-discipline is highly visible in the physical training culture in china. “training the body for china” reveals the government’s political strategy of claiming modernization that is infused with public culture (brownell 1995). although the culture of physical training was invented by the chinese government to unite the people, these facts are not well-known, and chinese people only regard physical training as a traditional virtue. young and healthy bodies were valuable for national productivity in the mao period, and are valuable according to consumerist standards in the post-mao period (brownell 1995). in this social context, chinese people train their body for themselves, being eager for young bodies. after the economic reforms, the post-mao government could not claim sole responsibility for the welfare of people, since they promote a competitive market for economic development. zhang (2009) points out that the aging experience has been stratified in china because of the economic gap between the rural and the urban area. since the government privatizes the elderly care systems, the quality of elderly care has stratified, according to the economic situation. although many chinese elderly suffer from lack of care, zhang argues that collective physical training among chinese elderly shows the possibility of active aging and mutual support in contemporary china (ibid.: 207). in light of this situation, the chinese government advertises the traditional concept of yangsheng. an interesting point is that modernized selfdiscipline management strategy is closely related to traditional chinese ideas (farquhar and zhang 2012). yangsheng is a traditional taoist way of self-training and self-management to balance the status of one's body. unlike foucault’s argument that individuals cultivate self-discipline after modernization, yangsheng (meaning self-discipline) is a classic ideology that has been handed down for thousands of years in china. in other words, it would be much easier to connect the traditional and modern ideology of self-discipline in the case of china. chinese elderly also have accepted self-health cultivation methods, called yangsheng, from institutionalized state discourse about aging in the field of traditional chinese medicine that regards aging as a disease (yang 2006). however, the elderly do not passively accept this concept. rather, they resist state discourse about aging by applying yangsheng in their own way. yang’s (2006) argument reveals that the chinese elderly are also agencies that reconstruct aging discourse by accepting and resisting dominant discourse at the same time. in this theoretical context, this study not only highlights the everyday life of the chinese elderly, but also tries to reveal rifts created in the modernization process led by the party-state. the chinese elderly have experienced both the pre-modern and modern periods in china. their life cannot be totally separated from the modernization discourse of the chinese government. subjects and methods this study was based on ethnographic field research, a standard tool for anthropological studies. given the difficulty of capturing life experiences and communication styles by analyzing documents or statistics, the ethnographic research techniques of participant-observation and interviewing were considered best anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 32 suited to the study goals. these techniques allow researchers to share subjects’ experiences and perceptions. in addition, documents needed for this research were collected. the researcher decided on a park in beijing as the research setting after a preliminary investigation in july of 2014, since more activities are performed there compared to other beijing parks. formal research in the form of participant observation and interviewing was conducted from september 2014 to february 2015. the researcher visited two groups (groups a and b) three or four times a week. this study was conducted on, most over 60 years oldiii. the age of 60 was set as the standard for subject selection because the current cpc defines people over 60 as elderly (laonianren). a master leads group a and teaches liangongiv. the master is a 90-year-old man who came to beijing from sichuan after retirement at age 60. he had been in the military but started to train liangong to cure himself. about 20 people participate in liangong every day. although members of group a range in age from their 20s to 80s, more than half of the participants are over 60 years old. new participants have to pay a onetime fee. group a has a vertical relationship that is seen in the way that members address each other. group a participants do not call each other by name. they call the teacher “master,” and long-time male participants “big disciple (dashixiong).” these terms are based on the period of apprenticeship, not age. this shows that an apprentice relationship (tudiguanxi) establishes hierarchy. master is central to this relationship, and most participants respect the master and believe what he says. master often infuses others with qi, and participants request qi from the master. however, this vertical relationship does not mean a rigid relationship between classes. although group a members all use appellation and respect for the elders, they are not ill at ease with each other. sometimes members even make fun of the master. although the official training program starts at 10 am, most members come around 8 am. this time is the key to their personal relations. they do training while chatting. many people emphasize that they do training every day, no matter how bad the weather is. when participants first arrive, they spread out a mat and start individual warm-ups. these gestures are ways to straighten the body. participants believe that they can receive qi from the ground as they straighten their own body. since personal training is nonofficial, there is no fixed rules and places. it means that they can do personal training in other places. however, they still get together and do personal training together. one participant said that “we can receive each other’s qi, and most of all, it is fun!” this shows the distinguishing aspect of collective physical training compared with other individual training. most of the participants do not socialize with each other outside of the park after the class ends. some participants even do not have the phone numbers of the others. the relationships within group a are limited to training time. unlike group a, group b members usually do not come together for healing. it is a kind of social group for aunties (ayi) with common interests. there is no master. however, the participant who has been longest with the group, jianghua (66 years old) leads the group. jianghua started to lead this group in 2001. she said that she learned dances from older people and now teaches them to new members. people wander into the park, see seniors dancing and decide to join. the number of people who participate alone is much larger than that of people who come with friends. most of them are women in their 60s. according to linan, there had been two men last year. however, they were not members when i joined. unlike group a, there is no fee to participate, except for the 25 yuan a year for the portable amplifier. relationships in group b seem horizontal rather than vertical. there seems to be no hierarchy, and members address each other by name. although jianghua lead the team, they are not treated as the master in group a is. unlike the elders in group a who are not accustomed to devices such as smart phones, most members of group b use smart phones; some have tablets. they use these electronic devices to maintain relationships. for instance, they use group talk in wechatv for announcements. one of the most anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 33 distinguishing marks of group b is that its members meet after the activity. group a members hardly meet outside of the park, but group b members go on a trip once or twice a year or have lunch. of course not all of them can participate. however, the relationship built by collective physical training spills over into these other activities. although it is hard to memorize all the songs followed by different movements, participants naturally master the hundreds of movements through repeated practice. those who have danced longer tend to stand in the front row, and those who have learn shorter tend to stand in the back. this arrangement is naturally formed rather than intended since new members cannot but emulate the older ones. for a long time, senior members have taught dance to new members. in addition, they listen to the latest music and learn new dance steps online. since guangchangwu is so popular in china, there are many videos in youku vi that can be found. jianghua studies these videos at home and teaches the movements or sometimes develop their own. one of the distinctive topics of conversation is “dancing instruction.” this emerges because members talk to each other while they are dancing. although jianghua teaches moves to others, those who learn quickly also teach those who need more practice. if members have questions, they ask the person next to them. in this process, they welcome newcomers and become friends by teasing people who appear awkward. dancing instruction is an important way for group b members to form relationships. aging discourse in china by looking at the discourse created by government policy and mass media, i examine the concept of aging in the chinese context as well as how this concept is reconstructed. this has hegemonic power in creating the “official” discourse in the communist society. social discourse in one society does not naturally exist; rather it has been created through historical and political contexts. we should take into account aging discourses in china to figure out the image of aging in china, since this discourse underlies the public’s view. government’s welfare policies aimed at old age current welfare policies targeted at the elderly in china are largely divided into two categories. one is old-age insurance, and the other is an id card only issued to people over 60. the cpc officially promulgated the elderly rights law 1996vii, which was edited in 2013 to cover the aging problem. after this period, elder care policies were implemented in earnest (佟新 2007). one of the policies that related to the elderly is an id card (an “aging certificate”) for people over 60. this card is issued to every elderly regardless of individual life condition. this aging certificate gives various benefits to the elderly, such as free entrance to parks. the cpc issues two different types of cards. one is for people from 60 to 64; the other is for people over 65. although the cpc issues cards to those over 60, most benefits are received by people over 65. and most of the participants in group a and b understand that the card can be issued to people over 65. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 34 [figure 1] id card for the aged (aging certificate)viii this id card practice highlights the fact that aging status is defined not by the elderly themselves, but by the government. the aging certificate policy shows the limitations of current welfare policies for the elderly in china, which defines the elderly based on chronological age alone. although participants in group a and b had relatively healthy bodies for their age, they also thought that they were already old because they had an aging certificate. the aging certificate is one kind of national apparatus regulating the elderly in a standardized way. so elderly individuals are constituted by the government from the moment of issue regardless of their own self-conception. another welfare policy for the aged is mostly focused on the care industry. the cpc emphasizes two major policies. one is old-age insuranceix and the other is aging care service. old-age insurance is for the elderly poor who do not receive severance pay or government subsidies. if the elderly pay a specific sum of money to the government, the cpc grants them a pension after the age of 65. although the elderly who worked in the work unit system (danwei) before the economic reform do not need old-age pension, since they receive severance pay, some of the elderly could not receive severance because they were farmers or peasants at that time. in addition, the cpc launched a pilot project of residential mortgage old age insurance in 2014, so called “reverse mortgage care (yiweiyanglao),” in four major cities in china, including beijing. this is a new type of insurance that offers a pension for only those who have housing. although the cpc launched this pilot project, this policy shows that the concept of care is transformed from a fundamental right given to everyone without discrimination in the socialist era to a privatized service offered only to those who have real estate after the economic reform. the cpc insists that the nation can no longer take care of people, and people should purchase care for themselves. in one government announcement,x the government wrote: “we chinese have traditionally taken care of the elderly in our own families. however, more and more of the young generation get stressed about the reality that the population available to support the elderly has been decreased by the one child policy, so that we should extend the care service market.” there is no argument that the government should take care of the people as in the socialist period. after the economic reform, the chinese government has marketized the aging problem. how old age is represented in mass media: the matter of longevity and care as mass media becomes more and more influential, the idea of aging is partially constructed by the way mass media represents old age. first of all, there are articles about the aging problem in newspapers. i will analyze some articles in xinhuawang, a website operated by xinhua—one of the most reputable press agencies in china. in particular, i will focus on two public trends related to the health and care problem in old age. one is about how to keep fit, while the other is about social issues related to the aging problem. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 35 delaying the aging process is important for the chinese, since aging is related with biological decrepitude. especially in the traditional chinese context, longevity is discussed in association with the idea of yangsheng. yangsheng, which comes from taoism, means balancing yin and yang in your body by self-discipline. yangsheng cannot be treated by medication. one can only recuperate yangsheng by meditation or self-training. as one participant in group a said, “yangsheng is one of the most famous words among the elderly,” it emerges in articles quite frequency. [case 1] can we live to 100? the four yangsheng secretsxi there is an anecdote—written in yangshengbuyu by chen jiru, in the ming dynasty—about a long-lived old man who always eats salt. chen jiru recalls a time when he visited one village and witnessed three brothers over 80 years old who were still young and robust. he asked them the secret of yangsheng. the three brothers answered, “we cannot find salt in this area, so we have to eat very little salt and farm.” although yangsheng comes from traditional chinese taoism, “the secret of yangsheng” in this article does not contain an ideological concept; rather this only contains a common rule for daily life. for example, the articles argue that one should “not eat too much” and one should “drink enough water.” however, the media leads people to act with self-discipline and gains the public’s trust by promoting yangsheng. another topic that appears in news articles related to aging is the care problem. in china, “4-2-1” emerges as a serious problem along with aging. 4-2-1 means that there are four grandparents, two parents and one child in families because of the one-child policy. one child has to take care of all six parents and grandparents after they grow up (胡莎莎 2014). when i search on the internet website baidu using the keyword “4-2-1xii”, there are 167 articles that come up. among these articles, 65 include “care of the elderly (yanglao).” this shows that nearly 39 percent of articles directly connect the 4-2-1 problem to the care problem for the elderly. [case 2] can’t wait to solve “4-2-1 problem”xiii four elderly, two parents, and one child—the “4-2-1” family is a new composition of the family in the one child era. parents are in trouble since they have to take care of their own child and grandparents. reverse mortgage old-age insurance emerges as a substitute for “growing children as a backup for old age.” another argument that reveals how the mass media represents aging is welfare reform. the cpc recently tried to solve the care problem by marketizing care service and insurance. now the government only assumes part of the care responsibility and individuals have to take on costs. this means that “the welfare system that people can enjoy from the cradle to the grave during the socialist era,” without discrimination, has disappeared (이경아 2006). the media veils this policy as the perfect solution and propagates “purchasing discourse.” the social context of collective physical training among chinese elderly individuals are unconsciously affected by their preferences in their process of growth (bourdieu 1979). these preferences are not formulated independently but through the social conditions in which people live. old age is a part of life; thus, it is also affected by the preferences that penetrate our lives. although the elderly, as a group, retire at a similar age and are defined as “elderly” from a chronological perspective, their life experiences vary. therefore, the ways in which they decide to spend their old age also vary, and the real lives of the elderly do not perfectly match the uniform aging discourse in western gerontology (cohen 1998). anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 36 elderly people in china inhabit a reality in which the welfare system for the aged is poorly established, there are few leisure activities for the financially strapped, and severance pay is too low to cover medical expenses. furthermore, the elderly distrust the medical approach to aging. they also have memories of the government fully controlling and taking care of all aspects of life; however, they are now in a desperate situation in which they have to take responsibility for their later years by themselves. in this situation, as we will see, they survive by constructing social networks in which members take care of one another through collective physical training. limitations on welfare for the aged; lack of leisure facilities the cpc recently recognized the danger of becoming an aging society and proposed several welfare policies for the elderly. however, such proposals cannot be fully implemented due to china’s lack of infrastructure (김병철 2010). although there are 101 elderly leisure facilities in beijing, only 17xiv are assigned as senior activity centers (laonianhuodongzhongxin), not including other small silver halls (laonianhuodongzhan) in villages. however, senior activity centers do not provide total-care services. for example, there are no social workers in these places. they are only places for seniors to play sports. participants feel confined because of the limited types of activities that can be performed in senior activity centers. on the other hand, participants can do whatever they want in the parks. in the parks, they participate freely in collective physical training, while the senior activity centers actually limit their freedom. furthermore, participants feel uncomfortable because the senior activity centers are small and confining. they go to the parks to enjoy “fresh air.” even though the press in china has recently warned about refraining from outdoor activity because of the fine dust in the atmosphere, participants still think that outside air is fresher than indoor air. thus, when participants say “fresh air,” they are not referring to the level of air pollution but to a subjective sense of a park as an “open space.” engaging in multiple physical activities, participants try to show that they are still useful to other society members. however, the welfare system for the aged in china does not offer a stage that makes them visible. the welfare policy for the aged in china only concentrates on business expansion for elderly care services. this stigmatizes the elderly as subjects who only receive support, reducing the likelihood of them being perceived as the relatively healthy elderly. in this situation, parks are the only places that appeal to the active public. as mentioned above, there are few leisure facilities for the healthy elderly; in contrast, the number of parks is approximately 600.xvfurthermore, if participants have elderly cards (laoniandaiyuka), they can enter any park in beijing for free. this offers important suggestions on why elderly people prefer parks to other spaces. severance pay: just enough to scrape by the reason why the elderly choose to participate in collective physical training after retirement is significantly related to their economic situation. all of the participants in groups a and b, except one who was a farmer, were office workers who lived off severance pay. some participants noted that they lived with children who supported them. they said they could cover “basic living” expenses using only their severance pay. except for one individual who served in the army, however, no respondents felt that their severance pay was sufficient for living. they could, at best, scrape by on what they had, but they could not afford to do other activities. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 37 [case 3] gongfang, male, 60 years old, group a gongfang: the severance pay is enough if there is nothing else you can do. if you have a disease, you soon spend all of it. researcher: ah…when you have a disease… gongfang: if you have a disease, it isn’t enough, even if you have insurance. if the elderly get sick and are hospitalized, they say that they cannot afford the high hospital bills. furthermore, in many cases long-term care is needed, since many diseases in later life are chronic, hard to treat, and need continuous treatment. the participants do collective physical training to avoid getting sick. they consider training important not only because they love the outdoor activity but also because they cannot afford treatment if they get sick. although the government recently designed several policies related to subsidies for the aged, such as medical endowment insurance, many participants still depend on their children or severance pay in their old age. physical training in free—at least for the elderly—open spaces, such as parks, appears to be their spontaneous choice. however, an examination of the hidden side of chinese society shows that this activity reveals the weaknesses of the national welfare system for the aged. distrust of medical approach participants see being treated for chronic diseases or mobility impairments in old age as an economic burden, even if they think such treatment is not effective. again, this is related to the fact that diseases in later life are usually chronic diseases that cannot be cured completely. [case 4] liwei, female, 73 years old, group b liwei: in fact, i don’t take medicine. some elderly people go to the hospital every day and take several pills at one time. but they don’t train. i think training is better than that. if you train, you can maintain low blood pressure, be free of disease, and be happy. researcher: you mean that training is better than going to the hospital? liwei: better than going to the hospital or taking medicine. training is much better than taking medicine. taking medicine, in some cases, is not healthy. the chinese traditionally emphasize the concept of yangsheng, which refers to mental and physical selfdiscipline; elderly participants think they can maintain their health without the help of medical experts. since the concept of yangsheng emphasizes self-discipline, it is regarded as not only a traditional idea followed in the specific chinese cultural context but also as a noble theory followed by strong modern subjects who can manage themselves (chen 2003; farquhar and zhang 2012). thus, participants resolve to take care of themselves in later life, as they distrust medical interventions. they believe they cannot reach longevity only through medical treatment. medical approaches have to run parallel with self-discipline of mind and body, since longevity refers to the whole life, not just the actual corporeal body itself. the distrust of the medical approach and the concept of yangsheng combine to trigger participation in collective physical training. embodied memories of life in the work unit system participants have memories of life in the work unit system, the basic social and working structure of the socialistic planned economy in the mao period before 1978. people shared everything and worked together in one community, which was called a “unit” (danwei) and was controlled by the cpc. people in anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 38 a unit were bound to their own unit for their whole lives. every person was involved in a unit. since people in one unit shared housing, canteens, welfare services, childcare, etc., their lives totally depended on their unit. the cpc controlled these units, so when people wanted to do something, they had to get permission from a manager dispatched from the cpc. the memories of those days are still alive within participants. but china has changed dramatically since it was governed by the cpc in the context of socialism. because of that, the various generations “cannot be completely assimilated with each other,” and they embody very different social contexts, given the dramatic regime shift. the current elderly adapted to the work unit system before chinese economic reform. on the other hand, younger people who were born after 1980 have lived very different lives (이응철 2011). most participants think that training has to be done together. in reality, they have done the same sort of training with each other for more than 10 years, so they do not have to train with others for learning purposes. however, they still prefer to train with others for several reasons, one of which might be their shared memories of life in the work unit system. [case 5] 2015. 02. 15. field notes on a participant in group a i sent the master a traditional confectionery gift set containing many cookies as a gift for chinese new year. the master handed out the cookies to the other participants. (omitted) when i ate most of the cookies i had received, the master gave me another and said, “eat whatever you want; this is a communist society.” following economic reform, the cpc in fact admitted individual ownership. since then, the idea of “my thing” has arisen instead of the idea of “our thing.” however, the master’s statement shows that elderly participants still reflect their past memories of collective life in the current society despite the changed economic system. chinese society continues to define the elderly as the old generation, differentiating it from the current generation, and generating negative discourse about the elderly. those who embody the lifestyle of the work unit system are regarded as social misfits, and they are considered to be in conflict with the younger generation (yan 2009). most of all, the opinion gap about the public dancing culture between generations is still too wide to allow formation of an alliance. chinese society pays attention to the social conflicts related to the public dancing culture. [case 6] on the conflict of generations, which is the reason behind the conflict on public dancingxvi in fact, the core of the conflict on public dancing appeared due to differences in lifestyle (omitted). meanwhile, public dancing has been a contentious issue in china. some young people, especially, hate the public dancing. in the middle of the conflict of generations, which has become harsh, there is a heartless phrase: “it is not the elderly that have become bad; innately bad people became elderly.” many young people insist that public dancing is just a past memory that symbolizes the older generation’s backwardness, which causes noise pollution. the participants accustomed to the work unit system not only spend their lives emphasizing mutual support but also are accustomed to the culture of sharing open spaces, such as parks. on the other hand, younger people who live in a social atmosphere that emphasizes the right to private property of individuals do not understand the public dancing culture, and they think of it as noise pollution. from the perspective of young people, public dancing is a symbol of pre-modern china that has to be abolished. including the debate on public dancing, the media describes the social conflict as only a matter of a generational problem between the elderly and young people, and defines the elderly as a past anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 39 generation that cannot adapt well in today’s rapidly changing society. though the elderly definitely live in the present, these kinds of media reports describe them as if they are bound to the past, and take away their voice. through this stigmatization, they become individuals who “cannot fully assimilate into society” (goffman 2009). in this situation, the participants, however, reveal themselves through collective physical training, which was discounted as a past thing, rather than allowing chinese society to stigmatize and hide them. in the name of modernization, chinese society defines the participants as the old generation and objectifies them as non-productive subjects. the participants, meanwhile, prove themselves productive by keeping alive this pre-modern activity. building sympathetic and mutual relationships even if participants start collective physical training for their physical health, they also regain their mental security as they interact with each other in collective training. they participate in the activities not only for physical health, but also for friendship (zhang 2009). they know each other better than family, since both groups engage in daily activity, and most of them have participated for more than five years. for participants who moved from rural areas at the request of their children who live in beijing, it is hard, as a stranger, to build new social networks. under these circumstances, collective physical training becomes a mutual caring environment in which those who cannot receive care elsewhere take care of one other. the participants experience a sense of belonging through the action of sharing. furthermore, the sharing action itself creates a sense that they are taking care of one another, since it encourages others to share something. this action helps them develop psychological stability. the sharing behavior of participants in collective physical training includes various activities from sharing things to sharing knowledge. the most common sharing activity centers around food. the participants usually eat what they bring in the middle of the training session, sharing it with others. the activity of sharing knowledge is also common. the participants participate in this activity to maintain their health in old age, and topics related to health tend to be shared animatedly. for example, one day, a participant brought some horse oil balm and showed it to the other participants. i asked her about this, and she said it was especially good for joint pain. although horse oil balm is a kind of folk remedy for which there is no medically proven effect, participants still believe in the efficacy of this balm. while proving the effectiveness of horse oil balm in the context of medical science is very difficult, the participants are not interested in medically proven benefits but in the experiences of others who have already used it. the participants tend to trust other participants’ reports on their experiences, since they trust each other. given their trust in each other, it is obvious that the social network created from collective physical training is at the forefront of their lives in old age. the participants not only share things but also take care of each other. sometimes, those who live with family take care of others who live alone. the participants consider each other more than friends. they are concerned (guanxin) for the other participants’ safety. [case 7] chunyang, female, 55 years old, group a chunyang: i think the master is very unfortunate. researcher: why? chunyang: he doesn’t have anyone who takes care of him, and he does not receive any money from the government. though the master insists that he was a war veteran, i heard that war veterans receive quite a large amount of severance pay. but i think he does not receive any money from the government. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 40 (omitted) i heard that he lives alone and his children do not take care of him. he usually does not speak with them. as mentioned above, the master receives deference from the members of group a. on the other hand, he is a lonely man with no fixed income and no children who take care of him. all the participants in the group recognize this situation. the participants say, “the master is also elderly, so he might not be able to teach us.” therefore, they make a united effort to give the master pocket money. they even keep track of the master’s birthday. the master is not only a teacher who instructs them on liangong moves and provides them knowledge about health; he also receives care from his disciples. the caring relationship is not unilateral but mutual. regardless of their previous lives, they are all living in old age, so they know more about each other’s situation than anyone else could know. they encourage and embrace one another without separating givers and takers (stalp, williams, lynch and elise 2008). if the participants do not participate in any other social activities after retirement, they not only spend a lot of time at home, but also take care of other family members, such as grandchildren. there is no other place to relieve the stress and conflicts of their family relationships. in this situation, the social network formed through collective physical training becomes the only refuge from the family. the participants empathize with each other’s lives, chatting about the discord and conflict between mothers-in-law and daughters-in-law. sometimes, voicing their complaints about their arduous lives takes a load off their minds, or they derive comfort from listening to other participants’ stories that are more miserable than their own. they can fully focus on the “activity of the body” since physical training is a vigorous activity that can preclude much thinking. during physical training, participants can fully escape from home. they can forget their complicated thoughts about their families. just as a shaman goes into a trance during a ritual, the participants experience a state similar to liminality, removing themselves from the world (social structure) by concentrating on physical activity (turner1995). although they must return to the reality of life as a chinese person who has social constraints, they enjoy the sense of freedom they gain from the training session by fully focusing on themselves. conclusion although the participants seem to autonomously choose collective physical training based on their own preferences, the context of chinese society leads the elderly to participate in training. though the agent making the selection is an individual, chinese elderly (who are just scraping by on severance pay) have few choices, since the complex social context pushes them to choose certain ways of living. nonetheless, this limitation of choice actually has the effect of priming the pump for maintaining this activity, since it means that many chinese elderly actually participate in the activity. if people get together and create a community, it is easier for them to voice their opinions effectively. the government promoted physical training in the past, but now, when the government no longer takes care of them as it did in the mao period, the participants themselves are actively involved in this training. in reality, the elderly must take full responsibility for themselves in later life, so the participants choose collective physical training as a means of survival. in this process, participants have established a strategy to live as social people who are productive subjects. though collective physical training is considered a symbol of pre-modern culture, ironically, participants use training to transform themselves into self-disciplined subjects and to counteract the aging discourse that discounts them as pre-modern people. they can literally show their healthy and active bodies—seen as productive bodies in the context of the market anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 41 economy—in the public space. in short, collective physical training has emerged as a way for the elderly who have lost their social lives to regain them. however, considering the social context in which collective physical training is so prevalent, there is a hidden intention of the government; that is, the government endeavors to make the chinese elderly self-disciplined modern subjects. participants inevitably conform—even if they do not realize it—to the government’s expectations rather than fully resisting the policies that have left them with an uncertain future. anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 42 references bourdieu, pierre. 1984. distinction: a social critique of the judgement of taste. harvard university press. brownell, susan. 1995. training the body for china: sports in the moral order of the people's republic. university of chicago press. chen, nancy n. 2003. breathing spaces: qigong, psychiatry, and healing in china. columbia university press. cohen, lawrence. 1998. no aging in india: alzheimer's, the bad family, and other modern things. university of california press. farquhar, judith, and qicheng zhang. 2012. ten thousand things: nurturing life in contemporary beijing. mit press. foucault, michel. 2007. security, territory, population. springer. goffman, erving. 2009. stigma: notes on the management of spoiled identity. simon and schuster. morris, andrew d. 2004. marrow of the nation: a history of sport and physical culture in republican china. vol. 10. university of california press. powell, jason l. 2012. “china and the bio-medicalization of aging: implications and possibilities.” in aging in china, 11-22. springer. stalp, marybeth c, rachel williams, annette lynch, and m elise radina. 2008. “conspicuously consuming: the red hat society and midlife women's identity.” journal of contemporary ethnography 38(2): 225-253. turner, victor. 1995. the ritual process: structure and anti-structure. transaction publishers. yan, yunxiang. 2009. “the good samaritan's new trouble: a study of the changing moral landscape in contemporary china.” social anthropology 17 (1): 9-24. yang, xiaohui. 2006. “dusk without sunset: actively aging in traditional chinese medicine.” university of pittsburgh. zhang, everett yuehong. 2011. “introduction: governmentality in china.” in governance of life in chinese moral experience, edited by everett yuehong zhang, arthur kleinman and tu weiming. routledge. zhang, hong. 2009. “the new realities of aging in contemporary china: coping with the decline in family care.” in the cultural context of aging: worldwide perspectives, edited by jay sokolovsky. abc-clio. 金, 欽昌. 1994. “实际出发积极发展我国群众性体育事业谈谈我国全民健身计划的实施.” 浙江体育科学 16(6). 新, 佟. 2007. “我国的老龄化、性别和养老政策.” 华中科技大学学报. 哀, 丽. 2014.“前中小城市群众性健身舞蹈的现状与思考以湖南益阳市群众健身舞蹈现状调查为例.”黃河之聲 4. 胡, 莎莎. 2014. “中國養老地產現狀及前景研究.” 城市住宅 58-60. 김, 병철. 2010. “개혁개방 전후 중국의 노인복지제도 비교: 양로보험제도를 중심으로.”국제보건복지정책동향 1. 이, 경아. 2006. “중국사회 가족구조의 변화와 현대적 적응.” 중국학연구 33. 이, 응철. 2011. “상하이(上海) 화이트칼라 ‘바링허우(80 後)’의 소비행위와 태도: 소비의 사회적 속성과 새로운 관계의 형성.” 한국문화인류학 44(2): 139-177. 2014. “北京等四市试点以房养老: 保监会宣布 7 月 1 日正式启动，60 周岁以上拥有房屋完全独立产权可申请 .” 新京报. june 24. http://bj.house.sina.com.cn/news/2014-06-24/07382789062.shtml 杨, 羽.2015. “如何长命百岁？长寿老人的四字养生秘诀.” 新华网.april 22. http://fashion.ifeng.com/a/20150422/40102147_0.shtml 半, 月谈. 2009. “中国“独子养老”时代来临“421”家庭遇养老困境.” 新华网. nobember 25. http://news.xinhuanet.com/politics/2009-11/25/content_12535859.htm anthropology & aging vol 38, no 1 (2017) issn 2374-2267 (online) doi 10.5195/aa.2017.140 http://anthro-age.pitt.edu park | 43 杨, 建蓉. 2014. ““421 家庭”养老不能等.” 新疆都市报. october 29. http://news.163.com/14/1029/10/a9ngsgs900014aed.html 彭, 晓芸. “广场舞之争背后的代际冲突.” 南方日报(广州).may 27. http://news.163.com/14/0527/09/9t88s4os00014aed.html notes i verified by seoul national university institutional review board (irb) for research ethics. verification number: irb no. 1404/001-012 ii based on the 2015.06dissertation. park, yeori. (2015). chinese senior citizens’ collective physical training and the reconstruction of old age: the case of a park in beijing. department of anthropology in the graduate school of seoul national university, chapter 4. iii in order to protect the identities of my informants, i do not specify the individual's name. all names in this article are pseudonyms. ivthe dictionary definition of liangong is “a method of training the body to follow a regular motion.” according to the master, liangong is a physical training technique that originated from qigong. it is not like a martial art such as tai chi quan, which is aimed at fighting, but like a meditation training program based on taoism.(reference: homepage for korean traditional knowledge portal http://www.koreantk.com/ktkp2014/) vweixin is a mobile messenger application widely used in mainland china. viyouku is a video streaming website like youtube. chinese must use their own website because the communist party of china prohibits access to youtube. vii中华人民共和国老年人权益保障法 1996 viii北京市园林绿化局关于进一步做好老年人游览公园景区优待及相关服务工作的通知 2008 ix北京市人民政府办公厅转发市劳动保障局等部门关于市属科研就所转制企业参加养老保社会统等实施办法通知2001 x国务院办公厅关于印发社会养老服务体系建设规划(2011-2015 年)的通知 xi 杨, 羽.2015. “如何长命百岁？长寿老人的四字养生秘诀.” 新华网.april 22. xii research at 19th march 2015. rounded to the nearest whole number from 38.9% xiii 杨, 建蓉. 2014. ““421 家庭”养老不能等.” 新疆都市报. october 29. xiv homepage for http://www.tuofangying.com/news_view.aspx?id=26 xv based on the officially marked parks on china’s baidu site: http://map.baidu.com/ xvi 彭, 晓芸. “广场舞之争背后的代际冲突.” 南方日报(广州). may 27. ryan_finaldoc reading and wellbeing in old age carrie ryan university of oxford author contact: carrie.h.ryan@gmail.com keywords: reading; wellbeing; population ageing; interdisciplinary anthropology & aging, vol 40, no 2 (2019), pp. 67-71 issn 2374-2267 (online) doi 10.5195/aa.2019.242 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. ryan | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.242 http://anthro-age.pitt.edu 67 reading and wellbeing in old age carrie ryan university of oxford author contact: carrie.h.ryan@gmail.com for the past year, i have been a visiting academic at oxford’s institute of population ageing, an interdisciplinary research centre that investigates the implications of population change globally. i arranged this opportunity after the submission of my doctorate, when i was eager to expand my view of ageing research outside of anthropology. while it had become clear to me during my doctorate that the burgeoning realm of ‘ageing research’ required interdisciplinarity facility, i found myself struggling to find the time both to develop an anthropological expertise in ageing and to learn how to converse in the worldviews of sociology, economics, and demography on which global ageing research relies heavily. i hoped that time at the institute would give me the skills to engage a variety of disciplinary approaches to ageing research. i was also eager to imagine a future, postdoctoral ageing research at the institute with implications not just for anthropology, but for a much broader audience as well. i learned how important interdisciplinary facility is for ageing research during the institute’s weekly seminars, where scholars from across the university come to speak on a variety of topics relevant to population ageing. in these seminars i watched as economists asked probing questions about biomedical research and policy analysts questioned demographers about the potential legislative implications of their conclusions. i also listened to qualitative researchers argue for the value of their approach to quantitativeminded disciplines (‘we can shape the language you use for your clinical trials,’ a psychologist told an epidemiologist, ‘we can understand the why of the big data patterns you are detecting’ a geographer told a statistician). through these seminars, i pushed myself to think about what anthropology could contribute to each piece of research (how might discourse analysis advance the research, or attention to lived practice), as well as how anthropology could benefit from these other approaches. what could anthropology do with sprawling data sets, for example, or with population-level concerns? for the first part of my tenure at the institute, i treated the seminars as classrooms for crossdisciplinary engagement. but in the spring of my academic visitor-ship, the seminar became the catalyst for my new, future research. in early march, oxford’s english department’s dr. kirsten shepherd-barr and her postdoctoral scholar dr. alex paddock came to the institute’s seminar to speak about the potential of reading to facilitate ageing wellbeing. they were developing a smartphone application called lithits, which curates a piece of standalone literature for any amount of time you have—from ten minutes of free time while on a bus ride, to a twenty-five minute gap of time between lunch and the next meeting. shepherd-barr had developed this application out of a concern that the slow, extended process of sinking into a book no longer jived with the fast, chaotic pace of the modern world. she hoped that readers might use lithits in the midst of their busy day, and, through their ‘hit’ of literature, might be drawn back into the practice of reading literature in its full form. dr. shepherd-barr always intended this application to be used for public benefit. and, in the wave of scholarly interest in oxford around ageing research with the announcement of united kingdom’s industrial challenge strategy fund of £300 million for healthy ageing research (uk government 2018a), shepherd-barr suggested in her presentation that it might be worthwhile to explore if lithits could help facilitate wellbeing in old age. after shepherd-barr and paddock finished their talk, and during the question-portion of the seminar, the institute’s audience was somewhat sceptical about the utility of lithits for older adult care. a gerontologist asked if the app was user-friendly for older people. ‘what about shaky hands,’ the gerontologist wondered, ‘or eye-sight issues?’ an economist questioned how reading could ryan | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.242 http://anthro-age.pitt.edu 68 reduce loneliness if most people read alone. would it not be better, the economist suggested, to get them involved in some kind of social activity? but i was intrigued by the idea, having just read daniel miller’s (2017) the comfort of people. in his research with people in an english hospice, miller artfully shows that technology does not isolate people at the end of life, but instead connects them socially in new and powerful ways. while critics suggest dying people prefer in-person connections, miller found that the practicalities of dying (feeling sick, being bedridden), as well as the social habits of the english (reticent, private, and unwilling to invite many into the home), make in-person relationships at the end of life nearly impossible. technology, however, facilitates just the kind of sociality the english hospice patients wanted: it allows patients to update networks of friends about their progress, while keeping them at an appropriate distance. my own personal experience, having taught hundreds of computer classes to older adults, told me something very similar: facebook and twitter, i found, often allowed older adults at the retirement community to expand their social circles and to form connections across time and space that their immobility had once made impossible. in the audience of the seminar, i wondered what these anthropological insights could contribute to shepherd-barr’s research ideas. was the audience’s presumption that an application like lithits would further isolate older, english adults correct, or just a recapitulation of our dominant, yet little interrogated view that technology and reading alienates? what if, i conjectured, lithits actually made people feel less lonely, instead of more so? the more i thought about lithits and older adult loneliness, the more i became intrigued. if we found, for example, that older adults felt less lonely after using lithits, what would that say about the relationship between loneliness and reading, and the potential of technology in old age? ethnography could open up these questions, and may tell us something surprising, where old presumptions might have shut them down. i was enthused by the potential of this research. i had just spent the majority of my doctorate trying to think about how activities in retirement communities, like dance, song, and games, contributed to the formation of residents’ belonging and self. though i had written a whole chapter on the power of the bingo game in the retirement community, i had left my dissertation wishing i had spent more time thinking about the place of activities in old age, not just from a critical perspective about the political and economic push towards ‘active ageing’ (katz 2000; lamb 2017), but also from a humanistic perspective like barbara myerhoff’s in number our days (1980) that emphasised the centrality of ritual and story to meaning-making in old age. intrigued by the potential of the questions lithits raised in relation the healthy ageing agenda in the uk, my mentor at the institute of population ageing, dr. george leeson and i approached shepherdbarr and her postdoctoral scholar, dr. alex paddock, hoping to explore further the potential impact of lithits on older adult wellbeing. in february 2019, we applied for a research seed-grant through the university of oxford to develop the outline of a future research project and were successful. for the next four months, we explored whether our research question about loneliness and reading could make public and intellectual contributions to population ageing research. we found it does so in three ways: first, it reframes debate on the intersection of our three key research terms, technology, loneliness and reading; second, it addresses current population ageing concerns in the uk in new and needed ways; and third, it has the capacity to contribute a genuinely interdisciplinary approach to population ageing research. asking if reading through lithits can alleviate older adults’ loneliness raises new questions about what loneliness is, what reading does for us, and what reading on new technologies could enable. loneliness is a largely misunderstood phenomenon, and it is common for loneliness to be confused with social isolation (coleman 2009; coplan and bowker 2014; willis, vickery, hammond, and jessiman 2019). ryan | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.242 http://anthro-age.pitt.edu 69 the problem of loneliness, scholars suggest, is not determined by the state of being socially isolated, but by the experience of feeling disconnected whether alone or while surrounded by others (mansfeld et al. 2019). especially as older adult social circles tend to wane at the end of life, what, we wondered, allows older adults to feel connected even while isolated? reading, we found, enables feelings of connection while isolated. while reading is often a solitary act, people tend to report it as a deeply engaging and connecting activity: indeed, research shows that people experience reading as an intimate form of accompaniment as well as a meaningful dialogue between reader and author, and reader and characters (age uk 2018; hilhorst, lockey, and speight 2018; mclaine 2012; rajan and rajan 2017). further, research shows reading helps individuals to develop a rich ‘inner life,’ which allows people to translate social isolation not into loneliness, but into meaningful and enjoyable solitude (fernyhough 2016; hilhorst, lockey, and speight 2018). even though several social interventions advocate person-to-person socialisation to reduce loneliness in old age, our research into reading confirms loneliness might well be reduced through relations with things, like texts, and with the self, through the development of an ‘inner life.’ further, reading on smart devices has the capacity to complicate the standard view that technology is fundamentally alienating. indeed, as miller’s (2007) ethnography argues, technological applications enable instead of disable our relationships and activity. while there are cultural fears that reading on technology lessens the ‘actual’ experience of reading from a book, several studies suggest that people who read on their phone or smart device develop just as strong of a relationship with the text; they also report that they read more and more often (pew 2012). anthropology has long challenged the idea that introducing technology into older adult care will reduce the love, warmth, and ‘personal touch’ that good care requires; ethnographies show that caring technology can be experienced as satisfying and robust as well (haraway 2008; pols 2012; petersen 2017). reading on technology, therefore, might not only encourage deep and meaningful reading experiences, but it might also be experienced as an avenue of care, intimacy and connection. there are not just intellectual reasons to get clearer about loneliness in old age and the potential of reading for ageing wellbeing, but political ones as well. biomedically framed as having mortality risks as high as those of smoking (holt-lunstad, smith, and layton 2010), loneliness is seen as one of the most significant public health issues that threatens the achievement of ‘healthy’ population ageing globally, and particularly in the uk (age uk 2009). while loneliness is often medicalized in the clinical encounter (mclennan and ulijaszek 2018), the national health service (nhs) has created a new social intervention called ‘social prescription,’ defined as the clinical referral to a range of activities in the community for the facilitation of patient health and wellbeing, including dance classes, volunteering, and, in our case, reading groups (uk government 2018b). the concern about loneliness and the interest in the impact of reading, therefore, arise in an uk political context that is seeking to use social and humanistic activities for health purposes (ageuk 2018). in our research, we have been careful to examine the ways in which the concern around loneliness and its proposed solutions, like reading, are intimately connected to political goals to make ageing and the humanities fit state agendas of health and wellbeing, personal control, and self-sufficiency. deeply aware of the political potency our research questions have, we are especially keen to find surprising ways in which the humanities might contribute to population ageing outside the political metrics which currently seek to measure its effect. our aim is to show the political and economic genealogy of the problem of older adult loneliness and proposed solutions for ageing wellbeing and to imagine alternative framings and futures for reading in old age. ryan | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.242 http://anthro-age.pitt.edu 70 in order to discern the potential impact of reading on older adult loneliness in the contemporary context, we have generated a research proposal that aims to address the conceptual and public gaps in loneliness and reading research through a genuinely interdisciplinary approach. broadly, this project will utilise ethnography and insights from humanities research to discern how older people use lithits in their everyday lives. we will use humanities research, including english literature, philosophy and history, to frame our understanding of reading, the definition of wellbeing in old age, and the contribution the humanities can make to the good life. we also aim to explore how older people themselves experience, understand, and define their loneliness, as well as the ways in which they conceptualise how reading might contribute to the good old age. our research goals are to reshape debate about loneliness in the uk and to contribute new measurements for the nhs to discern the impact of humanistic activities on wellbeing. research rooted in interdisciplinary thought, dovetailing humanistic queries with social science methodologies has emerged through this four-month journey. our collaboration seeks to make contributions not only to anthropology, english literature, and medical humanities, but also to public health and primary care. we are excited to learn more about the potential of lithits, and eager to see how the technology can advance our thinking on and potentially serve as a way to address older adult loneliness. i have been amazed by the ways in which my interdisciplinary facility has strengthened throughout the development of this research. in having to make questions about reading for ageing wellbeing relevant to scholars across the institute, i have learned how to frame my research for a broader audience, and to imagine ways my research could contribute to public policy, demography, and statistics. while there are fears that interdisciplinary research exchanges depth for breadth, i have found that in this project my commitment to anthropology has been strengthened, not weakened. by interacting with scholars outside of the discipline, i have had to dive deeper into anthropology in order to articulate how it can make unique contributions to ageing research. it seems as if my time at the institute has proven our disciplinary adage true: sometimes different worldviews clarify our native—disciplinary—value(s) more clearly. references age uk. (2009). loneliness and isolation: evidence review. accessed august 12, 2019. https://www. ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health-wellbeing/rb_june15_lonelines_in_later_life_evidence_review.pdf. age uk (2018). ‘creative and cultural activities and wellbeing in later life.’ age uk, london. coleman, l. (2009). being alone together: from solidarity to solitude in urban anthropology. anthropological quarterly, 82(3), 755-777. coplan, r. j., and bowker, j. c. (2014). the handbook of solitude: psychological perspectives on social isolation, social withdrawal, and being alone. oxford, england: wiley-blackwell. fernyhough, c. (2016). the voices within. new york: basic books. haraway, d. (2008). when species meet. minneapolis: university of minnesota press. hilhorst, s., lockey, a., and speight, t. (2018). a society of readers. london: demos. accessed august 14, 2019. https://readingagency.org.uk/news/a%20society%20of%20readers%20%20formatted%20%283%29.pdf holt-lunstad, j., smith, t.b., layton, j.b. (2010). ‘social relationships and mortality risk: a meta-analytic review. plos med (7): e1000316. katz, s. (2000). ‘busy bodies: activity, aging, and the management of everyday life. journal of aging studies, 14(2): 135-152. ryan | anthropology & aging vol 40, no 2 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.242 http://anthro-age.pitt.edu 71 lamb, s. (2017). successful aging as a contemporary obsession: global perspectives. new brunswick, nj: rutgers university press. mansfeld, l., daykin, n., meads, c., tomlinson, a., gray, k., lane, j., victor, c. (2019). ‘a conceptual review of loneliness across the adult life-course (16+ years).’ what works wellbeing. accessed june 14, 2019. https://whatworkswellbeing.org/product/loneliness-conceptual-review/. mclaine, s. (2012), ‘bibliotherapy: reading for wellbeing in old age’, alzheimer’s australia dementia forum. accessed august 1, 2019. https://www.dementia.org.au/sites/default/files/susan_mclaine.pdf. mclennan, a. k., and ulijaszek, s. j. (2018). beware the medicalisation of loneliness. the lancet, 391(10129), 14801480. miller, d. (2017). the comfort of people. cambridge: polity press. myerhoff, b. g. (1980). number our days (1st touchstone ed.). new york: simon and schuster. petersen, a. (2017). ‘posthuman wellbeing: an anthropological study of how a social robot in eldercare opens the possibility of a new kind of wellbeing.’ (masters thesis) aarhus university: aarhus, denmark. accessed june 12, 2019. https://www.academia.edu/35377738/posthuman_wellbeing_-_an_anthropological_ study_of_how_a_social_robot_in_eldercare_opens_the_possibility_of_a_new_kind_of_wellbeing. pew research center (2012). ‘the rise of e-reading.’ pew research center internet and technology. accessed here: https://www.pewinternet.org/2012/04/04/the-rise-of-e-reading-5/ pols, j. (2012). care at a distance: on the closeness of technology. amsterdam: amsterdam university press. rajan, kumar and rajan, rekha (2017). “staying engaged: health patterns of older americans who participate in the arts.” washington, d.c.: national endowment of the arts. uk government (2018a). ‘government announces £300 million for landmark ageing society grand challenge [press release].’ accessed july 12, 2019. https://www.gov.uk/government/news/government-announces-300million-for-landmark-ageing-society-grand-challenge. uk government (2018b). pm launches government’s first loneliness strategy [press release]. accessed august 1, 2019. https://www.gov.uk/government/news/pm-launches-governments-first-loneliness-strategy. willis, p., vickery, a., hammond, j. and jessiman, t. (2019). ‘older men at the margins: guidance for practitioners and services’. age uk. book review review of aronson, louise. elderhood: redefining aging, transforming medicine, reimagining life. new york: bloomsbury publishing. 2019. pp. 464. price: $26.99 (hardcover); $ 18.00 (paperback). britteny m. howell university of alaska anchorage bmhowell2@alaska.edu anthropology & aging, vol 41, no 2 (2020), pp. 274-276 issn 2374-2267 (online) doi 10.5195/aa.2020.290 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | howell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.290 http://anthro-age.pitt.edu 274 book review review of aronson, louise. elderhood: redefining aging, transforming medicine, reimagining life. new york: bloomsbury publishing. 2019. pp. 464. price: $26.99 (hardcover); $ 18.00 (paperback). britteny m. howell university of alaska anchorage bmhowell2@alaska.edu university of california san francisco professor and geriatrician, louise aronson’s newest book, elderhood: redefining aging, transforming medicine, reimagining life (2019), provides a comprehensive and sweeping look at how the medicalization of aging has negatively affected our views of older adulthood. this book is both a memoir of her personal experiences caring for elders and a treatise on how we should reframe aging in our society. the book outlines depressing stories of misdiagnosis and maltreatment of older adults as the result of ageism rooted in our medicalization of the aging process. the author also counters these discourses by providing suggestions about how to transform medicine and rethink aging. this monograph brings together research from anthropology, sociology, psychology, biology, and public health to examine the roots of ageism that dehumanize older adults. the author artfully weaves research findings with recommendations for physicians and society-at-large to learn to respect and value elderhood. the 14 chapters are grouped into five sections that follow the life course: from birth and childhood, through adulthood and elderhood, on to death. these chapters also provide a life course analogy of the author’s own process toward becoming the geriatric educator that she is today. section one, “birth,” has only a single chapter and serves as an introduction to the book and to her life as a geriatrician. she recalls that midway through her first year of medical school, weary of chemistry and biology courses, she started contemplating a switch to graduate school in medical anthropology or policy because it “provided glimpses of a worldview absent from my medical textbooks and the lectures i attended” (3). this chapter sets the stage for the many experiences that have disillusioned aronson throughout her medical training and geriatric career. section two on “childhood” is the largest one in the book, containing five chapters that delve deeper into the causes of the unequal spread of medical specializations. aronson argues that a great deal of interest in the field of medicine goes to understanding and treating conditions of childhood, and this to the detriment of geriatrics. with chapters titled “infant,” “toddler,” “child,” “tween,” and “teen,” she argues that pediatricians address many of the social and medical needs of children, but few physicians or other professionals are trained in the unique aspects of older adulthood. in chapter 5, aronson points out that the current standards of medical education emphasize algorithms, statistics, normativity, and standardized protocols that work to exclude older adults and many others who fail to comply to such a narrowly-defined medical conceptualization of ‘normal’ (63). by beginning medical education with http://anthro-age.pitt.edu/ book review | howell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.290 http://anthro-age.pitt.edu 275 the expectation that all humans should present to their physicians like norm, future medical professionals are learning to treat aging as experiences outside of the normal, thus systematically reinforcing ageism in the health care system. section three, “adulthood,” contains four chapters (“young adult,” “adult,” “middle-aged,” and “senior”) highlighting the author’s experiences completing medical school and finding her way to a career in geriatrics. although this book is filled with several heartwarming personal stories about her journey, this section of the book also includes brutal honesty about the author’s experiences with stress and burnout. she talks in detail about the experience of what she terms “the snap” (220), or her breaking point that led to a period of self-imposed unemployment. she details each step of the physician burnout process from the research literature – from emotional exhaustion to depersonalization to reduced accomplishment – she highlights how she experienced each of these phases. she reports that her exhaustion and work stress caused mood swings at home ranging from “the calm, cheerful person i mostly was with patients and colleagues into a whirling dervish of wrath” (216). upon recognizing that she “lit up” the burnout scale (220), she began taking time off work to re-evaluate her goals and determine if she was still able to rectify her personal goals with the field of medicine as it is practiced in the us today, a process that took a year and a half. the fourth section, on “elderhood,” contains three chapters (“old,” “elderly,” and “aged”) most notable for aronson’s evisceration of the modern system of medical education throughout the book. she also offers concrete recommendations for the future: according to the author, medical education standards will need to be completely redesigned to include a foundational understanding of the sociobiological nature of aging. she rightfully states that western biomedical education devotes few resources to teaching students about aging or elder care, resulting in a sharp geriatric provider shortage she does not, however, provide recommendations or remedies for the currently critically understaffed geriatric workforce. research shows that few students are willing to consider geriatric or gerontology careers (haron et al. 2013; meiboom et al. 2015; ní chróinín et al. 2013), so this oversight detracts from her overall message of hope for the field of geriatrics. in chapter 4, she points out that dementia diagnoses are frequently missed until its later stages due to inexperience, lack of training and skills, and lack of time reported by physicians. at her own place of work, she discloses that dementia diagnoses are uncommonly low, partially because physicians “feel there’s no point in making the diagnosis, since they have little to offer by way of treatment” (53). to remedy such problems, aronson calls for an ageinclusive curriculum for all medical students throughout their training and careers and for replacing american medicine’s current disease-centeredness with a new “care paradigm” (379) to allow for an emphasis on the concern for the human needs of patients of all ages and stages of life. section five, “death,” contains a single, short chapter titled “stories,” that highlights the disconnect many older adults feel because of our society’s focus on the physical deterioration of appearance as we age. she analyzes an essay by emily fox gordon in which the author conveys the broad societal disconnect between the reality of the lived experiences of old age and our beliefs about aging. fox gordon’s complaints about stiffness and pain are tempered because others have deemed her “younglooking” and therefore concluded that “being old wasn’t half bad” (397). to this effect, aronson indicates that we are all affected by such views that prioritize physical appearance and strive to remain young, sharing her own struggles with letting her hair go gray and signaling to others that she, too, is aging. throughout the book, aronson argues that aging and dying are medicalized in ways that do not consider the impact on older adults’ wishes and dignity. older patients are provided with ineffective and even harmful options at the end-of-life, caught in endless quests to conquer and cure diseases rather http://anthro-age.pitt.edu/ book review | howell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.290 http://anthro-age.pitt.edu 276 than respecting patients’ wishes about how they want the end of their lives to look. for example, aronson recalls the story of laila, a woman with dementia and challenging behaviors among her house call patients. because laila had diabetes and dementia, she frequently fell and developed infections to which the family would often call 911 for assistance. paramedics would contribute to her trauma experiences by applying medical devices to her body and rushing her to the hospital where she would receive more “bodily assaults and invasions” (210) in unfamiliar rooms by strangers. geriatric training and expertise allowed the author to identify the interpersonal and medical reasons for her screaming and challenging behaviors in the comfort of her own home. additionally, in chapter 11 the author tells the story of cathy’s long battle with cancer. aronson states that although cathy was on hospice care, hospice has “transitioned from vocation to industry” (299), resulting in inconsistent care practices in an increasingly for-profit business enterprise in the us. cathy’s family was left with an incredible burden of home health care tasks to conduct themselves without proper assistance or training. these are just two examples aronson shares to illustrate the ways that medicalizing aging has resulted in inappropriate treatments and prolonged suffering. this book would be excellent material for health professionals, policymakers, service providers, and the general public. it would provide them with an insider’s critique of the invasive and sometimes pointless treatments with which modern medicine battles the “disease of aging.” especially delightful in this work is the evidence of aronson’s training in creative writing. this is reflected in the poignant ways in which she is able to describe and reflect on her own personal experiences and the failings of the modern medical establishment throughout the text. however, less cogent in the sprawling text are her musings on the positive aspects of aging, which may not be entirely convincing when juxtaposed against the generally grim picture she paints of physician ineptitude and societal age discrimination. the text is a bit too long and redundant in several places. for use in upper-division anthropology or gerontology courses, utilizing sections of the book to facilitate understanding of specific topical areas may be more helpful than requiring students to read the entire tome. references haron, yafa, sara levy, mazal albagli, ruth rotstein, and shoshana riba. 2013. “why do nursing students not want to work in geriatric care? a national questionnaire survey.” international journal of nursing studies 50(11): 1558-65. meiboom, ariadne a., henk de vries, cees m p m hertogh, and fedde scheele. 2015. “why medical students do not choose a career in geriatrics: a systematic review.” bmc medical education 15(1): 101. ní chróinín, danielle, edel cronin, walter cullen, diarmuid o'shea, michael steele, gerard bury, and lorraine kyne. 2013. “would you be a geriatrician? student career preferences and attitudes to a career in geriatric medicine.” age and ageing 42(5): 654-57. http://anthro-age.pitt.edu/ book review | samanta | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.267 http://anthro-age.pitt.edu 122 book review review of king, andrew, kathryn almack and rebecca l. jones, eds. intersections of ageing, gender and sexualities: multidisciplinary international perspectives. 2019. bristol, uk: policy press. pp. 246. price: $97,75 (hardcover); $35 (paperback and ebook). tannistha samanta humanities and social sciences, indian institute of technology (iitgn) gandhinagar, gujarat anthropology & aging, vol 41, no 1 (2020), pp. 123-125 issn 2374-2267 (online) doi 10.5195/aa.2020.267 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ book review | samanta | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.267 http://anthro-age.pitt.edu 123 book review review of king, andrew, kathryn almack and rebecca l. jones, eds. intersections of ageing, gender and sexualities: multidisciplinary international perspectives. 2019. bristol, uk: policy press. pp. 246. price: $97,75 (hardcover); $35 (paperback and ebook). tannistha samanta humanities and social sciences, indian institute of technology (iitgn) gandhinagar, gujarat coming out of gerontology’s heteronormative trappings of ‘successful aging’ and the muchaspired ‘good life’ in later life discourses, king, almack and jones’ edited volume on the complex intersections of gender, age and sexuality makes for a novel intellectual disruption. this volume reimagines and “queers” (sandberg and marshall 2017) gerontology’s futures as well as capably harnesses the “cultural turn” (gilleard and higgs 2013) by weaving queer temporalities with interlocking themes of subjectivities, identities, bodies and embodiment. this focus on the performative multiplicity of aging subjectivities allows for radically questioning the cultural friction between people whose lives are considered “desirable to live and thrive into old age” and those “whose aging is understood as liveable aging” (sandberg and marshall 2017: 7). thus this volume addresses both the epistemological, political, social and vital limitations of a “hetero-happy” context (van dyk 2014), where able-bodiedness and heterosexuality are normativity’s second name. hence, by representing aging futures that are marked by alleged ‘failures’ of menopause, sexual dysfunction and chronic ailments, the volume achieves two significant goals: (1) it offers a potent critique of mainstream gerontology that has for long organized itself along the binaries of successes and failures, and (2) it opens up a range of alternative voices, realities and practices that have been neglected in gerontological studies due to similarly binary epistemologies. this volume is organized around four substantive thematic sections: “theoretical interpolations,” “representations,” “dis/empowerments” and “health and well-being.” the first section focuses on gerontology’s ongoing attempts to bridge theory and lived reality. building on theories of intersectionality, toni calasanti (chapter 1) offers a heuristic model, where sexual orientation and gender intersect to influence the division of care labour among older couples. drawing from queer theory, yvette taylor’s semi-biographical contribution (chapter 2) offers an innovative critique of a ‘chrononormative’, neoliberal capitalist academic space. vanessa fabbre and anna siverskog (chapter 3) use queer and life-course perspectives to understand the role of social capital among trans older persons in the united states and sweden. interestingly, in both the second and third chapter, queering ‘time’ serves to both illuminate and critique how (hetero)normative expectations are reproduced, disciplined and yet disrupted. “representations” focuses on portrayals of aging, gender and sexualities, drawing from textual analyses of web columns and magazine articles. this deconstruction reveals the aging body as a site of new forms of governmentality. elizabeth barry (chapter 5) uses virginia woolf’s mrs dalloway to think imaginatively about menopause and later life sexuality. comparing germaine greer’s and simone de beauvoir’s depiction of menopause, barry argues that, while both these leading feminists sympathize with the gendered experience of aging, they ultimately employ the same spurious scientific concepts that pathologize menopause by naturalizing the idea of decay and incapacity associated with aging female bodies. marciel oro piqueras (chapter 6) takes three contemporary british fictional texts to complicate the contemporary social space for later life sexuality, most commonly caught between the “asexual” and the “sexy oldie” (sandberg 2015). piqueras aptly reminds that, although the female protagonists in the texts do http://anthro-age.pitt.edu/ book review | samanta | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.267 http://anthro-age.pitt.edu 124 not conform to the normative models of (female) aging, this does not prevent their affective and sexual assertions to occur outside the tropes of the heterosexual family. the contribution on midlife motherhood in denmark and israel by kinneret lahad and karen hvidtfeldt (chapter 7) neatly follows this caution. based on data from online web columns and magazines, the authors distill the theoretical concept of “aging capital” (indicating experience, patience, wisdom and hence agency) to demonstrate how ‘late’ mothers negotiate aging in the face of pro-natal regimes and public moralities on appropriate motherhood. the third section on “dis/empowerments,” explores how (social) positioning emerges in the continuous affective interplay between individual and institutional hierarchies. authors jill wilkens (chapter 8) and elham amini (chapter 9) creatively import bourdieu’s habitus to critique the intersection of social mobility and the practice of social scientific research. wilkens indexes habitus dislocation to understand her participants’ – british lesbian and bi/queer older women born between 1940 and 1958 – differential access to education and employment. amini writes from her positionality as a female, highly educated young health professional among a group of menopausal iranian women practicing shia islamic faith. the negotiation of her insider/outsider status during research, inspires her reflections on social location and shifting power dynamics. feliciano vellar’s examination of sexual expressions and practices of elderly in spanish long-term care facilities, is an atypically a-theoretical contribution to this volume. yet, it adds significantly to the understanding of the way sexual lives of institutionalized older adults remain embedded in highly regulatory regimes that perceive sexual behaviors “as potentially problematic or even pathological” (165). vellar concludes with practical guidelines, emphasizing the need for a rights-based, person-centred model of care to ensure sexual citizenship of elderly with dementia, as well as lgbtq older adults. in chapter 11, finn reygan and jamil khan take the reader to south africa to offer insights on the lives of lgbtq older adults that are informed by “contextual realities and african ontologies” of care (171). the authors contend that constitutionally guaranteed freedoms do not necessarily translate into substantive equality for older people in a context that has long, complex histories of racial and class-based inequality. taken together, the four chapters demonstrate that dis/empowerment grows from differential social mobility, sexual citizenship and the practice of social scientific research, and is thus continuously recreated at the intersections of hegemonic epistemologies with socio-political realities. the last section, “health and wellbeing,” challenges the normative constructions of age, illness and masculinity. mark hughes’ (chapter 12) contention of the potential dangers of quantitative research aggregating people into one lgbtq category, is a rare one. drawing from existing large-scale studies on australia, uk and the united states, hughes shows how “population level analysis can powerfully illustrate the systemic subordination of some people on the basis of multiple and intersecting social categories” (193). in a similar vein he critiques the tendency of quantitative studies to valorize experiences of marginalization as ‘additional’, rather than vital. in the last two chapters, raffaella ferrero camoletto (chapter 13) focuses on mature masculinity in the viagra era and julie fish (chapter 14) offers an analysis of older gay and bisexual men’s experiences of prostate cancer. both authors reaffirm the persistent cultural tension between successful aging, respectable sexuality and aging masculinities and demonstrate how older men’s lives are disciplined by dominant tropes of heteronormativity and bodily functionality. overall, the volume’s multidisciplinary interrogations are well served owing to the editors’ diverse intellectual engagements with lgbtq older adults, end of life care, housing and social care. the editors have involved a range of actors, hence staying true to gerontology’s fundamental question of ‘so what’ or: how can theories and empirical insights effectively improve the lives of older persons? this is however also where the volume somewhat disappoints its publics: despite the editors’ involvement with lgbtq activism, this current volume does little to add voice to the growing movement of sexual citizenship and the affirmative political discourse of later life sexuality. one is left wondering: how do historical, social and cultural forces shape resistance, advocacy and pride in lgbtq lives? how will future gerontologists http://anthro-age.pitt.edu/ book review | samanta | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.267 http://anthro-age.pitt.edu 125 engage with the shifting regimes of lgbtq politics and policy? that said, this volume’s engagement to privilege the “international” perspective, or at least “not to prioritise voices or perspectives from the global north, at the expense of others” (3), undoubtedly comes as a relief. the volume invites the reader to deliberate on pertinent questions that challenge the euro-american hegemony of gerontological knowledge systems and to reconsider the convergence of who and how is known: “where does this knowledge come from, in whose name is it written, whose voices are heard and whose are not?” (3). to summarize, this volume surely delivers its original promise: understanding the complex intersections between different forms of social division, identity, (in)equality, power and privilege. although its rich analysis will be primarily appealing to academics, it can also be a useful teaching resource for upper undergraduate and graduate students interested in intersectional frameworks, both theoretically and methodologically. while all contributing scholars are primarily, and actively seeking to hybridize the heteronormative boundaries and underpinnings of gerontology (and aging), the volume certainly has the breadth to be appreciated by literary experts, cultural theorists, medical practitioners or anyone interested in rethinking cultural imaginaries of failing bodies, fragmented identities and sexual pluralities. references burawoy, michael. 2005. "presidential address: for public sociology." american sociological review 70: 4-28. gilleard, chris and paul higgs. 2013. ageing, corporeality and embodiment. london: anthem press. halberstam, jack. 2005. in a queer time and place. new york: new york university press. putney, norella m., dawn e. alley, and vern l. bengtson. 2005. "social gerontology as public sociology in action." the american sociologist 36(3): 88-104. kafer, alison. 2013. feminist, queer, crip. bloomington, in: indiana university press. sandberg, linn j., and barbara l. marshall. 2017. "queering aging futures." societies 7 (3): https://doi.org/10.3390/soc7030021. sandberg, linn, j.. 2015. "sex, sexuality and later life." in routledge handbook of cultural gerontology, edited by julia twigg and wendy martin, 218-225. new york: routledge. twigg, julia, and wendy martin. 2015. "the challenge of cultural gerontology." the gerontologist 55 (3): 353-359. van dyk, silke. 2014. "the appraisal of difference: critical gerontology and the active-ageing-paradigm." journal of aging studies 31: 93-103. http://anthro-age.pitt.edu/ https://doi.org/10.3390/soc7030021 book review review of bamford, sandra, ed. the cambridge handbook of kinship. cambridge: cambridge university press. 2019. pp. 750. price: $157 (hardcover); $120 (ebook). irina kretser saint-petersburg state university i.kretser@spbu.ru anthropology & aging, vol 41, no 2 (2020), pp. 286-288 issn 2374-2267 (online) doi 10.5195/aa.2020.293 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | kretser | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.293 http://anthro-age.pitt.edu 286 book review review of bamford, sandra, ed. the cambridge handbook of kinship. cambridge: cambridge university press. 2019. pp. 750. price: $157 (hardcover); $120 (ebook). irina kretser saint-petersburg state university i.kretser@spbu.ru at its core, the cambridge handbook of kinship, edited by sandra bamford, explores “how kin connections are imagined, formed, and administered in the twenty-first century” (5). the book consists of six parts and opens with three cases, focusing on issues of assistant reproductive technologies, of kinship and citizenship and of adoption and private rehoming of a child, thus immediately immersing the reader in the complexities of modern kinship and pointing out to some of the themes that will be dealt with in the rest of the volume. part i presents classical anthropological kinship theories from a new angle and analyzes the intellectual history of some of the significant anthropological concepts in this field. gillian feeley-harnik (chapter 3) scrutinizes the linkages between the notion of ‘descent’ and ideas of connection, selection, development and improvement. she deals not only with descent in the human world, but includes animal worlds as well, describing, for example, sheep breeding experiments in 18th-century great britain. isabelle clark-decès (chapter 4) studies the effects of the implication of alliance theory to south india, and sarah franklin (chapter 5) pauses on different ways of thinking about ‘biology’ in the context of kinship studies. at the end of part i, janet carsten (chapter 6) suggests shifting from the very classical opposition between ‘biological’ and ‘social,’ to questions of how kinship works, focusing on the importance of “stuff,” temporality and gradations of kinship. in sum, part i provides the reader with the basic concepts in kinship studies, while raising new questions and indicating future directions for the field. further scrutinizing the cultural dichotomy between ‘biological’ and ‘social,’ part ii mainly argues not to reduce ‘biological’ to ‘reproduction,’ and offers ways of balancing the ‘social’ and the ‘biological’ in localized and historically contingent ways. the body becomes a domain where the ‘social’ and the ‘biological’ merge, as it embodies, reflects, and materializes kinship relations. kathryn e. goldfarb (chapter 7), observing the behavior of kids in child welfare institutions in japan, describes how kinship, care, or its absence, are embodied in bodily practices. for example, the proficiency of using chopsticks is interpreted as ‘embodied signs’ of previous family relations. drawing on another example, she asks: “is being leftor right-handed biological? is it cultural? or is it an emblematic case of ‘local biologies,’ the result of dynamics across both domains?” (153). this is a pivotal question, and a most relevant starting point for studying our bodies and relations. furthermore, gail landsman’s account of the role of technology in childhood disability (in part v, chapter 24) focuses on how an assemblage of bodies, http://anthro-age.pitt.edu/ book review | kretser | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.293 http://anthro-age.pitt.edu 287 technologies and people, redefines personhood and social relations of a person with a disability. in part ii, and throughout the volume, the authors emphasize that kinship is deeply embedded in ‘biological materiality’ (154) and inseparable from it. in part iii the authors bring to the fore how cultural, political, legal and kinship orders are inextricably interwoven with, and foundational for mundane realities of kinship, established through everyday practices. noa vaisman (chapter 12) tells one of the most dramatic and memorable stories in this book: during the dictatorship in argentina (1976-1983) about 500 children – “living disappeared” – were transferred from their own families (their parents were murdered) to other families, where “their biological identities were erased, by changing their dates of birth, names and kinship ties” (279). modern governments and nongovernmental organizations still try to restore the truth and return the “living disappeared” to their biological relatives but, as the author indicates, these processes raise a lot of questions that touch upon the sensitivity and complexity of the relation between kinship and state power. does the argentinian state have the right to intervene in people's lives and forcibly reunite them with a family they never knew? does the state have the right to collect a dna sample of the “living disappeared” without their permission? do these, now adults, have the right to refuse to undergo a dna test? do their biological relatives have the right to know the truth? biological, social, political, legal and ethical issues get inextricably entangled and mixed up in these contradictory narratives. what is private? what is public? there is no answer, no border. part iv gives considerable attention to the role of migration in the context of kinship. lieba faier (chapter 18) provides a rich guide to japanese ways of living, exploring how filipina female migrants become “oyomesan” (412) – traditional japanese brides and daughters-in-law – thus transforming not only their own lives and selves, but also influencing japanese patterns of kinship. in the remainder of part iv, however, the authors go beyond positive effects of transnational connection and focus on the precarious position of transnational migrants and their unstable kinship relations: jessaca leinaweaver (chapter 17) calls attention to inequality and racialization in the context of transnational adoption and poses the question what ‘transnational’ means in this context; nicole constable (chapter 16) focuses on the vulnerable lives of hong kong former foreign domestic workers and their families or “temporary family formation” (373), and deborah a. boehm (chapter 19) describes how mexican families are scattered across the us-mexico border due to deportation from the us. in part v kinship is interwoven with technologies. marcia c. inhorn et al. (chapter 22) call attention to the linkage between particular religious ideologies and types of permitted assisted reproductive technologies in sunni muslim arab countries, secular turkey, shia muslim iran, and jewish israel. other authors in part v provide interesting insights into studies of surrogacy: janet dolgin (chapter 21) examines the court cases of surrogacy and transformations of the notions of ‘mother,’ ‘family’ and ‘childhood’ in this context. elly teman and zsuzsa berend (chapter 23) focus on the similarity between surrogacy practices in israel and the usa, and tsipy ivry and elly teman (chapter 25) analyze common cultural roots and mutually constitutive relationships between surrogacy and pregnancy in israel. part vi thematizes the failed artificial distinction between the modern nation-state and kinship ideologies. as most of the authors here amply demonstrate, state and kinship are inseparable from each other: the ‘political’ intervenes in family lives and redefines kinship relations – through the carceral system, as hollis moore shows (chapter 27) or through development programs, as koreen m. reece illustrates (chapter 29). furthermore, “the nation-state is frequently in tension with kinship and religion considered together, as an alternative . . . space for the making of persons and relations between persons” (711). in the same vein, susan mckinnon (chapter 26) describes how the image of cousin http://anthro-age.pitt.edu/ book review | kretser | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.293 http://anthro-age.pitt.edu 288 marriage is changed in great britain: from positive ratings, when this practice was still associated with aristocracy, to stigmatization, when it started to matter as part of british pakistani muslims’ kinship. to conclude, i wish to highlight several themes that are compelling about this book and that run through the different parts. the authors bring to the fore, firstly, the importance of religion as the basis of kinship ideologies in modern states; secondly, the increasing role of the law in redefining kinship; thirdly, that particular forms of kinship can have both negative and positive effects, and fourthly, that information, whether it’s dna tests or adoption documents, is becoming a new essential part or “stuff” of kinship. this elaborate volume will be of great value for a diverse audience interested in how inconsistent, competing and contested narratives merge in the domain of modern kinship. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2013: 34 (2) 213 aaq welcomes submissions of new and engaging work that contributes to the anthropological study of aging. this may take the form of original ethnographic or experimental research, or work that applies anthropological methods and perspectives to the study of aging more broadly. see http://anthropologyandgerontology.com, for the latest calls for papers, deadlines, news updates, and to download current and back issues for free. submission process all manuscripts should be submitted electronically, via e-mail attachment. anthropology & aging quarterly accepts four types of submissions--research reports, policy and news reviews, commentaries, and articles. aaq invites unsolicited contributions in several forms. research reports are brief discussions of ongoing or recently completed study (including doctoral research) and should be between 2,000-4,000 words. policy and news reviews are pieces which offer thoughtful and reflective commentary on current events or social policies pertaining to aging and culture. commentaries provide authors with an opportunity to discuss theoretical, ethical and other time-sensitive topical issues which do not lend themselves to a full-length article. policy reviews or commentaries may range from 3,000 to 6,000 words with the optional format of printed responses from members of the editorial advisory board. articles are peer-reviewed and manuscript submissions should include the following: a cover page with the author’s full name, affiliation, contact information, manuscript title; a 250 word abstract; the text; references cited; and tables or figures (chicago manual of style, 16th edition). endnotes are permitted but should be used sparingly and with justification. articles should not exceed 10,000 words, including all notes and works cited. published materials will open-access and authors are protected by a creative commons copyright. we are also encourage submissions of visual work for the “portfolio” section of our journal, including photographic essays and artwork relevant to the subjects of the journal. all submissions should be submitted via e-mail to journal@anthropologyandgerontology.com evaluation as a digital journal, aaq stresses timely publication. manuscripts are evaluated by the editoral staff (editor-inchief, and sometimes associate editors), by anonymous peer referees (double-blind), and occasionally by members of the editorial advisory board.. every effort is made to expedite the review process, but authors should anticipate a waiting time of two to three months. before a final decision is reached. in leiu of a publication fee, authors of accepted submissions should be current members of aage. this allows us to make your work open-access and grants you the regular member benefits. anthropology & aging quarterly the official publication of the association for anthropology & gerontology information and submission guidelines anthropology & aging quarterly is the official publication of the association for anthropology & gerontology (aage). it is published quarterly (march, june, september, december) by aage. aage is a nonprofit organization established in 1978 as a multidisciplinary group dedicated to the exploration and understanding of aging within and across the diversity of human cultures. our perspective is holistic, comparative, and international. our members come from a variety of academic and applied fields, including the social and biological sciences, nursing, medicine, policy studies, social work, and service provision. we provide a supportive environment for the professional growth of students and colleagues, contributing to a greater understanding of the aging process and the lives of older persons across the globe. mailto:journal%40anthropologyandgerontology.com?subject= anthropology & aging quarterly 2013: 34 (2) 214 book reviews gonzalez sanders, delia j and fortinsky, richard h. dementia care with black and latino families: a social work problem-solving approach. springer publishing. 2012 isbn978-0-8261-0677-3 (paper) $55 this book is divided into three sections: 1) setting the context for understanding ethnic dementia care; 2) social work process: tools and applications for ethnic populations and 3) foundations and future care. the majority of the book focuses on section two, “social work process”. the primary theoretical orientations, 1) systems theory and 2) cognitive behavioral theory, are clearly laid out and defined in the preface. as the title indicates (dementia care with black and latino families: a social work problem solving approach) is directed toward social workers, though it would also be very useful for nursing, medical, public health, anthropology and sociology students. it gives an introduction to trends in alzheimer’s disease and related dementias (adrd) among diverse populations in the united states. many of the chapters open with a vignette narrative of actual clients who are caring for someone with adrd. these narratives provide a reader with a “human face” to the disease to counter the statistical trends. the vignettes and case examples present reasons why people in minority groups might choose to care for a loved one with adrd at home (rather than skilled nursing care) and the myriad of challenges that they can face while providing this care. issues presented in the case examples are explored throughout the chapters, but it is not until chapter 7 (gonzalez sanders and fortinsky 2012:207) that the authors walk the reader through a case example, issue by issue, suggesting problem solving techniques and solutions. in earlier chapters, the reader might be left wondering how to address the presented challenges, without finding answers until much later in the book. this structure, while disconcerting at times, might serve as a useful critical thinking exercise for students. a glaring concern from an anthropological perspective is that the authors speak extensively about culture, ethnicity, (and to a lesser extent, race) without defining these concepts. a definition of culture is eventually provided in chapter 4 (gonzalez sanders and fortinsky 2012:95). these are contentious issues and it is understandable that the authors would wish to side step the complexity of these definitions, but it is necessary to address and define these concepts from the beginning. without these definitions, the reader is left to define the terms in any way they choose, complete with the stereotypes presented in popular culture. for example, the authors use the terms “black” and “african americans” in cultural and ethnic terms, rather than biological, however, this might not be clear to students. this concern could be rectified from an instructional standpoint if the book were augmented by articles that addressed the concept of culture, ethnicity and race in the medical field. in contrast, the authors do problematize the gendered skew of caregiving trends; most caregivers are women. the book does offer useful problem solving techniques, sample forms, and documentation, which could be useful for social workers, nurses, physicians and researchers alike. some of the suggested techniques, such as the “ethnocultural genogram” in chapter 6 (gonzalez sanders and fortinsky 2012:181-204) are adaptations of the family tree diagrams that anthropologists have historically used during ethnographic research. the adoption of the techniques and forms in this book could yield very rich and useful data for individual problem solving and identifying further social trends in social work practice and applied medical anthropological research alike. janelle j. christensen, m.p.h., ph.d palm beach state college osage, patricia and mccall, mary. connecting with socially isolated seniors: a service provider’s guide. berkley, ca: health professions press. 2012. isbn 9781932529739, 360 pp. price $32.95 (paper) authors patricia osage and mary mccall explore the challenges associated with senior isolation in connecting with socially isolated seniors. designed as a service provider’s guide, this resource is a result of years of experience and expertise at the request of the staff and residents of satellite housing, inc. satellite housing, inc. is a provider of affordable housing to the san francisco area whose service coordinators and caregivers were in search of a consolidated resource of best practices. the book summarizes the findings from a large survey of older adults living in independent senior housing communities and from focus groups conducted with senior caregivers, service coordinators, and activities directors. the authors addressed three big questions: • do you recognize an association anthropology & aging quarterly 2013: 34 (2) 215 between certain types of seniors and social isolation? • what have you tried that was successful in reaching out to the aging? • how can we prevent isolation and its’ impact in our housing communication? the book is easy to understand and divided into fifteen short chapters; 10 of which identify key risk factors associated with social isolation in the elderly. besides succinct information, the book has numerous resources, including checklists, a quiz to help quickly identify individuals who are at risk for social isolation, contact information for specific public agencies, and “how to help” sections that describe how to intervene with specific, actionable-specific items. in addition each chapter includes a detailed case study that reinforces the information within the section and that may potentially help others identify risk factors with their residents, patients, or loved ones. several key behavioral and cultural issues are addressed within the book; including hoarding, substance use, intimate relationships, and language and culture. for example: hoarding: although unfamiliar to many several years ago, today this phenomenon is common. the term hoarding is associated with the term “messy” but oftentimes the core issue of why a senior becomes a hoarder is overlooked. hoarding is a result of loneliness and material objects often replace relationships (p. 53). a great take-away from this chapter is the reminder that as a service provider/ caregiver the goal is not for the senior to get rid of everything, but to organize things giving them more use of their room. the “eliminate –all” strategy can often do more harm than good. a great suggestion in this chapter is to seek out peer or clinical groups for reducing hoarding; matching seniors with their peers for support and social connection. intimate relationships: many seniors deal with the loss of a loved one/spouse which can lead to social isolation. challenges associated with older adults who self-identify as lesbian, gay, bisexual, or transgendered (lgbt) are often neglected. homosexual seniors 65 years and older grew up during a time when they felt they needed to hide their relationships. living in senior housing they still may perceive the need to hide those same feelings leading to increased isolation and loneliness. again, networking with support groups, sharing their feelings with others, particularly people they do not live with may help. a great resource, cited in this chapter and can be referenced to any senior is “sage” (services and advocacy for gay, lesbian, bisexual, and transgender elders) (p. 62). one might assume that this resource could only be used within the california area due to the origin of the material, but the fact is this evidence-based handy 127-page guidebook can be used universally. working in medical education myself, i would recommend this book to any medical students who consider getting into geriatrics or who have grandparents, my peers who have taken on the responsibility of caring for their parents, and/or anyone in the healthcare profession. in the “notes” section of the book, is a reference-ready listing of agencies, websites, textbooks, journal articles, all current which can be applied to any senior housing or residential/personal care situation. this resource will help identify seniors in any community and in residential care whose health and well-being are in jeopardy. highly recommended. diane l. brown, ms program manager ii geriatrics education teams (gets) medical college of wisconsin lynch, caitrin. my name is julius: a film about growing old, staying young, and confronting a lifetime of hearing loss. that’s my film! 2011. oclc 785724214 17 min. 36 sec. dvd. lynch, caitrin. retirement on the line : age, work, and value in an american factory. ilr press. 2012. isbn 0801477786, 228 p, $21.95 (paperback) the current economic crisis has brought the plight of older adults in the united states workforce into sharp focus. many older adults would like to retire but cannot afford to do so due to uncertainty in the stock market, while currently unemployed older adults face age discrimination in their search for employment. at the same time, many retired older adults face a crisis of meaning in their lives. if identity and worth are defined by what job title and productivity, what is a nonproducing older adult worth? and if people stay connected socially through the workplace, how do the retired combat a sense of isolation and a lack of belonging? my name is julius, a seventeenminute documentary film produced by anthropologist caitrin lynch, examines the themes of loneliness, isolation, and connectedness. in this film, julius barthoff, pictured at 99 and 100 years of age, speaks movingly about his attempts to stay connected in the world. having experienced hearing loss at a young age, he has always had to struggle to stay connected due to his disability but more so now with age. as he sits in conversation with other older adults, julius has trouble following the conversation and knows he is not anthropology & aging quarterly 2013: 34 (2) 216 hearing everything. he does not isolate himself but strives as much as possible to stay connected, to help others and to still make the rest of his life “happy”. not interested in material wealth, he does a good deed daily by delivering newspapers to other residents of his senior housing complex. watching the film, the parallel between the disabled at any age and the position of older adults in american society become apparent. while those who experience a disability can feel isolated and apart at any age, previously wellconnected older adults may start to experience isolation and loneliness as they retire, move into age-segregated housing, and lose contact with younger generations. the film can be useful in demonstrating these concepts to a class in gerontology, cross-cultural gerontology, or aging. turning to how older adults may capture that sense of belonging and connectedness in the workplace, caitrin lynch’s aptly entitled ethnography, retirement on the line, is a study of the vita needle factory in needman, massachusetts. a light manufacturing plant making needles for a variety of purposes, the median age of the workers was 74 and the oldest worker was aged 99 in 2011. lynch spent five years studying vita needle using interviews with workers and management as well as actually working on the factory floor herself for one summer. the book is divided into two parts. in part one, lynch focuses on how the company is structured and how life operates inside the factory. the owners of this company, which has received much media attention, focus on hiring part-time workers, mostly older adults, who will forgo high wages and benefits in exchange for supplemental income, flexible hours, job accommodations, and a no-layoff policy. the owner, fred hartman, claims that older adults are not only reliable, dedicated, and dependable, but also most likely to work part-time to supplement their other income. older adults also qualify for programs such as medicare , so they don’t need employer health benefits. the work does not require much physical strength and accommodations are made for those workers who require help lifting and moving, as well as allowing workers to rotate between jobs to avoid boredom and loss of productivity. further, hiring managers look for those whose motive to work is to escape monotony, inactivity, or loneliness at home and weed out those who want higher wages or only want to do specific kinds of jobs. for vita needle, this results in a homogenous (yet economically diverse) workforce of older local, white, mostly nonimmigrant, christian (catholic or protestant) workers. some need the supplemental income to get by on retirement income, while others view it as “mad money”. yet lynch finds this to be a “win-win” situation for all. she convincingly documents the sense of family, belonging, productivity, and meaning that the older workers derive from their employment at vita needle. they no longer feel “useless”, isolated, disconnected, and non-productive. the flexibility at vita needle in hours, work load, and attendance allows the accommodations needed for older workers. yet the owners claim that their intention is not just to benefit seniors but assert that this model makes good economic and business sense. lynch documents how this model allows them to get dedicated workers without paying high wages and benefits, while attracting customers with their “moral high ground” [and getting kudos for the non-diversity of their workforce]. the workers do not appear to resent the idea that their labor makes the company profitable and recognize the inherent reciprocity, as demonstrated by one of their stock phrases, “making money for fred”, which also results in a “christmas” bonus for them. lynch characterizes these practices as “elder sourcing”, an alternative to outsourcing similar work out of the country and with the benefit of retaining business in the united states economy. while lynch makes a strong case for the benefits these workers and the owners find in such a “homogenous” and non-diverse work environment, she does not really address the potentially discriminatory and possibly illegal nature of such hiring practices nor other problematic practices, such as the “men’s lunch corner”. in part two, she documents and analyzes the media attention, which includes her own presence, that the company receives and how this affects the workers. interviews, filming for documentaries, and tv coverage, including a tv discussion where lynch herself appeared with the owner and one worker, were frequent events. for example, stories about the company became part of political discussions about the meaning of retirement in france. these types of stories were followed by letters and e-mails from people in europe (posted in the workplace) who reinterpreted their own status as retired adults after seeing the coverage of vita needle and wished for a similar chance to work. lynch felt that the vita needle workers learned to interpret the meaning of their own lives by “consuming” media coverage of the company. for example, they expressed appreciation for their situation compared with the situation they imagined in europe based on the letters. yet, cooperation with the various media, such as news crews and documentary makers, as well as with lynch herself, varied. some felt participation was “part of the job”, while others used fake names anthropology & aging quarterly 2013: 34 (2) 217 for media photos or altered their identifying information. some chose never to talk to lynch or declined to participate in various media events or participated selectively. lynch attributes this to a need to exhibit “agency” in their own lives, a desire not to be treated as a research subject, and a need for “balance” between work, media, and everyday life. lynch does point out that the media rarely shows any kind of “conflict” or “debate” at vita needle, while noting that she did receive some criticism or complaints about both management practices and co-workers. yet these are not well-documented compared to the overwhelming positive feedback documented. while lynch herself used pseudonyms for most of the workers she interviewed or quoted, obviously management and co-workers could probably identify each worker. we are not left with a clear understanding of whether or not lynch felt free to print criticisms, if workers requested she not print them, or if those with a less than positive viewpoint simply refused to be interviewed. while understandable in view of the location and lack of anonymity of the company, it leaves the book somewhat one-sided in its positive treatment of the workplace. lynch never resolves the question of whether or not this workplace model is exploitative of older adults or not and if it should be adopted more broadly. instead, she asks us to think differently about the meaning of work in people’s lives, especially older adults, while pondering whether or not one group of workers can trade economic for noneconomic benefits and how that affects the rights of all workers. this lack of a wider social context makes the book less suitable to discussions about how to get and keep older adults employed in today’s economic circumstances. as ethnography, this book would be suitable for use in a gerontology, crosscultural gerontology, or aging studies course to illustrate attitudes about work and meaning for older adults. anne velardi university of alaska anchorage phd candidate anthropology & aging quarterly does not accept unsolicited reviews at this time. if you wish to review a book, film, exhibition or other works of interest to this journal, please contact book reviews editor, joann kovacich jkovacich@ rochester.rr.com. include your name, areas of expertise, current affiliation and status (research, professor, graduate student, independent scholar, e.g.) and any titles you would be interested in reviewing from the last three years. when does fertility end? the timing of tubal ligations and hysterectomies, and the meaning of menopause lynnette leidy sievert university of massachusetts amherst, leidy@anthro.umass.edu laura huicochea-gómez el colegio de la frontera sur, unidad campeche diana cahuich-campos el colegio de la frontera sur, unidad campeche lynn morrison department of anthropology, university of hawaii at hilo daniel e. brown department of anthropology, university of hawaii at hilo abstract we applied a biocultural lens to examine the temporal order of biological, behavioral, and medical events related to fertility across the female reproductive lifespan in three sites, two in mexico and one in the united states. using a mixed-method design, we expanded our thinking about the end of fertility in order to examine the timing of hysterectomies and tubal ligations. we discovered that menopause is not the end of fertility for a surprisingly high number of women. across the three sites, between 43% and 50% of women underwent tubal ligations at mean ages of 32 years (in campeche, mexico) and 33 years (puebla, mexico). in puebla, 23% had a history of hysterectomy at a mean age of 42 years, similar to hilo, hawaii, where 20% had undergone a hysterectomy at a mean age of 40 years. we hypothesized that women who underwent tubal ligations would less frequently describe menopause as the end of fertility. this was true in hilo, hawaii, where women with a history of tubal ligation were almost half as likely to choose “loss of fertility” to describe menopause. however, in urban and rural campeche, mexico, there was no indication – from either quantitative or qualitative responses – that individuals with a history of tubal ligation or hysterectomy were less likely to describe menopause as the end of fertility. keywords: menopause; hysterectomy; tubal ligation; sterilization; fertility anthropology & aging, vol 42, no 1 (2021), pp. 10-29 issn 2374-2267 (online) doi 10.5195/aa.2021.254 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 10 when does fertility end? the timing of tubal ligations and hysterectomies, and the meaning of menopause lynnette leidy sievert university of massachusetts amherst, leidy@anthro.umass.edu laura huicochea-gómez el colegio de la frontera sur, unidad campeche diana cahuich-campos el colegio de la frontera sur, unidad campeche lynn morrison department of anthropology, university of hawaii at hilo daniel e. brown department of anthropology, university of hawaii at hilo introduction across the female lifespan, fertility1 is an imagined potential that starts and stops with the onset and cessation of menstruation. fertility is invisible to the eye (inhorn 2015) but assumed (without evidence to the contrary) and managed through the use of contraceptives as part of a lifelong interplay between reproduction and technology (franklin 1997). our focus on fertility introduces the biology of menarche and menopause into the chronologized life course (kohli and meyer 1986), along with the conventional understanding that fertility declines with advancing age. based on work in rural gambia, caroline bledsoe (2002) outlined two ways of perceiving the decline in female reproductive capacity with age and how those perceptions relate to the use of birth control. the “linear” perception understands an abstract, universal, and naturalized loss of fertility, ending with menopause. the “contingent” viewpoint situates the decline of reproductive capacity within the context of women’s health, social circumstances, and personal actions, including the use of contraception. in the study presented here, we examine fertility from the latter point of view – as conditional and dependent on a woman’s history of hysterectomy and/or tubal ligation. reproductive capacity from menarche to menopause does not always follow a linear path from a peak through a gradual decline. sometimes reproductive capacity is sharply truncated by sterilization. here we apply a biocultural perspective to examine the chronology of biological, behavioral, and medical events potentially associated with the “biological clock” of reproductive aging, as well as variation in the experience and perception of reproductive capacity and menopause. menarche, the first menstruation, occurs just after the peak of the adolescent growth spurt and indicates the beginning of hypothalamic-pituitary-ovarian cyclicity, although not necessarily the start of fertility. even if menarche coincides with sexual activity, there is generally a period of adolescent sterility (or subfecundity) that reduces the chance of pregnancy (wood 1994). menopause, the last menstrual period, is identified in retrospect after twelve months without menstruation. clinically, menopause marks the end of the peri-menopause and the beginning of the early post-menopausal stage (harlow et al. 2012). for women, the last menstrual period can mean many things, including the end of fertility, no need for contraception, and no more fear of pregnancy (dillaway 2005; hvas 2006; lindh-astrand et al. 2007; morrison et al. 2014; utz 2011). although women may think of menopause as the end of fertility, menopause is not synchronous with the end of fertility, just as menarche is not synchronous with the start of fertility. fertility ends before the last menstrual period, as documented by studies of anti-müllerian hormone (amh) which is http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 11 produced by ovarian follicles. years before the last menstrual period, amh levels fall so low as to be undetectable (depmann 2016; kelsey et al. 2011; kim et al. 2017). low levels of amh indicate that ovarian follicles are not developing, there will be no egg produced by the ovaries, and the woman cannot conceive a child, even though she may still have menstrual cycles. thus, there is a period of subfecundity prior to the last menstrual period (wood 1994). in the absence of laboratory tests for ovarian function (e.g., falling levels of amh or rising levels of follicle stimulating hormone; kim et al. 2017) menopause and the end of fertility become conflated. for example, one researcher matter-of-factly described the end of menstruation as the “undeniable end of a woman’s ability to procreate” (utz 2011,144). in denmark, hvas (2006) found that menopause was perceived to be “a milestone marking the end of the child-bearing years” (247). for many women, menopause silences the ticking of the biological clock. as a result, menopause may be associated with grief or relief (de salis et al. 2017; dillaway 2005; khademi and cooke 2003; martin 1993). in a qualitative study (morrison et al. 2014) of attitudes toward menopause in hilo, hawaii, some women described themselves as “infertile” and expressed sadness or ambivalence. for example, “i have mixed feelings, i’m looking forward to [menopause] and mmm, i feel kind of sad about not being fertile anymore, but i think i’m going through acceptance” (8). menopause is a “time when you aren’t able to reproduce anymore, a time when maybe it’s the autumn season, or winter season” (morrison et al. 2014, 538-539). in a qualitative study by de salis et al. (2017) a nurse in the u.k. explained: i did, actually, mourn the passing of a phase of my life because i thought, this is a phase where you’re, kind of, fertile, and, you know, you’ve been doing this since you were 12, or whatever. you have your little cycle and then suddenly it’s not going to be happening. and it’s like, you know, it’s a bit of a realization that you are mortal, and things pack up, and you’ve reached this, sort of, your biological usefulness is over. you know what i mean? as a species, you can go now, you’ve done what you need to do, you’ve reproduced. . . . like the old, sort of, withered apple on the tree, you know, there’s no seeds in it! (de salis et al. 2017, 9). in the study presented here, we question the interpretation of menopause as the end of fertility by looking beyond the loss of ovarian follicles. the end of childbearing can be brought about in various ways. for example, in some societies women have been expected to practice terminal abstinence. in this case, sexual activity is avoided by women after their own daughters start to have children, perhaps to avoid competition for resources between children and grandchildren (caldwell and caldwell 1977; leidy 1993). the upper parameter of the reproductive period can also be permanently altered through biomedical interventions, such as hysterectomy (removal of the uterus), oophorectomy (removal of the ovaries), or sterilization by tubal ligation (cutting or blocking the fallopian tubes). additionally, the reproductive span can be lengthened through assisted fertility practices that make it possible for women of 66, 67, and even 70 years of age to carry a pregnancy to term with a donated egg (banh 2010; cutas and smajdor 2015; majumdar, this issue). figure 1 illustrates the potential temporal order of these biological, behavioral, and medical events during the reproductive period. http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 12 figure 1: the temporal order of biological, behavioral, and medical events that may occur during the reproductive period and are potentially associated with the “biological clock.” the purpose of this study was to use existing data to examine the frequency and timing of tubal ligations and hysterectomies in three sites, two in mexico and one in the united states. these populations were chosen because of the relatively high frequency of hysterectomies in hilo, hawaii (sievert et al. 2013) and puebla, mexico (sievert and hautaniemi 2003), and because of the relatively high frequency of tubal ligations in hilo, puebla (rudzik et al. 2011), and campeche, mexico. our intent was to illustrate how menopause is the “end of fertility” for a surprisingly high number of women who experienced tubal ligations, hysterectomies, or both. in addition, we hypothesized that women who underwent tubal ligations would less frequently describe menopause as a freedom from pregnancy or as the end of fertility. samples and methods campeche, mexico we first carried out a qualitative pilot study in 2012 (huicochea et al. 2017), followed by a mixedmethods investigation of symptom experience at midlife in the state of campeche from 2013 to 2015. our primary focus was to compare the experience of hot flashes between maya and non-maya women living in 12 sites across three municipalities (campeche, hopelchén, and calakmul). we compared: i) the capital city of campeche, ii) two rural maya communities within 40 km of the capital (hopelchén norte), iii) four rural, isolated non-maya communities in calakmul, and iv) five rural, isolated maya communities (hopelchén sur). in the city, women were drawn from offices, businesses, schools, the city market, and by giving presentations to groups of women in private homes in eight neighborhoods. in the rural communities, women were invited to participate through the support of local medical providers, following presentations to community leaders and the public (sievert et al. 2019). in total, an opportunity sample of 543 women aged 40-60 years participated in face-to-face interviews and anthropometric measures. ethical approval for this study in campeche was obtained from the institutional review boards of umass amherst, the university of hawaii at hilo, and the comité de ética de la secretaría de salud del estado de campeche. semi-structured interviews were carried out in spanish to collect demographic, biobehavioral, and reproductive information, including age at first menstruation, number of children, dates of births of first and last child, date of last menstruation, history of birth control (including age at tubal ligation), and history of hysterectomy or oophorectomy, at what age, and why. menstruation was carefully queried in order to classify women as i) regular, ii) having changes in quantity or frequency of menstruation, iii) experiencing more than six days of difference in cycles, iv) experiencing two or more months without menses, or v) experiencing more than twelve months without menses. additionally, an index of socioeconomic status was constructed (sievert et al. 2019). women were also asked 21 structured questions about their perceptions related to menopause. for the analyses presented here, we focused on three questions: “do you feel that it is a freedom, to know that there is no risk of pregnancy?” (¿siente que es una liberación saber que no hay riesgo de embarazo?); “can http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 13 you better enjoy sexual relations with your partner?” (¿puede disfrutar más las relaciones sexuales con su pareja?); and “do you see this as an easier and more tranquil stage of life?” (¿en esta etapa ve la vida más fácil y tranquila?). in addition, women were asked the open-ended question, “what is menopause?” (¿qué es la menopausia?). puebla, mexico a study of age at menopause and symptom experience at midlife was carried out in puebla, mexico from 1999 to 2000. puebla is the capital of the state of puebla, 130 km from mexico city, with about 1.5 million residents at the time of study. an opportunistic sample of 755 women, aged 40 to 60 years, was drawn from across socioeconomic strata of the city through invitations extended to women in parks, at bus stops, in open-air markets, in front of a hospital, and at other public sites (for sampling details and a map, see sievert and hautaniemi 2003). in face-to-face interviews, women were asked the date of their last menstrual period, whether they had undergone a tubal ligation (yes/no) and age at tubal ligation, whether they had undergone a hysterectomy (yes/no), when, and why, along with many other demographic, reproductive, lifestyle, and health-related questions (rudzik et al. 2011; sievert 2006; sievert and espinosa-hernandez 2003). ethical approval for this study in puebla was obtained from the institutional review board of umass amherst. all interviews were carried out in spanish. hilo, hawai’i a study of age at menopause, symptoms at midlife, and blood pressure was carried out in the multiethnic city of hilo, hawai’i from 2004 to 2005 (brown et al. 2011). hilo is the county seat of the big island, with a census of about 46,000 residents. a postal survey was mailed to a randomly generated sample of women within the city and was returned by 1824 women (sievert et al. 2007). participants aged 40-60 years who identified themselves as european-american, japanese-american, or of mixed ancestry (including those of hawaiian descent) are included in the analyses presented here (n=793). the postal survey queried marital status, economic comfort (struggling, ok, comfortable, well-off), age at first menstruation, age at last menstruation, menstrual cycle characteristics, ages at birth of first and last child, use of birth control, history of tubal ligation (yes/no), and history of hysterectomy (yes/no), when, and whether women were still menstruating just before they underwent the hysterectomy. women were also asked, “how would you describe menopause?” and asked to check any of eight possible characteristics: freedom, natural, loss of fertility, eagerly awaited, onset of old age, loss of femininity, a nuisance, and/or no problem (morrison et al. 2010). in a study that included all participants aged 16100 years, 26% of pre-menopausal, 29% of peri-menopausal, and 21% of post-menopausal women described menopause as a loss of fertility (morrison et al. 2010). ethical approval for this study in hawai’i was obtained from the institutional review boards of umass amherst and the university of hawaii at hilo. analyses descriptive statistics were carried out, and frequency of menopause, hysterectomy, and tubal ligations were compared across four subsamples in campeche and three subsamples in hilo, hawaii, by chisquare and anova as appropriate. see table 1 for description of subsamples. to establish the temporal order of events across study sites, mean recalled ages at menarche, first birth, last birth, tubal ligation (in mexico), hysterectomy, and natural menopause were determined for each population. to further examine variation in the timing of these events, the number of years between age at menarche and age at first birth, age at last birth and age at natural menopause, age at last birth and tubal ligation, and age at tubal ligation and age at natural menopause were computed. we did not combine the three datasets for cross-population statistical analyses. http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 14 in all three sites (campeche, puebla, and hilo), a structured questionnaire was administered to assess women’s attitudes toward the menopausal transition; however, the questionnaires were not exactly the same, so cross-population comparisons of attitudes are limited. in puebla, mexico, the attitudes queried did not include a reference to fertility (sievert and espinosa-hernandez 2003). using data from campeche and hilo we were able to examine the relationship between questions associated, directly or indirectly, with fertility and age at interview, marital status, number of children, socioeconomic status index, as well as having undergone a tubal ligation (yes/no) or a hysterectomy (yes/no). all variables were also considered together in a logistic regression. we repeated the analyses with only preand peri-menopausal women, comparing attitudes related to fertility between women who had and had not undergone tubal ligation. fisher’s exact 1-sided analyses were applied with the expectation that women with a history of tubal ligation or hysterectomy would be less likely to describe menopause as a loss of fertility. the logistic regression was also repeated. finally, in campeche, mexico, we examined all open-ended responses to the question “what is menopause?” we noted every instance of a participant explaining that menopause is the end of fertility, and then noted whether the participant had undergone a tubal ligation, hysterectomy, or both. we hypothesized that women who had undergone a tubal ligation would be less likely to describe menopause as the end of fertility. results in campeche, mexico, mean age did not differ across the four sites, with an average of 47.4 (s.d. 4.9) years (n=543). across the four sites, women attended 9.7 (s.d. 5.6) years of school, and women in the city had significantly more years of formal education (13.2 years) compared to the rural municipalities (4.2 years, p<0.001). as shown in table 1, women in the rural communities reported significantly higher parity (p<0.001). there was no difference in menopausal status across sites, with 40.5% of the entire sample pre-menopausal (stages i and ii, as described above), 24.1% peri-menopausal (stages iii and iv), and 35.4% post-menopausal (stage v). across the entire sample, 8.7% of women reported a history of hysterectomy, with a higher frequency among urban participants (p=0.05). there was no difference across subgroups in the frequency of tubal ligations, with 50.6% of the entire sample reporting a history of tubal ligation (table 1). twenty-one women (4%) underwent both tubal ligation and hysterectomy. there were no differences in frequency of tubal ligation or hysterectomy by ethnicity (maya vs. nonmaya, not shown). http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 15 campeche, mexico n=543 puebla mexico n=755 hilo, hawaii n=793 city hopelchén norte calak mul hopelchén sur all europeanam japaneseam mix ed ethn icity n 305 78 84 76 755 203 248 342 mean age at interview (yrs) (s.d.) 47.5 (5.0) 47.4 (4.6) 47.3 (5.0) 47.1 (4.4) 50.0 (6.3) *** 50.6 (5.2) 50.7 (5.0) 49.2 (5.1) parity range mean (s.d.) *** 0-7 2.0 (1.2) 0-11 4.1 (2.1) 0-17 5.1 (3.2) 1-12 5.1 (2.5) 0-15 3.6 (2.3) *** 0-8 1.8 (1.5) 0-5 1.8 (1.0) 0-8 2.4 (1.4) % postmenopausal 34.1% 35.9% 36.9% 38.2% 59.9% 45.2% 46.5% 42.4 % % hysterecto my * 11.5% 6.4% 6.0% 2.6% 23.1% *** 12.2% 17.6% 25.3 % % tubal ligation 50% 54.5% 52.4% 46.7% 42.5% *** 35.2% 49.4% 60.0 % table 1: sample characteristics. comparisons across four subgroups within campeche, and three subgroups within hilo, hawaii. * p≤0.05; ***p≤0.001 in puebla, mexico, women were on average 50 (s.d. 6.3) years of age, had 8.1 (s.d. 4.4) years of formal education, and reported 3.6 children. almost 60% of the sample was post-menopausal, 23% had undergone a hysterectomy, 42.5% had undergone a tubal ligation, and 8% experienced both surgeries. in hilo, hawaii, women were 50 (s.d. 5.2) years of age on average, with 2.1 children, and 43.7% of all women had a 4-year college degree or higher. women of japanese ethnicity had the highest level of education (p<0.001). across the sample, 48.1% were pre-menopausal (regular menses), 7.5% perimenopausal (irregular menses and missed periods), and 44.4% post-menopausal (no menses within the past 12 months), with no differences in menopausal status across ethnic groups. frequency of hysterectomy was 19.5%, and women of mixed ethnicity were more likely to have had undergone the surgery (p=0.001). among all, 89.3% were still menstruating when the hysterectomy occurred. half (50.3%) answered yes to the question “have you been sterilized (tube’s cut or tied)?” women of mixed ethnicity were more likely to have undergone sterilization (p<0.001). across the entire sample, 78 women (11%) underwent both tubal ligation and hysterectomy. table 2 compares mean recalled ages at menarche, first birth, last birth, tubal ligation, hysterectomy, and natural menopause across the three populations. table 2 also shows the duration in years between the age at menarche and first birth, age at last birth and age at natural menopause, age at last birth and tubal ligation, and age at tubal ligation and natural menopause. http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 16 recalled age at menarche mean (s.d.) age at first birth mean (s.d.) age at last birth mean (s.d.) age at tubal ligation mean (s.d.) age at hysterectomy mean (s.d.) recalled age at natural menopausea mean (s.d.) campeche, mexico n=540 n=496* n=499* n=263 n=47 n=142 12.4 (1.67) range 8-20 yrs 22.8 (5.71) range 9.9-44.9 yrs 31.2 (5.99) range 13.7-46.7 yrs 31.8 (5.18) range 20-46 yrs 40.4 (6.02) range 27-51 yrs 46.7 (4.32) range 35.0-57.6 yrs puebla, mexico n=745 n=697 n=697 n=292 n=161 n=259 12.8 (1.61) range 7-18 yrs 22.7 (4.99) range 11.4-41.6 yrs 30.9 (5.70) range 16.0-46.6 yrs 33.0 (5.25) range 21-50 yrs 41.9 (6.19) range 25-58 yrs 47.1 (4.29) range 36-58 yrs hilo, hawaii n=777 n=681 n=672 n=104 n=219 12.4 (1.64) range 8-18 yrs 25.1 (5.75) range 14-45 yrs 30.4 (5.57) range 17-47 yrs n/a 39.6 (7.00) range 23-53 yrs 49.3 (3.59) range 36-57 yrs years between age at menarche and first birth mean (s.d.) years between age at last birth and natural menopause mean (s.d.) years between age at last birth and tubal ligation mean (s.d.) years between age at tubal ligation and natural menopausea mean (s.d.) campeche, mexico n=493 n=117 n=262 n=65 10.5 (6.04) range -3.11b33.86 yrs 13.4 (7.41) range -4.16c30.25 yrs 1.1 (3.47) range -8.98d – 21.95 yrs 15.4 (6.6) range 0.32-28.73 yrs puebla, mexico n=688 n=236 n=293 n=88 9.9 (5.06) range -1.10e28.75 yrs 15.0 (6.83) range -2.40f30.60 yrs 2.2 (4.25) range -6.80g-23.80 yrs 13.6 (6.31) range -2h-29 yrs hilo, hawaii n=673 n=155 12.7 (5.98) range -1i-32 yrs 18.2 (6.02) range 1-35 yrs n/a n/a table 2: recalled ages at menarche, first birth, last birth, tubal ligation, hysterectomy, natural menopause, and the duration of time between select events. * sample sizes vary because not all women had children or remembered their age at first or last birth. a limited to menopause >35 years b three women had negative durations. (1. urban): first birth at 10.9 years, menarche at 13. (2. rural calakmul): first birth at 11.2 years, menarche at 12. (3. rural hopelchén): first birth at 13.2 years, menarche at 15. c two women had negative durations so that their last birth came after the age they gave for menopause. participant #76c menopause 42.55, last child 46.72; participant #42n menopause 39.77@, last child 41.88. @when her menses started to diminish. http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 17 d nine women with negative durations of two years or longer (9/262 or 3.4%). either incorrect ages were recorded or tubal ligations did not work. one woman gave details about how she was surprised by a pregnancy after her tubal ligation. e two women had negative durations. (1) first birth at 15.9 years, menarche at 17. (2) first birth at 11.4 years, menarche at 12. f one woman had a negative duration. she reported a last menstrual period at 40.0 years, and last birth at 42.4 years. g six with negative durations of two years or longer (6/293 or 2.0%). either incorrect ages were recorded or tubal ligations did not work. h one woman reported her last menstrual period at 40, and a tubal ligation at 42. i one women with a negative duration. (1) first birth at 16, menarche at 17. across the three populations, there was consistency in mean recalled age at menarche (12.4 to 12.8 years), as well as the youngest (7 or 8 years) and oldest ages (18 or 20 years) at first menstruation. in mexico, there was a shorter duration between ages at menarche and ages at first birth compared to women in hawaii. in all three populations a very small number of women reported giving birth before menarche (three in campeche, two in puebla, and one in hilo). mean ages at first birth were earlier in mexico compared to hilo, but the oldest age at first birth was the same in campeche as in hilo (45 years). mean ages at last birth were very similar across the three populations (30.4 to 31.2 years). the oldest age at last birth was the same (47 years) in all three populations. the time between age at last birth and age at natural menopause was shorter in mexico compared to hilo, and in both sites in mexico a very small number of women reported giving birth after their menstruation ended (two in campeche, one in puebla). mean age at tubal ligation was a little earlier in campeche (31.8 years) compared to puebla, mexico (33.0 years). in both sites mean ages at tubal ligation were within 1 or 2 years of the mean age at last birth. in both campeche and puebla, a number of women gave birth after having undergone a tubal ligation. in campeche, 9 women (3.4%) reported births at least two years following a tubal ligation. in puebla, 6 women (2.0%) gave birth at least two years following a tubal ligation (a two-year lag was used to avoid rounding errors in recalled ages at tubal ligation and/or last birth). mexican women menstruated, on average, 15.4 years in campeche and 13.6 years in puebla between their tubal ligation and their age at natural menopause. mean age at hysterectomy was about the same in campeche (40.4 years), puebla (41.9 years) and hilo (39.6 years). mean recalled age at natural menopause was later in hilo (49.3 years) compared to puebla (47.1 years) and campeche (46.7 years). with regard to the end of fertility, in campeche, mexico, where the mean recalled age at menopause was 46.7 years, menopause was not the end of fertility for the 51% of women who underwent a tubal ligation at a mean age of 32 years and the 9% who reported a history of hysterectomy at a mean age of 40 years. in puebla, mexico, where the mean recalled age at menopause was 47.1 years, 43% of women did not biologically experience menopause as the end of fertility because they had undergone a tubal ligation at a mean age of 33 years, and 23% had a history of hysterectomy at a mean age of 42 years. in hilo, hawaii, where the mean recalled age at menopause was 49.3 years, menopause was not the end of fertility for half of the women, aged 40-60, who had undergone a tubal ligation and were already http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 18 unable to conceive. almost one fifth of the women had undergone a hysterectomy at a mean age of 40 years and were unable to conceive. figure 2 illustrates how fertility ends early in women with tubal ligations (assuming that the tubal ligations are successful which, as table 2 shows, is not always the case). the solid dark blue line indicates fertility between the onset of sexual activity (which is generally after menarche but, as table 2 shows, not always) and tubal ligation. after tubal ligations, women continue to menstruate for an average of 15.4 years in campeche and an average of 13.6 years in puebla (table 2). for these women, menopause is the end of menstruation, but menopause is not the end of fertility. figure 2: tubal ligation as the end of fertility: timeline showing mean recalled ages (in years) at menarche, first childbirth, last childbirth, tubal ligation, and menopause in campeche, puebla, and hilo. dark blue indicates fertile period. figure 3 illustrates how fertility ends early with hysterectomies. the solid dark blue line indicates fertility between the onset of sexual activity and the hysterectomy. after the hysterectomy, women no longer menstruate, but if their ovaries are intact, then they continue to produce the hormones associated with fertility. they cannot, however, conceive. the hysterectomy marks both the end of menstruation and the end of fertility. figure 3: hysterectomy as the end of fertility: timeline showing mean recalled ages (in years) at menarche, first childbirth, last childbirth, and hysterectomy in campeche, puebla, and hilo. dark blue indicates fertile period. the results in the following sections address the question: did women respond differently to questions about menopause if their ability to conceive ended prior to menopause due to tubal ligation or hysterectomy? http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 19 campeche, mexico from a list of questions about menopause, 72.4% of participants agreed that it is “a liberation” to know that they were no longer at risk of pregnancy (n=214). the response was not associated with marital status, number of children, education, urban/rural residence, or socioeconomic status index but women who said “yes” were more likely to be older (mean 49.6 years vs. 46.8 years, p=0.001). post-menopausal women were more likely to agree that menopause is a liberation (85%) compared to pre-menopausal (61%) and peri-menopausal (49%) women (p<0.001). there was no significant difference between postmenopausal women with or without hysterectomies (81.8% vs. 86.2%, p=0.548). women with tubal ligations were more likely to agree compared to women without tubal ligations (77% vs. 68%), but the difference was not significant (p=0.088). using logistic regression (results not reported here), postmenopausal status continued to be significantly associated with the opinion that menopause is “a liberation” after adjusting for age at interview, urban/rural residence, menopausal status, parity, marital status, education, and socioeconomic status. women who had undergone a tubal ligation were significantly less likely to report menopause as “a liberation” (odds ratio 0.378, p=0.008). in order to further test the hypothesis that having a tubal ligation changes a woman’s perception of menopause as the end of fertility, we examined this question about menopause as “a liberation” among women who were not yet post-menopausal. there was no significant difference between those with and without tubal ligations in the sentiment that menopause is a liberation from the risk of pregnancy (60% vs. 51%). neither was tubal ligation significant when the logistic regression was repeated in this sub-group. when asked if they thought menopause is an easier and more tranquil stage of life, 64.3% of the sample (n=403) said yes. this response did not differ in relation to marital status or socioeconomic status, but women who said “yes” were more likely to be older (mean 48.2 vs. 46.3 years, p<0.001) and tended to have more children (mean 2.9 vs. 2.5, p=0.067). post-menopausal women were more likely to agree (78%) compared to pre-menopausal (57%) and peri-menopausal (55%) women (p<0.001). the difference was not significant for women with hysterectomies compared to women without hysterectomies (70.0% vs. 81.1%, p=0.157), or between women with and without tubal ligations (63.9% vs. 64.2%, p=0.516). the logistic regression showed that post-menopausal status, but no other variable, was associated with the opinion that menopause is an easier and more tranquil stage of life. in a repeat of the analyses among women who were not yet post-menopausal (n=351), those with and without tubal ligations did not differ in their response to this question. finally, 61.8% of the sample said that they can better enjoy sexual relations with their partner (n=173). in bivariate analyses, the response to this question was not statistically associated with age at interview, marital status, socioeconomic status, or number of children. there was no difference by pre(72%), peri(61%), or post(59%) menopausal status (p=0.348) in relation to greater enjoyment of sexual relations. neither was there a difference for women with hysterectomies compared to women without hysterectomies (69.0% vs. 55.0%, p=0.191), or between women with and without tubal ligations (67% vs. 58%, p=0.136). the same lack of significance was true in logistic regression results. with regard to the open-ended question, “what is menopause?” most women described menopause as the end of menstruation, or the time when physical and/or emotional symptoms occur. in the city, but not in the rural communities, women talked about changes in hormones. table 3 presents a sample of the open-ended responses associated with menopause as the end of fertility. the important point from table 3 is that, in response to the open-ended question, very few women described menopause as the end of fertility. women in the city were more likely to volunteer “the end of fertility or childbearing” when describing menopause, but even in the city only 29 of 305 respondents (9.5%) volunteered that http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 20 answer (see table 3 for variation in the wording of open-ended responses). the percentage of women in the rural communities describing menopause as “the end of fertility or childbearing” was even lower: calakmul 6%, hopelchén sur 1%, and hopelchén norte 0%. campeche city hopelchén sur calakmul a sample of the 29 responses describing menopause as the end of fertility. 29/305 = 9.5% only 1 participant described menopause as the end of fertility. 1/76 = 1.3% five participants described menopause as the end of fertility or productivity. 5/83 = 6% periodo de receso de la reproducción femenina. (a break from female reproduction.) entiendo que ya terminó uno de tener hijos, ya no hay que preocuparse de embarazarse. (i understand that we stop having babies, we don’t have to worry about pregnancy) el doctor dice de la menopausia, que se siente bochorno, desesperación, es cuando una va a dejar de tener hijos… quedas otra vez como niña. (a doctor says about menopause, that one feels heat and desperation, it is when a woman stops having babies . . . they go back to be childlike) el cierre del ciclo de la mujer, que te dice tu cuerpo ya no vas a tener más hijos y viene una nueva etapa. (the end of a woman’s cycle that tells you that your body is not going to have more children and a new stage is coming.) cierre del ciclo de la fertilidad de la mujer. (the end of a woman’s fertility.) es un indicativo de que inicia la vejez y ya no hay más productividad de ella mujer. ya caducó. (it is a sign that old age is beginning and a woman stops being reproductive. it expires) cambios para que termine el ciclo productivo. (changes leading to the end of the reproductive cycle.) cuando la mujer deja de ser fértil. (when a woman stops being fertile.) etapa en la que se va a ir terminando el proceso de ovulación. (the stage in which the end of the ovulation process starts.) es el fin del ciclo reproductivo de la mujer en la edad adulta. (it is the end of the reproductive cycle of women in adulthood.) dejar de reglar, no se puede embarazar, termina ciclo reproductivo. (menstruation stops, cannot become pregnant, the end of the reproductive cycle.) el cuerpo de la mujer deja de “servir” porque ya no puede concebir. (the woman’s body stops being “useful” because it cannot get pregnant.) es una etapa donde dejas de, tus óvulos y ovarios empiezan a envejecer como envejeces tú, y como que ellos ya, como que se secan, y tú ya no reglas, y no nada, envejeces como quien dice, tu aparato reproductor, ya que llega el momento en el deja de trabajar. (it is a time when your eggs and ovaries start to get old, like you get old, and they la que escucho y la biblia dice: la menopausia es cuando ya no puede tener hijos, termina su periodo de reproducción. (the one i listen to and the bible says: menopause is when you can no longer have http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 21 shrivel, you stop menstruating and that’s it; you and your reproductive organs grow old because it’s time [for them] to stop working.) children, your period of reproduction ends.) table 3: responses from three sitesa in the state of campeche, mexico, to the question, “what is menopause?” (¿qué es la menopausia?). these are responses having to do with the end of fertility. a no women in hopelchén norte described menopause as the end of fertility, 0/40 hilo, hawaii when asked to choose words to describe menopause, 26.0% of the sample (n=719) chose the word “freedom.” women who chose “freedom” were more likely to be older (p<0.001) and had fewer children (1.87 vs. 2.19, p=0.001), but did not differ in marital status or level of economic comfort. postmenopausal women (35%) were more likely to choose freedom compared to pre(16%) or peri(28%) menopausal women; there was no difference by hysterectomy or tubal ligation status. when all variables were entered into a logistic regression model (results not reported here), only parity was associated with the choice of “freedom,” with an increasing number of children lowering the likelihood of selecting the word “freedom” to describe menopause (odds ratio 0.812, p=0.007). “onset of old age” was selected by 32.8% of the sample (n=719), with no difference by age at interview, marital status, parity, financial comfort, menopausal status, hysterectomy status, or history of tubal ligation in bivariate or logistic regression analyses. “loss of fertility” was selected by 23.1% of the sample (n=719) and did not differ by age at interview, marital status, parity, financial comfort, or menopausal status. however, consistent with our hypothesis, women who had undergone a hysterectomy were less likely to say that menopause was a loss of fertility compared to women who had not undergone a hysterectomy (17% vs. 24.1%, p=0.047). likewise, women who had undergone a tubal ligation were less likely to say that menopause was a loss of fertility compared to women who had not undergone a tubal ligation (20% vs. 26%, p=0.027). after adjusting for the variables above, tubal ligation remained significant in the logistic regression model, with women who underwent sterilization almost half as likely to choose “loss of fertility” to describe menopause (or 0.577, p=0.003). when a selection was made for women not yet post-menopausal (n=377), history of tubal ligation was not associated with “freedom” or “onset of old age,” but continued to be associated with “loss of fertility.” women with a history of tubal ligation who had not yet reached menopause were less likely to describe menopause as a loss of fertility (19.5% vs. 27.1%, p=0.054). discussion this study examined events related to fertility among women aged 40 to 60 in three populations. the focus was on the timing of hysterectomies and tubal ligations, but a longer frame of reference was used to understand the chronology related to the “biological clock” of fertility (figure 1). there are social and economic differences across the three populations, but also important similarities. only 12.4% of the population in the municipality of calakmul, campeche, mexico, has access to running water (ineg 2015). why, then, are the rates of tubal ligations so high? although the municipality of http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 22 calakmul lacks basic infrastructure, our pilot interviews in the community of cristóbal colón showed that women received health-related information from “physicians, workshops, public talks, and caravanas de salud (mobile health centers) that reinforce biomedical ideas and, most likely, the positive opinion and acceptance of the biomedical care that is available in this isolated site” (huicochea 2017, 58). most people living in the communities of calakmul attend a primary care clinic run by the mexican social security institute (imss). there, an allopathic doctor and nurse are available 24 hours a day to provide medicine, vaccines, and a suite of complementary services for clinical and preventative care. during the 1970s and 1980s, in response to one of the highest population growth rates in the world, the imss created family planning campaigns to reduce risk due to unwanted pregnancies, provide better maternal care, create public awareness around family planning, and instill a sense of responsibility about the birth rate and its consequences in mexico (ramos de viesca 2014, 159). the imss programs continue to focus on women’s and children’s health. although calakmul is isolated and lacks basic infrastructure, the theme of health is central to women’s lives, and women expressed confidence in biomedicine and regularly sought medical attention. although the state of hawaii has been ranked as having the best health care system in the u.s. (u.s. news and world report 2018), the research presented here was carried out in hawaii county (the big island) where more than 20% of the east hawaii residents live below poverty. the native hawaiian, pacific islander, and filipino populations have the lowest levels of educational attainment and are most impacted by limited access to care and poor health outcomes (belforte et al. 2013). why, then, do those most impacted by limited access to care have the highest rates of hysterectomy and tubal ligation? it may be that tubal ligations and hysterectomies are a more expedient way of dealing with birth control and cervical dysplasia, uterine fibroids, or other concerns among women of mixed ethnicity (table 1) that include the native hawaiians and pacific islanders. in an overview of the three studies, there were remarkable similarities across sites in many reproductive events, such as mean recalled age at menarche (12.4 to 12.8 years), mean age at last birth (30.4 to 31.2 years), and mean age at hysterectomy (39.6 to 41.9 years). there was more variation in mean age at first birth than mean age at last birth. it is striking that the oldest age in the range of age at last birth was the same (47 years) in all three populations. in all three sites, menarche was not always the biological marker of fertility that we expected. figures 1 and 2 represent the majority of women in our study, but there were a few exceptions. three women in campeche, two in puebla, and one woman in hilo reported ages at first birth that preceded their ages at menarche because the onset of sexual activity came before the first menstrual period. in the two mexican sites, some births occurred after the age of tubal ligation. in campeche, nine women reported an age at tubal ligation that was two or more years earlier than the birth of their last child and, therefore, not the result of rounding error in ages at childbirth or tubal ligation. this rate of tubal ligation failure (9/255 or 3.5%) is possible, as the failure rate for tubal ligation surgery ranges from 7.5/1000 (0.8%) to 54.3/1000 (5.4%) depending on the type of procedure (peterson et al. 1996). a study of pregnancies after tubal ligation in india found that tubal ligation failures were more likely after surgeries carried out in primary health centers, and were due to recanalization (up to 20 years after the procedure), improper surgery (e.g., operating only on the right or left side), and tuboperitoneal fistula (date et al. 2014). in the population sampled here, one participant (a mother of 11 children) described, in detail, her surprise and dismay at being pregnant again after a tubal ligation. después que ella nació me hicieron mi salpingo, pero de repente a los dos años me sentí que estoy diferente, me da sueño, me da flojera, y digo “dios mío, esto porqué, si a me tienen hecho la http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 23 salpingo”, agarro me acuesto y tallo ahí y siento una bolita ahí, dios mío ¿y esto? ¿será que estoy herniada?, será que algo me pasó, pero si yo tengo mi salpingo, no puede ser, no puede ser que estoy embarazada, agarro me fui con la sra. que dicen que es muy buena, me talló, me dijo que estoy embarazado, le dije que no es cierto que me tienen hecho mi salpingo, y me dice “pues con todo y tu salpingo mamita, esto es embarazo, ni es hernia, si es hernia te lo digo, cuando te toco te va a doler, pero esto no, esto es embarazo”. agarré y me fui con doctor en campeche, le dije “usted me engañó me dijo que me había hecho mi salpingo y todo” me dijo que me hablaba con sinceridad y me dice que ellos no son dios, somos hombres del mundo, pecado, nosotros hicimos tu salpingo, me saco todos los papeles, haita ahí lo hicimos todo, pero si las cosas no fueron como nosotros hicimos, quiere decir que nosotros no somos las que mandamos, la que manda es dios, nuestro dios sabe por qué te lo va a mandar este bebé. after [my daughter] was born, they did my tubal ligation, but suddenly after two years i felt that i was different. i was tired, felt lazy, and i said, “my god, why this if i had my tubal ligation?” i lay down, touched my belly, and i felt a small ball there. my god, what is it? am i herniated or did something happen to me? but since i had my tubal ligation i cannot be pregnant, it cannot be! so, i went with the lady that everyone says is very good. she touched me and told me that i was pregnant. i told her that was impossible because i had my tubes ligated and she said, “despite your tubal ligation, mamita, you are pregnant not herniated; if you were herniated it would hurt you when i touch it but, no, this is a pregnancy.” so, i went to a doctor in campeche and told him, “you lied to me, you told me you ligated my tubes and all.” he told me that, honestly, they [the doctors] are not god, just plain men; they did the tubal ligation. he showed me all the papers; they did it all. “but if things were not as we made them, it means that we are not in command. it was god’s command and he knows why he is sending you this baby. using the entire sample from campeche, including post-menopausal women, participants with a history of tubal ligation were less likely to say that menopause was “a liberation” after controlling for demographic and reproductive variables. however, in contrast to our expectations, a history of hysterectomy or tubal ligation was not associated with the description of menopause as “a liberation” among preor peri-menopausal women. we were thinking of menopause as a liberation from concerns related to fertility, but perhaps the study participants were thinking about menopause as a liberation from menstruation. women with tubal ligations continue to menstruate until menopause, so there is no reason to think that their answers would differ from women without a history of sterilization if menopause were considered a liberation from menstruation. neither was a history of hysterectomy or tubal ligation associated with the description of menopause as “an easier and more tranquil stage of life.” it may be that midlife is filled with economic, familial, and emotional demands that extend beyond concerns specific to fertility (sievert et al. 2018a, 2018b). finally, a history of hysterectomy or tubal ligation was not associated with better enjoyment of sexual relations with a partner. when we asked women in campeche, “what is menopause?” very few women described menopause as the end of fertility or childbearing – 29 (9.5%) in the city (12 of whom had undergone a tubal ligation), five (6%) in the non-maya rural communities of calakmul (two of whom had undergone a tubal ligation) and only one participant in the maya communities of hopelchén. there was no indication among women in the state of campeche – from either quantitative or qualitative responses – that individuals with a history of tubal ligation or hysterectomy were less likely to describe menopause as the end of fertility. http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 24 in hilo, hawaii, there was no relationship between a history of hysterectomy or tubal ligation and the word “freedom” or “onset of old age” to describe menopause. however, consistent with our expectations, women who had undergone a hysterectomy or tubal ligation were significantly less likely to say that menopause was a loss of fertility compared to women who had not undergone a hysterectomy or tubal ligation. after adjusting for demographic and reproductive variables, women with a history of tubal ligation were almost half as likely to choose “loss of fertility” to describe menopause. on the basis of qualitative interviews with 45 perior postmenopausal midwestern u.s. women aged 38 to 60 years, dillaway (2005) suggested that the use of any contraceptive – not just sterilization – “makes menopause an insignificant marker in some women’s lives, because menopause no longer represents a symbolic end of fertility” (404). she noted that most of her study participants and their partners actively avoided pregnancy long before the onset of reproductive aging. consistent with our findings (figures 2 and 3), reproductive capacity was confined to a period of time much shorter than the span determined by menarche and menopause. one of dillaway’s participants explained, “i think people should go through menopause early. . . . i had my tubes tied when i was 35. so that i knew, you know, from the time i was 35 until 52 i could still have sex and not get pregnant. so [menopause] meant nothing to me” (dillaway 2005, 407). unlike dillaway’s midwestern u.s. sample, it may be that women in campeche do not have the same level of trust in the efficacy of tubal ligations, and so did not demonstrate a difference in their attitudes toward menopause in relation to their history of tubal ligation. future researchers could examine the high rates of hysterectomies and tubal ligations in mexico and the u.s. in relation to attitudes held by health care workers. for example, a study among u.s. and mexican college students found a significant positive correlation between scores for hostile sexism and negative attitudes toward women with hysterectomies among mexican male students (chrisler et al. 2013). access to tubal ligations is also shaped by gender relationships in which men may resist giving permission to their wives or partners to curtail childbearing (castellar et al. 2003). future work could also examine attitudes of women themselves (reyes and rosenberg 2019) or the role of the culture of biomedicine (mccallum 2005) or governments (smith-oka 2009) in shaping high rates of hysterectomies and female sterilization. from a political economic perspective, smith-oka (2009) suggests that contraception has been used as a means to modernize mexico. her ethnographic work among the nahua of northern veracruz, mexico, showed how cash transfer policies that encourage the use of medical services (e.g., oportunidades) may result in women feeling coerced into having smaller families and undergoing certain procedures, such as sterilizations (smith-oka 2009). future work should also delve into potential ambivalence associated with the biotechnology of contraception and the nature of women’s roles (roberts 2016). as has been shown among men’s choices about the use of medicine to manage erectile difficulties with age (wentzell 2013), it may be that women’s attitudes, and potential ambivalence about both fertility and the biotechnology of sterilization, shape decisions about undergoing tubal ligations and/or hysterectomies. we expected that ideas about menopause would be contingent on past biomedical experience with tubal ligations and hysterectomies. what we encountered among women in their 40s and 50s was evidence that menopause serves as a marker for the end of menstruation, but that menopause is not an important marker for the end of fertility. women who were still pre-menopausal did not indicate, through questions and answers about menopause, that tubal ligations had already ended their childbearing. perhaps, particularly in mexico, this is because of the failure rate of those “permanent” methods of sterilization. the effect of other contraception methods that are imperfect (condoms, iuds, birth control http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 25 pills) may have even less influence on women’s perception of menopause. the loss of fertility is real, imagined, and “local” (lock 1993), and the truncation of fertility by sterilization through tubal ligation may not be understood in the same way as the loss of fertility signaled by the cessation of menstrual blood. future work should consider how the concepts of “chronologization,” or “standardization” of the life course (brückner and mayer 2005; emonds 2014; kohli and meyer 1986) can be further applied to understand the timing of the biological, behavioral, and medical events potentially associated with fertility and the “biological clock.” there are some limitations to the study. we asked questions about menopause, but not about the end of fertility, and those two things are not synonymous. we missed the opportunity to ask women about their feelings about their own fertility. perhaps, after a tubal ligation, women still feel fertile in the sense of investing in children, tending to grandchildren, and perhaps menopause is a visible reminder to a woman that she can no longer bear children of her own. if we were to repeat this study, we might ask women to describe when their fertility began and when it ends. the three datasets were not merged to test for statistically significant differences. this is because the questionnaires were similar but not exactly the same. for example, in hilo, hawaii, women were asked “how old were you at the birth of your first child? your last child?” in puebla and campeche, women were asked for the actual dates of their first and last childbirths. in hilo, we asked about levels of financial comfort (e.g., “struggling,” “ok,” “well-off”), whereas in campeche we constructed a socioeconomic index based on materials used in house construction and other variables. in hilo and campeche, women were asked specifically about whether menopause was seen as an end to fertility among other conceptions of menopause, while in puebla, reliance was placed on an open-ended question about the meaning of menopause. in the study presented here we report recalled ages at menopause for comparison, but those ages are subject to error in recall as well as truncation toward an earlier age than the median computed by probit (sievert and hautaniemi 2003; sievert et al. 2013). in addition, we did not make use of all of the qualitative data collected in campeche. instead, we chose just one of the questions that assessed women’s understanding of the meaning of menopause. this partial utilization of the data might limit the scope of the analyses presented here. the data will be studied more closely utilizing an ethnographic lens in the future. it is also important to point out that our thinking has been somewhat unidirectional in the sense that we considered attitudes towards menopause and the loss of fertility only after the experience of hysterectomy and/or tubal ligation. it may be that attitudes toward fertility and aging were among the factors contributing to the high rates of tubal ligation. given the cross-sectional nature of these data, we cannot reconstruct attitudes prior to sterilization, but this is something to be considered in the future. in summary, tubal ligations were experienced by half of the women in campeche and hilo and by just under half of the women of puebla. hysterectomies were experienced by 9% to 23% of the women across the three locations. at least half of the women across these three populations curtailed their fertility years (sometimes decades) prior to menopause. we did not show that a history of tubal ligation or hysterectomy was associated with attitudes toward menopause in campeche among preor perimenopausal women. in hilo, women with a history of tubal ligation were almost half as likely to choose “loss of fertility” to describe menopause compared to women who had not undergone a tubal ligation. remarkably, there were numerous similarities in women’s reproductive life histories and attitudes toward menopause despite the cultural and geographic differences. women’s attitudes toward fertility, and subsequently end of fertility, are complex and may be influenced, in part, by a pervasive biomedical model in all three sites. http://anthro-age.pitt.edu/ sievert et al | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.254 http://anthro-age.pitt.edu 26 note 1. here, “fertility” is used to mean the capacity to reproduce, what demographers preferentially define as “fecundity.” acknowledgements this study was funded by nsf grant #bcs-1156368, nsf grant # 9805299, and nih grant no. s06gm08073-32. we are indebted to lourdes cahuich as well as the women and authorities of campeche, ich ek, suc tuc, ukum, xmabén, xhanha, chunchintok, cristóbal colón, ricardo payro, narciso mendoza, and ley de fomento agrario. likewise, we thank the medical staff of ricardo payró, ich ek, and cristóbal colón. finally, we thank brenda araujo, shoshana berenzon gorn, leydi cen, isai delgado, gía del pino, natalia dzul martín, raquel dzul martín, elizabeth dzul martín, zayda gonzález, guadalupe islas monter, lizbeth de las mercedes rodríguez, maría magdalena montaña barbano, alejandra mosqueda, giselle o’connor, elena pasqual, alba valdéz tah, ingrid vargas huicochea, and adela velazco. references 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midlife health 4(4) https://doi.org/10.1186/s40695-018-0034-1 sievert lynnette l., lynn a. morrison, angela m. reza, daniel e. brown, erin kalua, and harold a.t. tefft. 2007. “age-related differences in health complaints: the hilo women’s health study.” women and health 45 (3): 31-51. sievert lynnette l., lorna murphy, lynn a. morrison, angela m. reza, and daniel e. brown. 2013. “age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: the hilo women’s health study.” maturitas 76 (4): 334-341. smith-oka vania. 2009. “unintended consequences: exploring the tensions between development programs and indigenous women in mexico in the context of reproductive health.” social science & medicine 68: 2069-2077. u.s. news and world report. 2018. https://www.usnews.com/news/best-states/rankings/healthcare/healthcare-quality utz rebecca l. 2011. “like mother, (not) like daughter: the social construction of menopause and aging.” journal of aging studies 25:143-154. wentzell emily. 2013. “aging respectably by rejecting medicalization: mexican men’s reasons for not using erectile dysfunction drugs.” medical anthropology quarterly 27: 3-22. wood james w. 1994. dynamics of human reproduction: biology, biometry, demography, new york: aldine de gruyter. http://anthro-age.pitt.edu/ smithisland_layout aging in place changing socio-ecology and the power of kinship on smith island, maryland jana kopelent rehak university of maryland, baltimore county and college park author contact: jrehak@umbc.edu abstract this article examines how the people known as smith islanders interact with their environment over the life-course. the purpose of the study is to contribute to a better understanding of aging in a small, rural, coastal community which changes are environmentally driven. to address the aging process in changing environments in this essay, i explore the relationship between the place, sense of self, and knowledge. because the majority of people on the island today are in late life, the main threads in the fabric of this ethnographic narrative weave themselves into stories about aging experiences. i focus on males’ experiences, their traditional knowledge, and the role of kinship over their life-courses. the life history narratives of a smith island waterman known as eddie boy, discusses two elements present in both his childhood narratives and his late adulthood: work and kinship. i show how changing socio-ecology has altered the potential for intergenerational relations, which older islanders cherish, and how such changes in late life pose a new aging dilemma for current smith islanders. keywords: aging and changing socioecology; kinship; lifecours; heritage anthropology & aging, vol 40, no 1 (2019), pp. 48-62 issn 2374-2267 (online) doi 10.5195/aa.2019.181 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 48 aging in place changing socio-ecology and the power of kinship on smith island, maryland jana kopelent rehak university of maryland, baltimore county and college park author contact: jrehak@umbc.edu “we are, in a sense, the place-worlds we imagine.” wisdom sits in places (basso 1996) photo 1. smith island maryland (photo by jana kopelent rehak) this research examines how the people known as smith islanders interact with their environment over the life-course. the purpose of the study is to contribute to a better understanding of aging in a small, rural, coastal community which changes are environmentally driven. to address the aging process in changing environments in this essay, i explore the relationship between the place, sense of self, and knowledge. i combine two analytical models, the socio-ecological framework (berkes 2015) and the life-course perspective (lynch and danely 2013). i bring together these two approaches to show how people on smith island have traditionally moved through their life-courses in a culture that is historically informed and specific to a geographically unique place. my focus is on the way they integrate traditional knowledge into changing socio-ecological systems. because the majority of people on the island today are in late life, the main threads in the fabric of this ethnographic narrative weave themselves into stories about aging experiences. this article is part of a larger ethnographic study aiming to capture people’s sense of self and their attachment to a place embodied in the aging process. kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 49 i focus on males’ experiences, their traditional knowledge, and the role of kinship over their life-courses. the life history narratives of a smith island waterman known as eddie boy, discusses two elements present in both his childhood narratives and his late adulthood: work and kinship. in the first section i explore how, in his view, experiential learning about work on the water and reliance on kinship have contributed to his development of a sense of self and place over his life-course. in the second section, i discuss eddie boy’s kinship-aging dilemma, one he shares with others on smith island. working analytically with traditional, ecological, and sensory knowledge, i show how labor in a kinship-based community defines islanders’ senses of self, which are integrated into their socio-ecological systems. further, i take smith islanders’ ways of knowing (berkes 2015) as a dynamic process embodied in their life-courses. i show how changing socio-ecology has altered the potential for intergenerational relations, which older islanders cherish, and how such changes in late life pose a new aging dilemma for current smith islanders. context and methodology smith island, accessible only by boat, is the home of maryland’s largest island community in the chesapeake bay (9.2 mi², 4.5 mi² land / 4.7 mi² water). the island community’s 200 people are divided into three distinct villages: ewell, tylerton and rhodes point. most smith islanders refer to their island as the only home that they have ever known. kinship structure is central to smith island’s social organization. smith island descendants trace their history back to the original british, welsh, and cornish settlers from the 1600s. moving from virginia and maryland’s eastern shore, they sustained themselves on the island by small scale farming, gardening and hunting, and later by crabbing and oystering. they, and others, refer to their occupation as being “watermen.” historically watermen used sailboats, called skipjacks, and left home for days to sail north in the chesapeake bay in search of blue crabs and oysters. during the youth of those whose life histories i collected, many young men left home as teenagers and worked for several weeks at a time with their kin on sailboats in the bay. boys were socialized and prepared by their kinsman for working on the water from an early age. smith island families were forced to part with some community members multiple times in the past, whenever the crabbing and oystering economy was in decline. they were particularly hard-hit during world war i and world war ii. working on the water in the bay changed drastically after wwii, when many watermen transitioned to working on motorized boats and again, during the 1980s, when a gradual change, caused by new environmental regulations for waterman, took place. i began fieldwork on smith island, maryland in the summer of 2013 when i returned to the island for my second visit after a brief, but memorable, visit in 1995. it was in 1995 that i met smith islanders ken and his wife iris on the dock in crisfield when they welcomed me onto their boat. in the summer of 2013, iris was 89 and ken 88; they were the oldest people on smith island. i visited them every day. we talked, watched television, and listened to the marine radio. they let me photograph them and answered my many questions related to their life histories. these experiences with iris and ken led to my interest in researching aging on smith island. i met other people on the island in those first two years and on my visits in 2013 and 2014 and with some who were open to talk to me and invited me to their shanties and homes, like eddie boy, i developed closer connections. i recorded 24 life histories, observed and photographed people at work, at church, their homes or when walking in public spaces. it is from those histories, observations and visual practices, that i developed an interest in exploring smith islanders’ patterns of knowledge as they relate to patterns of learning about a place to which they are so deeply connected. kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 50 between 2015 and 2017, in addition to casual conversations with individual islanders, i participated in social events, such as church meetings and traditional annual celebrations on the island. drawing on ethnographic fieldwork on smith island between 2013 and 2017, i developed my thesis identifying the significance of relationships among the self, work, knowledge, kinship and sense of place which were developed over the lifecourse. from the beginning of my fieldwork, i was struck by the contrast between the membership and leadership of older adults in the smith island community and the struggle for “agency of marginalized older adults” lynch 2013, 199 on the us mainland. their engagement in their island’s traditional work, social life, and problems with land management proved to generate an “active and energetic adulthood” lynch 2013, 188. yet, as did other social scientists working in communities affected deeply by environmental and population changes (marino 2015; norgaard 2011; paolisso 2006), in my research site, i witnessed painful dilemmas lingering over the community’s vision of its future while experiencing major land and population changes. in recent studies focused on a sense of place, some scholars have pointed out that sense of place and the belonging to a home, territory, landscape or seascape, often becomes apparent when such attachment is threatened (basso 1996; casey 1993; king 2014; paolisso 2006). smith islanders’ have a sense of self and kinship-based community, which, connected to their place-based knowledge, provides them with an existential sense of what they call independence and freedom. these related sensibilities are being challenged by local as well as global socio-ecological changes. anthropological studies of life-course processes across time and cultures emphasize the link between individual experience, social relations, and the environment (sokolovsky 1990; danely and lynch 2013). theoretical models applied to analysis of human ecology and environment, are generally defined by cross disciplinary approaches (berkes 2015; roscoe 2014). research that addresses alarming and uncertain changes in diverse coastal socio-ecological systems world-wide, suggests that because the globalization of trade in marine products is impacting marine ecosystems and global climate patterns, it is critical to reconnect social (human) and ecological (biophysical) systems (berkes 2015; paolisso 2006; roscoe 2014; fiske 2016). place making and ways of knowing through the process of place-making, smith islanders construct not only their social history and traditions, but also personal and social identities over generations. the process of place making correlated with the process of growing old on smith island, results in a deep attachment to place. today, smith island narratives are still defined by membership in a closely knit, kin-based island community. to define smith islanders’ belonging to their ecology, i take their sense of self as connected to a process of place-making (basso 1996). keith basso wrote in a different ethnographic context, “knowledge of places is therefore closely linked to knowledge of the self, to grasping one’s own community and to securing a confident sense of who one is as a person”. for smith islanders, water and weather define every aspect of their daily lives and their prosperity, as well as their losses, their happiness, fatigue, joy, suffering, and death: “weather is everything and wind is the weather here,” islanders say. this is a very significant ethnographic “rich point” (agar 1994, 141) shared by the islanders, and it precisely defines the relationship with their sense of place, knowledge, and identity. water and weather, controlled by the unpredictability of wind, is to them a humbling force. the limits set by their integration within larger complex ecological systems is what connects smith islanders, in their perceptions of a self in time and place, with their ancestors. for generations islanders have continued to re-invent their lives. all the while they try to stay connected with their kin from the past by what they define as their cultural heritage and their traditional life. smith islanders’ definition of a traditional life is closely related to the concept of traditional knowledge (tk) and traditional kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 51 ecological knowledge (tek), defined by fickert berkes (2015) as “a cumulative body of knowledge, practice, and belief by adaptive process and handed down through generations by cultural transmission about the relationship of living beings (including humans) with one another and with their environment” (3). when examining smith islander’s tek from a life-course perspective, i further differentiate tek from ways of knowing (berkes 2015), which is considered a process (berkes 2015; ingold 2000) “you have to be born on smith island to be a smith islander,” islanders say. this saying expresses their deep awareness of the skills one must learn from relatives in the early stages of life in order to survive and do well on the island. i further explore in this article the process of “becoming” with special emphasis on an experiential learning from early childhood and a development of sensory knowledge islanders have in relation to their environment. i encountered another example of process of becoming a smith islander when one father expressed to me his joy over a photograph of his little boy in a family album. the photo showed his boy alone on a small boat. the father’s gaze on this image evoked his sense of pride and accomplishment, as it was part of his son’s experiential learning. experiencing water, in addition to mastering the skills of how to manage the boat, is for islanders a vital form of day-to-day close sensory interaction. veronika strang (2004) points out that while water shapes diverse sensory perceptions and meanings, water also has universal, consistent qualities evident in its continual change and movement. as some islanders told me, their attitude, “going with the flow,” is their way of responding to the movements of the water surrounding the island. these sensory skills are inherently necessary in adaptation to the island environment. peoples’ analogies about movement in life on the island are accounts of sensory ways of knowing, reflecting on their outlook on life. for smith islanders, water is a powerful metaphor expressing ideas and emotions in their lives and correlating with the concept described by strang (2004): “people imagine ideas and emotions flowing between themselves and the world, and in this system, as in any other, there is a ‘proper order boundaries and limits, a correct balance’ of flow” (68). letting her go eddie boy retired from working on the water in the summer of 2016. when i walked into his shanty (a working space that is a wooden building dedicated to processing and storing the waterman’s catch and other work), it was a hot and humid morning at the height of the summer season. to my surprise he was not there, so i stepped outside and looked for him on the boardwalk where his boat was tied up. eddie boy was standing on the end of the pier by his shanty watching two young men getting ready to leave with a boat. having spent considerable time there, i recognized that they were not from smith island. eddie was intensely quiet, leaning on a piling while the boat was slowly pulling out of the slip. having watched watermen on smith island operate their boats with practiced ease, i could tell that these strangers were just learning the craft. it was when the boat turned and i could read the name “june” on the stern of the boat, that i realized what just happened. eddie boy had sold his boat (see photo 2). the boat headed out of the harbor and i followed eddie boy as he walked quietly inside the shanty. during early mornings in the summer, his wife june was always there with him, picking crab meat. but that morning, eddie boy sat down in his chair, situated in the middle of the room, and june was not there. in his quiet, i realized that i had just witnessed an extraordinary event. i broke the silence by asking about the absence of his wife, and he said, “june went to the mainland. she is not happy about this, she is not ready, but i told her i am.” then he continued, “i had to slow down first, but now it’s time to stop. i had to let her [the boat] go.” there was no regret in eddie’s voice. he had come to accept that he had to let his boat go. having witnessed the life-long connections between a waterman’s sense of self, his family and his boat, i recognized the symbolic power of the boat in the men’s lives. eddie boy’s childhood memories shed a new light on what i witnessed that summer morning, when eddie boy made a step towards retirement and “let her go.” kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 52 photo 2. smith island maryland, eddie boy “letting her go” (photo by jana kopelent rehak) “i can’t imagine living my life elsewhere,” said eddie boy when i asked him about aging. “i take time to sit and observe nature and enjoy,” he calmly said. “we live a simple life here, without major distractions and material conveniences people have on the mainland,” as he put it when he spoke about his sensory joy and personal satisfaction. emotional engagement with the landscape, as anderson suggested, is not limited to sources of food and shelter, but includes sources of beauty, power, excitement and other human values (anderson 1996). one evening, while sitting on a bench by his shanty at the end of the day, watching the sun set, eddie boy said: every year a group of men, well to do men, reserve a winter weekend in my shanty. they come from up north in february to smith island. they stay around the table here and shuck oysters while they keep the outside door open to watch the sun on the water. they come down here from their ‘worldly life’, all the way to me, to seek something special. one of them told me that this is the best time in his whole year. for me this is what i have every day and all year around. i am happy. they come for one weekend i have a year to feel my happiness. when reflecting on his growing old in a place, eddie boy often speaks of joy from gazing at the sky, watching light on the water and listening to the birds. he takes time to sit and observe the island’s landscape, a beauty he does not take for granted. such “mesmeric qualities” of water, as strang (2004) put it, “are of particular interest in considering sensory perception and the creation of meaning” (51). his stimulating day-to-day interaction with seascape and island landscape, resulted in a strong bond between eddie boy and his environment. a year later, eddie boy was diagnosed with an advanced cancer. after his brief stay in a mainland nursing home, he decided to come back to his island home. uncertain about how much time he had to live, eddie boy kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 53 remained inside his house in the care of his wife and children through the summer of 2017. for a while eddie boy’s sickness made him invisible to the public. the smith island community was distressed over his rapidly diminishing strength and his absence from public spaces. that distress intensified in the community with the news about his brother junior, also diagnosed with cancer. eddie boy had established an important role in the smith island community over his life-course. he was among the islanders who never left the island even when others evacuated before a storm. fellow islanders consider him and his brother junior to be pillars of the community. “eddie boy is a very good waterman,” people say, and, emphasizing his wisdom, “one you can always ask for advice.” during summer social events smith island collectively expressed compassion for the pain and physical suffering of the two brothers. it was apparent to me that their sickness affected the whole community. the male life-course on smith island: learning the ways of the waterman “for her size, she was about as smart a boat as there was on the bay.” capt. edward harrison edward asbury evans, called “eddie boy,” was born on smith island in 1938. with the exception of two years in baltimore during world war ii, he has lived on smith island all his life. for eddie boy’s generation, as for previous generations, survival on smith island depended on absorbing traditional knowledge while growing up. people originally settled smith island with the intent to farm. he traces his ancestry back eight generations to the eastern shore of virginia on his mother’s side, and to the western shore of virginia on his father’s side. eddie boy recalled how he first recognized his desire to become a waterman: well, all my life from when i was a small kid, i always desired to grow up, naturally, like most children do, to be like their father. i mean my father and grandfather was with me like anybody else. they were role models with me. i never cared to go to school, if i could get out and work on the water. i always had a desire from a very early age to have my own boat and just be my own boss. now, at that time you didn’t look at it as being your own boss; it was more or less the freedom part of it. from the perspective of his childhood memories, eddie boy recalls his first taste of being on the water as a feeling of power and freedom. but learning how to captain a boat is not just knowledge of certain skills, it is part of the larger process of ways of knowing, which include social, sensory, and emotional knowledge as well as knowledge of trade and the environment (see berkes 2008), eddie’s admiration of his father and grandfather is not exceptional among smith islanders. as i noticed during my fieldwork, other watermen expressed their childhood memories of togetherness and closeness during the learning process with their kinsmen in a vivid way. for some it is their strong relationship with their fathers, other male kinsmen or mentors, like a boat captain. a boat is an essential part of a man’s life-course on smith island. eddie boy reflects on the process of developing ways of knowing through learning how to captain a boat, a critical skill for smith island boys entering manhood: and pretty well every kid around here, when they got eight, ten years old, in between there, had a skiff of some type. now, some was fortunate enough to have new ones, some was lucky enough for to be able to find one that somebody had throwed away and they’d fix it up and whatever. but we were always just messing around with these type of skiffs, riding ‘em like our fathers’ boats and what have you, and it was a lot of fun, but it also built the desire into you to be competitive, because you always wanted a boat that was better than the next boy’s that was your age, and you were trying to do something different than he was or trying to go faster and things of that nature. kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 54 i would say that when i was no more than nine years old, i had my first skiff, which was a big thing for us at that age. it’s more or less like a kid today when you get 16 and you get your first automobile or something. it was really a big deal with us when we got our first skiff. probably didn’t cost over 30 or 40 dollars. didn’t have a motor on it, but at that age we could take that skiff here in the shallows all around the island with a sail on it. we were always rigging sail on it and it was something that your parents pretty well let you do your own thing. if you wanted to put a funny looking sail on it that was fine. it was your boat. as i show here, eddie boy’s recollections of learning on a small boat, a skiff, provide an insight into the process of becoming a smith island waterman. getting that first skiff, when eddie boy was growing up, was a rite of passage on smith island. it meant learning traditional skills, gaining sensory knowledge and emotional satisfaction in a child’s desire to be like his parents. it was a first taste of being empowered and feeling freedom, as eddie boy put it, and away from parental restrictions, while learning “the seascape’s rhythm” (maurstand 2004, 277). becoming a smith islander and a waterman is a long process of sensory and experiential learning that stretched over the course of childhood and gradually into manhood. buddy, one of the middle-aged watermen, remembers how his dad would take him to work on his boat: “my dad put me in the box on the boat and i would be with him all day. i even fell asleep and was mad when my sister woke me up when we arrived home in the afternoon. i didn’t want them to know that i was sleeping, but it was all so good.” mark, one of buddy’s contemporaries, remembered, “as kids we would play in a skiff catching crabs with nets. we would also go dock to dock when we didn’t have a skiff catching crabs hiding near pilings. later when i began with my father at first, i would do small jobs like steering the boat, throwing buoys overboard, whatever was helpful to my dad and the mate he had working with him.” learning the rhythm and craft of their work from an early stage over the life-course, is a pattern in the many childhood memories that i collected from smith island’s three communities. the smith island men, with whom i had the opportunity to talk, remembered their childhood play related to their father’s work and their initiation into the process of becoming a waterman. some men discontinued their seasonal crabbing and oystering, over their life-course, yet their childhood narratives reveal similar patterns of learning. bobby, a tugboat captain, described how his dad would teach him to control his skiff: “one day dad asked me to take crabs to the shanty. our shanty was out on the water near marshes on your way to rhodes point. as i was coming closer, i stopped the engine and let her drift slowly towards the shanty. ‘you have to get her there much faster than that,’ he let me know. i need to move faster with her.” for watermen, experiential knowledge of the seascape is part of the traditional knowledge that they learn from older male kin. “the seascape evokes the senses in various ways and the body responds to this particular environment through engaged forms of sensing,” wrote anna maurstand (2004) in her articles about small-scale fisheries in the north of norway (280). smith island watermen live most of their lives on the water and it is their extensive sensory knowledge of the seascape that shapes “men-only” ways of knowing. when defining their work, “on the water” as they say, eddie boy and others rely on their sensory experiences drawn from their closeness to nature and, in particular, the water. the sensory experiences on the island, expressed as the fabric of everyday life in the sounds, smells, tastes and sights, are all shared elements of smith islanders’ sense of place. the earthy smell of marshland, the smell of freshly washed clothes and perfumes in church, the taste of local food, the sounds of the wind crossing grassland, the sound of water pushed by wind into the island shore, the water trickling on swimming crabs in shanties, and the sputter of crab boat engines before sunrise returning from work kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 55 in the heat of midday are all parts of what paul stoller (1997) may call sensual cultural complexities. eddie boy’s memories further show how early experiences on the water with a skiff lead to a quick transition from mimetic and ritualized play on the water to the final stage: a rite of passage to an assigned job. this is how he recalled his first work trip to the mainland, the first time that i had-and i remember it real distinctly. i was 12 years old, and my father let me go to crisfield the first time by myself in a big boat to take the crabs (a one hour boat trip). and looking back on it, i can see where it’s pretty young, you know, to trust a large boat to go to crisfield, even though – i’m quite sure my father had thought this out plainly and he picked the type of day that he says it’s okay to do, that he felt that it was going to be a beautiful day and you could see a long ways and them type of things. but, still, looking back, it was pretty young for to be trusted with that. i didn’t trust mine with my boat at that age. i mean, they were a little bit older than that before i would trust ‘em with that type of a boat. but anyhow, my father did. we can see here how this first work assignment quickly turns from childhood play on the water to an adult experience of taking responsibility. we can also see the kind of sensory knowledge smith islanders must learn early in their lives. eddie boy gives us a suggestion here, that while mastering the boat on the water is a critical skill for watermen, sensory knowledge learning is also about learning to embrace and overcome ever present solitude and fear of death when working on the water. in looking back on his youth and his father’s approach, and from the position of a parent, eddie further reflects: he always gave me the freedom to do these types of things, and it was a good thing that he did, because by the time i was 16 years old, my father became seriously ill and he couldn’t work for two years. i had to take charge of the family at 16 years old. my brother was 14 and i was 16, and we’d take that boat, i was in charge because i was the oldest. my father made that very clear. and we managed, believe or not, to look out for our family, and we had a large family. it was six children of us and plus mom and dad, and dad was sick. and we managed to keep that family together with enough – put food on the table and all the other expenses going for them two years. so if we look back, then my father was wise to let me learn at an early age…naturally after that, as i began to get a little older, then i wanted my own boat. and at 18 years old, i had my own boat, my first boat. eddie boy’s reflexive memories show how, on smith island, men’s relationships with kin and boats are formed in early childhood and continue to develop well into manhood. eddie boy’s life on the water and on the island continued with his marriage to june and the birth of five children. when i first met him, he was in his seventies, he was a working waterman and respected leading elder in his community. his narratives led me to further explore others’ memories of childhood which reflect experiential learning and the role of a boat in the lifecourse of an islander. i found that learning by playing with a skiff was preceded during early childhood by much earlier play with a small toy boat. the toy boats were carved from one piece of wood, then painted and boys would pull them with a rope. jennifer, eddie boy’s sister, remembered when her son got his first tall boots that made it possible for him to play in the backyard at high tide: “he was there for hours, playing in the water with his tall boots on. after he set up the stations in line and connected them with a rope, he pushed his little toy boat from station to station, playing crab pots pulling.” what makes jennifer’s story such an interesting example about childhood on smith island is the interconnection between experiential learning and imaginative play. for some, the connection with the work kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 56 boats is also manifested in their interest in work boat models. when visiting smith island homes, i noticed work boat models, old and new, displayed in the living rooms. some models are passed down from the previous generation, others are more recent. these boat models are considered a form of art and skillfully crafting them is a creative activity. they also enable cultural heritage to be shared by makers during local art festivals and events. because of their location and livelihood, smith islanders’ lives are inseparable from their boats, or, as eddie boy puts it, “a boat has a very significant place in the life of a smith islander.” from early childhood imaginative play mimics adulthood. the child’s ownership of a small skiff provides a first taste of freedom, of competition, and of adventure, as well as a taste of desired adulthood. work on the water begins during childhood and continues into late life, and the boat is one of the central elements of family sustainability. smith island work boats are cared for daily. watermen clean their boats every day and do small scale repairs during the season, while large scale maintenance of the boats is done during the off season. in addition to their care for each work boat and pride in model boats symbolic of their cultural heritage, i noticed the watermen’s emotional connections to their boats. watermen refer to a boat as she and often name their boats after their wives or daughters. paula johnson (1992), in her book about smith island work boats, emphasized how the workboats were personalized by watermen and families. glenn lawson, in her book, said that a boat was always treated like a very important member of the family and with respect. capt. edward harrison, as johnson (1992) pointed out, expressed the sensory experience embodied in working on the boat. “being on the boat all your life, that boat becomes part of you. helps raise your family” (12). the notion of freedom, embodied in a man’s boat and work on the water, is one of the significant patterns in eddie boy’s life-course narratives, one which he shares with his fellow watermen. dwight, eddie boy’s brotherin-law, spoke of how a sense of freedom comes from working on the water: “when you look from your window, here on the island, you see what is happening outside on the water and right then you can tell how weather will affect everything. you are free to go and do what you need to do. you have knowledge and experience and act on it as you please with flexibility.” for eddie boy, dwight, and others, this sense of freedom comes from the flexibility and ability to move physically with the water and weather and the ecology of which they are a part. it is what maurstand (2004) defines as temporal rhythms and belonging to a particular lifeway. in related discussion, strang (2004) discussed a manageable flow between the social context and the environment. an experienced sense of freedom combined with knowledge of ecological diversity and change and with sensory knowledge of the seascape drives the islanders’ own flexibility to interact with their environment. both ecological knowledge and flexible work practices are an approach strategically important for local sustainability in small scale fisheries. this has been well researched by berkes (2013) and other socio-ecologists (e.g., paolisso 2006; ponkrat and stocker 2011; roscoe 2014). the islanders’ ecological knowledge includes their concepts of cyclical and annual time, their understanding of weather and water patterns affecting the island, and a developed comprehension of the biodiversity in the bay’s ecology, all of which is recorded in journals and passed on by mentoring watermen. becoming part of the island’s ecology in the company of their kin has been essential for smith islanders. their shared knowledge of the bay’s water, crabs, fish, oysters, birds, and other animals inhabiting the ecosystem is passed down through generations. as it is in many diverse coastal communities, traditional knowledge on smith island is an evolving process, one which is learned by the practice of doing (berkes 2015). a cumulative body of knowledge based on collective experiences and observations brought together, interpreted, and shared produces what berkes (2015) defines as a community knowledge (229). the opportunity to pass their knowledge on to the next generation, a practice that smith island watermen are well-known for in the bay community (warner 1976), seems to be a kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 57 significant part of the work. from eddie boy’s and others’ narratives we can see how, from early boyhood to late life, work shapes “the life-course obligation” guyer and salami 2013, page 206 in the life of a resident of smith island. due to better availability of health care, increasing longevity, and the absence of a younger generation, islanders find themselves working longer. as is happening in many other places, smith islanders are now experiencing a rapid demographic change and are becoming a “super aging society” (lynch and danely 2013). older adults are the largest full-time working population on smith island today. many return to their work shortly after they undergo a major illness or surgery and continue to work until they reach the physical limits of their working lives due to illness or death. as they approach what bateson calls “stage in adulthood ii” bateson 2013, page 21 many adapt by working fewer hours on the water during the crab season and not working during the winter oyster season. unless they have to stop going out on the water because they are seriously ill, they battle illnesses, overcome work injuries, and work until the final stage of their lives. watermen forced to move to a nursing home on the mainland still follow seasonal weather, crab cycles, and the market in media and by calling their kin. moving to a nursing home on the mainland is a painful time, both for an individual and for the community. when individuals in late life cannot sustain themselves on smith island, and there is no family or friend who can help them, they have to leave. people generally resent leaving and feel overwhelming stress at such a possibility. they do everything they can to stay as long as they can. growing old as a waterman: stories in the place eddie boy, like other aging watermen, maintained his excitement about work into his late seventies. admitting that his physical limits frustrate him, he tried to retain the status of a working waterman into late life. since work and individual independence are generally highly valued on smith island, the main occupations for older adults become those of maintaining economic independence, sustaining heritage, and managing one’s work and health conditions. on the island, some watermen meet for early morning coffee in the local shop and talk while they listen to the marine radio and television. in the company of others, they enjoy telling stories and jokes, discussing their work and weather, and supporting each other in times of hardship. elders on smith island enjoy their place in the community. as watermen on smith island grow old, participation in storytelling becomes an obligation connecting people and places across successive generations. storytelling practice has long served effectively in passing on knowledge and providing a space for elders to actively participate in the social life of the community. storytelling, just like experiential learning, has a significant place in the life-course of people in the smith island community. barbara myerhoff compared story-telling to soul making, and further wrote, “growing souls through stories is the making of the world” (2007, 89). storytelling practice has been deeply established in the life-course of smith islanders for generations. stories are told during social gatherings and community events and are often also part of casual talks. “at tangier they call us ‘yarnies,’ said jennings, one of the elders, with laughter, “meaning we could tell long yarn stories.” storytelling relates to smith island life in the broadest sense; stories are related to serious tasks, such as weather, work, social life, faith or death, but are used as well as to entertain. some stories, deeply rooted in the island’s oral traditions, are re-told and could be called “old yarns,” addressing upcoming crisis shared crosstime. “any crisis that comes up has been dealt with years back, and that’s how stories came into being” (kitching 2011, 81). the stories, important in the times of crisis, as jennings puts it, represent old wisdom, available for smith kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 58 islanders across generations. these stories, based on actual events or dreams and visions, and often related to the dead, have a significant place in the smith islanders’ oral traditions and circulate in the community through successive generations. confrontation with the death of a kinsman is a severe condition of the life-course for smith islanders. nearness to death is always part of day-to-day life, as jennings points out, “you go out and you don't know if you will come back.” stories of the dead are structured according to knowledge of a place, a body, or self and faith, and often include aspects of a secret. some stories and dreams overlap, just as they do in the story involving eddie boy ,which i encountered while having casual conversation with anita, the librarian. anita, remembered the story about her uncle’s death. “he was going out in a small boat, just to check on something. weather changed fast and the wind was so strong that his little boat was swept up. his body was lost in the sea and they couldn’t find him for days. then, eddie boy had a dream about the place where he was. they went there and found him.” when i asked him about this story, eddie boy confirmed it: it was sunday afternoon, after church, when i came home and like my usual routine is, i eat and lay down on the sofa. that day i couldn’t fall asleep. i was slowly drowsing away when in my mind i keep returning to one place on the water in a grassy area. i got up and told my wife june that i have to go there. i was thinking for a moment that i may go later, but then i went and the body was there. i am glad i did, because if i waited for later we would have never found the body. eddie boy finished retelling his story and the resulting silence in the living room carried a chilling sense of the sacred surrounding events in his narratives. “wisdom sits in places,” wrote keith basso (1996, 75) about landscape and language in different contexts. for smith islanders, the wisdom accumulated in stories also sits in places. place-based stories and dreams are closely related to seascape knowledge, supernatural powers and belief systems, as well as islander’s relationships with their dead. eddie boy’s detailed knowledge of the seascape and his concern with a fellow islander, mirrored in his dream, prompted further action, and became a story circulating throughout the community. while all age groups can participate in story-telling, elders, as they are in other small traditional societies, are the keepers of old stories, reflecting the values and a knowledge of their community. as berkes (2008) put it, “elders provide corporate memory for the group, the wisdom to interpret uncommon and unusual events and they help enforce the rules and ethical norms of the community” (132). the current generation faces a painful dilemma. “there is hardly anybody here to tell the stories to,” as one elder put it. holding onto their stories in the absence of a next generation, smith islanders’ find their traditional roles in intergenerational relations challenged. migration of younger generations to the mainland has a profound influence on their aging parents and grandparents on the island. aging smith islanders are still active storytellers in their community today, but, in the absence of their children and grandchildren, they are losing the opportunity to pass their stories on to the next generation. while older adults could not likely imagine their lives in any other place, being engaged in different work, or losing their smith island community, they have supported their children in seeking education followed by finding a new profession on the mainland. the majority of eddie boy’s children’s generation left the island for work. the grandchildren are not pursuing careers on the water, instead they are seeking higher education. they visit the island sporadically, usually only one or two times per year. typically, their parents and grandparents travel to the mainland to participate in their grandchildren’s lives or for holidays. in a kinshipbased community, separation of the family by migration presents a dilemma for this super-aging island community (lynch and danely 2013). kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 59 eddie boy and his wife june, like many others, are proud of their kids: “my granddaughter is doing really well at the university of baltimore law school. she already has an internship and her article was accepted to a professional journal, she is doing well!” eddie boy said multiple times over the last two years: “as far as i know she is the first lawyer from smith island and when the judge picked her for an internship, he told her that a reason he picked her is because he knew she must have worked twice as much than others to get where she is.” watching their granddaughter succeed on the mainland, they are caught in the kinship/community dilemma. for eddie boy, like others on smith island, witnessing his children and grandchildren leaving the island first for school, and then for jobs, foretells the absence of people on the island in the future. while excited about his granddaughter’s success, he also knows that there is a painful price to pay: the continuation of his community. struggling to hold onto their stories in the “absence of the listener is like the deprivation of an individual” (myerhoff 2007, 20). myerhoff (2007) writes of this experience, “it is as if all creation stories are stories of separation” (21). smith island story-telling is an integral part of active agency for older people. lynch (2012) points out that agency and control are two nouns that may not be typically associated in american society with older adults. lynch (2012) writes, “whereas they are important values in the united states, americans seem to assume stereotypically that old people do not have agency: their bodies are failing, they are not in control, their life choices have already been made, and they are just finishing up their years” (199). smith islanders’ engagement in active work provides them with a sense of purpose, “an agency in their late adulthood,” (lynch and danely 2013, 199) and contributes to their “active and energetic transition to adulthood ii” bateson 2013, 27. yet, their obligation to carry on the island’s traditions, for the instance inability to pass on old stories to the next generation, leaves them unfulfilled. socio-ecology and life-course small island ecosystems, also known as “personal ecosystems” (berkes 2018, page 97), are an interesting site for research, because island people often see limits to their environment more clearly than mainlanders. just as in many other coastal small island communities, smith island’s ecology has been affected by storms, hurricanes, and land erosion. today, with rapid environmental change and the decline in human population, members of an aging generation on smith island recognize their vulnerable position. many smith islanders are not comfortable discussing the changes to their land in the context of global climate change, but they are very proactive in their land management activities preventing the land erosion. land erosion on the northwest side of the island and high water levels on the east side have become critical focal points for the smith islanders’ efforts to improve their land resilience. losing land to erosion poses a serious threat to smith islanders and requires careful land management. the us government funded the construction of a seawall by the army corps of engineers in two areas on the northwest side of the island, and it approved further funding for an environmental engineering company to investigate a land erosion improvement plan for the entire island. in addition to long-term communal land management supported by state and federal funding, smith island residents employ short term strategies to address high tide issues affecting both public roads and private yards. social and environmental scientists are trying to make sense of the complexities surrounding issues of climate change in traditional and often predominantly aging communities. some anthropologists who are working with communities directly affected by rapid socioecological changes observed the problem of denial of climate change and defined it as a disconnect. they tackled the denial of climate change by conceptualizing it, based on a cultural model transparent in modes of communication, as environmental skepticism (fiske 2016; kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 60 marino 2015; paolisso 2006). shirley j. fiske (2016), for example, defined climate skepticism to be a uniquely american belief system and the result of certain groups’ resistance to scientific and governmental authority. as fiske points out, among skeptics a sense of confidence is culturally bound and is a direct outcome of placebased knowledge and values. current climate change has focused ethnographic encounters on local populations in small, rural communities, which, in turn, have provided evidence of a need to address the vulnerability of places affected by global environmental changes (marino 2015; norgaard 2011; paolisso 2006). in my work, i offer an ethnographic account of place-based knowledge and values as they are connected to the aging process. the purpose of this research is to move beyond an academic critique of the denial of climate change. it is from here that i take a multiple analytical approach: the socio-ecology and life-course. danely and lynch (2013) write, “a life-course approach to aging recognizes that as individuals age, their lives unfold in conjunction with those of people of different ages, and that all of these actors, who occupy different and changing positions of multiple cultural and physical environments over a period of historical time, are shaping and influencing each other in important ways” (3). in their publication transitions and transformations danely and lynch, offer cross-cultural comparative accounts of aging from a life-course perspective. they emphasize that a focus on the life-course in anthropological studies of aging represents, in theory, a shift from the static category of one person towards an inclusive multigenerational approach. from this life-course perspective, examination of work and kinship on smith island shows it to be a cross-roads of locally specific patterns of traditional work, storytelling, and a newly emerging multigenerational dilemma in a small rural community affected by socio-ecological changes. in this predominantly aging community, life history narratives, casual conversations, and ethnographic observations provided me with deeper insights into the meaning of work and kinship as it is integrated into the island’s socio-ecology. conclusion eddie boy died in january 2018. at his funeral, silence overpowered the traditional storytelling. typically, at a smith island funeral people share stories and even jokes. at eddie boy’s funeral, all the designated speakers struggled physically with their voices. it was as if all speech was silenced by the pain of losing him. i recall only one message as a collective echo across the crowded church in ewell, “he was a person to go to, always available to share his wisdom.” everyone agreed that eddie boy’s accessibility and ability to share his knowledge with others has become, in the eyes of smith islanders, a heroic way of being. his skill at surviving made him a successful waterman, yet at his funeral, i began to realize that the triumph of his life is his service to the community, the place where he belonged. eddie boy’s life history is an account of personal experience over his life-course in relation to a place defined by a unique socio-ecology. i recognize in his lifecourse experiences multiple and conflicted elements which define eddie boy’s agency in a small coastal community. my focus on smith islanders’ life histories provides a larger context for understanding how traditional knowledge is constituted in the life-courses of individuals who are connected to a place. reading eddie boy’s life history and tracking narrative speech patterns about his work on the water, opened a new space for further exploration of traditional, ecological, and sensory knowledge. moreover, his life history and speech open up a space to explore the symbolic embodiment of boats in the life-course of smith island males. by examining eddie boy’s memories of his childhood, i show, from the perspective of his life-course, how the process of his becoming an adult waterman is defined by intergenerational practices structured by knowledge. i present outcomes showing how knowledge embodied in the life-course of an older person, eddie boy, underwent major shifts related to socioecological changes. kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 61 smith islanders’ traditional knowledge, as i discovered, integrated into intergenerational relations over the life-course, gives purpose to residents a sense of agency in their late life. linking the concepts of knowledge, place making, work, and story-telling to the process of growing old provided me with tools to illustrate islanders’ sense of self, but also highlighted a late adulthood dilemma in in a place affected by socioecological and familial change. smith islanders’ feelings of belonging to the island gives them a deep sense of being connected to their ancestors, cultural traditions, work and community. to continue their traditional island life into their late adulthood, they must remain active and manage their work and health. they must do all this while bearing witness to the erosion of their land and community. as his case illustrates, eddie boy’s emotional engagement with his boat, the seascape, and the island are essential parts of successfully aging in place. yet as i see it, trends toward change also presented him with a kinship dilemma related to the discontinuity of his own heritage. these are elements which shape life-course experiences. references agar, michael. 1994. language shock: understanding the culture of conversation. new york: quill. anderson, eugene. 1996. ecologies of heart: emotion, belief and the environment. new york: oxford university press. basso, keith h. 1996. wisdom sits in places. university of new mexico press: albuquerque. bateson, mary catherine. 2013. changes in the life course: strengths and stages. in transitions and transformations: cultural perspective on aging and the life course. edited by danely, jason and caitrin lynch. 21-34.new york: berghahn. berkes, fikret. 2015. coast for people. new york: routledge. ----. 2008. sacred ecology. new york: routledge. casey, edward. 1993. getting back into places: towards a renewed understanding of the place-world. bloomington: indiana university press. danely, jason and caitrin lynch, eds. 2013. transitions and transformations: cultural perspective on aging and the life course. new york: berghahn. dize, frances. 1990. smith island, chesapeake bay. centerville, maryland: tidewater publishers. fiske, shirley j. 2016. “climate skepticism” inside the beltway and across the bay. in anthropology and climate change. ed. by susan a. crate and mark nuttall. new york: routledge guyer, jane.i. and kabiru k. salami. 2013. “life course of indebteness in rural nigeria.” in in transitions and transformations: cultural perspective on aging and the life course. edited by danely, jason and caitrin lynch. 206-217.new york: berghahn. ingold, tim. 1987. the appropriation of nature. university of iowa press: iowa city. johnson, paula. 1992. the workboats of smith island. johns hopkins university press. king, sarah. 2014. fishing in contested water. university of toronto press, toronto. kitching, frances and susan stiles dowell. 2011. mrs. kitching’s smith island cookbook. schiffer. lynch, caitrin. 2012. retirement on the line: age, work, and an american factory. ithaca, new york: cornell university press. marino, elizabeth.2015. fierce climate sacred ground. university of alaska press. maurstand, anna. 2004. “cultural seascapes: preserving local fishermen’s knowledge in northern norway.” in northern ethnographic landscapes, edited by igor krupnik, rachel mason, and tonia horton. 277-297. washington, d.c.: smithsonian institution. myerhoff, barbara. 2007. stories as equipment for living. new york:a touchstone book. kopelent rehak | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.181 http://anthro-age.pitt.edu 62 norgaard, kari marie. 2011. living in denial: climate change emotions and everyday life. cambridge. massachusetts: mit press. strang, veronika. 2004. the meaning of water. new york: berg. paolisso, michael. 2006. chesapeake environmentalism: rethinking culture to strengthen restoration and resource management. college park: maryland seagran. ponkrat, bob and laura stocker. 2011. anthropology, climate change and coastal planning.london: routledge. helen kopnina and eleanor shoreman-ouiment. ed.2011. london and new york: routledge. roscoe, paul. 2014. “a changing climate for anthropological and archeological research: improving the climate-change models.” american anthropologist 116 (3): 535-548. sokolovsky, jay.1990. the cultural context of aging. new york: bergin & garvey publishers. stoller, paul. 1997. sensory scholarship. philadelphia: university of pennsylvania press. warner, william. 1976. beautiful swimmers. boston: an atlantic monthly press book. an attitude of gratitude: older japanese in the hopeful present iza kavedžija university of exeter i.kavedzija@exeter.ac.uk abstract in this article i explore ideas of a good and meaningful life in older age, based on ethnographic research with older japanese people in the city of osaka. some of my interlocutors and friends in the field spoke about their approaching end of life. when speaking about the time remaining, many expressed their sense that the future will work out “somehow” (nantonaku). this statement of quiet hope acknowledged change, and encapsulated a desire to support others; it also shifted emphasis away from the future. this is not to say that the experience was, for my interlocutors, primarily marked by an orientation toward the past, through reminiscence and recollection. inhabiting the moment was equally important. while reminiscing and narrating past events comprise a form of meaning-making, how does dwelling in the moment contribute to maintaining a meaningful existence? i will argue it allows for the cultivation of an ‘attitude of gratitude,’ which lends meaning to life. this attitude of gratitude binds together both reflections on the past and attention to the present moment in its fullness. it also, i suggest, opens up space for a particular kind of hope, one grounded in the moment. thus, the sense of a good and meaningful life that these elders conveyed encapsulates an attitude of gratitude as a way of inhabiting the present, rather than dwelling in the past or leaping toward the future. keywords: gratitude; quiet hope; aging; japan; ends of life; meaning anthropology & aging, vol 41, no 2 (2020), pp. 59-71 issn 2374-2267 (online) doi 10.5195/aa.2020.244 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 59 an attitude of gratitude: older japanese in the hopeful present iza kavedžija university of exeter i.kavedzija@exeter.ac.uk the uniqueness of old age lies in its being the end period, the “meanwhile” that is to terminate radically within a time that, although indefinite, is proximate… living is always planning, expecting—futurizing, one might say… during the ”meanwhile,” to the extent our minds can be free of anxiety, they can also be free of time. and that is what i consider the state proper to old age. stanley a. leavy (2011, 709) what does it mean to hope at the end of life? what do people look forward to in their older age? writing about his own experience with aging and time, psychoanalyst professor stanley leavy, cited above, suggested that a certain liberation from the burdens of time can take place toward the “last of life.” the experience of time and the horizon of temporality are always entwined with morality, yet approaching the end of life brings these issues into relief. moving through older age is, in this sense, a ‘moral timeline’ of changes (long this issue). the aim of this special issue is to investigate the ends of life as a temporal horizon, but also in the sense of what lends life a sense of purpose (introduction this issue). in this article, i explore the sense of temporality in later life among older inhabitants of an old merchant neighborhood in south osaka.1 my starting point is the observation that, despite evident difficulties, and in the context of widespread anxieties about aging (kavedžija 2016), many of these people, particularly those in their eighth or ninth decade, have manifested quite hopeful dispositions. i found this striking because hope is so often understood as being future oriented: as the way one feels about what lies ahead. authors have emphasized the potential that hope holds, the unknown nature of that which has not yet come into being, as in ernst bloch’s idea of the “not-yet” (1995 [1986], 13). in this sense, hope can be seen as a mode of anticipation (see miyazaki 2006) or a prospective orientation (reed 2011, 529), where one’s gaze is firmly fixed on the future that lies ahead. yet, if hope is a prospective orientation, what form does it take in the later years, as one approaches the end of life? in this article, i explore senses of hope as expressed by my older japanese interlocutors and their basis in what i term an “attitude of gratitude”: a diffuse sense of thankfulness for the various forms of care and support that one has received from others over the course of life. i suggest that, while sometimes bringing with them a sense of loss, the later years may offer an expanded scope for reflection on the life course and a heightened realization of interconnections with others. this, in turn, gives rise to an attitude of gratitude that is not merely restricted to reminiscing about the past, but also allows one to inhabit the present in a resolutely hopeful way. a world perceived as one in which much is owed to others is a quite different place than one from which much has been lost, even if the facts of life are the same. http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 60 so far, anthropological work on gratitude has primarily focused on expressions of gratitude and formal exchanges of gifts. for example, the fire hunting practices of xavante, an indigenous people of mato grosso in brazil, are interpreted as a source of gifts that are crucial for maintaining social ties and facilitating weddings. they are also seen as appropriate sources of gifts for expressing gratitude (welch 2014, 48). similarly, appadurai (1985, 238) discusses gratitude as a social form among the tamil in south india. while linguistic expressions of gratitude are often deemed superfluous or even inappropriate, appropriate gifts at appropriate times are in line with the broader hierarchical moral universe of duty and obligation. the emphasis on nonverbal expressions of gratitude and gift exchanges places gratitude outside the realm of discussions of authenticity and sincerity—if a gift is reciprocated with an appropriate return gift, it is deemed appropriate and the question of whether the gratitude is genuine or not is irrelevant. in other words, gratitude is not assumed to be an inner disposition of the actor (1985, 243–244). the japanese, no doubt, have their fair share of formalized and beautifully organized gift exchanges, and the discussion of the hierarchical flow of duty and obligation in japan is well described in numerous contexts. the performance of gratitude and its formal expressions are, in this sense, similar to the description in appadurai’s work among the tamil people, with the exception that various forms of thanks are given verbally in myriad ways, formally and informally. furthermore, gratitude in japan can be seen to a large extent as a disposition: a recognition of how much one relies on others as one moves through life. this does not entail a focus on sincerity, but highlights instead one’s own feelings of interdependence in the social world. in this article, i explore this aspect of gratitude and its cultivation as an attitude in everyday life. this work is largely based on fieldwork i began in 2008 and continued through follow-up visits in 2013 and during four months in 2019, all in the japanese city of osaka. at the core of the discussion is the ethnographic fieldwork i conducted for 14 months in 2008-9, based in a community salon in a merchant neighborhood, which i call shimoichi, in the south of osaka. the shimoichi salon was an open-for-all community space run by a non-profit organization that also organized various forms of support in the neighborhood: home-helper services; hobby activities, such as weaving or film screenings; and singing sessions, to name a few. the salon itself was a warm, welcoming space on a popular shopping street and offered hot drinks for a discounted and set price, allowing visitors to sit and chat or relax for a long time. some would come regularly for several hours, while others might drop in briefly once a week or merely attend the organized events. it was favoured by older people living independently in the area. most of the regulars were by no means affluent, but most owned their own homes. i was allowed to volunteer, making tea and coffee for the salon-goers, and had the privilege to be involved in a variety of activities run by the non-profit organization that started the salon. during this time, i was also welcomed to the salon and visited on the days i was not volunteering. it was an easy place to either participate in conversations or simply listen in without interference, depending on the situation. in their conversations with me and between themselves, some of the regular visitors to the salon—many of whom i grew to know very well—would occasionally express concerns about their future. “i hope i won’t get dementia (boke),”2 said okubo san, a lady in her early seventies. “both of my parents lived very long lives and they both had it towards the end. i am worried that i will become a burden on my children.” the issue of becoming a burden and of losing the ability to take care of one’s needs, was not uncommon among my interlocutors.3 and yet, when talking about their future, on more than one occasion, i heard people remark that things will work out “somehow” (nantonaku). such statements were often vague, but were far from expressing a kind of passive resignation. the same people, while accepting the uncertainty ahead, were actively engaged in their wider community, and forged their own futures, at least to an extent. their hope relied on the active cultivation of social ties. in fact, my friends were maintaining a social network of support that afforded a sense of security and http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 61 offered them some confidence that things will, indeed, work out somehow. this is what i refer to as “quiet hope.” quiet hope in an aging community the community salon that became my ibasho, my place to be, is based in shimoichi—an old, merchant, downtown south osakan neighborhood. here, new, shiny buildings and brightly lit stores line the avenues bordering the neighborhood, but smaller streets inside those boundaries remain quiet and residential. that year, i noticed that a couple of higher, ten-story buildings had been built since my last visit, making me even more aware of the fact that the neighborhood was still predominantly comprised of two-story family homes on the smaller streets. here, people air their bedding and plant vegetables or flowers in eclectic assortments of pots lined up carefully between houses, parked cars, and bicycles. a large proportion, almost a quarter of its inhabitants is over the age of 65. at the same time, there are fewer people of working age and, as families have gotten smaller, the capacity of a decreasing number of siblings to care for aging parents has diminished.4 this kind of population structure is not exceptional in japan, but it has serious consequences that are visible at a glance. for instance, some houses appear in need of repairs, which their older residents struggle to organize or afford. many small shops are run by older people and face imminent closure, as their proprietors become unable to continue with their work and have encouraged their children to find more lucrative or prestigious careers. there seems to be a chiropractor every few hundred meters; there are few children playing in the streets. the neighborhood is beloved by most inhabitants and does not seem to be too quiet, in fact, the small streets pulse with life, albeit at a slower pace. this persistent sociality became apparent to me whenever i joined one of my older friends for a stroll or, more often than not, on a purposeful march to carry out someone’s many chores and social obligations. for instance, whenever i would walk down the street with my friend, kobayashi san—a single woman in her mid-sixties—she would stop repeatedly to talk to people she knew in the street, perhaps helping to arrange a friend’s visit to the dentist, or to recommend a hairdresser. she explained that she enjoyed the social interaction but also felt that, because she had no close family, all she had were her friends and neighbors; so she helped them where she could, and expressed a vague hope that things will surely work out somehow, should she ever be in need of help. many other older people in shimoichi, including volunteers in the salon (who were mostly in their sixties or early seventies), much like kobayashi san, harbored a diffuse but enduring hope that things will all work out in the end, without necessarily expecting that the favors bestowed would be returned. ueda san, one of the salon volunteers, who used to work as a home helper and now also organized karaoke gatherings for people in the neighborhood, mostly the elderly, told me she helped others partly to acknowledge the support her mother received in her later life. the attentiveness of her neighbors meant her mother could continue living on her own and ueda san could continue working. ueda san had no children of her own but did not exactly consider her care and support activities to be an “investment” in her future security. nor did she have clear expectations or hopes as to how exactly things would work out when she grew older (she was in her early seventies when our conversations took place). but she was generally quite optimistic and believed that “if there is something,” some kind of community, then people would help each other and get by. as already noted, a sort of diffuse hope that the future will be all right “somehow” (nantonaku) was widespread among this resilient group. admittedly, many of them were still in good health and fairly http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 62 independent, but quite a few were living on their own and were by no means affluent, even if most of them owned their own homes. the hope expressed by many might seem, in some ways, like a fairly passive attitude: mere waiting, with an optimistic outlook that things will somehow fall into place in the future. yet, as closer examination of the varied expressions of concern for others reveals, this attitude is anything but passive waiting. instead, it is bound up in the subtle but proactive weaving of networks of support5, while avoiding the re-creation of a more traditional, “village like” community6 (see knight 1996, 220), with its interactions of debt and burdensome “sticky” relationships.7 while some of these community-creating efforts were encouraged and supported by people working in local government and in the non-governmental sector, with varying degrees of conscious determination to bring about desired social change, for many it was merely an everyday practice borne of a hopeful attitude and providing a source of hope about the future. in other words, hope as an attitude is neither a passive optimism, nor is it necessarily an active, reflexive stance with a clear objective. in his seminal piece, vincent crapanzano describes hope, in contrast to desire, as characterized by “passivism” and suggests that there is “a resignation . . . inherent in the notion of hope” (crapanzano 2003, 5). since its publication, there have been several notable contributions to the task of understanding and conceptualizing hope anthropologically (hage 2003; miyazaki 2004, 2006; riles 2010; moore 2011; reed 2011). miyazaki’s conceptualization of hope as a “reorientation of knowledge” has been particularly fecund, as it places in the foreground the link between hope and a shift in ways of seeing and acting in the world, in effect complicating the description of hope as predominantly passive. in his anthropological theory of morality, jarrett zigon introduces hope as central to leading a social life (zigon 2009, 257). based on his ethnographic work with muscovites, he argues against conceiving hope as necessarily oriented toward a better life and acknowledges the contingent (or passive) nature of hope as something dependent on external circumstances, not merely on what one does. he suggests that hope has two (temporal) aspects in constant interplay: one that acts as a background to everyday life—for instance, supporting perseverance in the face of difficulty—and another that characterizes the intentional action required in moments of “moral breakdown”, when events challenge our standard ethical responses (2009, 254). zigon’s work therefore encourages conceptualizations of hope that go beyond the passive–active dichotomy in an approach that resonates with the attitudes of my osakan interlocutors. the elders in the neighborhood did not merely passively await the future that was to come; they engaged with others and participated in the neighborhood. quiet hope is understated, yet practical. it is cultivated, relational, incremental, and modest and brings social worlds into being.8 hope in japan japan is becoming an impoverished country. a society where hope has turned scarce and the future has become bleak or inconceivable altogether (allison 2013, 6–7). japan has, for some time now, been perceived as increasingly hopeless, in part due to demographic aging associated with increased responsibilities and burdens placed on a shrinking working population. in a now-famous book, yamada (2004) describes japanese society as an “unequal hope society” (kibou kakusa shakai), a society of hope-haves and hope-have-nots or those who cannot hope, where the gap between these hope “winners” and “losers” is widening. the increasing pressures on families and communities to care for its youngest and some of its oldest members, and concerns about working conditions, give rise to anxieties over an increasingly threadbare safety net. this wakening of support networks is associated with a growing gap between those with secure permanent employment and those without, those with savings and those without, those living comfortably and growing numbers of those falling into poverty (hommerich 2012). http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 63 at the same time, empirical studies of hope, spearheaded by the social sciences of hope (kibougaku) group at the university of tokyo and led by scholar genda yuji, suggest that hope in communities is rather more resilient and deeply relational. one of the key words emerging from their extensive studies is tsunagari, or “connections”: hope requires and thrives on connections and links between people, organizations, and individuals (genda and nakamura 2009). various contributions to the volume i edited several years ago on hope in contemporary japan pointed in various ways to the importance of relationships and connections for the maintenance and emergence of hope, and its inverse the isolating effects of the hopelessness of workers suffering from exhaustion, sometimes leading to death from overwork (north and morioka 2016). conversely, hope is rekindled through connections, for example, as fostered by ritual events (robertson 2016). if links, connections, and relationships with others are seen as fundamentally important for the emergence and maintenance of hope, how do older people remain or become hopeful in their later years? as years go by, many of those with whom they have moved through life—their “consociates,” to use schutz’s term (also favored by david plath in his description of the process of maturing in japan)—are no longer alive. while the later years may be marked by loss, many older people become actively engaged in “rituals of concern” and strengthen their links with their ancestors by taking a leading role in the family practices of caring for ancestral tablets in domestic buddhist altars (traphagan 2004). in this sense, transcendence becomes an important aspect of hope in later years, particularly in the face of loss, as described by danely (2016) in what he terms “lunar aesthetic.” “lunar” hope is best understood as linking and transforming loss into transience and transcendence through ritual and attention to the spirits (hotoke) of the ancestors and those departed (2016, 16). lunar hope among older kyotoites relies heavily on the cultivation of links with the departed and ancestors. in this sense, it resembles the imminence described by golomski in the south african context (this issue). the temporality of such a “lunar aesthetics” of hope is constituted less as a form of anticipation and more in cyclical terms, combining apparently contradictory feelings of loss and hope. quiet hope is cultivated through practice, through many small everyday acts. it links people and does not take place in isolation. the hopeful attitudes of others affect us, and hope thrives in circulation (kavedžija 2016, 10). vaguely stating that things in the future will turn out all right, that things will work out somehow, does not paint a clear picture of the future that one is moving toward, a scenario that is hoped for. instead, it allows for unknown outcomes. it appears to shift attention away from the future, while at the same time acknowledging movement toward it. if the temporal texture of hope is reconstituted as one moves through the life course, how does this change take place? i suggest that this move occurs with a gradual emphasis on being thankful and a careful cultivation of an attitude of gratitude. temporality in later life in her ethnographic work on hospices, julia lawton (2002) points to an increasingly circumscribed sense of time. bodily deterioration in the hospice was accompanied by a gradual “erosion of self” (2002). drawing on the idea that the experience of space and time is related, lawton suggests that the bounded space results in a shift of temporal perspective: “as patients’ bodies become reduced to a progressively inert state, their constructions and perceptions of space and time also appeared to become more increasingly bounded and static” (2002, 44). in contrast to much gerontological research pointing to an increase in orientation toward interiority, to reminiscing or thinking about the past, lawton’s work points toward apathy and disengagement, to a loss of interest in both the future and the past. as a http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 64 consequence, “not only did patients lack a conception of a ‘future self,’ they had also ceased to preserve self in the present through the reconstruction and incorporation of memories from the past” (lawton 2002, 100). against the backdrop of such radically constrained experience in the face of bodily deterioration, the relative mobility and good health of my interlocutors stands out. nonetheless, in their later years, their words were somewhat circumscribed, not least due to a shrinking number of consociates. shioya san and her older sister suggested i visit them in their house one afternoon. the quiet smiling and bespectacled seventy-nine-year-old had moved in with her ninety-year-old sister after a difficult surgery a couple of years earlier. the move was initially temporary, the older sister looking after the younger, but they seemed to thrive in each other’s company and decided to live together. shioya san allowed her nephew to take over her own house. it was a hot and bright day, but when i entered, their old, narrow townhouse was dark inside. the room they led me to, at the back, behind two sets of sliding doors, was small and fitted with a low table and low armchair. a neon light and the tv were on—the room would have been cozy were it not for the brightness. the sisters were enthusiastic hosts and showed me around the house. they knew i wanted to ask them to tell me their life stories, but instead of settling down to talk, shioya san took a different approach and insisted on showing me all of her possessions. her house was no longer there to be viewed, but she had with her a number of selected items, not too many, as the house was her sister’s and already quite full. she started with her kimonos, folded away in large, shallow wooden drawers, separated with tissue paper. she showed me her furniture and her room but then decided the photo albums were really what she wanted to use. describing the photos, she realized, was a good way to tell me about her life. “look, this is me! i used to be round, always round—it was not until my surgery that i became this thin!” she spoke about her plumpness with pride, and later, after she and her sister told me about the hunger and hardship of the war and the post-war years, this apparently minor remark took on a different hue. while her older sister had many children, shioya san had none. she spoke of her nephews fondly and told me about her married life: “we travelled a lot, often with my husband’s work colleagues. here, see, this is an onsen (a spa) we visited, and here we are in the mountains. we had such fun! . . . we did not have children, but we had many good times. it was a good life.” shioya san stopped to think for a moment, and said, “i am grateful (arigatai).” a brief expression of gratitude and a pause. the pause of gratitude. many of my interview recordings, i later came to realize, captured the same space of silence before an expression of gratitude. i seem to remember, although i might be mistaken, that this was, in many situations, accompanied by a downward gaze. when shioya san eventually resumed her narrative, she spoke about her sister and her husband, who had passed away. the pause and the space between: ma and gratitude in many of the life history interviews with older people in osaka, but also in some of the stories they shared with me or with others, expressions of gratitude were marked by a palpable pause in the life story narrative. in this brief moment, my interlocutors seem to have been taking a moment to look at their lives, to make some sense of them. the pause here does not feel like a break or disruption in the narrative, or merely an absence. rather, it seems to be an important and productive space. as such, i believe it may be helpful to consider the significance of this quiet moment in light of the japanese concept of ma (間), which refers to an interval or space between two things, persons or sounds: between two spatial or temporal entities. ma is seen as pertaining to the religious and aesthetic domains and is a constitutive element of rituals and traditional arts, where, for instance, an opening in the physical http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 65 space in a piece of calligraphy might be important for the overall flow of the writing, or the way in which pauses contained in the performance of noh theatre plays are understood to be one of their key features. ma, therefore, refers to both space and time (pilgrim 1986, 255–6). in this sense, it is not merely an absence or a break, but rather a space of potential. the same character (間) can also be read as aida, which has slightly different overtones and emphasizes the relationship between the entities (innami 2011, 114). aida is used in the compound ningen (人間), or human, where it refers to the interpersonal space, the connections between or among people (okuno 1983, cited in pilgrim 1986). ningen and aida stand at the center of watsuji tetsuro’s ethics (1996). this prominent japanese philosopher locates the ethical domain not in the consciousness of a lone individual, but among people, ningen, who are already relational. the space between people, or what watsuji refers to as aidagara, glossed as “in-betweenness,” is the space of all those relationships that constitute a human life. watsuji’s student, yuasa yasuo, states that “aidagara consists of the various human relationships of our life-world. to put it simply it is the network which provides humanity with a social meaning, for example, one’s being an inhabitant of this or that town or a member of a certain business firm. to live as a person means . . . to exist in such betweenness” (yuasa 1987, 37, cited in krueger forthcoming, 4). while watsuji’s aim is to develop a phenomenological framework for ethics, his work captures something of the broadly understood meaning of ningen, a human in the japanese context. ningen encapsulates a sense of a relationship, a space in between oneself and the other (krueger forthcoming, 6). the ma in the telling of the life story, i suggest, is thus not merely a break or rupture, nor an absence. the temporal pause of ma appears to be related to the productive space among people, a space between one person and another, containing all the affective potential of that encounter. recalling who they are, my interlocutors cannot help but stop and say, “i would not be this person— indeed, i am not this person—without these significant others.” an attitude of gratitude my senior interlocutors and friends in the field were generally reluctant to talk about the good life in any ideal or abstract sense. it was equally difficult to elicit comments about how satisfied they felt with their lives. they were reluctant to label themselves as happy, probably because, for their tastes, this would come too close to bragging. they were even disinclined to use the word “satisfied,” manzoku: “i would not go so far as to say i am satisfied,” many told me. and yet, expressions of gratitude abounded. the phrase that i heard often was arigatai, “i am grateful,” and sometimes kansha, “gratitude.” sometimes it was gratitude for having been able to lead a full life, having had a good husband who supported the family, sometimes for having understanding in-laws, or for an opportunity to work. iida san lost two husbands earlier in life and brought up her son as a single mother. she had felt lonely and worried, but also lucky that her parents took her son on holidays and that she found stable employment through friends. now she enjoys her retirement and the independent life of her adult son, taking up a range of social activities—"a light, cheerful life she was grateful for,” as she told me more than once. like many others, iida san told her life story as it related to other people in her life, who often opened up pathways for her that she otherwise would not have considered. she learned, pushed herself, and grew. having suffered many losses, and now living alone in older age, she could have told me (and herself) a very different story, one of loss, mourning, and solitude. but having spent many mornings and afternoons walking with her, sometimes (at her choosing) around various buddhist temples, i was impressed with her attitude of calm and appreciation. this gratitude was not merely a transitory emotion, but rather a more consistent and enduring attitude toward the world. the idea of gratitude as an attitude can be approached through phenomenology, which draws attention to the temporal aspect of human experience and the way each moment bears http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 66 traces of the past, anticipates what comes in the future and is affected by the different attitudes of actors (desjarlais and throop 2011, 88). in the words of desjarlais and throop: “from a phenomenological perspective . . . distinctions between subjective and objective aspects of reality, between what is of the mind and of the world, are shaped by the attitude that a social actor takes up toward the world, as well as by the historical and cultural conditions” (2011, 89). the world cannot be grasped in its totality, and we always turn our attention to particular aspects of the world and the reality that surrounds us. as we do that, other aspects fall out of focus. our changing perspective and our shifting attitudes influence our perception or experience and, ultimately, our actions (2011, 90). i am interested in gratitude as such a mode of attunement to the world, which highlights relationships to others and what we owe them and for how much we have to thank them. as an attitude, it could further be understood as a form of temporal reorientation of hope. some practices in japan are, in fact, explicitly focused on fostering such an attitude. a prominent example is naikan, a therapeutic practice sometimes compared to psychotherapy (reynolds 1980). it can be seen as an example of the powerful effects that gratitude can have on the way we inhabit the world. as chikako ozawa-de silva (2006) writes in her insightful ethnography, naikan’s roots in buddhist thought draw on the insight of “interdependent selfhood”: that we are not independent actors in this world but are here thanks to others. the person undertaking naikan (literally “inner-looking,” an introspection), guided by a practitioner’s questions, is asked to quietly recollect their past while reflecting on three specific themes in relation to a significant person in their life: what they received from this person, what they returned to this person, and what trouble they caused for this person. the interviewer guiding the process visits them every few hours in a semi-secluded space and enquires about their recollections over the course of seven days, reconstructing or rearranging the memories of their life. this frequently results not only in an altered perception, but also in intense feelings of guilt and gratitude in relation to the care and favors received from others, which are seen to constitute one’s life (ozawa-de silva 2006). despite the specific and peripheral nature of this practice, it is interesting because it very clearly shows the link between the recognition of dependence and wellbeing as a source of positive meaning. even the most autonomous individuals will have to admit that we all owe a great debt of gratitude to a great many people, for all kinds of favors, support, and kindness throughout our lives. this is an extreme example of an intervention that, in my view, aims to change the way people relate to the world by focusing on gratitude. yet, gratitude was present in a myriad of small everyday practices that are less specific and more widespread in japanese society, not least among my interlocutors.9 thanks are given when eating or receiving food, even if the food is consumed alone, bought and prepared by yourself—so even a solitary meal places us within a complex network of obligation and debt. yet, these relationships need not be viewed primarily as a burden or a source of constraint. the subjectivity of grateful interconnection i was a sickly child. my parents were not young when i was born, after the war, and i was weak when growing up. i am grateful (kansha shiteimasu) my parents looked after me with care. i was born with a purpose, i was their oldest son and so they looked after me well, perhaps better than after my younger sisters. through all their efforts, i grew up healthy. i am grateful (arigatai). goto san, a carefully dressed man in his seventies, smiled as he spoke these words, recalling his childhood years. i did not meet him in the shimoichi salon, but through a mutual friend. later that day, he told me that respect is important to him and went on to discuss some of his professional successes, http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 67 while making clear that his story was not his alone. this proud man took ownership of many of his achievements—and yet his parents’ support and expectations were ever-present, with his gratitude linking him strongly to them as he reflected on his life. this propensity to include others in the life story was even more noticeable among some others with whom i spoke. people rarely described their lives as a series of events that merely happened to them, and even less frequently as a series of choices and decisions. often, people explained the sequence of events and their causation by referring to others’ actions and suggestions: “and right about time, that i have left my job due to health problems and to care for my mother, x-san mentioned this part-time work,” or describing a difficult time after their partner passed away, “my friends introduced me to their friends and that is how i met current partner”; “my children were in school and i started thinking i would like to do something useful in the society. and sometime around then, x-san suggested that i could join a group that helps blind people, reads books for them.” these moments in life could have been described in different ways: for instance, “i have decided that working full time does not suit my situation and switched to this other part-time work,” or “i felt lonely and searched for another partner,” and “i always liked volunteering work, so when the time permitted, i joined a group that supports blind people.” in this kind of narrative, the world is constituted by encounters, serendipitous moments, and connections with others. the word en (縁) refers to fate, opportunity, or chance, and at the same time indicates a link or a relationship. some links are viewed as more fateful than others, and the role of some people shaping the flow of one’s life is seen as more pronounced. becoming an adult requires a recognition that one’s life is intertwined with the lives of others, and that one is dependent (goodman 2008, 60). the process of maturation is considered to be a lifelong process “in which individuals come to understand themselves first and foremost as social beings, as products of units and forces larger than themselves and without which they could not exist” (lock 1993, 202), at least ideally. in becoming an adult in japan, the notions of autonomy and dependency are not in opposition, but in a complex relationship: “independence leads to adulthood, but interdependence with others is necessary for full adulthood (ichininmae)” (rosenberger 2007, 92). in his seminal work on maturity in japan, david plath (1980) links personal growth to one’s consociates, people to whom one relates with a level of intimacy and who participate in the making of one’s biography. a person moves through life with others, maturing as one “evolves through the long engagements of a web of intimate consociates” (plath 1980, 222). the process of maturation continues into older age and towards the end of life and takes a different hue as many of one’s consociates pass away. various aspects of japanese language require its speakers to be aware of the flow of goods and favors. i could simply say that i volunteered in the community salon in shimoichi, or i might—as polite japanese language would encourage me to do—state that i was “allowed to volunteer” (borantia sasete itadakimashita), that i was given a chance to do so, as it were. this kind of phrasing is customary and habitual, but it also effectively attunes the speaker to the role of others in our actions and de-emphasizes the sole agency of the individual. like the narrative structure of a life story, this might be a convention, but it nevertheless focuses on the relationship and attunes one to the flow of favors. apart from expressions of gratitude for large events in life, and indeed life itself, my interlocutors took time to express their gratitude for everyday beauty and kindness. “the sun came out, and it is so nice to walk . . . it is good to live in a place like this, so convenient!” naka san said, as she headed toward the park. “you kite hurehatta,” they would often say to each other, or to me, in their thick osakan dialect: “how good that you came!” stories of challenging experiences, including financial hardship or problems at work, or having to leave work to care for a family member were often recounted with a http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 68 reflection at the end: ii benkyou ni narimashita, “i have learned from this”—a statement that could perhaps also be interpreted as a form of gratitude. if happiness was rarely mentioned directly, gratitude, on the other hand, seemed to underpin many of their statements. whereas happiness is typically forward oriented, an elusive goal slipping ahead, gratitude appears more concerned with the past. it involves appreciation of what has taken place, of what we have and of what we were given. reflecting on one’s life after i told you my personal history, i was surprised how much it caused me to reflect on the path i have travelled so far. having recalled that i have at various points in my life met people who have become important to me and have led me the way i become filled with a feeling of gratitude (kansha no kimochi). (kameda san, 22 july 2019) i opened my email one morning to find this message from kameda san. she wrote it about ten days after our interview, in which i asked her to recall the events of her life. a youthful woman in her midsixties, who has a daughter that is my age and two young grandchildren, kameda san still works full time and has a hobby to which she dedicates much of her time. as such, it is possible that she simply may not have had many opportunities to reflect on her life in such a concerted way. to think about her life as a whole, as i had encouraged her to do, was unusual for her—as she told me herself a few weeks later when i met up with her again, together with her friend, a mutual acquaintance who had introduced us. “it was a bit like therapy,” she said over a cup of coffee. i have met kameda san as part of a different, more recent project on the meaning of work in older age. this allowed me to spend more time with younger “seniors,” mostly in their sixties, a much younger cohort than the older people i encountered during my previous fieldwork visits. the sexagenarians appeared much more surprised when i asked for their life story. this, in turn, made me more aware of how naturally narrating their life stories came for the older people i met in the shimoichi salon, who were in their late seventies, eighties and early nineties. they told stories to each other, and narrating became an increasingly important part of their lives (myerhoff 1980; see also kavedžija 2019). indeed, reflection and reminiscing increases in older age. my older interlocutors, those with whom i spoke for the first time when they were in their eighties and nineties, often and readily told me the stories of their life. those whom i met in the community salon exchanged stories of their past, the food that reminded them of a particular time, and of trips to onsen or spa towns with their friends or work colleagues. as people become older, they tend to take pleasure more often in reliving some of their memories and sharing them with others. yet, this does not mean that they were simply dwelling in the past. the storytelling takes place in the present. furthermore, it would be a mistake to believe that gratitude is a retrospective orientation alone, one that simply evaluates the past. when taking a moment to appreciate the kindness of others, or some particular challenge one faced, this takes place in the moment, and it affects one’s disposition to what might come ahead. in other words, the experience was for my interlocutors not primarily marked by an orientation toward the past, by reminiscing, and recollection. inhabiting the moment was equally important. dwelling in the moment, as contained in that pause in the narrative i mentioned earlier, allows for the cultivation of an attitude of gratitude, often highlighting the sense of meaning in life as bound up with others. this attitude of gratitude entwines the reflection on the past with an attention to the present moment in its fullness. it also, i suggest, opens up space for a particular kind of hope that is grounded in the moment. my argument is that gratitude as a mode of attunement offers the basis for what i have described as quiet hope, whereby dependence on others is recognized not simply as a burden or potential source of embarrassment, but also as moving and deeply meaningful. the sense of the good http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 69 and meaningful life that my older friends conveyed thus encapsulates an attitude of gratitude as a way of inhabiting the present, rather than dwelling in the past or leaping toward the future. notes 1. i owe a great debt of gratitude to all the people in the field who allowed me to spend time with them and let me into their lives. earlier versions of the paper were presented at the american anthropological association annual meeting, and in the departmental seminars of university college london, university of bristol, and the university of exeter. the numerous comments and suggestions that ensued were invaluable. i am also grateful for the thoughtful comments of the anonymous reviewers. this work was supported by funding from the japan foundation. 2. for an account of dementia in japan, see trapahagan (2000) and yamashita and amagai (2008). most of my interlocutors were in good health, as those who attended the shimoichi salon mostly lived independently in their own homes. this choice of setting was well suited to my interests, as i wanted to give an account of aging outside institutionalized settings, such as nursing homes. 3. in the east asian context filial piety remains an influential ideal, but the demographic changes have placed serious constraints on the ability of families to take care of their elders. this results in a tension between the ideal to care for aging for family members and the wish of those who may be entitled to that care to remain independent and avoid becoming a burden (see traphagan 2000; danely 2013; kavedžija 2019). 4. for more about aging in japan and its effects on communities, see kavedžija (2020). 5. networks of support were effectively crafted by the elderly each time when they enacted care for each other in numerous small way, by keeping track of each other’s health and whereabouts, offering information or putting people in touch. 6. the latter was seen as a very cohesive social group, with responsibility shared by the membs of the community, for instance, through the local neighborhood association (chonaikai or jichikai; see sugimoto 2003, 273–4). 7. hope here seems to encompass a prospective character with retrospective elements, somewhat resembling a desire of inhabitants of sarajevo after the war, as described by stef jansen: “ ‘normal life’ was what one had lived in socialist yugoslavia, and it was an aspiration for the future. this does not mean that people desired to have exactly the same life again. in both its pastand future-oriented modalities, ‘normal life’ remained vague” (2014, 7). a hope for a functioning, working community in shimoichi was similarly normative and vague, rather than a clear vision described and pursued by the activists and volunteers. 8. in this sense, hope can be seen as a political emotion, to which martha nussbaum (2013, 2) directs our attention when she suggests that emotions, particularly those in the public sphere, should be taken seriously when thinking about the functioning of societies and striving for justice. to the extent that the hopes and hopelessness of others affect us, hope—even quiet hope—does not merely pertain to an individual but can be seen as a potentially powerful political emotion, at times transformative and at other times preserving, nurturing, and stabilizing. 9. during the course of my fieldwork—in which i particularly focused on those who were able to lead a good life despite the challenges presented to them, those who were able to maintain a sense of wellbeing and craft a sense of meaning in life—i noticed they appeared to express gratitude readily. it may well be the case that their ability to emphasize gratitude as a positive orientation to the world allowed them a greater sense of wellbeing. indeed, one psychological study with middle-aged women http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 70 in japan suggested that those who felt a sense of gratitude upon receiving a favor from a friend generally evaluated that experience more positively than those who associated this with gratitude as a sense of debt, obligation, and/or burden, that has been placed on their friend (naito and sakata 2010). references allison, anne. 2013. precarious japan. durham, nc: duke university press. appadurai, arjun. 1985. “gratitude as a social mode in south india.” ethos 13(3): 236-245. bloch, ernst. 1995 [1986]. “the principle of hope.” cambridge, ma: mit. crapanzano, vincent. 2003. “reflections on hope as a category of social and psychological analysis.” cultural anthropology 18(1): 3-32. danely, jason. 2016. “hope in an ageing japan: transience and transcendence.” contemporary japan 28(1): 13-31. desjarlais, robert and jason c. throop. 2011. “phenomenological approaches in anthropology.” annual review of anthropology 40: 87-102. genda, yuji. ed. 2006. kibōgaku [hope studies]. tokyo: chūōkōron shinsha. genda, yuji. 2008. “kibō to ningen [1]. tokushū: shakai no kibō – chiiki no kibō: kibōgaku no genzai.” shakaigaku kenkyū 59(2): 1–9. accessed 7 september. 2015). http://hdl.handle.net/2261/28530 genda, yuji. and naofumi nakamura. 2009. kibogaku [2]: kibo no saisei: kamaishi no rekishi to sangyo ga katarumono. tokyo: tokyo daigaku shuppankai. goodman, roger. 2008. “marginals, minorities, majorities and migrants: studying the japanese borderlands in contemporary japan.” in transcultural japan: at the borderlands of race, gender and identity. edited by david blake willis and stephen murhpy-shigematsu, 325-334. routledge: london and new york. hage, ghassan. 2003. searching for hope in a shrinking society. sydney: pluto press. hommerich, carola. 2012. “the advent of vulnerability: japan's free fall through its porous safety net.” japan forum 24(2): 205-232. innami, fusako. 2011. “the departing body: creation of the neutral in-between sensual bodies.” asian and african studies 15(3): 111-130. kavedžija, iza. 2016. “introduction: reorienting hopes.” contemporary japan 28(1):1-11. kavedžija, iza. 2019. making meaningful lives: tales from an aging japan. philadelphia, university of pennsylvania press kavedžija, iza. 2020. “communities of care and zones of abandonment in ‘super-aged’ japan.” in cultural contexts of aging: worldwide perspectives. edited by jay sokolovky, 211230. westport: preager. knight, john. 1996. “making citizens in postwar japan: national and local perspectives.” in the anthropology of civil society. edited by elizabeth dunn and chris hann, 222-241. london: taylor and francis lawton, julia. 2002. the dying process: patients' experiences of palliative care. city: routledge leavy, stanley. 2011. “the last of life: psychological reflections on old age and death.” the psychoanalytic quarterly 80(3): 699-715. lock, m.margaret. 1993. encounters with aging: mythologies of menopause in japan and north america. berkeley: university of california press. miyazaki, hirokazu. 2004. the method of hope: anthropology, philosophy, and fijian knowledge. stanford, ca: stanford university press. miyazaki, hirokazu. 2006. “economy of dreams: hope in global capitalism and its critiques.” cultural anthropology 21(2):147-172. http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.244 http://anthro-age.pitt.edu 71 moore, henrietta. 2011. still life: hopes, fesires and satisfactions. cambridge: polity press. myerhoff, barbara. 1980. number our days. new york: simon and schuster. naito, t. and sakata, y. 2010. “gratitude, indebtedness, and regret on receiving a friend’s favor in japan.” psychologia 53(3): 179-194. north, scott and rika morioka. 2016. “hope found in lives lost: karoshi and the pursuit of worker rights in japan.” contemporary japan 28(1): 59-80. nussbaum, m.c. 2013. political emotions. harvard: harvard university press. okuno, t. 1983. ma no kozou [the structure of ma]. tokyo: shuheisha. ozawa-de silva, c. 2007. “demystifying japanese therapy: an analysis of naikan and the ajase complex through buddhist thought.” ethos 35(4): 411-446. plath, david w. 1980. long engagements: maturity in modern japan. city: stanford university press. pilgrim, richard b., 1986. “intervals (‘ma’) in space and time: foundations for a religio-aesthetic paradigm in japan.” history of religions 25(3). 255-277. reed, adam. 2011. hope on remand. journal of the royal anthropological institute 17(3): 527-544. riles, aannelise. 2010. “is the law hopeful?” in the economy of hope. edited by hirokazu miyazaki and richard swedberg, 125-146. philadelphia: university of pennsylvania press. robertson, stephen. 2016. “hope that sustains: revisiting new year’s divination at suwa taisha.” contemporary japan 28(1): 101-122. rosenberger, nancy. 2007. “rethinking emerging adulthood in japan: perspectives from long‐term single women.” child development perspectives 1(2): 92-95. traphagan, john w. 2000. taming oblivion: aging bodies and the fear of senility in japan. albany: suny press. traphagan, john w. 2004. the practice of concern: ritual, well-being, and aging in rural japan. durham: carolina academic press watsuji, tetsuro. 1996. watsuji tetsuro’s rinrigaku: ethics in japan. translated by seisaku yamamoto and robert edgar carter. albany: suny press. welch, james r., 2014. “xavante ritual hunting: anthropogenic fire, reciprocity, and collective landscape management in the brazilian cerrado.” human ecology 42(1): 47-59. yamada, masahiro. 2004. kibō kakusa shakai: “makegumi” no zetsubōkan ga nihon o hikisaku [unequal hope society: despair of the “losers” pulls japan apart]. tokyo: chikuma shobō. yamashita, mineko and manami amagai. “family caregiving in dementia in japan.” applied nursing research 21(4): 227-231. yuasa, yasuo. 1987. the body: toward an eastern mind-body theory. edited by thomas p. kasulis. translated by shigenori nagatomo and thomas p. kasulis. albany: suny press zigon, jarret. 2009. “hope dies last: two aspects of hope in contemporary moscow.” anthropological theory 9(3): 253-271. http://anthro-age.pitt.edu/ covid-19 and the kin contract: navigating the family and the state during the pandemic cortney hughes rinker george mason university chughe13@gmu.edu m. aspen bataille george mason university mbataill@masonlive.gmu.edu loumarie figueroa ortiz george mason university lfiguer2@gmu.edu anthropology & aging, vol 41, no 2 (2020), pp. 141-146 issn 2374-2267 (online) doi 10.5195/aa.2020.307 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. rinker, bataille and ortiz | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.307 http://anthro-age.pitt.edu 141 covid-19 and the kin contract: navigating the family and the state during the pandemic cortney hughes rinker george mason university chughe13@gmu.edu m. aspen bataille george mason university mbataill@masonlive.gmu.edu loumarie figueroa ortiz george mason university lfiguer2@gmu.edu if a family has an older person in it, it possesses a jewel. chinese proverb introduction the following are some of the headlines that have appeared in english-language news sources in 2020 amid the coronavirus pandemic; the articles call attention to how and when grandparents can interact with their grandchildren safely: “spain warns elderly to keep away from grandchildren as covid-19 cases soar.”1 “when can i see my grandkids?”2 “new national lockdown childcare rules explained and what they mean for parents and grandparents”3 “for grandparents this holiday, coronavirus separates them from grandkids: 'it's going to be hard'”4 anthropologists know that growing older is conceptualized and experienced differently in different societies (e.g., sokolovsky 2020). with its long-standing interest in kinship, anthropology has pointed out that in many places, the norm has been for the family to take care of their elderly. however, in varying locally inflected ways, global capitalism, neoliberal reforms, and national and international policies have often caused this care to shift onto others, due to changes in family and community structures and the expectation for younger generations to achieve financial success and independence (danely 2019; keimig 2020; zhang 2020). for example, in china, attitudes towards care in institutional settings have become more favorable as it becomes evident that adult children are no longer able to care for their parents.5 likewise, “changing family and demographic structures in the arab region” (hussein and ismail 2017, 276) have made it clear that new policies and models of elder care that move beyond http://anthro-age.pitt.edu/ rinker, bataille and ortiz | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.307 http://anthro-age.pitt.edu 142 the reliance on kin are needed. the elderly are increasingly being cared for by individuals and institutions outside of the family in certain countries, which is also due to the recognition that family members cannot always provide the complex care that some older relatives need. today, these same elderly have become a main focus of responses to covid-19 in much of the world. the world health organization (who) states, “covid-19 is changing older people’s daily routines, the care and support they receive, their ability to stay socially connected and how they are perceived.”6 the pandemic has exposed the complexities of growing older and has brought to light the point at which the family and politics merge in society. older adults are being cared for both inside and, increasingly in various countries and locations, outside of the home, but they are also caregivers, especially to younger children (i.e., grandchildren). some families may rely on older adults, such as grandparents, to care for younger children during working hours (usual business hours or blocks of shift work) because of the costs of childcare. grandparents living with and taking care of grandchildren may also be a cultural norm, or some parents may find having grandparents live with them, or visiting each other, to be a way of keeping their parents engaged in everyday life. all these activities have become much more complicated during the pandemic due to the elderly tending to be at higher risk of infection. data have also shown that this risk is confounded by socioeconomic status and race and ethnicity.7 the kin contract covid-19 has made both formal and informal caregiving much more complicated due to the relative ease at which the disease can be transmitted from person to person. to analyze this complexity of informal caregiving during the pandemic, we re-visit the concept of the “kin contract” developed by suad joseph (2005), in order to reflect on how the involvement of older adults in the care for others — especially grandchildren—within a household during the covid-19 pandemic urges us to raise broader questions about belonging, identity, citizenship, and responsibility. joseph explains, “the kin contract is organized around the notion that all citizens belong to families prior to membership in the state and that families claim the primary and primordial loyalties of citizens” (2005, 149). in her work on women’s citizenship in lebanon, joseph suggests that “families are critical mediating mechanisms for state political institutions” and that the family is central to “states’ social and political organizations and actions” (2005, 149). we find the “kin contract” to be a useful tool to explore the juncture in society at which politics and the family come together in general, and to illuminate how the pandemic has revealed that this joint is messy and quite precarious. following joseph, we pose that the relationship between the family and the state needs to be complicated and examined from the perspective of the everyday experiences and the negotiations that both parents and grandparents have to make, in particular with regard to caring for and visiting grandchildren during the pandemic. there is much more to this story than the mere transmission of the coronavirus from one body to the other. the political response to covid-19 reminds that bodies are always governed by the state and local authorities (foucault 1990, rose 1990); today they define the safe distance that must be maintained between bodies in order to prevent the spread of the coronavirus, and impose rules of comportment (e.g., the mandatory wearing of masks and face coverings in some places). today, parents and grandparents must navigate state and local policies put into place to slow the transmission of the virus, and the guidance from national and international agencies like the world health organization and the us centers for disease control and prevention (cdc), all while needing to provide care for family members and the familial and cultural expectations for human interactions. http://anthro-age.pitt.edu/ rinker, bataille and ortiz | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.307 http://anthro-age.pitt.edu 143 the “kin contract” enables us to account for these navigational practices, and to inquire about the everyday choices that parents and grandparents have made during the pandemic. there is ample reason to believe that the role of grandparents in family life has, in the current situation, become more important than ever before. parents may be juggling work and their child’s school schedule (in-person or remote/virtual learning) and need to call on grandparents for help; or grandparents may have always played a role in childcare, and are now asked to keep a ‘safe distance’ from their grandchildren. in the midst of the pandemic, grandparents may feel an increased pressure to help with childcare, if parents do not have other options and cannot, for practical and/or financial reasons, stay at home. this moral obligation competes with an increased health risk, especially as places like the united states and europe are moving into colder months, where activities are shifting from outdoors to indoors and there may be increased interactions between grandparents and children in enclosed spaces. the messaging that has accompanied security measures, is for all of us to act as if we are already infected, meaning we should monitor our behavior and take caution in order not to infect others. with this, grandparents who care for grandchildren face the dilemma of needing to abide by the guidance issued by authorities to protect themselves and the broader community, and needing to assist their adult children while they try to balance work and family life. this may mean they have to disregard some of this counsel, such as not socially distancing or wearing face masks when around others indoors, and that they have to choose between being a good grandparent and being a good citizen. covid-19 in northern virginia part of our interest in exploring the “kin contract” developed out of discussions of covid-19 in northern virginia, in the areas surrounding washington, d.c. all three of us live in northern virginia and have experienced the region’s response to covid-19 first-hand. this piece is based on our use of an anthropological perspective to analyze public discourses, news and media, official reports, and our own experiences with the pandemic as it has unfolded since early 2020. in fairfax county,8 where george mason university is located, latinx have been disproportionately affected by covid-19 in the county, making up roughly 60% of the cases, even though latinx are only about 20% of the population.9 news stories and comments on social media dealing with the reasons why covid-19 has disproportionately impacted latinx in this region, focus on the prevalence of multigenerational households among latinx communities, their socioeconomic status, their immigration status, and the fact that a number of latinx are essential workers (e.g., construction, landscaping, domestic work, childcare, or the service industry). as the story goes, “workers are more likely to be exposed to infection at work and then bring it home to their cramped apartments.”10 wiith the new school year upon the region this fall, the concern that has circulated in local online parents’ groups, such as those created through facebook, and among faculty and staff in public schools, is that children could contract the coronavirus and only express mild symptoms or none at all, but still transmit the virus to parents and grandparents who may live with or take care of them. there is a great deal of anxiety in the conversations about covid-19 in northern virginia, and particularly among latinx, as presented in the local media and briefings from authorities and academics on the covid-19 situation. given this, we considered where grandparents help with childcare regularly or on occasion, and the cases where grandparents are actively involved in their children’s lives and families. this is where the “kin-contract” proves to be a productive concept, since it exposes both tensions and intimate connections, that exist between the family and state/national levels. politics and the family: a sense of identity, responsibility, and belonging covid-19 is a public health crisis that calls on all of us to recognize the responsibility that we have to protect ourselves as well as each other. this responsibilization is clearly the rhetoric behind mask wearing and other security measures. for example, dr. robert r. redfield, director of the cdc since http://anthro-age.pitt.edu/ rinker, bataille and ortiz | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.307 http://anthro-age.pitt.edu 144 2018, stated, “cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus . . . all americans have a responsibility to protect themselves, their families and their communities.”11 ”responsibility” is also a pilar of the “kin contract.” as joseph states: “the kin contract presumes that males and females, seniors and juniors are engaged in complex webs of rights and responsibilities for each other” (2005, 150). today, the question is then: how do these “webs” of rights and responsibilities inform the decisions that parents and grandparents make with regard to grandchildren at times when they may counter the orders put in place at the state and/or local levels or guidance offered by health professionals and scientists to curb the virus’ spread? an article in the washington post states, “there are no easy answers for grandparents yearning to be with their grandchildren. the situation is far from clear cut . . . and there is no unanimity among experts on the best approach.”12 for grandparents who assist with childcare by watching grandchildren while their parents work, either living with them or visiting their home, this is even more of a difficult situation given without this care, parents may have to pay additional money for outside care. the financial livelihood of parents may be at risk without the grandparents’ contribution to the household. the economic aspects of care come into conflict with the potential physical danger of having grandparents be around grandchildren during the pandemic. the “kin contract” brings to light the relationships among multiple interlocking domains of life during the pandemic—finances, politics, family, and culture – that are mediated daily and are an integral part of family life. joseph’s concept helps us think through how grandparents and parents balance belonging to a family that has particular needs with their belonging to the broader community or nation, that also must be sustained and cared for, and in this crisis, more than ever, requests their full accountability. in this sense, the current pandemic also raises questions about what it means to be a citizen, and what the relation between citizenship and (grand)parenthood entails. abiding by guidance provided by governments and other reputable entities is not always straight-forward, especially when we must physically care for someone else. ultimately, these lived complexities highlight the ways that the relationship between the state and citizens is mediated by kin/the family. the “kin contract” shows that the family and the state are “mutually constitutive” (joseph 2005, 149) even though they may at times contradict each other, as under covid-19. for example, staying in a ‘bubble’ can help fight the spread of the coronavirus, but yet, grandparents may need to enter this ‘bubble’ to provide care, or are already living with their children and grandchildren, which could put them at higher risk if other family members have to travel outside the house for school or work. taking the “kin contract” seriously, also allows us to analyze how exactly the effects of economic inequalities have intensified in light of policies implemented during the covid-19 pandemic. multigenerational households may be of cultural importance for many who identify as latinx, but for some who experience financial hardships or who are undocumented, multi-generational households can also – additionally or exclusively – be motivated by economic needs. due to cultural inclination and socioeconomic status, many latinx people live in multigenerational, interconnected homes that affect their ability to follow who/cdc social distancing/isolation recommendations without issue (gil et al. 2020). this, of course, does not mean that latinx communities are unaware of how to stop the transmission of the virus or disregard guidance from health care professionals out of neglect. rather, due to economic needs and structural power imbalances in society that disadvantage certain groups, some live in multi-generational homes out of necessity to ensure that families, children, and the elderly are cared for. with care needs exacerbated by the pandemic, families may find themselves with working members spanning multiple generations, while childcare and eldercare are delegated to various family members, including adolescents. although a health risk, coming together in these ways may be necessary for the good of the family and lessen the dangers involved with improper childcare and social http://anthro-age.pitt.edu/ rinker, bataille and ortiz | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.307 http://anthro-age.pitt.edu 145 isolation of older adults, and may prevent additional financial burdens (e.g., paying for childcare) (paredes et al. 2020; thomas and smith-morris 2020). with responsibility to the family, in addition to the community and nation, ‘good’ citizenship (as historically and socially contingent), can come into conflict with the “kin contract.” exactly this tension between citizenship and kinship values, raises questions about responsibility and belonging, as well as about identity and self-worth of older adults, given that grandchildren may figure greatly into how they define and think of themselves. concluding comments: the push and pull of the kin contract analyzing the impact of covid-19 among latinx in northern virginia and in the region more generally, we find that older adults must deal with a push and pull: do they see themselves as being part of the nation and therefore needing to adhere to social distancing guidelines to protect others? or, if they provide care for their grandchildren, do they put their families’ needs first? as explored in this thinkpiece, the “kin contract” allows to focus on the nuances of the inherent relationship between kin/family and the state and the ways that these two are linked in people’s daily lives. the sense of duty that some families have towards their elder members, and the responsibility that elders may feel towards their children and grandchildren, have been impacted by the ‘new-normal’ of the covid-19 pandemic. some people in the united states feel that they cannot rely on the state for support during the pandemic – such as migrants, underrepresented and minority groups, including some latinx, and those identified as vulnerable, such as the elderly. there have been several news stories reporting how poorly the united states has handled the pandemic as compared to other countries.13 in times like these, family and close social ties increasingly become their ‘safety net’ for care and support. however, current policies and guidelines put in place to curb the spread of the coronavirus do not always take this social and cultural web into consideration. the negligence of micro-social realities can affect older adults, and particularly those who have strong relationships with grandchildren or play a role in their care out of desire or need, as they are now forced to negotiate their relationship with their families alongside the need to slow the transmission of the virus, on the messy joint between citizenship and (grand)parenthood. notes 1. rodriguez martinez, marta. 2020. “spain warns elderly to keep away from grandchildren as covid-19 cases soar.” euronews march 11. accessed september 1, 2020. https://www.euronews.com/2020/03/11/spain-warnselderly-to-keep-away-from-grandchildren-as-covid-19-cases-soar. 2. parker-pope, tara. 2020. “when can i see my grandkids?” new york times may 20, 2020. accessed september 1, 2020. https://www.nytimes.com/2020/05/20/well/family/coronavirus-grandchildren-grandparents-when-can-isee-my-grandkids.html. 3. lovell, joanna and alex grove. 2020. “new national lockdown childcare rules explained – and what they mean for parents and grandparents.” leedslive. november 1. accessed november 25, 2020. https://www.leedslive.co.uk/news/uk-world-news/new-national-lockdown-childcare-rules-19202879. 4. pagones, sara. 2020. “for grandparents this holiday, coronavirus separates them from grandkids: 'it's going to be hard'.” nola.com november 24, 2020. accessed november 25, 2020. https://www.nola.com/news/northshore/article_17ce8862-29ff-11eb-bcb6-9b7ed8b062c3.html. 5. yan, zhe. 2020. “glimpses into care work in chinese nursing homes.” anthropology news may 29, 2020. accessed august 20, 2020. https://www.anthropology-news.org/index.php/2020/05/29/glimpses-into-care-workin-chinese-nursing-homes/. 6. world health organization. “older people & covid-19.” https://www.who.int/teams/social-determinants-ofhealth/covid-19. http://anthro-age.pitt.edu/ rinker, bataille and ortiz | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.307 http://anthro-age.pitt.edu 146 7. haynes, norirsa, lisa a. cooper, and michelle a. albert 2020. “at the heart of the matter: unmasking and addressing the toll of covid-19 on diverse populations.” circulation 142: 105-107. 8. fairfax county has a population of 1.147 million people as of 2019, with 50% of its population identifying as white (non-hispanic or latino), according to the u.s. census bureau. 9. cheslow, daniella. 2020. “coronavirus flourishes among latinos in wealthy areas of northern virginia.” wamu may 12, 2020. accessed september 9, 2020. 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"family and family-like relations for transnational migrants: ideals of care informed by kin, non-family, and religion." hispanic journal of behavioral science 42(3): 344-362. zhang, yan. 2020. “debating ‘good’ care: the challenges of dementia care in shanghai, china.” anthropology & aging 41(1): 52-68. http://anthro-age.pitt.edu/ https://www.huffpost.com/entry/film-exposes-united-states-mishandled-covid_n_5f85cb7ac5b6c4bb54703622 https://www.huffpost.com/entry/film-exposes-united-states-mishandled-covid_n_5f85cb7ac5b6c4bb54703622 bryanton_carlin_report (3).docx ob edit bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 6 all in this game together a conversation between aging researchers about research on aging olive bryanton university of prince edward island obryanton@upei.ca leslie carlin university of toronto leslie.carlin@utoronto.ca anthropology & aging, vol 41, no 1 (2020), pp. 7-16 issn 2374-2267 (online) doi 10.5195/aa.2020.270 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 7 all in this game together a conversation between aging researchers about research on aging olive bryanton university of prince edward island obryanton@upei.ca leslie carlin university of toronto leslie.carlin@utoronto.ca olive bryanton and leslie carlin both conduct research on aging. we are connected to age-wellnce, which—perhaps gracelessly—stands for aging gracefully across environments using technology to support wellness, engagement and long life – network of centres of excellence, a federally-funded canadian project that bills itself more briefly as “canada’s technology and aging network” states:“agewell is dedicated to the creation of technologies and services that benefit older adults and caregivers. our aim is to help older canadians maintain their independence, health and quality of life through technologies and services that increase their safety and security, support their independent living, and enhance their social participation” (https://agewell-nce.ca/about-us). from leslie’s point of view, the network came to funded life in 2015. age-well’s usp is its aim to bring together technology, enterprise and social good. researchers, partners, and trainees from fields as diverse as biomedical engineering and social work, with clinicians, policy professionals, lawyers, and entrepreneurs belong to the network. the training and mentorship component is the jewel in the agewell crown: a significant portion of the funds go toward support of and activities for the ‘highly qualified personnel’ or hqp: the trainees who enrol in the ‘epic’ (early professionals, inspired careers) program. (fortunately, there is no closed-book quiz on the acronyms required for participation.) my role in the project is with the training and mentorship team. i used my anthropological background to gather and interpret qualitative data regarding experience of and aims for effective and transdisciplinary training. equity, diversity, and inclusion are more bywords than buzzwords within age-well and in canadian research and enterprise more generally; the training program must impart these values, too. my anthropological credentials get me so far and no further; for a good portion of my mission, i learn as i go. i am becoming knowledgeable about curriculum-building and transdisciplinary training as well as technology and innovation for aging. age-well is good for me. each year, trainees may apply to join the “epic summer institute,” (epic-si) a five-day residential intensive teaching and learning endeavour. program organizers select 18 applicants to participate; an almost equal number of mentors affiliated with age-well. the goal of the si is to guide these rising professionals from multiple disciplines to work together conceiving and developing plans for an innovation that will benefit older adults in canada. during a series of in-depth interviews conducted previously by me, leslie carlin, and a colleague, ëuson yeung, to understand how the epic program worked, we heard numerous laudatory comments about earlier sis as a learning experience. i wanted to understand the magic. to collaborate in this rapid incubation process, three ‘older adult experts’ attend the residencies, with one assigned to each group of six trainees. in july 2019, dr. olive bryanton, age 82 and from the province of prince edward island, attended the si as one such expert. i attended as a participant-observer bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 8 paying special attention to how teaching and learning operated within the si. i am younger than olive, but approximately the same age as the other two older-adult experts; i could have played that role, too. as so often in the course of working with age-well and more broadly on the topic of aging, i observe that the devil is in the pronouns: who is “we” and who “they”? if i knew more theology i would cite martin buber and refer to “i” and “thou.” for the bulk of the five days of the epic summer institute the participants convened in a thickwalled, high-windowed room at a resort in the tiny town of montebello, quebec, about halfway between canada’s capital city ottawa, and montreal, on the banks of the ottawa river. angled sunlight penetrated early and late in the day but from inside our chamber, we could see nothing. on the afternoon of the fourth day, a hot, sultry thursday following a spectacular summer thunderstorm, olive and i found ourselves at liberty and she agreed to an informal informational interview. i wanted to understand the perspective of the older adult expert. what unfolded in our conversation went beyond that basic question and led to questions about the nature of participation and co-creation of knowledge, how they intersect, and which pronouns to use in recounting the story of a research project. ***** when olive and i excused ourselves, during a time that the groups of trainees devoted to planning their innovation, we wanted to escape the walls and sit by the river. olive brought a thermos of water and i carried out a cup of mint tea. we emerged from shadow into the hot, humid, very still afternoon and crossed the wide lawns to a picnic bench near a small marina on the riverside. a gravel path ran nearby but not many people trod it. we were interrupted just once, by a small child who ran up to us and said, “il y a des poissons! dans le fleuve!” (there are fish! in the river!) her parents called her to follow them, and olive and i carried on our conversation. i knew from a presentation olive had given the previous day that she had recently obtained a ph.d. in education from the university of prince edward island, straddling the roles of trainee, mentor, and older adult.1 while i felt i ought to focus our discussion on the nature of teaching and the role of transdisciplinarity in the epic curriculum, i found that the more interesting topics emerged from letting go of the structured questions in my head and following the lead of my ‘informant’. in the end i would have been hard put to say which of us, olive or myself, was in fact the interviewer. in the pages that follow, i have removed the “m” for “moderator” and “r” for “respondent” as typed by the transcriber, replacing them with olive’s and my names or initials. institutional review for ethical proceeding had been obtained much earlier to cover interviews about the epic program; and the interview as intended would have fallen into that category. however, the conversation that developed strayed from even a broad interpretation of ‘semi-structured’. i orated a consent-to-participate agreement at the start, to which olive assented; in the end, however, we effectively co-operated to produce this manuscript. the transcript has been edited for length. leslie carlin: i know a little bit about you. we met at the discussion group you led [an age-well activity]. can you--for the transcript--tell me about yourself and your background and how you came to be involved in age-well? olive bryanton: i guess i’ve always been an activist, and primarily an advocate for older adults. i’m not sure where that came from because in my earlier days, i was in nursing and i was in obstetrics and gynaecology. lc: but even then, you were an advocate for older adults. bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 9 ob: i think so, yeah, and i think that was because i was always surrounded by older adults. lc: why was that? ob: i was born before my mother was married, which was quite a horrible thing in those days, so i was brought up by my grandparents. i knew who my mother was but she was kind of like a favourite aunt, and it was merely my grandparents who were kind of the people i looked toward as my parents. i knew my great grandparents quite well as well. it was just always you look toward your elders. lc: how old was your mother when she had you? ob: she was 20. lc: and how old are you? ob: i’m 82. lc: and where were you born? ob: it was called princetown in prince edward island. lc: [so] you sort of have this sense of always having been involved with older adults. ob: yes. lc: how did that translate into connection with age-well? ob: through my studies, my studies were always around older adults. actually, my connection with age-well, happened about three years ago, i was invited to come to [the university of] waterloo to their spring symposium as a keynote [and] all of a sudden i met all these wonderful people who were doing research on aging. the person who invited me was dr. paul stolee and it was primarily his students i was meeting. to me, they became my family away from home [ ...] i was looking at older adults. i was in education because it was one of the few phd programs on my campus, so i could look at older adults and learning or older adults and adult education, that kind of thing. but my interest was around what are the realities of their life. because my studies were within the faculty of education, one of the questions i put in was related to education. and it was how do women 85 and older learn where to go for the information they need and how do they share their knowledge with others (bryanton 2018). lc: what did you find? ob: certainly, for this group of people, their education was very informal and mostly chatting with one another. lc: in real life. ob: in real life, yes. and, for the most part, they didn’t think they had anything to share. but before we were finished, they realized they did. bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 10 lc: what is photovoice and how did you use it? ob: photovoice is a participatory research method where you give the participants cameras to take pictures of issues that impact on their lives (wang 1999). in my case, the question was what supports or what limits your ability to age in place. we gave them cameras to take pictures of what supported or limited their ability to continuing aging in place. we provided training in how to use the digital cameras and in taking pictures, and provided some general ideas around the kind of picture to take. things like, something you use every day. for some it was a glass, for another it was their purse, those kinds of things. another question was something that helps you to be a healthier person. we were doing our group meeting in one of my committee member’s lab which had exercise machines and things, so they took a picture of an exercise machine. it was those kinds of thing that we asked them to figure out. lc: so, they got to choose the object or whatever they photographed…and then used that as a prompt to talk about. ob: yes. we gave them the cameras and said, you can take as many pictures as you want, but before i come to visit i want you to choose the six pictures that you like the most that are related to what is supporting you or what is a barrier for you. when i came and met with them, i took a little printer and printed their pictures off for them, just the six they chose. then we talked about those pictures. then i said, you need to choose the four pictures that you believe best represents your reality, and those four, were the ones they submitted to my study. after that individual meetings, we came together as a group and they each brought their four pictures to share with one another, and discuss why they took the picture and what it meant. we then asked them to categorize their pictures. they became very animated, putting the pictures together in categories. the study was during the winter and the most important person in their life was the person who cleaned their driveway and shovelled their steps and things like that…ethically, we were very clear with them that they were not going to be anonymous. they knew we were going to have an open house and they were going to be with their pictures, so people would know who they are. we made sure they understood if they took a picture of a person, whether it was family or whoever, they had to get permission and they had to get it signed. sometimes it was after the fact but they were very diligent. lc: that they did it. i can just imagine the person shovelling the driveway being asked to sign that. in a way, that’s almost disseminating the research, right, because they then had to explain why they were asking for permission….how many participants did you have? ob: i had 10, and they were age 85 to 92. the goal of the photovoice is social change, and we had what we called a “knowledge sharing open house” to share our learnings. i framed their photographs and borrowed stands from the music department to display their photographs. each person was with their four pictures. thus, when the guests came in for the knowledge sharing open house, the participants were there with their pictures and everybody went directly to them. lc: that’s so interesting. were the guests their friends and family? ob: it was friends, family, academics and policy people. one of the policy people who came was the minister responsible for seniors…for pei. she came and she spent a lot of time there. this was in july. in november, she announced a new program for seniors called seniors independence initiative, and publicly announced that she was inspired by my study and the opportunity to talk to the women…i was talking with her after and i said, to her really, what did you mean when you said you were inspired by the study? she said, i got your invitation to come to the open house. i came to support your work. i had absolutely nothing in my mind when i walked in that building. when i walked out, my head was spinning…so, bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 11 having the opportunity to listen to the women tell about why they took the pictures and what it meant to them and what they would need to help them age in place, was very inspirational for her lc: that’s spectacular. what were the most common photos? ob: well, those who had walkers, took a picture of their walker and talked about how it enabled them to remain independent and do some of the things they wanted to do. their vehicle. lc: right. i was wondering if the vehicle was going to be… ob: their biggest fear was what am i going to do if i can no longer drive, because they loved living in the community they grew up in or at least raised their families in. they didn’t really want to leave the community because their friends are all there. they’re cherished in their community. people know them. they know what their strengths are and that kind of thing. so, it’s a real worry for them because there’s no public transportation in the rural areas, and that was a real concern for them. the person who shovelled their driveway, was also really important. lc: that’s eye-opening. ob: yeah. the groups they belong to, the things they did in their communities….for instance, there was one woman who took a picture of their women’s institute, it was a very small group. but then she started telling me some of the things they did, it was totally amazing how they were really benefiting the community. another one had a picture of a group of them sitting around the table, and they were developing a recommendation to submit to government saying, you have designated our road for a bicycle path to go to the north shore and it is not safe, it’s one of the most dangerous roads on prince edward island (pei). the women live on that road and know how dangerous it is for bicycles. lc: they’re worried about the danger to the cyclists? ob: yes, exactly. some of the women, very active, not just in their own community but provincially. lc: and not just on their own behalf. ob: and not just on their own behalf. their involvement in the community was usually around development. in one community, the church was too close to the road. they were going to have to move it back. lc: move the church back? ob: …move the church back. so, they had raised the money to move the church back. it’s no longer a church. they’re making it into a community centre. so, they not only had to raise the money to move it back, but they had to raise the money to renovate it a bit to make it into a community centre. lc: that’s nice. ob: it was, yeah. another woman was constantly writing proposals to get funding for their seniors’ group to do things. the one they were working on when we were doing the study, is a proposal to new horizons for seniors to interview and learn about four immigrants. and so they worked with the newcomers association. bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 12 lc: is that a community? ob: it is a group in charlottetown. so, the seniors got to meet four different immigrants. they found out why they came to pei and, learned about some of their customs. the senior women put together storyboards about each immigrant and were loaning them to grade 4 students in the schools. lc: where were the immigrants from? ob: i can’t remember where they were from. i know there was one from iran, but i never did ask where the immigrants came from. lc: i was going to ask what was the most surprising photo that you saw in the collection. i’m wondering if that was it or if it was something else. ob: no, they didn’t give me a photo of that. one of the most interesting, i think, was one of my participants was an artist, very detailed. [s]he couldn’t just show me the railing in the bathroom. it was the railing in the bathroom, the railing along the corridors, the railing outside…railings were a big important thing for her. but in order to do it, she couldn’t just take a picture of one, she took a picture of all three and then put them together into a collage. lc: you said that your understanding of photovoice is that it’s meant to engender social change. ob: yes. lc: would you say that, in fact, that was the outcome? ob: i would say it was the outcome, but it’s also very much a learning, an educational thing for me and for my participants. the thing they enjoyed most about it was the group get-togethers. oh, they loved them. i did a lot more individual meetings with them because i felt that they would feel more comfortable discussing their photo with me alone first before they would tell others about it. what was really interesting is when they chose the four photographs that they wanted to submit, i asked them if they would do a write-up about it, and if possible, to give a caption. so, when they met as a group, they were reading their story. [w]hen we had the open house, they did not use notes. when guests came to the open house the women talked about their picture. they were as comfortable as could be. [t]hey knew their story inside out, so they told it. two of them kept diaries, since the 1980s, so, can you imagine that treasure? …you truly got a sense of what it was like during their lifetime. lc: their lives… ob: the important things i found were their own agency, their family support and friends and neighbours support. i remember one clearly telling me the difference between family and neighbours. lc: and what was that? ob: just with your family, you might discuss the most intimate things. with your neighbours, they’re there every day. especially in the communities where there were actually people home during the day, so they would drop in, they would chat or they’d bring some biscuits or they’d do something like that, very neighbourly kind of thing. i remember the participant saying, there’s such comfort in having people like bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 13 that around. there were only two who had a spouse. and they all had been farmers at some point. this couple they were both 87, the husband and wife. they had stopped farming and their son had taken over the farming. but the husband was out every day in the woods cutting wood for the next year. lc: at 87. ob: yeah, at 87. and she had had a stroke and was getting around quite well. she paced herself. she did the things she could do. the other thing i found about them was they were able to recognize what they could do and not dwell on what they couldn’t do. and i thought that’s again part of agency. the other one that was married, was very much a caregiver. her husband was in a wheelchair. one of the questions i had asked them was, do you believe you have enough resources to continue the lifestyle you have chosen? and most of them, said yes. and that doesn’t mean they had a lot of money. it means they had what they felt they needed. this one lady whose husband was in a wheelchair, her very quick answer was, as long as my husband is alive. she said, if he goes first, his pension is cut back to 60%. and they had 10 children. she worked part-time to accommodate the family. she was a teacher by training. but by the time you stay home and you accommodate 10 children, a lot of your life has been part-time work, so no pension. anyway, at the end of her work career, her pension is $27.00 a month. but because she accommodated her husband so that he could work full-time, his pension if he died would drop to 60%. she knew some women in her area who couldn’t stay in their home because what you’ve lost is one mouth to feed, the other expenses remain the same. anyway, it did happen. he did die. lc: and so what became of her? ob: she’s still doing okay. they had 10 children. one of her granddaughters is living with her. i always knew she’d be okay because her family would make sure that would happen. one of my participants had married a sailor and i think there was a girl at every port. every time he came home, a new child was produced. she had eight children and it was on her shoulders to make sure they had a roof over their head and food in their tummies. lc: did he not contribute financially at all? ob: no, he was a dreamer. she lived with him until her children were all able to go out on their own. she married three times after that. lc: after her children left home? ob: yeah, and she said she got rid of him […] and then she got married again and it really wasn’t a best choice. the third husband was the love of her life. it was so neat. lc: and did you meet him? ob: no, they were only together seven years and he died. and then her last husband was a bit okay, but it was the third one that was really the love of her life. lc: and you knew that because she told you? ob: yes, and just listening to her talk. she loved to dance. he was the first husband she ever had who loved to dance and do things. and the other thing about her is she went from rags to riches. bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 14 lc: really? ob: yeah…i think her last two husbands had resources which she benefited from. it’s not that she ever strived to make a lot of money or anything, but it was just so nice to see her end up comfortable. the other thing i saw in the women, some of them didn’t really have any agency when they were younger, but it grew. so, it’s good to know that happens too. lc: the benefits of aging. ob: the benefits of aging, yes. lc: how much familiarity do you have at the moment with the epic program and how it works? ob: not a lot. i’m learning so much just being here and watching. yesterday when i watched the groups gel together around the ’tetris’ game i thought, wow, this is powerful. lc: you brought this up too about how part of the education and training program involves communicating with older adults. ob: yes. lc: maybe you can tell me a little bit about that and why that’s important and how you think it should be working and how you think it is working now. ob: my [phd research] participants were just a few years older…they all are older than the life expectancy in canada. they’re all 85 and older. so, i looked at them as pioneers in aging. they are really role models for the rest of us coming behind. and just to be able to ask them questions and have them answer. because they were involved in my study for approximately eight months, you get to know them quite well, and they trust you. i think that relationship development is so important you welcome that person in as someone that you’re going to learn with. one of the things that photovoice does, it removes you from being the so-called expert, so that you’re all in this game together and you’re all learning. it’s a little bit like what age-well is doing with these summer institutes you’re learning together. it doesn’t matter what your background is, we have this goal, we’re all working toward it. photovoice is kind of like that. lc: just get back to the role of older adults either with photovoice or the summer institute. for you, what does that tell you about the effectiveness of this training program? ob: it tells me that the people who are developing something, whether it’s a program or a service or a new technology, they are taking into consideration the person who is going to be using it. so, that they are actually asking them would this work for you or what could i do to make a change that’s going to make it more user-friendly, those kind of things. i mean you can’t develop something and then say, is this working for you? you need to know from the one who is going to be the user, so really, what is it you need and how can we help? that’s what i really liked about age-well is the fact that they were actually taking into consideration the end user. lc: i agree, and i think that’s definitely by design. i’m always really interested in the use of pronouns. who is we and who is they? bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 15 ob: that kind of gets eliminated too when people start working together. there are no ‘we’s or ‘they’s. lc: in your group, this group that you were working with, and i guess i haven’t looked at the whole program but will continue to work with, what did you find? what pronouns were being used and how were people positioning themselves and how were you positioning yourself? ob: i think because we all came knowing kind of where our role was going to be. and the students were told, welcome your stakeholder. they all introduced themselves and one of the young men said, can i get you a glass of water? and then those formalities kind of fell away and we just started talking. and i’m listening because i see them as the experts from what they were doing. i remember in my undergrad [days] walking across the campus with a young girl. she said, you must think we’re so dumb. and i said, look, it’s the total opposite. i think you guys are so frigging smart…they’re learning all these new things that i had never even heard of when i was in school. and so they seemed to be quick with answers. i just admired them. [discussion of the role of older adults in age-well/ epic] ob: i think by having the older adult there and realizing that, yeah, they’re not just a body that’s declining. they are someone who had a life, they’re someone who did this in their lifetime i think it’s that connection that is really going to help people understand one another. my big thing is ageism. and there’s no better way to reduce ageism than working together on something. that all of a sudden this is another person who has knowledge who can contribute to what i’m trying to do, sort of thing. so, you forgot there was an age difference. lc: when you and i first met we were in a group discussing the raging grannies (raging grannies international 2020) about aging and activism and the contributions that have been made and will continue to be made. and for me that always ends up getting back to that devil-in-the-pronoun. when “we” talk about “them,” we are uncovering biases. ob: but then when you start looking together at an issue and talking about it, it’s no longer, we/they. we’re working together. ***** in conclusion, we return to the (ungrammatical) question of who is “we”? both leslie and olive regard ourselves as older adult researchers whose subject is older adults. with each passing day, the boundaries become less clear, more malleable. other anthropologists have addressed the topic of insider/outsider—of identity and intersectionality. olive commented that her interest was sparked by age-well’s commitment to partnering with older adults. “to me,” said olive, “it’s the older adults who are the experts in their lives, not us.” notes 1 olive’s ph.d. is profiled in a 2019 documentary never too old (canadian broadcast corporation (cbc) 2019). bryanton and carlin | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.270 http://anthro-age.pitt.edu 16 references bryanton, o. (2018). pioneers in aging: voices of women age 85 and older aging in place in rural communities ph.d., university of prince edward island canadian broadcast corporation (cbc) (2019). "never too old: meet olive bryanton." raging grannies international. (2020). "raging grannies." accessed february 7, 2020, https://raginggrannies.org/. wang, c. c. (1999). "photovoice: a participatory action research strategy applied to women's health." journal of women's health 8(2): 185-192. ”it spread like a wildfire”: analyzing affect in the narratives of nursing home staff during a covid-19 outbreak andrea freidus university of north carolina charlotte afreidus@uncc.edu dena shenk university of north carolina charlotte dshenk@uncc.edu anthropology & aging, vol 41, no 2 (2020), pp. 199-206 issn 2374-2267 (online) doi 10.5195/aa.2020.312 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. freidus and shenk | 199 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu ”it spread like a wildfire”: analyzing affect in the narratives of nursing home staff during a covid-19 outbreak andrea freidus university of north carolina charlotte afreidus@uncc.edu dena shenk university of north carolina charlotte dshenk@uncc.edu introduction chaos reigned as the life care center nursing home in kirkland, washington, made frontline news in february 2020 when covid-19 was discovered to have been circulating among residents, staff, and visitors. while this nursing home was originally identified as the epicenter of the us epidemic, it has since become apparent that there were numerous other cases and outbreaks throughout the us. still, the damage was done, and the nursing home has received significant negative attention ever since (watkins et al. 2020). data have shown that the older population, especially those in congregate living communities, are being hit hard by this epidemic that has wreaked havoc throughout the country (gardner, states, and bagley 2020). [covid-19] just went through the whole building. . . . one day we went from one person that had been sent to the hospital coming back positive, and as soon as that happened, it was like everybody that she was around had it within a matter of a day, two days. the above is an excerpt from an interview with a direct care worker (dcw) who volunteered to work on a covid-19 unit in a skilled nursing home (snh) in central north carolina, where an early outbreak led to the death of over 20 residents in just under two-and-a-half months. the dcw reported vacillating between feelings of anger, frustration, helplessness, fatigue, and deep-seated grief. she mourned over residents she knew and loved and had watched “suffocate” to death. she felt helpless, unheard, and angered that her experiences weren’t being used to prevent mortality. this article is an attempt to make their voices heard and make their anger matter. we foreground the narratives of a group of workers who are often ignored, undervalued and without voice. four of these workers volunteered to work in a covid-designated hall during one of the worst outbreaks recorded in north carolina and the fifth is the administrator. their interviews are a subset of 60 interviews on perceptions and experiences of workers providing long-term care (ltc) during the covid-19 epidemic. studying ltc is crucial in this http://anthro-age.pitt.edu/ freidus and shenk | 200 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu pandemic because covid-19 differentially impacts older americans, especially those living in ltc communities. in north carolina, 40% of covid-19 mortality has been associated with adult congregate care including snh, assisted living (al), memory care units, adult family care homes and continuing care retirement communities (ccrc). methods in this paper we draw from findings of an irb-approved project that entails a rapid qualitative appraisal of the perspectives of workers providing ltc to older adults in north carolina during the pandemic. we use data from the second phase of this on-going project and focus on staff in adult congregate living communities. we will complete over 70 in-depth, semi-structured interviews by the end of the third phase. the purpose of rapid appraisals is to employ a methodology that collects trustworthy, actionable data and disseminates it to decision-makers in a timely fashion (mcnall and foster-fishman 2007). these projects are often team-based and involve a collaboration with community leaders, political officials, and/or interested non-governmental or governmental organizations who request information to improve policy and programming. sampling of participants is typically purposive and not designed to be random or representative, although knowledge about the area of study allows for some degree of representativeness to be built into the design (vindrola-padros and vindrola-padros 2017). in rapid appraisals, data analysis is an iterative process that is ongoing in order to distribute findings quickly so decision-makers can act on them expeditiously, especially in times of crisis. rapid ethnographic appraisals are unique in their focus on a narrower range of qualitative research methods. they have not been used previously to study ltc but prove to be very effective to qualitatively analyze the effects of a crisis, such as the one we are facing today. this paper is a case study of interviews with staff who worked on the covid-19 unit during a major outbreak. the site is a corporately owned snh in central north carolina. six staff members volunteered to work on the covid unit: an lpn, rn, three certified nurse assistants (cnas) and a housekeeper. we interviewed four of these staff members from the covid unit, and the facility administrator. interviews were video-recorded using a web-based platform and were transcribed verbatim. we recorded five-and-a-half hours of interviews in total from these five participants and generated codes for these data through a grounded, inductive approach. through initial and ongoing data analysis, the researchers noted the emotional nature of the interviews and decided on introducing codes on ‘affect.’ codes were discussed collectively and were then applied to each of the interviews individually. researchers thus compared their results, agreed upon data categorization, and coded using nvivo software. no identifiers (date, facility, names, …) are used to present the data because of its sensitive nature and the small sample, and in order to protect the anonymity of the facility and the individual participants. based on our inductive approach, we turned to affect theory, to analyze the narratives of these five participants and maximize the analytical value of their feelings and sensory experiences about providing care through a covid-19 outbreak. drawing from their expressed affective experiences, we demonstrate how affect and emotion circulate to structure the experiences and perceptions of ltc workers, through their engagement with each other, with residents, families, administration, policy, and the virus itself. we report on the emotional experiences of direct care workers as they emerged from their narratives of caring for older adults in long-term care during the covid-19 pandemic. four affect categories emerged from our data analysis: fear/anxiety, sadness/grief, anger/frustration, and trauma/stress. we report on them separately to illuminate how these feelings are expressed and structure experiences of these dcw. http://anthro-age.pitt.edu/ freidus and shenk | 201 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu circulation and affect scholars – including anthropologists, phenomenologists, philosophers, and feminists – have convincingly demonstrated that affect structures how humans interpret, understand, and make sense of their lives (ahmed 2004a, 2004b; griffiths and scarantino 2008; skoggard and waterson 2015; slaby, muhlhoff, and wuscher 2017). however, it is in the fluid and dynamic nature of affect that it remains difficult to document and analyze affective engagements, or to understand and make social scientific claims about subjective, emotive experiences (ahmed 2004b). with regard to these methodological perils, sarah ahmed suggests a narrative approach, arguing one can “read” the affective in texts (2004b, 27). affect theory has become increasingly popular as a way to make room for ethnographic scholarship that values the emotions, feelings, and subjectivity inherent in the lived experiences of individuals and communities, that are foundational to how they understand and interpret their own and others’ lives (martin 2013; skoggard and waterson 2015; stewart 2007; white 2017). affect is being used here as a framework that focuses on an examination of one’s visceral, emotive experiences within the material world (lyon 1995). affective analysis is often understood as that which is individually felt but simultaneously informed by social context (stewart 2007). “affective arrangements” are always considered as relational or “transpersonal,” because affect is modulated and made through interaction (slaby, muhlhoff, and wuschner 2017). there is an ongoing debate in academia on the relationship between affect and emotion. some, looking back to durkheim, argue that ‘emotion’ has historically been used to indicate an individual, embodied experience: a feeling that is primitive, primordial, and autonomous (durkheim 1965 [1915] in skoggard and waterson 2015, 110). ‘affect,’ according to these scholars, is distinct from emotion, as it is defined by sociality, and refers to the feelings, sentimentalities, and embodied experiences generated from the circulation of bodies with other objects or bodies in the public realm (richard and rudnyckyj 2009). csordas (1990) and lyon (1995) suggest that visceral, intimate encounters with the material world (including other bodies) is both constituted by and in turn constitutes culture that determines social location and the structuring of everyday lived experiences (ramos-zayas 2011). according to parreñas (2012, 682): “affect does not reside within a human individual’s body and mind nor does it solely reside within the interface of human bodies. . . . it is between bodies that we come to feel affect. following skoggard and waterson (2015), we are not convinced of the need to distinguish between affect and emotion. emotion, in our view, is not as individualized as some scholars would suggest. we draw on ahmed (2004a) to demonstrate that emotions do not exist in a vacuum: they are always already structured by the social context within which someone is born and lives, and by the interactions that occur within their socio-material lives. to put it differently: while we cannot speak of emotions lest they are individually felt/embodied, emotions are induced, shaped, and molded by the social context and the material world, past and present. since emotions and affect are more similar than they are different, we use them interchangeably. our emphasis here is on the way emotions are structured by the social, and by circulating between bodies and objects (including policy). hence, we document dcw emotions as individually felt and expressed, but assess them in terms of how they are constituted by and also constitute the socio-political landscape. the implications of which include allowing a critical review of long-standing structural inequities, ageism, and inadequate policy and programming in ltc. findings we present our findings according to the codes that emerged from the analysis, while recognizing that emotions are rarely discrete categories. they often overlap with some narrators expressing anger, fear, and frustration simultaneously. we do not suggest that the categories we identify as emerging from this analysis are straightforward. instead, we draw on the range of expressed emotions to illustrate the http://anthro-age.pitt.edu/ freidus and shenk | 202 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu broader affective experience of working on a covid-19 unit in a congregate care community with substantial morbidity and mortality. we distinguish four major affective themes that emerged from the data, from what are, in actuality, a cluster of related feelings. these include fear/helplessness, anger/frustration, sadness/grief, and trauma/stress and exhaustion. fear/helplessness each of our interviewees volunteered to work on the covid hall because they knew “someone had to do it” and some of their colleagues refused to work on the positive unit for fear of contracting the virus. as one of the respondents said: “i did have a little bit of fear. i have four kids at home and a husband. so, i was really worried that i'd take something back home to them, but i was very cautious.” by “cautious,” they meant wearing full protective personal equipment, changing clothing when they got home before entering the house, showering and washing their hair, and not visiting relatives and loved ones. fear is evident in relation to the circulation of the virus itself, but also in relation to how workers do or do not circulate among their own loved ones. interviewees also expressed fear associated with helplessness. they discovered that a group of residents had tested positive, after initially being told all the tests came back negative and their initial wave of relief was immediately overtaken by dread. one explained: our unit supervisor walked in and she was like, "everybody's positive, we read the test wrong." yeah, so i think that was the first day i literally cried because as soon as she told me that, i dropped to the floor and i just bawled like a baby 'cause i knew, i knew we were gonna be in for it after that. this respondent’s visceral response of crying like a baby embodied their all-too-correct fear about what was about to happen to the residents they cared for. this respondent cried during the interview when she talked about having to say goodbye to residents because their family members were too afraid to come into the covid unit while their loved ones were transitioning (the phrase commonly used in this field when someone is dying). fear, helplessness, and grief collided in their narratives. grief and sadness was something that all respondents experienced and spoke of in-depth. they demonstrated these feelings in the interviews through crying and cracking voices. sadness/grief all five respondents, including the administrator, expressed a deep connection and respect for the residents they cared for on a daily basis. participants evoked fictive kinship as they referred to residents as being like family, saying “they are the reason i get up and go to work every day. . . i really love them all …” remembering residents they loved that died was emotional for them all and two of them cried during interviews. one explained that “if it weren't for [a colleague] i probably wouldn't have made it through that two and a half months, 'cause i literally, i cried on a daily basis.” in one interview, a participant was overwhelmed with grief when describing how the virus took a resident she had a strong relationship with. she regularly took walks with this older, male resident she described as “healthy.” he contracted the virus and died within days. she talked about his loss several times in the interview and a co-worker independently recalled how sad her colleague was when that particular resident died. another caregiver explained that it was too painful and sad to deal with and the only way they could “survive” the experience was to “just shut down.” they explained: you can't feel anymore. i think after the tenth person dying, i was like, "okay, i can't, i can't. if i keep feeling like this, i will not walk into that door." and after that, i was just http://anthro-age.pitt.edu/ freidus and shenk | 203 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu like, "okay, so they died. okay, so they died. okay, so they died." and now. . .we're going from the hall where everybody was and where we started, and it's not the same people, we've lost them, we've lost them all. and you're just like: “why?” another participant shared how they struggled to control their own emotions in ways that had never happened before. they said: i've done this for a long time and never, ever have i not been able to make it out of the room [without crying]. . . . it just overwhelmed me at that point that all these people we were testing, you knew they were gonna come back positive, and you knew in your heart that they probably weren't gonna make it 'cause they're already sick to begin with. grief was tied not just to the affective encounters between staff and residents, but also as staff bore witness to the suffering and grief of family members trying to console the residents. one interviewee recalled how husbands came to visit their wives daily by standing outside the windows. they explained: the resident doesn't even know they're there because of their level of dementia, but that husband is still there all day. one brings a bar stool and an umbrella, and he does that during the rain, whenever. . . he has a cooler with water, and he sits there at the window with her. so that's really sad to watch. it's really great that you're loved that much, but it's gotta be heartbreaking for all of them. anger/frustration the covid unit staff were isolated in a very real sense. they didn’t feel like people were listening which led to extreme frustration and anger. there was generalized anger at the virus itself for taking so many lives in such a violent way. anger and frustration were directed at policies and procedures that did not take into account their perspectives and experiences. finally, there was a sense of anger and helplessness in relation to the broader community for not taking covid-19 seriously enough and not following cdc and health department guidelines. during one interview, a participant became agitated and raised their voice as they discussed anger at death, not being listened to, and also at colleagues and other staff who did not acknowledge the suffering and grief dwc experienced as they watched residents die. they explained: i had a lot of anger during this process: i was angry at the fact that these people had to die the way they had to die, and that no one cared. i really honestly felt like the people who were on the floor, living it day by day got it, and the people who weren't there, it's like we couldn't get them to see it. … and it's like, “i can't process this person just died. now, you want me to hurry up, pack their stuff up, . . . so somebody else who tested positive can come right in this room?” since this was an early outbreak, there was little understanding of the virus, and the participants expressed frustration at the plan that was initially instituted to contain the virus. this snh has several different halls, and each could be somewhat isolated. one hall became a ‘covid unit’ where anyone who tested positive, along with their roommate, would be moved to. once in the covid unit, both would be tested to see if they were positive. the caregivers believed that close proximity to covid http://anthro-age.pitt.edu/ freidus and shenk | 204 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu positive roommates all but ensured conversion to positive. they watched initially negative roommates test positive and then die. one caregiver explained: . . . we had two roommates. one tested positive, one tested negative, but just because the roommate tested positive, they moved both of them over to covid. so, she got tested again when they moved over there . . . came back negative. two days later, she was moved back out to her room. and then literally within a day of her being moved back, the pa sent her out to the hospital with a 102 fever, respiratory distress and we knew damn well what was wrong with her. we didn't have to have a test to tell us. another caregiver echoed frustration about the decisions to move residents excessively, as administration and corporate worked out procedures. the administrator said it felt like there were 100 room changes in 100 days, which he acknowledged was an exaggeration but said he felt like that, because it was so “mentally and physically exhausting.” one dcw explained: ... and our whole thing was, "why are they not listening to any of us?". . . "we were there, we're in the midst of this. we're trying to tell you what we need to do that might, could help this situation. and you're not wanting to listen. this same respondent said they did not feel like they had a voice as “lower-tier staff,” adding that even the nurses expressed concern about the movement of residents that went unacknowledged. the administrator expressed his admiration for the corporate office that worked tirelessly to create and implement strategies during the early chaotic days of the epidemic when little was known about the virus and its transmissions. he rightfully said, “nobody was prepared for this.” he went on to explain that protocols and procedures changed almost daily in an effort to consolidate ever evolving recommendations and policies from the level of the federal government, state, and county. in trying to juggle the needs of his covid-positive patients, the protection of himself and his staff, as well as the quickly shifting policies and procedures he did acknowledge some mistakes were made explaining, “i wish i could have known then what i know now.” trauma/stress and exhaustion stress, trauma, and exhaustion were discussed by all five participants. trauma was expressed in several ways including vivid descriptions of the violent death residents faced since many had orders refusing transportation to the hospital for life saving procedures. two caregivers stated they suffered from ptsd. sleeplessness, exhaustion, and disturbing images of death and dying haunted the staff following the major covid-19 outbreak at their snh. one of the caregivers shared that when the initial outbreak occurred the attending physician wrote prescriptions for morphine for all the residents saying, “you’re going to need it.” all interviewees discussed the helplessness and violence associated with dying from covid-19 that related to their traumatic experiences working on the covid unit. one respondent explained this violence and their frustration at what they felt might have been preventable: … they're literally smothering to death, they're literally choking to death. and all you can do is sit there and hold their hand and try to make them comfortable . . . 'cause there's nothing else you can do. and then you look and you go, "you know what? this possibly could have been prevented." http://anthro-age.pitt.edu/ freidus and shenk | 205 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu another participant provided a similar depiction of the traumatic experience of watching residents suffocate: even the morphine wasn't helping. . . .they were still fighting for air . . . and it was like somebody holding a trash . . . bag over their heads, and smothering them. one participant clarified that they had confirmed the residents’ wishes and families’ for those who were unable to make that decision: we did send all residents that indicated they would want to be transferred to the hospital when their symptoms became the level for that type of intervention. witnessing violence and death can be associated with ptsd and two participants believed it was affecting their mental health in sustained ways. one of these two stated plainly: me, personally, with my experience, i have ptsd . . . going through this trauma, i'm still trying to come out of it. . . . i don't ever wanna do it again. . . . i say that i don't think i mentally could do it, but i sit here and i tell myself, like i just told you, if i had to do it, i would do it again . . . i probably wouldn't be the same, second time around, as this took a lot to get back to a normal life for myself after coming off of it. another said they suffered flashbacks that they relate to their sleeplessness and associated trauma, “it's just that i close my eyes and it's like i'm there again. i see and i hear. and that's something i don't wanna see and hear ever again.” conclusion these narratives demonstrate the multifaceted, socially embedded nature of affective engagements that reflect the way we generate feelings through circulation between a range of actors, objects, and policies. the virus, co-workers, family members, residents, and policy restrictions in turn structure how participants understand and manage their experiences. we argue that troublesome cultural values, social injustices, and structural failings, which are all too often easily ignored or erased, can be made visible through chronicling these affective dimensions. we amplify the voices of the formal caregivers in this work to demonstrate how their sensorial and emotive experiences can speak to the unjust human suffering they bore witness to, the underlying ageism that permeates our culture, and the social hierarchy that devalues their labor and their worth as they serve on the frontlines during this unprecedented global pandemic. this perspective is particularly important in light of the media coverage on the failures of nursing homes and the larger healthcare system to respond effectively to the pandemic. this media coverage generally positions administrators and facility staff in conflict with long-term care residents and their families. these dcw perspectives add a valuable, nuanced view of the heroic measures being taken, including risk to the self, by administrators and staff, to protect the lives of residents. we must keep considering the structural barriers they face within these long-term care congregate communities, that are informed by the broader socio-political context that – both historically and in this contemporary epidemic – limit their agency in caring for those they serve. their expressions of sadness, helplessness, and grief illuminate both their individual devaluation as low-paid formal caregivers, and that of their aging residents, by the larger society. their palpable anger, frustration, and trauma speak to the violent, unnecessary suffocation and perhaps preventable deaths, as well as despair at the social http://anthro-age.pitt.edu/ freidus and shenk | 206 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.312 http://anthro-age.pitt.edu hierarchy that prevents formal caregivers’ voices and perspectives from having value. their fear is shared to some extent by all of us living in the chaotic age of covid-19. acknowledgements our special thanks to the frontline caregivers who shared their experiences with us so openly and honestly. sincere appreciation to graduate assistant christin wolf for her dedicated efforts as an essential member of our research team. references ahmed, sara. 2004a. “affective economies.” social text 22: 118-139. ----. 2004b. “collective feelings or, the impressions left by others.” theory, culture & society 21(2): 25-42. csordas, thomas j. 1990. “embodiment as a paradigm for anthropology.” ethos 18(1): 5-47. gardner, william, david states, and nicholas bagley. 2020. “the coronavirus and the risks to the elderly in longterm care.” journal of aging and social policy. https://doi:10.1080/08959420.2020.1750543. griffiths, paul and andrea scarantino. 2008. “emotions in the wild: the situated perspective on emotion.” in the cambridge handbook of situated cognition. edited by philip robbins and murat aydade, 437-453. cambridge, u.k.: cambridge university press. lyon, margot. 1995. “missing emotion: the limitations of cultural constructionism in the study of emotion.” cultural anthropology 10(2): 244-263. martin, emily. 2013. “the potentiality of ethnography and the limits of affect theory.” current anthropology 54(7): s149-s158. mcnall, miles and pennie g. foster-fishman. 2007. “methods of rapid evaluation, assessment and appraisal.” american journal of evaluation 28(2): 151-168. parreñas, rheana “juno” s. 2012. “producing affect: transnational volunteerism in a malaysian orangutan rehabilitation center.” american ethnologist 39(4): 673-687. ramos-zayas, ana y. 2011. “learning affect, embodying race: youth, blackness, and neoliberal emotions in latino newark.” transforming anthropology 19(2): 86-104. richard, analise and daromir rudnyckyj. 2009. “economies of affect.” journal of the royal anthropological institute 15: 57-77. skoggard, ian and alisse waterson. 2015. “introduction: toward and anthropology of affect and evocative ethnography.” anthropology of consciousness 26(2): 109-120. slaby, jan, rainer muhloff, and philipp wuschner. 2017. “affective arrangements.” emotion review 11(1): 3-12. stewart, kathleen. 2007. ordinary affects. durham: duke university press. vindrola-padros, cecilia and bruno vindrola-padros. 2017. “quick and dirty? a systematic review of the use of rapid ethnographies in healthcare organization and delivery.” bmj: quality and safety 27(4): 321-330. watkins, derek, josh holder, james glanz, weiyi cai, benedict carey, and jeremy white. 2020. “how the virus won.” new york times. june 24, 2020. https://www.nytimes.com/interactive/2020/us/coronavirusspread.html. white, daniel. 2017. “affect: an introduction.” cultural anthropology 32(2): 175-180. http://anthro-age.pitt.edu/ https://www.nytimes.com/interactive/2020/us/coronavirus-spread.html https://www.nytimes.com/interactive/2020/us/coronavirus-spread.html sleep as homework and engagement in rehabilitation trine schifter larsen mari holen copenhagen university hospital hvidovre roskilde university, denmark trine.schifter.larsen.01@regionh.dk holen@ruc.dk abstract in today’s push for shorter and quicker hospitalizations, everyday life often becomes a place of rehabilitation for people after they undergo surgical procedures. in order for hospitals to manage shortened periods of admission and to facilitate post-operative rehabilitation, a patient‘s active engagement has become a central element to clinical treatment and care in denmark. for example, in the recovery from orthopedic surgery, sleep becomes a type of "homework" assignment that is a vital element of the patient‘s rehabilitation trajectory. building on the theoretical concept of ‘engagement’ developed by gilles deleuze and félix guattari (2005), we examine the patient‘s relation to sleep as part of recovery; we refer to this as 'sleep engagement.' in particular, we analyze sleep as part of an institutional pedagogy in rehabilitation, and we ask how this pedagogy mobilizes rehabilitation for older patients after they have been admitted to the hospital for an orthopedic surgical procedure. using ethnographic material, our analysis leads to a discussion of institutional expectations for what it means to be engaged in one's own patient trajectory. the article presents three results: 1) expectations of sleep as an institutionally defined homework assignment are fulfilled through the establishment of the ‘rehabilitable and non-rehabilitable body’; 2) as an active attempt to mobilize resources in rehabilitation, patient sleep engagement becomes part of a historical and contextual nexus; and 3) institutional sleep potential creates new points of ambivalence—on the one hand, sleep is an optimization-promoting requirement in order to exercise while, on the other hand, the midday nap reflects an outdated view of old age that opposes an active lifestyle perspective. keywords: sleep; patient-engagement; rehabilitation and everyday life; aging; relational ontology anthropology & aging, vol 42, no 2 (2021), pp. 105-125 issn 2374-2267 (online) doi 10.5195/aa.2021.284 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. larsen & holen | 105 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu sleep as homework and engagement in rehabilitation trine schifter larsen mari holen copenhagen university hospital hvidovre roskilde university, denmark trine.schifter.larsen.01@regionh.dk holen@ruc.dk introduction with the introduction of ‘fast track’ programs in danish hospitals and generally reduced admission periods, patients’ own efforts in post-operative rehabilitation have gained importance. fast track is the name of a trajectory that allows patients operated with total hip alloplasty (tha) and total knee alloplasty (tka) for faster discharge. the purpose is to reduce the length of hospital stay and prevent readmissions, minimize surgical complications, decrease morbidity, and improve cost-effectiveness. these goals are founded on standardized regimes that are based on a large amount of research-based evidence from randomized controlled trials (rcts). previously patients used to lie in bed for weeks after an operation (søndergaard 2007), whereas now bed rest is considered problematic. instead, patients are encouraged to engage in physical ‘activity’ that e.g., involves getting out of bed and engaging in their own recovery trajectory through activity and taking responsibility and initiative for activity to happen (holen and ahrenkiel 2011; larsen 2019). this new patient position becomes the new mantra after surgery and particularly orthopedic surgery. being active thus becomes a way for patients to express their motivation to participate in the institutionally defined activities (holen and ahrenkiel 2011; meldgaard hansen 2016) during hospitalization and after discharge. in a joint seminar prior to the scheduled surgery, the surgeons, physical therapists, and nurses involved typically emphasize the need for activity, personal responsibility in management of the rehabilitation process. it is also during this seminar that the term 'patient' is replaced with the term ‘partner,’ indicating the desired clinical relationship in the trajectory to come. these changes in patientand rehabilitation regimes invite for a conceptualization of rehabilitation. illness and trauma limit or alter bodily capacity and thus change the relations we have with our surroundings (fox and alldred 2016). rehabilitation is the process of making new and effective relations in a changed reality. what is conceived as effective does not refer to a biological issue but rather to the possibility of (re)integrating the injured body into one’s environment and daily life. anthropologist cheryl mattingly explains why integration is more than a biological issue: “the patient had not just injured a hand or suffered a brain lesion, but in the process disrupted an entire life” (mattingly 1991, 983). mattingly emphasizes how historicity is built into bodies and into the way bodies engage with the surroundings in everyday life, or what can be stated as ‘functionality.’ mattingly focus on the phenomenological experiences of rehabilitation and describes the body as phenomenological with own sense of identity and lived experiences why body changings imposes a process of making sense of these changes in functionality and reclaiming the body, and thereby articulate a new sense of self (1991). another way to conceptualize ‘functionality’ is proposed through science and technology studies in which the focus is on how a network of relations that enable one to act is created. this means that people are enabled to act in and by the practices and relations in which they are located (moser 2006). functionality or capability is here understood as a relational matter enacted through the social and physical surroundings. changed bodily capacities are, in this sense, a disruption of everyday http://anthro-age.pitt.edu/ larsen & holen | 106 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu relational arrangements. moser (2006) further argues how the concept of ability, and thereby disability, is shaped through technology and medicine as a capacity of active agency and independence. this concept of ability, she argues, directs relational engagements through a normalizing mode of ordering that centers agency in the body. eli clare—an author and activist who writes and lectures about disability, queer and transgender identities, and social justice—discusses how the concept of ‘cure’ via biomedicine becomes a matter of getting as close as possible to the normative universal middle-class body (2017). this pursuit is seen as essential to achieve what anthropologist matthew wolf-meyer calls “full personhood” (2020, 233). the link between the body and personhood causes disability and illness to be associated with not full personhood, which is equated with limited social participation (rapp and ginsburg 2001). as a result, biomedicine promises both the restoration of the ‘normal’ body and full social participation (wolf‐ meyer 2020). after orthopedic-surgical procedures, the focus of rehabilitation is on creating physical functionality; e.g., how much the knee can bend after an operation is measured and used to evaluate the rehabilitation outcome. however, this concept of functionality is linked to the notion of a universal (lock and nguyen 2010) and middle-class body (lupton 2013; skeggs 1997, 2005) as the norm against which other bodies are measured and which is used to determine adequacy (buch 2018; wolf‐meyer 2020). anthropologist elana buch states that the idea of the body as a universal and pre-social object form special expectations, as modes of ordering, affecting the body’s relation to its surroundings, as she defines as ‘embodiment’ (buch 2018). in a similar conceptualization and body norm critique, embodiment is described as “interactions that are obscured through ideological practices that support neoliberal notions of the individual” (wolf‐meyer 2020, 232). from these theoretical perspectives, we understand that what can be termed as functionality and how to become a functional subject is also directed by modes of ordering such as through medical and institutional concepts such as fast track programs and associated patient positions and pedagogies foregrounding a particular conceptualization and significance of engagement. with the term institutional, we draw on james g. march and johan p. olsen (1989), who see institutions such as the hospital as producing norms for appropriate behavior specifying the role of the actor. these norms and rules of appropriate behavior they define as “the routines, procedures, conventions, roles, strategies, organizational forms, and technologies around which activity is constructed. we also mean the beliefs, paradigms, codes, cultures, and knowledge that surround, support, elaborate, and contradict those rules and norms” (march & olsen 1989, 22). biomedicine is often foregrounded as a dominating force directing modes of ordering. however, we understand biomedicine as one force among others forming institutional norms such as engagement. in this article, we examine engagement as a question of how older patients engage in making new and relational arrangements after orthopedic trauma and/or surgery and thereby (re)integrate the body into their environment. to examine engagement we draw on gilles deleuze and félix guattari’s concept of ‘engagement’; i.e., as the effort and desire to build capacity to create effective relations (2005). with this concept of engagement, we discuss what can be termed as effective in the sense of building capacity and how normalizing modes of ordering produced through medical and institutional concepts form in and exclusions of bodies and forms of agencies. the article builds on ethnographic fieldwork carried out by one of the two authors. http://anthro-age.pitt.edu/ larsen & holen | 107 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu sleep as a rehabilitative potential sleep is being incorporated into the system of rehabilitation management institutionally constituted as what we propose as ‘rehabilitative homework.’ in the pedagogy for the recovery of ‘partners,’ to practice sleep1 becomes a means of engaging in one’s recovery trajectory. along with activity as a dominant requirement, sleeping shifts from being a biological and mundane habit to something individuals can actively manage. with reference to sociologist deborah lupton (1997), this practice may be and is likely to be associated with knowledge and motivation shaping a pedagogy of sleep, why sleep managing approaches such as sleep-hygiene-rules have been developed and implemented in clinical practice (ghavami, safarzadeh, and asl 2018; ghorbani et al. 2019; greve and pedersen 2015; machado et al. 2017). sleep hygiene includes guidelines developed by, among others, the american academy of sleep medicine. sleep hygiene is a central part of the national clinical guidelines in denmark for nursing interventions concerning sleep. the latter defines sleep hygiene as related “to the habits, relations, and rituals that promote unbroken, strengthening and effective sleep”(fog et al. 2016). good habits involve following prescripts about tobacco and alcohol intake in the evening, napping, physical activity, eating, bedroom environment. in the context of rehabilitation in orthopedic trajectories and ‘fast track’ regimes, sleep is seen as both a barrier to training and as a facilitator for the opportunity to train. in both instances, sleep requires a balancing of time. balancing time here means that you need sleep to build physical and mental capacity to optimize training possibilities, but time spent on sleeping may not subsume the time that should be allocated to training. sleep, thereby becomes a means for rehabilitation as well as rehabilitative work in itself (aasvang, luna, and kehlet 2015; gong, wang, and fan 2015; greve and pedersen 2015; krenk, jennum, and kehlet 2013; sveinsdóttir and skúladóttir 2012). within this notion of rehabilitative sleep-practice and as something to be managed, patients’ sleeppractices are assessed as being either an active or passive form of patient engagement. active sleep engagement is viewed as developmental and motivated sleep behavior, as a will-driven intention to portion sleep in time and place according to institutional time (larsen 2019). passive sleep is stagnating and non-motivated sleep behavior. what may be interpreted as passive sleep behavior in practice is often pathologized and, as such, regulated. sleep as a rehabilitative practice makes an interesting case for studying how institutional understandings of patient engagement correspond with how patients build capacity to make new arrangements during rehabilitation, and how institutional understandings of engagement allow or prevent the possibility of creating effective relations. through what we refer to as patients’ ‘sleep engagement,’ we ask how such engagements can be understood as either active or passive in one’s own care trajectory, and how sleep practices may create certain subject positions for some older people. this paper is based on an ethnographic study in which data was collected via participant observation and interviews with eight patients aged 67-86. data were gathered during the patients’ hospitalizations for orthopedic surgical procedures and over the course of six to eight months post-discharge during 2017. the research is part of the ph.d. project, “the role of sleep in rehabilitation of older patients during hopitalisation and rehabilitation at home.” the project is co-funded by roskilde university and the department of clinical research and the department of orthopedic surgery at amager and hvidovre university hospital. rehabilitative homework – how the analytical focus differs and builds on the field and methodology within rehabilitation studies many patients can expect an extended period of rehabilitation after they undergo an orthopedic surgical procedure and hospitalization. patients are typically discharged to their own homes but some may first http://anthro-age.pitt.edu/ larsen & holen | 108 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu be sent to specialized centers for respite care. hospitalization varies depending on the diagnosis and can last from one or a few days and sometimes weeks. such shorter periods of hospitalization can be seen as part of larger neoliberal transformations of the health care sector with centering competencies and resources in fewer but highly specialized hospitals with specialized care guided through quality standards (christiansen and vrangbæk 2018) and fast-track programs based on ideals of cost-efficiency, productivity, and individual responsibility. as part of this movement, and in response to a growing aging population and the need to control increasing costs political and economical interests are deeply attached to home-based rehabilitation (mikkelsen, schwennesen, and lassen 2019), and in producing knowledge about how people engage with this rehabilitative homework and the tasks associated with it (clotworthy 2018; mattingly, grøn, and meinert 2011). from a clinical perspective, research is largely focused on examining patient compliance and the management of self-care with respect to patients’ completion of homework assignments related to rehabilitation and as part of overall care trajectories and treatment outcomes (e.g., hørdam and boolsen 2017; kuo et al. 2019; szöts et al. 2015). rehabilitation research related to ‘homework’ also focuses on the increasing number of people who are living with chronic disease—many of whom are expected to undertake a greater range of tasks. these tasks may include more technological and instrumental tasks related to their own care and treatment, such as through tele-rehabilitation. here, telecommunications technology is used in rehabilitation (bugajski et al. 2020; crotty et al. 2014; edbrooke et al. 2020) and patients are digitally given tasks previously performed by medical staff. also, studies addressing municipal rehabilitation programs related to tasks of everyday life may focus on ‘homework.’ here rehabilitation also focuses on increasing the level of functionality through training in activities of daily living (adls), such as bathing, dressing, cooking, and other household chores, known as reablement (clotworthy 2017; cochrane et al. 2016; glendinning et al. 2010; hjelle et al. 2017; lewin and vandermeulen 2010; meldgaard hansen 2015; thuesen 2013; vedsegaard 2019; wilde and glendinning 2012). utilizing a social determinant of health perspective, helle vedsegaard (2019) divides home rehabilitation research into two categories: research focusing on the effect of rehabilitation in relation to the citizen’s ability to account for care needs and practical tasks in the home; and research focusing on the subjective construction of meaning between institutional rehabilitation initiatives and everyday practice at home and in neighborhoods. this latter field of research highlights the consequences for meaning-making when there is a discrepancy between categories of institutional practice and everyday practice (andersen, pedersen, and steffen 2016; bødker 2018; hjelle et al. 2017; mattingly, grøn, and meinert 2011; meldgaard hansen 2015; thuesen 2013; vedsegaard and dybroe 2020). in this article, we draw on a third field of research in which home rehabilitation is understood from a socio-material perspective, and which is particularly concerned with technologically mediated homework (mort, roberts, and callén 2013; oxlund and whyte 2014; pols 2012; pols and moser 2009; pols, willems, and aanestad 2019; schwennesen 2017). within this field technology such as e.g., telecare which is technical devices and professional practices applied in ‘care at a distance,’ that supports chronically ill people living at home (pols 2012) is seen as without an inherent essence and the focus is on studying the effects of the complex assemblage of relations technology is part of. these studies show how homework technology is applied in practice and what this practice is helping to create. they illustrate how technology is creating not only new concepts of care and relations of caregiving, for example, but is also inviting new subject-positions. new modes of caring and notions of rehabilitation both offer new possibilities for agency and becoming-citizen, and simultaneously impose new and changing requirements to live up to in order to be a ‘good’ citizen or a ‘good’ patient. utilizing a socio-material perspective shifts attention away from rehabilitation as the subjective construction of meaning to a focus on rehabilitation as a process of making new relational arrangements. http://anthro-age.pitt.edu/ larsen & holen | 109 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu we work with a concept of rehabilitation that concerns how people with bodily changes that occur suddenly may create or restore their way of being in the world. inspired by deleuze and guattari, we understand “being in the world” as a way of forming relations with one’s environment (‘environment’ is understood as both social and material) (2005). these relations are created continuously and situationally; in this context, “being” or existence is understood to mean “becoming” (deleuze 1994; deleuze and guattari 2005). working with becomings means to understand processes as unfinished and delimited events since events are connected to other events, which in themselves are an assemblage of different elements. examining the rehabilitation process, we explore how ways of becoming-subject emerge. becoming-subject through rehabilitation and as a temporary knotting of relations is perhaps what anthropologists joão biehl and peter locke describe as “the power of specifically growing out of one’s self, of making the past and the strange one body with the near and present” (2017, 4). ethnographically following and analyzing this process of subjectification as materialization, we undertake an anthropology of becoming (biehl and locke 2017). the focus on becoming instead of being is also employed by sarah nettleton, robert meadows, and joanne neale in a sociological sleep-rehabilitation project (2017). their aim is to study the ontology of sleep as complex socio-material interactions. they investigate sleep in rehabilitation within an institutional setting; specifically, in relation to residential services for drug and alcohol rehabilitation. in this article, we study sleep as an orthopedic homework assignment in order to analyze the enactment and transformation of ‘engagement’ as an institutional category in mundane practices of becomingsubject through rehabilitation. an anthropology of becoming acknowledges how power and knowledge form bodies, identities, and meanings, and how inequalities disfigure living – while, at the same time, the anthropology of becoming refuses to reduce people to the workings of such forces (biehl and locke 2017, 5). instead, plasticity is emphasized, which also applies power (biehl and locke 2017), as the directions that process becoming (skrubbeltrang, olesen, and nielsen 2016). the notion of ‘plasticity’ give us the opportunity to study both stability and instability of the enacting forces and allow us to comprehend how patients live up to, co-create, rework, and ultimately depart from the possible positions that exist for doing rehabilitation (skrubbeltrang, olesen, and nielsen 2016). through our examination of older patients’ sleep-practices this article contributes to research on rehabilitative homework with the focus on the transition established between the hospital and everyday life at home. this is an investigation of how institutional norms flow through mundane practices and affect the capacity to make new and relational arrangements after orthopedic trauma and/or surgery and how new ways of becoming subject is directed. methodology the article is based on an ethnographic study of the role of sleep in hospitalization and rehabilitation for older patients who have undergone orthopedic surgery. the empirical material that provides the basis for this analysis was generated during one year of fieldwork, with three months of participant observation in two different units of an orthopedic-surgery department in denmark: an inpatient unit for scheduled surgeries and a unit for acute orthopedic surgeries. as a follow-up to the participant observations, 24 exploratory interviews with eight patients were conducted after discharge. these patients were aged 67–86, five women and three men. other than one of the women, who was still working as a teacher (yet who retired six months after her operation), all of my interlocutors were retired. the participants were all part of the danish ethnic-majority group and had different occupational histories and retired at different ages. three of the women and one of the men lived alone. three of them lived alone because their spouses passed away. of the eight interlocutors, four had planned hip or knee surgery, and the other four were hospitalized due to trauma resulting in knee, http://anthro-age.pitt.edu/ larsen & holen | 110 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu pelvic, neck, and/or hand injuries. some of those injuries resulted in surgery, and others in pain treatment and relief for the joint. one interlocutor was hospitalized after years of complications from an earlier hip surgery in order to undergo re-surgery. in this article, we focus primarily on the interviews conducted after discharge, while the fieldwork conducted in the hospital is used as a backdrop to illustrate the medical pedagogies that underpins sleep, and to discuss how this relates to rehabilitation. the interviews were divided over three visits with each patient and were conducted at intervals of approximately one week after discharge, one month after discharge, and eight months after discharge. the interviews focused on questions about how the patients were doing, how their days would unfold, and their everyday practices, which also presented the patients with the opportunity to reflect on changes over time. at the end of each final interview, concrete sleep-hygiene rules were presented in order to discuss the medical pedagogy of sleep. these were read aloud in the interview and followed by an open discussion about how they related to such rules/guidelines in their everyday lives. exploring the concept of engagement ‘engagement’ is an empirically based concept but one that we also approach theoretically in order to examine how sleep can be understood as a way of making one’s own patient trajectory. based on deleuze and guattari’s definition, we understand engagement relationally; this means that engagement is a capacity to create effective relations (2005) in new realities with different bodies. effective relations are socio-material relationships that for the individual can mobilize resources in everyday-life encounters with other people, things, and places (vitus 2018). people are made up by relations – as the lived entanglement with their surroundings formed in particular ways due to both historical and present circumstances (lock and nguyen 2010). in other words, throughout their lives, people practice how to enter and participate in both physical and social contexts. this process is ritualized through everyday practices—practices that also help direct them into new contexts or relations in which they are included (deleuze and guattari 2005, 204; wolf-meyer 2012). relations are materialized through the body, which is why these relations affect the body, while the body, in turn, affects the relations. these relational practices are not deterministic; they can be changed but in a directive sense. the way these relations can be created is influenced by power structures and discourses—e.g., in the field of health, which deleuze and guattari argue can serve as a territorialization of the body (2005, 72-73). territorialization can affect or block the capacity to create effective relations. however, “de-territorializing” and “re-territorializing” relations can be made, as the movement out of territorialization that restore the capacity to create effective relations (deleuze and guattari 2005, 7273). de-territorialization, or lines of flight, can also be made through re-territorialized manifestations by which the relations can be legitimized (deleuze and guattari 2005, 5-34). engagement and the desire that direct the making of new arrangements with the environment are thus steered by what opens or closes for the individual in terms of the body’s capacity to create effective relations and a new way of becoming subject. an analysis of patients’ sleep engagements also addresses how sleep—as an institutionally enacted rehabilitative potential—can have either a conducive or obstructive impact on a patient’s efforts to create effective relations. analyzing sleep as engagements the various socio-material conditions of which patients are part of are, together with patients’ bodies, included in their engagement in their current situations. in this article, we refer to them as ‘sleep engagements.’ the focus on sleep engagements is a strategy that, in keeping with nettleton, meadows, http://anthro-age.pitt.edu/ larsen & holen | 111 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu and neale (2017), allows us to examine how a patient’s sleep during rehabilitation comes into being in concrete settings and circumstances. we analyze three sleep engagements here to show how they correspond with the hegemonic medical definition of sleep engagement in rehabilitation and how the pedagogy connected to this definition may open or close the possibility of creating effective relations. the three analytical sections, constructed as narratives, begin with a presentation of the participant and their sleep in everyday life. for our interlocutors, the body has a particularly prominent status in their everyday life and the cases describe how the body is made significant for the way sleep is practiced and positioned during rehabilitation. each sleep engagement we introduce concludes with an analysis of how sleep as an institutionalized homework assignment may or may not create effective relations in rehabilitation. all interviews have been anonymized, and all of the interlocutors’ names are pseudonyms. eva’s narrative: “oh, there’s nothing wrong with my sleep” eva, age 85, was admitted to the acute orthopedic surgery department because she fell at home and broke her kneecap. eva had also been diagnosed with a lower-intestinal condition in 1986, and she has chronic obstructive pulmonary disease (copd), which restricts her breathing. because of this, she must often sleep sitting up with the aid of a support on the mattress. but she does not consider her sleep to be problematic. during the first visit to her home, she explained, “i sleep wonderfully (emphasizing wonderfully), whether i’m in or out.” with this, she meant in the hospital or out at home. she remarked, “oh, there’s nothing wrong with my sleep.” she told me how she sleeps without interruption from midnight until 5:30 am when, as she said, “then i just lay there for a while.” if she is occasionally unable to fall asleep, she just reads a little. she also does this if she wakes up in the middle of the night. the dynamic and everyday body and sleep management during rehabilitation for eva, sleep is not the only practice rearranged around bodily changes. for example, she does not leave her apartment before the afternoon because of problems related to her intestinal condition. the biological conditions that regulate her everyday life – such as copd and the intestinal condition she has lived with for many years – are something that she has integrated into her everyday life and around which she has coordinated her everyday practices. this also applies to her sleep, which is a routine practice that she rarely even thinks about—not even now when additional elements, such as an injured knee and a wheelchair, must be incorporated into her daily sleep practice. eva, therefore, has established and keeps re-establishing her own rhythm based on her body. eva has a routine of turning off the television every night at exactly 10:00 pm, putting on her robe, and sitting in the kitchen where she plays solitaire and listens to the radio while drinking a beer and smoking a cigarette. she finds this routine relaxing and, in her view, this is precisely what helps her sleep well. thus, she does not view it as something the hospital needs to interfere with or that necessitates any type of intervention in relation to rehabilitation. she feels provoked when, for example, the hospital asks about her alcohol consumption: “yes, and when it’s 10:00 pm, i drink a beer. and they stand there looking at me like it’s so cheeky of me to say that.” in eva’s case, sleep is rather unproblematic and something that does not require any type of intervention. not being able to sleep once in a while is not a cause for any concern or irritation, nor is it necessarily indicative of missing out on something valuable. she sees sleep as something that has a life of its own and is not something to be controlled. the same applies to her approach to the body as a condition that is as it is. as such, agency does not center in the body as a potential that can be fulfilled through the ‘proper’ strategy in eva’s own sleep engagement. http://anthro-age.pitt.edu/ larsen & holen | 112 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu effective relations across medical and everyday categories arranging her everyday life based on the health conditions she has—and thereby not articulating them as limitations or complaining about them—is a form of self-preservation that is part of eva’s explanation of why she manages well. not only has she always wanted to take care of everything on her own, but she also believed that she could. she thinks this stems from her childhood, growing up as the eldest daughter with three younger brothers. because her mother was ill and often hospitalized, she was almost like a mother to the others. additionally, she helped her father with finances. when she had hip replacement surgery a few years prior to our interviews, eva explained that she was not offered rehabilitation. she enjoyed a good post-surgical outcome and her ability to handle things on her own and in her own way becomes her explanation of the good outcome. she compared her own patient trajectory with that of a friend who had received rehabilitation offered through her municipality after the same type of hip operation. eva concluded that her own outcome was better than if she had participated in municipal rehabilitation: “when she [eva’s friend] was still walking very badly, i was walking really well.” eva did not adhere to the hospital approach to managing rehabilitation, which is illustrated by the following excerpt from the field notes after a conversation with eva during her hospitalization. at that time, eva was close to being discharged, and she drew upon the positive experience of doing things her own way: “now it’s about me,” she says. i wonder what she thinks it has been about so far. i ask her. she has difficulty explaining it, she says, but makes a movement with her arms as if she is pushing something away. now she just wants to get out, she says, and do her own thing.” eva’s practice is a matter of what she thinks will improve her life as it is now, but the fieldnote indicates that this is not what she finds the institutional instructions addressed to her to necessarily be about. eva does not try to change her body, but with actions and everyday rhythms and routines, she adapts her environment to her body. in this way, she builds the capacity to create effective relations or new arrangements in her everyday life. she creates rehabilitation through effective relations motivated by self-confidence—this is a subjectivity that is strengthening engagement in a de-territorialization (deleuze and guattari 2005) of a medical discourse on sleep management. prescribed sleep management of not drinking and smoking in the evening becomes, on the contrary, a constraint for the capacity to create effective relations; this is why eva sticks to her own ways of organizing sleep. one may say that eva enacts the concepts of independency and responsibility for her own situation, representing the socially affirmative relations and norms concerning patient engagement as presented initially. the enactment of independency and responsibility provides eva with an opportunity to reterritorialize (deleuze and guattari 2005) her body in the medical discourse on rehabilitation. however, this re-territorialization is also a process through which she simultaneously confirms her sleep through medical-related ideals of sleep. even if she defies health recommendations by maintaining her practice of smoking and drinking alcohol in the evening, eva as well argues for these habits as relaxation, which medical discourses recognize as being conducive to sleep quality and uninterrupted sleep. sleeping through the night is also a standard to which eva adheres. although sleep is something that eva just does and does not immediately experience as a matter of concern or special interventions, she also finds that she is sometimes overpowered by sleep during the day, as she told me during the third visit. she characterized this as involuntary sleep and problematized it. for her, sleep and everyday life are structured according to certain set times. with calm and contemplation, eva’s evening ritual in the kitchen lasts for approximately two hours, which is why she goes to bed at 12:00 am and perhaps reads a little. even if she goes to bed at 12:00 or 1:00 am, she gets up early at 6:00 am. she again sits and http://anthro-age.pitt.edu/ larsen & holen | 113 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu enjoys the quiet; she has a cup of coffee in the kitchen and eats some breakfast. she sits there until around 9:00 am, after which she gets dressed if she needs to go into town; otherwise, she sits in the kitchen until 12:00 pm. she does not only sit there because she thinks it is nice—she specifically sits in her kitchen chair to avoid falling asleep. she waits until 12:00 pm before she goes into the living room, where she eats lunch and later dinner in her recliner in front of the television. however, she often falls asleep here after eating, which makes her extremely unhappy. she does not think it can be good for her to sleep so much over the course of the day. thus, the qualitative time-space she practices early in the morning and late in the evening does not give her many hours during which to sleep she nonetheless thinks there must be something wrong since she just falls asleep throughout the day, against her will. therefore, she wants to speak to her doctor about it. for eva, sleep is concomitantly unproblematic and problematic. it is something that is as it is and not subject to control but, nonetheless, it becomes problematic when it occurs during the day. eva’s sleep engagement can be seen as a de-territorialization of the body from medical discourses that promote sleep as a health practice and through which the body can be optimized. however, sleep during the day is pathologized by eva, as also represented through the sleep-hygiene rules in which napping is something to be restricted. the midday nap is represented through her perspective as an outdated category connected to ‘elderly people’. as such, medical concepts of sleep might reject a concept of aging associated with daytime napping affecting evas identification and concerns. the following sleep engagement is an example of explicitly disassociating oneself from the image of aging linked to being more tired. sten’s narrative: “no, no, i don’t use it at all. i don’t use it at all” sten, age 78, underwent two hip replacement surgeries a few months apart. he has also lived for many years with back pain due to a sports injury and later hip pain as a result of osteoarthritis. because of this pain, he has had to reconfigure his life in several ways. for example, he had to stop participating in sports, which had been a very important part of his life, he had to move from a house with a garden to an apartment in town, he had to take pain-relieving medication for many years, and he had to reduce his travel activity. unlike eva, who acts with her body as an everyday barometer against which she coordinates her activity, sten has more difficulty accepting that his life is changing because of his body. sten’s rehabilitable and potential body sten is used to being able to achieve the goals he sets for himself by adopting the right approach and mindset. he nearly lives by the motto of ‘control and discipline.’ for example, he told me during the third visit: “i’m probably one of those people who, if you make a decision, then it tends to apply to every other thing in life as well. everything else is just nonsense,” and “there are two types of people, those who get moved around and those who move others around. and you can decide which type you want to be.” unlike eva, the bodily changes for sten are not merely an accepted development that determines what shape life can take, even if he says, “and then you try to get the most possible out of it (life with bodily changes) in some other way, but it’s still difficult, isn’t it?” two hip-replacement procedures have strengthened sten’s approach to control and discipline. he talks about an active life filled with sports, travel, and professional responsibilities, but that is now changing because of bodily changes, which are significant consequences not only to him but also to his family. one experience in particular “broke” him, as he told me in an interview. he recounted the time when he had to interrupt a vacation because he could not walk around. the experience he described is full of guilt and shame towards his family, who had arranged the trip. this guilt can be related to a sense of http://anthro-age.pitt.edu/ larsen & holen | 114 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu not having done what was planned, doing too much, or doing it the wrong way. he said, “i’ve played handball, football, and table tennis, and i have been on zealand’s [a region in denmark] premier teams in both handball and football. but, on the other hand, this is perhaps also the type of thing that contributed to the deterioration [of my joints].” as a result, he indicated that he is personally responsible for the way his body is today and that he had failed to maintain his health competence (fristrup and munksgaard 2009). by doing so, he deprived himself and his family of some opportunities. in this sense, sten positions physical decline as something shameful. however, in relation to his two hip-replacement procedures, sten realized that doing exercises at home, with which he is highly disciplined, in combination with participating on the municipal physiotherapeutic rehabilitation team for patients who have undergone hip surgery, have given him a new opportunity for control—particularly control over his body through muscle-building. he remarked, “the thing i think is important is to keep your muscles fit, so you don’t just fall apart and think, ‘well, i don’t give a damn about this anymore.’” he suggested that his efforts were useful, which is why he wants to continue with daily strength-training for the rest of his life: “i would like to go as far as i can with this, and there’s no doubt that exercise is something i will do for the rest of my life. . . . there’s no reason to believe that when you get old, or very old, that you can just say 'that's fine enough.’. . . no! it’s exercise once a day at a minimum.” with this, sten also indicated that becoming older and weaker is not an excuse to ‘take it easy’ and to withdraw from engaging in optimizing one’s possibilities as a potential for agency he locates in the body —for sten, this engagement with exercising is forever. sten identifies with the responsibility that has been institutionally assigned to him through the patient trajectory—a responsibility that involves taking the initiative for activity as an institutional category of practice that is related to optimization of the body. at a pre-surgery joint seminar, the surgeon jens explained to those to be operated: “the bed is a dangerous place—get out of it. the studies show the sooner, the better.” like this surgeon, sten identified the bed as a threat: “it can’t do any good to just lie there and just say, ‘now, i’ll just stay in bed’ and so on. that’s not how it is. it’s a question of getting up—it’s about getting up and getting started with these things.” however, sten underlined a contradiction—it is not only about getting up, as also stated by marianne the physical therapist at the seminar. she said, “you may become tired, lie down and rest your legs several times a day.” hence, sleep and rest are conveyed as a central element in hospital discourse on rehabilitation, but it is not merely addressed as a matter of sleeping as well and as much as possible. rather, it is a matter of coordinating sleep and rest in the correct way so as to fully tap sleep’s potential as a tool to improve the patient’s mental and physical capacity in rehabilitation. although he engages in this rehabilitative concept of sleep potentiality, sten illustrates how hard it is to succeed. sten’s sleep management it is difficult for sten to accept that the body determines how life can take shape. he also struggles with accepting that his own body cannot comply with the health-promoting recommendations that he witnesses in his everyday life e.g. through friends and media and through interactions with healthcare that he wants to follow, such as with sleep. he said, “my only problem is that—and this happens to everyone—i have to get up several times at night to use the toilet. it’s a moment of irritation because i never get eight hours of sleep. i get sleep in two-hour increments, you see, and it’s a problem.” according to sten, eight hours of uninterrupted sleep is the ideal against which he measures his own sleep. even though sten experiences the consequences of not getting consecutive hours of sleep (being tired during the day) which irritates him, he does not take a midday nap: sten: no, i don’t sleep at 12:00 pm. i’ve actually wondered whether i should sleep a little at 12:00 pm, but i never really get to it. http://anthro-age.pitt.edu/ larsen & holen | 115 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu tl: why do you think that might be? sten: yes, i could just go in there, but . . . it’s not like, i could just go in and take a nap and say, “now, i’ll just lie down for an hour and a half” and then be done with it. it would be easy . . . but then you also want to be able to fall asleep in the evening and sleep through the night, right? sten considered a midday nap to be a possibility in his everyday life, but he did not do it because he was afraid of how it might impact his sleep at night. the midday nap, which he actually thought could be necessary, thus became one of several elements that might theoretically disrupt his ability to fall asleep or sleep through the night. as such, the thought of a midday nap had a controlling effect over his actions. preventing something that might be disruptive is an approach that was also mentioned in the interview: sten: we drink a lot of coffee at home. and we probably drink too much of it, but we’ve started to drink less at night, i have to admit—much less than we used to. tl: why do you think that is? sten: it’s just because i heard someone say that we won’t be able to sleep at night, so we don’t drink coffee—we don’t drink coffee after such and such a time. these preventive actions are not based on personal experience but rather on sten “hearing someone say” something. sten changes his actions according to something that may give him sleep-possibilities rather than based on actual experiences of sleeping better if drinking less coffee. in his statement, “we probably drink too much of it,” he also refers to the fact that there might be an additional health promotional and rehabilitative potential in drinking less coffee. as such, it becomes something he ‘should’ do. similarly, based on the idea of a defined amount of sleep that he should have, sten thinks that he should prioritize the time at which he goes to bed a little differently. we actually go to bed rather late; i have to admit. we go to bed between 10:00 pm and 12:00 am. and 10:00 pm is very early right now, but . . . or it’s very early in general, i should say. it’s probably between 11:00 pm and 12:00 am, at some point, when we go to bed. and when it comes down to it, that’s probably a little late. it should probably be 11:00 pm, in any case, instead of 12:00 am. paradoxically, sten was irritated by the fact that his body does not allow itself to be controlled, such as in the case of night-time urination, which interfered with his ‘you can get what you want if you work for it’ philosophy. he was frustrated by his inability to control his will during the night. thus, it was a dilemma for him that, following his hospital discharge, his legs needed rest throughout the day when activity was the very thing that he considered important to do. he illustrated this dilemma in the following quote, in which he sarcastically emphasized the first part of the sentence and—with a sense of acknowledgment—inflected the last part, saying, “even if i fully know they (healthcare professionals) say, ‘just get moving, just get moving’ (sarcasm), it’s all about just getting moving (recognition).” with this, sten both disassociated from and acknowledged the expectation of activity in his patient trajectory. effective relations: across normative and medical categories at the joint pre-surgery patient seminar, the physical therapist marianne emphasized an increased need for sleep and rest in rehabilitation, while simultaneously suggesting that they must be carefully balanced by standardizing the increased need for sleep that an operation produces: “you will get exhausted and have an off-day where you might not be able to exercise three times a day, but only http://anthro-age.pitt.edu/ larsen & holen | 116 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu twice. then it gets better the following day.” in her view, an increased need for sleep is not an obstacle to a training opportunity—in any case, there might just be a single day when the training can only be done twice instead of three times. yet, she stressed that after this little break one will bounce back and be able to perform optimal training again. there appears to be an implicit concern that orthopedicsurgery patients see themselves as sick and associated with having to stay in bed and get a lot of rest, which is why an increased need for sleep is recognized but at the same time emphasized by healthcare professionals as something to be minimized. sten’s narrative illustrates the dual nature that is embedded in sleep as a potential homework assignment in post-operative rehabilitation. sleep is an individual bodily event and biological force. when placed into a rehabilitative management context connected to medical concerns of recovery, sleep is expected to be practiced and controlled in ‘the right way,’ with the promise to achieve health-promoting potential of the body. this concept of potentiality can be examined through a health-policy lens. here, the patient’s rehabilitative change process should lead to an improved level of bodily functioning that allows for active agency and independence. independence is precisely the objective sten hopes to achieve; he would like to postpone or avoid having other people “take over,” as he told me. the body becomes the means for this independence, which is why the body needs to be controlled. resting during the day can take time from the most important thing—activity—which can be seen as a lack of will or control, and perhaps even be associated with laziness. in the following interview excerpt, sten rejected the midday nap and he emphasized the idea that a midday nap is something he can choose to forego. sten: no, no, i don’t need the nap at all. i don’t need it at all. it’s true that right when i came home [after hospital discharge], then it was really nice to lay down to sleep for an hour or so. that’s over with now. that was a long, long time ago. tl: it’s not something you used to do in your normal everyday life before the surgery, either? sten: no, no—i could have done it if it were necessary, but it wasn’t like that. not anymore. that’s over with. while eva associates daytime sleep with the notion that something is medically wrong, for sten, daytime sleep is perhaps associated with laziness and is thus something that one can choose. according to sten, daytime sleep is almost something that can only be legitimized through illness and daytime sleep is something sten chooses to distance himself from when it is no longer a question of having recently undergone an operation or being affected by complications such as diarrhea due to analgesic treatment, which left him very exhausted for a week after the operation. in this example, another dual nature regarding sleep is mobilized—one in which sleep that does not take place at night is for sick people and, if one is not sick, then sleep is for lazy people. for sten, sleep is something that can be optimized—not because ‘a good night’s sleep’ is a goal in its own right, but because it can become a means to something else, such as preventing disease. sleep can also support his ability to exercise and therefore prevent decline, which can lead to being able to maintain or improve his independence. routines and arrangements are therefore established in another way—in order to make the best possible conditions for sleep. for example, sten avoided watching nighttime television shows that might have an emotional impact on him. if he needed to get up during the night, he used a flashlight so that a more intense light would not wake him up too much. the key point is that sten’s sleep was planned in advance—unlike eva, for whom sleep was something that simply is and was unproblematic. in sten’s case, however, sleep was something to be protected and http://anthro-age.pitt.edu/ larsen & holen | 117 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu promoted through control and discipline. with his sleep engagement, sten enacts a notion of potentiality also represented in medical discourses of rehabilitation in which control and discipline enable a person to shape their body and strengthen independency. engaging in a bodily optimization with the promise of independency sten builds relational capacity. but, at the same time, these engagements frustrated him because his body disrupted his plans for what he wants, and he consequently felt guilty when it was not possible for him to engage in certain activities. he also felt frustrated when he had to adhere to conflicting rehabilitative logics about both training and sleep and rest. in this way, sleep as a medical defined homework assignment and potential may both close and open sten’s capacity to form effective relations that mobilize resources in his everyday life. in the following case, we illustrate how the physical changes generated by disease and/or trauma neither can be included as a part of an obvious and everyday engagement or as an engagement in which sleep takes place as a rehabilitative potential that can be managed. here, the non-rehabilitable body is created, but sleep is also included in an effective relation that is a matter of preserving authority in repudiation of institutional requirements performed by both hospital and the municipal services and standards for health behavior. henning’s narrative: “this is not for us” henning, age 72, was hospitalized in the acute orthopedic unit for a week after breaking his pelvis. against medical advice, henning discharged himself from the hospital early, and he did not want to go to a specialized centers for respite care because he could not afford to go there and because his wife could not join him. henning’s general weakness and pain after hospitalization and recovery for his pelvic fracture made him extremely tired, and he slept frequently following his discharge. municipal services supporting him in the home after discharge installed a hospital bed in his home, so he could get into bed on his own and avoided disturbing his wife connie, when getting up at night to urinate. however, at the time of our interview, the municipality had removed the hospital bed from his home why he was sleeping on the sofa in the living room. according to henning, the reasons why the municipal service retrieved the bed and other kinds of equipment were because the municipal authorities did not believe that he still demonstrated a need for these assistive devices since he was not complying with the hospital’s recommendations. he gave the example, that he was walking around even though the hospital staff told him to try not to support his own weight until six weeks after surgery. however, he was walking because he experienced he was capable of doing so why he also suspected the healthcare professionals of imposing on him unnecessary restrictions as an act of power. henning’s non-rehabilitable and non-potential body even though henning and connie took midday naps together every day at fixed times, sleep was not a delimited event in henning's life after hospital discharge—instead, it was rather fluid. he spent most of the time on the sofa in the living room, drifting in and out of sleep. eight months after discharge, sleep was still something that filled much of his everyday life, especially because he was bothered by abdominal pain and chronic lower-intestinal disease, the symptoms of which worsened after his orthopedic hospitalization. regarding the sleep-hygiene rules, connie told me: “this is not for us.” with this, she meant that their various chronic disorders—such as diabetes, copd, osteoporosis, lower-intestinal disease, and complications after hip and pelvic fractures—would prevent them both from practicing the healthpromoting sleep hygiene rules regarding exercise, fresh air, no napping (or only very briefly), no eating before bedtime, etc. with these sleep rules, sleep becomes a potential for health—but, as henning and connie saw it, they are only for people who are already healthy. she problematized what psychologist http://anthro-age.pitt.edu/ larsen & holen | 118 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu niels christian nickelsen has also problematized; i.e., standards are attached to concepts of normality that create order for those with standardized—or here, potential—bodies, yet they create problems and exclude others with non-standardized or non-potential bodies (nickelsen 2008). henning’s sleep management for henning, sleep was neither something that is just figured in as a balanced part of everyday life like it was for eva, nor was it something that he problematized as such. sleep was also not something he could organize into a rehabilitative-potential perspective, defined by medical and institutional rationale—rather, it was something to which he must surrender in a bodily sense, day and night. sleep also proved to be an accessible strategy henning used to ‘check out’ whenever something became unpleasant or difficult. whether it was pain, arguments with connie, or when the demands of the municipal services or hospital were difficult to fulfill, henning explained: henning: i’m more tired now. i’m more tired. i don’t do much, and if i were to lie down now, i could easily sleep until 3:00 pm, and it wouldn’t bother me a damn bit. tl: but you don’t do it, or . . .? h: yes, i might definitely do it. once you’ve left, that is. connie: or, let me put it a bit differently. if there is anything bothering him, then i have to deal with it, and he just lies there, and then drifts off . . . h: yes, i just lie down. i don’t like to argue, so i just lie down and sleep, and then you all can just disappear. for henning, there is also a social potential in sleep as the possibility to escape both private and institutional demands. effective relations: a de-territorialization of medical and institutional categories several times during our interviews, henning circled back to the importance of making his own decisions. he kept on top of patient law, about which he also advised his neighbors and referred to terms such as “self-functional,” he said: as long as we do not present a risk to others or ourselves. and we aren’t – we get the food and care that we need. we’re not a danger to ourselves or others when we can manage ourselves, so we are self-functional. we can handle it ourselves. so, people are actually allowed to say, “no, thank you.” . . . it’s what the law says today, and that’s what we choose. they cannot make decisions for me—not when i’m self-functional. although it is henning’s legal right to opt-out of hospitaland municipal recommendations and offers, he found it strange that opting out can have consequences. for example, he was convinced that the hospital did not want him to come in for a follow-up x-ray of his pelvic fracture because he had discharged himself against their recommendation. for henning, sleep is something that just happens and to which he has to surrender, but it also becomes a conscious way of distancing himself from institutional requirements and other difficulties he experiences in his life. therefore, it can perhaps be seen as though he is not engaged in forming relations with the world. but, on the other hand, this sleep practice can also be seen as a re-territorialization through an engagement that can realize self-determination and where power over the body is reclaimed from state and municipal institutions. the modes of ordering creating a medical pedagogy of sleep that requires a special form of engagement deprives henning of the opportunity to legitimate his actions, http://anthro-age.pitt.edu/ larsen & holen | 119 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu and the hospital and municipal requirements thereby obstruct his ability to create effective relations. sleep as something one can tighten down through control or change through one’s evening routines is not an option. hennings sleep practice cannot be formed to the medical notion of active engagement with the potential to optimize the body and hereby give him independency. but, at the same time, sleep becomes an effective relation that, like a body-based resistance and position allowing for self-authority. the desire that guides henning to build relational capacity thus becomes authority or integrity (bakken 2020), and an option of de-territorialization of the medical logic; for him, it is a connection that does mobilize agency. henning cannot optimize his body, it is non-potential from a medical perspective. with the notion of ability proposed by among other ingunn moser, this non-potential body gives him fewer possibilities of action and of participation, however, henning creates a body of resistance destabilizing an institutionally sanctioned subjectivity of the ‘good patient.’ effective relations and becoming subject the three sleep engagements we have described in this article point to the different ways in which effective relations are created, and how they are mobilized (or not) by the institutional expectations of sleep as an ideological practice and homework assignment in post-operative rehabilitation. referring to sociologist pierre bourdieu’s concept of habitus, buch argues that humans have different embodied dispositions created through different backgrounds and generational histories (buch 2018). the consequence of embodiment connected to ideological practices formed through modes of ordering is that, when those from non-dominant groups fail to embody the habitus of more powerful groups, embodiment is used to justify their disadvantage and exclude them from opportunity (buch 2018). our analysis here suggests that rehabilitation is formed as a biomedical neoliberal practice as the ideological practice that creates different bodies and thus different opportunities for inclusion in the subject position of ‘engaged patient and responsible citizen,’ which is linked to full social participation. our analysis also indicates that some patients, through their engagement, must free themselves from these subjectifying forces and power structures in order to create effective relations. through this process of de-territorialization, patients create new bodies, as the everyday body and the body of resistance, and new forms of social participation. in doing so, they destabilize the medical/institutional category of engagement (deleuze 1994; deleuze and guattari 2005). the first sleep engagement (eva’s case) illustrates how sleep and the body are included in an everyday relation with built-in distance to medical and institutional categories. but, at the same time, it is an engagement that simultaneously draws upon medical concepts—not only in conjunction with its legitimization but also its problematization. the other two sleep engagements (sten and henning’s cases) characterize engagements that, each in their own way, differ from eva’s sleep engagement. in sten’s sleep engagement, sleep and the body are directly connected to medical categories of sleep as rehabilitative potential, while in henning’s sleep engagement, sleep becomes a means of deterritorializing the body from the medical rehabilitative potential. throughout these three different sleep engagements, bodies come into being in the relation between everyday life and medical and institutional categories as well as through the individual’s embodied biographical practices. therefore, the ways in which these changed bodies are incorporated in the formation of relations also differs. in eva’s everyday life, the body becomes one of the structuring forces that she does not consider to be beholden to institutional norms of sleep while, in contrast, sten’s body must comply with the requirements; he assumes the regimen of the body and sleep as potential. henning’s body becomes a ‘non-rehabilitable and non-potential body’ that cannot be directed and thereby optimized by a choice to do something in another way with regard to rehabilitative notions of http://anthro-age.pitt.edu/ larsen & holen | 120 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu controlling sleep. in contrast, sten’s rehabilitable and potential body can make napping something he can choose, and allow him to regulate eating or drinking if he wants, in order to sleep better. henning’s body cannot be adapted to the environment at all, as eva’s everyday body can, and still preserve the temporality of everyday life as she knows it. the non-rehabilitable and non-potential body cannot be directed. through his non-rehabilitable body, henning’s self-determination is consolidated in his encounters with the healthcare and municipal systems and, for him, sleep becomes an opportunity to preserve authority as a biographical force that guides his ability to create relations with the surrounding world. henning’s sleep engagement mobilizes resources in everyday life but in a very different way than in the other two sleep engagements. elena buch emphasizes, as we also suggest here, that “embodiment is ongoing across the life course, as people engage in intertwined biological, environmental, and social processes” (2018, 133). she calls embodiment, “bodily continuity” (buch 2018), which refers to both the present and the past. based on the concept of engagement that we have described here with reference to deleuze and guattari, rehabilitation is about creating effective relations, and that which is effective is tied to—but not determined by—the embodied dispositions and bodily continuity. we demonstrate that creating effective relations, therefore, does not become an issue that can be defined by the degree to which the knee can bend but rather by the degree of disrupted continuity and new acquisition. acquisition is not dependent on the body ‘regaining’ its former physical form (buch 2018), but it requires a body that, in its transformation, can create new relations with its surroundings, and in which the person can recognize him or herself and thus everyday life. what is essential to focus on in these three engagements is that sleep occurs as an effect of the various and embodied biographical ways that people are included in relations with their environments, which is why sleep and the potential embedded in it must first and foremost be seen as connected to a long life and then to a patient trajectory. this analysis suggests that what directs the formation of these relations has its own biography/historicity but a biography/historicity that is also created through institutional categories. we see these institutional categories enacted through the patients’ affirmations, reand deterritorializations. in different ways, eva, sten, and henning incorporate the institutional dichotomies of active and passive engagement into the way they connect sleep, health, and aging. both eva and sten associate daytime sleep to a notion of passivity, and the opposite, activity, becomes, for eva and sten, either a right or a duty. when eva is unwillingly overpowered by sleep during the day, it prevents her from being the active person she identifies with. to her, daytime sleep becomes a medical concern and not a natural part of aging. for sten, staying active and not giving in to daytime sleep is a choice. it is also a matter of moral engagement in his recovery trajectory because he can demonstrate that he is not being a “passive citizen” (mikkelsen 2019); he does not give in to sleep but keeps on working to improve his musculoskeletal system which cannot be done while sleeping. through their different discursive-material sleep practices, we argue that sten and eva subjectify to the discursive context of health as active aging. from a medical perspective, henning enacts sleep as a passive form of engagement in relation to going to sleep when demands are put on him oposed to a notion of actively engaging with them. however, for henning this enactment is a way to resist this normative and unequal understanding of engagement as either active or passive or potential or non-potential and of this being a choice or something he lacks motivation to do; as such, this sleep-practice can be characterized as a political act (mikkelsen 2019) that demonstrate that he doesn´t subjectify to this concept. when sten’s sleep engagement matches institutional expectations, it is because his approach to practicing sleep corresponds to the way he is historically directed through changes. the historical practice of disciplining himself and working hard to enable himself to remain in control of the situation he has confirmed to be effective throughout his patient trajectory. the same thing may also apply to http://anthro-age.pitt.edu/ larsen & holen | 121 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu henning. the institutional categories of sleep as a homework assignment and potential reinforces his lack of opportunity to legitimize his body and his practices. on the other hand, henning’s sleep engagement acts as a retaliation to the institutional approach; here, as a desire that directs his engagement, his authority is preserved. our analysis of ‘becoming subject’ thus demonstrates how we live “alongside, through, and despite the profoundly constraining effects of social, structural, and material forces, which are themselves plastic” (biehl and locke 2017, foreword, x). as these sleepengagements show is that how and by what they are directed is an enactment of biographical forces, not understood as definitive, that themselves are effects of social, structural and material forces affecting the building of new arrangements. with this perspective on rehabilitation, we cannot make a linear cause-effect explanation, as represented through biomedicine, of how the building of new arrangements are mobilized or what they should be constituted of. conclusion sleep is increasingly addressed by media, consumer markets, and through healthcare interventions as a matter of concern regarding health and prevention of disease. in institutional rehabilitation practices, sleep becomes a homework assignment based on an idea of sleep as a particular type of potential. this movement makes sleep a rehabilitative task with an integral rehabilitative potential that patients are expected to achieve through the correct behavior, coupling sleep with patient engagement in postoperative rehabilitation. in this article, we consider sleep as an activity that, through the recovery trajectory after orthopedic surgery, is instrumentalized and transformed into rehabilitative homework in which the conditions for optimal rehabilitation can be fulfilled. the institutional concept of sleep potential connects sleep to a concept of passive and active engagement. however, drawing upon deleuze and guattari’s (1994, 2005) concept of engagement, we find that the patients in this study cannot be viewed as passive and predetermined. our analysis suggests how patients’ sleep practices are always an active and motivated socio-material engagement in creating effective relations that, in various ways, serve to mobilize resources in everyday life. however, these relations are also influenced by biomedical health categories co-creating institutional categories of engagement and potentiality. these categories create different types of bodies and agencies—for some patients, these categories have a conducive effect with respect to creating effective relations while, for others, it has the opposite effect. although it is stated in this article that patients’ sleep practices are always an active engagement in creating effective relations the way arrangements are made possible and the way in which the elements are linked to one another do not always correspond with institutional expectations of mobilizing forces. however, living up to institutional expectations for what it means to be an engaged patient can be followed by shame and a guilty conscience, as seen in sten’s case, or by retaliation with exclusion as a consequence, as seen in henning’s case. however, another position emerges that can both present an opportunity for self-recognition through practices and the fulfillment of institutional categories, as was the case for eva. with a relational perspective on post-operative rehabilitation and engagement, sleep as a homework assignment can be seen as a type of becoming that opens up possibilities for action—but perhaps not always the kind of action that fulfills institutional expectations. notes 1. with the concept of sleep as a practice, we include ‘resting.’ one can rest without sleeping, but these two practices often flow into each other and are difficult to separate. when patient engagement is considered to be ‘not active enough,’ rest and sleep are often put together in one category. http://anthro-age.pitt.edu/ larsen & holen | 122 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.284 http://anthro-age.pitt.edu references aasvang, eske, iben engelund luna, and henrik kehlet. 2015. “challenges in postdischarge function and recovery: the case of fast-track hip and knee arthroplasty.” british journal of anaesthesia 115 (6): 861–66. https://doi.org/10.1093/bja/aev257. andersen, signe lindgard, maja pedersen, and vibeke steffen. 2016. “diabetic foot ulcers and the logic of choice.” ewma journal 17 (1): 23–29. bakken, runar. 2020. alle vil leve længe, men ingen vil blive gamle. 1. udgave. frederiksberg: 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university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | tripathi | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.297 http://anthro-age.pitt.edu 259 book review review of biggs, simon. negotiating ageing: cultural adaptation to the prospect of a long life. routledge. 2017. pp 178. price: $159 (hardcover); $55.00 (paperback); $50 (ebook). ashwin tripathi indian institute of technology, gandhinagar ashwin.tripathi@iitgn.ac.in negotiating ageing: cultural adaptation to the prospect of a long life, authored by simon biggs, presents us with a quintessential reading of contemporary developments in the field of social gerontology. interested in social identity and adult aging, biggs advocates for a life course perspective, generational intelligence, and an analytical focus on cultural adaptation and negotiation in this book. he presents us with a nuanced understanding of aging and pragmatically embeds his analysis within contemporary societies. furthermore, the discussion is enhanced with analytics at the intersection of psychosocial, politico-economic, and social-constructivist approaches. it is a truism that the world is growing older. this increased longevity, induced by medical advancements and improved health care, has in itself caused structural shifts: growing commodification of bodies, increased social inequality among older adults as well as many other socio-cultural, biological, and ideological changes. this publication invites the reader to explore the aforementioned changes as they affect the aging demography across cultures. this becomes both interesting and exciting when generations are bearing an almost equal number of individuals. in examining the cultural negotiations of older adults, biggs elucidates four major areas in the narratives of older adults: work, spirituality, body, and family. the book centers two questions: (i) what is the purpose of a long life? and (ii) how do we adapt to societies where generations are approximately the same size? biggs asks these questions at the intersection of premature answers developed in contemporary policies related to older adults in an expanding anti-aging industry, in older adults market segments, and in critical approaches to family relationships. these developments destabilize the traditional imagination of old age as consisting of predominantly weak, feeble, and dependent adults. in ‘aging’ societies, multiple scripts for negotiating the life course emerge. this negotiation in the everyday lives and subjective experiences of older adults, is the focus of study throughout the book. the initial chapters (1 and 2) set the background and identify the key tropes in contemporary thinking about aging, such as the rapid demographic changes that have marked the transition from 20th to 21st century, and concomitant cultural shifts in the meaning of a long life. these changes are a global phenomenon, across all rich and poor societies, which implies addressing global aging as primarily a process of cultural adaptation (world economic forum 2012). thus, critical questions arise as to which adaptations suit which interests. biggs mainly provides analytical (and pragmatic) tools from the field of gerontology, for exploring these negotiations. he argues that intergenerational competition with http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.297 http://anthro-age.pitt.edu 260 regard to productivity and economic inequality, has distracted scholars from cultural uncertainties that come with the expectations of a long life. he also explores the cultural meanings attributed to aging and later life, and the possibilities for self-realization. here, biggs advocates for a more holistic discussion, that takes into account all aspects of life and calls for a more subjective understanding of personal experiences of aging, intergenerational negotiation and a re-evaluation of the contribution of older adults. thus, he brings us to the crossroads of our structural and personal worlds, exactly where he suggests that gerontology can provide tools to understand the world and ultimately act upon it (8). the author prioritizes the negotiations and cultural adaptations on the level of everyday identities and experiences of aging, through which older adults give purpose to their lives in increasingly complex intergenerational networks. as the title reveals, he encourages readers to see how ‘negotiation’ requires creating critical distance between ourselves and the stories we are being encouraged to live by. therefore, this work is premised on finding possibilities for the future, rather than immersing in or critiquing pre-existing assumptions. throughout the book, biggs suggests to examine life trajectories of older adults within structural, social and cultural contexts, and in this regard brings to the fore “life-course specificity” and “generational intelligence” (15), as the nodes along which personal and social priorities are negotiated. the book moves back and forth between highlighting the different ways dominant narratives shape our expectations of aging, and the possibilities for personal expression at the margins of common sense. simultaneously, the book elaborates on major themes, theories and discussions in gerontological scholarship. chapters 3 and 4 discuss the complex relations between work and aging, following two threads: a shift from active aging to productive aging, and a critique of the disempowerment of older adults through forcible exclusion from working life. according to biggs, work here does not appear as an adaption to a longer life at all (41) but is nevertheless foundational to the emergence of the category of the ‘third age’ that capitalizes the increased spending power of ‘active agers’ and consecutively relegates decline to the ‘fourth age.’ however, although the exclusion of older adults from the job market can easily be diagnosed as ageist, at the same time, it has also provided them with opportunities for “positive discontinuities” (19), where they experience more time for leisure, for family, and for their overall wellbeing. chapters 5 and 6 thematize ‘spirituality’ in old age as an in-between or liminal phase. this dimension counters the common sensical western perception of elders as predominantly feeble and weak, because integrating spirituality allows us to value how aging implies an awareness of oneself, in oneself and in relation to others. ‘spiritual aging,’ relies heavily on the power of discontinuity. both – changing perceptions of old-age and a growing focus on spirituality – have been explained in a broader ambit of late modernity characterized by uncertainty and insecurity, where all is susceptible to revision and renegotiation. chapter 6 briefly discusses the influence of consumerism on changes in spiritual practice and on the renewed interest in humanism. these changes are characteristic of contemporary identity management, emphasizing interchangeability and choice. he further probes “gerotranscendence”: a process in which self-conscious individuals in consumer driven societies can freely choose from a range of traditions to give meaning to a prolonged life. both spirituality and gerotranscendence are here presented as an alternative cultural narrative, that fully integrates the prospect of a long life, that provides answers for what could be its purpose, and that supports the adaptation to changing intergenerational relationships. chapter 7 follows the ‘somatic turn’ (gilleard and higgs 2012) in social gerontology. this highlights the historical tensions between biological and social models of aging and the increasing interdependency http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.297 http://anthro-age.pitt.edu 261 between biological, psychological, and social aspects of the aging process. as the body emancipated from the field of biomedicine (e.g., in cultural gerontology), a biopsychosocial lens now prevails and new and critical ways of asking questions about agency of older adults emerge. the growing commodification and successful aging paradigm tap into the anti-aging market, which presents itself as anti-establishment but tends to carry on the age-old discussion of “liberating oneself from old age” (gilleard and higgs 2005). the successful aging paradigm (rowe and kahn 1998) supports the neoliberal ideals of individuals to be blamed for their lack of health, leaving social and political institutions absolved of their responsibilities. in the end, the resource rich, who can afford this investment in life extension, are the beneficiaries of this ideology. summarizing the aforementioned critiques, biggs concludes that the purpose of life is beyond work and continued consumption of antiaging products and life-styles (chapter 8). chapter 9 in turn provides evidence against the prolongivists (who argue for a bright future in extending life as long as possible), where he discusses the other side of aging that makes individuals socially and personally vulnerable, for example when considering dementia. he considers dementia as a threat to long life, making older adults increasingly at risk. the discussion throws light on the need for including older adults in mainstream societies and on the burden of emotional labor experienced by their informal carers, which in turn leads to commodification of care, time poverty, and social inequality. this book brings together multiple discussions and provides early-stage scholars in the field of age studies – anthropology, sociology, public health – as well as policy makers, a holistic read. the book is easy to read and understand, although there were some typos, word repetition (112) and sentence formations that were difficult to understand at a couple of instances. the chapters are well-connected, with each chapter beginning with a key themes’ pointer. as the author himself suggests, some areas (e.g., gender, age-friendly cities, and unpaid labor) could have been developed further. a larger discussion of intersectionality might have helped in providing a better representation of negotiations taking place at multiple levels. at the same time, and surprisingly as biggs discusses a global phenomenon, more culturally nuanced examples were missing. nonetheless, i agree, in this case, it was outside the scope of the research aims of this book. overall, the work is argumentative and opens up a range of diverse realities and negotiations. as an anthropologist, i look forward to more culture-specific narratives, which could benefit from this foundational research as a starting point. references gilleard, chris and paul higgs. 2005. contexts of ageing: class, cohort and community. cambridge: polity press. gilleard, chris and paul higgs. 2015. "aging, embodiment, and the somatic turn." age, culture, humanities: an interdisciplinary journal 2: 17-33. rowe, john w., and robert l. kahn. 1998. successful aging. new york: pantheon. http://anthro-age.pitt.edu/ book review review of kaplan, matthew, leng leng thang, mariano sanchez and jaco hoffman, eds. intergenerational contact zones: place-based strategies for promoting social inclusion and belonging. new york: routledge. 2020. pp. 332. price: $165.81 (hardcover); $55.26 (paperback); $49.73 (ebook). meghan joy concordia university meghan.joy@concordia.ca anthropology & aging, vol 42, no 1 (2021), pp. 167-169 issn 2374-2267 (online) doi 10.5195/aa.2021.345 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | joy | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.345 http://anthro-age.pitt.edu 167 book review review of kaplan, matthew, leng leng thang, mariano sanchez and jaco hoffman, eds. intergenerational contact zones: place-based strategies for promoting social inclusion and belonging. new york: routledge. 2020. pp. 332. price: $165.81 (hardcover); $55.26 (paperback); $49.73 (ebook). meghan joy concordia university meghan.joy@concordia.ca i am writing this review during a cold montreal winter and the pandemic has been raging, both keeping many of us indoors. for almost a year now, we have been out of contact with the places and people we love. this has been a time of reckoning in many ways, one of which is with rampant ageism in the form of neglect for the care of older adults: we must come to terms with why this profound dehumanization has occurred, and we must grieve. we must also imagine new paradigms of community and institutional care, of living, relating, and organizing that challenge loneliness and political apathy. this edited volume invites such an imagining through the concept and practice of intergenerational contact zones (iczs). its 27 chapters offer short bursts of playfulness and creativity. the case studies of iczs provoke much needed information-sharing and mutual learning for practitioners, community-builders, policymakers, planners, designers, and researchers across boundaries and borders. it is a timely and generative read, offering tangible insights for various audiences currently imagining and building those intergenerational communities and societies many of us desperately want and need. the editors, each immersed in the practice and theory of intergenerational place-making, conceptualize iczs in the introduction to the volume, urging readers already convinced of the importance of intergenerational programs to think more fully about how the settings in which these programs occur both deepen and sustain intergenerational encounters. under the flag of the icz conceptual framework, kaplan, thang, sanchez, and hoffman challenged chapter contributors to examine existing intergenerational programs through a “psycho-socio-techno-spatial” (2) lens. more concretely, they invited the authors to identify in their own fieldwork and practice how eight varying “physical, temporal, psychological (perceptual, cognitive, and psychosocial), sociocultural, political, institutional, virtual, and ethical” (6) dimensions can prompt and facilitate regular contact, understanding, and mutuality across generations. the book is divided into five thematic subsections (community life, parks and recreation, education, residential and family, and socio-political contexts). throughout these sections, the reader learns how seemingly ordinary and everyday spaces—a museum, a bus stop, a community garden, a beach, a barn, a library, an urban park, a rooftop, a university campus, a housing community—can be transformed into meaningful places that are socially informed and negotiated, leading to richer and more consistent http://anthro-age.pitt.edu/ book review | joy | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.345 http://anthro-age.pitt.edu 168 intergenerational encounters. sometimes such encounters occur in pre-existing but artificially transformed anchor institutions, and sometimes zones of contact are built from scratch. either way, we learn that iczs must be designed in a way that is both participatory and generationally informed, as well as intentional and fluid, as learning happens in situ. several chapters (2, 4, 10, 22) highlight how an intersectional approach to generational knowledge is also crucial; disclosing spaces of culture and heritage in societies with colonial histories and past and present socio-political conflict can be both harmful and healing. as iczs offer opportunities for each participant to sit with their own generational intelligence and trauma as well as that of others, their design requires careful ethical consideration. other chapters examine different practices and objects through an intergenerational lens, offering generative insights for how to place these materials—such as the japanese teapot (chapter 18), open fire cooking in south africa (chapter 2), and the palestinian olive tree (chapter 22)—at the centre of intergenerational pursuits. material culture draws the authors’ attention to the revival of traditions, indigenous economies, and access to food placed at risk by capitalism and geo-political conflict. most of the book’s chapters end with practical takeaways and speak to the ways in which varying dimensions of the icz framework foster intergenerational place-making. the final methods section of the book (256) is particularly helpful for readers working to create and sustain intergenerational settings. a core teaching is that participation is foundational to the process of mutual belonging, respect, and meaning-making central to intergenerational place-making and is a never-ending pursuit. facilitating participation requires a deep awareness of the goals of the intergenerational project and of the context of the project and the populations in question. chapter 23 operates from these principles and presents a toolkit for when and how to use tools like design charettes, oral histories, and mapmaking as blueprints for creative intergenerational action. however, certain contextual elements that are not so favorable to iczs or that have the potential to coop aspects of the movement to prevent its future flourishing are marginal throughout the text. neoliberal ideologies and material practices treat older adults as a costly ‘problem,’ children and youth as future labourers and consumers engaging in ‘self investment’ behaviour, and the middle-aged as labourers and caregivers for all (joy 2021). juggling these expectations across the life course can make life a drag as generations struggle for constant self-improvement and self-sacrifice. rarely do contributors of this book mention the potential of such intergenerational programming to place even more of these demands onto individuals, to remediate and legitimate cuts to collective care and provisioning. iczs require significant and sustained public investment in education and care across the lifecycle, in libraries, museums and parks, in bicycle and accessible transit infrastructure, and in public health care, rather than in exploratory pilot programs that are never extended. iczs—and the philosophies that motivate them—must engage in immanent critique of the role that they play in the de-institutionalization of care and the optimism placed on non-state alternatives. as chapter 5 on intergenerational cycling zones notes, we must also change the intention of activities in cities from purely functionalist movement to the joy of being out and about in space, at a leisurely pace. an intergenerationally inclusive attunement to space, thus, also requires ‘space’ for ‘time’ and ‘time off.’ chapter 7, on chinese urban parks, for example, highlights the importance of places both inside and outside the city that enable relaxation in nature, while resisting over-programming and development (83). this, and other chapters such as the one on australian pools and beaches (chapter 21), speak to how urban entrepreneurialism and real estate speculation limit the availability of public space and investment needed to create iczs. while the book clearly advocates for interdisciplinarity in academic research and in practice to build iczs, politics and policy are addressed more rarely. chapter 20 on japan’s multigenerational cyclical http://anthro-age.pitt.edu/ book review | joy | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.345 http://anthro-age.pitt.edu 169 support system is most insightful here, highlighting intricate ways in which national and municipal policy has jointly promoted intergenerational community in urban space. in this case, a national policy supports municipalities to incorporate “. . . services such as medical care, homeand community-based long-term care, preventative services, and livelihood supports . . . in an integrated manner in the community for the elderly to live in the community” (218). further analysis on policy agenda setting, design, and implementation in this case and others would offer crucial insights for policymakers on how to institutionalize and resource iczs more fully. we learn through the chapters that spaces must be designed, planned, and programmed through icz concepts, which should be taught in policy, planning, and architecture. i urge practitioners and academics from these disciplines to read this book and contribute to core learnings on the physical, political, and institutional components of the icz framework. this will also mean addressing bureaucratic siloes that might challenge co-location in schools or care homes or result in age-friendly indoor places located in inaccessible outdoor environments. aligning iczs with the age-friendly program is an interesting avenue for movement-building here as strategies, plans, and toolkits have been produced to support “aging in place without isolation” (300). as chapter 6 on re-imagining bus stops to include intergenerational virtual games—such as electronic chess—notes so playfully, iczs have the potential to make age-friendly more “age-fun” (71). this must challenge the privatization of public space where many such transit stops are wrapped around with private advertising. we should all have a right to play, as we should have the right to restful, quiet, and leisurely places and paces. this is the kind of world i want to play a part in building! references joy, meghan. 2021. “neoliberal rationality and the age friendly cities and communities program: reflections on the toronto case.” cities, 108. https://doi.org/10.1016/j.cities.2020.102982. http://anthro-age.pitt.edu/ https://doi.org/10.1016/j.cities.2020.102982 book review review of sokolovsky, jay, ed. the cultural context of aging: worldwide perspectives, 4th edition. santa barbara, california: praeger. 2020. pp. 707. price: $108 (hardcover); $59 (paperback); $56 (etextbook). bjarke oxlund university of copenhagen bjarke.oxlund@anthro.ku.dk anthropology & aging, vol 42, no 1 (2021), pp. 189-191 issn 2374-2267 (online) doi 10.5195/aa.2021.348 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | oxlund | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.348 http://anthro-age.pitt.edu 189 book review review of sokolovsky, jay, ed. the cultural context of aging: worldwide perspectives, 4th edition. santa barbara, california: praeger. 2020. pp. 707. price: $108 (hardcover); $59 (paperback); $56 (etextbook). bjarke oxlund university of copenhagen bjarke.oxlund@anthro.ku.dk in this fourth edition of jay sokolovsky’s award-winning textbook on the cultural context of aging, anthropologists and other social scientists closely examine some of the challenges posed by global aging and the subsequent changes in demographic dynamics. the volume documents how the consequences of global aging will continue to influence life in the 21st century, both in relation to the human life span, cultural constructions of the life cycle, generational exchange, and the social fabric of households and communities as well as to attitudes toward disability and death. the new edition is completely revised and includes 20 new chapters covering places such as china, japan, denmark, india, west and east africa, indonesia, mexico, peru, amazonia, and italy as well as diverse ethnic landscapes of the united states. the volume sports an overwhelming 55 chapters. out of these, 24 chapters are available in the print version of the book, while another 31 chapters are available online in a web book format. since its first publication in 1990, the volume has gradually increased from 12 chapters to the 26 chapters contained in the second edition (1997). with the third edition published in 2009, the number of chapters grew to 45, out of which ten were published in a web book format thereby taking advantage of the availability of online publishing. with the 2020 release of the fourth edition, the web book chapters now outnumber the print book chapters. the benefit of this mode of publishing is, of course, that the volume succeeds in covering even more scholarly ground than its predecessors. yet, this increase in scope does, to some extent, come at the cost of overview since the 707 pages of the print version are already quite a lot to digest. the growth of the volume is at the same time a crude marker of the rapid growth of the field of aging studies. over the past three decades, aging populations have become a hot topic to anthropologists and other social scientists as well as to policymakers at the united nations, the world health organization, and at national governmental bureaucracies (xv). local and global aging simply warrants massive interest since demographic changes follow in its wake and come to have a fundamental bearing on social, financial, and political arrangements. the new edition of the cultural context of aging cements its position as one of the most central sources for social scientists and professionals working in the field of aging and gerontology when it comes to global variation and cultural diversity. more so than the three previous versions, it pays broad attention to local and global policy frameworks for managing http://anthro-age.pitt.edu/ book review | oxlund | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.348 http://anthro-age.pitt.edu 190 aging populations and proportional attention to the multiple technological innovations in the field of elder care. this is a break away from the first and second editions of the volume, which mostly aimed at shedding light on how the cultural context in which people grow old creates a varied reality of what aging means. whereas the third edition already expanded beyond an interest in “cultural scripts” and “cultural spaces” to “elderscapes” and cross-cultural phenomena (2009, xiv), this fourth edition has broadened the scope further to include more pieces on scientific, popular, and policy-oriented understandings of aging as well as pieces on diversity and technological innovation and policy intervention. philip y. kao and steven m. albert (chapter 10) thus write about the new life course, while sarah lamb (chapter 4) provides a powerful analysis of the dominant concept of successful aging. jenny-anne bishop and sue westwood (chapter 8) take a closer look at transgender aging, while joel michael reynolds (chapter 50) writes about disability and aging. meanwhile, david prendergast (chapter 11) looks at how new technologies aim to support independent living and “living in place,” while james wright (chapter 45) provides examples of how robotics are used in eldercare in japan and europe. finally, caitrin lynch’s chapter (13) on eldersourcing challenges the necessity of retirement in old age, while jay sokolovsky (chapter 40) himself examines elders who seek healing through involvement in community gardens. all of the aforementioned chapters go beyond the book title’s promise of seeing aging in its cultural context. political, technical, and material dimensions take center stage in these chapters, which help broaden and deepen our understanding of factors that have an influence on aging. the inclusion of all of these pertinent and exciting perspectives, however, raises the question: to what extent do the chapters still draw on the unifying concept of ‘culture’ or ‘cultural context’ to make sense of aging? in all fairness, many chapters in the volume still do, but many do not. given that the third and fourth editions of the volume have already seen a split between online and print publication of the numerous chapters, it would have been worth considering doing a brand new volume called ‘emerging contexts of aging.’ this would have allowed for a more consistent divide between the culturally oriented chapters, which could go to the web book, and chapters that focus more in-depth on the impact of aging policies, technological developments and material conditions, which could go into print. as it stands now, it is difficult for the reader to figure out which principle was used to decide on where each chapter belongs. the etextbook provides easy access to the links to the web book chapters, but with a view to keeping track of the many chapters, this reviewer prefers the print version over the etextbook. these remarks take nothing away from the fact that the cultural context of aging is still a remarkable source on worldwide perspectives on aging. the textbook (in tandem with the website) is at its most generous ever and includes highly informed and instructive introductions for each of its parts. in an era marked by rapid social and technological transformations, this volume does a fine job of documenting how these developments come to have a bearing on health and the later life course in community spaces across the globe. seeing the total range of sources represented in this fourth volume, sokolovsky must be commended for his careful pooling of resources in the field of aging over the past three and a half decades. students and scholars interested in socio-cultural, political, and technical contexts of aging should make sure to get a copy of this volume. it may also appeal to policy and decision makers, although some will probably find the length discouraging. references sokolovsky, jay, ed. 1990. the cultural context of aging: worldwide perspectives. new york: bergin and garvey. http://anthro-age.pitt.edu/ book review | oxlund | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.348 http://anthro-age.pitt.edu 191 sokolovsky, jay, ed. 1997. the cultural context of aging: worldwide perspectives, 2nd edition. westport: bergin and garvey. sokolovsky, jay, ed. 2009. the cultural context of aging: worldwide perspectives, 3rd edition. westport: praeger. http://anthro-age.pitt.edu/ portfolio “ends of life”: an interview with sarah lamb iza kavedžija john carroll university long@jcu.edu sarah lamb brandeis university lamb@brandeis.edu anthropology & aging, vol 41, no 2 (2020), pp. 110-125 issn 2374-2267 (online) doi 10.5195/aa.2020.302 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 110 portfolio “ends of life”: an interview with sarah lamb iza kavedžija university of exeter i.kavedzija@exeter.ac.uk sarah lamb brandeis university lamb@brandeis.edu introduction sarah lamb is professor of anthropology and barbara mandel professor of humanistic social sciences at brandeis university and a 2019-2021 andrew carnegie fellow. she specializes in aging, family, gender and personhood, with fieldwork experience in india and the us spanning two decades. sarah’s work exemplifies the anthropology of aging at its best, illuminating existential concerns beyond older age, while offering insight into broader moral orders. for me (iza kavedžija), as the editor of this special issue on ends of life, it was particularly valuable to have the opportunity to speak to sarah about questions of meaning in older age, and the ways in which people map out different endscapes in india and the us as they approach the ends of their lives. our conversation touched upon issues of temporality and experiences of time at life’s horizons, as well as the current complex global public health situation. like so much during this pandemic-affected period, this photographic interview took place virtually and via email. though geographically distant, we were able to exchange thoughts and images, allowing the interview to take the form of both a conversation and a photo essay. the relationship of the images to the text is dual: some of the questions i asked arose from the images sarah selected after our initial conversations, while other photographs illustrated the points sarah made in her responses. “ends of life” iza kavedžija: your most recent volume, successful aging as a contemporary obsession: global perspectives (2017), invites the reader to think critically about our visions of successful aging. what makes this idea of ‘aging successfully’ so compelling? sarah lamb: this is a question i’ve been thinking a lot about. successful aging envisions postponing or even eliminating the negatives of old age by medical intervention and individual effort. on the face of it, it’s a very appealing notion. who wouldn’t want to be ‘successful’—healthy, active, fit, engaged, happy—as one ages? the ideology that health and aging are within one’s own personal control can feel very inspiring and comforting. http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 111 figure 1. visions of successful aging: racing toward immortality1 the successful aging movement is also partly motivated by the needs of governments, i’d say. as the logic goes, if older people—who make up an increasing share of almost every nation’s population—can stay fit, active, and productive, they will not become burdens to healthcare systems and economies. but what else is going on? i myself believe that the idea of successful aging is also connected to an extreme discomfort with oldness in north america. the prospect of being old—as in, you know, really old, different from your previous self, possibly frail, or needing care—is more shocking to a sense of self and more terrifying to many even than death. that’s why it’s impolite in us society to call someone ‘old,’ for instance, and embarrassing to need a cane or walker. this antipathy to oldness underlies the successful aging movement. you see bestselling books with titles like live young forever, how not to die, own your health: healthy to 100, age in reverse, and younger next year: live strong, fit, and sexy until you’re 80 or beyond.2 i recall a line from one of these bestsellers: “ailments and deteriorations are not a normal part of growing old. they are an outrage.”3 these texts resonate with broader cultural aspirations to eradicate the human conditions of frailty, dependence, vulnerability, and illness that might otherwise be viewed as a normal part of a long human life course. figure 2: a selection of popular successful-healthy-anti-aging texts http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 112 ik: while some ideas of aging well focus on notions of ‘remaining the same’ person as in one’s earlier life, others place greater emphasis on change. in your work, you contrast the idea of an ‘ageless self’ with that of meaningful decline. what is it that imbues decline with meaning? sl: that decline can be meaningful seems almost an oxymoron perhaps. but isn’t the fact that no person can live forever, or stay the same, what gives human life much of its meaning and urgency? the other day i came across a line i jotted down in a small notebook some years back: “is not impermanence the very fragrance of our days?” the line is attributed to poet rainer maria rilke from his book in praise of mortality.4 i often keep my eyes and ears alert for lines like these. i chose for the epigraph to successful aging as a contemporary obsession japanese writer haruki murakami’s words: “one of the privileges given to those who’ve avoided dying young is the blessed right to grow old. the honor of physical decline is waiting, and you have to get used to that reality.”5 how can physical decline be an honor? but i know that my own encounter with a serious form of cancer near ten years ago now was both terrifying for me and also gave me a beautiful, profound, heightened sense of joy in living. i now have a much greater admiration for the hoped-for fortune of living into old age, even if this means i must walk unsteadily to the end of the driveway to pick up the morning paper rather than run a marathon. i also recall that medical anthropologist arthur kleinman reflected eloquently about how caring for his ailing wife, who was suffering from dementia, made him more present and taught him what it means to be fully human.6 he was also very sad and angry at times, as he realized that his wife’s disease would not go away. but he felt that by engaging more fully with the humanness of another through caregiving, his own humanness deepened. so, i’d like to use the critical, exploratory lens of anthropology to help myself and others better accept the normal human conditions of transience, decline, dependence, and need for care. we all have to die; and we all will get old if we’re fortunate to live long enough. why not try to accept and learn from the changes of age rather than deny them and shroud them in stigma? i’d like us to come to a point in my us society where not all situations of dependence, debility, and oldness in later life will be viewed and experienced as “outrages” or failures in living well. i welcome anthropology’s potential to evoke and enable differently viable modes of living. ik: as people approach the end of their lives, their temporal horizons change. how would you describe shifting experiences of time among your interlocutors in india? in what ways were these experiences similar to or different from those of your interlocutors in the us? sl: one thing i’ve noticed among my older interlocutors in india is that it’s super common to express a readiness to die, and a sense that one’s time in this life with this body is coming to near its end. one can’t expect, and doesn’t wish to expect, and is not supposed to expect, that they will keep on living and living. so, if i’m taking leave from an older person and say something like, “i’ll see you next year when i return,” a common reply goes, “who knows if i’ll still be here then or not? i may not live that long,” or, “if i’m here when you return, fine; and if i’ve gone to the cremation ground by then, you won’t see me!” (figure 3). these remarks are generally uttered cheerfully by people in around their 60s, 70s, and 80s and in good health. http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 113 figure 3: uma-di, 77, elder-home resident, kolkata: “if i’m here when you return, fine; and if i’ve gone to the cremation ground by then, you won’t see me!” courtesy: sarah lamb such ready-to-die statements became more vividly apparent to me after i began doing real fieldwork in the united states, because in the us, my older interlocutors, especially among the more elite, commonly express aspiring to live well into their 90s or 100 or beyond, and they do not often bring up the topic of death on their own. if i ask about it, people often dismiss the subject, saying something like, “i’ll cross that bridge when i come to it,” or, “i really don’t think about death much. i prefer to live in the present.” my friend and interlocutor purnima banerjee of kolkata, india, in her early 70s, would often speak about her readiness for death (and i would jot down her statements in my notebooks). she would say, “i am not afraid of death, because it is inevitable. because i am born, i know i have to die,” and, “we have to accept decay. i have accepted,” and, “when clothes are worn out, you just take them off and wear new ones. the body is also like that” (figure 4). figure 4. purnima-di, early 70s, kolkata: “when clothes are worn out, you just take them off and wear new ones. the body is also like that.” courtesy: sarah lamb http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 114 it’s relevant that i do fieldwork mostly among hindus in india, hindu bengalis. hinduism is the majority religion in india, with about 80 percent of the population identifying as hindu, 13 percent as muslim, and the rest as christian, sikh, buddhist, jain, and others.7 even those i know who do not see themselves as particularly “religious” tend to accept in a kind of taken-for-granted way that the soul lives on after death and is reincarnated. this perspective has a big impact on a person’s sense of temporality—the temporal horizon of the self is very extended, even if this one body and life will not, cannot, last forever. purnima expressed: the body will die, but the soul will not die. wherever i go, i will go somewhere else. those dear ones who have died, why should i cry for them? there is no use crying for a departed soul. god is a giver and a taker. today is mine; tomorrow i will go, and the day will be someone else’s. i should not be sorry for that. another interlocutor, mahamaya, commented when i asked what happens after death: “i can't know the future – i don’t know if my next life will be good or bad.” but she hoped she would have the opportunity to become much more educated in her next life. “of course, rebirth happens,” she replied to my silly follow-up question. in the united states, i am finding that one reason the decline of the body and temporariness of life may be so hard for many to accept is that most people i speak with express little certainty that anything happens after death. this may be because i have been conducting my us fieldwork in the quite secular and cosmopolitan milieus of boston and san francisco. however, even many of my interlocutors who see themselves as religious express doubts about an afterlife. when a student research assistant and i asked an observant catholic woman in her 80s if she believed in life after death, she paused, and replied, “i try.” the feeling of finite time left for oneself seems to motivate many older americans to partake in the successful aging movement, in the sense of striving to make the very most of whatever time one has left to live, and to take all measures necessary – through medical intervention, diet, exercise, etc. – to preserve one’s one-and-only body. for another perspective on time and aging, i love ursula le guin’s essay, “in your spare time,” written at age 80 and appearing in the collection of essays published after her death, no time to spare (2017). le guin is responding to a questionnaire she received from harvard for the sixtieth reunion of the harvard graduating class of 1951. harvard asks, “what do you do in your spare time?” and tells respondents to check all activities that apply; the list begins: golf. le guin wonders, what’s the meaning of spare time in your 80s? if the opposite of spare time is occupied time, then at age 80, all her time is occupied – occupied by living – perhaps even more than before, given how little time is left. she describes her many daily activities, including at her age, “mere bodily maintenance, which is tiresome,” and writing, thinking, reading, cooking, talking with her husband, meeting friends, walking when she can walk, vipassana meditation, and lying down for an afternoon rest with her slightly crazy cat. she closes the essay: “none of this is spare time. i can’t spare it. what is harvard thinking of? i am going to be eightyone next week. i have no time to spare.”8 ik: you recently undertook a period of fieldwork in india. what insights or perspectives is this new project bringing to the fore? sl: my aim this past january 2020 was to explore new trends in ways of aging in and around kolkata. recently, my fieldwork in india had focused on never-married single women, so this january i was eager to get back to the topic of aging. one question for me was how and if globalizing healthy-activehttp://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 115 successful aging ideologies were being taken up in india, shaped and inflected by local cultural and political contexts. so, i was indeed struck by all the talk of “active” and “healthy” aging around me in india, evident in everyday conversations, news media, the health sections of women’s magazines, and new groups like healthy aging india. kolkata’s parks in the early mornings and late afternoons were filled with older people walking, some also meditating, practicing yoga, and congregating on benches with their mostly gender-segregated peers, sporting white sneakers or nikes and adidas running shoes, as signs of their active lifestyles. several women told me proudly how they were able to take control of their health and prediabetes by walking two kilometers daily around their apartment complex’s inner courtyard, or by taking a brisk morning walk around the whole village each dawn. several emphasized, using the english term “active” even when speaking in bengali, that good health in old age depends on staying “active,” or that if you don’t stay “active,” your health will not be good. at the same time, when i would tell kolkatans about my interest in older people and exercise, or that i had heard of a neighbourhood gym catering to seniors, several laughed and said, “i don’t think working out for seniors is a very bengali idea.” figure 5: the idea of the gym is really taking off in india, as part of a global trend emphasizing personal responsibility for keeping the body fit. courtesy: anindita dutt i was also struck this past january by the changing connotations of the old age home. when lawrence cohen and i first wrote about the emergence of elder homes in india in the late 1990s, we noted the prevailing sense that institutional care for the aged represented “bad families,” and a throwing away of indian culture and of elders themselves (cohen 1998, lamb 2000). ten years later when i conducted the research for aging and the indian diaspora, old age homes still tended to entail stigma for both the elder and their family (lamb 2009). but now, in 2020, i noticed how many were speaking of the old age home positively as an aspirational desire. true, i had been hanging out with a lot of never-married single women with no children to provide more conventional family care. but i was nonetheless struck by how even many older people with children were speaking positively of old age homes as sites of care, comfort, security, and even prestige. one group of women at a pleasant elder home on the southern outskirts of kolkata exclaimed: “we came here wilfully! there is a long waiting list to get in! we were lucky to get a seat!” (figure 6). other people would tell me yearningly, “i wish i could secure a place in an old-age home for my retirement, but where would i get that kind of money?” http://anthro-age.pitt.edu/ http://www.healthyagingindia.com/history.aspx portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 116 figure 6: lady retirement home residents: “we came here wilfully!” courtesy: sarah lamb of note is that ordinary ideas about old age in india highlight that older persons are deserving recipients of care, and that they will need care—just as people in the us imagine that children will need care and are deserving of it. the ideal of the successful older person caring for themselves independently, as elana buch describes in inequalities of aging: paradoxes of independence in american home care (2018), does not hold the same kind of appeal in india as it does in the united states. in the indian context, the oldage-home is taking on the resonance as an aspirational site of secure care, for older people who are appropriate and natural care recipients. both of these interests of mine—in globally circulating healthy-active-successful-aging ideologies, and in new connotations of the retirement home—came together one evening when an older couple i had long known told me about a posh new retirement community “for active seniors” they had joined, aumorto. the name aumorto literally means “immortality,” and the institution had chosen “young forever” as its english subtitle or motto. using our smartphones to look up their website, i read: “aumorto is for those who choose to remain young, … people who may be retired but are far from tired.”9 the couple told me excitedly that the place even has a gym! and a swimming pool! they had bought into an apartment there, and presently divided their time between their ancestral home in kolkata and the retirement community, where all meals are provided and a schedule of daily activities posted. when the couple invited me to go with them to spend a night at the place in one of its guest suites, i jumped at the opportunity. mr. benoy das drove us to the retirement community himself, with his wife piyali sitting next to him up front, and me in the backseat sheltering two large boxes of bengali sweets the couple was bringing to share with their fellow residents. as we left the urban sprawl of kolkata and wove through the narrow roads of suburban villages with bustling roadside markets, mr. das grew increasingly excited. “see all the vegetables! oh ho! cauliflower, eggplants, carrots, beets! oh! see all the fruit! look at those guavas! fresh and perfect –ready to eat! all from local trees! look, there are trees in every direction!” http://anthro-age.pitt.edu/ http://www.aumorto.in/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 117 figure 7: the aumorto (immortality) “young forever” retirement home, about 40 kilometers from kolkata. courtesy: sarah lamb as we drove along, benoy and piyali told me more about aumorto, emphasizing that it’s absolutely not an “old age home” (or briddhabas: abode for elders). “if anyone calls it an old age home, we are very much opposed! instead, what do they call it in your country? a ‘retirement’ – a retirement what?” “a retirement home,” i replied, or “community.” “yes! yes! retirement home. that’s good. because, you see, it’s better not to use the term ‘old’ (briddha), because we don’t think of ourselves as old! what do you think my age is?” he asked with a big smile. “i don’t know,” i hesitated. “guess then!” mr. das urged. “ok. 64?” i knew it must be more. mr. das emitted an exclaim of delight: “good! very good!” he took his hands off the steering wheel for a moment to clap. “i’m actually 78! and i drive a car! i go out and mix with my friends! i still do some work! [he had taken two business calls already on the journey]. i’m very ‘active’! [he used the english term]. you see, i’m not old!” as we approached aumorto about an hour from kolkata, turning off the main road to wind through fallow winter rice fields and past small mud-and-thatch village homes, benoy pointed ahead, “look! you can see our home now!” i spotted a large gated compound arising amidst the fields. mr. das pointed to the logo, “young forever.” “see! it is not an ‘old age home.’ we are young forever! now, see all the flowers! wonderful! see the roses!” the several multi-storied pristine white apartment buildings were surrounded by lush green lawns, decorative pools, and abundant flowers in bloom. http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 118 figure 8: aumorto’s smallest apartment building, optimistically named hope. courtesy: sarah lamb the staff greeted our car warmly, calling mr. and mrs. das by their names, and taking our small bags to deposit in our rooms. as we entered the landscaped grounds around 5 pm, the various residents were coming out from their apartments, the ladies dressed up in fine saris and jewelry with intricately embroidered shawls. there was going to be a baul folk music performance that evening, out on the lawn. i could keep on going, describing the scenes, and my lovely, pristine, pure-white guest suite with two bathrooms, a kitchenette, sitting and bed rooms, a large-screen tv, and a welcoming balcony overlooking the countryside. i enjoyed meals and conversations with the residents. one topic that kept coming up was the fact that the place had so many modern amenities, even a gym! but when i asked a small group over dinner if any of them go to the gym, they laughed, and said, “no! no!” so, the next morning, i decided i should walk around to go see the gym for myself. i asked a few people where it was, but no one could say. i walked up and down the halls, and found the library, meditation room, art gallery, and infirmary, but no gym. my host piyali said she thought maybe it was up on the roof level. but then a staff member corrected her, “no, it’s downstairs, on the third floor.” a lady resident standing nearby volunteered, “i’ll go with you. i haven’t seen it yet either.” the staff member went off to get the key, and we waited awhile in the hall. finally, the staff returned and escorted us to the gym, which he unlocked. there was no sign outside to alert anyone to the room’s contents. the gym housed two small rooms with a filtered water dispenser and five pieces of new-looking equipment— two treadmills, two stationary bikes, and a rowing machine. i asked the staff, “does anyone use the gym?” “yes,” he sounded a bit doubtful. “well, if guests come.” “oh, ok. does anyone who lives here use it?” i persisted. “well,” the staff replied. “yes, they could.” again, he sounded doubtful. “well, if they find the time,” he added. i smiled and jotted down his replies in my notebook. doesn’t everyone living there have an abundance of time? i wondered. i then persuaded my lady resident companion to get on one of the treadmills for a photo, reassuring her that we would not need to actually turn the machine on. she slipped off her sandals out of respect for the machine, and mounted for a pose. she said happily that she would send http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 119 the photo to her son. we walked out, and the staff re-locked the door. i should add that the ‘swimming pool’ i had heard of was not yet filled with water, and was shaped more like a lily pond than a medium for working out. figure 9: posing on the treadmill. courtesy: sarah lamb so, i shared a longer story here than you likely expected. my visit to aumorto brought to the fore for me a few things. one, i saw the allure of the posh new retirement community idea for elite bengalis, who can imagine retiring in luxurious surroundings in the fresh countryside of their ancestral origins,10 yet surrounded by modern amenities, entertained by friendly peers, and cared for by attentive staff. two, i witnessed many symbols of active and youthful aging as aspirations: residents praised the fact that their place has a gym, and mr. das especially was delighted by the “young forever” motto of aumorto (immortality), while he himself cultivated a distinct persona of being not old. third, i witnessed a sense of purposeful exercise for seniors, beyond walking, as more of a symbol – of modernity? of prestige? – than an actual practice. when i left india at the end of january, just as the global pandemic was taking off, but before i was paying any attention to it, i had expected to return soon for more fieldwork. now those plans, like so many others, are on hold. ik: the ongoing situation surrounding covid-19 and public health responses to the pandemic variously affect different age groups. media reports have emphasized the vulnerability and isolation of older people in the us. at the same time, older people may have other memories of large-scale, life-changing events, which may afford them a different perspective on the current times. what were your impressions of the various responses of older people in india and the us to the pandemic and its challenges? sl: when the covid-19 pandemic hit, i had to adjust to virtual fieldwork. i’ve engaged in informal communication with friends and interlocutors in india, via whatsapp, email, google meet, and zoom. but my main research these past few months has focused on older americans. so far, i’ve been spending time virtually with 20 primary interlocutors ranging from ages 67 to 93. none are living in institutions, and they all describe themselves as economically comfortable or privileged (although some were raised http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 120 poor). they are of various race-ethnicities, including white and black, and live mostly in massachusetts and new york. figure 10: zoom fieldwork in pandemic times we are all inundated by news of the heavy toll the novel coronavirus is taking upon vulnerable older people. but in my conversations with older americans, what has struck me most is a strong sense of resilience. common themes in the interview conversations are that the pandemic is less hard on older people than on many younger folks, and that many older people are able to maintain social connections, meaningful activity, and a sense of control over their own health, even amidst lockdown. “even though i’m 93 and have lived a very long time, i have never experienced anything like this!” exclaimed walt over zoom with a huge smile on march 27, 2020, twelve days into the “lockdown” of his state of massachusetts. but when i ask older people, “is the pandemic harder on the older or younger generations?” i’m struck that most reply that it’s harder on younger people. sure, in terms of physical health, older people are at higher risk of developing serious complications from the disease. but because they have already retired and fashioned the large contours of their lives (marriages, careers, education …), many imagine that, compared to the young, the quarantine is less disruptive to their daily routines, incomes, and aspirations. many also describe a resilience that comes with age and accrued life experiences, giving them strength and insight to brave the pandemic. shirley, age 69, reflected, “older people tend to be a lot more flexible and creative. the more experiences you have, the more ways you have to look at life.” harry, age 73, told of how this pandemic brings to mind his vietnam war experiences, where he first developed resiliency. to my anthropology students on our group zoom chat, he recalled: i was dealing with something really scary when i was your age, 19 years old in vietnam, and there was no guarantee i was going to come back. … i wasn't the fastest. i wasn't the strongest. i was scared! you know, i was a kid from the southside of chicago and suddenly at 19, i’m confronting this craziness and confronting my mortality. so, now http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 121 you may be confronting your mortality. … but what you learn from this experience … can help prepare you for your future. pointing to his six other older friends on the group chat, he said, “we all, you know, we’ve overcome a lot. … i guess the message about aging is that resiliency is really important.” my older us interlocutors also report being motivated now, more than ever during the pandemic, to take daily walks, engage in virtual exercise classes, and interact online and outdoors with family and friends. many are proud and buoyed by their regimens of healthy diets and supplements. walt at 93 exercises avidly every day (“it’s almost an addiction!”), and quickly adapted to holding the music appreciation class he teaches through his temple over zoom. when i asked gayle, 84, how she was doing with the pandemic, she replied, “i’m fine! i have a deck. i can have one or two people over for lunch 7 days a week. if it’s cold, we either drink more wine or bundle up!” ken, age 75, remarked, laughing: “zoom has become even more popular than toilet paper!” in india, a common theme among those i am in conversation with about the pandemic is the humdrum and taxing travails of quarantined life without domestic staff, and how performing all one’s own household work is especially hard for older people – who should at this life stage be the deserving recipients of household labor rather than its main providers. i must note that my conversations since the pandemic began are restricted to people from the middle and higher classes, those with technology to communicate easily abroad. after shrestha and i reassured each other that our health is still fine, shrestha, age 70, commented via whatsapp in early april: “no domestic help. ajay [my husband] and i are cooking, mopping, cleaning.” medha, age 60, fearful about the safety of my father and stepmother in the us (“they are elderly people”), sent a whatsapp message to check in, and then commented on the terrible plight of the poor laborers in her country under lockdown, and the trying domestic situation for older people: “everybody has to do every household work himself. even the lonely elderly sick people have to do everything.” these discourses lead me to consider the ways old people are figuring into public imaginaries of the pandemic. although we hear some talk of the naturalness and even social-economic benefit of “culling the herd,” so to speak, by allowing greater numbers of elderly persons to die, we hear even more proclamations of the value and belovedness of older people: if not to protect ourselves, we should each be practicing social distancing and wearing masks in order to safeguard vulnerable others, namely the cherished elderly among us. so, for instance, the college youth who was first criticized for partying over spring break on the beaches of florida (“if i get corona, i get corona”), later performed over instagram and on cnn a big apology saying that he hadn’t intended to harm others, and that he has “elderly people who i adore more than anything in the world and other family members who are at risk.”11 anthropologists are well situated to scrutinize the varying ways such public discourse on the value of older people plays out in different contexts. an india today story on “how to protect elderly people from covid-19” mobilizes a common indian paradigm of intergenerational reciprocity and indebtedness to motivate care and vigilance, namely that elders are deserving of love and care now, because of how much they sacrificed for you and gave to you in the past: if this [all these protective measures – social distancing, wearing masks, sanitizing doorknobs, etc.] appears a difficult task to do, close your eyes and think how much you love your elderly. if this is not enough, close your eyes again and think what all they sacrificed during their youth while you were an infant, a toddler and a vulnerable teenager. this is your payback time.12 http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 122 ik: covid-19 is an event par excellence: it is one of those events that truly mark a juncture in history, and which brings a range of social and existential issues to the fore. the peculiar situation that some older people find themselves in pertains directly to the question of the ‘ends of life’: one’s experience of time as one moves towards the horizon, and questions around what matters or gives life meaning are both thrown into relief. did some of your conversations touch upon themes of meaning and time? sl: yes, the covid-19 pandemic has brought existential issues to the fore for many older people. although i’ve found over the years that many americans prefer not to talk much about their own approaching mortality, more are now bringing up the topic on their own. all people over age 65 are hearing constantly about their vulnerability to the disease. my interlocutors have reported how the virus has motivated them to make sure their affairs are fully in order, and to communicate any special directives, including pet care, should they suddenly drop dead. jack, age 71, recounted to me and several friends over zoom, “i used to think i was invincible and invulnerable. … this event has awoken me to my vulnerability.” he told of how he and his granddaughter sophia met outside in the driveway after sophia’s mother cautioned the girl again not to touch her grandfather. sophia asked, “grandpa, are you going to die?” peter, age 73, highlighted how the pandemic has amplified his sense of the time limit on his lifespan: each day that passes is one day less than i can play baseball with [my grandson] elliott. that personal sense of our mortality and the limitation of one’s days – it’s not crippling; i need to press on – but that shadow is taking a clearer outline now. even if you feel great – i feel terrific now – you also know, there’s a time limit on that. and every day we spend inside is a day missed. cynthia similarly invoked her intensified sense of moving quickly now toward the limits of her timespan: “ok, so we just turned 70. say we have ten more years to live. if we spend two of them locked down, that’s 20% of our remaining lifespan.” she disagreed with others in my study that the pandemic is even harder for younger than older generations, because missing one or two years of regular life will only be a fraction of remaining time for a 25-year-old. the young have years of future ahead, while the old are seeing now their approach to the ends of life. ik: this brings me to the last question, which underpins the contributions to this special issue: what form does hope take, as older people approach the ends of their lives? how is hope experienced, and kept alive, while traversing endscapes the shifting and uncertain terrain of life’s end? sl: hope always has to do with the future, right? – a feeling of aspiration for a certain future thing to happen or not happen. i often ask older interlocutors, “what more wishes or hopes do you have in life?” – aiming to get at their sense of what the future holds, and what really matters, as one approaches life’s end. some in india reply that there is not much future left – for them, in this life, as individuals – so what more wishes would they have? subhagi, a bengali day laborer at about age 60, cheerfully replied when i posed the question of her future wishes and desires, “what more will happen in the future? it’s already all happened!” she laughed. “now when i die, they [all the younger ones in her family] will be the ones to see what happens. how many more days will i live? my age (bayes) has already come!” a few continents away, in the u.s., walt at age 93 expressed a similar sense of limited need for future hopes: “i don’t think as much about hopes for the future at my age. when you’re younger, you think, ‘next year, i’ll do this. or maybe the year after. or in two years, or five years.’ well, we don’t think like that anymore. it’s too iffy. i increasingly think about today – what i want to do today.” such replies are http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 123 not despairing, but rather articulate ways that the future in old age belongs more to others than oneself. and this is ok. yet one hope that looms large for older people across the world is the hope for good health. in india, despite the perceived normalcy of human transience and decline, many older people still talk of wishing to die “while their hands and feet are still working,” before they become completely bedridden or hooked up to hospital machines. in the us, my older interlocutors talk of hoping to die quickly of a heart attack rather than by stroke or dementia, and some divulge plans with friends to secure life-ending medications if the need arises. the key motive here is to avoid the spectre of becoming a “burden” on their children (anathema to most americans) and of “losing who you are” – an identity intimately tied to an enduring, fit bodily and cognitive self. such hopes for long-lasting good health connect back to the successful aging movement we began by discussing. amidst the pandemic, hope is taking on an intensified and uncertain quality for many older people, who hope both to stay safe and not succumb to covid-19, and to be able to return to ordinary social interactions in a time frame relevant for them, before the ends of life. this past march 2020, two kolkata women in their middle and older ages emerged from the shelter of their homes to participate in the celebratory spring festival of holi (figure 11). during holi, people come outside carrying powdered and liquid colors to throw and smear on the clothes and faces of neighbors, friends, and relatives. anindita, on the left, sent me the photo to help with my virtual fieldwork. with the pandemic on the rise, although before india’s official lockdown had begun, many in india approached holi with more caution. but my friend anindita found other older neighbors celebrating at the local school. “indians overall have a c’est la vie attitude,” anindita commented, and many old people “feel depressed bolstered indoors.” let’s live today and paint each other with colors now. figure 11: pandemic days: playing with colors during holi, march 2020, kolkata. courtesy: anindita dutt acknowledgements this publication was made possible in part by a grant from carnegie corporation of new york. the statements made and views expressed are solely the responsibility of the author/s. http://anthro-age.pitt.edu/ portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 124 notes 1. the new york times magazine, racing toward immortality, january 30, 2000, magazine cover, accessed july 27, 2020. https://www.amazon.com/york-times-magazine-january-2000/dp/b07hvbdg2d 2. lalanne 2009, greger 2015, fleckenstein and weisman 2006, schuster 2017, crowley and lodge 2007. 3. chris crowley and henry lodge, younger next year (workman publishing company, 2007), 29. 4. in doing a little more searching, i realize i must have heard rilke’s words quoted in an episode of npr’s “on being” with krista tippett: “joanna macy: a wild love for the world,” (september 16, 2010). https://onbeing.org/programs/joanna-macy-a-wild-love-for-the-world/ 5. from what i talk about when i talk about running (murakami 2008); quoted lamb, ed. 2017: p. v. 6. see kleinman 2009, 2012, and “arthur kleinman on caregiving,” religion and ethics newsweekly, national public radio, (october 1, 2020) – accessed july 22, 2020. http://www.pbs.org/wnet/religionandethics/2010/10/01/october-1-2010-arthur-kleinman-on-caregiving/7146/ 7. table 21: distribution of population by religion, census of india 2011 – accessed 27 july 2020. https://censusindia.gov.in/census_and_you/religion.aspx 8. ursula le guin, no time to spare: thinking about what matters, (houghton mifflin harcourt, 2017), 7. 9. aumorto, 2018 http://www.aumorto.in/ -accessed july 20, 2020. 10. many urban bengalis envision their ancestral roots in village life, the “real” bengal, and schoolchildren across india are often asked to write essays about “my village.” 11. aimee ortiz, “man who said ‘if i get corona, i get corona’ apologizes,” new york times, (march 24, 2020) – accessed july 22, 2020. https://www.nytimes.com/2020/03/24/us/coronavirus-brady-sluder-spring-break.html 12. prabhas k. dutta, “coronavirus in india: how to protect elderly people from covid-19,” india today, (march 20, 2020) – accessed july 22, 2020. https://www.indiatoday.in/coronavirus-outbreak/story/coronavirus-in-indiahow-to-protect-elderly-people-from-covid-19-1657778-2020-03-20 references buch, elana. 2018. inequalities of aging: paradoxes of independence in american home care. new york: new york university press. cohen, lawrence. 1998. no aging in india: alzheimer’s, the bad family, and other modern things. berkeley: university of california press. crowley, chris, and henry s. lodge. 2007. younger next year: live strong, fit and sexy until you’re 80 and beyond. new york: workman publishing. fleckenstein, alexa, and roanne weisman. 2006. own your health: healthy to 100. deerfield beach, fl: health communications. greger, michael, with gene stone. 2015. how not to die. new york: flatiron books. kleinman, arthur. 2009. “caregiving: the odyssey of becoming more human.” lancet 373: 292-293. kleinman, arthur. 2012. “caregiving as moral experience.” lancet 380: 1550–1551. lalanne, jack. 2009. live long forever: 12 steps to optimum health, fitness and longevity. mississauga, on: robert kennedy publishing. lamb, sarah. 2000. white saris and sweet mangoes: aging, gender, and body in north india. berkeley: university of california press. lamb, sarah. 2009. aging and the indian diaspora: cosmopolitan families in india and abroad. bloomington: indiana university press. http://anthro-age.pitt.edu/ https://www.amazon.com/york-times-magazine-january-2000/dp/b07hvbdg2d https://onbeing.org/programs/joanna-macy-a-wild-love-for-the-world/ http://www.pbs.org/wnet/religionandethics/2010/10/01/october-1-2010-arthur-kleinman-on-caregiving/7146/ https://censusindia.gov.in/census_and_you/religion.aspx http://www.aumorto.in/ https://www.nytimes.com/2020/03/24/us/coronavirus-brady-sluder-spring-break.html https://www.indiatoday.in/coronavirus-outbreak/story/coronavirus-in-india-how-to-protect-elderly-people-from-covid-19-1657778-2020-03-20 https://www.indiatoday.in/coronavirus-outbreak/story/coronavirus-in-india-how-to-protect-elderly-people-from-covid-19-1657778-2020-03-20 portfolio | kavedžija and lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.302 http://anthro-age.pitt.edu 125 lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. new brunswick, nj: rutgers university press. le guin, ursula k. 2017. no time to spare: thinking about what matters. new york: houghton mifflin harcourt. schuster, steven. 2017. age in reverse: look and feel younger, be more energetic and have better memory: live a long and healthy life. scotts valley, ca: createspace independent publishing. http://anthro-age.pitt.edu/ book review review of shea, jeanne, katrina moore and hong zhang, eds. beyond filial piety: rethinking aging and caregiving in contemporary east asian societies. new york, ny: berghahn. 2020. pp. 432. price: $149.00 (hardcopy); $39.95 (ebook). francesco diodati university of milan-bicocca f.diodati@campus.unimib.it anthropology & aging, vol 42, no 1 (2021), pp.161-163 issn 2374-2267 (online) doi 10.5195/aa.2021.342 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:f.diodati@campus.unimib.it book review | diodati | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.342 http://anthro-age.pitt.edu 161 book review review of shea, jeanne, katrina moore and hong zhang, eds. beyond filial piety: rethinking aging and caregiving in contemporary east asian societies. new york, ny: berghahn. 2020. pp. 432. price: $149.00 (hardcopy); $39.95 (ebook). francesco diodati university of milan-bicocca f.diodati@campus.unimib.it jeanne shea, katrina moore, and hong zhang’s edited volume, beyond filial piety: rethinking aging and caregiving in contemporary east asian societies, brings together qualitative studies that address the social and cultural transformations of aging and caregiving in east asia. as the editors state in the introduction, traditional confucian ideas of filial piety that prescribe adult children to fulfill their obligations to respect, obey and care for their elderly parents have become increasingly more difficult to put into practice, given the unprecedented acceleration of population aging in east asian societies (1). this volume engages in a constant dialogue with charlotte ikels’s (2004), filial piety: practice and discourse in contemporary east asia. shea, moore, and zhang discern important continuities with the findings in ikels’s volume about the ways in which, in this geographical area, demographic change and welfare transformations continue to affect care practices and support for the aged as well as challenge the understandings of filial piety and obligations toward old age within communities, families, and individuals (2). however, the editors also note that a decade and a half after ikels’s collection, “much has changed in demographic, social, and public policy terms” (2). with respect to the demographic transition of western countries from aged (14 % elderly) to super aging societies (21 % elderly), that of east asia has increased even more rapidly (17). in response to this demographic trend, the editors aim to update relevant ethnographic material by including geographic locations such as hong kong, taiwan, and singapore, in addition to china, south korea, and japan. the contemporary sociodemographic reality additionally necessitates the editors to give proportional scholarly attention to research that deals with care for and by the aged “whether for themselves, their spouses, or their children or grandchildren” (6). moreover, increasing possibilities for nonfamilial options of eldercare, both government and market driven, also need to be considered because they impact the practice and imaginary of good care and aging (6). the present collection expands ikels’s (2004) work into a new research area that combines more geographic locations and recent changes in terms of practices and values toward aging and caregiving in east asian societies. methodologically, the book engages with aging and caregiving through mixed methods and ethnographic approaches to provide additional qualitative data to the massive research conducted on a macro-demographic or policy level (10). the authors in this volume are concerned with bringing http://anthro-age.pitt.edu/ mailto:f.diodati@campus.unimib.it book review | diodati | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.342 http://anthro-age.pitt.edu 162 together the macro-level of demographic changes with the micro-level of everyday lived experiences which are documented through participant observation, interviews, and popular and media representations. the theoretical frameworks adopted throughout the chapters include classical anthropological and sociological perspectives of interpretivism, critical theory, globalization theory, and social constructivism. the volume also incorporates approaches from social gerontology, such as the life-course perspective, age-stratification theory, and exchange theory (10-11). additionally, some research draws on feminist approaches to show how many contemporary east asian societies are increasingly moving toward gender equity and neutrality (e.g., chapters 2 and 3). this methodological and theoretical orientation allows for a very dynamic and textured account of aging and caregiving from differently situated perspectives (e.g., caregivers, cared-for, health practitioners, grandparents, spouses, children, grandchildren, migrant workers, transnational families, and communities), oscillating between individual biographies and molecular accounts of family and community life and social structures and policy-making processes. the book is divided into three macro sections according to specific cultural areas, but all the parts describe socio-cultural contexts rooted in confucian traditions of filial piety. part i, “aging and caregiving in chinese contexts” (chapters 1-6) engages with aging and caregiving in china. this part includes youcai tang and jeanne shea’s exploration of the “jianxiang model”: an experiment in community-based care for seniors to solve the problems of old-age support in rural areas (chapter 1). in these areas, which have the highest proportions of senior citizens and the lowest levels of economic prosperity, the “model of jiangxiang” succeeded in reviving collective agriculture and establishing free senior cohousing to provide material support and care for elderly people. these programs also achieved higher levels of life-satisfaction in the elderly population and fostered positive bonds between adult children and their aged parents, precisely because they went beyond ideas about seniors’ dependency and filial co-residence that were declining anyway (64). leng leng thang and kalyani mehta (chapter 5) share the results of a study on grandchildren’s perceptions of caring for grandparents. their chapter starts with the description of a controversial state-sponsored film about filial piety in singapore. the film was meant to restore feelings of filial piety in singapore’s next generations by narrating the story of a son watching his father who tenderly cared for his grandmother affected by dementia (142-143). thang and mehta illuminate how many young people in singapore demand the government to take on more responsibility when it comes to elder care programs. they still see filial piety as an aspiration, but face their limits in fulfilling it due to a heavy workload, hefty medical costs, and high costs of living (chapter 5). in part ii, “aging and caregiving in japanese contexts” (chapters 7-9), susan long and ruth campbell examine the changes in the meanings of family caregiving in japan after the establishment of the national long-term insurance care (ltc) system (chapter 9). the two researchers criticize biomedical notions of caregiving burden and advocate for a conceptualization of caregiving that embraces variations over different stages and historical changes in cultural ideas about care (242-243). the “caregiving career” concept allows them to explore the meanings contemporary japanese family caregivers give to care activities in relation to the illness trajectory, including how caregiving still continues after the death of the people cared-for (243). finally, part iii is dedicated to korean contexts (chapters 10-12). in chapter 10, hyun ji lee and kyong hee chee state that the institutionalization of eldercare through the ltc national program has effectively changed the idea of filial piety. many caregivers declare no longer feeling guilty after having entrusted elderly family members to a nursing home, as the number of ltc facilities has increased nowadays. the authors also report that many family members believe that trained and certified ltc workers may provide better care than them. chapter 11 focuses on a group of south korean seniors who were repatriated from sakhalin island, where they were sent to serve as laborers during the japanese occupation of korea in the 1930s and early 1940s, and http://anthro-age.pitt.edu/ book review | diodati | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.342 http://anthro-age.pitt.edu 163 then retained after the island came under russian control. in this chapter, dorota szawarska examines the intergenerational and family tensions brought by repatriation programs as well as the discriminatory behaviors directed toward sakhalin elderly migrants. the ambivalence of caregiving and filial piety are well exposed in her work, as she deals with the dynamic conflict of being responsible for caring for parents and children at the same time. this volume is an extensive collection of ethnographies and qualitative studies. as the editors note in the conclusion, there are certain limitations to the book’s content; the studies were not able to acknowledge the transformations caused by the covid-19 pandemic and do not address the full range of diversity within the contexts examined. this includes care and aging among lgbtqi and minority groups (387). however, the collection successfully challenges the popular and academic romanticization of filial piety and caregiving in the east (buch 2015; sivaramakrishnan 2018) and also contributes to revealing the ways in which elders, families, and communities can reimagine traditional cultural values and actively respond to population aging. for this reason, i would recommend it to students, researchers, and practitioners in many fields, including east asian studies, social research on kinship and caregiving, anthropology of morality and ethics, anthropology, and gerontology. references buch, elana d. 2015. "anthropology of aging and care." annual review of anthropology 44: 277-293. ikels, charlotte, ed. 2004. filial piety: practice and discourse in contemporary east asia. 1st edition. stanford, calif: stanford university press. sivaramakrishnan, kavita. 2018. as the world ages: rethinking a demographic crisis. cambridge, massachusetts: harvard university press. http://anthro-age.pitt.edu/ book review review of gilleard, chris and paul higgs. social division and later life: difference, diversity and inequality. bristol policy press. 2020. pp. 216. price: $103.75 (hardcover); $37.55 (ebook and paperback). ashwin tripathi indian institute of technology, gandhinagar ashwin.tripathi@iitgn.ac.in anthropology & aging, vol 42, no 1 (2021), pp. 180-182 issn 2374-2267 (online) doi 10.5195/aa.2021.350 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | tripathi | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.350 http://anthro-age.pitt.edu 180 book review review of gilleard, chris and paul higgs. social division and later life: difference, diversity and inequality. bristol policy press. 2020. pp. 216. price: $103.75 (hardcover); $37.55 (ebook and paperback). ashwin tripathi indian institute of technology, gandhinagar ashwin.tripathi@iitgn.ac.in in social division and later life: differences, diversity and inequality, chris gilleard and paul higgs emphasize the increasing heterogeneity of a growing group of older adults, here looking through the lens of social divisions to interrogate the diversity of later lives. at large, they reiterate the importance of including—or rather not excluding—age and aging in both social theory and social sciences in general. both social divisions and differences are explored in the text using social differentials like gender, class, and ethnicity and race. while the former emphasizes the objective structural differences (i.e., position and hierarchy), the latter focuses on the process of subjective identification and belonging. additionally, the body, which has previously been largely ignored in social scientific work on aging, with health and frailness viewed as a natural outcome of social divisions (gilleard and higgs 2017), is now studied as both the site and the source of these divisions (v). this rise of disability movements has made the ‘body’ more salient in these discussions (gilleard and higgs 2014). the authors use these differentials not only to denounce the effect of, for example, class differences on aging well, but rather analytically, to make sense of the diversified nature of old age. against the backdrop of increased life expectancy, the authors view the phenomenon of old age as both the product of social divisions and as a socio-demographic reality, which reworks and reframes understandings and aspirations of earlier life. at the same time, according to the authors, these social divisions confer unequal access, opportunities, and constraints to older adults (4), which are often constructed, just like ‘social facts.’1 the four core chapters of the book discuss the social differentials of class, gender, ethnicity and race, and finally, disability. the latter half of the book focuses on intersectionality as a viable analytical tool to study the workings of these social differentials in later life. chapter 2, “social class and inequality,” discusses class as a zombie category: i.e., dead but still living amongst us. the authors propose alternative, more historically contingent approaches to ‘class difference’ focusing on consumption, identity, and lifestyle and introduce bourdieu’s habitus, thus shifting the focus from hierarchy-based divisions to more cultural framings. they conclude with a brief discussion of how the introduction of the universal basic income (ubi) has rendered class differentials problematic. without going into much detail, the authors overlook the uneven provision of ubi across the world in their analysis. for instance, in india, ubi continues to be in its formative phase and far off from implementation. at the same time, class continues to be a major determinant in the aging process. in fact, the idea of “third age” has a strong class grounding in the indian context (samanta 2018). http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.350 http://anthro-age.pitt.edu 181 chapter 3 discusses gender as a “structural social division, a source of inequality that runs throughout the adult life course” (41). along with discussing different strands in feminist research, the authors elaborate on the ways in which gender contributes to “later life’s inequalities and injustices,” and also point out how it “adds to its complexity, richness and diversity” (66). the overall shift in the social sciences and humanities from ‘structural inequalities’ to a focus on ‘identities and subjectivities’ is emphasized by the authors. this phenomenon has been studied through the lens of the cultural turn in social gerontology (2020, 147; twigg and martin 2015), along with the changes from first to second modernity. however, gilleard and higgs limit their discussion of inequalities in gender to the strict binaries of male and female and scantly touch upon same sex couples/households. chapter 4, “ethnicity, race and migration in later lives,” is based on previous empirical research from the uk and the us and provides a detailed theoretical analysis of race and ethnicity in later life. both differentials play an important role in structuring these social divisions, which are inseparable to those in positions of power (70). at this point, the authors include a brief discussion of the composite process of migration relevant to ethnicized and racialized divisions that contributes to the complexities of later lives. gilleard and higgs do not always see this differentiation as detrimental to group solidarity; they see ethnic and racial divisions as ways to foster a sense of community as people within and across generations attach themselves to their specific group identities. the book interestingly raises the issue of the often-neglected aspect of the narrative performance of ethnicity. using the lens of performativity, allows scholars to cast new light on differences, identity, and lifestyle in later life while “illuminating ethnicity as a social location and social identity whose meanings differ with age” (91). the importance of recognizing social differentials such as gender, class, ethnicity and race, and disability has been reiterated in all chapters, illustrated in particular with examples from the global north. however, i believe this discussion would benefit substantially by providing evidence from the global south, where the adverse effects of social differentials are widespread. although stable social divisions (95) can be understood through variation across differentials, identities and processes of subjectification remain fluid and particularly anchored in bodily appearance and physical functioning (gilleard and higgs 2015). chapter 5, thus, deals with the corporeal markers of illness, impairment, or infirmity, emphasizing “the greater degree of inter and intra-subjective negotiation and re-positionings in late modernity” (97). due to the compounding effect of disability and age, the authors discuss the incompleteness of using disability theory in considering the corporeal differences in later life. chapter 6, “identity and intersectionality,” places greater emphasis on the increased diversification of later lives, particularly among third agers. the contours of a new aging imaginary are most evident among the baby boomer cohort whose “consumer habitus continue to expand” (123). using intersectionality as a methodological framework, the authors work to further demarginalize particular groups in social gerontological research and—ideally—in everyday practice. furthermore, this allows us to evade the binary structures of our discussions and thus revisit the dualism (i.e., structures and subjectivity) that pervades the social sciences. in fact, social reproduction and cultural participation have become key concerns to researchers, allowing them to articulate relational identities and shift away from a discourse on frail, dependent, and powerless older adults towards one on more agentic individuals. in a closing chapter, this book brings to our attention how later years are as much about difference and diversity as they are about exclusion and inequality. this requires us to recognize the potential richness that arises from the performative multiplicity of varied aspects in later life. the book is succinct in its discussion, citing a plethora of useful literature, and straightforward in its layout. the objectives are clearly laid out, and impetus is placed on detailed theoretical discussion. as such, it will be useful for http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.350 http://anthro-age.pitt.edu 182 scholars interested in the social sciences in general and in the later years of the life course in particular. with the growing differentiation of particular forms of later life, this book definitely sets the stage for more discussion along these lines. like much of gilleard and higgs’ previous work, it will be useful in teaching the foundational understandings of a wide range of older adults’ experiences. moreover, this unquestionably pushes researchers to think about how later years are—and will keep—diversifying in societies across the world. notes 1. social facts are values, cultural norms, and social structures that transcend the individual and can exercise social control (durkheim 1982). references buch, elana d. 2015 “anthropology of aging and care.” annual review of anthropology 44: 277-93. durkheim, emile. 1982. “what is a social fact?” in the rules of sociological method. edited by steven lukes, 50-59. london: palgrave. gilleard, chris, and paul higgs. 2014. ageing, corporeality and embodiment. anthem press. gilleard, chris, and paul higgs. 2015. “aging, embodiment, and the somatic turn.” age, culture, humanities: an interdisciplinary journal 2: 17-33. gilleard, chris, and paul higgs. 2017. “ageing, corporeality and social divisions in later life.” ageing and society 37 (8): 1681-1702. samanta, tannistha, 2018. “the ‘good life’: third age, brand modi and the cultural demise of old age in urban india.” anthropology & aging 39 (1): 94-104. twigg, julia, and wendy martin. 2015. “the challenge of cultural gerontology.” the gerontologist 55 (3): 353-359. http://anthro-age.pitt.edu/ recognizing older individuals: an essay on critical gerontology, robin hood, and the covid-19 crisis annette leibing university of montreal annette.leibing@umontreal.ca anthropology & aging, vol 41, no 2 (2020), pp. 221-229 issn 2374-2267 (online) doi 10.5195/aa.2020.315 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 221 recognizing older individuals: an essay on critical gerontology, robin hood, and the covid-19 crisis annette leibing university of montréal aleibing@videotron.ca cockroach and bug infestations, seniors calling out repeatedly for help, rotting food, covid-19-infected patients put in the same room with those who are healthy, missed meals, seniors left in soiled diapers and linens – these are just some of the things canadian armed forces (caf) personnel have seen while helping in five longterm care homes in ontario. the military, called in to help at some of ontario's worst-hit longterm care homes during the covid-19 pandemic, confirmed what caregivers and family members of those in the homes have been saying for years: there is a crisis in how we care for our seniors. malek 2020 introduction sending canadian soldiers into nursing homes in ontario and québec – where the lack of care resources and subsequent deaths caused by covid-19 was much more pronounced than in other provinces – was a desperate last resort for saving nursing home residents and the image of canada as a progressive, caring country. this image, often evoked when describing canada’s approach to health care as superior to the ultra-neoliberal us american system, was shattered with the revelation that – as the author of the article above pointed out – there was a crisis, something observers “have been saying for years.” all scholars in aging studies – critical or not – agree on one point: the covid-19 crisis laid bare structural and interpersonal factors of neglect which have been going on for a long time; and with that, catapulted older people out of their partial invisibility as has rarely happened before. the most vulnerable individuals became front page news around the world. images of their tired, worried and sometimes lost expressions reminded readers on a daily basis of something central to critical gerontology: that living conditions for many older people, especially those in nursing homes, are too often inhuman. the frequently repeated statement that ‘covid-19 only affects older people’ sharply reflects the lack of valorization of such lives, especially in québec where the number of deaths in nursing homes was for a while one of the highest in the world (paré 2020). the kind of care prevalent in such living spaces, critical scholars argue, reduces older people to objects who do not receive much more than a basic management of needs – at least those individuals who don't have the means and resources allowing them to be recognized as someone.1 older people in nursing http://anthro-age.pitt.edu/ leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 222 homes, generally perceived as living in spaces of ‘bare life’ – a living space comparable to a “state of exception,” just like townships and prisons (cf. mbembé and meintjes 2003) – are at the core of critical gerontologists’ writings, including the more recent field of critical dementia studies. the focus on a lack of recognition of some older people as persons in dehumanizing living spaces is probably the reason why there is such an immense preoccupation on the part of critical scholars with questions around personhood and social citizenship. in a blog post on “what is the next stage in critical gerontology?” mario paris (2016) states that social recognition is at the core of the discipline. the “critical” therefore refers to an engagement with an individual who should not disappear in a homogenized group of ‘elderly,’ but who needs to be seen as someone beyond handicaps and frailty. the covid-19 crisis is forcing scholars, as well as the general population, to recognize the existence of a concrete link between the state, society and interpersonal relations – something that arguably is sometimes neglected in critical gerontology, in which, as tom kitwood (1997) once stated, the “person comes first.” a lot of critical gerontology studies (e.g., de medeiros and basting 2014) are rightly about interventions conceived as providing better, more human, more creative care and activities, rhetorically projected against the screen of neglect and social exclusion. however, by focusing on the older personin-need-of-help, critical scholars ultimately reinforce dehumanizing practices, because without acknowledging (and changing) political and structural factors, interventions such as some personcentered approaches often only help to cope with insufficient care systems. leibing (2020) in this regard, talks about the establishment of “momentary citizenship,” since unsuitable forms of living and a lack of recognition are only for a short period of time interrupted by such interventions. however, some forms of more radical ways of conceiving dementia care might provide solutions, for instance by rethinking architectural spaces (e.g., lubczynski 2011) and by “queering dementia” – not only as a means to more inclusive practice regarding minorities, but also as a radical way of rethinking the normative ‘self’ in dementia (foth and leibing, submitted article). furthermore, the all-encompassing image of ‘frail older people’ overshadows nuance and becomes an ideology that turns researchers and care staff into sort of robin hoods. hood, who himself is a liminal figure, nevertheless fights in a clearly divided world of good and bad, in which victim and oppressor – poor and rich people – are unquestioned categories. just like some critical gerontologists who also position themselves, apparently, outside of norms of common dementia care practices, conceived as inhuman. and although this kind of positionality happens as a result of an admirable intention, it can make such scholars at least partly blind to nuance, in line with what sartre once called ‘transcendent givens’ – values as independent of human subjectivity (see collier 2003). as an example, francis vailles (2020b), a quebec journalist and specialist in social epidemiology, recently reminded us that the generalized image portraying older people as endangered by covid-19, but equally as a dangerous source of contagion – as “super-spreaders” – needs to be relativized or nuanced. vailles (2020b), partly reacting to senior citizens being refused access to supermarkets at the beginning of the pandemic, showed that individuals living in nursing homes in québec were at high risk of dying from the virus, and in urgent need of more resources and better organized care. however, older people living in the community were actually dying of covid-19 at lower rates than adults under 65.2 the protection of the ’frail’ older person became here a category fallacy, since such a ‘robin hood activity’ did not resolve the urgent need of those who needed protection, while equally denying citizenship to older people who were neither frail nor in need of such a limitation of their liberty. in the following i will give a short overview of the covid-19 crisis in québec in order to reflect on critical gerontology and, as i will argue, to draw attention to the need of also critically analysing critical gerontology. i will argue that accounting for different, complementary approaches in critical http://anthro-age.pitt.edu/ leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 223 gerontology might help avoid ‘robinhoodism’ and provide more nuanced data about aging and the life course. québec’s covid-19 crisis over the course of several weeks in spring 2020, newspapers and other media outputs published daily the map of canada, in which the reader could find for each province the total number of covid-19 cases, the number of new cases (within the last 24 hours), as well as the total number of accumulated deaths. on june 5, 2020, for example, the most western canadian province, british columbia, announced its numbers, which differed profoundly from those of québec in eastern canada – “as if we were living in two different countries,” anthropologist stacy pigg from simon fraser university in british columbia commented (personal communication). until june 05, 2020 british columbia québec all cases 2632 52143 new cases (24 hrs) 9 259 all deaths 166 4885 source: la presse online, “actualités“ 2020. but, if testing and analysis were following more or less the same protocol, why was there such an immense gap between the two provinces? in terms of numbers, québec counts twice the number of older people of british columbia, but that does not explain the great difference between the provinces. and even in ontario, where more older people live than in québec (respectively 2,292,790 versus 1,534,300 for the 65+; see statista.com 2019), covid-19 cases and deaths were lower than in québec. three principal explanations were provided by public health experts and – finally – discussed intensively in the media. first, in québec more older people live in residences (for autonomous and semi-autonomous individuals) than in other canadian provinces. these agglomerations are known for higher numbers of covid-19 cases when compared to the general population, although still much less than in nursing homes. a québec tax initiative seems to explain why many older people moved into private residences and so, as some critics remarked, private owners of residences were financed in a public health and social system (see vailles 2020a).3 a second factor that is regularly mentioned by researchers and in the media is the administration of health care in quebec, whose structure has been described as “monstrous,” “too big,” “too centralized,” “chaotic,” “detached from reality,” and so on (e.g., lemay 2020). an example of the chaotic situation is that, although the catastrophic management of nursing home care was admitted to (especially the fact that nursing home staff were constantly moving between ‘hot’ and ‘cold’ zones and therefore contributed to contagion), now, in the fall of 2020, at a moment when a second wave is building up, this situation has not changed in québec. british columbia, on the other hand, was able to regulate staff movement between infection zones within one month (chouinard 2020). further, for a long time, québec’s head of public health denied the need to wear masks for the general population, and even for health care professionals protective material was missing during the first weeks of the pandemic. finally, as elsewhere, staff shortages became increasingly dramatic as the pandemic unfolded, in a system that was already operating beyond its limits before the covid-19 crisis. this, in combination with a chaotic and top-heavy administration imploded care work in québec’s nursing homes and led to scandalous conditions and many preventable deaths. it lead to what some called a “genocide in québec’s nursing homes” (e.g., patenaude 2020). http://anthro-age.pitt.edu/ leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 224 two scandals less perceivable and highly value-laden aspects of life are often revealed in major narrative changes (similar to what paul rabinow (2012) calls “chronicles of shift”); changes that carry the potential of transforming existing ways of thinking. defined by the merriam-webster dictionary (n.d.) as “a circumstance or action that offends . . . established moral conceptions,” scandals are, because of their disruptive nature, an ideal way of getting closer to core values of a given society. the first scandal of the covid-19 crisis in québec is obviously the extreme neglect of nursing home residents already mentioned in the introductory quote. the direct critique in the form of public outcry and indignation regarding conditions that had already been known for a long time, but that now, because of its extreme manifestation, could not be ignored, directly targeted the current, but also previous governments. as an example from olson (2020): bedridden residents were lying in sheets stained brown up to their necks in excrement, so long had it been since their diapers had been changed. some were dehydrated and unfed. "the conditions were disgusting. the patients were drenched in urine and feces," said loredana mule, a replacement nurse who worked that evening. . . . one lpn and two patient attendants were trying to care for 130 residents. food trays had been placed on the floor, dishes untouched because residents with mobility issues couldn't reach them. at the end of that shift, the last remaining lpn on herron's staff went home and never came back. no "hot zone" for infected patients was established — and residents known to have tested positive for covid-19 were wandering around the floor. . . . one attendant described working from 3:30 p.m. until 7:30 a.m., to tend to the needs of the dozens of seniors on the floor. nursing homes generally have a very negative public image, and this is not only the case in québec (leibing, guberman, and wiles 2016). it is disturbing that, while at the core of critical gerontology’s preoccupations, and regularly documented in the media, not much has changed regarding such living (or dying?) spaces. and as the author of the introductory quote remarked, “… it is a sad irony that it took the traditionally male-dominated military to get the attention of politicians when workers in the homes, most often racialized women, have been raising the same concerns for years” (malek 2020). a second scandal is related to the first one, but represents a different kind of critique. again, a quote from the local media: quebec’s confédération des syndicats nationaux (csn), which represents more than 30,000 caregivers in the province’s beleaguered health-care system, is pushing back hard on recent comments made by the minister for the elderly, marguerite blais. the union thinks blais . . . should be remembered as the minister whose main contribution to quebec’s long-term-care centre network was “clowns” and “mechanical seals” rather than any genuine assistance to the elderly or those who attend to them. as long ago as 2012, the csn repeatedly put pressure on the provincial government to reduce the workload faced by caregivers or increase funding for chslds [nursing homes]. “no one listened, there was no change,” said gingras. rather, said gingras, blais announced clowns and mechanical seals would be sent to the centres to entertain the residents, a move that drew criticism at the time. gingras said blais felt “the elderly deserved a chance to smile” rather than ensure those residents had the necessary resources to be fed and bathed. (bergeron 2020; emphasis added) http://anthro-age.pitt.edu/ leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 225 in a way, this kind of media output is a critique of critique or: a critique of robinhoodism, that has been taken for granted for a long time. the journalist not only challenges the governance of older peoples’ lives in quebec (as does the first scandal), the prescriptions found by the minister, clowns and seals for older people – for many considered good practices in elder care (e.g., warren and spitzer 2011) – get now inversed. these interventions become inappropriate, even cynical, once the need of targeting structural factors becomes evident. in the concluding section i want to reflect a bit more on these two kinds of critique. critical aging/dementia studies 1.0 and 2.0 the following discussion is the result of a certain discomfort caused by discussions with colleagues and students due to the glitchy definition of ‘critique.’ i felt that thinking critically about (covid-19 and) aging needed to distinguish between kinds of critique – a need that in an earlier publication i attributed, at least partly, to the pitfalls of humanism as a predominant framework for thinking about care (leibing 2019). in humanistic frameworks, as in my understanding of the first scandal, questions of responsibility are raised and a clear division between good and bad is established. of course, several authors have mentioned similar blind spots within humanist kinds of caring for others that, as didier fassin (2012), in the context of international humanitarian work, describes as ideologically based on equality and inclusion, while practically reinforcing the “inequality of lives” as the “invisible foundation” of humanitarianism (242). within this kind of framework, care work is deeply linked to empathy, which fritz breithaupt (2017) considers a dilemma. empathy is positive, he argues: it makes us human and can lead to doing good, but can also be negative, since it is rarely acknowledged how empathy polarizes by engaging with only the victim, and in this way nuance is lost to one-sidedness. in a similar vein, michael ridge (2015) talks about “impassioned belief”: he argues that normative judgments motivate people’s action through affect. however, they turn actions, like care, into a “desire-like” and “belieflike” state, often expressed through “'ought’ and as unquestioned ‘good’” (2015, 9). another argument stems from the point miriam ticktin (2011, 5) raises in the context of immigration activism in france. in some studies in critical gerontology older individuals – like ticktin’s immigrants are reduced to the single category of “older people.” ticktin writes that “[r]egimes of care are grounded in a politics of universality . . . [however,] [i]mmigrants are stripped of their legal personas when identified solely as suffering bodies, . . . they are not liberated into full citizenship” (2011). ticktin’s argument is highly relevant here, because this is exactly what also often happens in care for older people. by engaging with nursing home residents, many of them with an advanced dementia, and by offering happiness in form of arts-based therapies for example, only “momentary citizenship” in the form of a partial we-ness is realized (leibing 2018, 2020). and finally, looking again directly at aging studies, thomas cole (1992, 233) writes that “[t]he fashionable positive stereotype of old age showed no more tolerance or respect for the intractable vicissitudes of aging than the old negative stereotype.” the radicality of cole’s observation is important for reflecting on pitfalls of humanistic approaches to care for older people, which i tried to do by distinguishing between two kinds of critique (or scandals). different from the first, the second scandal of the covid-19 crisis in québec is linked to a more radical conscientization that questions exactly what is close to the heart of critics of the first group: saving frail older people through humanist interventions. while therapeutic clowns were often presented as positive interventions in the local media, or as signs of ultimate humanity and researcher’s ‘equality’ (hendriks 2012; 2017), this also made the public aware of the need to root ‘happiness’ more deeply in structural problems, and without which laughter (and tenderness) resulting from clowns and mechanical seals couldn't be sustained. http://anthro-age.pitt.edu/ leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 226 in this sense, anthropologist cheryl mattingly’s (2019) division of critical phenomenology into 1.0 and 2.0 might be helpful in rethinking critical gerontology, because she not only distinguishes between two kinds of critique, but also claims that both are necessary: the blind spots found in one do not mean that they are not both needed. “in anthropology,” mattingly (2019) writes, . . . work that has been explicitly designated ‘critical phenomenology’ usually refers to approaches that bring together critical sociopolitical voices and scholarly traditions with phenomenological ones. for my purposes, i will refer to this as ‘critical phenomenology 1.0.’ but there is also a second sense in which phenomenology is critical: phenomenology as a project of concept critique. this speaks to the phenomenological insistence on destabilizing all concepts. when both these senses of critique are taken together, critical phenomenology emerges as a radical provocation to disquiet dominant sociopolitical concepts, including those we ourselves hold. this disquiet becomes part of our own political theorizing. let’s call this, for the moment, ‘critical phenomenology 2.0.’ (2-3) sociologist thomas lemke (2011) provides a similar analysis. he shows that foucault, especially in his later work, bases critique on experience: the notion comprises two seemingly contradictory dimensions. experience is conceived of as dominant structure and transformative force, as existing background of practices and transcending event, as the object of theoretical inquiry and the objective of moving beyond historical limits (27). this kind of argument could be linked to mattingly’s preoccupation with critical phenomenology, if we assume that experience is a central notion within phenomenological thinking (see also rabinow and rose 2003). methodologically, experience can be captured by intensive engagement with lives, ours and others, as it is the case in some ethnographic approaches. however, ethnographers also sometimes look exclusively at the interpersonal dimension of care, in which victims and ‘the bad’ are firmly established from the beginning. radical or 2.0 ethnographies would, after mattingly, also destabilize this order of things. such an approach would help to describe the deeply disturbing effect of covid-19 on many lives, and especially older individuals’ lives, and at the same time take this as an opportunity to rethink present landscapes of care (and the obscured position of both ‘the elderly’ and ‘the carers’ in this landscape). both perspectives are needed: as lemke remarks regarding foucault’s later understanding of critique: “there cannot be any critique without an idea of what is conceived as intolerable and unacceptable” (2011, 40). however, studying the experience of the covid-19 crisis is not only describing the horrific conditions older people were (and are) going through, as in the shocking quotes above. it would also mean, among many other possibilities, to follow closely those who want to help, nurses for example, and show how they face their own fears of getting sick and dying or of transmitting the virus to their children at home (and therefore quit). it would further mean creating a deep understanding of the multiple, sometimes unsurmountable hurdles these nurses experience on a daily basis in the chaotic québec health care system. finally, such an approach would make us wonder how, historically, such a neglectful system could come into existence and survive. such an ideal ethnography would document, closely tied to experience, how such categories through which older people live and get perceived by themselves and others, are accepted, contested, embodied, and articulated in concrete lives, and not in pre-established models, even not if such models resemble well-meaning robin hood. http://anthro-age.pitt.edu/ leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 227 acknowledgements i thank the canadian sshrc (social sciences and humanities research council) for funding my research. i further thank stephen katz for his (as always) so insightful comments at the online workshop critical approaches to dementia in the pandemic and post-pandemic, organized by the critical dementia studies network, in june 2020. christine verbruggen provided extremely helpful and very much appreciated comments and questions to an earlier version of this text. finally, i dedicate this article – because of ongoing discussions (and some delightful fights) – to my dear friend and colleague thomas foth. notes 1. “becoming someone” here relates to the argument, often made using agamben’s (1998) concept of ‘bare life,’ that some people get marginalized and their lives banalized in a way that they are not considered worth caring for anymore (like some poor people with dementia, despite all discourses of inclusion made by gerontologists). however, bare life-like states can be facilitated by resources like financial means that are able to buy dignity to a certain degree and adapted environments of care or, the fact of being white (and therefore worth recognizing) – as opposed to being aboriginal, as jiwani (2013) has shown in her study of missing women in vancouver. 2. the following table is based on vailles (2020b; published with the author’s authorization). the numbers refer to deaths per 10 000 in different living spaces in quebec: chsld (long-term nursing home) 865 intermediate resources (semi-autonomous) 196 residences, autonomous 62 at home, 65+ 2 at home, 65 0.4 whole population 6 based on data published by inspq, msss, aqra and isq (see vailles 2020b). 3. freeman (2020) explains why so many more quebeckers move into senior residencies than aging individuals in other provinces: “thanks in part to a generous provincial tax credit for housekeeping and meals, quebec is the capital of canada’s senior housing business. according to the statistics for 2018, 17.9 per cent of quebecers over the age of 75 were living in nursing homes and seniors’ residences compared with just 5.5 per cent in ontario. and probably in part because of the subsidy, the average rental cost in quebec per unit was just $1,678 a month, half the cost in ontario.” references agamben, giorgio. 1998. homo sacer, sovereign power and bare life. california: stanford university press. bergeron, patrice. 2020. “csn pushes back on comments by quebec's minister for the elderly.” montreal gazette. accessed may 7, 2020. https://montrealgazette.com/news/local-news/csn-says-pushes-back-oncomments-by-quebecs-minister-for-the-elderly. breithaupt, fritz. 2017. die dunklen seiten der empathie. berlin: suhrkamp. chouinard, tommy. 2020. “la protectrice des citoyens accuse québec de laxisme.” la presse online. https://www.lapresse.ca/covid-19/2020-09-24/chsld/la-protectrice-du-citoyen-accuse-quebec-delaxisme.php. http://anthro-age.pitt.edu/ https://montrealgazette.com/news/local-news/csn-says-pushes-back-on-comments-by-quebecs-minister-for-the-elderly https://montrealgazette.com/news/local-news/csn-says-pushes-back-on-comments-by-quebecs-minister-for-the-elderly https://www.lapresse.ca/covid-19/2020-09-24/chsld/la-protectrice-du-citoyen-accuse-quebec-de-laxisme.php https://www.lapresse.ca/covid-19/2020-09-24/chsld/la-protectrice-du-citoyen-accuse-quebec-de-laxisme.php leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 228 cole, thomas r. 1992. the journey of life: a cultural history of aging in america. cambridge: cambridge university press. collier, andrew. 2003. in defence of objectivity and other essays, on realism, existentialism and politics. new york: routledge. de medeiros, kate and anne basting. 2014. “‘shall i compare thee to a dose of donepezil?’: cultural arts interventions in dementia care research.” the gerontologist 54(3): 344-353. fassin, didier. 2012. humanitarian reason, a moral history of the present. berkeley, ca: university of california press. foth, thomas. 2020. “rethinking dementia as a queer ‘way of life’: implications for practices of care.” unpublished manuscript. freeman, alan. 2020. “time to re-think seniors’ housing and long-term care in canada.” ipolitics. accessed april 3, 2020. https://ipolitics.ca/2020/04/03/time-to-re-think-seniors-housing-and-long-term-care-in-canada/. hendriks, ruud. 2012. “tackling indifference: clowning, dementia and the articulation of a sensitive body.” medical anthropology 31(6): 459-476. https://doi.org/10.1080/01459740.2012.674991. hendriks, ruud. 2017. “clown’s view as respiciō: looking respectfully to and after people with dementia.” medicine, health care and philosophy 20: 207-217. https://doi.org/10.1007/s11019-016-9734-1. jiwani, yasmin. 2013. “‘bare life:’ disposable bodies, race, and femicide in the trial coverage of vancouver’s murdered ‘missing’ women.” synaesthesia, communication across cultures 1(4): 87-127. kitwood, tom. 1997. dementia reconsidered: the person comes first. london: open university press. leibing, annette. 2018. “on heroes, alzheimer’s, and fallacies of care: stories of utopia and commitment.” in: kulturen der sorge, wie unsere gesellschaft ein leben mit demenz ermöglichen kann, 177-194dited by harmpeer zimmermann, campus. leibing, annette. 2019. “geriatrics and humanism: dementia and fallacies of care; special issue “fallacies of care.” edited by annette leibing and natashe lemos dekker. journal of aging studies 51: 100796 (online issue). leibing, annette. 2020. “heroic stories of dementia care: grandchildren as caregivers and fallacies of care.” in the cultural context of aging: worldwide perspectives. edited by jay sokolovsky, 4th edition, chapter 52, praeger ed./abc-clio. leibing, annette, nancy guberman, and janine wiles. 2016. “liminal homes: older people, loss of capacities, and the present future of living spaces.” journal of aging studies 37(1): 10-19. lemay, éric yvan. 2020. “structure du réseau de la santé: ‘c’est trop gros, c’est pas gérable.’ ” journal de montréal. accessed 21 april, 2020. https://www.journaldemontreal.com/2020/04/21/cest-trop-gros-cest-pas-gerable. lemke, thomas. 2011. “critique and experience in foucault.” theory, culture & society 28(4): 26-48. malek, jan. 2020. “military report on long-term care homes reveals long-known truths.” the council of canadians. https://canadians.org/analysis/military-report-long-term-care-homes-reveals-long-knowntruths. mattingly, cheryl. 2019. “defrosting concepts, destabilizing doxa: critical phenomenology and the perplexing particular.” anthropological theory 19(4): 415-439. mbembé, achille and libby meintjes. 2003. “necropolitics.” public culture 15(1): 11-40. olson, isaac. 2020. “‘it was so inhumane:’ conditions in dorval seniors’ residence prompts investigation.” cbc news online. accessed april 10, 2020. https://www.cbc.ca/news/canada/montreal/west-island-staff-covid19-1.5528956. paré, isabelle. 2020. “après 100 jours de lutte contre la covid-19, où se situe le québec?” le devoir online. accessed june 20, 2020. https://www.ledevoir.com/societe/sante/581212/100-jours-de-crise-sanitaire-ouse-situe-le-quebec-dans-la-lutte-contre-la-covid. http://anthro-age.pitt.edu/ https://ipolitics.ca/2020/04/03/time-to-re-think-seniors-housing-and-long-term-care-in-canada/ https://doi.org/10.1080/01459740.2012.674991 https://doi.org/10.1007/s11019-016-9734-1 https://www.amazon.ca/cultural-context-aging-worldwide-perspectives/dp/1440858268/ref=sr_1_2?qid=1558358341&refinements=p_27%3ajay+sokolovsky&s=books&sr=1-2 leibing | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.315 http://anthro-age.pitt.edu 229 paris, mario. 2016. “what is the next stage in critical gerontology? the struggle for recognition.” international network for critical gerontology. accessed december 16, 2016. https://criticalgerontology.com/next-stagecritical-gerontology-struggle-recognition-mario-paris/. patenaude, alain. 2020. “assistons-nous à un génocide gériatrique?” vigile québec. accessed april 14, 2020. https://vigile.quebec/articles/assistons-nous-a-un-genocide-geriatrique. rabinow, paul. 2012. designing human practices, an experiment with synthetic biology. chicago: the university of chicago press. rabinow, paul and nicholas rose 2003. “introduction: foucault today.” in the essential foucault reader. edited by paul rabinow and nicholas rose. vii-xxxv. new york: the new press. ridge, michael. 2015. impassioned belief. oxford: routledge. ticktin, miriam i. 2011. casualties of care, immigration and the politics of humanitarianism in france. berkeley: university of california press. vailles, francis 2020a. “maintien à domicile des aînés: l’aide fiscale incite plutôt à déménager!” la presse. accessed may 29, 2020. https://www.lapresse.ca/affaires/economie/2020-05-29/maintien-a-domicile-desaines-l-aide-fiscale-incite-plutot-a-demenager. ----.2020b. “le risque de mourir.” la presse. accessed june 13, 2020. https://www.lapresse.ca/covid-19/2020-0613/le-risque-de-mourir. warren, bernie, and peter spitzer. 2011. “laughing to longevity – the work of elder clowns.” the lancet 378(3791): 562-563. http://anthro-age.pitt.edu/ book review | vana and hazan | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.268 http://anthro-age.pitt.edu 120 book review review of davies, janette. living before dying: imagining and remembering home. new york and oxford: berghahn books. 2017. pp. 160. price: $127,5 (hardcover); $30 (paperback and ebook). noa vana department of sociology and anthropology, tel aviv university haim hazan department of sociology and anthropology, tel aviv university anthropology & aging, vol 41, no 1 (2020), pp. 121-122 issn 2374-2267 (online) doi 10.5195/aa.2020.268 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ book review | vana and hazan | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.268 http://anthro-age.pitt.edu 121 book review review of davies, janette. living before dying: imagining and remembering home. new york and oxford: berghahn books. 2017. pp. 160. price: $127,5 (hardcover); $30 (paperback and ebook). noa vana department of sociology and anthropology, tel aviv university haim hazan department of sociology and anthropology, tel aviv university reviewing janette davies' monograph has been a compelling and challenging task. in our most recent work and haim's diverse books over the years, we have pondered upon the concept of 'home' and its transformative nature in old age a social conundrum that is also the focal point of davies' detailed account of the intimate interconnection between elderly people with dementia and professional caregivers in a residential 'home'. in her careful and crafted depiction, davies resonates the voice of people who are often muted in anthropological discourse (hazan 2015). in the first three chapters she introduces her field: a professional care ecology for elderly people with dementia in a residential 'home'. the fourth and fifth chapters contains the stories of several residents that illustrate the interdependency between the elderly with dementia and the care assistants. therefore, people with dementia are not the only 'silenced witnesses' that claim a voice here. this book also sheds light on the care assistants' experiences and plights – working class women who are mostly underpaid for their tedious labor and whose position is rarely questioned. most importantly, davies highlights the vitality of the interactions and interdependency of care assistants and older people with dementia in everyday care practices and temporalities as they are continuously negotiated against the backdrop of management's constraints which are deeply impacted by profit-making goals. one telling example of the convergence of needs of both caregivers and the elderly is the account of valerie's dilemma during her weekend shift. "she described finding a trail of feces from the lounge to the toilet… rightly guessing that it was arthur, who was frequently unable to understand where to defecate… the lounge was full of residents and their visitors, many of whom were concerned that the care assistants had to clean it up, acknowledging how busy they had been that day due to a shortage of staff" (62). this account reminds the readers that care is situated, relational, and reciprocal, not necessarily instrumental. davies' complex and realist descriptions of the everyday reciprocity of caregiving, can be understood as a result of her janus-faced presence in the field as both an anthropologist and a trained nurse, which allowed her a unique position in the field: she was able to access, observe, and actively share the staging of human dramas at the residential home, day by day as they emerged, for over a year, that other participant observers would never have gained admission to in a similar level of controlled intimacy. from this position in the field stems her monograph's greatest strength and main contribution: her anthropological gaze at the minutiae of life in a uk residential home. for instance, she delicately explores the loss of privacy, dignity, and self-esteem, mainly during bathing times, through very personal stories of residents, and through her active involvement. such a 'careful' research position allows her to describe some of the residents' mundane comments that "they enjoyed coffee that morning…[since] it was not 'slopped'", while deducing that "well-made and well-served hot drink could provide real pleasure" (91). http://anthro-age.pitt.edu/ book review | vana and hazan | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.268 http://anthro-age.pitt.edu 122 however, it is precisely in this double entanglement that one of the monograph's drawbacks is found as well. though the author acknowledges her position in the field, she does not comprehensively reflect upon the power inequality between her as a researcher and a trained nurse with abundant experience and prolific academic background versus the underpaid and worn out care assistants. this accounts for an essential aspect of positionality in the field (rosaldo 2000, 532), which is not adequately addressed in the monograph; hence, producing an account that is deceivingly 'real'. another remarkable aspect is that davies is not reflexive to the significance of the time gap between the publication of the monograph in 2017 and the data collection which transpired during the last decade of the 20th century (2). she respectfully chose to publish her findings only after the last resident who participated in the research has passed away. nonetheless, this time gap of around roughly twenty years has implications that should have been considered and contemplated upon. firstly, although there is a vast literature of ethnographic research in institutional settings, ethnographic research with people with dementia at a large residential home has become an almost impossible mission for anthropologists to carry out in the last decade: vulnerability often equals inaccessibility. hence, the raw data collected in this research is of great value due to its uniqueness, and from the positionality of an anthropologist. davies should have pondered upon this temporal challenge critically. secondly, as davies' monograph is undoubtedly an important addition to several other prominent works that address the caring for older people with dementia in institutional settings, such as gubrium's (1975) groundbreaking ethnography on "bed and body work" and kitwood's (1997) writing on "person-centered care", these classical and influential works are blatantly absent from davies' literature review. thirdly, davies considers the 'home' trope in old age in general and in institutional care settings in particular. however, she does not sufficiently incorporate recent notable theoretical and empirical writing on this topic (e.g. mclean 2007), mostly limiting her theoretical background to the last decade of the twentieth century. moreover, while davies refers to the topsy-turvy category of 'home', she morally absolves the care assistants of dehumanizing and malignant care at times, not to mention the absence of presence of the encounter with death as a formative constituent in the construction of the home as a home in the sense of a safe haven from the impending end. despite these analytical and methodological shortcomings, davies provides ample valuable suggestions for improving residential home care. for instance, she proposes mealtime adjustments, such as offering a variety of food choices and rearranging seating positions. she also encourages professional caregivers to enhance activities in the afternoon to relieve the residents' boredom, such as engaging them in craft-making, cooking or cleaning, and spending some time outside. overall, her insights into the everyday routinized life of older residents in an institutional setting are likely to interest health practitioners, social workers, professional caregivers and hopefully policy makers and executives. furthermore, her empirical data will be captivating for anthropologists and align well with other ethnographies of nursing homes. to conclude, we recommend undergraduate through graduate students and professionals to consider adding davies' monograph to their reading list. references gubrium, jaber f. 1975. living and dying at murray manor. new york: st. martin’s press. hazan, haim. 2015. against hybridity: social impasses in a globalizing world. cambridge: polity press. kitwood, tom. 1997. dementia reconsidered: the person comes first. philadelphia: open university press. mclean, athena. 2007. the person in dementia: a study in nursing home care in the us. toronto: university of toronto press. rosaldo, renato. 2000. “grief and a headhunters rage.” in anthropological theory:an introductory history edited by jon r mcgee and richard l warms, 521–535. mountain view, ca: mayfield. http://anthro-age.pitt.edu/ introduction: covid19 and aging bodies – what do we mean when we say that older adults are most ‘affected’ by covid-19? christine verbruggen ku leuven christine.verbruggen@kuleuven.be anthropology & aging, vol 41, no 2 (2020), pp. 126-131 issn 2374-2267 (online) doi 10.5195/aa.2020.325 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. verbruggen | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.325 http://anthro-age.pitt.edu 126 introduction: covid19 and aging bodies – what do we mean when we say that older adults are most ‘affected’ by covid-19? christine verbruggen ku leuven christine.verbruggen@kuleuven.be the covid-19 pandemic and – in particular – the socio-political responses to it (fassin and lipman 2020), are persistently challenging aging bodies across the globe: virally threatening, distancing and isolating them; categorizing, protecting and neglecting them; relocating, disinfecting and re-educating them; slowing down, accelerating and virtualizing them, and, too often, killing them. covid-19 and its consequences for older adults and processes of aging also pose a challenge to the body of work that explores the intersection of aging and anthropology. while often cut off from those whom they wanted to voice the most, scholars were nevertheless urged to speak out and say something, preferably avoiding the much voiced adjectives “unprecedented” or “unseen.” it is on the juncture between both bodies challenged to transform – “both a reference point in a world of flux and an epitome of that flux” (frank 1991, 40) – the contributions in this special section were developed. each accounting for the complexities of bodily agency, they articulate particular answers to the question: what do we mean when we say that older adults are most ‘affected’ by this pandemic? reading the articles in this section diffractively, i.e. “considering the entanglement of bodies, texts, relationships, data, language, and theory that we are just beginning to understand” (mazzei 2014, 745), more generally offers different counternarratives to homogenized vulnerability, different faces of suffering, different allocations of responsibility and different possibilities for the anthropology of aging to account for different processes of aging. we surely mean that responses to covid-19 have changed the spatio-temporalities of aging bodies and have challenged the often precarious and vital relations of interdependency older adults are constituively part of. for older adults in networks of care in south africa, lenore manderson and susan levine consider how “caregiving continues in environments of lack” during covid-19’s harsh lockdown. while a minority of white, middle-class older adults have suffered from months without face-to-face contact in institutional care, the majority of black and colored south africans has suffered from the isolation that has only exacerbated existing health problems and has led to an increase in sociobiological suffering and mortality (suicide, cardiomyopathy, alcohol-abuse, gender-based violence). while there was certainly an excess mortality among aged south-africans due to the virus, the consequences of covid-19 have mostly negatively affected the possibility to care for oneself and for others. whether south african older adults are care recipients, care providers, or both, they generally rely on fluid and instable households. this fluidity is further exacerbated by the effects of covid-19, such as higher unemployment rates and changes in household composition. the already fragile http://anthro-age.pitt.edu/ verbruggen | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.325 http://anthro-age.pitt.edu 127 infrastructures of care – “the assemblage of people, spaces and material items that link the home with external structures of care” – are now extremely disrupted due to the shifting proxemics of external resources. covid-19 security measures have thus amplified the syndemics of poverty, racial inequality, chronic conditions (such as hiv) and aging. cortney huges rinker, m. aspen bataille and loumaire figueroa ortiz revisit the concept of the “kin contract” (suad joseph 2005) to account for the conflicting responsibilities latinx elderly face today in northern virginia, as family and the state converge. the “kin contract” brings to the fore how “belonging, identity, citizenship and responsibility” are firstly negotiated on the level of the family. older adults are an important and complexly wired node in the web of family life; e.g., as caregivers for grandchildren, and multi-generational households are often the pilar of economic subsistence and the result of financial, political, familial and cultural negotiations. today, latinx older adults are increasingly forced to navigate good citizenship – respecting physical distancing and keeping away from family members – with good (grand)parenthood – fulfilling the familial and cultural duty to care for grandchildren and support the family. the political response to covid-19 has been both a magnifier of socio-economic and racial inequalities and a disrupter of the navigational practices of citizens to cope with these inequalities and articulate modes of belonging. for middle-clas indian older adults, tannistha samanta foresees more promising and democratic consequences of the reorderings of space and relationality during covid-19. she engages with bourdieu’s concept of habitus to illuminate the cultural politics of space-making, democratic belonging and intimacy through the performance of non-kin amity and friendship among older middle-class indians. covid-19 restrictions have repatterned the occupation of public space and have challenged the common practice of adda or ‘morning walks’: routinized walks and unfocused conversations, commonly conducted as modes of later-life conviviality, strongly tied to the cultural memory of place and generally patterned by class and gender. the processual and agentive nature of habituation invites for the hypothetical question as to whether post-pandemic re-ordenings of public spaces will ultimately transform the habitus of older middle-class indians, as they engage in alternative performances of the ordinary practices of adda, in their houses, maybe across gender and class divides. she argues for a postpandemic environmental gerontology that focuses on the socio-spatial dimensions of public spaces and foregrounds the performance of later-life amity as a particularly powerful counternarrative to the discourse of victimhood and passivity that was invigorated by the covid-19 pandemic. additionally, the author advocates for a culturally sensitive sociology of age, where multiple, often contradictory modernities are recognized and where age is consistently thought relationally, historically contingent and spatio-temporally performed. the processuality of spaces, webs and relations of aging is similarly addressed by nanami suzuki, who explores the future possibilities for pandemic and post-pandemic aging-friendly societies in japan. building on years of experience in fostering intergenerational solidarity and supporting older adults to become “visible” as experienced and skilled members of society, she shares diverse flexible adaptations to the limitations in face-to-face interactions in japan throughout first, second and third waves of covid-19 infections. she provides examples of more extraordinary good practices such as “alternative facetime” in nursing homes and signs of solidarity from school children to hospital staff. she also pays particular attention to how aging-friendly spaces and communities can be designed to adapt to everchanging circumstances while seeing to the needs of “living” through multiple stages of life, such as moving to a ccrc, starting the schoolyear or celebrating cultural festivities. suzuki powerfully imagines the normalization of a community woven with threads of diverse opportunities, a social tissue flexible enough to support the abilities and needs of all generations, and particularly, to foster the communication between them, also when this means engaging with unworldly others. http://anthro-age.pitt.edu/ verbruggen | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.325 http://anthro-age.pitt.edu 128 when we say that covid-19 has mostly ‘affected’ older adults, we also means that their possibility of exerting agency in relation to the state, to the family and non-kin peers, to physical impairments and to the future has been challenged. amy clotworthy and rudi g.j. westendorp illuminate the dialogue between governmental “risk management” and political agency by older adults during the covid-19 pandemic in denmark. as in many countries over the world, the danish government has taken on an authoritative approach based on a risk analysis, which has led to measures that aim to protect a large, homogenized group of older adults (65+), together with the chronically ill. this policy in crisis contrasts starkly with the more neoliberal approach (e.g., risk-adverse policy, stressing individual responsibility to take rational decisions (see clotworthy 2020)) that denmark has developed since the nineties, and is more similar to the previous scandinavian model, where the common good was protected and furthered by the state. today, older adults find themselves anachronistically in a paternal state, that takes rational decisions for their “own good.” the authors show how, rather than becoming docile bodies overnight, older adults build on decades of taking up their own responsibility to respond as citizens to the uncertainty and ambiguity of political strategies by acting upon “their situated risk” (e.g., comorbidities) and reclaim political belonging through relational autonomy. the authors argue that, in future public health crises, the state would do good to take appropriate and proportional measures, taking into account that older adults are capable of acting as rational agents, and that this strategy would ultimately benefit “the common good.” also, sarah lamb highlights how older adults do much more with the pandemic situation than ‘just coping’ and draw on experience that comes with aging to maintain and transform selves amidst limitations. she draws from virtual and telephone conversations with older americans, to show the variety of older adults’ experiences and strategies. whereas, in the midst of real and large-scale human suffering, it might feel odd to voice humor, resilience and pleasure, she rightfully diagnoses this as a necessary antidote against the ageism that stems from the homogenization of a large group of older adults. lamb shows another face of intergenerational solidarity, where most of the participants witness feeling the pandemic and quarantine as much heavier for the younger generation: while they ‘are basically fine’ as they witness having “had a good life,” younger people are now missing out on some of the chances to build one. the narratives also tell of how the pandemic is faced against the backdrop of accrued life experience (vietnam war, hardship, …) that has given them the time to accumulate resiliency to cope with the fears and losses that come with the pandemic. while much of the attention in terms of sociality of older adults has been on isolation and loneliness, these narratives also tell of another vibrant sociality, that is re-invented by older adults: while not denying that they would “dump the alone time in a second,” the narratives tell of chairs being pulled in the door opening and garden diners, of zoomtime and facetime, and of learning experiences in the present. similarly pointing out the agency of older adults to relate – and transform – their categorization, “oldness” and the security measures and recommendations that come with it, are embraced as an empowering category. while equally resilient and agentive in ‘peace time,’ a phenomenological analysis of the “stories of remoteness” by older adults in rural areas in south karelia (russia) konstantin galkin has collected during the pandemic, shows that there are limits to processes of adaptation, that these limitations intersect with deficit infrastructures, and that isolation, loneliness and fears of becoming obsolete are felt throught the body that becomes “closed and squeezed up in a narrow frame.” the stories of marina, ekaterina and sergei, three older adults facing multiple chronic health conditions, show how the restrictions imposed by covid-19 add up to the infrastructure deficits of the villages of renelle and pyatnoye, and mostly impact their sense of agency and the possibility to choose where to go, whom to meet, and where to seek the best medical care. the complex intertwining of physical, social and mental well-being older adults reported before the outbreak of the pandemic, is now distorted, and this crisis http://anthro-age.pitt.edu/ verbruggen | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.325 http://anthro-age.pitt.edu 129 makes clear that the quality of life older adults has always depended on the possibility to leave the village to go the city where they could “communicate” with friends (not unlikeable neighbors) and where they could relax, and feel alive. caught between the fear of contracting the virus and the fear of aging or “degenerating” in isolation, the older body loses agency, mobility and futurity, as limitations endemic to living in rural areas, become insurmountable due to the consequences of covid-19 that the consequences of the pandemic are primarily felt through the body, is also powerfully voiced in the rapid qualitative appraisal of narratives of care workers in a long-term care facility in north carolina by andrea freidus and dena shenk. turning to affect theory, they analyze fear/helplessness, sadness/grief, anger/frustration and trauma/stress and exhaustion as affective engagements with the structural deficits that prevent care workers to properly care for older adults, and for themselves. not unlike the latinx community, the black majority in south africa or the older adults in south karelia, care workers are reminded during this crisis, of their position in society and of the position of those they care for. freidus and shenk maximize the analytical potential of emotion and the circulation of affect: while emotions are individually felt, they reflect and make up the socio-political landscapes, including persistent inequities, state’s negligence of care work and ageism. the prominent feelings the care workers report during a major outbreak reflect the structural devaluation of care workers’ lives, and of the lives of those they care for, that is even more palpable during – but far from exclusive to – this public health crisis. the stories of untimely and lonely deaths due to covid-19 such as reported by freidus and shenk, contrast starkly with viggo’s dying as recounted by his family and friends and evoked in the multimodal ethnographic piece by sofie rosenlund lau, nanna hauge kristensen and bjarke oxlund. the authors realistically capture the unforeseen opportunities for qualitative and worthy dying in pandemic times, as the ordinary modern practices of “timing and taming death” are disrupted. the life of viggo, a danish man in his mid-70’s, living with several impairments, was commonly characterized by the ordinary pace of caregiving. as the soundbites express, covid-19 was first but a background noise, a politicized event intersecting with the sounds of pills ticking in a glass, the hello’s and goodbye’s of careworkers, the making of sandwiches and viggo’s laughter and cheerfulness. when viggo becomes infected with covid-19, this ordinariness was distorted and an “interlinkage of personal and intimate time with national and global biopolitical chronologies” takes place. yet, viggo dies a death that was out of tune with the public spectacle of covid-19, “that was not ugly at all” and that reversed the modern pace of dying and the pace of traditional mortuary practices. this reversal allowed for both dying and mourning to regain a timeliness and intimacy, that is not only exceptional for the pandemic episode, but also questions the timeliness of modern dying as stretched in time through life-sustaining treatment, and of modern mortuary rituals as detached from the social process of mourning. of course, we also mean, that – on the juncture of both bodies – (critical) gerontology and the anthropology of aging are ‘affected’ as well, as they are confronted with latent tensions and lacunae in theorizing age and aging. “two scandals” in quebec invite annette leibing to once more think critically about critical gerontology, as “scandals are, because of their disruptive nature, an ideal way of getting closer to core values of a given society.” the first scandal pertains to, as evocated by freidus and shenk, the inhumane living (and dying) conditions in nursing homes that have escaped the confines of closed, understaffed care units and have become center stage during covid-19, especially now that the male-dominated military have entered the field of emergency and voiced their concerns. the mediatic and gerontological responses to this scandal, predominately reproduce the humanitarianism of a critical gerontology 1.0, and, as leibing points out, its limitations. humanitarian critiques are founded in a clear division of responsibilities and of the ‘good’ and the ‘bad.’ the strong empathic http://anthro-age.pitt.edu/ verbruggen | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.325 http://anthro-age.pitt.edu 130 affects this rhetoric provokes re-inforces homogenized categories (e.g., vulnerable older adults needing care from resilient citizens) and clearly divides those responsible to care from those worthy of care. the moral responsibility to “do some good” can only result in “momentary citizenship,” as it only surfaces the structural inequalities that are foundational to humanitarianism in the first place. as modern robin hoods bring laughter to older residents with dementia disguised as well-meaning elderly clowns, the categories that are the starting point of this encounter, have remained the same, which leibing rightfully diagnoses as the second scandal. she argues for adding 2.0. to the current version, 1.0. this would be the foundation of a critical gerontology that both looks for concrete sollutions for situations of injustice, inequality, exclusion, and everyday suffering, and critiques the very grounds upon which the subject of their concern and the affects this provokes are articulated. christine verbruggen, britteny m. howell and kaylee simmons, similarly address the importance of a concept critique to avoid contesting the othering in ageism with different forms of othering. like leibing, they question the benefits of humanitarian approaches promoting intergenerational solidarity to contest ageism during and after covid-19 or promoting the image of older adults as sources of wisdom, warmth and innocence as a counternarrative to frailty and vulnerability. both benevolent ageism – calling to protect ‘vulnerable’ elderly from the threat of viral infection – and hostile ageism – calling to protect society from the threat of ‘vulnerable’ elderly – homogenize and other “the elderly.” what has gone largely unnoticed, however, is how the contestation of the “othering of elderly” has provoked the invigoration of different forms of both in and outgroup othering of those who will be “forever old”’ through an analysis of the newsletters published by the flemish council for the elderly during different states of emergency of covid-19 in belgium, they show how much anti-ageist discourse, both activist and academic, risks exacerbating the dichotomy between third and fourth age leaving older adults who cannot prove happiness, resilience, indispensability, and who might be frail, dependent on care, and maybe even without desires for the future, without a space to speak from. the authors remind of the possibility for scholars in the field of anthropology and aging, to account for the neither-nor that permeates all narratives of aging, and conclude that: “how older adults talk during a global pandemic, matters.” acknowledgements a sincere thanks to all the contributors for taking the time to pause and reflect in times of crisis, and generously share their materials, especially where these were often challenging times on a personal level. thank you, also, jason danely, sarah lamb and phil kao, for reviewing earlier versions of articles in this issue and to henrik mikkelsen for the faith in a young student putting together an issue about a global health pandemic. the myth of david and goliath was never far off. a special thanks to the magnificent janis woodward, student editorial assistant of the aaq, to meticulously scan the articles for errors and possibilities for improvement. notes 1. previous versions of the articles by amy clotworthy and rudi g.j. westendorp, konstantin galkin, tannistha samanta and sarah lamb (together with ji chen, clarie ogden, tirtza schramm, and lin xinbei) were published in the age of covid-19 blogpost series, a series of reflections on the experiences of aging during covid-19, simultaneously posted by aage and somatosphere: https://anthropologyandgerontology.com/aage-news/theage-of-covid-19/. as long as the effects of covid-19 impact lives of older adults, we are warmly welcoming new contributions to the series. http://anthro-age.pitt.edu/ https://anthropologyandgerontology.com/aage-news/the-age-of-covid-19/ https://anthropologyandgerontology.com/aage-news/the-age-of-covid-19/ verbruggen | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.325 http://anthro-age.pitt.edu 131 references clotworthy, amy. 2020. empowering the elderly? how ‘help to self-help’ health interventions shape ageing and eldercare in denmark. transkript verlag. fassin, didier and joanne lipman. 2020. “an unprecedented health crisis: didier fassin on the global response to the covid pandemic.” institute for advanced studies princeton. accessed october 30, 2020. https://www.ias.edu/ideas/fassin-covid-global-response. frank, arthur w. 1991. at the will of the body: reflections on illness. houghton mifflin. joseph, suad. 2005. “the kin contract and citizenship in the middle east.” in marilyn friedman (ed.), women and citizenship. edited by marilyn friedman, 146-169. oxford: oxford university press. mazzei, lisa a. “beyond an easy sense: a diffractive analysis.” qualitative inquiry 20(6): 742-746. https://doi.org/10.1177/1077800414530257. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2014: 34 (4) 225 aging can be defined as the accumulation and embodiment of time, and the ‘experienced body’ of older individuals is spatially grounded in a number of ways. the link between certain spaces, sites or places1 with health or illness may be obvious: for example, a hospital can be a site of healing and yet also a site of contagion and illness when understaffed or infested with a bacteria such as clostridium difficile. aging, sex and well-being in brazil heterotopia and illness: older women and hypertension in a brazilian favela annette leibing, phd professor of medical anthropology faculty of nursing université de montreal other links between place, health and illness are more complex: leon eisenberg (2004), criticizing some forms of naive geneticism, states that, “nature and nurture stand in reciprocity, not opposition. offspring inherit, along with their parents’ genes, their parents, their peers and the places they inhabit” (eisenberg 2004, 102; emphasis added). for older individuals, who experience more abstract this article is about older women and the way hypertension is linked to their life in a favela, a “shantytown”, in rio de janeiro. inspired by foucault, i suggest calling this complex phenomenon ‘heterotopic illness’. by calling attention to the importance of place for understanding certain illnesses, the limited usefulness of some public health prevention campaigns is shown. since hypertension can be considered a “disease of aging”, it will be argued that some place-related stressors often have a greater impact on seniors than they have on younger adults. keywords: heterotopic illness, favela, brazil, place, hypertension, aging. mangueira*, your scenario is a beauty mangueira teu cenário é uma beleza that nature created, oh oh... que a natureza criou ô ô... the hill with its huts made of zinc o morro com seus barracões de zinco how splendid it is in the early morning quando amanhecer que esplendor (“exaltação a mangueira,” samba composed by enéas b. silva and aloisio a. costa, 1956; my translation) * mangueira is a well-known favela (‘shantytown’) in rio de janeiro m-16p. g-3. ak-47 m-16p. g-3. ak-47 uzi. glock** uzi. glock a missile is being fired (...) fuzil lança rojão (...) to become stronger, to become stronger! pra fortalecê, pra fortalecê! (forbidden funk music about violence in a favela; quoted in: barcellos 2003: 29; my translation) **names of weapons anthropology & aging quarterly 2014: 34 (4) 226 annette leibing heterotopia and illness restrictions in their mobility, sensoriality (vision, hearing etc.), and decision-making capacities (e.g., dementias), a variety of public, private, virtual, and actual spaces play a role in impeding or enhancing citizenship, comfort and well being.  spatial dimensions of illness are often treated as a variable in public health studies for example whereby the willingness of individuals to maintain and achieve their health depends on their access to certain facilities such as gyms and public markets. social scientists (such as williams [1999] who writes about “therapeutic landscapes”) often concentrate on the impact of domestic or institutional environments on older people’s well being (e.g. wiles et al. 2012). these discussions can be diversified by applying michel foucault’s concept of “heterotopia” to certain illnesses and inquiring how illness and place are entangled on multiple levels, often configured by issues of identity and power.  foucault outlines an analytical framework for discussing “counter-sites” in his short essays on heterotopia.2 here, heterotopia refers to places that are exceptional to, or excluded from, mainstream society (cf. foucault 2005, sophia 2008, elden 2001) or, “spaces of alternate social ordering” (hetherington 1997).3 foucault was strongly influenced by georges bataille, who originally developed the concept of heterotopia in the 1930s, describing it as a “science of the other”, concerned about “the ‘garbage’ of society, its outlaws, … mad laughter, the erotic, and violence” (see chlada 2005, 13; translation mine). however, heterotopias are not conceived in opposition to mainstream society, rather site and counter-site are regarded as tightly interwoven in a very specific relationship:  but among all these sites, i am interested in certain ones that have the curious property of being in relation with all the other sites, but in such a way as to suspect, neutralize, or invent the set of relations that they happen to designate, mirror, or reflect. these spaces, ... are linked with all the others, ... however contradict all the other sites... 4 (foucault n.d.; emphasis added; see also sohn 2008, 44-45)  a counter-site – or, otherness as a mirror is not necessarily negatively related to mainstream society. however, when applying it to illness – an analytical choice that makes only sense when illness is embedded in a particular place the counter-site can be described as mostly pathogenic (contaminated, polluted, stressful, violence-stricken for example).  this article is based on ethnographic research on elderly hypertensive women who live in a well-known favela in rio de janeiro. for these women, their association with the favela – a kind of shantytown – defines their worth and determines which type of interventions (social, medical etc.) can be claimed from governments, non-governmental organizations (ngos) and other institutions. this kind of spatial citizenship is more often found in counter-sites heterotopias because of the tensions that come with the “reverse side of society” (sohn 2008).  initially, i had intended to study dementia outside of the institutional settings of psychiatry and neurology (e.g., leibing 2002, 2009). it was a surprise, then, that in the favela i had chosen, both patients and health professionals of the local health post deemed memory impairment, forgetfulness, senility and alzheimer’s disease as irrelevant to their reality. instead, aging was firmly and repeatedly linked to hypertension, and the narratives about hypertension were embedded in the life in the favela.5  in rio de janeiro, favelas are often located on a hill (as in the classic film orfeu negro [1959]), associated with a high crime rate (as in the well-known film city of god [2002]), but are also invested cultural heritage and considered as the site which originated popular music such as samba (see barke, escanasy and o’hare 2001). a favela is an “imagined community” in a double sense – it is the troubling shadow of modern brazil, evoking counter-narratives of the nation (cf. bhabha 1994, 13ff.), but at the same time an idealized site of authentic brazilianness and, therefore a mirror of society, as per foucault’s conceptualization of utopia (e.g. chlada 2005; see also leibing 2001 on the “good bandit”).  during one year my colleague daniel groisman and i followed every week two groups of older women (and one man) who visited the health post – the posto, as everybody called it located at the bottom of the hill. due to the advanced age of the women we worked with (approximately 25 women aged 57-83 years), we had suggested meeting on the hill in order to facilitate their participation. the women, however, insisted that the anthropology & aging quarterly 2014: 34 (4) 227 annette leibing heterotopia and illness health post was a safer place. but we also visited the homes of five of these women, who picked us up at the health post and carefully guided us into the favela, passing by the unofficial security people posted at the entrance, and through the meandering streets, paths, and staircases leading up the hill. in addition to the group meetings and the home visits, we conducted 10 individual interviews with group members, and five interviews, as well as regular informal chats, with the health professionals.  during the course of our fieldwork, we worked with two groups each one for two hours every week. different health professionals led the official “hypertension group,” and we were allowed to pose some questions towards the end of each session. we led the second group, called the “memory group”, because at the onset of our fieldwork, since dementia was not an issue, we were hoping to get at least some information on the concept of memory. this second group consisted of sessions based on themes preselected by members (some of the topics we discussed included: the favela versus the non-favela, women’s everyday preoccupations and their life histories). this group was also made up of patients suffering from hypertension. the favela, the non-favela and the health post in-between not all low-income communities in urban brazil can be called favelas. this term generally refers to areas with illegal housing and is associated with a high prevalence of violence. favelas emerged at the end of the 19th century as places of residence for newly-liberated slaves. later they became the home for many migrants looking for work and a better life: an important period for the formation and expansion of favelas were the 1940s when, during the government of president getúlio vargas, people migrated to the capital rio de janeiro and built their houses on the less valorized hills of the city. in the 1970s, another shift occurred when rural workers en masse moved into the big urban centers, most notably são paulo and rio de janeiro, the two cities where by far the highest numbers of favelas exist (see for a more detailed analysis valladares 2000, 2005, 2006; valladares and medeiros 2003; zaluar and alvito 2005, and many others).  many brazilians and foreigners consider favelas as dangerous areas associated with crime and illegality. because of the high rates of violence in many favelas, constant distress impacts on health and well being of its inhabitants (cf. epstein 2003; see also duarte 1986). life expectancy at birth can vary in rio de janeiro from 64.01 years in the poorer neighbourhoods to 73.25 years in the wealthier parts of the city (sczwarszwald et al. 2000). however, a key factor responsible for the lower life expectancy in the favelas lies in the high rate of violent death among young men (rocha 1998, huguet and szabo de carvalho 2008).6  not all favelas are violent and dangerous, but this reputation persists despite the attempts by nongovernmental organizations (ngos) and the state to alter that image (e.g. through the current pacification measures [see schiller 2013], favela tourism [e.g. hanrahan 2013]) and, indirectly, by turning illegal housing into a legal one (such as the huge slum-to-neighborhood initiative favela bairro; see rioonwatch 2010). cidade de deus (city of god), for instance – well known from the movie with the same name by fernando meirelles (2002) – should not be called a favela, because it is a government housing project. however, this part of rio de janeiro is called a favela due to its high rate of crime. this misrepresentation is a vivid example illustrating that ‘favela’ is less a geographic notion, but first of all a strong moral and stigmatizing term.  foucault describes a heterotopia to be a space of deviation, with ever-shifting points of reference. a widely discussed book in brazil entitled cidade partida (the divided city) argues that “[t]he city has been civilized and modernized by expelling its second class citizens to the hills and the periphery. the result of this kind of politics was a divided city… the choice was always the separation, or even a simple segregation” (ventura 1994, 13). this description creates the illusion of a solid and unchallenged boundary between two discrete spaces, contrasting a modern city with a lawless periphery. more recent authors (e.g. zaluar and alvito 2005) point out that the notion of a divided city – the favela versus nonfavela – is too simple for a complex metropolis like rio de janeiro.7 rather than two distinctly separate spaces, the favela and the ‘asphalt’ (asfalto) – as the non-favela is often anthropology & aging quarterly 2014: 34 (4) 228 annette leibing heterotopia and illness called are linked by everyday practices in a globalized world, constantly creating connections and reinforcing boundaries (cf. segre 2008, porto 2000). as an example, during our fieldwork, we encountered women from the favela who had little formal education and very limited means who adopted a “successful aging” discourse and other key psychological concepts in the same manner as the women of a similar age, living outside of the favela. the social workers, doctors, and psychologists at the health post, along with the world of television, were responsible for transmitting a notion of self that needed to be active and in need of a double improvement: through the working of self esteem being old and poor should become less disabling, mingling social, psychological and physiological factors contributing to hypertension, some of which will be discussed more in the section on ‘risk talk’.  a favelado is often seen as a marginalized person and a favela is what bachelard (1994) called a ‘hostile space’. but this is only one part of the picture – a number of associations are positive, such as the roots of popular culture found in the samba singers, the queens and kings of carnival, and a notion of community-based life versus the individualized life generally associated with the big urban centers.8 many women expressed their preference for the favela (as one stated, “on the asphalt, when you die, you lay there in your apartment and people don’t even notice”), but complained that the favela was becoming increasingly inhospitable with an increase of violence and the disrespectful attitude of the younger generation.  nevertheless the favela is often contrasted with the asfalto – in strong dichotomies of good and bad – while the health post can be described as a real heterotopia because it is a site of convergence for site and counter-site. the health post was always described to us as violencefree, although a big part of its raison d’être was based on treating patients directly or indirectly hurt through violent acts. the clean and friendly environment of the health post rendered it an exceptionally positive space for many of its clients. the women valued the respectful manner they were treated and were deeply attached to the posto: “at the souza aguiar hospital,” said one woman, “they treated me like a dog. here we are all equal. a family.” and another woman: “here (“remocei”) i became 10 years younger. this is better than my family. the family only likes us when we have money. without this here [the post], we are nothing. first jesus,9 afterwards this here.”  it is through the association with the health post and the psychosocial dynamics of the concept ‘self-esteem’ that the older women work on their citizenship, while both posto and self-esteem are tightly linked to their lives in the favela. the positive value given to self-esteem as a social factor that can be ‘treated’ through an originally psychological concept resembles the programs created by the state assemblyman john vasconcellos, who in the 1980s set up a task force on self-esteem in california. his argument was that “raising self-esteem in young people would reduce crime, teen pregnancy, drug abuse, school underachievement and pollution” (see baumeister et al. 2005). in the case of the older women in our study, the complex interconnection of space, identity, and age can be translated, at least partly, into the language of hypertension. hypertension, aging and place space is fundamental in any form of communal life; space is fundamental in any exercise of power. (foucault 1984, 252) the hypertension groups, alongside child health and pregnancy programs, were the main programs of the health post. the high profile of hypertension not only created something like a hypertension culture with its own language, slogans, and ideologies that was both incorporated and contested by the patients, it also showed the specificity of this favela as a hypertension-creating site.  the hypertension groups were organized almost like social clubs: one had access to a number of privileges after becoming a ‘member’ through referral by one of the doctors of the health post. if a patient was compliant (i.e. regularly attended the group sessions, took the medications as prescribed and sufficiently adapted one’s diet to the doctor’s recommendations), direct access to medical treatment was guaranteed and eliminated the need to wait in long lines in the early morning to receive clinical attention. compliance was regularly measured after sessions by dr mariax,7 one of the three doctors working at the health post and who was responsible anthropology & aging quarterly 2014: 34 (4) 229 annette leibing heterotopia and illness for the hypertension program: she was both feared as a controlling agent and gatekeeper and respected for her caring and sincerity. leisure activities like bus excursions and parties were organized for the hypertension groups, while other afternoons were dedicated to health promotion activities, such as films followed by discussions; a number of conferences about blood pressure, aging and other health topics; and conscious-raising occupational therapy like the production of collages or paintings, some of which adorned the walls of the posto. because of the importance given to self-esteem, group members were encouraged to attend the nearby state university of rio de janeiro, which had a third age university where some of the older women in the program learned how to read and write.  in 2010, the brazilian ministry of health reported that 63% of the elderly suffer from hypertension (versus 24% of the adult population), with rio de janeiro leading the country’s number of cases (formenti 2010; camarano 2002, 67).11 although not exclusively found within the elderly, hypertension can be conceived as a disease of aging. this is because there is a common notion that in most environments, blood pressure – both systolic and diastolic – generally increases up to age 60,12 which, after the national institute of aging (2010) is due to a number of risk factors of which only some (when they are lifestylerelated) can be targeted by public health campaigns.8  the intersection of the “spatial” with the “biological” is especially apparent in hypertension studies, which report a higher prevalence of hypertension in lower-income groups compared to higher-income groups (e.g. grotto, huerta and sharabi 2008). and since people generally gather together in places which are indicative of their economic situation – although there are exceptions to this – hypertension (as obesity and several other illnesses which are highly context-dependent) can be transformed into maps mirroring the interaction between poorer neighbourhoods and cardiovascular health (see the maps published by the brazilian institute for geography and statistics [ibge 2009] showing the distribution of brazilian seniors and several health-related issues). the apparent simplicity of this correlation, that can become an ecological fallacy is being disturbed by studies that found no clear geographical relation between socioeconomic factors and the distribution of hypertension. for the brazilian context, for example, a study by campos et al. (2009) about seniors living in the medium-sized city botucatu, in the state of são paulo, shows that although the distribution of socioeconomic status and living area can be mapped as a direct correlation, the distribution of hypertension (and diabetes) could not. the authors think that the senior population in the city of botucatu is much more homogeneous regarding lifestyle and ethnic origin than the socioeconomic differences seem to suggest.  the social sciences and the medical literature in the 1980s and 1990s, sometimes termed chronic health conditions such as hypertension as “diseases of civilization,” linking them to specific (‘industrialized’) sites (e.g. trowell and burkitt 1981). james et al. (1991), for instance, noted that the yanonami and other native brazilian groups did not show the elevation of blood pressure with age found in many studies on industrialized places. and when these groups live in closer contact with more “mainstream” brazilian culture, their mean blood pressure is significantly higher compared to those groups who live in more remote areas. this “native” phenomenon is a common finding in studies of indigenous groups around the world (e.g. frohlich 1995; rowe and kahn 1998, 35f.). the explanation provided is generally a combination of genetic factors, diet (less salt and fat in native diets) and the common association of a less stressful life when compared to urban settings (e.g., dressler 2004, dressler et al. 1987, kusuma et al. 2004, steffens et al. 2006), which is of course a generalization that does not apply to all indigenous groups.14 while these risk factors certainly play a certain role in the wider phenomenon of hypertension, reducing them to civilization-blaming “…still exercises a strong romantic hold”, remarked roy porter (1997, 599). he suggests that one looks critically at any such claim, because …with the spread of health education, with enlightened eating habits, …, it appears likely that today’s so-called diseases of civilization are not in any straightforward sense the products of affluence, but rather diseases disproportionately afflicting the less privileged members of advanced societies” (porter 1997, 598; see also roelcke 1999, esp. chapters 1 and 6; littlewood 2002, 74-93).  another recurring theme in hypertension studies is the connection between race, ethnicity (sometimes including racial genetics) and hypertension. for example, a number anthropology & aging quarterly 2014: 34 (4) 230 annette leibing heterotopia and illness of studies show that african americans have an earlier onset, a higher prevalence and more severe hypertension compared to non-hispanic whites (e.g., kurdian and cardarelli 2007). this generally accepted correlation is criticized by thorpe jr. et al. (2008, 1610) who conclude that the “socio-environmental context plays a substantial role in producing race disparities. ... given similar socioeconomic status and similar socio-environmental conditions ethnic disparities in hypertension prevalence are substantially lessened.” thorpe jr. et al.’s study raises the question whether a place like a favela, where a majority of its inhabitants has a darker skin, should be targeted by public health campaigns, when the target should not be the ethnic individual, but the stressful (in the widest sense) environment.  a further argument is related to the general increase of hypertension around the world. some authors call attention to the fact that recent classificatory changes have lead to a more inclusive understanding of hypertension in direct relation to the marketing of hypertension drugs, such as diuril (lakoff 2007, timmermann 2008). it is possible to imagine that due to changing inclusion criteria, new hypertension-related groups at risk can be detected and risk factors become more generalized, less specific. different from the concrete example of the women’s narratives located in a stressful favela (and validated by the health professionals), stress as a risk factor in biomedical reasoning is generalized (“a stressful life”), while intervention and prevention are dis-located and highly individualized: the american heart organization, for example, recommends that individuals become more joyful.15 risk talk the regular hypertension group meetings were held in the afternoon. once the small room with the wooden benches placed around the walls became available, group members entered and waited for the social worker or psychologist who would lead that particular session. this was the opportunity for informal chatting, gossip, and news. the women’s conversation frequently steered to the risk factors of hypertension. the women discussed their food-related transgressions and compliances, (such as celebrations with their inevitable fatty and sweet dishes), the difficulties in maintaining a diet whereby one had to avoid cheaper and less nutritious food when money was never enough for the whole month, along with the violence on the hill. dona elza: sometimes i eat things that i am not allowed to, just because i have nothing else. dona oneide: i eat everything because i have no shame (de sem-vergonhice). when there is, for instance, a wedding i eat everything i can. it’s hard to resist. dona teresa: she (dr. maria) told me that i can eat javali, wild pig meat – but where the hell do i find javali?16  dietary restrictions are difficult but not impossible – to follow, although most inhabitants of a favela have a limited income. however, the women who visit the posto do consider favelas are sites of violence that directly influence their well-being.17 as the following excerpt illustrates, the women’s regular exposure to violence explains the impossibility of controlling hypertension, but also the significance of the health post where they, at least for a short period of time, participate in a non-violent world (no assault of the post has ever been reported). dona elza: after 8 p.m., to leave the house only with faith and following god… we live through our faith. this group gives a lot of support to our egos. social worker: yes, to take the medication right is very important, but – [she points to the two sides of her head] – it’s a lot of pressure, gente (folks)! dona cecilia: and the police throw some drugs into your house, just to be mean.18 one word of them is 20 times more valid than ours. one has to close the windows. they think that everybody here is the same [a bandit]. policemen are liars. dona teresa: [she tells us that her son was shot by the police or by a bandit that was dressed like a policeman, she was not sure]. who to trust? there is no heart that can withstand all this. the bandits do not bother the inhabitants. (…) but the police. people are [their blood-] pressure. the nerves control the pressure, the heart beats.  crime is only one of the many forms of violence, which cause suffering for these women. gender issues, generational conflicts, and other family controversies are equally responsible for the stress19 they linked to hypertension. anthropology & aging quarterly 2014: 34 (4) 231 annette leibing heterotopia and illness dona teresa: one lives oppressed inside the house. with my husband there is no dialogue. with him, everything is through fighting [na marra] ....while my husband was still working, we lived well. he arrived in the afternoon, drank a little and stayed the rest of the evening in bed [she imitates a drunkard]. didn’t bother anybody. now it’s different. he observes me all the time.  violence has become a banal event, to a certain degree, among younger generations, and this aggravates the women’s suffering, who perceive this generation gap as a sign of the noxiousness of the times they live in. dona teresa: my granddaughter saw a child dying in the street and while grandma [herself] cried, granddaughter said that that was banal, ‘death is like that’. so my pressure was gone already. i pray to god. these young people are not afraid. i cannot lock my grandson in the house. he does not obey anymore.  furthermore, the women perceived themselves as more vulnerable now than they were at younger age. dona elza: after 40, we become more emotional, the older one gets, the more it is the emotional form of hypertension. the world became a violent world. before, there existed love, friendship.  the vulnerability of the aging body that provides less protection against a violent world, in the case of hypertension is being translated into a specific language of numerical relations. embodying risk and hypertension: living by the numbers although the women we worked with each had a different history, they identified themselves as ‘hypertensives’, creating a kind of biosociality (rabinow 1996) that structured a great part of their life, in which the social and the biological were fundamentally intertwined. as ‘hypertensives,’ the women’s entire lives were transformed into what rayna rapp (2000) calls “living by the numbers”. numbers helped articulate a great part of their identities and well-being. for instance, during the meetings, women frequently responded to greetings of “how are you” by scaling their degrees of hypertension with the degree of experienced violence: “yesterday [after the shooting] i was 17:12, today i feel better, probably 14:10.” in their everyday banter in the group, the degree of violence whether domestic or on the hill was directly related to the numbers indicating the degree of hypertension and for some, the higher the hill (where the poorer people lived), the higher the hypertension. the geographical attributes of the favela reflected the favela’s built hierarchy as related to health. accordingly, the physical and concrete materiality of the hill became central to our thinking early in our ethnographic research. at the beginning of the group sessions, we asked the participants to describe their social networks on the hill. rather quickly, a pattern emerged with living areas located most high on the hill being related to the severity of one’s hypertension. generally speaking, poorer individuals lived high on the hill, while more well-off ones resided at the bottom. violence is more accentuated higher on the hill, and the houses here, with their thinner walls, did not always offer suitable protection against the bullets, according to the women. “i think there are a few simple and exceptional examples in which the architectural means reproduce, with more or less emphasis, the social hierarchies,” writes foucault in space, knowledge, and power (1984, 255).  the professionals at the health post made a similar link between violence close to their patient’s living quarters and the degree of their hypertension. as dr. maria explained to us: …there are many problems. a new cycle of violence has just started. only last week we had ten deaths on the hill. and i can tell you, when they come afterwards to check their blood pressure, it is high – when i hear the shooting, i know already – they will come and their pressure will be terribly high. i hear the machine guns and in front of my eyes i see numbers [indicating the blood pressure]. it’s war…  for dr. maria – as for the women it was clear that hypertension is to a large degree a symptom, an idiom of distress linked to violence. the distress was felt, measured and categorized through the bodies of the women who lived that particular favela.  there were also numerical, interpersonal adjustments. for instance, the very fact of being an older individual was perceived as numerical: the older a person, the more vulnerable she was to the violent environment and everyday worries (the “emotional” form of hypertension). anthropology & aging quarterly 2014: 34 (4) 232 annette leibing heterotopia and illness but being old also meant to have a certain power: for the older women, self-esteem as a means to citizenship had a specific currency. the women were very clear about the fact that money played a major role in their family relations. since most elderly now receive a state pension (see e.g. simões 2000), and because often younger family members were unemployed, the older individuals gain the status of the head of the family that they had lost due to their age in a country that values youth and the youthful body to a significant degree (e.g. leibing 2001, leibing and collin 2013, edmonds 2010).  as the excerpts above show, conversations revolved around two of the three main attitudes for a good hypertension management and the difficulty of avoiding certain foods and life’s stress and strain when one is poor and lives in a violent environment. the third factor, hypertension medication, did not elicit much discussion. because they were poor and part of the hypertension program, the women had free access to medications and therefore took them for granted. however, health professionals brought up issues of non-compliance by discussing how some women changed the dosages of their medicine according to their daily circumstances – taking higher doses in response to negative life events or special occasions with forbidden food, and maintaining or reducing their dose when they perceived their life to be uneventful.  furthermore, hypertension medications are “prescribed by numbers” (cf. greene 2007) – that is, prescribed by diagnosing illness on the basis of numerical deviations from a norm established by more or less neutral experts and now often treated on a preventive basis before any sign of illness has developed. at the same time, patients were self-dosing by numbers: since the dose of medication and severity of hypertension can both be measured and related to each other, the language of numbers and its apparent objectivity is self-evident.20  another medication group, tranquilizers, were prescribed to one third of the women. dr. maria was aware of the profoundly troubling environment of the favela, but this did not translate to possible treatment options: dr maria: so there is the medication. they have to take care of what they eat; and self-esteem is also an important point. (...) here, there is a lot of stress, what can one do? i try to give as few tranquilizers as possible. it is wrong to prescribe them to these people, but i often have no choice. it’s either that or nothing. it is like [artificially] transforming the lion into a little mouse. and the groups help. the groups work like a valve and there is a lot of solidarity. the high stress level of modern life brings with it all these diseases. stress is the biggest problem.  to a certain degree, treatments and the discourse of risk also undergird the need for more nuanced understanding regarding the medicalization of poverty. borrowing the words of nikolas rose (2007): medicalization is not simply a “recoding of misery,” but involves “delicate affiliations” between complex matters such as the politics of identity and the moral economics of inclusion. dr maria’s statement that “[t]hese women have always been treated badly by the public health system. i try to really look at them, to touch them – that’s important” demonstrates her awareness of her role in acknowledging the citizenship of individuals who, for a long time, were invisible in public discourse unless they were depicted in extreme or stereotyped manners: on the one hand, part of the violent image of a favela, the criminals with their negative media, or, on the other hand, part of the positive favela of famous samba dancers or singers or, close to the elections, as voters. the mouse and the lion place is not always significant when talking about health and illness (although all practices related to health happen somewhere), yet i suggest that there are some forms of suffering which reveal the interconnectedness of place, the (aging) body, identity, and power, and may be understood as heterotopic illness.21 i focus on counter-sites taking michel foucault’s reflections regarding heterotopias as an inspiration – because these spaces generally create tensions by by inverting what is taken for granted – something that is felt most acute by those who suffer from place-related distress. the concept of heterotopic illness helps to pose questions, which challenge one to go beyond too easy recipes of self-care.  heterotopic illnesses, in this specific context, is critical of health promotion activities which reinforce the moral economy of neoliberal thinking by valorizing self-care. when illness is linked to place, hypertension is no longer anthropology & aging quarterly 2014: 34 (4) 233 annette leibing heterotopia and illness an illness/disease that can be centred on the individual. accordingly, the hypertensive bodies of the older women discussed in this article form the basis for articulating a citizenship based on a place-linked identity a mix of the favelado, the hypertensive, and the old as shared by all of them.  nevertheless, dr maria continues to prescribe tranquilizers, and the question of how exactly the “lion can be transformed into a mouse” remains unanswered. while the concept of heterotopic illness does not prevent the practice of medicating social problems; it does help us better understand how using mouse-traps (here meaning all interventions ignoring heterotopias) – while useful for catching mice – are an inadequate solution for fighting the lion. notes 1. like foucault, i am using space, site, and place interchangeably in this paper, since in most cases it does not make sense to separate phenomenology and dimensions of place/space from each other. many theoreticians distinguish among them. for example, michel de certeau defines space as the product of action and movement, while place implies stability (cf. reynolds and fitzpatrick 1999). others define space as linked to the question of dimensions, while place is the lived space (e.g. low 1996). 2. heterotopia was first mentioned by foucault in the order of things (1966). he rethought heterotopia in 1967, when he gave a lecture called “des espaces d’autres” at the cercle d’études architecturales in paris. his discussion of heterotopia drew greater attention in english-language scholarship two years after his death in 1986, when his 1967 conference under the title of “other spaces” was published in the united states (sohn 2008, foucault 2005, chlada 2005, 7-14). i have elsewhere applied the six principles through which foucault analysed a heterotopia to a brazilian favela (leibing 2010). because of the limited space of this article, i will just name them here: 1) heterotopias may be either based on crises or deviance; 2) the function of a heterotopia may change over time; 3) several spaces may be juxtaposed in a single heterotopia; 4) heterotopias are linked to ‘slices of time’; 5) heterotopias have systems of opening and closing; and 6) they function in relation to all remaining space. see also the critiques regarding heterotopias made by lefebvre (1991, 3-4) and giddens (1984, 145-161); see also philo (2000). 3.exclusion does not always have a negative connotation; it can be desired as in the case of exclusive spa sites or a university (comparable to goffman’s [1963] ‘positive stigma’). as well, heterotopias are not necessarily spaces with a negative impact on individuals (as the most perfect heterotopia foucault mentioned a ship), and such places can protect and enhance the well-being of its inhabitants or just have a neutral effect on people’s health. 4.my reading of the text on heterotopia stems from foucault (2005). for the quotes (the english translation) i used http:// foucault.info/documents/heterotopia/foucault.heterotopia.en.html 5. we tried to find out about this curious fact. it seemed that the older women strongly stigmatized people who showed the symptoms of dementia. at the time of fieldwork two famous members of the community were suffering from dementia (it had been reported in the media), and by using these concrete examples it became clear that the symptoms were associated with unpredictability and madness, and some of the women strongly condemned the antisocial behavior of these individuals. the health professionals thought that there might be some older individuals on the hill who suffered from a dementia. however, they did not see those patients and did not know what happened to them. their central health concern when treating their older clientele was hypertension. 6. there are many studies that link violence to hypertension (see, for instance the american institute of stress http://www. stress.org/) that i am unable to address here. 7. this notion dates back at least to the bohemian journalist joão do rio (1881-1921). 8. a certain paradox exists, since the carnival is produced by « favelados », but the key roles are increasingly taken by starlets and mannequins. the authenticity stemming from popular culture rooted in a low-income community has been questioned by many since the official carnival has been rigidly pressed into the sambodromo, an open space made of concrete and separated from the public, and has become an investment that a poor community could never produce without sponsors (who, for many years, have been the powerful bosses of the illegal “animal lottery”; see cavalcanti 2006). 9. the majority of the women we saw in these groups were catholic. although the new evangelic churches are now dominating low-income communities in brazil (arias 2004), many older individuals seem to stay committed to the catholic church. the women’s participation in afro-brazilian religions, such as umbanda, was not discussed in the group sessions, although we did broach the subject. 10. all names used in this article are pseudonyms. 11. for the state of são paulo zaitune et al. (2006, 285) conclude: “hypertension prevalence [in the elderly] was 51.8% (46.4% in men and 55.9% in women) and was higher among the elderly with less education (55.9%), immigrants from other states (60.2%), and the overweight or obese (57.2%)”. 12. after age 60, the systolic pressure might still increase, but diastolic pressure tends to stabilize or decrease http://foucault.info/documents/heterotopia/foucault.heterotopia.en.html http://foucault.info/documents/heterotopia/foucault.heterotopia.en.html http://www.stress.org/ http://www.stress.org/ anthropology & aging quarterly 2014: 34 (4) 234 annette leibing heterotopia and illness 13. the nih (national institute of health 2010) lists the following risk factors associated with hypertension: 1. older age; 2. race/ethnicity; 3. overweight or obesity; 4. unhealthy lifestyle habits (salt, alcohol, not enough physical activity, smoking…); and 5. other risk factors (such as family history, long-lasting stress, and so on.). 14. although limited to a journal with a specific scope – psychosomatic medicine – engel (1998) showed that all articles that appeared on blood pressure between 1939 and 1997 talk about hypertension as reactive to the environment in which a person lives. we are not able to outline here or even mention all discussions regarding risk factors for hypertension, such as physical activity or geneticenvironment interactions. see also sapolsky (1992), who relates stress (and hierarchy) to the aging brain. 15. (see http://www.heart.org/heartorg/conditions/ highbloodpressure/prevention%20treatmentofhighbloodpressure/ stress-and-blood-pressure_ucm_301883_article.jsp). conceptualizing hypertension as a heterotopic illness can resemble what some authors have called ´structural violence´. many people living in low-income neighbourhoods such as the favela clearly suffer from what farmer, nizeye, and keshavjee (2006, e449; emphasis in the original) explain as “arrangements [which] are structural because they are embedded in the political and economic organization of our social world; they are violent because they cause injury to people (typically, not those responsible for perpetuating such inequalities).” heterotopic illness is not necessarily associated with victims. good and bad, victim and masters, here and there are not predefined, but mingle and overlap. this way of perceiving social relations as related to counter-sites can avoid what loïc wacquant (2002) rightly condemns as “moralism” in some studies on low-income communities. 16. dr maria denied that she had recommended wild pig meat, but perhaps she had mentioned it as an example of a lower fat meat when compared to commercial pork. however, the example of ‘javali’ was well remembered by the group and was repeatedly referred to, becoming the symbol of the impossibility of respecting the nutritional prohibitions. 17. anthropologist cornelia eckert (2002) shows how older women in porto alegre link their life histories to the city, and how violence and chaos influence the way the women’s autobiographies are constructed. 18. the negative image of the police cannot be deepened here (see leibing 2001), but many studies have shown this (e.g. gonçalves 2000, antunes, conti and marqueiro 2000). 19. we adopt here the common meaning of stress to refer to any stressor that affects an individual’s well-being. for a critical history of stress see, for instance, viner (1999). 20. see greene 2007: chapters 1 and 2 on hypertension medications as a ‘therapeutic embrace’. 21. although foucault did not make an explicit link between heterotopias and health he must have known the medical term “heterotopia”, which indicates the displacement of an organ or cells from normal positioning in the body (see sohn 2008). 22. brazilian social epidemiologist cecilia minayo (2006, 380) observes: “the greatest difficulty lies in convincing a sector deeply marked by biomedical reasoning to accept in its model and dynamics complex problems of social character and not diseases. many times i ask myself: ‘does one die more when dying from aids or cancer than when dying from a traffic accident or murder?’” references anderson, elizabeth 2010 the imperative of integration. new jersey: princeton university press. antunes, l, conti, l and p marqueiro 2000 a estatistica do medo; pesquisa mostra que maioria no grande rio ja foi assaltado e desconfia da policia. o globo 18 06.2000: 16. arias, enrique desmond 2004 faith in our neighbors: networks and social order in three brazilian favelas. latin american politics & society 46(1): 1-38. bachelard, g. 1994[1958] the poetics of space. boston: beacon press. barke, m., escanasy t and g. o’hare 2001 samba: a metaphor for rio’s favelas? 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time; meaning; aging; death; endscape anthropology & aging, vol 41, no 2 (2020), pp. 1-8 issn 2374-2267 (online) doi 10.5195/aa.2020.320 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 1 introduction. the ends of life: time and meaning in later years iza kavedžija university of exeter iza.kavedzija@gmail.com how do ideas of meaning in life take shape or come into focus as people approach their final days? though often conceptualised in terms of decline or loss, older age can nevertheless bring new opportunities for meaningful reflection, or the attainment of a new perspective on one’s life and that which lends it a sense of meaning or purpose. approaching the end of life throws into sharp relief the very idea of a future: the experience of time takes on a different form when one’s life is not seen as extending very far ahead. if hope is a prospective temporal orientation, then, what shape does it take as one approaches death? furthermore, death is not always seen to constitute the ultimate end of life, given the importance placed on ideas of continuity or transcendence, and a range of possible understandings of finality. drawing on the idea of ‘ends of life,’ both in the sense of temporal proximity to death and in the sense of an end as a purpose, this special issue explores ideas of temporality and the future as well as meaning, purpose and fulfilment in our later years. death has an ambiguous relationship to meaning in life: on the one hand, death can be seen as delimiting and framing life and thus imbuing it with meaning. a good life, argued aristotle, can only be judged as a whole: a person can only be deemed to have led a happy (which is to say, virtuous) life once it is complete. for some people, approaching the end certainly does prompt reflection upon the life lived. and yet death and its approach are not infrequently seen as meaningless, or as throwing lives into disarray. “every day we die,” a middle-aged palestinian man in a refugee camp in lebanon told the anthropologist illana feldman (2017, 59). for these men for whom death was more like a bad companion, “living with dying in mind” turned out to be problematic, even pathological, as it unfolded within a humanitarian regime focused on the preservation of life but riddled with insufficient resources for care (2017, 44). a sense of meaninglessness in this troubled existence was pervasive and seen as itself a form of death that stretched across the life course.1 ends of life i borrowed the phrase ‘ends of life’ from the historian keith thomas, whose book (subtitled roads to fulfilment in early modern england) examined the particular pursuits that people in this milieu considered most worthwhile, or most apt in orienting them towards a life well lived: work; wealth; military prowess; reputation; personal relationships; and the afterlife (2009, 1). in thomas’s sense, the ends of life comprise particular aims in life, or avenues towards a life worth living. such concerns often come to the fore as people move through their lives, as they age. approaching the end of life throws into sharp relief the very idea of a future: the experience of time takes on a different form when one’s life is not seen as extending very far ahead. drawing on the idea of ‘ends of life’ in both these senses, then both in the sense of temporal proximity to death, and in the sense of an end or a purpose this special issue explores ideas of temporality and the future alongside meaning, purpose and fulfilment as these play out in the later years. http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 2 for the residents of withuis, the nursing home in south africa described by casey golomski in this volume, facing death catalysed considerations of the mystical, of divine presence. as many of their peers passed away, the residents and the staff were prompted to reflect on death and the process of dying itself. in this way golomski’s contribution places the final stage of life, death, and what comes after death in a meaningful and temporal sequence, focusing on the conceptual pair of imminence and immanence: the immanence of god in the context of imminent death (golomski, this issue). the scottish elders described by jane elliott and jd carpentieri strove for a meaningful life story that presented their aging as successful. elliott and carpentieri use the concept of generativity to explore the growth and expansion of capacities that persons can undergo at any stage of their life, including the end. using a biographical-narrative approach, they point to the prevalence of discussions of the past in the accounts of elders, largely to highlight the ‘stoical’ selves who remain ‘in control’ (elliott and carpentieri, this issue). while these narratives did not dwell on the future or the final days, these elders often planned for their death and made funeral arrangements, even while the uncertainty of the final days made this a difficult topic to broach. emily wentzell’s interlocutors in mexico made efforts to ‘age well’ by involving themselves in community health programmes, seeing this as a way to contribute to wellbeing in communities, and in the process linked their own bodies to a national body beyond themselves. their hopes to age in an admirable way could be seen as part of a moral project of improving the lives of others, not least by modelling what living well in later life might look like. aging and moving towards the end of life is explicitly portrayed here as embodied: one’s own bodily practices were seen to affect the broader collective ‘biology’ (wentzell, this issue). susan long in this volume focuses on what mattered most to her japanese interlocutors and their families in their last phase of life, their moral projects underpinned by attempts to be good, ‘steadfast’ and ‘reliable.’ a dying person here is not only one approaching death, but also one who is still alive, in a final stage of life. a good person in death is able to reflect on his or her relationships and to reciprocate care by expressing thanks. gratitude, for japanese elders, can be understood not merely as a form of evaluation of the past, but also as offering hope in the present (kavedžija, this issue). on flow and punctuation: time, temporality and life course time, as we experience it, is far from “like an ever rolling stream” as isaac watts described it—or, if like a stream, it is far more varied than the simile suggests, sometimes wide and placid and slow-moving, sometimes racing through narrow gorges, sometimes scattered with boulders. there are landmarks and turning points along the way. the pace changes. (bateson 2011, 38) the slow treacle of waiting, or hours simply vanishing engrossed in a favourite activity – these changes in the pace of subjective time are familiar to most of us. at different points in life, time flows differently. the experience of time is profoundly subjective, but it does not remain unaffected by what happens around us, not least because it is framed in shared and familiar terms: hours, years, seasons, and all the other kinds of time-maps and ideas that people have devised to navigate time (gell 1992). different groups and people use different time-maps at the same time. the temporalities resting on these timemaps coexist and at times they come into tension or clash. the productive time of a mother’s capitalist workplace might clash with her baby’s nursing rhythm. not everyone has the same degree of control over their time, its organization or framing, or their temporal resources. to understand this, laura bear (2014) calls for a marxist perspective, highlighting that not all time-maps and temporalities are equal – some are more influential, more powerful than others. http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 3 the passing of time also means moving through life: the experience of time’s flow and the life course are intimately intertwined. lives can be structured, even organized into life stages, and the flow of time in life may be perceived as unfolding in chapters, in eras, or as punctuated by events (bateson 2011, 39). life stages are not always stable, static, or everywhere alike. when they are discernible, they are best understood as emerging from particular social and institutional frameworks (johnson-hanks 2002). as these circumstances and frameworks change, however, the life course itself might undergo transitions. in places marked by apparently high levels of uncertainty and change, such as cameroon, the life course is not structured into coherent and demarcated stages. giving birth, for instance, does not entail moving into full adulthood or motherhood, as young girls might continue their education while their family takes on the role of parenting the baby. in this sense, particular statuses may be occupied temporarily and in no set order. in some places, one of the most notable life course changes stems from increased longevity and a longer period of maturity. this has led mary catherine bateson (2011) to propose that mature life in the context of industrialized societies might usefully be considered as comprising two phases adulthood i and adulthood ii – insofar as longevity has increased and expectations surrounding older age have undergone change. in this sense, as the lifespan extends, bateson argues that a new life stage follows adulthood and precedes senescence.2 what older age brings as a life stage is itself undergoing a transition, just as a large cohort of baby boomers is moving slowly towards senescence. older age, then, is structured and punctuated in myriad different ways across time and space. kao and albert (2020, 120) have proposed the concept of “elderscapes,” figured as institutional and cultural landscapes of aging, populated with imaginings and relationships. as people move through the geography of age their vantage point changes also. the spatio-temporal aspect of the elderscape metaphor emphasizes the temporal agency of individuals and groups. and yet, most do not simply move forward along a delineated trajectory, or march decisively into the sunset. the uncertain, shifting terrain complicates matters further: as people move through life, the circumstances around them change, along with ideas about what the future might hold. this elderscape itself also shifts, flows and undulates, however, as the actors navigate through time. in developing his concept of “social navigation,” henrik vigh (2009) stressed that the original sense of the word ‘navigation’ involved movement on the unstable surface of the sea. when moving through life, actors cannot presume that their circumstances will remain unchanged, particularly in times of uncertainty and crisis. and so, actors move through an environment that is itself constantly changing. elderscapes, i would suggest, are similarly best understood as fluid and shifting environments, such that moving through them demands a form of navigation, if one is to avoid all the hidden obstacles or shallows. as people move through elderscapes, moving towards a horizon, the landscape around them changes – the circumstances, expectations, and norms do not always remain stable. if the life course does not always follow neatly organized stages, is it then better understood as organized around events? certain historical events are obviously of major significance in a general sense, linking many lives together, but biographies are often punctuated by apparently quite minor and intimate moments that are nevertheless no less important for understanding living, dying and suffering. these might be likened to that povinelli (2011) calls “quasi-events,” which, she suggests, are “ordinary, chronic, and cruddy rather than catastrophic, crisisladen, and sublime. . . . if events are things that we can say happened such that they have a certain objective being, then quasi-events never quite achieve the status of having occurred or taken place” (2011, 13). in the context of older age and of our investigations of peoples’ biographies and life stories, events and quasi-events all add punctuation of one kind or another to the flow of the narrative. such a movement through time further recalls the concept of chronicity, as deployed in medical anthropology in order to foreground narratives of the http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 4 lived experience of chronic illness (e.g., smith–morris 2010, 25). chronic, of course, refers here to the enduring, temporal character of the condition with which one must live. experiences of time in older age . . . finally, there is the premonition that our future will not follow in an orderly way from our present any more than our present has from our past, which precedes but escapes it. in short, exactly the opposite of a curriculum vitae or a career plan, and sometimes the shadow of a doubt about our singular, individual identity (augé 2016, 22) temporalities in older age are often institutionally framed, particularly when playing out within care homes, nursing homes or hospices. these contexts imply specific time-structuring processes, some of which are focused on the past, and its reconstruction through narrative, while others focus on the future or the present. the latter is sometimes seen as extending in a timeless way, the passage of time arrested: ‘limbo time’ (laird 1979; golander 1995). evaluations of youth and older age in particular cultural configurations of aging moreover powerfully intersect with the managerial regimes deployed within healthcare systems. in the context of medicare in the united states, the dominant temporality may be one of anticipation, oriented around diagnoses and predictions of longevity. this correlates with attempts to grow old while remaining healthy and not only to predict the time remaining, but also to extend it (kaufman and fjord 2011, 209). the progress of aging itself is framed by many different cultural expectations and discourses. it may involve a rapid or slow deterioration, or one that should be managed, postponed or prevented, as in the ‘active aging’ and ‘successful aging’ paradigms (see lamb 2017; katz and calasanti 2015). aging ‘actively’ is sometimes seen as a commitment to the wider community: taking care of oneself is itself a contribution to improving the national body (traphagan 2000; wentzell, this issue). successful aging, a predominant model for moving through the later years in the united states, favours so-called ‘ageless’ ageing: active and engaged (lamb 2017, 234). the resources for success are, of course, not equally available to everyone, and many may feel left behind. by contrast, the progress of time as one nears the end might in some cases be seen as a process of disentanglement and detachment (desjarlais 2016, 654), of putting affairs in order, of expressing thanks (long, this issue), or inhabiting the moment through gratitude (kavedžija, this issue). older age might cast the future as a domain of uncertainty, shrouding the transition between life and death in ‘mystery’ (golomski, this issue). death figures as a certainty for which arrangements must be made (elliot, this issue), but also as an unknown, an ontological horizon. while culturally constructed knowledge of what death will bring can be quite elaborate, and while rituals provide structure for those who remain, the personal experience of death remains unknown, even unknowable. death can be paradigmatic of liminality (berger 2016), and as such may be viewed as a transition that is both dangerous and generative. in this sense, the end of a life is not altogether unlike the end of the world – unknown. terminal hope when the future appears inaccessible or is somehow blocked (e.g., in depression or death anxiety), hope necessarily disappears and life loses meaning. (rappaport et al. 1993, 371) if what lies ahead is seen as inaccessible, as can happen in the context of death anxiety (see rappaport et al. 1993), this might be figured as the loss of a future. in fact, older age is often marked by various http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 5 forms of loss (e.g., danely 2015): one’s consociates or significant others; of a way of life; of bodily capacities and abilities. at times, the future might itself seem inaccessible, lost. this immense loss can give rise to grief, perhaps even requiring bereavement counselling (see chatterji 2016, 700). how to imagine a future at the end of life? while people everywhere know a great deal about death, in one way or another, precise knowledge of death is impossible, and death is unimaginable (lambek 2016, 630). as the crow people of north america confronted the inevitable end of their way of life as they knew it (buffalo hunting was no longer possible and most of their other activities and roles seemed deeply entwined with it), their chief plenty coups expressed his hope that something good will nevertheless ensue, a good not yet knowable or even imaginable from the current crow perspective. this is what jonathan lear characterised as radical hope: “plenty coups responded to the collapse of his civilization with radical hope. what makes his hope radical is that it is directed toward future goodness that transcends the current ability to understand what it is. radical hope anticipates a good for which those who have hope as yet lack appropriate concepts with which to understand what it is. . . . [in this sense] the crow hoped for the emergence of a crow subjectivity that did not yet exist” (lear 2006, 103-104). what form does hope take, we might well ask, at the end of life? terminal hope is perhaps the quintessential radical hope, oriented towards the total unknown, while remaining open to the good. death may be the end of life but does not stand in opposition to it. as lambek reminds us: "the culmination of life is surely death, and the only way to make sense of death is surely life. they are two sides of a coin, and in fact literal coins are frequently what are placed in the mouths of the deceased, ready to help them make the passage, either from this life to an afterlife, or from death back to life. without life there could be no death. without death there could be no life. death and life are the mutual conditions for one another." (lambek 2016, 634). death is certain, yet unknowable. this ambiguity is captured by jackson in his discussion of the penumbral “all human experience remains ambiguous, containing within it both the seeds of its own comprehensibility and nuances and shadings that go beyond what can be comprehensively thought or said " (jackson 2016, 451). such ambiguity can be a source of uncertainty, leading to anxiety, but can also be open, making space for hope. by definition, hope reaches out towards the unknown (cf. bloch 1986), and even though forward oriented, might not entirely be at odds with the approaching end of life. death delimits but also contains life and holds it together. endscapes how does it feel, to approach death? how do people navigate social relationships, time, and uncertainty in this period? such a profoundly intimate experience may be difficult to communicate, or put into words (see chatterji 2016), but it can also be watched, witnessed, accompanied. green writes of various ‘exit strategies’ that people employ, suggesting that death is not a momentary occurrence but rather a process: “we all die a bit every day just to keep ourselves alive, but not all of us do so at the same rate” (2008, 45). among yolmo buddhists, death is viewed as a creative process, desjarlais argues – an act of poiesis. while it involves gradual disentanglement and detachment, this is precisely why it also involves others: “dying often emerges as an active, conscious project in life, as an action to be undertaken. a person strives, often with the help of others, to create the conditions whereby she can contribute to the creative subtraction of her place within the world” (desjaralais 2016, 654). the aim of this volume is to add to the literature on older age and life course by attending carefully to the period of facing death and approaching the end as a particular part of a life. scholars of the contemporary hospice movement suggest that approaching death requires coming to terms with the finitude of life (see kübler-ross 1969). for residents of the south african care home, the imminence of death was joined with the process of getting used to death, of living with it. here, the endscape spanned http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 6 the time of approaching death, as well as what came after it, extending into the unknown: ‘yesterday is history, tomorrow is a mystery’ (golomski, this issue). the endscape for the scottish elders described by elliott and carpentieri in this volume seemed to allow and even demand some degree of futurizing and planning, but the bodily changes and decline were also often conjoined with stoicism. the endscape for the relatively young mexican elders extends far into the future, where their own bodily practices are seen to affect the national body, with its own temporality (see wentzell, this issue). in japan, too, the endscape opens up towards others (long, this issue; kavedžija, this issue), with these vital relationships extending beyond the horizon. writing about his own experience of nearing the end of life, the psychoanalyst stanley leavy (2011) suggested that this final stage of ‘meanwhile’ allowed for a certain freedom, a release from earlier statuses and expectations. he argues that thinking of the openness of the time in this ‘meanwhile,’ and some of the limitations that people might experience as they approach their final days, lend a special quality to the ‘last of life.’ discussions of older age in predominantly negative terms, as a time of loss and frailty, or in overly positive terms, as a time of active involvement, equally neglect the possibility that this is a novel and productive time that offers something new and specific due precisely to its limitation: “that it may be unique, new, fresh, and that its benefits exist not in spite of physical and mental limitations, but joined with them” (leavy 2011, 708). the contributions herein hopefully go some way towards investigating the particular challenges, but also the promise, that the ends of life can hold in store. they invite us to reflect on the diversity of human endscapes, those fluid terrains of meaning that all must navigate. acknowledgments this special issue started to take form as an invited panel of the anthropology of aging and life course interest group at the american anthropological association congress in washington dc in 2017. my special thanks go to jay sokolowski and bjarke oxlund who supported the organization of the panel, and to jason danely, who supported a previous incarnation of this panel at the anthropology and gerontology conference held at the oxford brookes in 2017. i am extremely grateful to all the participants in the panel discussions, who have all remained actively involved with this project. notes 1. ‘living with death’ is not necessarily desperate or meaningless – the presence of loss provided a source for meaning in life for her interlocutors in new mexico’s espanola valley ‘living-with-death’ is seen as a source of natality for kin who care for one another, in a context in which loss produces a connective tissue between the past and the future (garcia 2016, 316). 2. social gerontologists similarly question the homogeneity of the ‘older age’, with some making a distinction between ‘the third age’ and ‘the fourth age’ (gilleard and higgs 2010). references augé, marc. 2016. everyone dies young: time without age. new york: columbia university press. bateson, mary catherine. 2011. composing a further life: the age of active wisdom. new york: vintage. bear, laura. 2014. “doubt, conflict, mediation: the anthropology of modern time.” journal of the royal anthropological institute 20: 3-30. bloch, ernst. 1986. the principle of hope. cambridge, ma: mit press. berger, peter. 2016. “introduction.” in ultimate ambiguities: investigating death and liminality. edited by berger berger, and justin kroesen, 1-11. oxford: berghahn books. http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 7 chatterji, roma. 2016. “the experience of death in a dutch nursing home: on touching the other.” in living and dying in the contemporary world: a compendium. edited by das veena and han clara, 696-711. oakland, california: university of california press. danely, jason. 2015. aging and loss: mourning and maturity in contemporary japan. new brunswick, nj: rutgers university press. desjarlais, robert. 2016. “a tood death, recorded.” in living and dying in the contemporary world: a compendium. edited by das veena and han clara, 648-61. oakland, california: university of california press. feldman, illana. 2017. “humanitarian care and the ends of life: the politics of aging and dying in a palestinian refugee camp.” cultural anthropology 32(1): 42-67. garcia, angela. 2016. “death as a resource for life.” in living and dying in the contemporary world: a compendium. edited by das veena and han clara, 316-28. oakland, california: university of california press. gell, alfred. 1992. the anthropology of time: cultural constructions of temporal maps and images. berg: the university of michigan. gilleard, chris, and paul higgs. 2010. “aging without agency: theorizing the fourth age.” aging & mental health, 14(2): 121-128. green, james w. 2012. beyond the good death: the anthropology of modern dying. university of pennsylvania press. golander, hava. 1995. "rituals of temporality: the social construction of time in a nursing ward." journal of aging studies 9(2): 119-135. jackson, michael. 2016. “life and concept.” in living and dying in the contemporary world: a compendium. edited by das veena and han clara, 449-462. oakland: university of california press. johnson‐hanks, jennifer. 2002. “on the limits of life stages in ethnography: toward a theory of vital conjunctures.” american anthropologist 104(3): 865-880. kao, philip, and steven m. albert. 2020. “aging and society in the new life course.” in the cultural context of aging: worldwide perspectives. edited by jay sokolovsky, 111-129. westport: praeger. katz, stephen, and toni calasanti. 2015. “critical perspectives on successful aging: does it ‘appeal more than it illuminates?’” the gerontologist 55(1): 26-33. kaufman, r. sharon, and lakshmi fjord. 2011. “medicare, ethics, and reflexive longevity: governing time and treatment in an aging society.” medical anthropology quarterly 25(2): 209-231. kübler-ross, elisabeth. 1969. on death and dying. new york: macmillan. laird, carobeth. 1979. limbo: a memoir about life in a nursing home by a survivor. chandler sharp publishers. lamb, sarah. 2017. “ageless aging or meaningful decline?” in successful aging as a contemporary obsession: global perspectives. edited by sarah lamb, 230-241. new brunswick, nj: rutgers university press. lambek, michael. 2016. “after life.” in living and dying in the contemporary world: a compendium. edited by das veena and han clara, 629-647. oakland, california: university of california press. lear, jonathan. 2006. radical hope: ethics in the face of cultural devastation. harvard: harvard university press. leavy, stanley. 2011. “the last of life: psychological reflections on old age and death.” the psychoanalytic quarterly 80(3): 699-715. povinelli, elizabeth a. 2011. economies of abandonment: social belonging and endurance in late liberalism. durham and london: duke university press. rappaport, herbert, robert j. fossler, laura s. bross, and dona gilden. 1993. “future time, death anxiety, and life purpose among older adults.” death studies 17(4): 369-379. ringel, felix. 2016. “can time be tricked?: a theoretical introduction.” the cambridge journal of anthropology 34(1): 22-31. http://anthro-age.pitt.edu/ kavedžija | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.320 http://anthro-age.pitt.edu 8 smith-morris, carolyn. 2010. “the chronicity of life, the acuteness of diagnosis.” in chronic conditions, fluid states: chronicity and the anthropology of illness. edited by leononre madison and carolyn smith-morris, 21-37. new brunswick, nj: rutgers university press. traphagan, john. 2000. taming oblivion: aging bodies and the fear of senility in japan. albany: suny press. thomas, keith. 2009. the ends of life: roads to fulfilment in early modern england. oxford: oxford university press. vigh, henrik. 2009. “motion squared: a second look at the concept of social navigation.” anthropological theory 9(4): 419-438. http://anthro-age.pitt.edu/ how we talk about aging during a global pandemic matters: on ageist othering and aging ‘others’ talking back christine verbruggen ku leuven, belgium christine.verbruggen@kuleuven.be britteny m. howell university of alaska anchorage bmhowell2@alaska.edu kaylee simmons north greenville university simmons4855@ngu.edu anthropology & aging, vol 41, no 2 (2020), pp. 230-245 issn 2374-2267 (online) doi 10.5195/aa.2020.277 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:christine.verbruggen@kuleuven.be mailto:christine.verbruggen@kuleuven.be mailto:simmons4855@ngu.edu verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 230 how we talk about aging during a global pandemic matters: on ageist othering and aging ‘others’ talking back christine verbruggen ku leuven, belgium christine.verbruggen@kuleuven.be britteny m. howell university of alaska anchorage bmhowell2@alaska.edu kaylee simmons north greenville university simmons4855@ngu.edu introduction as gerontologists, anthropologists of aging, advocates, and older adults have over the last months demonstrated, the covid-19 pandemic has seen a parallel viral spread of ageism and the ‘othering’ of ‘the elderly.’ the effects of a discourse of protection of a homogenized group of older adults have been widely discussed (e.g., morrow-howell and gonzales 2020). however, how reactions to the outbreak of ageism have amplified the rift between third and fourth age has gone largely unnoticed.1 this article first sketches “ambivalent ageism” (cary, chasteen, and remedios 2017) throughout covid-19 policy decisions, media coverage, and public opinion, as they reflect important tensions in the master narratives of aging. we show how both “compassionate” ageism (vervaecke and meisner 2020), framing elderly at risk, and “hostile” ageism (cary, chasteen, and remedios 2017), framing elderly as risk, flourish in the united states and in belgium in different discourses of (intergenerational) solidarity.2 we provide these two countries as case studies because they demonstrate the highest rates of positive covid-19 cases (us) and some of the highest possible death rates of covid-19 (belgium) in the world.3 although belgium has a more liberal calculation of suspected covid-19 deaths (schultz 2020), both countries provide the ideal ecology for this discourse of vulnerability in places with high case counts, deaths, and therefore negative impacts of covid-19 on older adults. we then draw attention to how opposition against age discrimination and generalized frailty have amplified the performance of the third age. for example, benevolent ageism from the ‘younger old’ towards the ‘older old’ or the contestation of age discrimination based on social value and indispensability, have increased. reading the newsletters of the flemish council for the elderly (fce) with these persistent tensions in mind, we argue that one of the many side-effects of a pandemic ageism during covid-19 is a further devaluation and compression of the fourth age through counternarratives http://anthro-age.pitt.edu/ mailto:christine.verbruggen@kuleuven.be mailto:simmons4855@ngu.edu verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 231 against ageism: today, older adults who do not volunteer or watch the grandchildren and may be ‘frail,’ find themselves increasingly without a cultural ground to claim voice beyond a discourse of protection. we are reminded of the possibilities of an anthropology of aging to detect this persistent dichotomy between ‘still able’ and ‘no longer able’ undergirding contemporary (anti)ageist discourses. we argue for a narrative approach to older adult subjectivity that validates the ambiguous and in-between moments, experiences, emotions, and desires that have the potential to disrupt the dichotomized identities of the third and the fourth age. “we are in this together”: older people at/as risk and the fallacies of solidarity as in many countries around the world since march 2020, public rhetoric and policy guidelines in the united states have increasingly emphasized that anyone over 60 years old is incredibly vulnerable to the consequences of covid-19. aging people, often lumped together under ‘the elderly,’ have been ambiguously prioritized as at-risk. in the us, the centers for disease control and prevention (cdc), the administration on community living (acl), and the national council on aging (ncoa) have released several guidance sheets and webpages devoted to explaining the increased risk of complications for elderly people and to giving special behavioral recommendations for this age group (acl 2020; cdc 2020; ncoa 2020). discouraging physical contact and wearing face masks were recommended for older adults weeks before these practices were suggested for the rest of the public. nursing homes have been regulated most strictly, and grandparents over 65 were by default considered endangered by the same grandchildren they otherwise took care of. such pandemic discourses further notions of frailty, vulnerability, and the precariousness of old age. dormant ageism is invigorated by research and policy guidelines, by which societies continue to view aging as a perilous process into decline, that can be modified through social policies and interventions (crampton 2013, 318). segregating policies that are introduced to keep older adults safe during the pandemic result in ‘othering’ a large group of adults based solely on chronological age. for example, grocery stores in many american cities, as in belgium, have introduced “senior shopping hours” for those over 60 to reduce their exposure to the general public (aarp 2020), leaving many 60-year-olds who had counted on a little more time before having to identify as “old” with the feeling: “wait, what?!” (ellison 2020). before the coronavirus outbreak, media representations of the social capital of resilient, entrepreneurial, healthy agers had increased considerably over the last decades. since early-march 2020, however, the news media has exponentially reproduced policy and expert crisis-discourses, relentlessly framing all older adults as being at-risk and vulnerable to the virus (see e.g., healthline 2020) (berridge and hooyman 2020; fraser et al. 2020). these popularized discourses of vulnerability matter, because they further normalize how we talk about a large and heterogeneous group of older adults as “precarious” and “frail,” provoking “a parallel outbreak of ageism” (ayalon et al. 2020, 2; grenier and phillipson 2018; kaufman 1994). furthermore, they also obscure the realities of viral virulence and which people are truly vulnerable in this situation, as well as the ableism endemic to ageism (gullette 2018, 252; vervaecke and meisner 2020). a meta-analysis shows that people with hypertension, diabetes, cardiovascular disease, and respiratory system diseases are at highest risk of covid-19 complications, regardless of chronological age (yang et al. 2020). gerontologists and physicians agree that it is not age per se that puts someone at risk for covid-19 complications, but rather the increased risk of chronic conditions, compromised immune systems, or living in residential facilities (morrow-howell et al. 2020), factors that already represent social priorities. it is important to remember that older adults may or may not fall into those high-risk categories, and that these categories reflect socio-medical effects rather than biomedical causes. high mortality rates are partially consequences of sociopolitical choices made long before the outbreak of the pandemic and reflect the social determinants of health (e.g., gilleard and higgs 2020). http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 232 largely suspending the recognition of these structural differences, pandemic discourses have invigorated the stereotypes which ignore the great variation of biological, social, and health outcomes existing among older adults (ayalon et al. 2020, 2), a demographic cohort spanning more than three generations that is more diverse than any other age group (berridge and hooyman 2020). this generalizing discourse of frailty negatively impacts the contingent vulnerability of older adults and may exacerbate the long-term consequences of internalized ageism (laceulle 2017, 2; vervaecke and meisner 2020). as we will discuss in this article, such discourses of vulnerability demand a counternarrative. fallacies of solidarity: benevolent ageism the negative effects of ageism were hard to detect at first, especially as the protection of ‘our elderly’ during covid-19 was established under a loud ‘we are in this together’ message, prompting an affect of solidarity in the name of public health that gave the impression of lifting the masses over generational, racial, gendered, and spatial divides to ‘flatten the curve.’ this atmosphere of solidarity made up of global outcries and a myriad of small-scale acts, resembled an, albeit brief, moment of “collective effervescence” (durkheim 1912). an acute injection of ‘the common good’ (clotworthy and westendorp, this issue) obscured that ‘we’ would suffer differently now, as we suffered differently before. critics of covid-19 induced ageism have unequivocally denounced homogenization of ‘the elderly’ and the negative stereotyping of an othered group, while emphasizing intergenerational solidarity as an antidote to ageism (ayalon et al. 2020; fraser et al. 2020). seeing that age discrimination in care provision and other forms of hostile ageism are equally defended under the flag of ‘intergenerational solidarity’ (making older adults accountable for the future of the economy and the well-being of younger generations), we argue it is more accurate to say that, during the covid-19 crisis, a discourse wherein older adults are blamed and sacrificed (hostile ageism) runs in parallel with a humanitarian or “compassionate” ageism (vervaecke and meisner 2020). both in protecting and sacrificing older adults the category of ‘the elderly’ is othering, positioning “older people as a separate social group apart from ‘the rest of us’”(berridge and hooyman 2020). “compassionate ageism” (vervaecke and meisner 2020) – seeing to the needs of ‘the elderly,’ behaving well to protect ‘the elderly,’ or educating ‘the elderly’ about the risks of infection – indexes the paternalism that is imbued in mixed stereotypes, such as ageism. deanna vervaecke and brad meisner point out that “stereotypes are often a mix of perceptions of an out-group in two dimensions, warmth and competence” (2020). a group can be both positively stereotyped (e.g., as warm) and negatively stereotyped (e.g., as incompetent), as is the case for older adults. such mixed stereotypes (“high in perceived warmth and low in perceived competence”) induce both nurturing and patronizing behaviors towards those portrayed as incompetent (vervaecke and meisner 2020), even when one of the outcomes during covid-19 was that ‘the elderly’ as at-risk were embraced as deserving citizens (fassin 2005). as gerontologist peter janssen reminds: it’s for your own good. the more you age, the more you get to hear this. you have to give up your car or bike; you are not allowed to cook or clean, you have to move to a service flat or a nursing home, you cannot manage your own money and possessions, and intimacy and sexual desires are ignored, or even penalised. and now, you can’t even go outside anymore and you are locked up in your own room. no one can come to visit. that’s worse than prison. (janssen 2020; translation by author verbruggen) http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 233 one might rightfully argue that paternalistic attitudes are induced by the severity of the situation and are generally adopted even by otherwise more neoliberally-oriented governments in a state of emergency (clotworthy and westendorp, this issue). however, enforcing behavior does not take the same form across age groups. there is a general consensus among public health experts that “spoonfeeding” restrictions to younger adults is not the best strategy to raise awareness (stone 2020). a public health program manager at the san francisco bay area remarked that what could be more efficient is, “we ask how are you protecting your grandma from covid? and they may want to talk about their grandma and how she makes the best menudo” (stone 2020). indeed, benevolent ageism and intergenerational solidarity “flourish” in parallel (previtali, allen, and varlamova 2020): as younger generations are recognized in their capability of taking up responsibility (high in competence), the ‘elderly’ are innocent symbols of tradition and homeliness (high in perceived warmth), and therefore deserve protection. as postcolonial scholars have amply substantiated, paternalism can also mean that we forget that “they read what we write” (brettell 1993). as a manager of a belgian nursing home accurately remarks, “our residents question the restrictive measures. they also read the newspaper. they have the feeling of being given up” (ysebaert 2020; own emphasis). in a similar vein, the first author (verbruggen) vividly remembers a phone conversation with her 80-year old mother about three months into lockdown, really, christine, i can’t listen to the radio anymore, it is too much. it makes me sick. every day i hear how much i am in danger, how much i need help, how frail i am. it really gets under my skin. i stopped listening. do they even know how it feels to hear this all day? it is worth noting that combatting age discrimination, by lifting the age limit from 60 to 80, for example, would not have helped this older woman feel ‘less sick.’ fallacies of solidarity: contingent vulnerability and the elderly ‘as risk.’ of course, the policies of covid-19 have also unleashed more hostile ageist discourses and measures (cary, chasteen, and remedios 2017, e28), which reveal the contemporary social position of older adults as risk (beel 2020b). for example, on social media #boomerremover was launched, scapegoating the baby boomers for eroding society as a whole. an older generation is portrayed as passive and vulnerable, making “high mortality rates amongst older adults . . . an ‘inevitable’ and ‘normal’ outcome of this pandemic” (fraser et al. 2020). younger adults are concomitantly represented as strong and essentially invulnerable, affirming older adults’ social identity as leeches on an otherwise resilient society. in a similar vein, not even a week in lockdown, the belgian federation of intensivists stressed that, if hospitalization – due to covid or otherwise – would be necessary, the previous health condition should be “taken into account”: “elderly who are ‘frail’ (physically very vulnerable), or who have suffered from severe cognitive decline, maybe shouldn’t be hospitalized when they are infected with covid-19” (beel 2020b; translated by author verbruggen). also, the us has adopted the ventilator allocation guidelines “whereby ‘age may be considered as a tie-breaking criterion in limited circumstances’” (fraser et al. 2020). the vulnerability of the elderly and the vulnerability of a health care system continue to be weighed on a scale of lives worth living (gullette 2020). that aging into frailty, or aging at all, is perceived as a burden to society that needs to be compensated for, is also echoed in the proposal of behavioral economist jan-emmanuel de neve to introduce a “coronatax,” a tax every citizen over 65 would need to pay to compensate for the damage society suffered due their vulnerability, http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 234 and to show their gratitude for the efforts made by the younger generations (vlaamse ouderenraad 2020g). intergenerational solidarity and ageist stereotypes here work together to prove the threat of ‘the elderly’ as unproductive and frail, as in-groups are rescaled. the situation in nursing homes is equally indicative of how the currency of ‘dependent’ older lives is not as crisis-bound as it might seem. after a month of operating behind closed doors, the severity of the situation in belgium and the us, as elsewhere in the world, is revealed; the number of infections in nursing homes accounts for one fourth of the total confirmed cases and 38% of covid-19 related deaths in the us (new york times 2020). nursing homes face resource shortages (testing materials, personal protective equipment [ppe], etc.) and in the eldercare workforce (beel 2020c). the situation echoes priorities set long before the outbreak of covid-19 and the state’s neglect of investing in nursing homes, their staff, and their residents. elderly with more intensive care needs were already considered a burden and ‘as risk’ for economic growth (walker 2012). these blatant symptoms of ageism, that parallel a discourse of protection in crisis, reveal how older adults are constantly urged to prevent becoming socially superfluous, and always risk being sacrificed to prevent the boat from sinking. nostalgia for the “best menudo,” has never been sufficient to increase the value of frail older bodies. “we are not one”: validity versus vulnerability the othered speaking back anthropologists of aging have done substantial work in diagnosing and reducing ageism and age-based discrimination by redirecting the conversation around the processes and experiences of aging. the responses to covid-19 confront us with the question as to whether or not we have succeeded in finding a realistic, appreciative language and space for stories of people “aging into frailty” (gullette 2018, 263) and, whether or not fighting age discrimination by claiming agelessness is the best strategy to change internalized ageism (lamb 2018; leahy 2020; shimoni 2020). discourses and experiences of aging are historically contingent. what was once a discourse of unemployability, old-age pensions, and long-term care, older adulthood was reframed and diversified as the very different third age and fourth age by peter laslett (1989) to express changing demographics and socioeconomic development of older adults. the third age was marked by an idealistic discourse of a healthy, new generation of retirees who possessed greater autonomy and resources to pursue fulfilling lifestyles after retirement. emphasizing moral lifestyle choices, the third age harkens back to the rowe and kahn model of successful aging (1987), that excluded many older adults’ lived experiences with the aging process and has served as a cultural toolkit to prevent (some) older adults from becoming ‘the elderly.’ dismantling the anti-ageist and emancipatory effects of such a model, chris gilleard and paul higgs (2002) have rightfully argued that some models of the third age are rooted in contemporary structures of welfare, hyper-commodification, and the behaviors (i.e., free decision-making, individual responsibility) that come with this cultural ideal, that do not accurately reflect the range of embodied experiences of older adulthood. in a similar vein, sarah lamb argues that the normativity of a healthy, active, ageless third age has become a “contemporary obsession,” resulting in a newly discriminatory paradigm that denies normal health and functional changes as we age (lamb 2014, 2017). higgs and gilleard (2015) also contend that despite such an outward focus on healthy and active aging, an insidiously negative view of old age still lurks in the background of our collective consciousness: the fourth age. not simply the terminus of the third age, the fourth age is a “social imaginary” that contains the dark sides of aging (infirmity, long-term care, frailty) that were not undone but invigorated by the celebration of third age (gilleard and higgs 2013). third and fourth age are caught in a deceptive dialectic: one can fall into fourth age disregarding chronological age, and if one does, this is not because of the consequence of failed support systems across the life course http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 235 or discourses that make up “aging” but because of one’s own irresponsible behavior (katz and calasanti 2015; o’neil and haydon 2015, 6). the covid-crisis is a magnifying glass, making crystal clear that the social imaginary of the fourth age always risks ‘polluting’ the space of the third age and that the normativity of overcoming ‘being old’ through exerting individual agency (third age), has only exacerbated the fear of the stigma of vulnerability, that is still a daunting prospect lurking in an undesirable future (fourth age). with the governmental and social responses to covid-19, the danger of pollution by this stigma – formerly cast away in the fourth age – has even increased, and a large group of older adults fear being relegated to the space of “abjection” overnight (gilleard and higgs 2010). that this relation between the third and the fourth age is naturalized, exclusive and antithetical, becomes particularly clear from the strategies older adults use to resist the generalized imaginary of frailty as a consequence of covid-19: as the unrightfully ‘othered’ try to differentiate themselves from the ‘old,’ they resort to reinforcing the rift between third and fourth age, and – often unwillingly – become ‘others othering back.’ the landscape in belgium: “we are in this together” – tous ensemble much has been written about the cultural landscape of ageism during times of covid-19 in the us this section follows the developments of covid-19 in belgium through the eyes of ‘the elderly’ as voiced in the belgian newsletter of the flemish council of the elderly (fce). we look into similar significant shifts along the axes of third and fourth age and trace the persistence and reinforcement of (benevolent) ageism in anti-ageist discourses and practices.4 in belgium, on march 12, 2020, six days before the country went into a ‘lockdown light,’ visits to nursing homes were already strictly prohibited, as was “non-essential” movement, especially for “vulnerable elderly” (beel 2020a). citizens did not even need an official lockdown to launch initiatives of solidarity. for example, the facebook group “spread solidarity, not the virus,” was set up that same day. flyers were designed for posting to neighbors, that firstly urged “vulnerable people and elderly” to avoid crowded places and then offered help “for grocery shopping, food, or just a talk” (see figure 1). figure 1: flyer designed by the facebook group “verspreid solidariteit, niet virus” (https://www.facebook.com/groups/verspreidsolidariteitgeenvirus/)5 http://anthro-age.pitt.edu/ https://www.facebook.com/groups/verspreidsolidariteitgeenvirus/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 236 additionally, on march 11, 2020, seven days before the official soft lockdown in belgium, the flemish council for the elderly (fce) reported being “satisfied with the special attention that is given to vulnerable persons and elderly. it is ultimately this target group who is most vulnerable for the virus, and for whom the consequences are regularly more severe” (vlaamse ouderenraad 2020b). the fce is concerned about the loneliness of older adults but feels that cancelling their events is their “civic duty” (2020b). two days later, care institutions went into lockdown and adult daycare centers and social service centers were closed down. at that stage, issues such as how to stay mentally and physically fit during quarantine, how to detect misinformation in the newspapers, and how to make and wear face masks became central topics in their newsletters. on 20 march 2020, the fce echoed the decisions made by the federal government: 65-plus and in good health? still it is better not to watch your grandchildren. you are extra vulnerable for the coronavirus, even when you are healthy. are you younger than 65 and healthy? then you can watch your grandchildren, unless you work with older people. (vlaamse ouderenraad 2020c) when on 7 april 2020, the situation in nursing homes was revealed, ‘the most vulnerable’ were thrust into the center of attention in the corona-debates for weeks (rogiers 2020). the flemish minister of welfare, wouter beke, faced harsh critiques, as nursing homes were compared to the contemporary morgues where the most vulnerable are left to die. ‘the most vulnerable’ became ‘the most visible’ to occupy the space of aging (gullette 2018), while a general consensus emerged that this structural neglect of the institutionalized older adults in wartime (during covid-19) is simply an echo of structural neglect of investing in care for the elderly in peacetime (cochez and vanden bussche 2020). as if the seriousness of the situation had distracted the fce from the discursive framing of ‘elderly,’ it took the association more than a month into lockdown to address the homogenization of a highly diverse group of older adults, and their lack of voice in the debates, the past few weeks, the number of times elderly were mentioned in the media, is impossible to count. older generations are being targeted. . . . every day the vulnerability of elderly is mentioned, and this while the voices of elderly are notably missing. [own translation] (vlaamse ouderenraad 2020d) the council is interested in the myriad of feelings (“gratitude, helplessness, anxiety, curiosity, grief, happiness”) of older adults as “the most vulnerable” in this crisis (2020d). at the same time, signs of intra-group “caremongering” emerge: there is an often overlooked performative aspect of caremongering (vervaecke and meisner 2020). doing something good for somebody else implicates that one is able to do so (that one is competent), and hence, that one is not needy. this can be seen in the initative “geen belet” launched by fce on 27 april, 2020 to “hold on to this tous ensemble-feeling.” they join forces with different elderly associations to start calling “the oldest old” on a weekly basis (vlaamse ouderenraad 2020e). http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 237 figure 2: “het zal nog een aantal weken duren tot we terug nabij contact hebben.” [it will take a couple of weeks before we can be close again] (@vl_ouderenraad, 27 april, 2020). one 69-year old male volunteer reported that he has the feeling that, “the elderly are doing pretty well now. ‘loneliness’ and the feeling of being locked up, however, weigh heavily on them.” another female volunteer, 63-year old, clearly voices the value this has for herself, “the calls really give me a boost, because i feel that they are valuable. i want to continue doing this after the lockdown, maybe not on a daily basis, but every week, or when i feel that it is necessary” [own emphasis] [both retrieved from vlaamse ouderenraad 2020e]. in this well-meant act of solidarity, the immanent division between those who are responsible and can help, and those who require help and are deserving is confirmed (vervaecke and meisner 2020). while the ‘younger’ old can attempt to escape some effects of ageism through the performance of productivity and social engagement, the ‘older’ old are forever old (twigg 2004). in times of crisis-induced solidarity the fact that both spaces behave as interconnected vessels easily goes unnoticed. (ageism age discrimination) = fourth age? taking into account the social, cultural and political-economic motivations of third/fourth age tension, it should not come as a surprise that the tous ensemble feeling almost imperceptibly altered further once the first relaxation measures were announced in the us and belgium, when the relaunch of economic activities was at stake. the flemish council for the elderly and its members report being incensed by “the negative portrayal [of older adults] and the generalizing age marker of 65” in the exit strategy. the council initiates its own recommendations, stressing that the security measures have mostly impacted the older adults and that they now deserve positive discrimination (vlaamse ouderenraad 2020f). to validate this claim, ‘the elderly’ are firstly explicitly differentiated, at this moment, in the media and in policy ‘the’ vulnerability of ‘the’ elderly is highlighted. we understand that this is necessary and are aware of the fact that the virus in its most lethal form mostly hits the oldest and the most vulnerable amongst us. . . . on the other hand, we should keep in mind that the ‘elderly’ consists of three generations of people, and not all of them are vulnerable. you cannot compare the situation of a healthy 65-year old with that of a frail 95-year old. (vlaamse ouderenraad 2020f) http://anthro-age.pitt.edu/ https://twitter.com/vl_ouderenraad verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 238 the introduction to the recommendations for the exit-strategy is problematic in two ways. first, while it is reasonable to argue that frailty in older age is more common, both the frail 65-year old and the healthy 95-year old are invisible in these stereotypes. the voice of the single 82-year old man who witnesses that he had always given the best of himself in caring for other older adults in nursing homes or people in ill health, but that as now, in lockdown, all that has ceased, he feels he has lost solid ground (beweging.net mzwvl 2020), is missing from the introduction to the recommendations; as is the voice of the 83-year old father of the first author (verbruggen) who laments not being able to come and help her with fixing her chairs or painting her ceiling; as is the voice of the 63-year old woman who usually visits a daycare center due to her early-onset dementia, but is now alone, at home, with her fragmented memories haunting her. second, it paves the way for privileging the older adults (65-69) who are ‘still’ professionally or informally active and that are here paired with “healthy.” the recommendations stress that volunteering is important in the light of “the restart of society and the economy” and remind that a lot of “active young-retirees” provide transport for people with impaired mobility. ‘care’ as a distinctive capacity of some older adults is foregrounded: “we do fear the current focus on one age limit, without nuance or differentiation, will impact the support among elderly, and that a lot of real perils in the lives of elderly will remain unaddressed” (vlaamse ouderenraad 2020f) [own emphasis]. the discourse in the newsletters of the belgian fce has ranged from “civic duty,” over solidarity, over a rage about the situation in nursing homes to age discrimination in two months, paralleling the emergency of the lockdown and the re-awakening of common sense with the relaxation of security measures. older adults do not only make up for a very large group in society, they are mostly a particularly active and indispensable link in our society. they participate in cultural and sports activities, they go out and take part in all sorts of activities and events. but also the voluntary commitment of older adults is invaluable. they take up a wide variety of roles: as caregiver, as volunteer, as member of an organization, as grandmother or grandfather. they take up important roles on a wide range of (domains) such as sports, welfare, culture and care. (vlaamse ouderenraad 2020f) what is striking in this contestation of age discrimination, is not so much the content of the recommendations given for a reintegration in society, but their contextualization. when ‘warranties’ for good care and social contacts are asked for older adults in ‘precarious’ situations (vlaamse ouderenraad 2020h), there is no such introduction celebrating the indispensable character of these older adults. the fact that the fce stresses productivity and social value to counter a generalized “ageism,” leaving a large group of older adults across ages unaddressed, is not an exception. academic articles that address the rise of ageism during the coronavirus, rely on very similar cultural identities to legitimate their antiageist claim, older adults continuously and actively contribute to society with paid and unpaid work . . . ; they constitute a great bulk of informal care for partners, grandchildren and others . . . ; they are a vital part of voluntary and civic society . . . ; they support intergenerational transfers . . . ; and they secure the continuity of our identity, heritage, and memories. moreover, older adults are assisting others during this crisis; for example, those who are retired healthcare professionals answered the call and returned to work. (previtali, allen, and vadamova 2020, 510) they are a source of generational knowledge and wisdom, they contribute to the workforce in increasing numbers, they volunteer and they are key to the strength of http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 239 our economies and our families. we cannot afford to be careless about these lost lives because of ageist attitudes. (fraser et al. 2020) [own emphasis] ann leahy wonders whether during covid-19 active aging has revealed itself as a “flimsy” construct, “easily cast off if another narrative serves overarching purposes more expeditiously” (2020). our analysis of voices in the fce newsletters, however, indicates that the opposite is equally likely, and that the imaginary of the third age is not “cast off” but reinvigorated in reaction to a large scale accusation of frailty. in both cases, dichotomization persists. the dynamics of fighting age discrimination with other traits of ageism – patronizing behavior, stereotyping, claiming agelesness – we diagnosed here, only affirm that ageism is internalized, by both younger and older adults. as margaret morganroth gullette argues: perhaps what unifies a generationally-divided society now (where age is concerned) is that younger age groups fear aging-past-youth because of the ageism they unconsciously anticipate and which they too often damagingly internalize and sometimes hurtfully express. (2018, 261-262) discussion first, mainstream socio-political and media responses to covid-19 have cultivated an overgeneralized representation of everyone over 60 as vulnerable. second, the ageism in these representations has been contested, through calls for intergenerational solidarity and by older adults stating their social validity and productivity. the underlying message of both discourses is the same: “defy ageing for as long as possible and avoid becoming socially superfluous” (shimoni 2020). whereas a homogenizing public discourse and policy during covid-19 has indeed openly devalued old age experience (fraser et al. 2020), the counternarratives to ageism have not yet been particularly helpful in revaluing the lives of those unproductive, dependent and alive, or in overcoming the dichotomization of healthy versus frail aging. what we see here is a catch-22 of contesting the vulnerability of ‘the elderly’ by stating that a large part is productive, while, in doing so, relegating a large ‘residue’ of vulnerable older adults to a social space where they are merely worthy of care and protection. this is a logical consequence of the social location of all older bodies. gilleard and higgs argue that, as the aging body is interpellated by imaginaries of both third and fourth age, “real vulnerability” is relegated to ever darker spheres of social existence (2011, 137). the increased capacity to overcome the social and bodily signifiers of old age has resulted in “an intensification of ‘real’ old age with even less capacity to transgress the abjection that is associated with frailty and the loss of agency and symbolized by the fourth age” (2011, 137). this abjection, they remind us, is not limited to public policy or media coverage, nor to “the individual dilemma of being yet not feeling old” (2011, 138). the fourth age by default, describes a place close to death, indexed more strongly during the pandemic and concomitant discourses. this has only fueled the dismay of ‘deep’ old age, “denying the necessity of having to be embodied within the ‘excluded’ community of a fourth age” (2011, 138). there is always a residual other. “agentic transgression” of aging is not possible for every older adult – or might not even be desirable. the consequence is social – if not physical – death, as “in the absence of signs of socialized intent and individual purpose, no opportunity exists to challenge or escape what bataille has called this ‘exclusion from the moral community’” (gilleard and higgs 2011, 141). it has become clear that neither ‘we’ nor ‘the elderly’ are together in this crisis and that both benevolent ageism and proving indispensability are necessary tools for older adults to prevent falling into fourth http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 240 age. it is also clear that patronizing behavior or positive images of resilient, healthy, caring older adults densify the space of the fourth age, and that academics, news media, advocacy, and older adults, are not always fully aware of the negative effects of these ‘counternarratives’ on the social value of the ‘really old,’ and hence of what dichotomies ageism consists of. what remains pertinently unclear is how an older adult can claim value, desire, and agency with, or ‘not against,’ vulnerability (lamb, this issue). is there any claim that can be made that is not introduced by “older adults are a heterogeneous group that continue to make valuable contributions to society” (previtali, allen, and vadamova 2020, 509)? gilleard and higgs point to the potential of caring relationships to remoralize frail old age, and of embracing the frailty of the fourth age as a daily reminder of the existential vulnerability of common humanity on the other (2011, 141). focusing more on narrative representations of aging lives, ayalon et al. (2020, 4) recommend relying on a “personalized rather than generalized message,” while o’neil and haydon (2015, 5) stress avoiding incomplete narratives as they tend to only further reaffirm stereotypes. gullette proposes an “aging as process narrative” to overcome the binary between “progress narrative” and “decline narrative” (2018, 262). as we have illuminated in the analysis of the newsletters of the flemish council for the elderly, overcoming this binary making up ageism, is a hurdle many older adults face. considering future perspectives for narrative gerontology, kate de medeiros reminds us that counter-narratives, in this case of vulnerability, are always limited by a master narrative (2016, 66-67), that here again reveals itself as already a bifurcated phenomenon. more importantly, de medeiros goes on to argue counter-stories to the grand narratives are not necessarily counter-narratives, but small stories as they “may provide the means for people to express important thoughts, reactions, and other experiences of aging that are outside of the grand master narratives of age” (2016, 79). following along these lines, we see an important task for anthropologists, in the co-creation of stories of aging, as they need a care-ful audience (puig de la bellacasa 2017) to do justice to the radical emics of particular lives, and to the ways the “seemingly unsayable” (titchkosky 2003, 220), the in between – the neither vulnerable nor productive, the neither old nor young, the neither past nor present, the not-evenabout-aging – permeates all narratives with aging. how older people talk during a global pandemic matters. during the lockdown, the staff of the belgian nursing home where the first author (verbruggen) is conducting fieldwork for her doctoral research invited residents to send messages to ‘the outside world.’ on 21 march 2020, a letter by juliette is posted under the “corona-updates” of the nursing home. julliette lives with dementia in unit 11, together with 7 co-residents, and writes, i would like to tell you what i observe here in unit 11. pleasant, but also other things, when i look around. touching and sometimes even funny. today was the birthday of one of the other residents his daughter used her smartphone so they could see and hear each other. oh! what fun they had together! also the ordinary things suddenly become emotional. how people here in the unit help each other now: shall i pour you some coffee? do you want another biscuit? adorable! this week, i saw a man who has been having difficulty walking for quite some time. all of a sudden, he swiftly crossed the living room, because he didn’t know i was looking. http://anthro-age.pitt.edu/ verbruggen, howell and simmons | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.277 http://anthro-age.pitt.edu 241 all too human, yeah, but still a little funny. sometimes people are very tired here, and they sleep a lot. well, that’s cool right!? if i think about it now, i think that caregiving would be just the right job for me. if i would be 20 or 30 years younger … there is so much friendship around here. if i would be working here now, i’d also still enjoy it! juliette acknowledgements we are grateful to sarah lamb for her generous and valuable comments on earlier drafts of this article, and to julliette and the staff members of her care unit for sharing her voice. we also wish to thank janis woodward for her excellent and meticulous editorial work. notes 1 notable exceptions in this regard are leahy 2020 and shimoni 2020. 2 the dichotomous at/as risk is taken from work in the anthropology of children and youth by filip de boeck on the ambivalent nature of witchcraft accusations against children and younger adults in kinshasa (de boeck 2009). for the concept of ‘fallacies of solidarity’ we are indebted to the special issue of the journal of aging studies, edited by natashe lemos dekker and annette leibing, “fallacies of care” (2019). 3 as of this writing, the us has experienced 8.7 million positive cases with 225,000 deaths (2.5% death rate), while belgium reports only 321,00 positive cases and 11,000 deaths, for a death rate of 3.4% (our world in data, 2020). 4 the flemish council for the elderly (vlaamse ouderenraad) is the official advisory body for the flemish elderly policy of the flemish government, one of the three regional governmental institutions of belgium. the fce advocates for the political participation of elderly on a regional, provincial and local level, voices their concerns and informs older adults about social, economic, political, cultural and scientific matters that concern them. they also provide a platform for local elderly associations, organize trainings and study events, and publish a weekly newsletter, which this paper draws its ethnographic material from (vlaamse ouderenraad 2020a). 5 “dear neighbor! the coronavirus is dangerous for vulnerable people and elderly. if you belong to this high-risk category, it is best to avoid large groups of people: public transport, but also warehouses and other crowded spaces. stay at home as much as possible: if you need help with grocery shopping, food or if you just want to have a talk, this is my phone number: …. . you can call me, then we can see what i can do for you” [translation by author verbruggen]. references aarp. 2020. “supermarkets offer special hours for older shoppers.” accessed april 28, 2020. https://www.aarp.org/home-family/your-home/info-2020/coronavirus-supermarkets.html. acl. 2020. “coronavirus disease 2019 (covid-19).” retrieved april 21, 2020. https://acl.gov/covid-19. ayalon, liat, alison l. chasteen, manfried diehl, becca r. levy, shevaun d. neupert, klaus rothermund, clemens tesch-romer, and hans-werner wahl. 2020. 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[some don't want a lifesustaining stay in the hospital] de standaard avond online march 24, 2020. https://www.standaard.be/cnt/dmf20200324_04900687. http://anthro-age.pitt.edu/ risky business: how older ‘at risk’ people in denmark evaluated their situated risk during the covid-19 pandemic amy clotworthy university of copenhagen amy@sund.ku.dk rudi g.j. westendorp university of copenhagen westendorp@sund.ku.dk anthropology & aging, vol 41, no 2 (2020), pp. 167-176 issn 2374-2267 (online) doi 10.5195/aa.2020.318 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 167 risky business: how older ‘at risk’ people in denmark evaluated their situated risk during the covid-19 pandemic amy clotworthy university of copenhagen amy@sund.ku.dk rudi g.j. westendorp university of copenhagen westendorp@sund.ku.dk “i can certainly be frustrated that we have a government, particularly a prime minister, who thinks she has to be a mother to us more than she has to be a leader – that’s the thing that worries me” (jørgen, age 72; interview 5 may 2020) introduction throughout history, humans have had to assess and analyse risk in order to “cope with uncertainty, the essential unpredictability of the future, and account for past misfortunes” (alaszewski 2015, 205). in contemporary societies, such determinations are typically made by government officials in consultation with specific experts. thus, when the world health organization declared a pandemic in march 2020 (who 2020), governments around the world decided to ‘lockdown’ the usual movements of society. in denmark, the prime minister and national health authorities immediately assumed an authoritative and protective approach to reduce potential harms to both population health and the healthcare sector; i.e., by ‘flattening the curve’ of infections, they hoped to prevent hospitals and healthcare workers from becoming overburdened with patients needing intensive medical care. the political response was thereby to temporarily close businesses and schools, require ‘non-essential’ employees to work from home, and encourage all citizens to adopt specific preventative measures such as self-isolation, increasing hand hygiene, severely restricting group activities, and remaining physically distant from others. these recommended measures were also based on a risk analysis, which means that statistical models were used to calculate and predict future states based on cause/effect correlations and probabilities (boholm 2003, 167). in the case of the coronavirus, the danish government and health authorities had to calculate the chances of the population becoming infected and needing medical services as well as to predict which groups were most likely to get ill. based on the available evidence, there was a call to protect those who were considered to be particularly susceptible to the virus and thus with a higher risk of developing serious consequences and possibly dying from infection; i.e., people with clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 168 compromised immune systems or certain chronic illnesses (e.g., cardiometabolic disease, lung disease) as well as people age 65+ and especially age 80+ (dhma 2020). the covid-19 pandemic has presented us with a unique opportunity to examine how societies perceive urgent biological risk, and how they manage population groups who may be susceptible to such risks; e.g., older people. in this paper, we explore what it means to be categorised as ‘at risk’ and how people age 65+ managed uncertainty and risk during the initial months of the pandemic. to unfold this discussion, we first describe how, from a cultural-historical perspective, the danish welfare state has developed a risk-adverse position regarding public health with an emphasis on individual responsibility. we then draw upon semi-structured telephone interviews conducted with 32 people across denmark, including eight women and six men between the ages of 65 and 83, during the first months of the covid-19 pandemic (clotworthy et al. 2020). these qualitative interviews were conducted to gain insight into how the pandemic and the first months of the societal lockdown affected mental health, everyday behaviour, and social relationships among certain population groups. in our analysis here, we present older people’s narratives of being labelled a ‘risk group’ and how they negotiated their continued political belonging (thelen and coe 2019). we describe how, in response to unclear biopolitical discourses and decisions being made for ‘their own good,’ older people reclaimed their agency by evaluating their individual circumstances to determine their own “situated risk” (boholm 2003). in our concluding reflections, we discuss the possible consequences of public-health measures that categorise particular social groups, such as people over a defined chronological age. we also explore the potential future impact of state interventions on older people’s healthcare practices, arguing that political directives that label older people as ‘high risk’ may – paradoxically – put them at more risk. as the covid-19 pandemic continues, we suggest that a fairer approach to public-health crises that considers older people’s agency and their ability to evaluate their own risk may ultimately benefit ‘the common good.’ denmark’s risk-management strategy: individual responsibility to benefit ‘the common good’ the basis of public health is that government authorities identify widespread health problems and risks, and then set an agenda for appropriate action (vallgårda 2001, 388). as mary douglas (1966) suggested in her exploration of “purity and danger,” the meaning of ‘risk’ may be based in culturally embedded systems of logic and reason (cf. alaszewski 2015, 214). as such, many contemporary societies have emerged with a focus on mitigating the risk posed to individuals within the collective, with ‘risk’ understood as “the statistical probability of an outcome . . . estimated in terms of money, deaths, or cases of ill health” (boholm 2003, 160). to prevent or reduce such risks, certain societal and personal protections often emphasise ‘the common good’ (velasquez et al. 2018; anderson 2011, 247), a concept that is prominent in scandinavian welfare states that have historically focused on the community, universal rights and responsibilities, and the shared well-being of all citizens in order to overcome collective hardship. such an emphasis on social cohesion and egalitarianism has been instrumental in how denmark emerged as a modern european welfare state (lidegaard 2009, 28). moreover, the scandinavian model of social and economic development has traditionally included “a strong emphasis on security, safety, equality, rationality, foresight, and regulation” (gullestad 1989, 73). this focus on security and safety also tends to be inclusive, emphasising that everyone in the collective should be protected in order to ensure survival – of both the individual citizen and the state. clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 169 starting in the 1930s, social and welfare programmes in denmark were implemented to protect ‘the elderly’ and other ‘weak’ social groups (petersen, petersen, and christiansen 2010, 2011), such as children and people with disabilities, who may often require support from caregivers to survive and thrive. however, an “increasingly pervasive process of individualisation” (mik-meyer and villadsen 2013, 4) began to develop in the 1990s when the danish state assumed a more neoliberal character; i.e., “political, economic, and social arrangements within society that emphasize market relations, re-tasking the role of the state, and individual responsibility” (springer, birch, and macleavy 2016, 2). as denmark emerged as a ‘competition state’ with a focus on industrial growth and development (pedersen 2011), the government’s approach to protecting population health began to emphasise prevention. specifically, there was a growing interest in preventing lifestyle-related diseases in order to produce better average life-expectancy rates (vallgårda 2001) and to “improve denmark’s ranking in the global longevity competition, [which is] necessary for the common good of society” (anderson 2011, 247). thus, in its ongoing need to cultivate healthy and productive workers to drive the economy, the danish government has assumed a risk-adverse position, which has subsequently transformed all citizens into ‘pre-patients’ (larsen and esmark 2013, 6). this approach has also led to the development of health policies and welfare programmes that function to “create the self-caring self,” (rostgaard 2006, 452) wherein citizens should take care of themselves in order to remain active and independent for as long as possible. in practice, both health policies and healthcare practitioners encourage citizens to make the ‘correct’ choices (pedersen 2016, 37) – rational choices that should enable them to master their lives, take more responsibility for their own health and welfare, and continue to be self-governing and selfsufficient until they die at a ripe old age (clotworthy 2017, 21). however, despite this longstanding emphasis on citizens’ individual responsibility, the danish government adopted a parental approach to managing the covid-19 pandemic, as our interlocutor jørgen pointed out in the opening quote. the political decisions were not open to debate; they were made without democratic consensus nor consideration for citizens’ freedom of choice and selfdetermination. instead, the government consulted with experts – such as the danish health and medicines authority (sundhedsstyrelsen), the danish patient safety authority (styrelsen for patientsikkerhed), and particularly virologists at statens serum institut – to analyse the potential risks to population health. drastic protective measures, such as the societal lockdown and restrictions on visits to hospital patients and residents in long-term care facilities, were thereby implemented. this governmental response strongly resembles traditional clinical health encounters wherein medical experts make unilateral and paternalistic decisions, assuming that they can transfer information in an accurate and unbiased way to individual patients who will then be “filled up (like an empty glass) with new knowledge and thereby transformed into informed and willing decision-makers” (charles, gafni, and whelan 1999, 655). the danish government’s protective measures and restrictions also demanded specific rules for living; i.e., obedience and compliance from all citizens’ “docile bodies” (foucault 1979), which can be understood as the ultimate outcome of state intervention in individual citizens’ healthcare practices. however, it was not merely fragile people living in long-term care facilities whom the government sought to protect from the coronavirus. the public-health guidelines specified that all people age 65+ were ‘at risk,’ suggesting that they should self-isolate and “cocoon” as much as possible (schrage-frueh and tracy 2020), and indicating that other citizens should be extra-cautious to ensure that older people avoided infection. from a biopolitical perspective, old age is often a particular area of concern; it requires security mechanisms to optimise a particular state of life (foucault 2003, 246) and improve existing life by eliminating accidents; i.e., “the random element” (2003, 246; 248) in the life course. however, the coronavirus was more than just a random accident to be prevented, and the danish state’s clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 170 response was to revert back to its strategy from the 1930s: to manage and protect ‘the elderly’ and other ‘weak’ social groups in a way that would ensure their survival. as such, government officials made certain blanket decisions not simply for the ‘common good’ of the population but for certain groups’ ‘own good.’ on one level, the danish government’s protective approach seems to have reinforced sociocultural perceptions of older people as one homogenous category of passive, frail, dependent, and vulnerable – and thereby inherently ‘risky’ – citizens. this biopolitical logic may have also re-activated certain stereotypes and ageist assumptions about what it means to be ‘old,’ which has consequences for cultures of aging and the societal value of older people. but, on another level, our interviews indicate that people age 65+ in denmark reclaimed their agency by determining their own “situated risk”; i.e., “risks as they are actually understood and contextualized by people in social settings” (boholm 2003, 166). our analysis suggests that, when certain political decisions became confusing or unclear, older people acted as ‘rational actors’ by evaluating the official discourses based on their own phenomenological lived experience. in this way, they also resisted the tacit forms of biopower (rabinow and rose 2006) and negotiated their continued political belonging (thelen and coe 2019). furthermore, in making decisions for ‘their own good,’ they displayed a kind of relational autonomy that may ultimately benefit ‘the common good.’ older people’s rational agency and evaluation of their situated risk during major public-health emergencies, government directives often supersede individual rights and freedoms. this is because, in crisis situations, people can be overcome by emotions that may compromise their rationality and self-control. thus, when the covid-19 pandemic was declared and the societal lockdown was implemented in denmark, it seems that government officials expected that citizens would not behave as a ‘rational actor’: an “independent, autonomous agent that, given objective data, is capable of choosing to create a self that conforms to arithmetic averages” (powers 2003, 231; also tronto 2017, 29). the power of the ’average’ in risk management was so strong that, like many health and social policies, the danish government’s protective measures did not consider the lived experience of those whom these security measures directly affected (twigg 2002, 427). for example, with regards to the coronavirus, the individuals politically categorised into ‘high-risk’ groups may not actually be at increased risk for infection (compared to the general population) because they are used to taking the steps necessary to manage their health and protect themselves. many of our interlocutors used hand sanitiser and grocery-shopped early in the morning to avoid crowds, even before the pandemic. when asked whether she was taking extra precautions due to either her age or her chronic illness, alice (age 75) said, “i think i would’ve done it anyway. when they say that the best thing is to wash your hands, use sanitiser, and all that, then i would do it whether i was 100% healthy and well or as i am now” (24 april). during the government’s first press briefing on march 11 to announce the lockdown, prime minister mette frederiksen appeared strong and decisive, even as she admitted, “we’re in unknown territory. we’re in a situation unlike anything that we’ve experienced before. are we going to make mistakes? yes. am i going to make mistakes? yes. i need your patience” (regeringen 2020). the vast majority of our interlocutors were willing to be patient; they supported the lockdown and believed that the protective measures made sense based on the scientific evidence. like others, anders (age 76) also appreciated the prime minister’s humble approach, saying, “the [recommendations] have been wellfounded and well-argued. . . .the communication has been exceptional, and i think [the officials] have been very, very open” (17 april). however, as infection rates and overall risk decreased, certain political clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 171 decisions became more unclear and confusing. thus, similar to other interlocutors, anders nevertheless expressed doubt about the government's plans to re-open society: “there are some political parties that say, with blank eyes and great conviction, ‘now we can just open up shopping malls and everything else,’ and i think that’s a little unsafe.” this uncertainty and doubt were echoed by ingo (age 70). when asked what he thought about the government’s overall strategy, he said, “there are so many wise people sitting there – and one says one thing, and the other says something else” (22 april). alice (age 75) was slightly more critical, saying, “you couldn’t really call them clever – all of [the experts] who were supposed to know a lot, they didn’t really know anything. . . . you couldn’t really get a clear picture” (24 april). torben (age 72) said, “i think there’s no clear line [of communication]. i can sort of understand it because times change, and things change all the time. but there’s not a clear line, i think” (29 april). the uncertainty, confusion, and ‘mixed messages’ in the official risk analyses were especially difficult to understand for older people living with chronic illnesses. for example, jørgen (age 72), who has diabetes and several other health issues, said, the only information you get about being in the risk group is that you’re in the risk group. . . . the fact that i’ve had a small stroke and could have one again, does that mean i’m in the risk group or what? i think we just pack everything together and say we’re over 70, so there’s not much to talk about (5 may). jørgen’s quote points to how the official discourses regarding who is ‘at risk’ categorise those with chronic illnesses and older people as one homogeneous group in order to manage the risk presented both to and by them. while evaluating the available evidence is an important aspect of risk analysis, the resultant political decisions may contain certain biases and blind spots. in this case, a pragmatic and analytic generalisation failed to capture the complexity of individual citizens’ lived experience, leaving them with feelings of uncertainty and arbitrarity. this caused some of our interlocutors to question the logic behind the political decisions, especially in relation to older people. for example, edith (age 79) explained how she tries to decipher the official messages: “i listen just as much to what they don’t say. . . . [and] i hear them say that they actually don’t know what to do with the older population. because they have to be released [from isolation] at some point or have a vaccine, right?” (17 april). thus, in response to the government’s apparent lack of logical decision-making, many of our interlocutors drew upon decades of experience of being told to take responsibility for their own health: they actively assessed the official discourses in relation to their personal circumstances, and decided for themselves how they would manage the existential threat of the virus based on their subjective perceptions of ‘risk.’ for example, ingo (age 70) said, “i’ve had three small strokes, so i know very well what it’s like to be close to death. but i don’t [take precautions] because i’m afraid of dying of coronavirus. i just protect myself as best i can” (22 april). edith (age 79) was emphatic that older people should take responsibility for themselves: “i know full well that no one can give us an answer, so people will have to decide for themselves whether we continue to be in isolation or whatever. . . . what will [the government] do to protect us? we can only protect ourselves” (17 april). in order to cope with uncertainty regarding the duration of the lockdown, many of our interlocutors chose to accept the situation and remain positive. for example, alice (age 75) said, “it’s just the way it has to be – it’s sad and boring, but i’ve accepted that” (24 april). lars (age 73) echoed this point with regards to people who were worried or complained about the societal restrictions: “it must be because they have a more negative attitude than i have – like, ‘oh, it’s such a pity that i have to sit here and can’t clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 172 get around as i usually do.’ but you just have to try to take some initiative for yourself” (5 may). when asked about the possibility that he could become infected, lars insisted on remaining positive, saying, “of course [the virus] could hit me, but i’m not going to be negative, i’m certainly not.” katrine (age 65) was simply pragmatic about the risk of infection: “i don’t think it would be fun [to get infected]. . . . but if you do, then you just have to take it as it comes” (28 april). these quotes suggest that our interlocutors were able to rationally evaluate the government’s risk prediction and put it into context for themselves. this was especially clear when they were asked whether they thought about dying from the coronavirus. toini (age 73) said, “i imagine you can die in so many ways – you can be run over or you can fall off a cliff, you can die of cancer. . . . one’s just as uncomfortable as the other, isn’t it?” (22 april). mathias (age 83) also said, “i can’t help but think that covid-19 does this and that, but many people also die from cardiovascular disease or diabetes . . . or old age. . . . so, if they have to go anyway, then it’s not corona’s fault” (17 april). anders (age 76) did not consider the virus to be extraordinary, saying, i don’t have a strong opinion about [dying from] corona or something else. . . . in other contexts, i think we do what we can to make sure death isn’t a daily companion. we take pills to keep diseases in check, and we get surgery and do things to repair ourselves. and now, of course, we also take some precautions for this coronavirus. i think it’s just a given (17 april). many of our interlocutors were similarly realistic about the actual threat of the virus. thus, rather than fearing the perceived or predicted risks and allowing emotions to compromise their rational agency, they considered covid-19 to be just another way one could die – which, as hanne (age 76) said, is “something we all have to do at some point” (21 april). moreover, as we have described, our interlocutors actively evaluated their situated risk based on their lived experience, and subsequently chose to manage the existential uncertainty on their own terms. they did not allow biopolitical discourses and authoritative, protective measures to determine their rules for living. instead, they decided how to best manage their own personal risk. in this way, they acted with autonomous agency, marking out the parameters within which they were “immune from paternalistic intervention” (christman 2004, 157). however, these autonomous decisions – i.e., whether or not to self-isolate or adhere to extreme hygiene practices, etc. – were not simply made for ‘their own good’ as individuals. in times of both stability and precarity, there are exchanges and negotiations between the individual citizen and the state, and a person’s “perception of fairness may generate feelings of either belonging or exclusion” (thelen and coe 2019, 292). as our interlocutor anders said, the government’s plans to re-open society were perhaps “unsafe.” jørgen, on the other hand, suggested that there is a tendency to pack people over a certain age together, which meant “there’s not much to talk about.” thus, they both judged these political decisions to be unfair. yet, our interlocutors did not allow such unfairness to exclude them from the political collective. by questioning the government’s ‘unclear’ decisions and deciding for themselves which protective measures to follow, they acted with relational autonomy; i.e., as a “free, self-governing agent who . . . defines her basic value commitments in terms of interpersonal relations and mutual dependencies” (christman 2004, 143). as such, our interlocutors’ evaluations of their own risk and the protective practices in which they engaged were not purely individualistic; rather, these ‘at risk’ people chose to govern themselves and comply with certain precautions in order to protect their co-citizens’ health and clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 173 thereby contribute to ‘the common good.’ as signe (age 83) said, “all of society should be protected” (16 april). this rational, relational autonomy is something that governments should consider when faced with future public-health crises, as we elaborate on in our final reflections. a post-corona risk-management strategy: rational agency to benefit ‘the common good’ the covid-19 pandemic has presented us with a unique opportunity to examine how societies manage urgent biological risk as well as how people phenomenologically experience risk-adverse public-health measures. and, with some degree of hindsight, we can say that prime minister frederiksen was correct: we are in unknown territory, and everyone has made mistakes. in denmark, one mistake was that the political response to a potential threat was risk-adverse and authoritative to such an extent that it infantilised citizens, assuming that they would be unable to behave rationally under duress. another, related mistake was that the recommended precautions were overly protective towards certain social groups (i.e., older people and people with chronic illnesses), categorically labelling them as ‘vulnerable’ to infection. the official discourses also contained certain representations of aging, which can shape older people’s political belonging as well as the care and protections they are believed to require (thelen and coe 2019, 281). thus, marking all ageing bodies as ‘frail,’ ‘vulnerable,’ or ‘at risk’ is a form of ageism, implying that they needed to be managed, guided, and protected by governmental agencies (see e.g., kaufman 1994; weicht 2013). paradoxically, political directives that label all older people as ‘high risk’ and expect them to self-isolate during a pandemic may put them at more risk for age discrimination and social exclusion. everyone makes mistakes – even politicians. but our empirical material suggests that, when an urgent public-health crisis develops, it is essential that government officials and health authorities themselves behave as ‘rational actors.’ this means that they should analyse the available evidence and consult with experts in order to predict potential risk, and subsequently implement preventive measures to ensure that the highest proportion of the population is protected from harm. however, they should keep in mind that, although people age 65+ are indeed more susceptible to infection from covid-19, not all people over this defined chronological age are ‘at risk’ to the same degree. thus, being part of a risk group should not necessarily mean that the non-risks determine the rules for the entire group. furthermore, regardless of their increased susceptibility to biological infection, older adults have a right to selfdetermination – even during a pandemic. as such, the individuals who are ‘at risk’ should be able to claim that designation for themselves (after consultation with their primary healthcare provider). we suggest that, instead of going to extremes – such as denmark’s strictly paternalistic approach or the united states’ unstructured, ‘every man for himself’ non-strategy – decisionmakers should implement protective measures that are in proportion to the threat. an example of a more rational, balanced approach was tested in the netherlands; here, government officials started allowing older people in long-term care facilities (who have the absolute greatest risk of infection from covid-19) to receive personal visits again. a national study of 26 care facilities found that all participants recognised the added value of “real and personal contact” (verbeek et al. 2020, 904) between residents and their loved ones to improve well-being, which can positively impact overall health and longevity. importantly, the first results of this study indicate that compliance with local public-health guidelines was “sufficient to good” with no major incidents (2020, 904). such an outcome suggests that government officials and health authorities should endeavour to recognise the rational, relational agency of older people. not only does this mean replacing the word clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 174 ‘vulnerable’ with ‘valuable’ in official discourses – it also means considering older people’s lived experience and their competence to make rational decisions during a public-health crisis. as we have described here, older people willingly complied with the advised precautions when such directives were well-reasoned, open, and clearly communicated. our interlocutors did not expect limitless freedom of choice or to be consulted regarding the urgent public-health decisions that needed to be made for ‘the common good.’ however, they did want political decisions to be based on sound scientific evidence rather than made for economic interests. to avoid future mistakes, we suggest that the known facts (i.e., the calculated potential benefits and risks to the collective) should be openly and regularly discussed to establish trust and confidence in the decisions being made. reciprocally, people who identify as being in a risk group should be trusted to evaluate and manage their own risk, and to adopt appropriately responsible behaviour. going forward, we believe it is important that risk analyses of public-health crises consider older people’s lived experience, their capabilities and essential value to society, and the potential effects of specific restrictions on their mental health, quality of life, and well-being. when faced with future public-health crises, such considerations will ensure that the measures implemented to reduce harm and protect population health are more balanced, inclusive, and equitable for each individual. acknowledgements this research was conducted as part of an interdisciplinary project, ‘standing together – at a distance: how danes are living with the corona crisis’ (https://coronaminds.ku.dk/english), based at the university of copenhagen’s department of public health. we would like to thank everyone in the research group for their contributions to the project. the initial data collection for this project was supported by the velux foundations, grant no. 36336. the authors are supported by nordea fonden [02-2017-1749] and novo nordisk fonden challenge programme: harnessing the power of big data to address the societal challenge of aging [nnf17oc0027812]. these funding bodies had no influence on the design of the study or the collection, analysis, and interpretation of data, nor were they involved in writing the manuscript. data access for access to the data collected in the interdisciplinary project ‘standing together – at a distance: how danes are living with the corona crisis,’ please contact principal investigators naja hulvej rod (nahuro@sund.ku.dk) or klaus hoeyer (klho@sund.ku.dk). we welcome 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syddansk universitetsforlag. clotworthy and westendorp | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.318 http://anthro-age.pitt.edu 176 powers, penny. 2003. “empowerment as treatment and the role of health professionals.” advances in nursing science 26(3): 227-37. https://doi.org/10.1097/00012272-200307000-00007. rabinow, paul and nikolas rose. 2006. “biopower today.” biosocieties 1: 195-217. https://doi.org/10.1017/s1745855206040014. regeringen (the government). 2020. “situationen kommer til at stille kæmpe krav til os alle sammen” (the situation is going to place huge demands on all of us). accessed july 17, 2020. https://www.regeringen.dk/nyheder/2020/statsminister-mette-frederiksens-indledning-paapressemoede-i-statsministeriet-om-corona-virus-den-11-marts-2020/. rostgaard, tine. 2006. “constructing the care consumer: free choice of home care for the elderly in denmark.” european societies 8(3): 443–463. 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https://doi.org/10.1016/j.jamda.2020.06.020. weicht, bernhard. 2013. “the making of ‘the elderly’: constructing the subject of care.” journal of aging studies 27: 188-197. https://doi.org/10.1016/j.jaging.2013.03.001. who, world health organization. 2020. “who director-general’s opening remarks at the media briefing on covid-19 – 11 march 2020.” accessed april 8, 2020. https://www.who.int/dg/speeches/detail/whodirector-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. gender imbalance, marriage squeeze and multiple biological clocks: exploring challenges to the intergenerational contract in north india paro mishra ravinder kaur indraprastha inst. of information technology indian inst. of technology paro.mishra@iiitd.ac.in ravinder.iitd@gmail.com abstract this paper maps the impact of gender imbalance on intergenerational relations in north india. it uses the idea of multiple biological clocks to understand the impact that gender imbalance and male marriage squeeze have on two categories of persons: “overage” unmarried sons and their aging parents, and the inter-generational contract between them within the family-household. de-linking the idea of the biological clock from the female body, this paper demonstrates that social understandings of bodily progression are equally significant for men, who, in the indian context, need to marry by a certain age, and their elderly parents who need to be cared for. in north india, where family-household unit is the most important welfare and security institution for the elderly, disruptions to household formation due to bride shortage caused by sex ratio imbalance, is subjecting families to severe stress. families with unmarried sons struggle with anxieties centred on the inability to arrange marriages for aging sons, questions of allocation of household labor, the continuation of family line, and lack of care for the elderly. based on ethnographic fieldwork in north india, this paper explores the tensions and negotiations between elderly parents and unmarried sons concerning the fulfillment (or lack of it) of the intergenerational contract against the backdrop of gender imbalance. it concludes by discussing the various strategies available to families in crisis that involve shame-faced adoption of domestic and care tasks by unmarried sons or bringing cross-region brides who then provide productive, reproductive, and care labour. keywords: intergenerational contract; marriage squeeze; aging; biological clock anthropology & aging, vol 42, no 1 (2021), pp. 97-111 issn 2374-2267 (online) doi 10.5195/aa.2021.251 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 97 gender imbalance, marriage squeeze and multiple biological clocks: exploring challenges to the intergenerational contract in north india paro mishra ravinder kaur indraprastha inst. of information technology indian inst. of technology paro.mishra@iiitd.ac.in ravinder.iitd@gmail.com introduction this paper illustrates the impact of a demographic gender imbalance on the social life cycle of individuals, families, and generations in north india, a region known for historically long-standing skewed sex-ratios (arokiaswamy 2004; kaur 2008; visaria 2004). in particular, it focuses on the renegotiation of the intergenerational contract and gender roles in the context of skewed sex ratios and consequent male marriage squeeze1 in the north indian state of haryana. in doing so, this paper posits the idea of multiple biological clocks, affecting different members of a co-resident family unit, who belong to different genders and age groups, yet are interdependent. the notion of multiple biological clocks takes into account a broader view of age in the life cycle, to focus on social understandings of bodily progression that define not only the timely occurrence of rites of passage, such as marriage and childbirth, but also age specific expectations of care and support. this approach is unique in two ways. first, the idea of multiple biological clocks marks a departure from a gendered conception of the biological clock as centring on the reproductive body of the female (friese et al. 2006). equated with an “alarm clock,” the discourse on the biological clock has long been warning women that their bodies are on a course of reproductive decline and that their “time (to have babies) is running out.” critiquing this linkage of the notion of biological clocks solely to reproduction in females, this paper extends the concept to include not only unmarried “overage” men—who fail to marry and reproduce by socially appropriate ages—but also their elderly parents, both fathers and mothers, who need more care and support as they age, but are often unable to get it. second, this approach also shifts the focus from an individual to the household of co-resident members who are related through kinship and marriage links. in the indian context, multigenerational households remain common (shah 1999) and are the most important institution for the circulation of care and support for the young and old (gangopadhyay and samanta 2017). the focus on family-household units helps us illustrate how biological clocks of different categories of persons—unmarried sons and aging parents— do not simply operate in isolation but often interact with each other. for both groups, the anxieties around their ticking biological clocks and futures are getting exacerbated in the context of severe gender imbalance and bride shortage. the cultural practice of son-preference, rapid fertility decline, and rampant use of sex-selective technologies have led to a demographic imbalance of genders in the northern and north-western part of india (guilmoto 2012; kaur 2016; miller 2001). this is adversely impacting the marriage market where there are many more males than females in the marriageable age groups, a phenomenon referred to as male marriage squeeze. several scholars have calculated the extent of marriage squeeze for india. guilmoto (2012) predicts that in india, the total number of men remaining single between 2020 and 2080 will be closer to 40 million. kaur et al. (2015) show that the proportion of permanent bachelors in female http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 98 deficit states will go up from 3.7 to 8.1 percent between 2015 and 2050. a similar rising trend of ‘involuntary/forced bachelorhood’ in north india has also been documented in several ethnographic studies (chaudhry and mohan 2011, 2018; kaur 2004; mishra 2013). these ‘surplus men,’ on an average, are usually above 30 years of age, from rural poor families, with limited educational and income prospects, and have less favourable physical and personal attributes in the marriage market (mishra 2018). existing research shows that in hypergamous systems, men at the lower rungs of the socioeconomic hierarchy are worst affected by marriage squeeze as women marry upwards (bossen 2007; eklund 2013). given the practice of arranged marriage and lack of other forms of cohabitation, marriage for most indians marks the transition to social adulthood and provides them with the legitimacy to start their own families. but involuntary bachelors (henceforth, unmarried men) are denied these social milestones even as their biological clock keeps ticking. non-marriage of adult males also has varied consequences for their aging parents and the inter-generational relations between the two groups. this brings us to another crucial aspect of aging which is the demand and provision of care, for both elderly men and women, in the families affected by marriage-squeeze. family, in india, continues to be the most important social institution for elderly and childcare in the absence of institutional care structures. under patrilineal family systems, daughters-in-law are expected to provide old age care for the elderly parents of their husbands (allendorf 2017; bhat and dhruvarajan 2001; dharmalingam 1994; dey 2016; kaur 2008; shah 1999). daughters move away to join their husband’s family and, unless their brothers marry and bring home wives, the household becomes male biased with a single lone aging female left to take care of it. thus, the marriage squeeze, or the inability of many men to marry, places the care circulation within the family-household under severe strain. the situation is further aggravated with increased longevity of life. in haryana, the life expectancy at birth for males and females stands at 67.6 and 72.3 respectively for the reference period 2013-2017, rising from 59.0 and 55.6 in 1970-75 (sample registration survey 2019). with the older adults living longer, care-giving demands are increasing, but there are far fewer women on whom generally the social expectation of care provision rests. thus, in a society marked by gender imbalance, concerns around both aspects of the biological clock—the need to marry at an appropriate age and longer life spans requiring an extended period of old age care—need to be managed afresh. situated against this backdrop, this paper explains how the demographic imbalance in north india is affecting individuals, families, and intergenerational dynamics within the family. in particular, it uses the concept of intergenerational contracts (croll 2006; kabeer 2000) to explore the changes in the relationship between matured unmarried sons and their aging parents. it explains how the disruptions in family structure brought about by imbalanced sex-ratios, result in the re-writing of many extant social roles and expectations and involve multiple negotiations between different family members and generations to meet the care deficit. fieldwork and methodology this paper is informed by more than a decade of qualitative research done by both of the authors in north india. it is an outcome of a larger research project concerned with the broad question of the consequences of gender imbalance for family, marriage, and kinship practices in north india. the first author, paro mishra, conducted ethnographic fieldwork between august 2012 and december 2013 in five villages of sonipat and hisar districts of haryana, mainly focussing on the issue of changing marriage patterns as a response to marriage squeeze (mishra 2017) with follow up in october 2019. the second author, ravinder kaur, has been a long-term scholar of gender imbalance in haryana from 2001 http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 99 onward and has conducted extensive fieldwork in the rural and urban areas of sonipat, rohtak, jind, hisar, and kurukshetra districts. the state of haryana (image 1) has been known for its long-standing gender imbalance (see table 1). image 1: map showing location of study site haryana (marked in red) in india (source: www.haryana.gov.in) as a part of their long-term research, both authors have collected data using qualitative approaches such as semi-structured interviews with unmarried men and their married siblings, aging parents, men who married cross-regionally, female marriage migrants, and village elders. most of the interviews were conducted in the natural setting of the home of the respondents, barring a few that were conducted in public spaces like local teashops, village panchayat (council) premises, streets, and by-lanes. the interviews were conducted in hindi and haryanavi languages and ranged from 45 minutes to an hour and a half with multiple follow ups. they were accompanied by detailed note taking which was later translated and transcribed by the authors. the longitudinal engagement in the field site has proven extremely beneficial in noticing the changes that have occurred over time in regions affected by gender imbalance. this paper uses the narrative analysis method, which does not assume objectivity but privileges positionality and subjectivity of the respondents (butalia 1998; donner 2008; riessman 2000). this approach was useful in understanding the life experiences of the respondents and examining both the particular and the more generalized dimensions of the way people live their lives in the face of constraints and the choices they make. the names of all the respondents have been changed to protect their identity. http://anthro-age.pitt.edu/ http://www.haryana.gov.in/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 100 skewed sex ratios and the marriage crisis in haryana the state of haryana is a small but prosperous north indian state adjoining the states of punjab, rajasthan, uttarakhand and uttar pradesh, and the union territory of delhi (see image 1). despite its high per capita income and proximity to the national capital, delhi, is characterized by one of the most abysmal sex ratios in the country, with its child sex ratio (0-6 years) standing at 830 girls to 1000 boys from the 2011 census (see table 1). year 1971 1981 1991 2001 2011 haryana 898 902 879 819 830 table 1: child sex-ratio (0-6 years) for haryana since 1971. source: census of india in recent decades, new sex selection technologies, especially the widely available ultrasound, have enabled new forms of discrimination against female children, with pre-natal sex selection of boys over girls becoming pervasive (john et al. 2008; miller 2001). as a result of rampant sex selective abortion, hence smaller cohorts of female births (george and dahiya 1998; unisa et al. 2007), the shortage of brides in haryana has worsened, with nearly one in five men facing a marriage crisis (kaur 2004). research shows that in 2012 there were seven excess males in haryana per female and that this number would continue to rise to reach an excess of fifteen males by 2050, pointing to a long-term shortage of brides in the state (kaur et al. 2016). as lifelong bachelorhood has become untenable and older practices of dealing with bride shortages such as fraternal polyandry or inter-caste marriage have become socially unacceptable, men in haryana have taken to large scale “bride import” from other regions of the country (ahlawat 2009; kaur 2004, 2008; mishra 2013, 2017). yet, obtaining brides from other regions is not the first choice for men and their families. the search for a local bride delays men’s age at marriage and they generally succumb to a cross-region marriage as a “last resort,” around, or after reaching the socially “unmarriageable” age of thirty-five. as they wait to marry, the difficulties of coping with domestic and agricultural chores without a wife/daughter-in-law create anxieties for both the men and their aging parents. the law banning sex determination and sex selective abortion (pcpndt act 1994), improvements in male and female literacy, and the declining importance of the land-based patriarchal economy have had little effect on the rigid gender norms centred on son-preference and daughter devaluation that continue to characterize the state. most haryanvis tend to believe that it is not the demographic shortage of women that hinders them in finding brides but the lack of jobs. chowdhry (2005) notes the rise in youth unemployment, remarking that rural youth are no longer interested in farming work and prefer to wait for off-farm jobs, especially government jobs that ensure high social status and life-long job security. difficulties men face in finding heterosexual mates are exacerbated by a changing political economy resulting in shifting norms of marriage hypergamy that entail men to have greater wealth, education, and superior jobs. mishra (2017) noted how men who find it difficult to get married by the socially appropriate age often blamed the women and their changing aspirations and expectations vis-à-vis marriage. men’s unemployment was seen as a result of women’s entry into male dominated employment spheres (chowdhry 2007, 86). these factors, put together with traditional cultural norms of caste endogamy and clan exogamy (kaur 2010), result in tighter and multiple marriage markets in which many rural men find themselves at a disadvantage (jeffery 2014). as per 2011 census data, the http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 101 mean age of marriage for males and females in haryana stands at 24.6 and 20.9 respectively (bhagat 2016). however, many males in haryana fail to get married by this age and thus experience a period of what scholars such as singerman (2011) and hashemi (2015) call “waithood.” waithood is a liminal state during which men wait to find appropriate jobs and suitable brides. intergenerational contract and filial obligations in north india malhotra & kabeer define intergenerational contracts as the “mutual claims and obligations which govern relationships between different generations within the family, conventionally conceptualised in terms of three generations young children, adult parents and aging grandparents” (2002, 7). they are based on implicit shared understandings of the role and responsibilities, claims, and obligations, which different categories of family members have towards each other. the essence of intergenerational contract is that parents are obligated to invest in the upbringing, education, and well-being of their children and make decisions concerning their future. in turn, children are expected to return the favour by taking care of their parents as they grow older and become dependent (cohen 1998; croll 2000, 2006; gangopadhyay & samanta 2017; kabeer 2000; tiwari & pandey 2013; verasanso 2004). a peculiar feature of the south asian intergenerational contract is parents’ obligation to arrange appropriate marriages for their adult children, keeping in mind the various marriage rules and advantages that a ‘good’ marital prospect may entail in terms of status mobility for both the parties (karve 1993). adults rely on their parents to arrange and pay for their advantageous marriages and in return are expected to reciprocate care, support, and affection when the parents grow old. in doing so, they are guided by the notion of filial piety or what is locally known as seva. filial piety refers to “relationships in long-term bonds of intergenerational reciprocity and affection, in which juniors provide care for their senior parents, both in old age, and after death as ancestors, in return for all of the effort, expense and love their parents expended to raise them in infancy and childhood” (lamb 2002, 304). buch rightly argues that intimate care practices are often “a scarce resource that circulates through a complex web of kinship and intergenerational relations” (2015, 283). in india, where there is a near absence of alternative, institutional care-giving arrangements, family becomes the dominant welfare institution. sons are looked upon as a form of old-age security and parents expect more from sons than daughters (sharma and kemp 2012). patrilineality makes daughters temporary members of their natal family and thus married daughters are not expected to support their parents (donner 2005; kaur 2019, 2018; lamb 2009). however, even though intergenerational contract has been highly son-centred (croll 2000), patrilocality has meant that daughters-in-law, along with their husbands, provide care and seva for the husband’s co-resident aging parents (brijnath 2014; rangaswamy 2000). thus, the burden of maintaining social ties and nurturing inter-generational relationships falls mostly on women (allendorf 2017; gangopadhyay & samanta 2017; gram et al. 2018; katbamna et al. 2004; samanta 2019). this is the reason why in the process of matchmaking, girls are chosen carefully by the groom’s parents. an important consideration in the process is whether the girl will get along well with the boy’s family and whether she will look after her elderly in-laws (mathur 2007). many young men are particular about ascertaining that their future bride is willing to co-reside with their parents and look after them. it can be inferred from this discussion that daughters-in-law then become crucial players in the maintenance of intergenerational contracts, and sons’ marital status may have a significant effect on the intergenerational provision of physical care, emotional support, and co-residence. http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 102 “if my sons get married, i can die in peace”: failure of family social capital in the context of bride shortage in north india, monogamous heteronormativity is the privileged model and thus girls are easily absorbed into the marriage market as they constitute a scarce pool. however, parents face considerable difficulty in finding brides for their sons, and as such many men remain never married. evidence from the 2001 indian census data finds that of the 30-34 age group, only 0.59 percent of females are nevermarried. the corresponding figure for males is 4.94. that singlehood is not a matter of choice, surfaced in numerous discussions with the rural populace. hegemonic masculinity in north india is associated with the ability to marry, bear children, and continue the male lineage (mishra 2018). the desire, ideal, and expectation to marry and bear children, especially male offspring, and to continue the family line was voiced strongly by both aging parents and their grown-up sons. as master haridas, a 71-year-old father of three unmarried older sons (all above 37 years of age) remarks: my worst fear is dying without seeing them (his sons) decked up as grooms. i will fail as a parent if i am unable to find matches for them. after all, it is the duty of parents to marry their children so that there is someone to look after them when we are no longer there. […] without marriage, there will be no children. (then) who will look after him in his old age? similarly, patrilineality and filial ideals were endorsed by satbir, a 32-year-old recently married man who worked at a grocery shop: it is important for me to have a son otherwise my family name will be lost. my brother has two daughters who will go away (after marriage). the responsibility of taking forward my father’s name in the village is now on my shoulders. i am his only hope. in such a context where marriage and procreation are accorded a high social value, the inability to find matches for aging sons is often perceived as a personal failure by parents. dharambir, aged 63, father of two unmarried sons in their 30s, has made it his life’s mission to secure spouses for them. both of his sons are employed in a shoe factory as contractual labourers and hence have no source of steady income. dharambir spends his day mostly enquiring about possibilities of finding a match for his sons. his desperation was clearly evident when he asked one of the authors if she would know of someone who is willing to get married to his sons as she is meeting so many people in the context of her work: i don’t want anything else. my only desire now is to see them settled i really would like them to have their own families. i feel sad thinking about their growing age. in haryana, there are very few girls so families like ours suffer as we don’t have wealth or land. it is a long struggle for us […] if they get married, i will die in peace having fulfilled my responsibility. these narratives reveal how the tensions around finding suitable matches for sons are exacerbated in the context of a skewed sex ratio. parents fear having unmarried adult sons who will risk becoming “bare-branches” (chade) (see mishra, 2018 for a detailed discussion) due to bride-shortage. failure to marry their children at socially acceptable ages is seen as shameful for the parents as it is viewed as an act of faltering in their moral duty. http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 103 ticking clocks, anxious futures and gendered labour parental anxieties about their sons’ non-marriage are also powerfully motivated by concerns about their own well-being and care in old age, and the best possible ways to assure it (kabeer 2000; larsen et al. 2010). as the biological clock keeps ticking for the elderly, they become more anxious about their futures in absence of someone to care for them. an old man in his late 70s living with his wife and unmarried 42-year-old son vocalized this concern: age is debilitating us. till few years back we could take care of him but now we also want someone who can look after us. on whom else can we depend? in our village those who live with married sons and grandchildren are much happier and worry less about their futures. haryana’s sex ratio imbalance had made life difficult for families like ours. thus, rural parents fear having destitute futures in absence of daughters-in-laws under bride shortage. they compare their situation to other families with married sons and find themselves lacking the care and support that is usually provided in multigenerational household. this, however, is a one-sided accentuation of reality. conflicts between generations especially with regard to the provision of care are not unknown and daughters-in-law often complain about the lack of recognition for their care work in the family2 (gupta 2005; nandan 2007). married sons sometimes separate from the joint household, leaving parents and unmarried siblings together. daughters-in-law are considered to be the proverbial disruptors of the joint household. however, for the rural respondents of this study, the benefits of coresidence with married sons clearly outweigh the drawbacks. the concerns about their future in the absence of daughters-in-law are more strongly vocalised by aging mothers as compared to fathers. the division of labour in haryana is titled towards harder work and longer working hours for females than males. apart from domestic chores, care of children and elderly, women in haryana also do a considerable amount of farm work. animal husbandry is an important part of haryana’s economy and women do most of the work of taking care of the cattle (chowdhry 2007). having performed domestic and farm work from the time of marriage, a mother looks forward to being relieved of her domestic tasks by a daughter-in-law. kanta, a woman around 65 years of age, living with her unmarried son and husband shared: now i am burdened with a lot of work as there is no one else to help me. we are not getting any proposals. had my son been married i would have had some relief […] my body is weakening, and i am unable to do handle it all. the manner in which biological processes of aging interact with the social context in which elderly people are located is of paramount significance in understanding the experience of aging and their access (or lack of) to care and support. as a cultural practice, in india, marriage of a son marks the onset of aging, particularly for women as it entails significant shifts in her status and role within the family (sati 1996). the entry of a daughter-in-law invariably implies a reduced burden of household work on the mother-in-law. older women look forward to moving into a supervisory role while the bulk of the household and farm work is shouldered by incoming daughter/s-in-law. as kandiyoti (1988) points out, women make the patriarchal bargain of not questioning their lack of power as young wives and mothers, with the expectation that they would enjoy the fruits later on in the life cycle by moving into a position of power and authority vis-à-vis their daughters-in-law. in absence of daughters-in-law, the elderly woman, despite aging, has to continue to look after her husband and son/s and thus she feels that she has not been able to cash in on the benefits of the bargain she made earlier. kandiyoti http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 104 characterizes this as a “genuine personal tragedy” (1988, 282). over a period of time, a woman’s physical abilities begin to wane, and she also grows resentful of the continuing burden placed on her. yet, the gendered division of labour makes it difficult for men to share household and feminine farm tasks. notions of masculinity and family honour are tied up with males being breadwinners through their work outside the home; doing household chores such as cooking one’s food and washing clothes makes a man an object of ridicule and pity. the cultural significance of ghar basana, or setting up one’s house through bringing a wife, is an important rite of passage for upholding the patriarchal social order. thus, gendered norms and expectations fundamentally alter the experience of aging for elderly men and women even though the biological clock keeps ticking for both these categories. kittay (1996) rightly argues that popular and scholarly emphasis on intergenerational care obscures or renders invisible intra-generational forms of care. care that aging wives provide to their husbands is often ignored in discussions focussed on aging and intergenerational care transfer. an important question that emerges in this context regards the role of adult sons. when parents are unable to fulfil their side of the social contract, in terms of finding matches for their adult sons, do the latter violate their obligations towards elderly care and support? mediating the intergenerational contract: duty and reciprocity our research found that some unmarried sons do take care of their older parents, even though their parents have not been able to find them spouses. in earlier days in rural haryana, it was not uncommon to find unmarried men being accommodated in the joint household with a married brother’s family (kaur 2008). however, under modern conditions and rising costs of living domestic units are becoming increasingly nuclearized (2008). unmarried males living in joint families with married brothers often face marginalization and ridicule within their families (mishra 2018). although they can separate from the joint household and legally claim a share in family property, they normally refrain from doing so. this is because separation also entails managing the household independently and involvement in so called feminine domestic chores in absence of a wife. however, as married brothers separate from the joint household, unmarried men continue to live with their parents having no other choice left. those men whose parent(s) were too old to work or look after themselves often described how it is their obligation to take care of older parents. a 44-year-old bachelor kuldeep, who lives with his 65-year-old widowed mother, explains: i am her only support, so i have to take care of her. parents do so much for their children. when they grow old, it is our duty to look after them. if i had children, i would have expected the same from them. older bachelors, above 40 years of age, have resigned to their fates of remaining unmarried and have become primary caregivers for their aging parents. raju, a single, 47-year-old car mechanic and only male child of his parents said: i have accepted my fate. my parents did all that was in their hand to find a girl for me. my bad luck they couldn’t. they even saved some money to construct a new room for me after i get married. they have done all they could, now it’s my turn. […] now when they are old and sick, i am responsible for looking after them and i will continue to do so. once unmarried men cross the locally acceptable marriage age, which is around thirty-five years in haryana, their options narrow. in such a situation, both parents (and their unmarried sons) begin http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 105 envisioning a future without a daughter-in-law (wife) and renegotiate their strategies for social reproduction of family. our fieldwork revealed that in several cases where the mothers were too old to contribute towards household chores, the son assumed a more proactive role in the domestic sphere. they ended up taking charge of everyday household tasks like chopping vegetables, cooking, washing clothes and cleaning, in addition to their work outside home. however, a large part of this work is done in a covert manner, hidden from the public gaze of the wider community as there is an element of embarrassment associated with men’s household work and as labour within the private sphere continues to be regarded as women’s work (chowdhry 1994; kaur 2008). thus, in the absence of daughters-in-law, unmarried sons unwittingly disrupted gender norms and contributed towards the intergenerational provision of care when their parents couldn’t fulfil their expected role. however, as the next section highlights, some unmarried males did breach their side of the contract and felt justified in doing so. the frailties of the intergenerational contract in north india can be deciphered from the fact that if adult sons felt that their parents have not put in sufficient effort in finding them brides, they too have a right to breach the terms of this implicit arrangement. in some cases, sons felt cheated and expressed resentment over the fact that the obligation was unfulfilled, and as a result their desire to provide returns of care or economic contribution to the family lessened (kaur 2019). in a few cases, unmarried sons felt that their parents had given primacy to their own desires and compromised their duties with respect to them. below, ramesh, a 45-year-old bachelor, working as a truck driver for a transport service, describing himself as “blunt”, talks about his relationship with his father, who married for a second time after ramesh’s mother passed away due to illness: my father is selfish. he only thinks of his own desires. he was beyond sixty when my mother passed away, but he still desired a second wife for himself. both me and my brother were of marriageable age then. had there been any other father, he would have thought of his children’s marriage not his own. now, his second wife is also no more, and he is alone, but it doesn’t affect me. why should i care when he didn’t? a relationship should be maintained from both sides, not one. ramesh is the only care-provider for his aging father since his brother moved to delhi to work in a garment factory. but ramesh has withdrawn all association with his father. he is mostly on the move because of the nature of his work and comes back home for few days every month. his father’s survival is contingent on the food and care provided by his uncle’s (father’s brother) family. as per ramesh, they are motivated by the greed of inheriting his father’s house which he will not let happen. in another case, an unmarried man blamed his drunkard father’s recklessness which made his family lose their land and along with it his chances to find a spouse. he continues to look after his mother with whom he shares a closer bond. on her insistence, he fulfils basic requirements of his father. although, he does not share any emotional intimacy with him as he remarks, “i am only doing this for her otherwise i don’t feel obligated to it.” though cases like this were very rare, these ethnographic vignettes show that elderly unmarried sons may not contribute to parental care if they feel that parents had breached their side of the contract guided by personal desires, motives, or reckless behaviour. crisis of social reproduction and cross-region marriage as a family strategy by and large, the absence of daughter/s-in-law in the family places a disproportionate share of household work on older women who continue to shoulder responsibilities for much longer periods— some of which may later be shared by a son. although elderly parents appreciate the care their http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 106 unmarried sons extend towards them, they are also constantly worried about their unmarried son’s futures. the anxiety about ramesh’s future is evident in his mother kunta’s statement: i often worry that what will happen to him after we are gone. we at least had him. who will he have? he will be all alone [...] had he been married, he would have had his own family, his own sons to take care of him. in such a scenario where there is a shortage of local brides, and reproduction (both social and biological) and care are marked by a crisis, many rural families in haryana are bringing in cultural strangers from other distant regions of india as wives for their sons, breaching caste and other norms of propriety. though statistics on the number of these marriages are not available, they are fairly common in haryana with every village having at least 8-10 women hailing from distant eastern, southern, and north-eastern parts of india. in some larger villages the numbers are much higher. these unions are referred to as cross-region marriage (kaur 2004; mishra 2013) or long-distance marriage (chaudhary & mohan 2011). an interesting point to note here is that more than often it is the mothers of unmarried sons who often take the first step to seek cross-region brides for their sons. in many cases, the mothers also provide the money that a man needs to travel to a distant location to find a bride. damini, a 70-year-old mother who married her son cross-regionally to a woman from west bengal, narrated how her husband was not really convinced about marrying their son cross-regionally even as he was nearing thirty-five. the father kept on saying eventually they will find a match for their aging son. she gave her husband six months’ time to find a local match, knowing very well that he would not succeed. in the meantime, she herself approached another bengali bride in the village to suggest a potential bride from her community. within the next two months her son was married to a bengali girl. in families where the mother has passed on, men face increasing difficulties. sunil is the youngest of four brothers and one married sister. all his brothers separated from the joint household after getting married and he and his widowed father were left to live alone. he shared that as “there was no one to cook food” for them, he was forced to bring a cross-region bride from maharashtra, a state in the western region of india. in some cases, the fathers sourced cross-region brides for their sons through their links in other villages which had cross-region brides. in one case, a father took up match-making out of sympathy for families suffering the fate as his own family had prior to bringing home a cross-region bride. interviews with cross-region brides and their marital families suggest that a cross-region brides’ value as a ‘good daughter-in-law’ is tied to her caring attitude towards the husband’s elderly parents and her performance of household responsibilities (see mishra 2017 for details). sima, a 29-year-old, crossregion bride from maharashtra said that she was specifically instructed by her husband to “always obey his parents and take care of them.” the expectation that incoming daughters-in-law will take charge of household responsibilities and elderly care was so strong that in a few cases migrant brides were prevented from taking employment outside the home. sheetal, a 26-year-old bride from nepal, wanted to work in the same shoe factory where her husband worked, but her husband nakul preferred her to remain at home to provide company and care for her 65-year-old mother-in-law. she said: i thought if we worked at the same place, we could go and come back from the city (where the factory was located) together. it will be a convenient arrangement, but he didn’t agree. […] he said mother will be left alone in our absence and what if she needs some help. http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 107 cross-region brides occupy a lower bargaining position in their marital homes, especially in the early days, which makes them highly dependent on their husband and his family. thus, most brides accept what they are asked to do without challenging it. they also take on the care of in-laws to gain acceptance in the household and establish the legitimacy of their marriage. thus rani, a bangladeshi muslim married to a dalit hindu in the sonipat district was proud of the fact that her in-laws had chosen to make their home with her rather than with the families of her husband’s brothers whose wives were local women. fulfilling the cultural expectation of a son’s responsibility towards elderly parents helped her overcome her stranger status. her story also shows that family feeling is brought about through “obliged affections and affective obligations” (bourdieu 1998, 68) in the context of the moral scaffolding provided by the implicit intergenerational contract. the concerns raised by ticking biological clocks of both unmarried sons and aging parents in the context of gender imbalance and local bride shortage are addressed through the newer familial strategy of expanding the marriage radius through cross-region marriages. the entry of cross-region brides not only resolves the anxieties of involuntary bachelorhood and fatherhood for north indian men, but also helps fulfil the deficit of domestic and care labour within the family. for the men, cross-region marriages not only ensure marital intimacy and lineage reproduction, but also fulfilment of intergenerational contract towards their aging parents. the cases discussed above express that contrary to popular expectations, imbalanced sex ratios and ‘surplus’ men may not simply imply greater familial or social instability. rather, familial ties, intergenerational relationships, gendered and kinship norms are renegotiated in the face of challenges thrown up by gender imbalance. even though unmarried men covertly shoulder some responsibilities in the domestic sphere, in this process of renegotiation, a disproportionate burden of adjustment continues to be placed on aging women in comparison to aging men. thus, gendered norms and expectations fundamentally alter the experience of biological clocks for elderly men and women, as the latter continue to look after the former and also after adult sons. however, as the situation becomes impossible to address, the need for another woman in the house to replace elderly women’s labour becomes dire. thus, some families devise new strategies in the face of external constraints to offset the catastrophic consequences of local bride shortages. bringing in a bride through cross-region marriage is one such strategy even if it involves subverting the traditional norms of marriage. while such multigenerational, culturally complex families may have their own challenges, they help both adult sons and aging parents fulfil their obligations towards each other and also address the challenges that their biological clocks pose for them. conclusion it becomes evident from this discussion that the macro structural context of gender imbalance and marriage squeeze has implicated the family system into a complex web of social-moral crisis. with multiple ticking biological clocks, the anxieties around marriage, procreation, care circulation, allocation of household labour, and continuation of family name and lineage are becoming aggravated. this paper emphasizes the importance of looking at biological clocks in the context of household and familial relationships and not purely in terms of the individual body. in doing so, it goes beyond the conventional analysis of biological clocks as related to women’s reproduction and their resort to measures like adoption and assisted reproductive technologies. the paper argues how the concept of multiple biological clocks draws attention to life trajectories of two other categories of kinship related members of the household: unmarried men, who are passing the socially appropriate age of marriage and their parents, who are declining in health and age. the fate of the bodily clocks of these two categories is bound up and faces challenges as both parties are unable to http://anthro-age.pitt.edu/ mishra & kaur | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.251 http://anthro-age.pitt.edu 108 fulfil their sides of the intergenerational contract; parents, in not being successful in finding brides for their sons and the sons in not being able to extend the provision of care for their aging parents through their wives. the essential missing link in the failure to fulfilling the intergenerational contract is a woman—the wife and daughter-in-law—whose absence then forces adjustments in how the generational protagonists deal with the care deficit created by the demographic female deficit. acknowledgements the research for this study was supported by a fellowship grant from the university grants commission, new delhi. an earlier version of this paper was presented at the conference on reframing the biological clock: exploring aging and reproduction in contemporary ethnographies at iit, hyderabad and the paper has benefitted from the comments made by the participants. the authors are also thankful to the two anonymous reviewers for their constructive comments. notes 1. male marriage squeeze refers to the shortage of marriageable women in a particular age cohort. 2. in joint families where there are several sons and only one might be married, the daughter-in-law has to bear the burden of looking after the entire family with little help from others which makes her resentful. references ahalwat, neerja. 2009. 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(2): s288-92. doi: 10.4103/0019-5545.105553. unisa, sayeed, sucharita pujari, and r. usha. 2007. “sex selective abortion in haryana: evidence from pregnancy history and antenatal care.” economic and political weekly 42 (1): 60-66. visaria, leela. 2004. “the continuing fertility transistion.” in twenty first century india: population, economy, human development and environment. edited by tim dyson, robert. cassen and leela visaria, 55-73. new delhi: oxford university press. vera-sanso, penny. 2004. “they don’t need it and i can’t afford it”: filial support in south india.” in aging without children: european and asian perspectives on elderly access to support networks. edited by p. kreager and e. schroeder-butterfill, 77-105, new york and oxford: berghahn books. http://anthro-age.pitt.edu/ https://dx.doi.org/10.4103%2f0019-5545.105553 https://www.jstor.org/stable/4419111?casa_token=ksrwsrc0fgaaaaaa:c--dzwquewnttplqqkcyg7dvzz7gd9mhkwpk92d2irb90isjayy6-d1l6vndkis2sh48jfkxbyu3kwgqym0v7wacmi-k1qv4bpc2stnkx3fddunwe07c https://www.jstor.org/stable/4419111?casa_token=ksrwsrc0fgaaaaaa:c--dzwquewnttplqqkcyg7dvzz7gd9mhkwpk92d2irb90isjayy6-d1l6vndkis2sh48jfkxbyu3kwgqym0v7wacmi-k1qv4bpc2stnkx3fddunwe07c 157 anthropology & aging quarterly 2012: 33 (4) the measurement of ability has always played a central role in our understanding of aging. in some ways, the loss of ability is assumed to be a sign of aging itself. but, the relationship between the two is complicated. a greater degree of self-reflection is now changing the ways that we look at the tools and methods used to assess disability in aging studies. from the habits of clinical practice, to the assessment of function in community-dwelling elderly, and to the planning of “age-friendly” communities, i would argue that an anthropology of functional assessment is needed to examine the cultural constructs and practices at work in each domain. for many older adults in the u.s. today, optimism for new ways of aging is still mixed with lingering fears of physical decline. associated press polling data (2012), show that the majority of “baby boomers” are “upbeat” and not really c o m m e n t a r y rethinking aging and daily “difficulties” from functional bodies to functional communities alex costley gerontology and health education york college, city university of new york feeling “old,” but when asked to rank their fears, loss of independence due to physical illness leads the way (45%) ahead of “running out of money” (41%) and “worrying about dying” (18%) (cass and anderson 2012: 2). in the study of population health and aging, the achievement of increased longevity is often overshadowed by the projected prevalence of “disability” with age. in 2006, for example, the population council observed that “a fundamental question surrounding the increase in survival is whether the extra years of life are being spent in good health or bad health” and “ . . . subject to the most disagreement has been the trend in abilities to perform personal-care activities. . . ” [my emphases added]. similarly, demographic projections from the scan foundation on the need for long-term care, suggest that while “70 percent of seniors will be unable to live in their own homes without some kind of help” only “37 percent. . . understand how likely they are to need assistance” (weintraub 2011). yet, many have labeled this focus on physical decline and dependency as “ageist” (butler 1975) and a tool for generating “alarmist” population demographics (dant 1988; longman 1999; peterson 1998). in clinical practice, function and health are almost synonymous. the assessment of functional ability has been called the “lingua franca” of geriatric medicine (mortimer 2003) where care is aimed at both assessing and preventing functional loss. as gubrium (1993) observed, “the aging body” is both the subject and object of biomedical common sense allows that persons unable to handle a difficult problem can be labeled “disabled” . . . cultural analysis shows that disability refers most precisely to inadequate performances only on tasks that are arbitrarily circumscribed from daily life. disabilities are less the property of persons than they are moments in a cultural focus. everyone in any culture is subject to being labeled and disabled. -introduction from “culture as disability” (mcdermott and varenne 1995: 5) anthropology & aging quarterly 2012: 33 (4) 158 alex costly rethinking aging and daily “difficulties” encounters where “as subject, i describe; as object, i am described” (1993: 53). however, while the inevitability of decline and dependency seems so certain, it appears that after years of research on aging daily life through the assessment of adls (activities of daily living) and adls (instrumental activities of daily living), we are now in the midst of an intellectual and methodological crisis over the measurement and classification of disability in population studies. in january 2009, the national research council (nrc) and the national academy of sciences (nas) sponsored a summit meeting among experts in the field to improve the measurement of late-life disability in population surveys “beyond adls and iadls” (nrc 2009: 1). with so many tools, scales, and variations in national survey items, it was concluded that there was “no standard for ascertaining the occurrence of disability” (2009: 20) and “substantial differences “in prevalence rates due to a diversity of “conceptual definitions” measures, wording, sampling, and modes of data collection (wiener et al 1990). in other ways, the tools are not keeping up with the social transformations among older adults. the nrc participants, for example, cited data from the health and retirement study (2006) showing that: 14 to 20% of those over age 65 were using “some kind” of assistive technology regardless of task difficulty, and that by the mid-1990s, almost 50% had already adapted their homes to reduce barriers (nrc 2009: 69-70). at the root of this current debate, according to nrc, is also a growing ideological conflict over terminology and methods. on the one hand is the “medical view” where disability is seen as an “attribute” of the individual due to an underlying condition or impairment (2009: 6). on the other, is the “social view” where disability is seen as “the product of physical, organizational, and attitudinal barriers in society” (2009: 7). as the nrc participants noted, applying a more synthetic view would mean seeing that “disability is experienced when the person with functioning limitation interacts with the cultural expectations of the physical environment” and given that there are “far fewer measures of this type” to document this dynamic interaction, they recommended that this is “probably the direction that measurement should take to understand the full effects of functional limitations” (nrc 2009:16) [my emphases]. in further discussion about ways to improve measures of disability, a number of suggestions emerged including: 1) greater attention to the conceptual meanings of quality of life, coping, well-being, and social participation, 2) self-reflection not only on “what can be asked” but how, as well, and 3) the use of “vignettes” and other qualitative measures to better understand the dynamic “pathways” to disability in different populations (nrc 2009: 85-86). in the anthropological study of aging, the body, and disability, these suggestions should sound familiar and obvious. however, i would argue that this self-reflective turning point in the study of functional assessment is also an important opportunity for the role of anthropological inquiry in this growing debate between the “medical view” and the “social view” (nrc 2009: 6-7). the limitations of bio-medical approaches to ‘’the body” (burroughs and ehrenreich 1993, foucault 1978, turner 1992), are familiar as cross-cultural studies in medical anthropology have challenged the naturalization of certain somatic states associated with aging including: senility (cohen 1998; traphagan 2000), menopause (lock 1993), and urinary incontinence (mitteness and barker 1995). again, as mcdermott and varenne (1995) have argued, “disabilities are less the property of persons than they are moments in a cultural focus” (1995: 5). where might this anthropological inquiry lead for improving the measures of “daily activity”? it means more than creating new surveys. it requires a deeper exploration of the concepts whose meanings are too often taken for granted. a number of recent works are doing just on terminology that shapes assessment including: independence (portocolone 2011), autonomy (leece and peace 2010), neglect (iris et al 2010), and lifestyle behaviors (albert et al 2009). it requires, what one expert calls listening to the meanings “behind the words” of participants in the assessment process (brody 2010). it also requires paying more attention to the ways in which “environments” (physical, social, and natural), can enable or disable individuals (delatorre et al 2012; glass and balfour 2003; golant 1984). over the years, my own work has taken me across different domains of function and activity from: 1) broadening the scope of “comprehensive medical assessments” in medical education to 2) the qualitative assessment of individual function in communities to 3) the assessment of “age-friendly” (who 2007) community capacity in the midst of urban planning and urban renewal. i would argue that these domains of analysis should not be seen as separate and that each is crucial terrain for a critical anthropology of functional assessment. for a more complete review of geriatric assessment tools and methods (see gallo et al 2006: 193-240); for more on the classification of “disability” (see nagi 1991 and who 2002), and for more on the status of “disability studies” (see albrecht et al 2001 and davis 2006). alex costly rethinking aging and daily “difficulties” 159 anthropology & aging quarterly 2012: 33 (4) alex costly rethinking aging and daily “difficulties” alex costly rethinking aging and daily “difficulties” limitations in the assessment of daily activity over time, institutional and administrative demands (for example, a lack of time in clinical practice) have changed the ways the tools have been used and have led to a loss of specificity when assigning the status of disabled. even though the adl index (katz 1963) was originally designed to assess the rehabilitation process of hospitalized patients “with fractures of the hip” (1963: 915), to this day, the katz index remains the standard for assessing general “functional disability’ for older adults in the community as well. since it was first established and promulgated, several clinical investigators have remarked that the scoring system is one of its principal weaknesses (gill and kurland 2003, philip et al. 1998). on paper, the scoring form itself encourages observers to make subtle distinctions in performance (unassisted and assisted) for a variety of tasks (eating, getting dressed, grooming, walking, getting in and out of bed, bathing, and using the toilet), but then the final scoring process reduces these distinctions to binary opposites (independent and dependent) (bennett 1999). kane and kane (1981), for example, noted that “the individual who needs a corrective device to perform the function or who requires the help of another person is assigned an intermediate position between independence and dependence. [yet] sometimes, these two forms of dependency are equated and receive the same score” (1981: 43). this simplification has tended to increase over the years, thus eliminating much of the variability of the data (bennett 1999:23), as the original index has been modified for use in clinical practice (hartford institute for geriatric nursing 2007), where individuals receive scores of 1 for independent and 0 for dependent. for example, while katz originally allowed for some types of mechanical or personal assistance in his definition of “independence” with bathing and toileting (katz 1963:916), this has routinely been lost in translation over time. similarly, for the tasks in the iadl index (use of the telephone, shopping, preparing a meal, cleaning house, doing laundry, using transportation, managing medications, and managing finances (lawton and brody 1969, lawton’s 1971), the assessment options included a variety of intermediate scenarios between fully able and fully unable. for example, when using the telephone, options include: 1) being able to “answer” the phone and dial a “few well-known numbers” or 2) “answering” the phone, but no longer “dialing numbers.” for shopping, an individual might: 1) be able to do “small purchases” on his or her own or 2) need to be accompanied (lawton 1971: 473). yet, in clinical practice, a simplification in scoring is often accepted. citing “no systematic study of the relative frequency of the use of different scoring methods,” graf (2008), suggests that one “common” option is to rate each item “dichotomously” (0 = less able, 1 = more able)” (2008: 54). similar patterns are seen in population studies (for example, the national long-term care survey), where the criteria for “disabled” includes “any type of assistance, human or mechanical, for any adl . . . or for any iadl, that had lasted or was expected to last, for a minimum of 90 days” (nltcs 2007/1999). however, when put to the test, items in the iadl index exhibit much more variability in performance than do the items in the adl index owing to social, cultural, and economic factors (diehl 1998, horgas et al 1998, jette 1994, miller 2005). cross-cultural uses of the index (avlund et al 1996; martin 1989) have shown that the universality of these items should not be taken for granted and that performance on each is highly variable. in avlund et al’s (1996) study of english, west indian, asian, and danish individuals, they observed that “nearly all [adl] activities were performed by everybody, while none of the [iadls] were performed by everybody” (1996: 10) due to “cultural differences in washing habits and types of clothing” as well as “actual differences in health as well as differences in gender roles” (1996:12). in my own research in new york city (costley 2008) with 64 community-dwelling older adults between the ages of 69 and 91, an assessment of their adls and iadls using open-ended interviews (in addition to a semi-structured survey), revealed a number of issues that should challenge the use of these standard indexes and give insight into the social worlds of aging bodies. even when individuals agreed to be interviewed, it was clear that many had a critical view of the index questions and the scoring options. all the informants resisted being misrepresented as old or frail on scaled items that did not allow them to explain their answers in more depth. in some cases, certain questions about needing help with basic activities (like getting dressed or using the bathroom) were also seen as stigmatizing, or even a bad omen. for example, when i asked “mr. wilson,” a 75-yearold african-american man, living alone, whether he ever needed any help to get dressed, he replied, “no, no. i don’t need no help. you’re trying to make me old, before i get old. i’m pretty fortunate. . . . i can hold my own. so far, so good.” this reaction, i would argue, was not just avoidance and it should remind us not only to listen to others, but also to imagine how these questions sound to others. this reflexivity has always been a strength of anthropological inquiry. when maria vesperi (1998) explored the ways in which older adults became defined as a social problem in an economically challenged urban neighborhood in florida, she also argued that we need to anthropology & aging quarterly 2012: 33 (4) 160 alex costly rethinking aging and daily “difficulties” move past examining what it is like to be old and examine what it feels like to be regarded as old, where old age is not a discrete physical state, but a cultural “concretization” of abstract and often unexamined assumptions and everyday social interactions (1985: 22) [my emphasis]. in my interviews, individuals routinely made important and meaningful distinctions between “needing help” and “having difficulty” that made scoring their functional status challenging. these distinctions of did not always match with many examples of lived experience. one woman, “mrs. porter,” (at age 77), exemplified what i called “collaboration as an extension of self.” she was candid about needing help with walking (away from home) and bathing, but she said that managing her finances (normally considered a more complex task) was “easy.” she said. “i have a checking account. . . . i can pay my bills by check each month. but, i ask my home attendant to mail my bills for me, and sometimes, i ask my brother to go to the bank to get me spending money. sometimes, i need my home attendant to look at my insurance statements with me, too.” when i asked her whether, in her opinion, she felt she had any difficulty managing her own finances, she said, “no.” in other ways, the scoring system itself often seemed irrelevant to many participants’ lived experience. in one memorable encounter, for example, when i asked, “mrs. ivan” (at age 82) to describe (on a scale from 1-10) the level of difficulty that she was having while getting dressed in the morning she shot back at me, saying: “i manage. i have to do it. it’s not easy, okay. put whatever number you want. . . i have to get dressed every day, so what’s the use to cry over it. i have to do it; that’s it. listen, i had a very tough childhood, and there was no feeling about it. i never cried about things. you have to do it. i manage. i don’t make a big deal out of it.” “i can manage” was a phrase that i heard repeatedly during the interviews. it came to be a defining and revealing response on many levels. on one hand, it reflected a fundamental, vital effort to be recognized and acknowledged as a competent being. on the other, i came to realize that it revealed a participant’s resignation that social networks were weaker than expected. many participants in their retirement were actively caring for other family members, both younger and older (e.g. grandchildren and parents), yet had very low expectations for receiving daily support from family members in the future. proximity to kin was no guarantee of support when extended families were struggling with their own burdens and limited resources. while 72% of participants indicated that they had grown children and close kin in new york, 56% said that no one would be able to help them with daily activities “on a regular basis” if needed. when i asked several people to imagine a future where they could not manage on their own, many sat silently, not answering. some invoked the reluctance to become a burden to others. but, every participant’s story, i learned, had its own logic and revealed a carefully crafted calculus of his or her unique situation. functional bodies and functional communities the assessment of disability must account for the social and material world in which people live and the numerous factors (psychological, social, environmental, and geographic) that affect function. the fact that older adults can be made vulnerable by their social and physical environments, especially in times of extreme heat, has been well documented (klinenberg 2002). in many cases, we can also see that the greatest challenges to disability do not always begin with the individual. in my own study, an earlier community needs assessment, commissioned by a local non-profit agency (rosenthal and rubel 1989) had already estimated that over 4,000 of the neighborhood’s elderly residents were “to some degree disabled” according to criteria from the health resources administration. but, by suggesting that “problems of isolation were caused, in part, by a changing social environment, fear of crime, and a challenging physical geography,” they argued that physical weaknesses were not the greatest limitations (1989: 6). as more and more individuals, especially in large urban areas are now viewed as “aging-in-place” (aoa 2005), the qualities of our physical and social environments are getting more attention. population aging is now an issue for urban planning and public health and a catalyst for a number of initiatives to develop: “age-friendly” cities (who 2007), “lifespan communities” (stafford 2009), neighborhoods for “successful aging” (abbott et al 2009) and more “walkable” communities to promote daily physical activity (glicksman 2011). in 2010, portland oregon became the first u.s. city to join the world health organization’s global network of age-friendly cities (delatorre et al 2012). new york city was second (nyam 2008). in each case, substantial coordinated efforts are needed to ensure access to affordable healthcare and housing, safe and affordable public transportation, and opportunities for alex costly rethinking aging and daily “difficulties” 161 anthropology & aging quarterly 2012: 33 (4) alex costly rethinking aging and daily “difficulties” alex costly rethinking aging and daily “difficulties” employment and social relations. the common goal is to “create good place[s] to grow up and grow old” (stafford 2009). but, with each of these initiatives, i would argue that we also need to stay focused on the ways in disparities in geography, income, and homeownership patterns can lead to disparities in the distribution of these municipal investments and resources. we also need a variety of ways to explore the relationships between individuals and their environments. in the nrc workshop, it was observed that while iadls have typically been described as “concerned with a person’s ability to cope with his or her environment” (nrc 2009:22) a focus on the body, per se, has led to a “neglect” of the home environment with few measures to assess how “features” of the environment and home affect individuals (nrc 2009:72). we know that the physical environment can affect behavior and activity, but it would be mistake, i believe, to focus solely on the development of new objective measures of the physical environment. subjective views also matter in ways that require more study. for example, in albert et al’s (2006) study of variations in “clinician-rated and self-rated disability” with iadls, among 33% of respondents there were “discordant cases” where clinicians rated individuals as having “inefficient” performance, but where individuals had no self-reported disability. in other cases where individuals had self-reported iadl disability, clinicians saw them as “competent” (2006: 829). the authors discovered that “respondents who considered themselves disabled in iadls, but who were rated as competent by clinicians, lived in home environments that were rated as more cluttered and in need of repair . . . less adequate in space and comfort . . . and less secured for preventing crime…compared to the other [respondents]” (2006: 829). these results should challenge us to critically examine the impact of the environment not just on behavior, but also on the perception of culturally-constructed ideas of disability and competence. when individual perceptions, preferences, values, and expectations matter, the focus on measuring what “bodies can do” is inherently incomplete, especially when it seems to reinforce a western and a u.s. preoccupation (portacolone 2011) with maintaining “independence” at all levels. as a cultural value, it has reached the level of a social fact (durkheim 1966) as both socially reinforced and deeply internalized by individuals. an anthropology of functional assessment is needed in multiple domains. it is need to explore the degree to which older adults struggle with the imperative of dependence and the ways in which existing measures fail to match lived experience. it is needed to explore the extent to which we reinforce the expectation of independence in existing tools and methods through a “medical” model that appears to be losing its primacy. it is needed to build “community” and explore the dimensions of the environment in multiple ways beyond the physical that can become enabling and disabling for older adults. this current period of methodological introspection is an opportunity not just for building better tools, but for developing more 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national long-term care survey 1999 www.nltcs.aas.duke.edu/data.htm, accessed sept 27, 2007. national research council 2009 improving the measurement of late-life disability in population surveys: beyond adls and iadls: summary of a workshop [g.s. wunderlich, rapporteur. accessed june 30, 2012 http://www.nap.edu/catalog/12740.html new york academy of medicine (nyam) 2008 toward an age-friendly new york city: a findings report, fall. http://www.nyam.org/initiatives/docs/ agefriendly.pdf, accessed november 29, 2008 peterson, peter 1998 gray dawn: how the coming age wave will transform america and the world. new york: random house. philip, ian, and gillian k. armstrong 1998 a better way to measure disability in older people. age & ageing 27 (4): 519-522. population council 2006 trends in later life. www.popcouncil.org/projects/ sstrendslatelife.html, accessed november 7, 2006. portacolone, elena 2011 the myth of independence for older americans living alone in the bay area of san 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(ssa publication no. 64–039.) washington, dc: social security administration, office of disability programs. stafford, philip, b. 2009 design guidelines for a lifespan community. center on aging and community, indiana institute on disability and community. bloomington: indiana university. traphagan, john, w. 2000 taming oblivion: aging bodies and fear of senility in japan. albany, ny: suny press. turner, bryan s. 1992 regulating bodies: essays in medical sociology. london: routledge. vesperi, maria d. 1997 city of green benches: growing old in a new downtown. ithaca: cornell university press. verbrugge, lois, m., kalyani k. mehta, and ellen wagenfeldheintz 2006 views of disability in the unites states and singapore. research on aging, 28:216 weintraub, daniel 2011 poll: californians ill-prepared for the costs of aging. http://www.healthycal.org/archives/5485,accessed january 18, 2011. wiener, joshua m., raymond j. hanely, robert clark, and joan v. van nostrand 1990 measuring the activities of daily living: comparisons across national surveys. journal of gerontology: social sciences 45(6):s229–s237. world health organization 2002 international classification of impairments, disabilities, and handicaps. geneva, switzerland: world health organization press. 2007 global age-friendly cities: a guide, geneva, switzerland: world health organization press. retiring home? house construction, age inscriptions, and the building of belonging among mexican migrants and their families in chicago and rural mexico julia pauli hamburg universität author contact: julia.pauli@uni-hamburg.de franziska bedorf freie universität berlin author contact: franziska.bedorf@fu-berlin.de abstract the vacant retirement house has become a central feature of many areas of the global south. over the years, migrants’ savings are invested in the building of conspicuous houses for retirement in their areas of origin. but despite these substantial efforts, a number of migrants postpone their return or do not return at all. their houses remain empty, their purposes shifting as their owners reach old age. this stretching of time does not only affect the migrants’ livelihoods and ideas of home. furthermore, kin-scripts as conceptualized by stack and burton (1993) are being reconfigured substantially. this goes hand-in-hand with the reframing of culturally prescribed responsibilities, meanings, and social roles attached to certain stages of the migrants’ lives. based on long-term and multi-local ethnographic fieldwork in rural mexico and urban chicago since the 1990s, we analyze how remittance houses are tied and untied with their owners’ life courses in the later stages of life. furthermore, we examine how kin groups on both sides of the border deal with the new challenges this entails. keywords: mexican migration, chicago, house building, kinship, retirement anthropology & aging, vol 39, no 1 (2018), pp. 48-65 issn 2374-2267 (online) doi 10.5195/aa.2018.173 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 48 retiring home? house construction, age inscriptions, and the building of belonging among mexican migrants and their families in chicago and rural mexico julia pauli hamburg universität author contact: julia.pauli@uni-hamburg.de franziska bedorf freie universität berlin author contact: franziska.bedorf@fu-berlin.de introduction imagine a house. imagine a house with its façade painted in a bright fuchsia color, its windows ornate and made of etched glass. imagine this house as two stories high, columns framing its entrance, its two balconies facing the street and a carport right next to it. imagine this house with its two garages opening with a remote control, a corrugated iron fence shielding it from the street and a lavishly spacious patio that has a fountain in its middle and can be illuminated at night. imagine this house empty. this house is our starting point for telling the story that is to follow.i it is located on a dusty, potholed street in a relatively small village in the state of mexico, three hours by car from mexico city and about twelve hours from the mexican–u.s. border. with all its carefully selected features and shining appearance, the house forms quite a stark contrast to some of the buildings surrounding it. it stands out both from those that are significantly smaller (only one story high and made of adobe) and from the houses that employ a similarly grand style but are only halfway finished. unlike those places of the second category, our house, as well as a number of similar other ones in the area, clearly exudes the air of an inhabited place, although no one lives in it for most of the year. sometimes, however, mostly for a few weeks during summer or christmas time, the house awakes from its slumber and springs to life. weddings have been celebrated here, family gatherings have taken place, suvs with u.s. license plates have kept the house company and amenities and furniture have filled it after having been transported all the way from chicago. just like the people who live in it every now and then, the house has grown older gradually over the years, maturing through all the extra elements with which it has been equipped. the dimmable patio lights constitutes its latest upgrade. while the house’s proper owners only pay it a visit once in a while (they used to come and see it on a more regular basis in the past), during which they spruce it up, proudly present it to the neighbors and take pictures to show at home in the u.s., the house has other caretakers. family members—parents and siblings—have overseen its building and extension process and kept it in good shape as it is supposed to someday, in the near future, host the people who own it and have steadily sent the money to make it grow. houses like these have become a central feature of many areas in the global south. intending to return to their country and area of origin someday, at the latest after retirement, many migrants worldwide anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 49 are investing their remittances in conspicuous house constructions back home. these houses represent a “proxy-presence” (dalakoglou 2010) of the migrant, demonstrating that he or she truly belongs to a family, community and place, despite being bodily absent. belonging has turned into a key category to explore the lived experiences of migration and transnationalism (drotbohm 2008; lattanzi shutika 2011; pfaff-czarnecka and toffin 2011). the central meaning of houses for articulating, building and maintaining belonging and social relations over space and time and for asserting one’s rising status within transnational livelihoods has been demonstrated in a number of anthropological studies. migrants’ housebuilding practices have been analyzed for various mexican (e.g. cohen 2004; fletcher 1999; lattanzi shutika 2011; lopez 2015; magazine and ramírez sánchez 2007; pauli 2008; sandoval-cervantes 2017) and other transnational contexts, e.g., the philippines, ghana, peru and ecuador (aguilar 2009; coe 2016a; leinaweaver 2009; pribilsky 2007, 106-115). despite the great geographical range, all of these studies describe the substantial sacrifices migrants are willing to make to construct a house in a place where they do not live. fran markowitz writes this “call to home” is “a desire for reterritorialization in the homestead or homeland of past generations – still beckons as an antidote to partial belonging and unfulfilled dreams” (2004, 22). migrants often endure substantial humiliations and ‘dignity assaults’ (coe 2016a) while living and working away from ‘home.’ ‘home’ in these contexts has become a cipher for security, comfort and belonging (markowitz 2004; yuval-davis, kannabiran, and vieten 2006). building a house at ‘home’ and as a ‘home’ is an important way to maintain self-worth and to deal with feelings of only partially belonging in the migration contexts. yet despite all the dreams, dollars and efforts migrants and their families invest in such houses, a substantial number of people never come to live in them, but they postpone their return or do not return at all (bedorf 2014a; brettell 1979; sandoval-cervantes 2017). there is a remarkable research gap on this group and topic. while there is a growing body of research on how building and belonging are related in the first years after migrating, not much is known about the ways migrants’ casas de sueños (fletcher 1999) or “dream houses” are connected or disconnected from their—and their kin’s—life courses, especially their aging and their deaths. in her meticulous study of how remittance-generated house construction has changed the mexican countryside, sarah lynn lopez concludes, “the topic of transborder migrants’ strategies for coping with old age and the effects of age on identity, migrant clubs, and the spaces and landscapes of migration remains largely unresearched” (2015, 168). one reason for this empirical lacuna may be that in the majority of the above studies migrants have not yet reached retirement and old age. old age, kinship, migration and house construction are linked, and studies tend to either describe (future) retirement plans of migrants (bedorf 2014a; lattanzi shutika 2011) or migrants’ care for their aging parents through the building of new houses or old age homes (lamb 2009; lopez 2015, 61-67). additionally, lopez hints at another reason for this research omission. she suggests that discourses on the building of houses by migrants and belonging in their areas or origin are generally too hopeful and optimistic, envisioning remittance-building projects only as improvements: “remittance space is largely about building aspirations, desires, and hopes into the mexican landscape” (2015, 171). in contrast, as lopez (2015, 184-194) vividly demonstrates in her analysis of a remittance-financed retirement home in the mexican countryside that ends in ruins, research paying attention to aging, death, migration and housebuilding will also have to grasp the “inherent paradoxes and contradictions of remittance space” (2015, 171). these paradoxes can be painful, as some of the stories of built disillusions presented by lopez clearly show. her analysis is particularly illuminating in that it highlights the temporal dynamics of remittance building projects and the shifts they frequently undergo and signify. taking the remittance house as a point of departure, we will build on these insights and explore how such homes and their changing purposes affect the people on both sides of the border who are in one way anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 50 or another related to them: the ones building the houses, the ones owning the houses and also those who take care of the houses and who live in them while the owners are absent. in particular, we will focus on dynamics linked to the later stages of life of both the houses and their owners, thereby foregrounding the temporal dimension of migration (coe 2016b). looking at the remittance houses not as static entities but as subjects that might be transformed in their meanings and tell different stories at different points in time will allow us to grasp how responsibilities are reconfigured, roles reframed and aims adjusted as migrants age and postpone their return. employing the concept of ‘kin-scripts’ introduced by stack and burton (1993), we will discuss how new scripts have emerged as to who cares and who is being cared for (what stack and burton call ‘kin-work’), who is (made) responsible (‘kin-scription’) and when (‘kin-time’). additionally, we want to add ‘kin-place’ as the spatial ordering of family transitions, i.e., specific places like remittance houses that family members are expected to build in order to fulfil their responsibilities. in contexts of enduring high mobility as in mexico and the u.s., reconfigurations of order and belonging of kin through place making (appadurai 1996) can be as important as temporal orders. as we intend to show in the following sections, these evolving patterns often clash with existing norms and practices associated with specific stages of the life course and constitute ad hoc solutions. they may be temporary and unintended and at times cause conflicting social roles in their turn. in that respect, they constitute what cati coe and erdmute alber in the introduction to this special issue suggest are ‘age-inscriptions’ (coe and alber 2018). since “kin-scripts” specifically refers to orders of social relations, we consider them an overlapping category with these more comprehensive agespecific roles and meanings that structure time and encompass care patterns. in more general terms, we posit that the vacant remittance houses and the transformations in agerelated roles and responsibilities linked to them have far reaching effects on the reproduction of kin groups in transnational spaces. before international labor migration from mexico to the u.s. became an ever more widespread phenomenon in the second half of the twentieth century, kin-scripts in rural mexico were framed by a mesoamerican version of meyer-fortes’ ‘development cycle of domestic groups’ (1971 [1958]). our discussion of rural mexico will show that the building of remittance houses initially fit neatly into this cycle. the transformations we trace that took place within the vacant retirement houses however, have led to ruptures within this household system. ethnographic work in rural mexico and urban usa when we were conducting our research on different sides of the u.s. mexican border, we both found remittance houses to recurrently play a central role in the settings and narratives we encountered. since the end of the 1990s, julia pauli has observed a boom in house construction in the spanish-speaking, mestizo village of pueblo nuevo, valley of solís (estado de méxico), about three hours away from mexicocity. pauli started her long-term fieldwork in this village in 1995 and has returned to the “field” regularly over the course of twenty years (pauli 2000, 2002, 2008, 2013; pauli and bedorf 2016). the village pueblo nuevo is located in the valley of solís and is part of the state estado de méxico in the central highlands. within the last eighty years, national and international migration has played an important role in transforming the economic foundation of the village from subsistence-oriented land cultivation of maize and beans into a mixed economy of remittances and agriculture. as figures from two ethnographic census collected by pauli show, the number of households in the village has increased from 165 households in 1997 to 195 households in 2013 (pauli 2015). there are hardly any families in pueblo anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 51 nuevo that have not been affected by transnational migration. almost half of all adult men (fiften years and older) in 2013 had migrated to u.s. destinations. the building of conspicuous houses in ‘estilo del norteño’ (lopez 2015, 51) a u.s. american style, is tightly connected to this tremendous increase in international, mainly male labor migration to the united states. pueblo nuevo’s appearance changed considerably from being a ‘traditionally looking’ mexican village characterized by one-story houses made from adobe bricks (see photo 1) to a place where buildings compete with each other for the boldest and most flamboyant architectural designs and adornments (see photo 2). photo 1: ‘traditional’ house in pueblo nuevo, mexico (photo property of julia pauli) bedorf, too, was amazed by those buildings when she, in 2010, accompanied pauli and her husband and fellow anthropologist michael schnegg to the region, working as a scientific collaborator in schnegg’s and pauli’s then new research project on aging in transnational spaces between mexico and the u.s.ii for two months, bedorf conducted her doctoral fieldwork in pueblo nuevo and other villages of the valley of solís, seeking to explore people’s rationales for returning or not returning to mexico upon retirement. however, it was when she continued her multi-sited ethnographic research in chicago that she came even closer to those constructions. although they had been built in mexico, they sprang to life in rich detail in her interlocutors’ accounts as well as in the pictures they showed her, thus forming part of people’s chicagoan lifeworlds as well. while such houses were frequently discussed in the chicago setting, not everyone there owned a house in mexico. since migrating to chicago between the 1960s and 1980s, bedorf’s interlocutors had built and inherited houses, but they also had sold and gradually neglected places in mexico. anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 52 photo 2: new house design in pueblo nuevo, mexico (photo property of julia pauli) in both field sites, remittance houses had a story to tell. we originally intended to link the two field sites by exploring where older migrants from the rural mexican valley of solís who were living in chicago and close to retirement were planning to spend their old age. however, this idea turned out to be only partially feasible. most migrants from the area living in chicago were younger than expected and not close to retirement. we thus decided to extend the chicago ethnographic sample and include people from other parts of mexico. hence, our cases do not describe one transnational community, but we investigate the context and repercussions of the same phenomenon—the vacant remittance house—for both the mexican and the u.s. side of the border. this also leads to a certain asynchrony of our cases. whereas the people bedorf interviewed in chicago reflect upon their own retirement and how this is related to specific houses and spaces, migrants from pueblo nuevo have not yet reached retirement age and are more occupied with caring and housebuilding for their elder parents. ethnographic data about pueblo nuevo stems from several years of participant observation, life and migration histories, network data and repeated ethnographic census collections (pauli 2000, 2013). pauli conducted fourteen months of fieldwork from 1996 until 1997. shorter field stays of only a month or two were done in 2000, 2001, 2010 and 2013. ethnographic data about chicago was collected in 2010 to 2011 and is based on twelve months of participant observation, semi-structured and structured interviews on migration histories, dimensions of life and belonging in mexico and chicago as well as network data (bedorf 2014a, 2014b). anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 53 age-inscriptions in rural mexico: long-term exchange, care and house building until recently, elder people in rural mexico have depended on a specific household system bound to the peasant economy for security in old age (pauli 2008; robichaux 1997). this household system can be interpreted as a kinand an age-script (stack and burton 1993; coe and alber this issue). importantly, it is only a model. even before the rise of international migration and the sending of remittances, there have been variations of this rural household system (pauli 2002). in his comparative analysis of household and inheritance patterns throughout mesoamerica, david robichaux has described this “mesoamerican household formation system” in detail (1997, 2005). the starting point is the so called nuclear stage (magazine and ramírez sánchez 2007; robichaux 1997) consisting of parents and their unmarried children. the so called extended stage starts with the marriage of the first son and the move of his wife into his parents’ house (patri-virilocal residence). as time passes, more sons marry and live with their wives in their parents’ house. thus, households in the extended stage can be quite large. if a married son has acquired sufficient funds he will start building his own house, often on a parcel of land given to him by his father, and finally leave his parents’ house. the final stage of the household system, the replacement stage, is reached when only the youngest son and his wife reside with his elder parents in their house. the youngest son (and rarely the youngest daughter) and his or her spouse are mainly responsible for the care of his older parents. in return, they will eventually inherit the parents’ house (ultimogenitur). all siblings, however, support their youngest brother in caring for the elder parents and will also inherit some land from their father. with the death of the parents, the cycle begins anew. this household system provides a frame of reference for rights and obligations to care for and being cared for, or what stack and burton (1993) call ‘kin-work’. it goes hand in hand with a specific form of recruitment, meaning particular members are assigned responsibilities for care (‘kin-scription’). the intergenerational transactions (lamb 2009) within this system are gender specific and change over time. first, the parents care for and raise their children, giving them shelter, food, education and love. during the extended stage, young women move (are being ‘recruited’) into their mothers-in-law’s houses and support and often serve them for many years. they give them their labor and their respect but rarely their affection. finally, in the replacement stage, the younger generation provides care, affection and respect for the elder parents. in previous publications (see pauli 2008), we have unraveled the substantial tensions resulting from this kin-script. sons/husbands are mostly at ease with the script and often enjoy the continuous exchange with their brothers and their father. but wives/daughters-in-law express unhappiness and frustration about living with their mothers-in-law. many mothers-in-law humiliate their incoming daughters-in-law. elsewhere pauli has described the many abasements daughters-in-law have to endure (pauli 2000, 2008, 2013, 2015). housebuilding, household composition, kinship and age-inscriptions are thus intrinsically linked. those living together under one roof (have to) care for each other. thus, within the mexican context, there exists a certain script as to when and where specific kin are supposed to reside together and care for each other. this script also frames what is considered good aging, i.e., living together with kin under one roof, and bad aging, i.e. living alone (pauli and bedorf 2016). consequently, we suggest to extend stack and burton’s (1993) kin-scripts, i.e., kin-work, kin-scription and kin-time, by a fourth dimension that we call ‘kin-place’. to understand the contemporary remittance landscape, the new dream houses built from money earned through migration, one has to unravel these links and how they have transformed due to migration. the saying “la casada casa quiere” (“a woman who marries wants a house”) is widespread in pueblo nuevo and throughout mexico (hirsch 2003, 67-68; monto 1994, 102). with the massive influx of anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 54 cash earned across the border since the 1990s, young couples have been increasingly able to reduce the time of co-residence with the husband’s parents or even move into their own house right from the start (pauli 2008). consequently, it is not only ‘the’ male migrant who wants to construct a house in his place of origin to build his belonging and maintain his self-worth. his wife is as eager to build a house, albeit for different reasons, especially to leave her mother-in-law’s house (pauli 2008). this gender dimension of the remittance landscape is often overlooked. however, it is essential to understanding the emerging ageinscriptions in rural mexico. obviously, the spread of neolocal residence has substantially changed kin-work and kin-scription. a shift in power has occurred between the generations, reframing intergenerational transactions. while the younger generation used to depend on the elder generation for support, shelter and land for much of their life course, today, the elder generation often depends on the remittances send by their sons and daughters from early on in their life course. social security and pensions remain almost non-existent in rural mexico.iii without the help of their kin, elder people could rarely survive in rural mexico. consequently, incidences of isolation and nuclearization of families, a process described for europe and north-america where the state is largely responsible for old age care (bedorf 2014a), are until now rather rare. the elder generation is still being supported by the younger generation. but the age-inscriptions are changing. as we have argued elsewhere (pauli 2013) there is a reconfiguration of care and support away from the wife’s affines and towards maternal kin of the wife, especially the wife’s mother and her sisters. while many women today decline serving their mothers-in-law, they are very much willing to support their own kin. this is also expressed in new forms of ‘kin-place’. women try to build their houses as far away as possible from their in-laws and as close as possible to their own kin. regarding the third dimension of stack and burton‘s (1993) kin-script, i.e. kin-time, it is important to note that during the first years of international migration and housebuilding kin-time did not really change. the remittance houses fitted neatly into the overall household script and the embedded timing. however, when increasingly sons and even couples or daughters postponed their return to the village and into their dream houses, kin-scripts and with them age-inscriptions started to fracture. comparably, ‘kinplace’ remained largely intact as long as absent children continued to build houses in the village and returned to the village. but at least for some of the migrants, the ties and places that bind have loosened. adjusted age-inscriptions and networks of kin and remittance houses in rural mexico by comparing types of houses over time, we can assess how much the village’s landscape has changed and the associated kinand age-inscriptions. in a 1997 census, pauli collected information on types of houses (pauli 2008). she differentiated three types of houses. of the 163 houses surveyed in 1997, seventy-five houses (46%) were dwellings made of local materials, especially adobe and teja, a roofing tile. another forty-four houses (27%) were built using local materials like teja and adobe, but also included new construction materials like corrugated iron sheet and cement. in local perceptions, houses in these two categories were rather similar. thus, when taken together, 119 houses (73%) followed this building scheme. houses in a third category, however, were perceived as substantially different. in 1997, forty-four houses (27%) were built in u.s. american style with money from u.s. migration. the local landscape was thus already shaped by migration in the mid-1990s. however, sixteen years later, another housing census revealed a more extensive transformation of the landscape. out of the 119 houses pauli summarized under categories one and two in 1997 (i.e., local anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 55 materials and hybrid materials), only seventy-two are still in use in 2013. the other houses have been either torn down, making space for the building of new remittance houses, or are in varying states of decay. there are 128 new houses permanently inhabited and another forty-nine new houses not permanently inhabited. these forty-nine houses, “casas vacías” (lattanzi shutika 2011, 68-90), or “empty houses,” are the retirement dreams we have described previously. finally, there are a substantial number of remittance houses in all stages of construction. given the flux of the situation it is difficult to calculate percentages for different house types. nevertheless, what these distributions clearly show is a shift in the built environment, away from simple peasants’ dwellings towards fancy, conspicuous migrants’ mansions.iv although ostentatious consumption varies from house to house, some trends can be deciphered. like the house we described at the beginning of our article, most remittance houses in pueblo nuevo have two stories, a spacious layout, columns, brightly colored walls and large panoramic windows. some remittances houses are hidden behind large walls and gates. importantly, finished remittance houses with absent landlords are not being used or occupied by relatives or other caretakers. they are cleaned but remain empty until the owner and his nuclear family return. this almost sacral, shrine-like treatment of empty remittances houses has also been reported for other areas of mexico (lattanzi shutika 2011; lopez 2015) and the philippines (aguilar 2009). the different houses in pueblo nuevo thus summarize the migration history of the village. how is the emergence of a remittance landscape (lopez 2015) connected to changing ageinscriptions and a transformation of the household system? a look at the history and use of some houses gives some answers. pauli met sandra bolañosv in june 1996. sandra, then in her early twenties and with two small children in tow, approached pauli and asked her about life in the u.s. sandra’s husband had left the village several months earlier to do construction work in south carolina. sandra and the kids were living with sandra’s mother-in-law. with the remittances from her husband tonío, sandra was busy building a house. at the end of pauli’s first long-term stay in july 1997, a small one-bedroom, turquoise painted house adjacent to sandra’s in-law’s house was finished. sandra moved in and was very excited about having her own house. it was built using local materials like adobe with a few more extravagant elements, especially a larger window and two columns at the entrance. when pauli returned to pueblo nuevo in 2000, sandra and her children had left the village and had followed tonío across the border. by then, their turquoise house had been shut down for two years and was already starting to decay. a year later, pauli learnt that sandra was sending money to her mother and her sister to start building a new, much larger and more conspicuous house, clearly a dream house, on a plot she had bought close to her mother’s plot. the initial layout of the house was very impressive. another nine years later, in 2010, while walking down the village’s main road, pauli spotted what was left of sandra’s second attempt to build belonging in the area. sandra’s dream house was never finished and the still impressive ruins now served as a stable for her mother’s goats. this usage also indicates that the left-behind mother had lost all hope that sandra would ever permanently return to the village and finish her house. if sandra’s remittance house had been finished, her mother would have guarded and cleaned it but certainly not used it (and especially not as a stable). and indeed, sandra and her family hardly ever returned to the village. sandra’s initial plan to retire in her own dream house in pueblo nuevo had disappeared. what implications does this fading of transnational ties and remittance belonging have for aging and age-inscriptions? sandra clearly wants to stay in the u.s. two of her four children were born there. all her children want to live on that side of the border and sandra does not want to leave them when she grows anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 56 old. but how does the elder generation, i.e., sandra’s parents and her parents-in-law, cope with losing a daughter, a son? sandra has ten siblings and her husband tonío has eight. both of them are in the middle of the birth order. almost all of their siblings have migrated for work, either within mexico or to the u.s. some of them, like sandra and tonío, have started building remittance houses that they have left unfinished or uninhabited. however, two of tonío’s brothers have returned to the village and their wives who had remained there. now they make a living from farming and local construction work. one of them, the second youngest brother, is taking care of the widowed mother, who has moved into her son and daughter-in-law’s house. sandra’s mother is by now (i.e., 2013) also a widow. two of her daughters are living in the village in remittance houses. one of them has offered to take care of the elderly mother. but sandra’s mother has preferred to leave her own ‘traditional’ house and move in with her youngest son and his wife, also living in a remittance house in pueblo nuevo. as this brief description indicates, a remittance house almost never stands alone. to understand its ‘life’ and even its ‘death’ one has to embed it within the wider social landscape. thus, sandra’s two remittance houses belong to a larger network of at least ten houses in the village, all of them in different states of construction and use. these networks of kin and houses enable the elder generation to cope with the non-return of a child. but they also hint at new vulnerabilities. previous age-inscriptions implied that the elder generation lets the younger generation into their house. now, this movement is reversed and the younger generation offers space and care to the elder generation. the two widows, being invited to spend their last years in the houses of their children, have to be grateful for this help. this reversal of gratitude clearly leads to new vulnerabilities and uncertainties, especially for the elder generation (pauli and bedorf 2016). further, since the 1980s, fertility has substantially declined in mexico (pauli 2000). sandra and tonío, both born in the 1970s, still have many siblings. but the age of ‘demographic abundance’ is gone. it is unclear how ‘small’ families with few siblings will come to terms with providing old age care and houses in rural mexico while living on the other side of the border. building mexican dream houses from chicago: imagining return and fulfilling expectations in chicago, felipe and rosa have been meticulously planning their dream house in mexico for more than a decade. their property is situated in the village of tinguindín, in michoacán, méxico, where both are originally from, and it remains vacant for large parts of the year. over the years, their house has been growing from a modest structure into a stately home in the “colonial style of the village” vi as felipe proudly put it. both felipe and rosa are in their late 50s and have spent the better part of their lives in chicago. felipe’s position in a steel manufacturing company in chicago enabled them to buy a two-story brick house in pilsen shortly after migrating, a formerly czech neighborhood where mexicans have been accounting for the majority of the population since the 1970s. the couple has four children, aged between fourteen and twenty-one. their oldest daughter started college in california in 2010 and only spends the holidays at home. for the last ten years, felipe and rosa have devoted a large amount of money, time and energy to carefully remodeling the property they bought in mexico into a house that would incorporate all kinds of modern amenities, while at the same time, reflecting the classical ‘colonial style’ of the village of anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 57 tinguindín. the underlying goal had always been to return to mexico and move into the perfected home as soon as felipe would be able to retire at the age of 62 and receive part of his social security. with the help of felipe’s relatives in the village, who supervised much of the construction on site, the couple had been building for their expected future in mexico. when bedorf, felipe and rosa were sitting in the couple’s chicago living room one warm july evening in 2011 and looking at pictures of the most recent additions to the house, however, felipe dropped a startling remark: “well, we still want to finish the house, although we are not going to live there anymore.” felipe seemed to be trying to make sense of this surprising statement himself while explaining why their goal for old age did not fit the outlined path any longer; he pondered, “with time passing, the plan is changing.” the couple’s four children played a major role in that respect since their lives were firmly anchored in the united states. it had become clear that none of them would be eager to follow their parents to mexico. besides, felipe was concerned about the effects that moving into their own house in mexico might have on his wife’s old aunt who had been hosting them whenever they spent time in mexico and may “get ill if we do not stay at her place anymore.” although it was out of question to go back to mexico for good, felipe struggled with the feeling that he was neglecting his responsibilities for family there. both he and his wife still have relatives living in tinguindín and felipe is especially concerned about his mentally challenged brother whom his mother had left in his care when she died. just like felipe and rosa, a considerable number of the generation of mexicans who had moved to chicago between the 1960s and 1980s and whose life histories and future plans bedorf traced during her fieldwork had built houses for a future life in mexico after migrating. almost all of them were not going to live in these houses. their life courses had become disentangled from the remittance homes as they approached old age. to understand the situation of this particular generation of migrants (mannheim 1952), it is important to note that migration patterns from mexico to chicago, and to the united states in general, had assumed a different character in the 1970s and 1980s and hence at the time when our interlocutors came to chicago. since chicago’s flourishing industries had brought the first mexican workers to the city at the turn of the 19th century, chicago’s mexican population, in line with general migration patterns from mexico to the u.s., had steadily increased (arredondo 2008; de genova 2005). large parts of these cross-border movements had occurred on the basis of labor contracts and been of a seasonal character, with mainly male family members working in the u.s. for part of the year and spending the rest of it in mexico (gombergmuñoz 2011). consequently, migration at that time did not profoundly affect the migrants’ and their families’ aging trajectories and kin-scripts. however, in the 1970s and 1980s due to altered legal regulations and changed economic circumstances both in mexico and the u.s., undocumented migration started to prevail while border security was enforced at the same time. as a result, more and more mexican workers did not engage in seasonal migration, but moved to the u.s. permanently, often with their families (gomberg-muñoz 2011; massey 2002; massey and pren 2012). it was within that context that our interlocutors moved to chicago. they had crossed the u.s. border in search of work, attracted by the stories they had heard and following already established networks (wilson 1998). out of the sixty-six people included in the chicago sample of our study, two thirds had lived in the u.s. as ‘unlawful entrants’ (gomberg-muñoz 2016) for a number of years or even decades. regardless of what motivated their decision to go north, almost all of them had been certain to return to mexico someday, and to thus fulfil what george gmelch referred to as the “natural completion of the migration cycle” (1992, 284, cf. levitt 2001; rothstein 2016; serrano 2008). people differed as to how long anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 58 they sought to stay in the u.s., but had no doubts about their goal of going back after a few years, at the latest upon retiring. these plans fueled sustained connections to the home regions through the construction of remittance houses, thus “consolidating transnational social fields” (sinatti 2011, 154) people’s intention to return was in line with the culturally prescribed norms regarding the roles and obligations they were expected to assume at certain stages of their life trajectories. the same was true, by and large, for the act of migration itself. going to the united states for some years had come to constitute part of the ‘culture of migration’ (cohen 2004), of what a young man was supposed to do at a certain age in order to “seguir adelante,” meaning “to advance” as many of our interlocutors put it, or at least in order to contribute to the household income. since work opportunities in chicago were favorable until the mid1980s, the money migrants earned in the u.s. allowed for performing the roles of dutiful sons and daughters by sending remittances back to mexico. if sustaining ties to the mexican home regions physically proved difficult due to the migrants’ unlawful status that impeded traveling back and forth, remittances presented an accepted (and expected) means to comply with the scripted role of supporting family members in mexico. another common way of both maintaining relationships and confirming one’s intention to ‘complete the migration cycle’ and retake one’s spot in the household in mexico in the future was to invest money in constructing a house in the area of origin the way felipe and rosa did. these constructions not least represented future kin-places, promises of caring for the aging parents built in stone as well as places where the migrants’ own old age and care was supposed to overlap. today, half of the people from our chicago sample, like felipe and rosa, still own a house in mexico that they either constructed or bought and refurbished after leaving the country. yet, contrary to people’s original goals, many of these houses will never serve as retirement homes. leaving behind what was built: conflicting roles, new age-inscriptions and retiring in chicago as felipe and rosa’s example illustrates, the empty houses are often an expression of the fact that migrants have gradually abandoned their plans of returning to mexico, either entirely or partially. of the sixty-six chicago-based people included in the research—roughly half of whom were already retired—only eight, a little more than ten percent, still planned to move completely back to mexico in the future.vii twenty people (or 30%) sought to spend parts of the year in mexico and parts of it in chicago, whereas the remaining approximately 60% did not consider mexico as a future place of residence at all. their houses, apart from being used as occasional holiday homes and in some very few cases by family members who were living there until the owners return, would remain vacant. similar cases of return plans turning into a ‘myth’ have been documented for other migration contexts (anwar 1979; şenyürekli and menjívar 2012). in previous publications (bedorf 2014a, 2014b), we have analyzed these transformed return intentions and how they were closely linked with people’s life courses, changing notions of belonging and fading transnational ties. the numbers above indicate that people’s realities in many ways clashed with the goal of moving back to mexico they had been pursuing. as for felipe, who tried to reconcile the pre-set scenario of a return to mexico on the one hand with changed circumstances in both mexico and chicago on the other, this was often related to new age inscriptions that emerged for many of the migrants who were approaching old age in chicago. such nascent scripts concerned reconfigurations of the aims the migrants pursued, where the norm of returning was challenged by other conflicting aspirations like advancing further and adjusting to american life (bedorf 2014a). furthermore, new individual solutions, but also more overarching patterns, anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 59 evolved regarding the age-specific social roles and responsibilities people assumed, both towards the family in mexico (most notably the parents) and in chicago (as parents and grandparents). related to these transforming kin-scripts were reconfigurations of residence models as well as of the implications of retirement. for felipe and rosa, their children constituted the main reason for ruling out the idea of returning to mexico. all four of their children will probably have moved out and be leading independent lives by the time felipe retires, but both felipe and his wife consider it important to spend ample time with them as well as with possible grandchildren. even if caring for one’s children—including grandchildren at a later stage, and also the idea and hope of being cared for later—is in compliance with the kin-scripts stipulated by the household system we described earlier, in cross-border situations this tends to conflict with the care work people are supposed to undertake for aging parents or other family members. this tension caused by multiple responsibilities might be compatible when all family members live in one place, but it becomes difficult to reconcile in the context of transnational migration when there are not one but several physical kin-places people are expected to occupy. people are then only able to comply with one of the care scripts and most of our interlocutors prioritized their children (in chicago) over other family members (in mexico). in some of our cases, care responsibilities for grandchildren also played a role in that respect, albeit less so than in other cases of transnational migration (e.g., dossa and coe in press). to a certain extent, remittances and houses built for the parents in mexico constituted a form of replacing personal care, but the pain of leaving one part of the family behind remained nevertheless. “i left the family, i left everything,”viii is how maría described the frustration about not being able to be there for her parents after migrating to chicago in the late 1960s. maría, 75 years old in 2011, was born into a middle-class household in mexico city and followed her husband to chicago when she was thirty-two. bedorf met her at a lotería (the mexican version of bingo) afternoon in the little village neighborhood in chicago. her as well as felipe’s struggles to follow the kinscripts on both sides of the border, which resulted in partially neglecting both the responsibilities and the house in mexico, tell only one part of the story of how vacant remittance houses and emerging age inscriptions are related. when bedorf visited maría at her home in crest hill, a gated community of mostly retired residents outside chicago, a few days after the lotería afternoon, they not only talked about the challenges of balancing the obligations towards her family in mexico with her life in chicago, but also about maría’s current situation. she was always looking forward to activities like lotería and attended them regularly, maría said, since she was “often burdened by loneliness.” she had three children and three grandchildren who she was very proud of. her two sons and daughter all lived in the chicago area, but they had their own lives, “their duties, their professions” and maría had to content herself to “seeing them when they have time.” although maría, due to her children and security issues, has no intentions of moving back to mexico city and into the house she co-owns there with some of her siblings, she reminisces about “being with the family there, united.” similarly, when felipe indulges in memories of the family’s trips to mexico to finish yet another part of the house, his home there becomes a symbol of a world where norms are still in order. in both cases, the houses in mexico represent idealized kin-places where family would still form the nucleus of daily life and care. even if such images might be imbued with nostalgia, they clearly point to new age inscriptions characterizing the lives of older mexican migrants in chicago. although most people had lived in bigger households in mexico, their living arrangements in the u.s. looked very different. since the adult children anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 60 (and grandchildren) rarely shared one home with their parents, the mean household size of our interlocutors was, at 2.55 members, comparatively small. this usually implied less family time and tasks, such as looking after grandchildren, than would have been common in mexico. on the other hand, as maría’s example illustrates, this model also created room for new activities, such as gathering with friends and playing lotería. senior clubs providing all kinds of entertainment were very common in this respect. besides hosting dance, english, computer and drawing classes as well as the popular lotería sessions, the senior clubs functioned as social spaces. by doing so, they contributed to the emergence of new practices and meanings related to retirement, which were less characterized by family duties and more by social ties outside the family and leisure time. neolocality hence both reflected and gave rise to new notions of old age, regarding the responsibilities as well as the freedoms associated with this stage of life. institutions such as senior clubs, senior centers and retirement communities like the one where maría lives played a substantial part in reframing the role of the elders, while at the same time also replacing the family as ‘social care givers.’ maría’s children urged her to move to crest hill for the comfort and care. she appreciates the events the community organizes, maría says, “but when i am alone, it takes a lot to bring myself to attend.” part and parcel of how people’s roles – the ones of the older generation of migrants as well as the ones of their children and grandchildren – are being reframed is their greater economic independence. unlike the older people in our pueblo nuevo example who depended on their children’s support, our correspondents in chicago received or were going to receive social security. additionally, most of them would be able to draw on other income sources such as employer pensions, savings, rental income or the sale of a property upon retirement. conclusion in this article, we deciphered how the emptiness of remittance houses characterizing large parts of the mexican countryside are connected to their migrant owners’ life courses, particularly in the later stages of life. we looked at the changing meanings of remittance houses for both the people in a village in central mexico, pueblo nuevo, and older mexican migrants who were living in chicago and had constructed homes in their home regions in mexico. our examples also cast light on slightly different stages in the life of remittance homes. while the cases illuminate how the purposes of such buildings are reconfigured over time due to changing kinand age-inscriptions in the context of migration, our mexican example explores metaphorically speaking the mature stages of ‘adult’ houses, whereas the houses we discuss in our chicago example have already reached old age and sometimes death. our cases show that the considerable number of vacant houses characterizing the remittance landscape is tightly linked with changing norms and practices regarding care responsibilities and rights as well as, more generally, with meanings and expectations attached to certain stages of the life course, in our case particularly old age. these changes seem to be so fast that it is becoming very difficult for transnational families to plan their futures. thus, envisaged futures materialized in the construction of remittance houses for later phases in the life course are turning into ruins while still under construction (see sandoval-cervantes 2017). ‘traditional’ household-scripts that used to provide frames of references for kin-work and kinscription in mexico lose their power both in the rural mexican and the urban u.s. setting. instead, new forms of dwelling, ‘kin-place’, such as neolocal residence in mexico and living in old age homes or smaller households in chicago, emerge. the future plans of migrants diverge from the expected ‘completion of the migration cycle’ in that the idea of returning to mexico is often abandoned or translated into back and forth anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 61 movements between the two countries. what all of the emerging practices and norms we have described have in common is that they are evolving, leading to clashing with each other and existing norms. as people try to reconcile different expectations and responsibilities, the construction of houses reflects one envisaged future that is often overturned by conflicting aims and involvements in the u.s., giving rise to alternative scripts. one issue we have touched upon here, but which begs further investigation, are the challenges that these new arising age-inscriptions that are crystallized in the transformed meanings of remittance houses dotting the mexican countryside pose in terms of old age security (see also lamb 2009, pauli 2008, pauli and bedorf 2016). our examples illustrate that kin-centered ideas and practices of caring for older people have in both places largely been replaced by different forms of care taking. this concerns both the economic and the socio-emotional aspects of care. while the older generation in our mexican example primarily subsists on the remittance money sent by their children who have migrated to the united states as well as on larger family support networks, it is the state and the city who step in as the main providers in the u.s. setting. most of the migrants in chicago do not rely on the support of their children during the later stages of life. they are economically independent due to the social security payments and possibly further pensions they receive as well as apartments and other assets they own and live, if not by themselves, in old-age homes. both in rural mexico and in the urban united states, however, the fact that old age has become gradually disconnected from the family, not taking place in one common kin-place anymore, but rather as kin-work over a distance, creates new vulnerabilities (pauli and bedorf 2016). apart from leaving emotional voids, these nascent scripts also cause economic and health uncertainties. with shrinking family sizes in mexico, it is unclear in how far the younger members of family networks will still be able to provide for the older generation in the future. similarly, in the united states, where significant demographic shifts have led to a growing aging mexican migrant population that is projected to substantially increase in the upcoming decades, it remains to be seen in how far the state will manage to meet the health and social security needs of this rapidly increasing group. we have dealt with issues of gender and generation in depth, but we have not tackled class and economic stratification in detail in the article. however, class does frame our two cases and could be explored further. while the mexican case presents a “peasantariat” (griffiths 1997, 24-25), i.e., a group of people having to survive on a mixture of economic strategies, involving agriculture and unskilled wage labor through migration, the informants from chicago have a much more diverse class background. they also come from a wider geographical spectrum, i.e., from villages, towns and cities throughout mexico. these different class and geographical backgrounds might influence how much people feel obliged to adhere to specific kinand age-inscriptions, a point also raised by james ferguson (1999) in his work on rural return migration of urban mine workers in the zambian copperbelt. remittance houses by themselves are expressions of class status and the increasing economic stratification that has been unleashed by migration. an interesting extension of our analysis of remittance houses is looking at another form of built belonging, at tombstones. even if migrants might leave the houses they have constructed behind, thus severing ties of belonging to the home country, they often want to be buried there. migrants hope to resolve the difficult question of where they belong with this final decision (lopez 2015, 166-175). according to a 2008 estimation, one out of every six mexican migrants who dies in the united states is buried in mexico (lopez 2015, 172). among our participants in chicago, one quarter wished to be buried in mexico. their reasons were comparable to the one for constructing migrant houses in mexico—sustaining belonging. in that sense, conspicuous tombstones might take over the role of remittance houses. even the tombstones, however, might continue to mirror the many ambivalences and challenges attached to migration and the building of anthropology & aging vol 39, no 1 (2018) issn 2374-2267 (online) doi 10.5195/aa.2018.173 http://anthro-age.pitt.edu pauli and bedorf | 62 belonging in more than one place. some of our chicago correspondents had already bought the plot for their final resting place in mexico. however, they were uncertain whether they would really want to be buried there. even if their parents were there, they would deprive their children in the united states of the opportunity to visit their graves. acknowledgements we are especially thankful to michael schnegg, one of the principal investigators of the project, for his continuous and substantial empirical and theoretical support, ideas and comments. we further thank christine avenarius for her support of franziska’s research stay in the u.s. and susanne lea radt for her help with collecting census data in 2013. many thanks to the people of pueblo nuevo, and especially angela maya martínez, for all the kindness and time they have provided over the years as well as to the informants from chicago for lending their support and time to the research project. notes i the place we have just described does not exist as such, but constitutes a combination of several houses we found during our fieldwork and that we have assembled to build this imaginary prototypical house. ii the project has been funded by the german science foundation (grant schn 1103/3-1) and was led by principal investigators julia pauli and michael schnegg equally. the project has ethically and scientifically been approved through the research foundation. iii since the mid-2000s the state run program oportunidades is also active in pueblo nuevo. as my 2013 census data show, state support for older people nevertheless remains minimal. most older villagers only receive a monthly food basket. iv consumption habits have also changed. for example, in 1997, only 34% of the households had an indoor toilet and 26 percent owned a fridge. in 2013, 83% of the houses have a bathroom and 76% own a fridge. v all names have been changed. vi interview felipe gayón, july 28, 2011. the interview was conducted in spanish, translation into english by bedorf. vii the sample does not capture migrants who came from mexico to chicago in the 1960s and 1970s and already went back to mexico at an earlier stage of life, but focuses on migrants who still lived in chicago when they were approaching retirement. viii interview maría romero, may 2, 2011. the interview was conducted in spanish, translation into english by bedorf. references aguilar, filemon. 2009. 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"introduction: situating contemporary politics of belonging." in the situated politics of belonging, edited by nira yuval-davis, kalpana kannabiran and ulrike vieten, 1–14. london: sage publications. julia pauli franziska bedorf julia pauli franziska bedorf ethnographic work in rural mexico and urban usa building mexican dream houses from chicago: imagining return and fulfilling expectations in chicago, felipe and rosa have been meticulously planning their dream house in mexico for more than a decade. their property is situated in the village of tinguindín, in michoacán, méxico, where both are originally from, and it remains vacant for la... both felipe and rosa are in their late 50s and have spent the better part of their lives in chicago. felipe’s position in a steel manufacturing company in chicago enabled them to buy a two-story brick house in pilsen shortly after migrating, a formerl... when bedorf, felipe and rosa were sitting in the couple’s chicago living room one warm july evening in 2011 and looking at pictures of the most recent additions to the house, however, felipe dropped a startling remark: “well, we still want to finish t... just like felipe and rosa, a considerable number of the generation of mexicans who had moved to chicago between the 1960s and 1980s and whose life histories and future plans bedorf traced during her fieldwork had built houses for a future life in mexi... to understand the situation of this particular generation of migrants (mannheim 1952), it is important to note that migration patterns from mexico to chicago, and to the united states in general, had assumed a different character in the 1970s and 1980... it was within that context that our interlocutors moved to chicago. they had crossed the u.s. border in search of work, attracted by the stories they had heard and following already established networks (wilson 1998). out of the sixty-six people inclu... people’s intention to return was in line with the culturally prescribed norms regarding the roles and obligations they were expected to assume at certain stages of their life trajectories. the same was true, by and large, for the act of migration itse... another common way of both maintaining relationships and confirming one’s intention to ‘complete the migration cycle’ and retake one’s spot in the household in mexico in the future was to invest money in constructing a house in the area of origin the ... microsoft word spring2021_introduction_in template.docx introduction. contending with the hourglass: time, reproduction, and the problematization of ageing anindita majumdar indian institute of technology anindita@la.iith.ac.in keywords: temporality; reproduction; masculinities; intergenerational; egg freezing; menopause anthropology & aging, vol 42, no 1 (2021), pp. 1-9 issn 2374-2267 (online) doi 10.5195/aa.2021.353 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 1 introduction. contending with the hourglass: time, reproduction, and the problematization of ageing anindita majumdar indian institute of technology anindita@la.iith.ac.in anindita@la.iith.ac.in 2020, in many ways, embodied being ‘trapped in an hourglass.’ time stood still for many and raced in a blur for many others—but it was felt, nonetheless, through metaphors and practices of closing in and distancing. in this special issue, time is an important marker of change and identity. time is felt most acutely through the performance of bodily decline, yet, it is certainly no monolith, having its own structure, meaning and dynamics (hazan 1984). instead, time itself is temporal—open to manipulation, reframing and even annihilation. as we continue to engage with the ongoing covid-19 pandemic, an unprecedented occurrence in recent memory for the global community, the loss of innumerable lives and continued casualties make it imperative for us to think about our future in connection to our present and past. nowhere is the linkage with time more provocative than in the case of age and ageing. the taken-for-granted nature of bodily decline continues to organize our negotiation with life, choices, and relationships. constantly seeking to outlive, subvert decline (lamb 2014, 2018), we are nonetheless trapped in the hourglass. yet, the act of reproducing biologically—seeking progeny—is aimed towards facilitating a desire for longevity. through continued relationships based on ideas of genetic and social continuity, time and decline can be challenged (gullette 2004). in this special issue, six research papers chronicle the value of thinking through fertility and reproduction in terms of time, temporality, and age. the linkages between two important temporal moments in the human life cycle: birth and death have been part of seminal anthropological analysis (borneman 1996; das and han 2015; ginsburg and rapp 1995; kaufman and morgan 2005). the relationship between birth and time has become particularly provocative in looking at how medicine has reoriented the biological self (kaufman 2015; lock 2007); just as different biological stages have been implicated in experiential narratives and lived realities (lamb 2000; lock and kaufert 1998; mccourt 2009). thus, emily martin’s (2001) pioneering study of gendered medical texts has led to an engagement with how western medicine constructs the female subject in frames of productivity, wherein menopause is not only the end of the reproductive life cycle but is the end of life itself (lock 1994). however, in cross-cultural studies, menopause and puberty are seen to be more dynamic as fluid, changing lived stages in a woman’s life that are influenced by her relations, and cultural mores and norms (bledsoe 2002). this has also meant that pregnancy and childbirth have been complicated in how they seem socially essential to womanhood—in conversations around infertility (becker 1994; riessman 2000), delayed fertility (bewley et al. 2005) or the desire to be childfree (nandy 2017). it is important to understand that a large part of the birthing narrative is focused on women, and the gendered perspective is very much part of the academic study of reproduction (franklin 2002; rapp 2001). while many of the papers in this special issue also focus on women and the navigation of their majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 2 reproductive selves; an important addition comes through the examination of men and masculinities in the construction of reproductive bodies. in popular discourse, to begin to think about age and ageing is often to think about decline. both physiological and cognitive decline are often followed by social decline and exclusion—though this varies across cultures, political economies, and personal circumstances. yet, the fear of the inevitable that decline carries is very much part of what is widely conceptualized as a “natural process of ageing.” this natural process itself has been contested, changed, and reformulated through the intervention of medicine and medical technologies, and the social meanings associated with them (bledsoe 2002; gullette 2004; kaufman 2015; lock 1994). globally circulating contemporary ideologies of living actively and aging successfully contest the road to decline, by subverting social scripts associated with growing “old” and proposing instead that individuals can postpone or even eliminate the declines of old age through medical intervention and individual effort (lamb 2014, 2018). by focusing particularly on time and reproduction, the aim of this special issue is to examine how reproduction is deeply enmeshed with existing and emerging ideas of decline, life course, longevity, and ageing. this is especially important when engaging with recent research on time and temporality within anthropology that provokes us to think beyond linear progressive time, which is subject to a form of abstraction governed by capitalist market mechanisms (bear 2014). this form of dominant temporality reduces subjectivity to the machinations of technology and the demands of overarching consumerism. social time thus, comes to be marked by perceptions of linearity in which individual/collective subversions may go unnoticed (bear 2016; gullette 2004). biological time is also governed by such problematic markers of universalization that tend to subsume reproduction within it, ignoring other alternate, contradictory modes of becoming (lock 1994). these becomings may be culturally conceptualized (wentzell 2013) and may also carry within them dominant perceptions of decline (daly and bewley 2013; sievert 2006)—but the spaces in-between are what this special issue would like to explore. these “spaces” of maneuverability through the use of technology, changing social mores, and changing biologies are offering newer challenges to age and ageing—and it is to these that we turn. within such a framework, the relationship between time and reproduction begins to take on new and more potent meanings. thus, the choice to conceive and birth children may be determined by the natural process of ageing, but also becomes enmeshed within questions of temporality and lifestyles (bewley et al. 2005; pathak and nichter 2015). the study of ‘lifestyles’ is also part of the emerging engagement with cultural ideologies surrounding life goals in a neoliberal society marked by increasing capitalist consumption (pathak 2014; solomon 2016)—and the corresponding pathways towards achieving socially acceptable masculinity and femininity (pathak 2019). the idea of the biological clock, for instance, is one such conceptualization that provokes us to think about the ways in which reproduction is complicit within a gendered script that is dependent on social narratives of generational longevity. in contemporary medical practice, the biological clock has come to represent anxieties about the future (daly and bewley 2013), and assisted reproductive technologies (arts) provide the means to subvert temporal reproductive decline (friese, becker and nachtigall 2006). arts exist as markers of temporal inevitability in terms of reproductive decline and its subversion. in seeking to question the biological clock that positions bodily decline as inevitable—arts reposition the discourse in ways that unsettle nature (franklin 2013). thus, in lock’s (1994, 2007) work, ageing and the life course are now malleable—and subject to technological machinations. but what about the social experiences of reproductive decline? how can time be seen and understood within such an understanding? can one begin to think of the biological clock as pitted against a more majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 3 fluid timescape that embodies conflicts of social and “real” experiences of the body (riessman 2000)? for long, a significant part of anthropological analysis has looked at the cross-cultural manifestation of menopause, ageing, and generational decline in japan (lock 1994), gambia (bledsoe 2002), india (cohen 1998; lamb 2000; samanta 2018), and united states (crampton 2013; lamb 2014), amongst others. within such a tradition of seeking to explore age and reproduction are questions of temporality, cyclical manifestations of natural processes, and the rejection of linearity. these questions form a major part of the rich ethnographic explorations that the six papers in this special issue engage with in: mexico, india, hawaii, united states, and denmark. the cross-cultural explorations in these papers offer the opportunity to understand forms and meaning of temporal decline, ageing and reproductive desires through biomedicine, marital commitment, and gender. temporality and the subversion of bodily processes ageing and reproductive decline accompany each other in a form of inevitable temporality that may be contested, not only across cultures, but also in emerging dominant renditions of biomedicine in particular. in three of the papers in this special issue, the notion of linear time that is particular to the biomedical identification of reproductive decline—is contested and subverted through the meaningmaking processes linked to the use of medical and reproductive technologies. in lynette leidy sievert, laura huicochea-gómez, diana cahuch-campos, lynn morrison, and daniel e brown’s paper (henceforth referred to as sievert et al.), menopause and menarche are problematized in relation to fertility. this problematization becomes important for understanding layers of meaning associated with temporality and reproduction across differing cultural contexts such as hawaii and mexico. lauren jade martin brings forth embodied voices of felt and negotiated fertility amongst women in the us, who navigate their reproductive choices through multiple filters of biological, social, and clinical temporality. and in anindita majumdar’s paper, ageing and the life course are given new meaning through the use of assisted reproductive technologies in india. contingency is an important part of the temporal subversion that the reproductive body undertakes. in bledsoe’s (2002) understanding, contingency is both opposed to the linear narrative of decline—as well as subsumes chronological time to bring forth a completely new understanding of ageing. the perspective of contingent time values the life narrative of a person’s experience of tolls and tribulations—as much as the reframing of when senescence sets in. thus, reproductive decline is not always defined by age and ageing—but through experiential and relational engagement with the physical self. in the paper by sievert et al., contingency is part of the experience that defines ‘end’ of reproductive life. like lock (2007) and bledsoe, reproductive decline is culturally defined and experienced. despite the forms of definitional boundaries that biomedicine seeks to invoke on reproductive decline, especially in case of women—the experience of tubal ligations and hysterectomies reframe the ways in which menopause is understood amongst women in mexico and hawaii. engaging with complex ethnographic and quantitative data, the authors suggest that menopause as a decisive moment of biological reproductive decline is not always taken for granted. reproduction is constructed as time-bound, especially for women. lauren jade martin positions time through the complex examination of choice amongst american women and their reproductive selves. she focuses on how knowledge about one’s fertility and the “potential” to procreate is navigated amongst three different sets of decision makers. diverse social profiles add to the kinds of knowledge practices the respondents engage with in taking decisions about egg freezing and ivf. the knowledge majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 4 gained from personal experiences of bodily contingencies, and the accumulation and exposure to other sources of information become the key points of negotiation in understanding and “anticipating infertility” (martin 2010) over a period of time. however, in india, infertility is imagined and manipulated through the routinization of arts in the private healthcare sector—leading to conflicting discourses regarding reproductive decline. in anindita majumdar’s paper, this conflict is seen to operate in particular ways between women past their reproductive prime seeking to be pregnant through arts; and younger women seeking arts to manage familial expectations of pregnancy and childbirth soon after getting married. within the complex cultural space that india inhabits, arts are administered through competing discourses that constantly reengage reproductive biology with lived experiences. the conceptualization of the biological clock the biological clock has come to be increasingly identified with reproduction, and reproductive choices. marking our engagement with our bodies, relations, and medical technologies: this issue wishes to understand how the symbol of the “clock” comes to impress itself upon our bodies and social roles. the hourglass-clock is an important metaphor in emily wentzell and charlotte kroløkke’s papers. across widely differing contexts, clocks may not tick the same time, but may have cultural manifestations that bring the local-global together in interesting ways. thus, in emily wentzell’s paper mexican men create newer conflicting meanings of multiple biological temporalities that, in turn, makes their own fatherhood and spousal intimacy complicit. in charlotte kroløkke’s study, danish men battle stereotypes, much like wentzell’s study of mexican masculinity, in clinical and social discourse to understand declining fertility in the face of mythic representations of virility. the nature of reproductive decline is built into the idea of a seamless life cycle—one without disruptions (becker 1994). however, as gay becker has shown, infertility comes to represent a form of “disruption” in the narrative on life cycles and their aligned stages. in contemporary social life, the biological clock has become complicit in the narrative of disruption. at one level, the biological clock signifies the looming end of reproductive life, and life in general within western biomedicine; and at the other end, it signals the disruptive potential of overturning predetermined social processes and rituals through the exercise of “choice.” in many ways, this metaphor of the “ticking clock”—so provocative in case of population discourse globally (rao 2004)—is geared towards the inevitable conversation around fertility/ reproduction, and in many ways, death itself. the move from population discourse to assisted reproduction (gupta 2000; inhorn and patrizio 2015) has also signalled a shift from the global south to the global north—highlighting larger anxieties about reproduction and demography. in population and demography, the “ticking bomb” of overpopulation in the global south triggered invasive and large-scale involvement in birth control (murphy 2012)—but of late, this discourse has shifted towards ageing populations in the global north along with declining birth rates (crampton 2013). anxieties about delayed childbirth and increasing ageing populations have now become part of emerging state discourse in the global north that are geared towards pronatalism (krause and marchesi 2007). much of the responsibility within the declining-population discourse is focused on women’s inability, and unwillingness, to have children. pregnancy and childbirth have become centered on the pressure to reproduce at the “right age.” the biological clock, and associated discourses, link declining reproduction to women’s choices regarding conception, pregnancy, and careers (bewley et al. 2005; martin 2012; van de wiel 2019). majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 5 in this special issue, the traditional association of the biological clock with women’s reproductive decline, or anxieties about burgeoning/ declining populations is challenged with a focus on how male reproductive health is increasingly being subsumed under the same logic of decline and decay. the linkages between masculinity and virility across cultures remains uncontested, as the latter, ostensibly, does not decline with age. however, studies suggest that male infertility has an equal and important role to play in a couple’s long-term childlessness, and in many cases may be linked to chronicity as well (inhorn and birenbaum-carmeli 2010). even though the biological clock is embedded in a “masculine logic” (amir 2006, kroløkke, this issue), both wentzell and kroløkke’s research seeks to understand how masculinity is unmade, biologically, within emerging reproductive technologies. in kroløkke’s provocative analysis of danish advertising exhorting danish men to reclaim failing fertility, temporality is embedded in the sperm cell. thus, sperm freezing, and lifestyle changes become important signifiers of what she calls “reproductive masculinity.” “male repro-temporality” is represented through failing sperm health, and the impact of inherited genetic disorders amongst children born to older men. using an interdisciplinary lens, kroløkke engages with medical and selective social discourse looks at the emergence of the ‘male biological clock.’ in wentzell’s analysis, older mexican men suffering from erectile dysfunction are rejecting the intervention of western biomedicine to overturn their sexual debility, in seeking a responsible and mature social role. through the acceptance of their sexual and reproductive decline, older men are settling for a respectable life in opposition to their earlier promiscuous lifestyle. being and enacting “machismo,” and its associated stereotypes are being contested now. thus, the cultural identifiers of the biological clock are enacted differentially by men and women—in consonance with, or in opposition to biomedicine. the desire for intergenerational longevity through marriage the ways in which our future becomes enmeshed within the idea of our bodily decline is most potent when seen in relation to children, and the desire for offspring (franklin 2013). how such desires become marked with age, ageing and reproductive decline, is an essential focus of this special issue. thus, marriage and marital commitment emerge as significant leitmotifs in how life cycles are being negotiated across cultures. reproductive desires and intergenerational connectedness blend together in the pursuit of marital commitment (pooley and qureshi 2016). interestingly, emerging research on egg freezing suggests that a significant part of the discourse is focused on the pursuit of childbearing in the context of unfulfilled/seeking to fulfil marital happiness (martin 2012; van de wiel 2019). the pursuit of the happy heterosexual procreative family, for long the basis of euro american kinship through the schneiderian focus on blood and law—has again emerged as the pivot for the popularity of assisted reproduction, in its presumed refashioning of sexuality, desire and procreation (inhorn 1994). however, it is important to note here that marital commitment, desire for biological progeny and declining reproduction are “entangled” in anxieties about the biological clock, as well as in intergenerational legacies. all the papers in this special issue are concerned with the ways in which reproductive decline and ageing come to be influenced by ties of marriage. the dynamism of this theme is more potent when seen in relation to cross-cultural research. in wentzell’s paper on mexican men, ageing and declining sexual desire or performance provides an opportunity to reframe fraught marital ties. in the process there is a refashioning of hegemonic masculinity leading to an investment in a committed relationship and a withdrawal from a life of adultery. her paper engaged with a comparative analysis of data from younger men and women engaging in new forms of companionate marriage wherein testing for hpv and sharing otherwise stigmatising information about sexual and reproductive with an intimate majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 6 partner—reimagines masculinity. in many ways age and ageing are complicated in wentzell’s study of mexican men—and the process of negotiating with masculinity and its social trappings through marriage and reproduction. at the same time, in paro mishra and ravinder kaur’s ethnographic study of ageing bachelors in north india, in an agrarian setting where marriage promises children as heirs and caregivers, remaining unmarried is extremely stigmatizing. mishra and kaur engage with research on declining sex ratios in india to reflect on how ageing men who are unable to get married due to a paucity of women—are also facing a crisis of masculinity. unable to reproduce heirs and take their socially exalted and expected position as heads of households, means that they remain trapped in a vortex of dependency and nonadulthood. marriage means children, and heirs—and, ultimately, culturally valued ties that last beyond one’s death. except in martin’s research, heteronormativity remains the running theme through the papers (see kroløkke, wentzell, majumdar, this issue). but in highlighting the dominance of heterosexual marriage as an institution, the aim is also to highlight the ways in which ideologies and practices of marriage may be problematised within social discourse around ageing and reproduction. conclusion “ageing equals decline, a devastating formula. . .” notes margaret gullette (2004, 7), representing how western society views the aged and ageing as a “problem.” however, in this special issue, each of the papers have presented a complicated narrative that questions the “authoritative narrative of decline” (gullette 2004), embarking instead upon cross-cultural, interdisciplinary ethnographies that present alternative modes of being itself. in chronicling alternate modes of being, “progressive aging” movements (lamb 2014), especially in the west have sought to build on a narrative of anti-decline, rather than one insisting on anti-aging. this is also seen in the reframing of popular discourse on fertility and childbearing. thus, increasingly, despite the state’s exhortation to women of childbearing age to procreate (krause and marchesi 2007) especially in the provision of assisted reproduction (teman 2010) and renewed efforts to ban abortion (lentjes et al. 2020)—women in low fertility countries continue to resist and reengage with social demands to be pregnant and birth. again, a small section of women in high fertility countries are also beginning to question the socially eulogised roles of motherhood and mothering (nandy 2017). reproduction as a field of study provides the perfect opportunity to engage with conflicting discourses on what constitutes ageing and its linkage with gender, technological interventions, and the supposed importance of marriage and heteronormativity. and even though it seems women, and men, remain trapped in fulfilling reproductive expectations while battling social markers of decline—in complicating the process of conception, pregnancy, birthing and the eventual loss of reproductive desires or the inability to achieve fertility, lie varied negotiations that belie the power of the hourglass on social life, and on anticipated decline. acknowledgements i would like to thank sarah lamb for her help and guidance in writing this introduction. also, my gratitude to henrik hvenegaard mikkelsen, cortney hughes rinker and tannistha samanta at anthropology and aging for their support in bringing out this special issue. finally, thanks to emily wentzell, lauren jade martin, lynette leidy sievert, charlotte kroløkke, paro mishra and ravinder kaur for contributing such outstanding papers to the special issue. majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.353 http://anthro-age.pitt.edu 7 references amir, merav. 2006. “bio-temporality and social regulation: the emergence of the biological clock.” polygraph 18, 47-72. bear, laura. 2014. “doubt, conflict, mediation: the anthropology of modern time.” journal of the royal anthropological institute 20, 3-30. bear, laura. 2016. “time 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template.docx knowing and not knowing about fertility: childless women and age-related fertility decline lauren jade martin penn state berks ljm37@psu.edu abstract knowledge claims may play an essential role in reproductive decision-making, as individuals seek out, assess, reject, and use information about health and fertility gathered from numerous sources. this paper focuses specifically on childless women’s self-perceptions of knowledge about infertility and age-related fertility decline. how knowledgeable do childless women perceive themselves to be about fertility and infertility in general, and from where they do they obtain this knowledge? furthermore, how knowledgeable do childless women perceive themselves to be about their own fertility and ability to conceive, and to what do they attribute this knowledge? data for this project was gathered through semi-structured interviews with 72 childless american women; the interviews were inductively and thematically coded using qualitative-analysis software. childless women assessed their general knowledge of fertility as confident, self-doubting, or novices, and they claimed multiple sources as the basis of this knowledge, including formal education and training, media and popular culture, and family members and peers. when assessing knowledge about their own fecundity, the women tended to rely on two additional sources: biomedical diagnostics and embodied knowledge. childless women’s awareness of average statistics of age-related fertility decline did not necessarily translate to individual self-knowledge about their own bodies and fecundity. because knowledge claims were based on multiple information sources given unequal weight, this raises questions about authoritative knowledge—that is, the knowledge that “counts” for women as they make decisions regarding their future childbearing. keywords: life course; temporality; masculinity; sexual health; anti-aging medicine; mexico anthropology & aging, vol 42, no 1 (2021), pp. 30-48 issn 2374-2267 (online) doi 10.5195/aa.2021.259 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 30 knowing, and not knowing about fertility: childless women and age-related fertility decline lauren jade martin penn state berks ljm37@psu.edu an hourglass in the form of an upturned baby bottle appears next to text that reads: “advancing age decreases your ability to have children. while women and their partners must be the ones to decide when (and if) to have children, women in their twenties and thirties are most likely to conceive. . . . your decisions now can impact your ability to conceive in the future. get the facts.” this graphic, along with three others that focused on smoking, sexually transmitted infections, and weight, was part of an infertility-prevention campaign launched by the american society for reproductive medicine (asrm) in 2001 (american society for reproductive medicine, n.d.). according to michael r. soules (2003), former president of asrm, the campaign was initially small and targeted, involving public-service announcements on buses, 30-second radio spots, brochures, and a website. but the campaign soon caught the media’s attention, which ran stories about its content. in particular, the media focused on the campaign’s controversial images and messages as well as the backlash it was receiving from groups such as the national organization for women (bute et al. 2010; soules 2003). more recent controversies have erupted across the world when government agencies or private corporations have enacted awareness campaigns about infertility, demographic decline, and delayed childbearing. these include a “fertility day” campaign to raise awareness of infertility and to encourage young women not to delay childbearing in italy (pianigiani 2016), viral “do it for denmark!” videos encouraging danes to have sex to mitigate the country’s low birth rate (dearden 2016), and a polish campaign urging citizens to “breed like rabbits” in their reproductive years (associated press 2017). south korea, also facing low birth rates, courted controversy with a government website’s publication of a map that used shaded colors to rank the regions within the country that had the greatest numbers of women of childbearing age. after public outcry, the map was immediately removed (associated press 2016). in each of these instances, public reaction was negative, with commentators, including working women, pointing out that the matter of population decline may be better resolved by addressing the structural problems that make it difficult to have and raise children; e.g., job security and childcare. moreover, several of these campaigns, including the asrm campaign in the early 2000s, assumed that women are not knowledgeable about their bodies, fertility, or age-related reproductive decline. without acknowledging what women already know about fecundity—as well as the structural constraints that frequently lead to delayed childbearing—the messaging in these campaigns came across as overly nationalistic, paternalistic, and insensitive. women may also hear messaging from medical providers, the media, and peers about fertility, but they may not know how easy or difficult it will be for them personally to conceive if they have never attempted to get pregnant. thus, the influence of knowledge martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 31 claims may play an essential role in reproductive decision-making, as individuals seek out, assess, discard, and use information about health and fertility gathered from numerous sources. this article is based on research conducted for a larger qualitative project on the reproductive decisionmaking of childless women in the united states. in this article, i focus specifically on two issues: (1) how knowledgeable participants perceive themselves to be about fertility and infertility in general, and from where they obtained this knowledge; and (2) how knowledgeable they perceive themselves to be about their own fertility and ability to conceive, and to what do they attribute this knowledge. rather than measure or quantify childless women’s knowledge about fertility and infertility, this paper engages with epistemological questions: what do childless women claim to know, how do they know what they know, and how do they value what they know? central to this project is anthropologist brigitte jordan’s (1993) concept of “authoritative knowledge,” which posits that different knowledge systems exist simultaneously, but that only some types and sources of knowledge “count” and are seen as legitimate. as i discuss, women tend to rely upon and make various knowledge claims about fertility, and what they understand to be true or factual may not always be legitimated by medical providers, romantic partners, and others who are influential in their reproductive decision-making. background numerous researchers have studied the extent to which women and men are aware of age-related fertility decline—with sometimes contradictory results. for example, a telephone survey of 462 men and women aged 18 to 45 in australia revealed significant knowledge gaps about age-related fertility decline and factors influencing fertility (hammarberg et al. 2013), whereas a study of 3,000 childless women in canada found high levels of awareness (over 90 percent) of age-related fertility decline (daniluk, koert, and cheung 2012). in the united kingdom, a small qualitative study of 18 women over age 35 found that many were unaware of factors (including age) that contribute to infertility risks (cooke, mills, and lavender 2012). research conducted both in the united states and internationally indicates that awareness of age-related fertility decline is correlated with health literacy and education (bunting, tsibulsky, and boivin 2013; gossett et al. 2013). however, studies of reproductive-health professionals indicate that even those who are highly educated and have medical training are not immune to underestimating infertility risks or overestimating the effectiveness of fertility treatments (bonetti et al. 2008; garcía et al. 2017; revelli et al. 2016). misconceptions about the effects of aging on fertility or the effectiveness of assisted reproductive technologies may result in individuals delaying childbearing (balasch and gratacós 2011; mac dougall, beyene, and nachtigall 2013; maheshwari et al. 2008). in a study by health researchers judith c. daniluk, emily koert, and anthony cheung (2012), participants were very knowledgeable about age-related fertility decline but knew far less about the effectiveness of in-vitro fertilization (ivf). studies on people’s awareness of the effectiveness of assisted reproductive technologies are relevant to research on age-related fertility decline because they speak to the risks of assuming that fertility treatments can mitigate the risks of delaying childbearing (hodes-wertz et al. 2013; johnson and simon 2012; o’brien et al. 2017). however, measures of people’s knowledge about aggregated statistics of age-related fertility decline and other infertility risk factors do not fully capture all of the individual, social, and financial variables that people may consider in their reproductive decision-making (lavender et al. 2015; hertz 2006; martin 2017) nor do they capture the non-expert sources of reproductive knowledge gathered from peers, family members, or media and pop culture. for example, some researchers have studied the use martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 32 of blogs and anonymous online forums as sources of knowledge for people trying to gather and share information about infertility and treatment (harrison 2014; omurtag et al. 2012; speier 2011). feminist philosopher nancy tuana (2006) argues that the women’s health movement can be characterized as “an epistemological resistance movement” to reclaim, transform, and unleash knowledge about women’s bodies. activists gain and dispense knowledge and expertise about reproductive bodies and functions through performing vaginal self-exams (murphy 2004), reading and sharing health manuals such as our bodies, ourselves (davis 2007a), and forming reproductive health collectives (roberts, ross, and kuumba 2005). the above examples from the women’s health movement emphasize the importance of knowledge grounded in women’s experiences, particularly their embodied experiences. according to sociologist patricia hill collins (2000), the role of concrete experience in knowledge production and truth-telling is a kind of “wisdom” that lends credibility. sociologist dorothy smith (1991) likewise emphasizes the role of experiential knowledge, which is also located in and through the body. writing about women’s subjectivity in standpoint epistemology, smith describes the “woman knower” who “stands outside textually mediated discourse, in the actualities of her local and particular world. she exists in and as a body that is the body of a woman” (1991, 159). with this paper, i hope to contribute to this scholarship by highlighting the importance of knowledge construction, evaluation, and the use of meaning-making activities in reproduction, including utility in decision-making about the timing of childbearing, behaviors related to seeking medical help, and reliance on technology. anthropologist brigitte jordan (1993) describes the embodied knowledge of a laboring woman in her classic study of childbirth; here, the woman reads signs and signals from her own body, which inform her about, e.g., when to begin pushing. in medicalized childbirth, however, a woman’s embodied knowledge usually exists simultaneously with competing knowledge claims that are more procedural, status-bound, and typically accepted as authoritative. according to jordan, “in any particular social situation a multitude of ways of knowing exist, but some carry more weight than others. some kinds of knowledge become discredited and devalued, while others become socially sanctioned, consequential, even ‘official,’ and are accepted as grounds for legitimate inference and action” (1993, 150). what is important is not just what women know about fertility and about their bodies, but how they know what they know, and how they make use of their knowledge. methods this project primarily relies upon qualitative, semi-structured interviews conducted in two waves. between 2012 and 2014, i conducted interviews with 72 childless women either in person (primarily in public places such as coffee shops and parks), by phone, or over skype. in order to participate in this first wave of the study, participants needed to identify as a woman between the ages of 25 and 40, childless or not having given birth to any children, and residing in the united states. initially, i recruited participants by word-of-mouth through my own social networks, and then through ‘snowball sampling.’ this meant that participants turned to their own social networks (both real and virtual) to inform friends and acquaintances about the study and, in some cases, they provided me with contact information so i could directly reach out to potential research participants. the logic for this chainreferral, nonprobability-sampling technique is that childless women in their twenties and thirties are likely to know others who also met the study’s criteria. to compensate for the limitation of a small nonprobability sample, i aimed to include a sample that was diverse in terms of race/ethnicity, age, relationship status, and sexual orientation (see table 1). the martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 33 sampling method and inclusion criteria resulted in an overrepresentation of both highly educated and queer-identified women. participants were initially recruited from the northeast and mid-atlantic regions of the united states, and the snowball-sampling process resulted in additional participants from the west, midwest, and southern regions. there was participation from women residing in urban, suburban, and rural areas of these regions. participants were recruited and data was collected until both a diverse sample and data saturation were achieved (morse 1995). initial interviews with participants included a number of topics related to reproductive intentions and desires, family histories, and work/family conflicts. between 2017 and 2019, a follow-up study was conducted to track fertility outcomes (i.e., pregnancies and births) and changes in participants’ desire for children. this second wave of data was collected from 56 participants, each of whom completed an electronic survey; a smaller subsample also participated in a second round of in-depth qualitative interviews. in both waves, each interview took approximately one hour, was audio-recorded, and was later professionally transcribed. all names included in this article are pseudonyms. interview transcripts were inductively and thematically coded using the qualitative-analysis software atlas.ti. i used a process of open coding to generate general themes, and then used an iterative process that relied on axial coding to generate and relate categories and subcategories (strauss and corbin 1990). the majority of cases cited in this article draw upon the first wave of interviews, which included explicit questions about fertility knowledge and awareness. for this article, i specifically focus on the themes of knowledge about and awareness of women’s health, fertility, infertility, and assisted reproductive technologies. characteristics n = 72 mean age 32 race/ethnicity • white (not hispanic) 56 (78%) • women of color 16 (22%) sexual orientation • heterosexual 45 (62.5%) • lesbian/ bisexual/ queer/ other 27 (37.5%) relationship status • single 22 (31%) • partnered/ married 50 (69%) highest level of education • high school graduate or some college 5 (7%) • bachelor’s degree 22 (30.5%) • master’s degree 27 (37.5%) • doctoral or professional degree (jd, md, or phd) 18 (25%) table 1. sample characteristics of the interview participants although quantitative surveys offer a means to measure and quantify women’s awareness of fertility, age-related fertility decline, the effectiveness of fertility treatments, and related topics, these are not the focus of this article. rather than attempt to measure the amount or accuracy of participants’ knowledge, the use of in-depth qualitative interviews allowed me to gain a deeper understanding of how women assess and make sense of their own level of knowledge. martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 34 women’s self-assessments are important because public-awareness campaigns in various countries, including the united states, tend to presume that women lack education or knowledge about their infertility risks and age-related fertility decline. in this study, i aimed to assess childless women’s perceptions of how much they already knew on this topic. i asked the study’s participants specific questions about how knowledgeable they were about fertility, fertility decline, and infertility treatments; this included further probes about the relationship between aging and difficulty in conceiving. here, i find it important to make a distinction between how women typically assess their own general knowledge of in/fertility—i.e., information such as when fertility begins to decline on average, the relative effectiveness of infertility treatments, and factors that contribute to infertility, such as aging—and their assessment of their own fertility, which refers to their personal ability to conceive and birth a child. as i describe below, even when strong assertions of knowledge were made in the general domain, this did not necessarily translate to knowledge about or action in the personal domain. from confidence to doubt: self-assessment of infertility awareness during the interviews, i asked participants how knowledgeable they were about fertility, infertility, and reproductive technologies, and they responded with a self-assessment. participants’ self-assessments were not necessarily a reflection of how much they knew, but rather how much they thought they knew. this did not appear to be a reflection of education or other social categories, as each category contained a diverse range of education levels, ages, racial backgrounds, and sexual orientations. during the coding process, i identified three general categories related to how much knowledge participants attributed to themselves, and i then used an iterative process to go back and tag relevant sections with one of the three categories.1 i refer to these three categories of knowledge assessment as confident informationseekers, self-doubters, and novices. confident information-seekers ‘confident information-seekers’ is the term i apply to those women who strongly asserted their knowledge about fertility. this group comprises the largest category (29 women, or 40% of the total sample). confident information-seekers include those who described themselves as being “above average” in their knowledge, or who used phrases such as “pretty knowledgeable” or even “extremely knowledgeable” about fertility. two participants, unprompted by me, even used likert scales to characterize their knowledge as 3 on a scale of 0 to 5, and 7 on a scale of 1 to 10. all of the women in this category described what they knew about the point at which women’s fertility begins to decline on average, and about the ease or difficulty of getting pregnant. in addition to feeling secure about how much they knew about fertility, this group also seems to be characterized by a desire to do research and acquire more information. as i discuss below, the women’s knowledge came from a variety of sources, including from family members and books. some women also explained to me why they had above-average knowledge about fertility. within this group, some had actively sought out information or conducted research on their own because of an abstract interest in women’s health issues. others obtained their knowledge through workor school-related training in subjects such as nursing, biology, genetics, and sexual health. this group also includes those who said that their desire to learn about fertility stemmed from their plans to conceive. both personal and professional interests often intertwined to bolster this knowledge-seeking. for example, brooke, who was 34 during her initial interview, described how a job she once had at a women’s health clinic fed her interest in the topic: martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 35 my knowledge comes from two different places. one, personal interest. i’m just very interested in it. the second part is before i went back to school, i had a job where i worked in a women’s health clinic. it was an administrative position. it was for seven ob-gyns [obstetrician-gynecologists], and i spent my free time reading everything i could get my hands on. i filed lots of charts and, while i was filing them, i would, like, look at people’s stuff. i talked to the medical assistants. i was just very curious. i always am about whatever job i do. that was one that particularly had my interest so i tried to learn as much as i could about . . . fertility issues. it’s been an interest that continues, especially since it has a political dimension. it’s something that is interesting to me. similarly, belinda (age 34), attributed both personal and professional interest to her knowledge about fertility. belinda is a nurse who described herself as “pretty knowledgeable,” but said that she “had researched [fertility] pretty well” even before training as a nurse. her education to become a nurse only served to increase her knowledge: “as a nurse, i think i learned a whole lot more, so i would say that i am far above average on education for fertility.” self-doubters i categorize 22 of the women (30.5%) in my sample as ‘self-doubters’. self-doubters include those who were quick to state that they were not “experts.” typical statements included: “not an expert but not completely ignorant on the subject,” and “i think i’m very knowledgeable, but i’m not an expert.” in actuality, self-doubters may be quite knowledgeable about fertility but they were less confident about what they knew. for example, wilma (age 38) went to nursing school to become a midwife, worked in a postpartum unit, and pursued a ph.d. to research childbirth. to someone without training or experience in fertility or maternal health, wilma would likely be considered very knowledgeable about women’s health, but wilma did not see herself this way. instead, she described her knowledge about fertility as “. . . impressionistic. i don't know any actual figures. i mean, i know that your fertility drops off somewhat steeply, although that is debated, after 35. i guess it’s debated how much it drops off.” like the confidential information-seekers, self-doubters may have sought out information to educate themselves about fertility, but they were more likely to acknowledge how much they still do not know. novices i refer to the third and smallest group (12 women, or 17%) as ‘novices’. this term comes directly from a participant, shante (age 35), who pithily used it to describe her lack of knowledge about fertility. like others in this group, she stated that she did not know much at all about fertility; most of these participants were even less confident about their knowledge than the self-doubters. again, even though they may actually be quite knowledgeable, when responding to questions about how much they knew about fertility, they characterized themselves as having “minimal” awareness or being “not too knowledgeable.” in shante’s case, she was aware that age 35 is “the age where you need to start to get things on the ball if you’re going to do it,” and have increased risks. she had also received conflicting information from medical professionals about the relationship between age and fertility decline: i had one doctor say, ‘women are getting pregnant a lot later. if you keep yourself in good health, in good shape, exercise, you do all those things, it’s very possible. don’t stress. don’t worry about it.’ then i’ve had it from the perspective of textbook, pretty much. ‘these are the times that you know risks are more prevalent. make sure that you are careful, if you’re thinking about it, maybe you should start to think about it.’ i've had it from both ends. martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 36 such conflicting messages may contribute to shante’s sense that she lacks precise knowledge about fertility despite the fact that, by many measures, she was fairly knowledgeable about age-related fertility decline. some novices expressed embarrassment about what they perceived to be their lack of knowledge. alex (age 31) felt that she should know more than she does, telling me that she was “not as knowledgeable as a women’s studies major should be. it’s slightly embarrassing.” as with the self-doubters, novices may possess general knowledge about infertility or age-related fertility decline but, because they could not cite hard facts or statistics, they did not value their own knowledge. the category of ‘novices’ also included women for whom having children was not yet on their radar, or who were totally uninterested in ever having children. sources of knowledge: how do women know what they know about infertility? as i suggested above, when describing how much knowledge they felt they had about fertility, some participants also made claims about their information sources. these include expert knowledge gained through education and training or received directly from medical providers, knowledge gleaned from media and popular culture, and information passed on to them by family members, friends, and acquaintances. as some historians and women’s health scholars have articulated, the rise of procedurallyand technologically-based medical knowledge has often come at the expense of other knowledge sources, particularly in the realm of reproduction; this means that the expertise of, e.g., physicians supercedes the expertise of midwives (ehrenreich and english 2010; jordan 1993; rothman 2000). mothers, those seeking to become mothers, and anyone with the potential to one day become a biological mother are expected to seek out expert knowledge about pregnancy, childbirth, and childrearing in order to fulfill cultural expectations of motherhood and gendered subjectivity (hays 1996; waggoner 2017; miller 2003; rothman 2007). even if they did not necessarily describe themselves as “experts,” the study’s participants relied on education, training, and information they received from experts, particularly those in medical and scientific fields. participants cited the technical or scholarly information they learned via attending classes or work/volunteer training in fields related to health and biology, including nursing, midwifery, acupuncture, and genetics. they also received general knowledge about fertility and age-related fertility decline directly from medical providers. this information was not necessarily based on individual women’s biomedical profile or history, but rather the conveyance of generalized facts and statistics. conversations were initiated by either the medical provider or the woman about such topics as birth control or the timing of pregnancy. in addition to these forms of expert knowledge, the study’s participants also cited two additional sources of information: the media, and familial and peer sharing. due to patient mistrust, some individuals may act as “biological citizens,” seeking out health information on their own; this may sometimes contradict or disavow medical authority in favor of their own agency (rose and novas 2005). moreover, the internet and social media have facilitated the ability to seek out health-related information, including fertility-related information, from peers and other nonmedical sources (nettleton, burrows, and o’malley 2005; hardey 1999; hammarberg et al. 2017). when asked how they know what they know about fertility, some participants described conducting research and selfeducation on their own. they sought out books about fertility and tried to track down information on the internet. sometimes, they came across new information that challenged expert opinions about age and fertility. for example, several mentioned reading an article by psychologist jean twenge (2013) in martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 37 the atlantic monthly; it made them question whether one’s fertility really does steeply decline at age 35: marie (age 29): i’ve heard a lot [about fertility] but since reading the atlantic article, maybe i don’t know as much as i thought i knew. . . . the number-one thing that jumped out at me, which i think is what the article was sort of centered around, was that apparently a lot of this data that people cite about fertility declining was from populations from like 1670 to 1830 or something like that. i’m not a scientist, but i would like to dig into that a little bit more – like, what exactly were they looking at, like, how much could that be influenced by our different nutritional levels and, you know, we’re a lot taller than we were then, and we live a lot longer. natalie (age 37): i recently read the article, i forget if it was from the atlantic . . . it’s like this data that we have about women’s decline in fertility is based on french women from the 18th century. . . . so, i was, like, okay, that made me feel a little bit better. that’s been the knowledge i’ve been working with, has been the, you know, once you hit 30 you’re already starting to go down, and then past 35 is just a really quick slope into infertility. despite the idea of an age-related “fertility cliff” (waldby 2019) that some women have absorbed—and that reproductive medicine still generally upholds (practice committee of the american society for reproductive medicine 2014)—several of the study’s participants were willing to push back against this narrative. for example, lizzie (age 33) was a confident information-seeker who told me she knew “probably way more than most” about women’s fertility. describing herself as a “collector of knowledge,” she described how she sought out and assessed internet sources: the internet is a fountain of wealth if you dig though all the chat. you can actually find real good solid knowledge. i try to compare and contrast knowledge, so i’ll go to planned parenthood, and then i’ll go to an anti-abortion site. i figure if they agree on something, [then it’s] probably good knowledge. that’s how i collect my knowledge on the internet. . . . i’m a little bit more thorough than most. in addition to information from internet sources, lizzie also relied on what she learned and “collected” from personal contacts; these include her mother who is a labor and delivery nurse, friends who have experienced pregnancy, and a human sexuality class she took in college. as lizzie’s example indicates, in addition to online and media sources, individuals also seek out health information from their personal contacts; e.g., family members, friends, and work colleagues. participants in this study relied upon stories they heard about others’ ease with or difficulty in conceiving. as such, awareness of others’ experiences with infertility and treatments seems to inform what they know about fertility, infertility risks, aging, and the existence and effectiveness of reproductive technologies. sociologists sheila r. cotten and sipi s. gupta (2004) describe these personal sources as “local experts”; i.e., people who have experience with a medical condition and may appear to be a more approachable source for advice and health information than medical providers. in one location where i conducted in-person interviews, i spoke individually with three different women who all cited the same friend as a source of information. this person acted as a “local expert” in their shared social network because they had experienced infertility and were seeking fertility treatments. by conducting research and relying on stories from within their own social networks, combined with any information acquired from experts, lizzie and other study participants displayed their “biological martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 38 citizenship” (rose and novas 2005) and “epistemological resistance” (tuana 2006) as they considered and assessed knowledge about fertility, age-related fertility decline, and fertility treatments. how do women know what they know about their own fertility? knowing general facts and statistics about infertility or age-related fertility decline is different from having a sense about one’s own ability to conceive. that is, a person might be familiar with ‘common’ (albeit contested) knowledge about fertility decline after age 35, but this general knowledge is not necessarily helpful for gauging at what age a specific person should begin trying to conceive, whether or when they should seek medical assistance, or if they have undiagnosed infertility. therefore, in my interviews with this group of childless women, i also asked if they had any idea about their own fertility or their ability to conceive and carry a child. in the following section, i present several cases that illustrate the different sources and types of knowledge that women incorporate into their understandings of their own fertility. in addition to the sources of knowledge mentioned above (e.g., experts, media, and family/peers), two new sources of knowledge emerge: biomedical knowledge and embodied knowledge. biomedical knowledge reproductive endocrinologists and other physicians focusing on reproduction and fertility typically use a variety of tests to diagnosis and predict infertility in adult women (practice committee of the american society for reproductive medicine 2015). these may include ovarian reserve testing, which measures the number and quality of eggs through hormone tests and ultrasound. a woman’s access to such biomedical knowledge about fertility can be both empowering and confounding. in an ethnographic study of individuals who used ovarian reserve testing, anthropologist moira kyweluk’s (2020) participants reported gaining a sense of control from learning more information about their likelihood of future conception. this was especially important for lgbtq and single participants who would not otherwise meet medical criteria for infertility diagnoses. however, the results of fertility tests did not necessarily translate into kyweluk’s participants knowing what to do with this information, nor did the results contribute to their reproductive decision-making needs. several of the participants in my study also grappled with obtaining and acting upon biomedical knowledge about their fertility. marta was 30 years old when i first interviewed her over the phone in 2014. ambivalent about having children, she told me that she had been thinking a lot about her own “biological timeline” since turning 30. when i asked marta how knowledgeable she felt about women’s fertility as it related to aging, she replied that she was “pretty knowledgeable.” like the other participants who i refer to as ‘confident information-seekers,’ marta assessed her own awareness about fertility as relatively high, in part because of the research she had sought out on her own. in our conversation about children, fertility, and her own reproductive future, marta several times brought up a book she had recently read, the big lie: motherhood, feminism, and the reality of the biological clock (selvaratnam 2014). this book happened to be on my own bookshelf, and i recalled that it had an image of—no surprise here—an hourglass on its cover. in this book, author tanya selvaratnam catalogs her own pursuit of motherhood while dealing with infertility, and she expresses anger that she and other women like her had not been given adequate information about age-related fertility decline. selvaratnam advocates that women pursue this knowledge and become informed about “the reality of their biological clocks” (2014, 229). this advice is somewhat akin to the women’s health activists who had previously advocated for women to take control and learn more about their bodies with speculums and mirrors (murphy 2004; davis 2007a). but selvaratnam suggests very different means: instead of martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 39 women relying on their own hands and embodied experiences through the use of ‘do it yourself’ methods, ovarian reserve testing relies upon medical expertise and technology. this reliance on medical expertise ultimately proved to be a barrier for marta in her quest for more selfknowledge. after reading selvaratnam’s book and seeing an episode of the sitcom “new girl” about egg freezing, marta decided to get a blood test and ultrasound in order to get a sense of her own fertility. “i think most women—unless they’ve been around people who can’t have kids—just think they can get pregnant when they want to,” said marta. “reading that book and seeing that now is the time to find out what i’m working with, so to speak, really inspired me to be armed with as much education about myself as possible so i can make educated decisions.” although she had not yet pursued diagnostic tests, marta told me in her first interview that she had already visited a fertility clinic “just to open the dialogue.” at the clinic, they explained the process of egg freezing, which she said turned her off: “it’s ten days of injecting yourself with shots, and your body goes through all this crap it’s not meant to be going through at that time. it was a little bit scary, but doing the blood test and the ultrasound are not scary, so i’ll take those steps first.” four years after our initial conversation, i interviewed marta, who was then age 34, by phone. because she had never tried to get pregnant, marta told me that she still did not know whether or not she would have difficulty conceiving or need fertility treatments. the diagnostic tests that she had been so determined to take during her first interview had still not transpired. again, marta brought up the big lie and the feeling she had when reading it that she wanted to get as much information about her body as she could. a blood test and ultrasound were still on her agenda; however, marta said that she recently asked her doctor about whether she could still take “one of those tests” to measure her fertility, and she was informed that her doctor would not administer it unless she had been trying to get pregnant without success. so, to what end should attaining knowledge about one’s body be pursued? in marta’s case, there was a contradiction between why marta sought knowledge about her body, and what her doctor perceived to be an appropriate use of diagnostic tools. even though marta wanted to learn about her body and her fertility for her own knowledge—i.e., to help her make decisions about whether to pursue having children or to freeze her eggs—from her physician’s point of view, measuring fertility should only be done while actively trying to conceive and in the direct pursuit of an infertility diagnosis. thus, marta could freely pursue general knowledge about the relationship between fertility and aging, but she lacked—and was denied—the tools to pursue personalized biomedical knowledge about her own ability to conceive. other than those women who were actively attempting to conceive, most participants in this study had not undergone ovarian reserve testing. one exception was arie (age 37), who was determined to become a mother but worried about running out of time. she had already tested her fsh (follicle-stimulating hormone) and amh (anti-müllerian hormone) levels to gauge how easily she might conceive. she had had her fsh tested when she was 33 and then again shortly before being interviewed, along with two other hormone tests. because her results were contradictory, she had scheduled an appointment with a fertility specialist. arie was in somewhat of a bind, though, because she wanted to know definitively about the likelihood of having a biological child one day but she also worried about what she might learn: am i making a mistake by going to the doctor to face whatever they’re going to tell me so then i have the knowledge, so i can’t go on a date or go out with a guy and get to a martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 40 point where, i mean, at some point if i find out i can’t have kids, i’m going have to tell them. . . . in future relationships, would i be better off just not knowing so that i could go into a relationship and then [we] figure it out together? in a follow-up email to me, arie disclosed that the fertility specialist had informed her that she still had viable eggs, but a low reserve of them; this meant that she should act quickly to either freeze her eggs or inseminate with a sperm donor. knowledge obtained from family and friends assessing one’s own fertility can take the form of relying upon biomedical knowledge (as marta and arie did), undergoing diagnostic testing for evidence of fecundity, or receiving information from fertility experts about the probable chances of conceiving or carrying a pregnancy to term based on particular health conditions. however, acquiring biomedical knowledge from these sources may make one reliant on medical gatekeepers. thus, just as women like lizzie gained general knowledge about fertility from “local experts” within their own social networks (cotten and gupta 2004), some participants in my study also relied on stories told by family members, friends, and acquaintances in order to self-assess their own fertility. in some cases, discussions between friends may contradict medically-informed information about fertility. for example, ruthie (age 33) told me that she was pretty sure she wants to have a child. she belonged to the group i describe as ‘self-doubters.’ although she said she had “a decent amount of knowledge” about women’s fertility—in part because she grew up in a family with “fairly high access to medical information”—she qualified how much she actually knew: “i . . . feel like things are changing so fast in the field of fertility and reproductive health that i’m not sure that i actually feel like i’m a super-knowledgeable source.” within ruthie’s circle of friends, people talked about having kids on their own timelines, without much worry about the effect of aging on infertility. but when ruthie attended a training session for volunteer doulas (i.e., people who provide physical and emotional support during childbirth), the topic of an “optimal age” to conceive came up, and ruthie characterized it as contradicting how her friends thought about the relationship between age and reproduction. “i feel like i just had this moment where it struck me where it was just like hearing someone say, ‘oh yeah, it’s optimal to have kids between 25 and 35,’ and just kind of being thrown off because that’s not a fact that’s flung around in most of the circle that i’m in, and then kind of having a moment of, like, ‘oh my god, i’m almost 35.’” the significance of age 35 (or age 30 in marta’s case) in relation to fertility has larger cultural resonance in the united states and other western nations, as this age is frequently invoked as a milestone in the life course. specifically, it is the age at which pregnant people are labelled “geriatric” because they have a greater risk for having children with genetic conditions, and it is the age at which egg quality is assumed to begin its rapid descent (martin 2017; waldby 2019). this medically informed concern about age-related fertility decline was reinforced by ruthie’s mother, a physician who suggested that she and her partner freeze their sperm and eggs; she also warned ruthie that she had “read that babies born to mothers [over 35] are higher risk.” these conversations about aging seemed to impact ruthie’s feeling that she should have a child “within the next year and a half – like, i need to just make that a priority and get it done.” family lore also informed some women’s self-assessments of their own fertility. this meant that, in order to gauge their own fertility, women often considered their family members’ ease with or difficulty martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 41 in conceiving, their histories of miscarriage, and their use of reproductive technologies. for example: ingrid (age 27): you know, i don’t really know if i’m fertile or not. i take birth control because i just don’t want to have kids. historically in my family, my mom got pregnant late in life, and she didn’t need a lot of help, and my grandmother had twins without knowing it at a time when they were really poor. . . . there aren’t a lot of fertility problems in my family. my extended family, it seems like everyone has tons of kids. daphne (age 32): my cousin was actually unable to have kids. it hasn’t been a problem with anybody else in the family, but i tend to take after my aunt and my cousin more. … we are actually pretty similar. i have always wondered kind of about that. here, daphne claimed that her physical resemblance to some family members in terms of “body type and features and things like that” made her think that she may also share with them a genetic propensity towards problems with fertility. embodied knowledge another important source for women’s self-assessment was their embodied knowledge. according to sociologist kathy davis (2007a, 13) women are epistemic agents whose bodily experiences are “never a simple reflection of reality,” but they can “still be used as a starting point for understanding what it means to live in a particular body, at a specific moment in time, or in a particular social location”, and that this knowledge “can be juxtaposed with other forms of knowledge.” in my study, many of the women intuited information about their fertility based on their own bodies, experiences, and histories, but this knowledge was not necessarily isolated from information they received from experts, family members or peers, or through their own research. instead, they incorporated it with their own sense of what was happening to or within their bodies. as epidemiologist abby lippman (1999, 259) writes in her study of prenatal diagnosis, “embodied knowledge resulted from various transformative, interpretive, and integrative processes in which women engaged to refashion ‘received’ biomedical information, taking ownership of it and weaving it together with their own experiences and understandings and with ‘inside’ information, their feelings and beliefs.” the “inside information” to which the childless women in my study referred included prior pregnancies, lack of unintended pregnancy after unprotected sex, their history of birth-control use, the duration and frequency of their menstrual cycles, experiences with polycystic ovary syndrome (pcos) or other health conditions, or just “knowing”—i.e., having an internal sense about their probability of conceiving. like marta, ruthie’s actual fertility remained unknown to her except for the fact that she had never had an unplanned pregnancy in over a decade of sexual activity. since she had not yet intentionally tried to conceive, she worried about how difficult it would be to become pregnant. in fact, the thought of not being able to get pregnant was so scary to her, ruthie said that she was almost afraid to even try. despite these concerns, ruthie had not (as marta and arie had done) embarked on a quest for information about her own ability to conceive. never experiencing pregnancy, even an unplanned one, was significant for a number of participants, including jeannie (age 28). she told me that she wants to have children someday but did not know how easy or difficult it would be to get pregnant: this is kind of embarrassing. because i really don’t know anything about anything, but it’s definitely crossed my mind. i've been on birth control since i was 14 because i would martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 42 get my period every two weeks and pass out. i wasn’t, like, sexually active at 14. i’m, like, kind of worried about what my body’s going to do when i go off [birth control]. i don’t know. are there long-term effects to taking birth control for that long? i have no idea. i’ve made up scenarios in my head that are terrible. i should probably just research it. in this case, jeannie felt that she lacked the kind of embodied knowledge that would help her assess her fertility. because she had never tried to get pregnant and had been on birth control continuously since she was a teenager, she believed that she could not know her odds for becoming pregnant. moreover, she did not know “what [her] body’s going to do” if she stopped using birth control. whereas jeannie admitted that she did not know much about her own fertility, other women in the study expressed a “sense” or intuition about what their bodies were capable of. for example, gwendolyn (age 35) said that she does not want children but also does not think she would get pregnant easily. gwendolyn: i’ve never tried. and i’ve never had any sense – well, i have an intuitive sense that i would not have an easy time, but that’s just my psychology rather than anything. but intuitively, i don’t think it would be very easy for me. author: do you have any idea why it might be difficult? gwendolyn: well, i have health issues. i’m a very healthy person, and i exercise and eat well and whatever, but i just feel that my body has always had a harder time doing things than most people. i feel that that would be one more – you know, if i really wanted to have kids, i feel like it would give me a hard time just because it’s always given me a hard time. similar to jeannie, gwendolyn had never attempted to get pregnant, yet she relied upon her ‘gut feelings’ and intuition to make what she considered to be an educated guess about her ability to conceive. in gwendolyn’s case, her past experiences with her body having “a harder time doing things than most people” influenced her assessment of her own fertility. combining knowledge sources some women in the study used a combination of different types of knowledge to assess their ability to conceive. for example, at the time of her initial interview, jennifer (age 33) was actively attempting to get pregnant yet had so far been unsuccessful. i categorized her as a ‘self-doubter’ because, even though she described herself as becoming more knowledgeable about women’s fertility, she said, “i probably would embarrass myself if given a quiz. i do have the book taking charge of your fertility.” as far as assessing her own fertility, jennifer mentioned her mother, who had experienced infertility and a series of miscarriages but then got unexpectedly pregnant with jennifer years after adopting a child. jennifer also knew how “emotionally painful” infertility can be, based on a friend’s experience with ivf after not being able to conceive. “it’s tough,” jennifer said. “the desperation to have a child and then kind of not being able to.” moreover, jennifer had access to some biomedical knowledge about her own fertility from physicians: “i have one ovary because i had an ovarian torsion a few years ago so i’m working with half. i had an iud [intrauterine device], and i had it removed, and the surgeon said, ‘you’ve got some fibroids. that martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 43 can affect fertility. i wouldn’t suggest waiting. i would just go to the fertility specialist right now.’” despite being urged to seek fertility treatment, jennifer was hesitant. she was too busy to make time for an appointment, and she also worried about the possibility of having triplets if she went through ivf. recalling her friend’s “unpleasant” and unsuccessful experience with ivf, jennifer said, “one of the reasons i haven’t gone [to a specialist] was: what if they tell me i can’t do it at all? that’s obviously a concern but everyone has to bite the bullet.” by not seeing a fertility specialist, jennifer managed to shield herself from knowledge that she potentially did not want to hear; this echoed the fears that marta and arie expressed in relation to learning unwanted information. in the meantime, jennifer and her husband were trying to conceive without medical intervention. instead of seeking out biomedical treatment, jennifer wanted to be “more in charge of my fertility” by using ovulation test strips, which enabled her to rely upon embodied knowledge about her body and its natural cycles. another source of embodied knowledge was an unplanned pregnancy that she terminated early in her relationship. like other women in the study, jennifer hoped that previous pregnancies—even if they were unplanned and terminated—were at least evidence that conception would be possible in the future. through their evaluation, use, and/or rejection of different types and sources of knowledge, jennifer and the other women in the study thus acted as epistemic agents, literally “taking charge of their fertility,” as so many told me they were eager to do. discussion and conclusion in my study, the women claimed to possess different degrees of knowledge about fertility, regardless of their educational background or other social characteristics. this led me to categorise them as confident information-seekers, self-doubters, or novices. however, their self-assessment did not necessarily correlate with how much they actually knew, or how accurate their information was. thus, the women’s awareness of the relationship between aging and fertility decline did not necessarily translate to their individual self-knowledge about their own bodies and fecundity. furthermore, certain knowledge claims were based on multiple information sources. whereas some women relied on their formal education or diagnoses from physicians, others counted on their family history, signs they read from their own bodies and bodily processes, and even upon intuition. this raises many questions about authoritative knowledge—i.e., the knowledge that “counts” for women as they make decisions regarding future childbearing (jordan 1993). in some cases, “objective” medical or scientific claims from medical providers may provide women with useful information that helps them engage in reproductive decision-making, but this is only useful when they are given access to the knowledge they seek about their bodies (kyweluk 2020). expertderived knowledge may also be devalued or rejected by those women who research and seek out information on their own from sources such as social media or peers, or other non-medical sources, and who thereby enact their “biological citizenship” (rose and novas 2005; hammarberg et al. 2017). some women may also display epistemological resistance (tuana 2006) or exert epistemic agency (davis 2007b) when they take their own experiential and embodied knowledge as the most authoritative source to guide them in their reproductive decision-making. public-health campaigns often attempt to influence women’s childbearing behavior in a normative fashion, yet it is debatable whether they serve as authoritative sources of information that play a role in individual reproductive decision-making. in order to increase awareness about fertility and/or agerelated fertility decline, it is important to acknowledge the multiple sources of information that women typically seek out and rely on; teaching individuals how to locate and evaluate health information may martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 44 be a more sensible public-health goal (demner-fushman, mrabet, and ben abacha 2020). furthermore, while public-awareness campaigns aim to increase women’s general knowledge about potential risks to their fertility, including aging, what these campaigns cannot do is increase women’s individual knowledge about their own body’s ability to conceive. many participants in my study displayed an understanding about the differences between aggregated and statistical data (i.e., when women on average experience fertility decline) and individual circumstances (i.e., how one’s body, experiences, and family history impact one’s ability to conceive). my study suggests that, when it comes to assessing their own fertility, some women may not weigh average statistics about age-related fertility decline and other infertility risks as strongly as individual biomedical diagnostics, family histories, and embodied knowledge. despite the assumptions embedded in many public-health campaigns—i.e., that women are unaware of or uneducated about the potential risks of aging on their fertility—my study indicates that childless women are actually quite knowledgeable. they may doubt how much they know, or defer to the expertise of physicians and scientists, but nearly every woman i interviewed knew that, as we age, it becomes more difficult to conceive. images of hourglasses and clocks that evoke panic or anxiety are used to encourage women to not delay childbearing—but, as i have suggested, such imagery is both trite and unnecessary. by studying where childless women are most likely to receive information—and which sources they are most likely to consider authoritative and meaningful—we can better understand the epistemic context in which infertility awareness campaigns operate. we may also apply this to other domains within the sociology and anthropology of aging beyond fertility and reproduction. publichealth campaigns that attempt to raise awareness about, urge screening for, or nudge other actions regarding conditions or social problems associated with aging (e.g., breast and prostate cancer, cognitive decline, or social isolation) also occur within an epistemic context. it would be worthwhile for qualitative researchers to assess the existing knowledge claims and authoritative knowledge sources of those who, because of the aging process, have been labeled as “at risk” for certain conditions or social problems. notes 1. nine participants (12.5%) did not include much self-assessment of fertility knowledge during their interviews and were thereby not categorized. references american society for reproductive medicine. n.d. 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consequences of delayed childbearing?” journal of health communication 18: 118-28. https://doi.org/10.1080/10810730.2013.825677. hammarberg, karin, rebecca zosel, caroline comoy, sarah robertson, carol holden, mandy deeks, and louise johnson. 2017. “fertility-related knowledge and information-seeking behaviour martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 46 among people of reproductive age: a qualitative study.” human fertility 20 (2): 88-95. https://doi.org/10.1080/14647273.2016.1245447. hardey, michael. 1999. “doctor in the house: the internet as a source of lay health knowledge and the challenge to expertise.” sociology of health & illness 21 (6): 820-32. harrison, katherine. 2014. “online negotiations of infertility: knowledge production in (in)fertility blogs.” convergence 20 (3): 337-51. https://doi.org/10.1177/1354856514531400. hays, sharon. 1996. the cultural contradictions of motherhood. new haven: yale university press. hertz, rosanna. 2006. single by chance, mothers by choice. new york: oxford university press. hodes-wertz, brooke, sarah druckenmiller, meghan smith, and nicole noyes. 2013. “what do reproductive-age women who undergo oocyte cryopreservation think about the process as a means to preserve fertility?” fertility and sterility 100 (5): 1343-1349.e2. https://doi.org/10.1016/j.fertnstert.2013.07.201. johnson, katherine m., and richard m. simon. 2012. “women’s attitudes toward biomedical technology for infertility: the case for technological salience.” gender & society 26 (2): 26189. https://doi.org/10.1177/0891243211434615. jordan, brigitte. 1993. birth in four cultures: a crosscultural investigation of childbirth in yucatan, holland, sweden, and the united states (4th ed., revised and expanded by r. davis-floyd). long grove, il: waveland press. kyweluk, moira a. 2020. “quantifying fertility? direct-to-consumer ovarian reserve testing and the new (in)fertility 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delay in childbearing.” fertility and sterility 90 (4): 1036-42. https://doi.org/10.1016/j.fertnstert.2007.07.1338. martin, lauren jade. 2017. “pushing for the perfect time: social and biological fertility.” women’s studies international forum 62 (may): 91-98. https://doi.org/10.1016/j.wsif.2017.04.004. miller, tina. 2003. “shifting perceptions of expert knowledge: transition to motherhood.” human fertility 6 (3): 142-46. https://doi.org/10.1080/1464770312331369413. morse, janice m. 1995. “the significance of saturation.” qualitative health research 5 (2): 147-49. https://doi.org/10.1177/104973239500500201. martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 47 murphy, michelle. 2004. “immodest witnessing: the epistemology of vaginal self-examination in the u.s. feminist self-help movement.” feminist studies 30 (1): 115-47. www.jstor.org/stable/3178561 nettleton, sarah, roger burrows, and lisa o’malley. 2005. “the 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color: still building a movement.” nwsa journal 17 (1): 93-98. www.jstor.org/stable/4317103. rose, nikolas, and carlos novas. 2005. “biological citizenship.” in global assemblages: technology, politics, and ethics as anthropological problems. edited by aihwa ong and stephen j. collier, 439-63. malden, ma: blackwell publishing. rothman, barbara katz. 2000. recreating motherhood: ideology and technology in a patriarchal society. new brunswick (n.j.): rutgers university press. rothman, barbara katz. 2007. “laboring now: current cultural constructions of pregnancy, birth, and mothering.” in laboring on: birth in transition in the united states. edited by wendy simonds, barbara katz rothman, and bari meltzer norman. new york and london: routledge. https://doi.org/10.4324/9780203944554-10. selvaratnam, tanya. 2014. the big lie: motherhood, feminism, and the reality of the biological clock. amherst, ny: prometheus books. smith, dorothy e. 1991. “writing women’s experience into social science.” feminism & psychology 1 (1): 155-69. https://doi.org/10.1177/0959353591011019. martin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.259 http://anthro-age.pitt.edu 48 soules, michael r. 2003. “the story behind the american society for reproductive medicine’s prevention of infertility campaign.” fertility and sterility 80 (2): 295-99. https://doi.org/10.1016/s0015-0282(03)00667-8. speier, amy r. 2011. “brokers, consumers and the internet: how north american consumers navigate their infertility journeys.” reproductive biomedicine online (reproductive healthcare limited) 23 (5): 592-99. https://doi.org/10.1016/j.rbmo.2011.07.005. strauss, anselm l., and juliet m. corbin. 1990. basics of qualitative research: grounded theory procedures and techniques. newbury park: sage publications, inc. tuana, nancy. 2006. “the speculum of ignorance: the women’s health movement and epistemologies of ignorance.” hypatia 21 (3): 1-19. https://doi.org/10.1111/j.1527-2001.2006.tb01110.x. twenge, jean. 2013. “how long can you wait to have a baby?” the atlantic, no. july/august: 54-60. https://www.theatlantic.com/magazine/archive/2013/07/how-long-can-you-wait-to-have-ababy/309374/. waggoner, miranda r. 2017. the zero trimester: pre-pregnancy care and the politics of reproductive risk. berkeley, ca: university of california press. waldby, catherine. 2019. the oocyte economy: the changing meaning of human eggs. durham: duke university press. https://www.dukeupress.edu/the-oocyte-economy. book review review of aulino, felicity. rituals of care: karmic politics in an aging thailand. ithaca, ny: cornell university press. 2019. pp. 210. price: $ 125 (hardcover); $24.95 (paperback); $16.99 (ebook). katrina vincent-forbes university of southampton katrinavforbes@gmail.com anthropology & aging, vol 42, no 2 (2021), pp. 175-176 issn 2374-2267 (online) doi 10.5195/aa.2021.369 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:katrinavforbes@gmail.com book review | vincent-forbes | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.369 http://anthro-age.pitt.edu 175 book review review of aulino, felicity. rituals of care: karmic politics in an aging thailand. ithaca, ny: cornell university press. 2019. pp. 210 price: $125 (hardcover); $24.95 (paperback); 16.99 (ebook). katrina vincent-forbes university of southampton katrinavforbes@gmail.com in rituals of care, anthropologist and ethnographic filmmaker felicity aulino examines care practices predominantly in northern thailand. this ethnographic monograph uses a critical phenomenological approach to provide detailed information on how thai people care for their elderly relatives who are nearing the end of their lives. aulino’s work is a strong contribution to the study of aging in the field of medical anthropology specifically because of the focus on the embodied performativity of care evident in her research practice and analysis. with this monograph, the author attempts to deal with what she feels are lacks in anthropologies of care, stating that my focus is care in the everyday, and the ordinary is the route by which i want to bring attention to the habituated ways people provide for one another — not only at bedsides, but also in the boardrooms, corner stores, or any number of mundane daily interactions. (2) as such, she highlights limitations in the works of certain medical anthropologists who have, in her opinion, primarily focused on “emerging technologies of the self and subject formation, health-care professionalization, and social welfare reform” (22). within this scope, only a few have addressed embodied practices of care. ethnographic inquiries that have focused on embodied practices of care have been limited to mostly european, north american and predominantly christian cultures. to fully unlock care as an object of study, aulino argues, there needs to be more ethnographic inquiries outside of north america and europe (22). as the title suggests, in this book care for the elderly near the end of their lives is examined as a ritual or as the “repetitive acts that achieve effects through their correct performance” (13). aulino here follows in the footsteps of annemarie mol (2008), catherine bell (2008), and seligman and colleagues (2008), but explicitly focuses on the ritual mode of caring as a social practice as opposed to an individual experience: she examines the mundane bathing, cleaning, diapering, and feeding of various thai families as a performative ritual of caregiving, at the end of life (147). examining care as a ritual, allows her to focus on caregivers’ embodied routines in habituated action that “bring a wider range of human experience into view” (24). for example, since buddhism is the predominant religion of thailand, various ethnographic encounters taught aulino how important the concepts of karma and merit are in care practices. karmic debts and merit can span throughout a person’s lifetime. as a result, these are important factors influencing caregiving practices in thailand. karma offers the caregiver a reason to http://anthro-age.pitt.edu/ mailto:katrinavforbes@gmail.com book review | vincent-forbes | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.369 http://anthro-age.pitt.edu 176 accept a situation and merit is made by physically providing care for the elderly or person in need. aulino links care as a ritual to therevada buddhism, the abhidhammic theory of mind, social hierarchies, and the social body. the importance of karma and merit in caregiving practices can also partly explain the importance of volunteerism in thailand, which has become a national strategy to combine caring for the elderly with merit-making. the civic engagement of care is done by relatives rather than non-family members in a typical volunteer setting. caregiving is framed in such a way that the stress is on the merit that volunteers will gain through their good deeds rather than on the obligations that family members must care for their relatives. in chapter 4, aulino explores how volunteerism and caregiving are tightly mixed in with political issues in thailand, because the ways that people care and provide for one another through karma and merit are the very ideas that continue to maintain inequality and oppression. this brings us to the unique insight that, for social and political change to arrive, people would first have to detach themselves from the familiar ways of caring for one another and the social body. thus, framing care as a ritual—both embodied, connecting, religious and political—aulino humanizes the daily care of caregivers and those they care for while making her book an excellent example of the possibilities of holistic anthropology. one criticism of aulino’s books is that it is written very academically with a lot of anthropological jargon that may be difficult for the average audience to understand. this really narrows her audience to academic researchers. despite this, the book would additionally serve as a valuable introduction to those starting their education or career in the field of anthropology, exactly because she goes through many of the anthropological terminologies, defines them, and gives good references that examine these concepts further. overall, rituals of care is an excellent book, which offers a thoughtful approach to everyday care in thailand. by framing care as a ritual, it conveys the everyday mundane rituals included in care and the importance of embodied care practice. it also calls for anthropologists to be creative in their ethnographies by encouraging them to shift away from traditional european and north american populations and cultures. the book is also a great recommendation for those who wish to learn more about therevada buddhism, caregiving, volunteerism, medical anthropology, and thai society and culture in general. aulino delves into specific thai politics, economics, and religious aspects that many scholars may be unaware of. as the world emerges from the covid-19 pandemic, this book will serve as an exceptional starting point for how researchers can begin to examine care and caregiving around the world. references bell, catherine. 2008. ritual theory, ritual practice. oxford: oxford university press. mol, annemarie. 2008. the logic of care: health and the problem of patient choice. london: routledge. seligman, adam b., robert p. weller, michael j. puett, and simon bennett. 2008. ritual and its consequences: an essay on the limits of sincerity. oxford: oxford university press. http://anthro-age.pitt.edu/ from the editors: an introduction tannistha samanta amy clotworthy flame university, india university of copenhagen, denmark tannistha.samanta@flame.edu.in amy@sund.ku.dk anthropology & aging, vol 42, no 2 (2021), pp. 1-2 issn 2374-2267 (online) doi 10.5195/aa.2021.382 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. samanta & clotworthy | 1 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.382 http://anthro-age.pitt.edu from the editors: an introduction tannistha samanta amy clotworthy flame university, india university of copenhagen, denmark tannistha.samanta@flame.edu.in amy@sund.ku.dk since 1979, anthropology & aging (a&a) has demonstrated a strong commitment to publishing research that examines the plural ways of aging across cultural contexts. according to the journal’s focus and scope: anthropology & aging considers articles that expand and enrich our understanding of aging and the life course by utilizing the ideas and techniques of anthropological inquiry. we welcome submissions from scholars and professionals at all levels that showcase the diversity of research and writing within this field. we particularly welcome articles based on empirical research with a strong theoretical foundation that speaks to current topics and conversations going on within the broader fields of anthropology, sociology, social work, medicine, geriatrics, public policy, population studies, human development, and aging studies. this scope is not small. as such, we were honored and humbled when the leadership of the association for anthropology, gerontology and the life course (aage) asked us to take over as co-editors in february 2021. not only are we able to work with a fantastic team ⁠—including our book reviews editor, christine verbruggen, and editorial assistants, janis woodward and brandan culbert—we are also incredibly privileged to collaborate with a range of esteemed editorial board members, authors, students, and peer reviewers who are engaged in the exploration and understanding of aging within and across the diversity of human cultures. as new editors, we intend to take this opportunity to build on aage and a&a’s combined commitment to the multidisciplinary study of sociocultural gerontology while weaving anthropological imagination as the world rapidly ages. it has been heartening for us to receive submissions from a range of countries where authors interrogate, challenge traditional hierarchies of gender and generation, and go beyond the pathological bias of disease and debility. to this effect, we are committed to supporting the research conducted by early-career scholars whose work expands the intellectual ambitions of the anthropological “enterprise” of aging in a variety of ways: e.g., by combating age-related cultural stereotypes in countries where any discussion around “age” is relatively new, and by encouraging our colleagues who specialize in engineering, planning, and the biomedical fields to complement thick description and subsequently reinvent the “applied” dimension of anthropology. we are also acutely aware of the global inequalities of academic knowledge production with regard to the uneven gap in citations between scholars from the global south and north as well as the idiosyncratic and stylistic demands of scientific writing, which remains a challenge for non-english speakers . to address these inequalities and the academic underrepresentation of certain regions, we plan to exercise the utmost care and caution when delivering peer-review decisions on ethnographic work that comes from these regions. additionally, by being fully aware of the geopolitics of knowledge, we intend to reach out to reviewers who have demonstrated intellectual engagement with such “local” particularities. overall, our goal is to ultimately create transregional and transnational circuits of knowledge that highlight multiple perspectives, histories, and regions. http://anthro-age.pitt.edu/ mailto:amy@sund.ku.dk https://anthro-age.pitt.edu/ojs/index.php/anthro-age/about/editorialpolicies#focusandscope https://anthro-age.pitt.edu/ojs/index.php/anthro-age/about/editorialpolicies#focusandscope samanta & clotworthy | 2 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.382 http://anthro-age.pitt.edu to propel this goal forward, we are in the process of creating two new features on our website that will reflect our personal values: an ethics statement, which outlines our pledge to build a supportive and transparent scholarly community; and a diversity and inclusivity statement, which describes our aim to expand the breadth of a&a’s representation. our editorial worldview is that we are responsible for the journal’s integrity and reputation, and that diversity strengthens knowledge creation. thus, we are committed to fostering diversity, inclusivity, transparency, and equity within our internal practices as well as in our scientific publishing efforts. for our upcoming issues, we welcome contributions that offer practice-oriented, theory-driven, and ethnographically rich perspectives on people’s experiences of aging and the life course. our sustained commitment to support this goal is evident from the diversity of authors, peer reviewers, editorial board members, and leadership currently associated with a&a. going forward, we will be inviting scholars who reflect our core values and commitment to diversity to join the journal’s editorial board. furthermore, we are introducing fundamental changes to the journal’s structure. for instance, among other things, we are increasingly interested in encouraging student engagement with the journal. our new section, “aging talks,” launched as part of this issue, is illustrative of such an effort. in fact, we also envision the journal becoming an important resource for the teaching community. this is particularly pertinent as we continue to navigate the collective trauma of the covid-19 pandemic, which has challenged our ways of knowing, learning, and meaningmaking. we are firm believers in the power of anthropological story-telling, and we look forward to publishing work from scholars across the globe that allows for a creative resignification of theory, method, and analysis. we hope that articles published in a&a will begin to serve as a sociallymeaningful, people-centered teaching resource that can contribute to opening up pedagogical dialogues between the global south and north. for future initiatives, we have a long list of ideas that we believe will enable us to harness the critical questioning that anthropology so generously affords. to provide a teaser: there is a plan (at a very nascent stage) to introduce a new section curating certain themes from prior issues of a&a—themes that are conceptually innovative and theoretically challenging—while facilitating a dialogic discourse among emerging scholars. furthermore, we will be expanding from two issues to three beginning in 2022; this decision was made in the hope that the content of each issue would be more concise and coherent. but more significantly, this also allows us to move away from the dichotomy of fall/spring issues, which reflect a normative western worldview. we are also exploring ways to make the journal more accessible to readers with disabilities. in our respective research specializations, we focus on the interdisciplinary crossroads of family sociology and gerontology, and how health and social policies targeting older people influence the sociocultural dynamics of later life. with this broad perspective, we intend to use our time as editors to foster productive change and to develop anthropology & aging into a journal that is as rich, vibrant, and diverse as the topics—and people—on which it focuses. we would be remiss if we did not take this moment to also thank our reviewers whose commitment, dedication, and generosity allows a&a to maintain its quality and diversity. to all of our readers and authors: we appreciate your continued support of the journal, and we are especially grateful for your patience and understanding as we experience some inevitable “growing pains.” we are both open and available to any questions, comments, and suggestions regarding the current and future direction of the journal. we look forward to hearing from you, and to working together with you to strengthen a&a and our shared scholarly community. http://anthro-age.pitt.edu/ book review review of gamburd, michele ruth. 2020. linked lives: elder care, migration and kinship in sri lanka. new brunswick, new jersey: rutgers university press. pp. 206. price: $120 (hardcover); $34.95 (paperback, ebook). irina kretser saint petersburg state university i.kretser@spbu.ru anthropology & aging, vol 42, no 2 (2021), pp. 183-185 issn 2374-2267 (online) doi 10.5195/aa.2021.372 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | kretser | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.372 http://anthro-age.pitt.edu 183 book review review of gamburd, michele ruth. 2020. linked lives: elder care, migration and kinship in sri lanka. new brunswick, new jersey: rutgers university press. pp. 206. price: $120 (hardcover); $34.95 (paperback, ebook). irina kretser saint petersburg state university kretser@spbu.ru what does it mean to care for elderly parents in a changing world where traditions and new challenges collide? linked lives by michele gamburd provides fascinating insights into elderly care practices in a sri lankan buddhist village, presented in the book under the pseudonym ‘naeaegama.’ naeaegama has a symbolic meaning and can be translated to ‘village of relatives.’ this well-chosen pseudonym reflects not only the intertwined lives of people in naeaegama, which are the focus of the book but also reveals gamburd's affinity with the village where her mother also conducted research and where she herself lived as a child for some time. the connecting thread between gamburd and her informants and between the past and the present is siri, a long-time research associate of both gamburd and her mother. this book about kinship and care is dedicated to her mother, who died in 2014, and siri, who died in 2018. the book is divided into nine chapters, each of them—except the first and last chapters—dealing with particular forms of care or issues concerned with it. chapter 2 discusses norms and practices of family life in sri lanka and especially marriage and inheritance patterns, dravidian kinship terminology, and the principle of reciprocal intergenerational obligations. while the book begins with discussing the widespread issues of transnational care in chapter 3, the focus then shifts to how care practices are inextricably woven into social, economic, and cultural contexts. chapters 4 and 5 reveal inheritance patterns and emphasize the meaning of the ancestral home for social reproduction. chapter 6 sheds light on issues of health, illness, and the aging of bodies in the context of western discourses of successful aging and its buddhist interpretations. nursing homes as examples of institutionalized care and naeaegama attitudes towards them as a “cloud of shame” (121) are further explored in chapter 7. finally, buddhist religious beliefs and their impact on the care for living and deceased relatives is discussed in chapter 8. the entire book conveys the effects of a particularly interesting methodological approach used by gamburd in her ethnographic research. understanding the sensitivity of the topics discussed, gamburd did not prefer direct questions but rather the method of hypothetical scenarios, which allowed informants to express themselves more freely. the scenarios presented certain stories about caring for the elderly, and the informants were asked how they would act in a situation and why. the issue of a ‘sandwich generation’ caught between transnational migration and the persistent cultural expectations concerned with filial duties is raised in chapter 3. a ‘sandwich generation’ refers to middle-aged individuals, who care for both their children and their elderly parents. gamburd http://anthro-age.pitt.edu/ book review | kretser | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.372 http://anthro-age.pitt.edu 184 emphasizes that filial obligations are deeply rooted in a generalized reciprocity, which implies that “children are debtors” (4): parents care for children and then adult children ‘return’ to care for elderly parents. consequently, members of a sandwich generation often find themselves in a vulnerable situation. when migration—or just working outside the home—does not allow them to provide day-today care for their parents, this prevents them from living up to cultural expectations, while money and the financial stability of the family matters just as much. so, negotiation between caring obligation and financial support starts, and extended family comes to the fore. gamburd observes that “unemployed relatives or poor servants step in to help women in the sandwich generation to fulfill their filial duties. families distribute responsibilities between able-bodied adults so as to retain financial stability while simultaneously providing the care required for children and elders” (56). the distinction between care by kinsmen and care by market proxies is relevant here. while the former is ascribed, the latter is stigmatized because it reflects ruptures in the family fabric that cannot provide enough relatives to perform the necessary caring duties. as gamburd mentions in chapter 7, institutionalized care, such as nursing homes, similarly indicates a violation of traditional care practice, but, paradoxically, it is poverty that can force families to opt for this solution. as one of the informants, housepainter perera, mentioned: “if you can’t afford to feed someone, then by putting them in a free facility, you are taking care of them. you are sending them somewhere where they can eat! sometimes it is like a punishment to put someone in an old folks’ home. but sometimes it’s a necessity” (124). gamburd highlights that the space of social reproduction of the family is the family ancestral home or maha gedera. when people live in one place for generations, land, home, family, and identity are tightly interwoven: “in other words, ‘where is your maha gedera?’ is another way of asking someone, ‘who are you?‘” (80). the house reflects not only social status and wealth of the family but also displays the quality of relationships among relatives. for example, empty houses indicate a violation of the social reproduction of the family and of regular practices of elderly care. as chapter 5 clearly demonstrates, the house, care for older adults, the continuity of family life, and migration are closely linked; whereas due to ‘ultimogeniture’—a common pattern of inheritance of property in naeaegama—the youngest son traditionally inherits the house and takes up the duty of caring for the elderly in it, migration now involves selling the house, migrating to bigger cities or other countries, and outsourcing elderly care to professionals or other family members. in chapter 6, gamburd analyzes aging bodies as objects of care. in naeaegama, the fear of losing the ability to feed, bathe, and go to the toilet independently, induces talks about the preference of a quick death. the paradox here is that quick death can put chains of care in jeopardy: “when an elder dies suddenly, the loss leaves survivors feeling that they have not had the opportunity to reciprocate care that they have received in the past. the sudden death of an older relative may leave entrustments unfulfilled and debts unpaid” (106). care for aging bodies by relatives can be manifested through social constructions surrounding smell. therefore, idioms of smell are used to talk about norms and practices of care. whereas ‘getting/not getting smell’ means providing day-to-day care/evading it, the phrase ‘there was no smell’ indicates appropriate and high quality care work. the ability to take care of someone else also continues to matter for older people themselves. for example, siri’s aunt, padma, was very upset about her inability to treat guests with food, because this reflected a rupture in important social rituals due to infirmity of the body. http://anthro-age.pitt.edu/ book review | kretser | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.372 http://anthro-age.pitt.edu 185 in contrast to western discourses of successful aging, buddhist interpretations of aging well assume the inevitability of aging and death. one of the informants, dustin, said that “because people are afraid, they die quickly,” so death should not be feared, death should be “owned” (102). the next quote from chapter 8 illustrates this attitude to dying well poignantly. from the kitchen, telsie called siri to come help, and as he came by me typing at the dining table, he grumbled loudly, “i don’t know why some days i don’t just die like helga did.” “don’t be afraid; you will (indeed) die!” telsie replied tartly from the other room. instead of assuring him he would be fine, she assured him that he was going to die. (149) given that, appropriate end-of-life and after-death care and rituals matter greatly in naeaegama. afterdeath care includes regular almsgivings which aim at future rebirth of deceased relative. this rich, insightful, and very personal ethnography provides an essential guide to issues concerned with sri lankan elderly care and social reproduction of the family in the context of transforming society and can be recommended to a diverse audience. http://anthro-age.pitt.edu/ italy_layout keeping the elderly alive global entanglements and embodied practices in long-term care in southeast italy gabriela nicolescu goldsmiths, university of london author contact: g.nicolescu@gold.ac.uk abstract this article explores the success of the “migrant in the family” model of care for the elderly in southeast italy and the mechanisms that bond the caregivers and their patients in a mutual dependency. i describe this model as a meeting place between endurance and vulnerability, and between the fragility of the elderly and the fragility of most of the women who work as migrant care workers. i argue that migrant live-in care work for the elderly is a combination of attentive practice and detachment in completion to the current description of care work as ritual and as tinkering and adaptation. in a broader perspective, the article shows that the economic needs in poorer regions of the world manifest in the commitment and determination to keep the elderly alive in italy. this article reports findings from long-term ethnographic research among 34 migrant domestic care workers and 24 italian employers in a medium-sized town in italy. the article illustrates the findings by means of three case studies and engages with the existing literature on person-centered care in patients with dementia, biopolitics, and the global political economy of migration for work in the field of care. migrant work for the elderly is crucial for a general understanding of social reproduction in italy and in many other global contexts. keywords: care work, elderly, dementia, migration, italy, badanti anthropology & aging, vol 40, no 1 (2019), pp. 77-93 issn 2374-2267 (online) doi 10.5195/aa.2019.202 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 77 keeping the elderly alive global entanglements and embodied practices in long-term care in southeast italy gabriela nicolescu goldsmiths, university of london author contact: g.nicolescu@gold.ac.uk introduction camelia decided to immigrate to italy and work as a badante, a caregiver for the elderly. she needed money to pay for the electricity and gas bills for the flat she owned in a provincial city in romania. she also needed money to support the education of her children. in the salone, the high ceiling sitting room in the house where she lived and cared for octogenarian pepi, we sat and talked. the conversation often paused when camelia watched pepi in the room nearby having her afternoon nap. it was summer and the shutters were closed to keep the heat out. camelia was a single mother of two, and before coming to italy, she felt that her life was marked by growing uncertainties and economic insecurity, increased by the slow demise of the state sponsored factories where she could find a job. she explained that after 35 years of work in a state factory, the wage she earned in an administration position was insufficient to cover the costs of life. when her grown-up children mentioned that many mothers of their schoolmates emigrated to italy to work as live-in care-workers for the elderly, and to send money home, camelia felt she had to try this option too. camelia had no previous medical training. nevertheless, in 2013 when i first met her, she had been caring for pepi, who suffered dementia and partial paralysis, for five years. camelia and pepi were living by themselves in pepi’s large one-story house in the center of a middle-sized town in the region of puglia, italy. pepi had no children of her own, but just one brother and a sister who visited her daily, for five or ten minutes. camelia was pepi’s only and devoted partner who attentively nurtured her day and night and patiently endured her mumblings and occasional talk. pepi’s siblings appreciated what camelia did in the last years. they thought that camelia managed to improve pepi’s health condition and overall happiness. whenever camelia went on annual leave, usually for a total of three or four weeks a year for easter or summer, pepi’s health condition would deteriorate. this article explores the success of the “migrant in the family” model of care—like pepi’s reliance on camelia—and the mechanisms that bond the caregivers and their patients in a mutual dependency in south eastern italy. it also investigates the indirect result of the marginality and stringent needs of both migrant care givers and patients. on the one hand, care givers offer constant evidence that they are entitled to relatively good economic remuneration for their work. on the other hand, italian elderly benefit from virtually permanent care that leads in most cases to unique forms of sociality and sometimes solidarity. my research started by asking: how does the vested interest in keeping the elderly alive in order to preserve care workers’ own jobs impact bodily rituals of care and the care workers’ own emotions? what is the relationship between migrant care workers (like calmelia) and the italian employers (pepi, but also pepi’s relatives, for instance) in terms of caring relations? the dynamics of migrant live-in care work described in this article leads to an argument that is different from much of the exiting literature that tends to describe migrant care work in terms of familial bonding based on transferable human affects and intra-family dynamics (e.g., deneva 2012; ducey 2010; mazuz 2013a; ungerson 1990), or compassion, empathic imagination and ethical practices of care (e.g., danely 2015; degiuli 2010; kleinman 2009). in contrast, this article investigates the often-tensioned relation nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 78 between emotions, experience of domestic care, and economic interest in the work of care for the elderly that migrant workers perform in an italian context. the paper gives evidence to care work as a necessary combination between attentive practice and detachment in completion to the current description of care work as ritual (aulino 2016) and tinkering and adaptation (mol, moser and pols 2010). the argument presented here builds on the current need for theorization and contextualization of the concept of care (aulino 2016; biehl 2011, 2012; buch 2014, 2015; danely 2014, 2015; ducey 2010; kleinman 2009; mazuz 2013a, 2013b; mol 2008; mol, moser and pols 2010; muehlebach 2011, 2012; zelizer 2007). the article proposes an expansion of the concept of biopolitics, beyond the bound of state requirements that foucault (2008) outlined. it proposes a concept of biopolitics that is bound to the requirements of global capital. i argue that economic reasoning implies a permanent juxtaposition between proximity and distance. this process reflects the difference between economic contexts, life standards, and material imaginations. badare the italian term badare means to ‘watch over’ something and is associated to the act of caregiving for the elderly. badare implies a distance from the act of emotional labour, and attention focused on care as embodied experience. badanti (badante for women) are caregivers paid to watch attentively over the elderly and keep them in good physical shape and emotional balance, but not necessarily to love them. my own observations from the italian field of the use of the term badare supports aulino’s (2016) definition of care as ritual: ‘conceptualizing care as ritual allows us (…) to pay attention to what caregivers do rather than just what they say they do (…) in doing so, we can productively explore care as habituated action separated from belief or internal orientation’ (aulino 2016, 91). aulino continues: ‘in mundane, everyday routines as a source of insight about care (…) we can observe better what “counts” as care’ (ibid., 98). what counts as care for badanti in italy is embodied repetitive gestures, as aulino also found in her field site in thailand. in the italian case, these embodiments have a strong quality of endurance that is encountered neither in familial, nor in institutionalized care settings. for badanti, this kind of detachment they practice comes from understanding that care is not only in the proximity—in the here and now—but also elsewhere around the world, wherever their own children and relatives live. therefore, for most badanti i worked with, caring for italian elderly represents an enactment of the care they would have to have for their own families. in this way, a recurring theme in my research is that the quality of care practices in one side of the world mutually depends on the economic needs in other parts of the world. these ethnographic findings are supported by political scientist paolo boccagni who notes that for many migrants working in care jobs in italy there is a ‘deep-rooted centrality of a home/family dimension to their everyday thoughts and practices’ (2016, 298). the ethnographic material suggests that in cases where badanti would come to work for short periods of time (one up to three months), this would be to solve a problem in romania, such as gathering money to organize a wedding for one of the children. differently from this temporary circular migration which is recurrent in many eastern european contexts (vianello 2012), the strong bonds between caregivers and their patients happen when migrant care workers decide to invest in a care relation for a long period of time. most badanti who want to work for longer periods of time look to work for patients who they think will live for at least another four months, which represents a strategic decision that has been reported in nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 79 other global settings of care (e.g., ibarra 2000). during this time, migrant care workers perform specific types of gestures by strategically combining familial embodied practices and repetitive tasks conducted with determination, consistency, and a certain level of detachment. these attributes characterize primarily caring relations that are stable enough to last. on the other hand, patients get to know, trust and communicate with caregivers beyond basic needs and desires, likes and dislikes. my findings regarding care are supported by the two meanings of the term in english, as discussed by anthropologist elana d. buch (2015). care means a practical action (‘caring for’) and an affective concern (‘care about’) at the same time. in my research, ‘caring for’ was a direct action directed towards the italian elderly, while ‘caring about’ was an indirect action of badanti to invest in their children, kin, and material possessions left in their home countries. this is particularly useful to understand the context of need and dependency on the remittances sent from italy to romania. research shows that most badanti working in italy have children of their own in their home countries and only 15% of badanti bring their families to live with them in italy (federici 2007, 16). out of the total 28 romanian badanti i workerd with, 21 badanti had at least one child in romania and sent between €300 and €500 monthly remittances to their families at home. the rest (usually up to €600 monthly) would be spent on food, clothing and other daily needs. in this context, this article reveals some of the often overlooked consequences of the vulnerabilities and adaptability of migrant care workers who split themselves between ‘care for’ the italian elderly and ‘care about’ their own families left at home. the case of live-in person-centered care as performed by badanti builds on existing literature on the global transfer of care and emotions (hochschild 2000; kaneff and pine 2011; parreñas 2001) in the context of increased employability in care jobs for migrant domestic workers around the world (shutes and chiatti 2012; stilwell et al. 2004; yeates 2009). this article discusses the double meaning of care by analyzing three case studies. the case studies are representative of the overall motivations and practices related to extended care work of badanti in italy. camelia, the protagonist of the first case study, had been a former state employee, and a single mother of two. domnica, in the second case study, had been a day agricultural worker and mother of four. vali, in the third case study, had been an indebted entrepreneur and mother of one. despite the differences in their economic and social backgrounds, the three badanti shared a similar level of hardship in their personal lives and a determination to adapt themselves to the needs of their patients and of their employers – namely the relatives of the elder patients they took care of. this article is written in a style that emphasizes the role of long-term ethnography, where health issues are intersected with personal biography (biehl 2012; das 2007; fassin et al. 2008; steedman 1987). this style of writing facilitates opening complex questions in medical anthropology situated at the junction between geopolitics and global care, trans-national economics, and gendered migration. methdology this article draws on the ethnographic research i conducted between july 2013 and august 2014 on live-in migrant care work for the elderly in the southernmost part of the region of puglia, italy. during the research, i lived in a middle-sized town i will call grano, a pseudonym to protect the anonymity of the people i worked with. most of my research took place in grano and in the villages and cities around it. i rented a flat from one italian family who proved to be instrumental in starting my research. they introduced me to the first two romanian badante i interviewed and they gave me prime access to health care institutions in the area. the research followed the recommendations for good research practice and the ethical guidelines and procedures formulated by the association of social anthropologists of the uk and the commonwealth (asa 1999). all respondents were over the age of 18. the research was limited to nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 80 the categories mentioned above and did not involve communication with and or direct interactions with people with cognitive impairment (dementia). i kept the names of places and people anonymous throughout the research and when writing. the research involved conventional ethnographic methods, such as participant observation, semistructured interviews with care workers, members of the italian families, and relevant members of the community. i conducted a total of 58 interviews with 34 badandi and with 24 italian employers. the 34 badanti i interviewed were comprised as follows: 28 romanian women, two indian men, one polish woman, one bulgarian woman, one ukrainian woman and one italian woman. all my respondents were people i met while living in grano. about two thirds of the badanti who participated in the research i initially met in public squares. i was introduced to the remaining one third of badanti by italian people i knew in the region. in most cases, the initial conversations were followed by one-on-one interviews. out of the romanian badanti, 19 had emigrated from rural areas in romania and nine had emigrated from urban settings. all women from eastern europe were orthodox christian, the italian woman was catholic, and the indian men were hindu. in all cases, i received permission to take notes. i did not audio or video record conversations due to confidentiality. the interviews were carried out in either italian or romanian, as i am fluent in both these languages. i am native romanian. i have learned italian for eight years in school and i have spent a total of 12 months in italy as a student and temporary au pair during my undergraduate studies. a typical interview with badanti started with basic background questions, such as when did they arrive in italy, what where the reasons and social relations that determined them to work as badanti, and what were their previous professional occupations. i then asked how many patients they worked for (and in how many families), for how long, their daily routines of care, freedoms and limitations in terms of work and personal life, as well as how they would compare their different experiences they had as badanti in terms of the issues discussed. in the more in depth parts of the interviews i focused on four major aspects. first, i formulated questions around badanti relationships with the members of italian families they worked for and their kin, as well as with doctors and nurses in different health institutions who monitored the elderly on a regular basis or in case of emergency. secondly, i asked questions to caregivers concerning the medication for their patients, daily care practices (including caring for their bodies, such as washing, combing, dressing, moving them around the household or outside the house when possible), and physical exercises. then, discussion turned naturally to the third in depth aspect: communication. i was interested in the ways and methods to communicate with the elderly, especially in the context in which i thought italian language could represent a barrier for many. i explored these questions in the specific context of care work and affects exchanged with their patients. finally, i focused on the economic aspects of the badanti work. i asked about the levels and patterns of remittances and material goods badanti used to send in their home countries, the main and occasional beneficiaries of this help, including details about the different projects they supported, such as providing good education for their children, care for their own kin, or renovating a house. i usually ended the interviews with a discussion on their plans for future work and personal life. i observed a total of ten badanti during their workday in live-in care environments. typically, observation sessions took place while feeding, sitting and talking to the elderly, or putting the elderly to sleep, and lasted between 30 minutes and three hours. on one occasion, i spent four hours with a badante while she was doing gardening work. the number of observation sessions varied significantly, between two and three sessions in most cases to 10-15 sessions in three cases. this summed up to a total of more than 400 hours of observation of both indoor and outdoor activities. then, i interviewed other 20 badanti nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 81 with minimal observation (one or two observation sessions for each) and other four badanti without observing their relation with patients. due to the complexity of the issues discussed in interviews and the specific needs for constant care for their patients, interviews with bandanti were rarely completed in just one session. rather, interviews were conducted during few visits at their work place and sometimes continued in different settings, such as when accompanying their patients outside the house or in their own free time. thus, many interviews spanned over few months and in each occasion new elements, such as recent work events, brought new elements to the on-going discussion. in contrast, interviews with italian employers were very different. i interviewed a total of 24 italian people, usually children or children in law of elder patients. most of these interviews took place in public places, such as city squares, cafes and restaurants. interviews lasted between 45 minutes and 1.5 hours. i focused on three main aspects: the medical conditions of the elderly and their specific needs, the issues around domestic care, including personal responsibilities and comparison with institutionalized care, and the relationship with the current badante, including the contractual and financial aspects. in seven cases, the interviews were conducted over several sessions. after each interview and observation session, i filled in and elaborated field notes. observation sessions occurred during scheduled program activities, meal times, and when participants engaged in unscheduled activities, such as going to the main square or watching television. all these activities provided a field of experiential possibilities to observe and explore the ways in which migrant care workers interact with individuals with alzheimer’s disease. the application of observation methods was conducted in both romanian and italian, to facilitate communication with both caregivers and the family members of the elderly patients. the patients spoke only italian or the dialect in the region. the context of eldercare and romanian migrant domestic workers in southeast italy the life expectancy of italian people is currently among the highest in europe: 83 years, although disparities exist across regions and socioeconomic groups (oecd 2017). italy’s growing aging population is mostly cared for using a family-based care model (bettio, simonazzi and villa 2006; marchetti and venturini 2014), where migrant labor is preferred for 24/24 hours shifts seven days a week and low costs of employment. during my research, public or private retirement homes were not very popular among the italians in southeast italy. interviews confirmed that members of the family had to visit and feed their relatives as much as three times a day if they wanted to keep the costs to a minimum. italians saw this as a major inconvenience and so they regarded institutionalized care as a temporary solution only. these findings support arguments that institutionalized care in italy is limited and expensive (degiuli 2010; hugman and campling 1994). social scientist francesca degiuli (2010) recounts how traditional work of care for the italian elderly provided by their own kin were dominated by strong affection and dedication. my own ethnographic material, in line with more historical and sociological accounts in the region, suggests that especially among peasant families, care for the elderly has been a mixture of nurture and disregard (for a similar understanding of care see also biehl 2012). for example, at the start of the 20th century, peasant women were considered responsible with domestic care work for the elderly. but this responsibility was conceived along other duties like agricultural work for the landowners, agricultural work for the family plot, cooking, cleaning, sewing, and for those who had children, taking care of the children. according to social scientist ernesto de martino (2013[1961]), in the region, peasant women expressed the importance of their hard nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 82 work and of their many responsibilities in performative and ritualistic ways. up to the late 1960s, around the day of saint peter and paul in july, adult peasant women from the region would fall into trance to express the tensions accumulated over the year, or over a couple of years. while being in trance, laying on the floors of their homes or in public squares, musicians would come and sing to them to allow them to release the tensions, rest for a bit and cure while listening to the rhythmed tarantella music. at the end of the ritualistic healing, women themselves would pay the musicians. middle class families were few, and they did employ servants to care for children and elderly. authors have showed how especially in the aftermath of the second world war, domestic care for the elderly was severely transformed due to strong industrialization and new employment opportunities (crafts and magnani 2011). domestic care for the elderly performed by migrant workers was also a sign of social mobility among italian employers (catanzaro and colombo 2004). this took a particular form in southeast italy which saw massive emigration for work in north italy, switzerland, and in central europe across all social classes, with the exception of higher classes (romero 2002; zacchino 2007). as males mainly left the region, women who remained home had supplementary duties to manage relatively large households. in southeast italy, starting with the 1960s and 1970s women started to work in the local textile and tobacco industries. the women who were employed during the ‘golden age of post-war italian growth’ (crafts and magnani 2011) represented to a large extent the ‘golden generation’ of italian light industry. women started to gain constant money, which represented an unprecedented financial security for their households. this security was extended through recent times in the form of pensions and state benefits. at the same time, anthropologists have shown that in the region, the local population understood and expressed a clear discontinuity from the past (e.g., galt 1991). this sense of modern life also meant that many women preferred to pay for domestic care work rather than performing it themselves. even housewives preferred to externalize this work to migrant women. in this context, migrant domestic workers took on a central role in the household, even if they were often perceived as ‘outsiders’ or ‘aliens’ (sassen 1999). in the region, lower paid jobs are performed by migrant workers, following a general trend in italian emigration (luciano 2013). in italy, the national social security institute (instituto nazionale previdenza sociale inps) oversees family allowances and provides benefits to families that have elderly with disabilities. bettio, simonazzi and villa (2006) show that even low-income families in italy can receive €900 a month from state subsidies, which is enough to cover the costs of residential care work, pay taxes for that contract and support some of the living costs for the elderly and the live-in care worker. the same authors argue that a migrant care worker earns only 66% of the median costs that italian families receive from the italian pension schemes combined with other state benefits. italian families tend to use the rest of the money within their own households, such as to support un-employed members of the family, as the last case study presented in this article indicates. social scientists argue that the externalization of domestic care work needs to be called “migrant in the family” model of care (fedyuk 2012; lyberaki 2008). family heritage and property are instrumental in examining care work and care relations among generations. the economic reasoning behind this care model has gained huge popularity not only in italy, but also in other mediterranean countries in europe (bettio, simonazzi and villa 2006; lyberaki 2008). in 2007, romania became part of the european union and romanian citizens gained full access to the italian labor market. in just a few years, romanians became the largest community of migrant workers in the field of care in italy (ban 2012). since the early 2000s, romanians have become the largest community of immigrants in italy in general. this was related to the relative geographical proximity between italy and romania, the similarity of the romanian and italian languages, and by comparable patriarchal social organization in rural areas of the two countries. the severe economic crisis of 2008-2009 was especially felt nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 83 in rural and in small and medium sized urban areas in romania and added to the massive unemployment and hardship generated by the fall of the communist regimes in central and eastern europe (o’beachain, sheridan and stan 2012; stan 2010). this gave yet another impulse to the remittances sent by romanian badante in italy. at present, almost one million of romanian immigrants are women working in personcentered home care for the elderly (ins raport 2014). out of 28 romanian caregivers i worked with, only one was a professional nurse. all others had no formal medical training. nevertheless, during the years they worked in italy, many learned how to prepare meals, feed the elders, bath, walk, dress, assist with personal hygiene, change diapers, or clean the houses of their patients. those who kept their jobs for more than three months developed culturally intuitive sensitivities as well as developed their para-professional medical skills, including dispensing medicine, treating severe infections, connecting the patient to a dialysis machine, and feeding patients with feeding tubes. the strong bonding existing between patients and their caregivers would be manifested through body language, routinized practices of care, and the time and energy invested into improving the medical conditions of their patients. my research shows that all migrant women working as caregivers in italy supported their families by sending money and different goods to their respective home countries. the two indian men would save money to build or renovate houses in india. the monthly salary of a romanian migrant caregiver was of in average €600 and was paid by the italian employers. similar wages were reported as being affordable even for lower middle class families in italy (e.g., glucksmann and lyon 2006; marchetti 2004) and in other countries in south europe (lyberaki 2008). in few cases (six out of 34), the salaries of the migrant domestic workers were of €750, €800 and €1,100. although all italian employers used to pay these higher wages in order to distinguish themselves from the rest of italian local employers, not all the wages were declared officially. the families who afforded to pay these wages were of the higher middle class. members of these families were doctors, owners of designer shops or local supermarkets, or senior members of the police. only 20% of the migrant care-workers interviewed had formal contracts. the contracts allow employees to claim for their contribution to the italian state, receive unemployment benefits, and apply for state pensions. in the absence of contracts, many of badanti felt that the surest way to keep their jobs safe was to keep their patients alive and in good health. the determinacy to keep jobs, even without or especially because of lack of proper contracts, is paradigmatic for the intertwined needs of care badanti had to respond to both in italy and in their home countries. approximatively 70% of migrant caregivers’ salaries would be sent every month, or every several months to home countries to pay for daily needs, education of children or building and renovating houses. according to mmjs (2017, 12) in 2017 there were 6,267 families with children in romania where both parents (or the only single parent) worked abroad and 13,484 families where at least one of the two parents worked abroad. my research material indicates that many more young children were left alone than the data provided by the mmjs (2017). while their parents work abroad, children in romania are raised by relatives, or by their own brothers and sisters. scenes from the documentary film waiting for august (2014) show one such case: a fifteen year old girl takes care of six of her siblings while her mother works as a badante in italy. the following three stories are illustrative of how migrant care workers balance the care for the elderly in italy and the care for the people they left at home. time dedicated only to care: camelia and pepi when camelia first arrived in italy she was in her early fifties. like many other migrant domestic workers who had no experience of care work she learned everything from scratch with determination and nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 84 desire not to fail. when telling me her story, she laughed and looked amazed by her own courage and credulity. her former colleagues in the factory she left used to characterize her as an energetic person, one that would never have the patience to serve others and adapt to their many needs. still, three days after she considered emigrating to work in italy, she took the bus to southeast italy. five days later, she was in an italian home, starting to take care of an old person who lived with his own kin. camelia often said that her first employment as a care-worker was traumatic, but she never mentioned the reasons. she only implied that the patient, as well as his kin, had serious mental problems. after four months, camelia was helped by another romanian badante to literally escape from that house. the next job she found was with a very good and respected family from another nearby town. she worked there for two years until her patient died. her employers recommended her to the family where she was working when we met. initially, no one from pepi’s relatives believed that pepi would live more than one or two years. camelia started to treat pepi with affection, and soon her health condition improved significantly. pepi’s appetite grew, she was having fewer and less strong health crises and she would be more engaged in conversations. always cheerful, camelia used to talk to pepi loudly and gratify her for everything she would do good. “look how beautiful she is!” she told me once with an arm lifted in the air and a white handkerchief ready to lift any drop of saliva that would fall from pepi’s mouth. waking up at 6:00 am in the morning, camelia’s schedule was structured around pepi’s daily routine. she would prepare breakfast and say morning prayers in the salone where she used to sleep, before waking up pepi, change her diaper, and then give her breakfast. then, whenever pepi took a short nap, camelia rushed for about ten minutes to get some quick shopping done. she cleaned the house every other day. when she did not clean, she cooked for both pepi and herself. when doctors or nurses came to visit pepi, camelia always asked questions in her rough italian to learn how to adapt her treatment to pepi’s needs. at lunch, camelia used to watch romanian television and pepi did the same, from her medical bed offered by the inps. lunch followed the tv watching. in the afternoons camelia used to phone her two children and other relatives in romania and italy. the main event in the afternoon was the daily visit of one of pepi’s relatives, which usually took less than ten minutes. while most badanti looked forward to go to the city and spend time by themselves, camelia preferred to remain in the house. she did not like the company of other romanian badante. as she put it, “those who spend all their time on the bench in the main square only talk and laugh over vulgar jokes.” she never felt comfortable in their presence. camelia would go to bed around 9:00 pm, in a quite austere and less comfortable bed than pepi had. camelia’s reclusion used to intensify during winter holidays, especially in the days before christmas when the entire city was particularly lively decorated with christmas lights. in some years, she refused to go out the house for as long as few weeks in a row, fearing that the christmas spirit would make her nostalgic and make her want to be close to her children, at her own home in romania. camelia usually took her annual leave in summer. after the first year of employment for pepi, the italian employers felt that they could not take the responsibility of caring for pepi for a whole month. very often, the kin of nonagenarian patients are in their sixties or seventies and they find it difficult to lift the elderly so they can wash and change them properly or put them in wheelchairs or the usually high beds. the solution employers found in this case was to put pepi in a hospice during camelia’s month off. on her return, camelia found pepi in a very bad condition. in consequence, the next summer camelia decided to not take annual leave, but to ask her children to come and visit. some badanti feared that the health condition of their patients would deteriorate if they left for holidays. they knew that at their patient’s age nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 85 any slight deterioration of their patient’s health could have major consequences and make their own care work more difficult. this was the reason why some badanti prefer not take holidays at all. in the following years, camelia found another romanian badante to replace her during holidays, but for shorter periods of time, usually for two to three weeks. in one year, her employers found an italian care worker to replace camelia during her annual leave. camelia’s story is representative for those migrant care workers in italy who dedicate all of their time and energy into caring for their patients. as the following two stories confirm, migrant care workers strategically choose to work for patients that they perceive as good investments of care. badanti prefer to settle in families where patients are in relatively stable health conditions— that would allow them to live for relatively long periods of time—and where they can have a certain autonomy in the care decisions they make. when asked how long she would remain in italy to work, camelia replied that she wanted to remain for few more years until both her children would finish their undergraduate degrees. she was not sure if pepi would live long enough for this dream to become true. discussions surrounding money were not very important to camelia. for a few years, her employers used to transfer the money she earned, initially €550 and later €600 a month, into camelia’s children’s bank account in romania, on a monthly basis. employers also paid the bills for the house where pepi and camelia lived, the food, and other domestic products. after a few years, camelia asked to be paid in hand, and she would use some of the money to buy clothes and other products, like meat and cigarettes. she decided to invest her time in improving pepi’s health condition, in addition to purchasing food that she considered ‘nurturing’ and ‘tasty.’ cooking meat that she bought with her own money was also a way to prove her affection for pepi. camelia said, “how could i cook something that smells good and not give to her too?” deep affection and constant humor were central in her relation with pepi. my ethnographic material, such as my work with camelia and pepi, intersects with miller’s (2007) understanding of dialectics between ideals and realities in family relations. his argument is that the actual relationships are driven by ideal imagination of the respective relationships. in my research, badanti feel an important gap between imagination and reality. italian families consider that spending time with and nurturing their elderly represents a form of maximum respect. they employ badanti to pay this kind of respect as an ideal. as any ideal, it is not always realized given the reality. in 2016, three years after our initial conversation, camelia was still taking care of pepi. after eight continuous years of employment with this family, camelia received some criticism from pepi’s relatives. camelia felt that her italian employers were critical with what they called ‘her exaggerated care for pepi.’ at the age of 93, pepi was still alive and her health condition was stable. in this context, after continuous pressures from her employers, camelia decided to quit the job and return to romania. while writing this article, i found out that two weeks after camelia left her job, pepi passed away. pepi’s family declared that this was tragic, but they were expecting it. “making live”: dominica and signora carucci domnica did not speak italian and had never had any formal employment when starting to take care for signora carucci, an octogenarian suffering from dementia. in her early 50s, domnica found this first job in italy as really demanding, but uplifting. signora carucci used to have severe health crises that involved shouting and body convulsions. every couple of days, she was visited by her only child who lived and worked as a dentist in grano. as in the previous case, the visits were brief and lasted less than ten minutes. nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 86 all her adult life in romania, domnica worked in agriculture and was paid by the day. she raised four children and took care of her grandparents and other elder relatives who lived in the same village. domnica decided to emigrate for work in italy when her husband was made redundant (he was laid off) from a stable and relatively well-paid state job. domnica felt that italy was a viable option, as many of her relatives and other people from the village were already working there for several years. she thought that earning €600 a month as a badante would be ideal to secure the money her family needed. this was around three times more money than what she was earning as an agricultural day worker. however, things got complicated. after few months into her new job in italy, one of her children experienced a sexual assault in romania. domnica had to go back and be close to her family. four months later, domnica came back to italy because she felt that the money she earned would allow her family to also gain respect in their village. on her return in italy, domnica realized that her work was important and valued when she found out that a dozen other badanti had previously attempted to care take of signora carucci, but could not last more than a couple of weeks in the job. she asked carucci family to pay her informally in order to increase her income from €600 to €750 a month. domnica called this new deal ‘freedom.’ in her terms, it was freedom to move and change jobs with short notice. domnica, did not consider the consequences, such as losing the right to unemployment benefits and to qualify for the italian pension scheme. the precariousness and fragility of this condition make many badanti dependant, and paradoxically, dependable care givers. in this sense, the foucauldian phrase “making live and letting die” (2008, 32) is verified and challenged at the same time. in the case just presented, “making live” means coping with signora carucci’s serious health condition and “letting die” means neglecting their families, as illustrated in the case of domnica daughter’s sexual assault. at the same time, most badanti i worked with felt that their current jobs were improving the quality of lives of their families in romania. the inps in italy oversees family allowances and provides benefits to families who have elderly with disabilities. however, it is the family who decides the care solution and who receives the money. this mechanism allows many italian families to manage complex transnational arrangements and agree that the ‘migrant in the family’ model is the most efficient one. this model indirectly pays for the welfare of children and for other projects in poorer regions around the world. this kind of “biopolitics” could be summed-up as “the economic reason within governmental reason” (biehl 2011, 279). therefore, i suggest a concept of biopolitics that is bound to the requirements of global capital. it is this economic reasoning that implies a permanent juxtaposition between proximity and distance. the numerous deprivations in domnica’s life made her practice care work with a sort of detachment. this contrasts the findings that the act of caring for the elderly can be described as 'compassion fatigue’ (danely 2015) or bearing the ’stress, strain, and weariness of caring for others who are suffering’ (schulz et al. 2007, 6). compared to her compounded problems in romania, domnica felt that she should be detached from signora carrucci’s shouting and stubborn attitude. domnica focused extensively on the repetitive actions of care. domnica would bath signora carucci only in the morning, when the patient was more relaxed and quieter. domnica would cook and clean the house only when signora was asleep. she would let signora scream and give orders to an absent servant, while domnica had phone conversations with her children and chatted in front of the house with neighbors and friends who came to visit her. her replies to signora’s repetitive questions and orders used to be short and repetitive as well. domnica found out that this was the most efficient way to communicate with her patient. nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 87 the relation between domnica and signora carucci are in line with aulino’s (2016) definition of care as repetitive practice. aulino urges scientists to recognize care as “a much-needed space for ambivalence and ambiguity in the analysis of caregiver experience” (2016, 93). she suggests ways to expand our understanding of caregivers, by considering their individual needs, desires, thoughts and capabilities acquisitioned or instilled not only by proximity of elderly patients and the specific context of care, but also by their personal needs and desires. in this view, domnica’s detachment in her care work for signora carucci does not make her a worse care worker than camelia. it only shows that there is an adaptation that takes place between patients and their caregivers, which represents a permanent juxtaposition between the everyday practice of ‘care for’ and the ‘care about’ at a distance. anthropologists mol, moser and pols famously define care as tinkering and adaptation. they suggest, care practices move us away from rationalist versions of the human being. for rather than insisting on cognitive operations, they involve embodied practices. rather than requiring impartial judgements and firm decisions, they demand attuned attentiveness and adaptive tinkering. crucially, in care practices what it is to be human has more to do with being fragile than with mastering the world (2010, 15). in addition to these arguments, the two case studies presented so far indicate that in the context of migrant care work, adaptation to work conditions with the elderly is even more rapid and determined than in nonmigrant cases. domnica had to replace her limited knowledge of italian with innovative and familiar techniques and bodily skills she learned during her previous experiences of care in romania. anthropologists working with patients suffering from dementia have observed that communication dwells in corporeality and, more specifically, in the body's capacity to gesture (kontos 2005; 2006, 207; hendriks 2012). this form of communication, resembles what anthropologist janelle taylor describes in the conversations she had with her own mother who was suffering from dementia: “there is, in short, much more to conversation than speech, and much more to speech than the transmittal of information” (2010, 42). in the case of migrant care work, tinkering and adaptation is less reliant on language and depends even more on embodied and repetitive practices of care. my ethnographic material also shows that very often migrant care-workers use ‘positive person work’ practices like recognition, negotiation, facilitation, collaboration and play, using body gestures and mimicry that increase the well-being of their patients. psychologist tom kitwood (1997) affirmed that positive person work leads to the increase of self-esteem in elder patients, to improvement of their wellbeing, and recuperates forms of daily sociality. my research indicates that live-in migrant care workers cultivate positive person work practices because of loneliness, a desire to share affection, and sometimes because of personal interest. through attitudes and daily practices that resemble ‘positive person work,’ badanti observed that the well-being of their patients eases their own work substantially and also extends the lives of their patients. the next story is an example of involuntary ‘positive person work.’ co-adaptability: vali and signora alberti one summer afternoon in 2014, sitting on a shaded bench in the central square of grano, vali told me how she became a badante. signora alberti, the patient of vali, sat on a nearby bench eating an icecream, resolute and quiet. signora alberti refused to stay home and watch tv when vali went into the city. vali described herself with a high dose of anger as “an independent woman who became a servant who wipes the bottoms of italian elderly because romanian politicians did not do anything to save small firms nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 88 from going bankrupt during the 2009 economic crisis.” a successful entrepreneur in romania in her late forties, vali decided to emigrate to italy at the peak of the economic crisis, after her small enterprise went bankrupt. she followed a radio advertisement in romania paid for by an italian work agency that operated in the region. she calculated that she would need to work as badante for at least eight years in order to pay her debts. upon her arrival, the agency recommended vali to work in a wealthy family mostly because vali’s educational and entrepreneurial background would be a good fit for such a placement. vali visited the recommended family, but she refused to take the job. she thought she could never work for a very ill patient. the agency offered her a second job 12 days later. by that time, vali spent most of her savings. she was happy to accept the new offer. the family driver left vali in front of the house where she was to work. she entered the house and found her patient, signora alberti, sitting in a high chair with nobody else around. for two weeks, nobody showed her around, told her what to do, or how to take care of her patient and the house. vali found out later that her employers thought that a badante would know what to do. therefore, in the first couple of weeks, the only other italian person vali met was the keeper of a store where she used to buy cooking ingredients, like pasta and tomato sauce. every time she had to go out of the house, vali consulted the romanian-italian dictionary she brought with her from romania. when vali ran out of her own money, the shopkeeper contacted signora alberti’s nephew and informed him of the situation. the next day, the nephew and his wife came to meet vali. they paid her the monthly salary agreed with the agency and reimbursed all the money vali had spent on food. vali and signora alberti’s relatives liked each other instantly. they were older than she was and they made it clear that taking care of their aunt was not one of their priorities. the three developed a good relationship. vali felt that she was included and respected in the family. in the second month as badante, signora alberti’s nephew and his wife decided to offer vali €10,000, more than one year salary, to cover some of her debts in romania. vali saw this gesture as a blessing. it prevented the romanian bank from enforcing the requisition of her property. vali felt she could not thank the italian family enough for their help. however, anger and frustration towards the entire situation accompanied vali’s gratitude. she felt that the unexpected help limited her freedom to move to another job and her essential rights, such as vacation days and annual leave. this situation could be described in terms of a moral neoliberal gift specific to the italian context (muehlebach 2012). the italian employers trusted vali would take good care of signora alberti in their total absence. signora alberti had no friends, and even her own relatives would not talk to her, but rather to vali. when i first met vali, she had been working non-stop day and night and without a holiday for four years. two years later, she was in the same situation. she used to feel extenuated for long periods of time. whenever vali wanted to go out, signora alberti used to follow her. in public, vali would speak to signora alberti using firm looks and directing her what to do. she often talked to her in romanian. vali’s harsh looks did not frighten signora alberti and sometimes vali started to laugh of the entire situation. like in the previous two cases, the care relation between vali and signora alberti is shaped by economic and psychological co-adaptation. this process is marked by creative and ludic ways to cope with the hardship of life and care work, which nevertheless have positive impacts on the well-being of patients. the similarities between badanti and patients is the result of strategic decisions and co-adaptability. both signora alberti and vali come from rather wealthy families in their respective contexts. the constraints vali used to resent in her job were compensated by the many gifts she received from her employers and by the freedom to design her life inside and outside the house. for example, vali brought her daughter to live with her in italy for more than half a year. nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 89 the co-adaptation also means that many times badanti cannot plan their future properly and strategically. they sometimes value their work as ephemeral. three months into her employment, vali accepted to work with no contract. she presumed that another person from signora alberti’s family was registered with inps as the official care worker. although by not having a contract vali earned more money, after many years she realized that she would not be entitled to an italian pension. when she first came to italy, she never thought that she would actually work for ten years in order to be entitled to an italian pension. therefore, vali decided to contribute to a romanian pension scheme. vali knew that she has to endure the tough work as badanti if she wanted to pay back the debts and recuperate her properties in romania. social scientists have identified a causal relation between the economic and familial contexts of origin in the home countries and the live-in or live-out types of contracts of care that migrants opt for (marchetti and venturini 2014). in the context of a lack of contracts and lack of enforcement of regulations in the field of live-in care for the elderly, the relation between badanti and their patients is made durable by the mutual dependency. for signora alberti, vali represents a breath of fresh air that allows her to navigate through her medical condition and restore faint traces of sociality. through migrant residential care work for signora alberti, vali is more confident she would finally pay all her debts and be free to return to romania. keeping the elderly alive the article shows that the live-in “migrant in the family” model of care assumes a mutual dependency between care givers and their patients. on the one hand, italian elderly benefit of permanent care that leads, in most cases, to unplanned forms of sociality and sometimes solidarity. on the other hand, caregivers offer constant proof that they are needed and that they are entitled to relatively good economic remuneration for their hard work. prolonging the lives of their patients is intrinsically related to the desire to prolong and improve the lives of their own families. there is a meeting place between endurance and vulnerability, and between the fragility of the elderly and the fragility of most of the women who work as migrant care workers. the first case study focuses on the quality of the time, play, and humor dedicated exclusively to care work and the affective and economic bonds that are created. the second case suggests that the apparent detachment of some care workers can be explained as a response to even harder life conditions in their own families in their home countries. finally, the third story shows that the particular co-adaptation between badanti and their elder patients contribute to new forms of sociality in the house as well as in different social circles in the region. for example, while signora alberti had no friends of her own, vali brought her new forms of sociality. some of the relatives of patients also enter into social relations with badanti and they rediscover benefits in spending time together with their relatives. all three case studies suggest that the ability to use body gestures and mimicry in care work for patients with dementia is at least as important as mastering the language and cultural norms. badanti do use kinship terminology quite often in their work, but my research shows that this is not at all a reflection of new forms of trans-national kinship in the field of care work, as some anthropologists suggest (e.g., deneva 2012; mazuz 2013a). such claims are the consequence of the acclaimed finding that feeding, smelling food, commensality and living in the same house can lead to new forms of affinity (carsten 1995). my research shows that badanti were using kinship terminology as a sign of affection embedded in the act of domestic and intimate care, which also had the effect to make their work nicolescu | anthropology & aging vol 40, no 1 (2019) issn 2374-2267 (online) doi 10.5195/aa.2019.202 http://anthro-age.pitt.edu 90 easier. however, badanti were very aware that their kin were actually in their home countries. at the same time, many italian employers used to remind them of their place in the care relation. italian kin play a crucial role in the act of care, but indirectly, as mediators who set basic norms around essential tasks such as feeding, cleaning, medication for elder patients, and free time for badanti. in two of the three cases analyzed, elderly people with dementia felt more attached to the badanti than to their own kin. pepi and camelia, as well as signora alberti and vali had good and long lasting relationships. domnica and signora carucci also had a relatively long relationship, given the important challenges within it. when italian kin do not live close to their elder relative who is being cared for, they leave all responsibilities to badanti. this gives badanti unprecedented autonomy in decisions and sometimes even in movement. being habituated in this sense of autonomy, many badanti recognize they feel entrapped to remain and work in italy as a form of self-care. migrant work for the elderly is crucial for a general understanding of social reproduction in italy and possibly in many other global contexts. i show here that the economic needs in poorer regions of the world manifest in the commitment and determination to keep the elderly alive in italy. many badanti feel that through their work, they nurture their own families at home. at the same time, through their absence, some of them nurture for themselves. for example, the condition of “being away” allows badanti to negotiate difficult situations and conditions in their own families, such as situations of single motherhood or relations marked by domestic violence. in the same way in which italian employers use badanti to show and pay an ideal kind of care to their elderly, badanti use remittances to show and pay similar kinds of ideals to their own families in their home countries. in this context, their jobs in italy give them financial and personal autonomy, but also a social excuse for their absence. acknowledgements this article would not have been written without the warm support i received from domestic care workers and italian families in southeast italy. i also thank to sophie day, victoria goddard, claude jousselin, mark johnson, razvan nicolescu, alexandra urdea, william tantam and anonymous reviewers for reading various drafts of this article and for giving me insightful advice. some of the ideas presented here took shape while organising the seminar series economies of care and social 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teodora mihai. romania and belgium: clin d’oeil films, a private view, ecoute une fois. anthropology & aging quarterly 2012: 33 (4) 120 introduction my third summer as a researcher in the infirmary wing of the franciscan sisters of the heart convent , i found myself sitting in sr. theresa’s small room1. sr. theresa was in her mid-eighties and had lived in the infirmary for two years due to trouble walking and her limited ability to navigate the convent hallways and to negotiate physical tasks of daily living. we spent the afternoon as we’d spent many afternoons together. she spoke to me about the spiritual books she’d been reading and she talked about the spiritual connection she felt with god in nature. she spoke for quite a while, stopping often to laugh with reverence about the mystery and beauty of the world. after a pause, she began a story about speaking to jesus: the other night i was sitting here, and i said, “you know what jesus? i feel like an old married woman and you’re an old married man.” and i said, “we’re sitting in a swing on a porch. that’s where i see us right now.” and i said, “and i get the idea that you’re thirsty,” i said, “so, i’m going in to get you some lemonade.” so i come out with a big glass of lemonade, and he nearly drinks all that then he looks at me and smiles and said, “how did you know i was thirsty?” and i said, “’cause i love you.” a r t i c l e s let him hold you spiritual and social support in a catholic convent infirmary anna i. corwin department of anthropology university of californa los angeles at the end of this story, sr. theresa erupted into a bout of contagious laughter that punctuated all of her conversations. she ended the story with the statement: “so that’s my spirituality.” i asked her how often she talks like this to jesus, and she exclaimed, nearly exasperated by the naïveté of my question: “oh! all day, all day! we’re inseparable.” although sr. theresa was a joyfully unique personality in the convent – certainly the only person who mentioned sharing lemonade with jesus – her relationship with the divine is nonetheless representative of the relationship many of the nuns have with the divine. a majority of the nuns in the franciscan sisters of the heart describe experiencing the divine as an enduring presence in their everyday lives. they engage him2 in conversation, watch television with him, or hold his hand as they walk the convent grounds. they experience him variously as a spouse, a companion, a spiritual presence, and a caretaker. for almost all of the nuns in the convent, the divine is an enduring presence who accompanies them in every activity and shapes their experience of the world. in this article, i examine the caretaking interactions between the nuns in the infirmary wing of the franciscan abstract american catholic nuns have been found to age more ‘successfully’ than their lay counterparts, living longer, healthier, and happier lives. two of the key factors contributing to the nuns’ physical and mental wellbeing are the spiritual support they experience from the divine and the social support they provide for and receive from each other in the convent. i argue that by integrating the divine into their everyday interactions, the nuns engage in phenomenological meaning-making process through which mundane care interactions are rendered sacred. this communicative process, i argue, contributes to the nuns’ overall wellbeing by providing an enriched form of care and support, thereby enhancing their end-of-life experience. keywords: aging, care, prayer, wellbeing, social support, catholicism 121 anthropology & aging quarterly 2012: 33 (4) anna corwin let him hold you sisters of the heart convent to show what social and linguistic tools elderly nuns use to integrate the divine into their everyday interactions and how these interactions render all health-care interactions in the infirmary sacred. i argue that these care interactions impact the nuns’ wellbeing in three major ways: first, the care interactions include blessings through which the caregivers offer both social and spiritual support; second, the nuns invoke the divine in conversational care interactions in such a way that christ emerges as an engaged caretaker; finally, the nuns summon the divine into their lives by living the powerful trope of “being god” for each other and receiving others as the divine. these three practices, i argue, provide spiritual and social support that impacts the nuns’ quality of life. the sisters of the heart the franciscan sisters of the heart convent is a catholic convent in the midwestern united states that is home to more than 200 nuns. approximately 100 of them, having worked as teachers and missionaries outside the convent walls, have returned to the convent to retire. they now live in the convent full time where they have access to nursing care. this article draws on data collected in the convent over ten months beginning in 2008. during the summers of 2008, 2009, and 2010, i lived in the convent with the nuns for a period of one to two months each summer. for a period of five months in the winter and spring of 2011, i lived in an apartment near the convent and spent my days in the convent with the nuns. the corpus of data includes over 100 hours of recordings of naturally occurring events in the convent such as meals, social events, and care interactions. in addition, i conducted over thirty personcentered interviews (levy and hollan 1998). analysis in this article focuses on a corpus of over twenty hours of care interactions between a retired caregiver and the recipients of her care, many of whom are her contemporaries, recorded in the convent infirmary in 2011. background in her article communication and the institutionalized elderly, karen grainger describes the communicative exchanges between elderly individuals and their institutional caregivers. grainger describes an isolated communicative landscape in which individuals are often left alone (1995). when they are communicatively engaged, their concerns are often demeaned or ignored. this bleak communicative landscape with few “confirmative and stimulating adult-to-adult encounters” is unfortunately common in end-of-life care and has been found to negatively affect elderly patients’ cognitive function (williams 2011:9). grainger suggests that the “most important move” for the future of institutional care for the elderly, would be “for elderly long-term care to take place in an environment in which the status of caring (vs. curing) is elevated to the level of a valued occupation and skill” (1995: 433). the convent employs a palliative model of care, with the goal of providing ongoing holistic care to all of the sisters, attending to not only medical needs, but also the emotional, spiritual, and social concerns of each of the individuals in the community. the elderly catholic nuns examined in this article experience the type of care grainger envision as ideal, elevating “caring” over “curing,” prioritizing and implementing multiple modes of care at the end of life. epidemiologists have identified american catholic nuns as a group that lives longer healthier lives than their lay counterparts, experiencing less anxiety, pain, and depression at the end of life (butler and snowdon 1996, snowdon 2001). quality of life questionnaires (designed by cohen et. al 1997) i administered in this convent confirmed that, like their peers, the franciscan sisters of the heart report less anxiety and psychological distress and greater feelings of social support than their peers. in addition to education, nutrition, physical activity, and optimistic outlook, spiritual and social support have been found to significantly contribute to the nuns’ wellbeing. it has been found that there is a statistical connection between social support, including social interaction (cacioppo and patrick 2008), receiving the help of others (maton 1989, reichstadt et al. 2006) and the act of caring (corwin 2005) foster physical and mental health in elderly individuals. however, there has been little previous exploration of how these interactions unfold in situ. in addition, an increasing number of studies suggest that religious practices including prayer, meditation, and participation in religious services aid the mental and physical health of the practitioner, promoting physical well-being and protecting against depression (koenig et al. 1997, koenig 1999, newberg 2006, strawbridge et al. 1997). through meditation, for example, tibetan monks are able to neurologically train their brains to reinforce “positive feelings and well-being” (newberg 2006: 187). in the convent, prayer organizes catholic nuns’ daily lives, represents and encodes moral and ideological tropes, and impacts the nuns’ subjective and embodied experiences in the world (corwin 2012, lester 2005). pevey et al. (2008) argue that religion provides a supportive relationship with a divine being (2008: 55). although these studies have shown a quantitative connection between spirituality and wellbeing, this study is one of the first to document anthropology & aging quarterly 2012: 33 (4) 122 anna corwin let him hold you anna corwin let him hold you spiritual and social support interactions as they unfold in ethnographic context. in this article, i examine caretaking interactions in the convent infirmary to argue that: first, for the nuns, these two processes of social support and spiritual support are interactionally intertwined such that they jointly unfold in caretaking interactions. second, i show how spiritual support is communicatively established in caretaking interactions. i find that three activities within the caretaking activities: blessings, summoning the divine, and the trope of “being god,” contribute directly to the nuns’ spiritual and social support. i argue that through these processes, in which the nuns invoke the divine in everyday activities, the nuns engage in a phenomenological reality-shaping process outlined by alfred schutz in his article “on multiple realities” (1945). schutz argued that individuals pass through a number of experiential domains throughout the course of everyday life, each of which is associated with a particular cognitive style and a particular “accent of reality.” each of these “accents of reality” or particular ways of being in the world is contained within its own “finite province of meaning” that “would appear as merely fictitious, inconsistent and incompatible” (schutz 1945: 553) in another context. i follow schutz’s model to argue that this process contributes to the nuns’ overall wellbeing at the end of life. care in the convent care in the convent provides a contrast to that of most institutional care facilities. first, and perhaps most significantly, the nuns chose to enter this institution long before they were in need of care. the nuns joined the convent as sixteento twenty-year-old girls, choosing to dedicate their lives to service to the church as teachers, missionaries, and nurses. they have lived and worked as part of this community for all of their adult lives. the majority of the nuns live in small convents near catholic schools or parishes where they work and return to the central convent or motherhouse for summer retreats and meetings. by the time they enter the convent infirmary, they feel as if they are “coming home.” sr. carline, for example, spoke to me about her experience coming “home” to the motherhouse when she retired. she describes her return home as an experience of “coming full circle”: i came home here four years ago. and in the dining room we have these round tables, you know just sit wherever, and so i had no trouble adjusting when i came, retired, no trouble whatever, i mean it was like i started here full circle and i come here all the time you know for any kind of celebration full circle and i’m coming home. and so i’ve known these people for sixty-seven years, you know, so it’s not like i’m coming into a nursing home of strangers, these are friends. in many ways, this return “home” is the opposite of the move experienced by most lay individuals who must give up their homes when they enter assisted living or nursing homes. although the nuns may not know the individuals who live with them in the infirmary, the infirmary is part of an institution they’ve been part of for most of their lives, and they share a sense of community, history, and common life experience. sr. rita, who worked as a pastoral care minister in a hospital before she retired reflected on the convent infirmary. she describes it as a unique setting that maintains a deep sense of community, which she contrasts with a hospital or nursing home setting: i think that maybe in the hospital, nursing home, [the employees] don’t want to be attached, in the sense that it means that when that patient dies or goes, (you know) won’t be seeing (her) again, but here we have a continuity because this is our mother house, this is our home, this is home. so when you come here, we’re all going to be here. because the nuns take their peers in the infirmary to be an extended family, and they are cared for by people with whom they have a shared history, the nuns do not experience the same level of loneliness, isolation, or abandonment that many elderly individuals in long-term care facilities endure. in addition, since they have taken the vow of poverty, almost all of the income they generate throughout their working lives goes directly to the convent. the convent administrators manage the group finances and plan for the housing and medical care for all of the nuns. although many convents are struggling financially to manage the end-of-life care of their members, none of the members has the sole responsibility of financing her individual retirement and end-of-life care. the nuns, however, do not always find the transition into retirement to be easy. in this way, they share a few significant similarities with lay individual entering a longterm care institution. the majority of the nuns have not lived in the convent since they were novices. they have worked their whole lives, often much more than 40 hour weeks, and are deeply involved in the local communities in which they work and with the small usually multi-generational convent in which they live. these women rarely choose 123 anthropology & aging quarterly 2012: 33 (4) anna corwin let him hold you on their own to leave these busy lives in which they are important contributors to local communities, often in positions of authority as teachers or community organizers to come to a convent infirmary. most of the nuns work until physical or mental deterioration makes it impossible for them to continue. even then, many of the sisters retire to the convent only after they are asked, or sometimes required, by the convent authorities. when they do return to the convent, the nuns, again like their lay counterparts, must give up many of the freedoms and responsibilities they held outside the convent. in the small convents where they work, the nuns cooked, cleaned, and generally were in charge of themselves and their small community. in the motherhouse, they are served three meals a day in a cafeteria or in their rooms in the infirmary. they can travel the five miles into town only when someone with a car is scheduled or persuaded to bring them. if they are not mobile, they rely on nurses or aides to clean their rooms, and to clothe and to bathe them. for women who have spent their lives caring for others, and striving to ask for as little as possible, the transition from an active, working life, to a retirement in which they are dependent on others, can be very difficult. when the nuns retire to the convent, they live in one of three types of living quarters, which range from independent living, moderately assisted living, and fulltime care in the infirmary. active and working sisters, including newly retired sisters who can live independently, live in rooms with shared dormitory-like bathrooms and, in some cases, shared kitchens. even the nuns who are most independent adjust to reduced independence and self-sufficiency. they are no longer responsible for their own cooking or transportation, and now must fit into an institutional schedule of community prayers, meals, and daily activities and duties. the nuns who are primarily self-sufficient and require minimal physical assistance live in a three-floor wing of the convent that has been converted to offer private bathrooms that are handicapped accessible as well as easy access to the dining room and nursing station in the infirmary. the infirmary, which has full-time nursing care for those who need it, is a three-floor wing of the convent, housing 45 to 80 individuals at a time. nuns in the infirmary have private rooms with televisions connected to a closed-circuit channel that broadcasts community activities from the chapel, including daily prayer and mass. there is a nurses’ station on each floor as well as a dining room. nurses and aides, employed from the local community, care for the nuns’ daily personal and medical needs. in addition, each floor has a pastoral care minister, a nun in the community who cares for the nuns’ spiritual needs – making sure she is able to take communion, access spiritual books or materials, receive spiritual direction or confession if she desires. the pastoral care minister also helps with personal communication, opening and answering mail, and she organized group activities, such as special prayer meetings, in the infirmary. the convent also employs a wellness director who is in charge of physical activity, keeping the elderly nuns active, and assisting with any physical therapy. the care interactions in the infirmary are organized around meeting the physical, social, and spiritual needs of the elderly nuns. they do not receive medical care in the convent, and must be driven to doctor’s appointments. there are a number of retired sisters who volunteer to drive those who cannot drive to medical appointments. there is a large network of volunteers among the retired sisters, living both in the infirmary, and in the larger convent, who visit the sisters in the infirmary, pray for them, and who visit those who are in the hospital for surgery or other major medical treatments. the majority of the nuns in the infirmary are there for chronic conditions, most often those associated with old age and will therefore live out the rest of their lives in the convent. the majority of the sisters do not expect to be “cured” or “healed” of the particular chronic conditions from which they suffer, however they do strive for physical and mental wellbeing, with as little pain and physical/ mental suffering as possible. the concept of healing is rarely invoked in the infirmary. instead, the nuns see themselves engaged in an ongoing process in which they strive for wellbeing. this wellbeing includes acceptance of whatever may come, including the unpleasant experience of illness. sr. carline, who had an advanced form of bladder cancer, spoke about this process of acceptance and surrender: i know that physical healing isn’t gonna last forever; it doesn’t last forever for anybody, but for me it’s more imminent and i know it’s not gonna [last]. … the main kind of healing is spiritual healing; you know that your whole body can accept whatever is coming in your life. you know if somebody says ‘do you want to die’, no i don’t want to die, i mean you know it’s not that i’m craving to die although sometimes, sometimes when you’re feeling kind of sick or you know you don’t feel good you thought oh maybe that’s not gonna be so bad, you know? but it’s not that i’m uh you know sitting here waiting to die but i’m gonna take when it comes, you know, i want to be ready to hand it over, to surrender when that anthropology & aging quarterly 2012: 33 (4) 124 anna corwin let him hold you anna corwin let him hold you time comes. sr. carline contrasts physical healing, which she describes as temporally limited, with “spiritual healing” which she describes as a “whole body” acceptance of “what is coming”, meaning, in this case, her death. sr. carline’s model of healing, which is consistent with the model i found in the convent as a whole, exemplifies the nuns’ values of serenity and acceptance of the future, which they understand to be god’s path for them. unlike many christians, the nuns do not rely on the divine to intercede in their physical healing. although the nuns believe the divine has the power to intercede in the material world, they focus their petitions to the divine on requests for endurance and for spiritual comfort. instead of requesting the divine to change the material world, to heal them, the nuns rely on interactions with the divine for sense-making and for an enduring sense of wellbeing. sr. carline, for example, understands that she has a terminal illness and accepts her oncologist’s prognosis. she turns to the divine to help her develop a sense of peace and acceptance, what she calls “spiritual healing.” the nuns, like many elderly individuals, embody healing trajectories that are not strictly bounded in time. their healing trajectories are neither restricted to physical transformations, nor are they restricted by the temporal bounds of a healing event. the model presented in the convent by nuns like sr. carline is one in which healing is not contained by a bounded medical diagnosis. this model fits well with csordas and kleinman’s argument that healing is not contained within therapeutic events, but rather “spills” into the larger temporal framework of everyday life (1996)3. the nuns do not focus exclusively on physical healing, which is a unidirectional process in which healing events (such as surgeries or therapeutic treatments) are conceptually contained as either “successful” or “unsuccessful” events. instead, the nuns see themselves as involved in an ongoing day-to-day process in which they strive for spiritual as well as physical wellbeing. this process continues throughout the life course, beginning when the nuns join the convent to begin their spiritual journal as novices (see also lester 2005). in the next section, i will show how spiritual healing is constructed in the care interactions between the elderly nuns in the convent infirmary. caretaking sister irma is an 83-year-old nun, who worked in various positions throughout her life as a teacher and community leader before she retired to the motherhouse. now that she is retired, she spends part of the week providing foot massages to elderly sisters in the infirmary. sr. irma spends each monday and tuesday afternoon massaging the feet of the elderly sisters in the infirmary and providing acupressure treatment. she goes into each room and offers massage. when she is invited in, sr. irma removes the shoes and socks from the sisters’ feet; she encourages them to relax; and she massages their feet as they recline in an easy chair or on the bed. in these interactions, sr. irma sees herself as contributing to her peers’ medical care. she is working to generate circulation in the feet of elderly sisters who are no longer mobile. this form of physical care is essential for the protection of the elderly sisters’ limbs, the importance of which the nuns are acutely aware. during the final year i was in the convent, a 99-year-old sister had her leg amputated due to lack of circulation in her limbs. as sr. irma contributes to the nuns’ physical wellbeing, she simultaneously engages in spiritual care-taking. like many of her peers, when sr. irma engages with the sisters in the infirmary, she invokes the divine as an engaged interlocutor and caretaker. this is achieved in three ways: first, through prayer which occurs here primarily in the form of blessings, second, by summoning god as a participant in ongoing interactions, and finally through embodying the divine for others and experiencing others as the divine. 1. prayer the most common form of prayer in care interactions in the convent is blessings. blessings are an “invocation of divine favor” on an activity or individual (bruder 1998:466). as sr. irma blesses the sisters, she calls on the divine to care for them, to offer them peace, or to be with them as an enduring presence. the following excerpt represents a typical blessing in the convent: example 1: blessing si: sister irma ss: sister suzie si: there ya’ go. you ready for your blessing? ss: mm hmm si: okay. may the lord bless you and keep you. may he give you courage to live each day knowing he is with you. amen. blessings occur in the subjunctive mood (bruder 1998: 470). in providing a blessing, the speaker is speaking 125 anthropology & aging quarterly 2012: 33 (4) anna corwin let him hold you directly to the divine, petitioning him to provide a favor to the speakers. in this way, blessings can be seen as requests to a third party not previously addressed in the interaction. i suggest that blessings actively shift conversation from a typical dyadic arrangement in which the two individuals in the room are speaking to each other (represented below) to a tripartite interaction. before the blessing, the two participants are engaged with each other, each as a ratified speaker and listener (goffman 1979). figure 1: dyadic interaction when a blessing is introduced, the participant arrangement of the interaction moves from a dyadic arrangement to a tripartite or multiparty arrangement in which the divine is addressed as a participant (see also ochs and capps 2001). as the nuns ask the divine for a blessing, pronouncing an utterance such as “may the lord bless you,” in which they ask the divine to intercede in the room or in the world, the participants involved in the interaction now include both the two original interlocutors as well as the divine: the divine speaker 1 speaker 2 figure2: multiparty interaction including the divine in this way, the divine is brought into the room as a relevant participant in the interaction. as sr. irma blesses sr. suzie in the exchange above, saying “may the lord bless you and keep you”, she is calling the divine into the room as an interlocutor, asking him to hear her request for sr. suzie, and to intervene as he sees fit, presumably blessing sr. suzie, keeping her, and giving her the courage and peace of his presence. the blessing achieves three actions. first, it is a way for sr. irma to communicate to sr. suzie that she wishes her peace, courage, and an awareness of the loving presence of the divine in her life. in this capacity, the blessing is a form of peer social support through which sr. irma can offer intimate support and hope for sr. suzie. second, it is a direct request for the divine to intervene in the world by providing the requested blessing. finally, the blessing is a way for sr. irma to bring the divine into the room as an engaged interlocutor, as a being whose presence becomes engaged in the activity. through the blessing interaction, the divine becomes an addressed interlocutor, engaged in the communicative activity at hand. 2. summoning god sr. irma also brings the divine into the room by calling on him directly as an engaged participant in the interaction. sr. irma often reminds people to talk to jesus. as she leaves a room, she frequently says, “jesus said to tell you that he loves you.” while she is in the infirmary, she regularly calls on him as an embodied participant in the interactions. in following example, sr. irma massages sr. mary augusta’s feet. sr. mary augusta is in her late 80s. she had just explained to sr. irma that she is suffering from a “bad heart” and that she “won’t last much longer.” she has been having bouts of tachycardia for the past few weeks and has had little energy. sr. irma had encouraged her to relax while she received the massage, and sr. mary augusta had complained that she couldn’t. as sr. irma encouraged sr. mary augusta to relax, she invokes the divine. in the example, sr. irma encourages sr. mary augusta to call on jesus to comfort her and thereby to cultivate an embodied relationship with jesus that might benefit her physically and psychologically. example 2: let him hold you s.irma – sister irma s.ma – sister mary augusta s.irma: and know that the lord does love you. s.ma: i knew that. s.irma: and he wants you to relax. [and,] s.ma: [i know] s.irma: and let him hold you. s.ma: i have a hard time relaxing. s.irma: let jesus hold you, and don’t squirm in his arms. srs. irma and mary augusta are embedded in an institutional framework in which the divine is understood to be a constant embodied presence. sr. mary augusta, like sr. theresa, describes jesus as a constant companion. she describes watching television with him each evening, his interlocutor 1 ↔ interlocutor 2 anthropology & aging quarterly 2012: 33 (4) 126 anna corwin let him hold you anna corwin let him hold you hand holding hers. she talks about engaging in physical embraces with him (a huge hug, as she describes it) each time she passes a crucifix in the convent. sr. irma’s directive, imploring sr. mary augusta to let jesus hold her in his arms therefore emerges in a framework in which jesus exists to them, if not necessarily visibly, as nonetheless real and embodied. sr. irma’s directive “let jesus hold you, and don’t squirm in his arms” is not just a metaphor. it is an embodied directive that emerges in a context in which touching jesus and being held by him is common and, moreover, possible. in this interaction, sr. irma instructs sr. mary augusta to call the divine into the room and to rely on him to help quell her anxiety. in addition to encouraging sr. mary augusta to summon the divine, sr. irma is also engaging in peer socialization, communicating what she sees as appropriate and expected behavior for a catholic nun in their community. by suggesting that sr. mary augusta engage with jesus in a physical way, allowing him to care for her, sr. irma is suggesting that she experience the embodied states the nuns associate with a divine embrace such as peace, love, support, and calm. she redirects her complaints, subtly suggesting that the complaints may not be appropriate. in doing this, sr. irma communicates to sr. mary augusta not only that it is expected for her to turn to god in her times of need, but also that that the divine is the interlocutor and embodied caretaker who can offer her the most support and assistance with her physical and psychological ailments. 3. being god finally, the nuns also bring the divine into their everyday interactions through the trope of “being god” for each other. as sister irma explained in an interview: to be there for other people is my greatest prayer. i pray with my community and with other people, through who i am and what i do. so communicating with them, the god in them, the god in me in a peaceful and gentle and just a way of graciously being. for the nuns, embodying the divine means two things: first that they will model christ’s behavior as closely as they can, serving others with humility and compassion. second, it means treating others as they would treat the divine. as one nun explained to me, this means communicating with others as if she or he is christ himself. in a talk on prayer that sr. irma gave to a group of the retired nuns, she made explicit the metaphor of “being jesus” for others. in this lecture, she argues that in order to follow jesus’ command to “go out and be the light of the world” (line 1), the nuns should embody the physical presence of the divine (line 3) through everyday acts of prayer and compassion. here, she describes this in detail: example 3: be the light of the world s.irma – sister irma s.lup – sister lupita 1 s.irma: if jesus says, “go out and be the light of the world,” 2 we are his presence. 3 the physical presence of jesus among others, 4 and so, it is our vocation as christians to be that in some way. 5 whether it’s just praying for people, 6 or listening to people, 7 or serving people in any way, 8 but when we’re in need, 9 we have to be gracious 10 to allow others to do that for us. 11 to share our pains, 12 to share our needs, 13 to let others listen to us, 14 so it’s a two-way street. 15 if i am jesus for sr. lupita today, 16 tomorrow i may need sr. lupita to be jesus for me. 17 would you do that lupita? 18 all: ((laughter from sisters)) 19 s.lup: ((sr. lupita nods)) 20 s.irma: she would do that. 21 alright. at the end of the passage, sr. irma gives the example of “being jesus” for someone. she suggests that while she might “be jesus” for sr. lupita one day, sr. lupita will reciprocate by embodying the divine for sr. irma another day (lines 15 and 16). by embodying the divine, sr. irma suggests the nuns will continue god’s work on earth with him and for him by spreading love, compassion, and by serving others. the nuns see themselves fulfilling this goal through everyday activities both spiritual and mundane. for example, many of the nuns serve others by bringing them feeding them or helping them bathe. others might fulfill the quotidian tasks necessary to keep the convent running, for example, answering the phones or cleaning the bathroom. one of the ways that sister irma strives to communicate the “god in [her]” with the “god in them,” as she put it, is through the foot massages she gives. as she sits by the elderly sisters’ feet, and takes them into her hands, she, and the other sisters in the community are consistently made 127 anthropology & aging quarterly 2012: 33 (4) anna corwin let him hold you aware of the story of jesus washing the disciples’ feet. in embodying this metaphor, sister irma superimposes the trope of jesus’ humility and devotion on top of her own interactions with her community of elderly peers. the nuns’ awareness that sr. irma is indexing the interaction between jesus and the disciples is made salient through the frequent references they make to letting sr. irma “serve” them. sr. irma also sometimes jokes about the engagement and its similarity to jesus’ washing of the disciples’ feet. in the example below, sr. irma teases another nun about the work involved in removing and replacing her stockings, saying that jesus never had to wrestle with the disciples’ stockings: example 4: in jesus’ time s.irma – sister irma s.irma: i wonder jesus didn’t have to do this, did he? ‘cause they didn’t wear socks then. (laughter) you just hadda put the slippers back on ‘em. that’s okay, i won’t charge you extra. through this practice in which she serves her fellow nuns with humility as christ served the disciples in the bible, sr. irma is performing both a symbolic, metaphorical act and a ritual act. like all embodied practices, this practice “confirms the reality – not just the symbolic idea – of a ritual act” (mcguire 2009: 7). as the ritual act of being christ is overlaid on a mundane interaction promoting circulation, sr. irma constitutes a sacred reality in which she, as a divine servant, is humbly serving her peers in the infirmary as christ served his disciples. the act of massaging the nuns’ feet brings the divine into the nuns’ tangible daily lives. my corpus of interview data has shown that interactions like these produce a calming, loving experience for the elderly nuns as they receive sr. irma’s service. in this way, sr. irma’s embodied ritual produces tangible, subjective and social effects in the world. conclusion through everyday linguistic and embodied practices, i have argued that the nuns engage the divine in three primary ways (1) through prayer, (2) by summoning the divine’s presence into the room and (3) through the powerful trope of “being god” to each other. through these processes, i argue that the nuns constitute a particular reality, or, in schutz’s terms, a “finite province of meaning” in which the divine exists in every interaction as a caretaker, in which other persons are no longer just human subjects, but also representatives and embodiments of the divine. through these interactions, the nuns create for one another and for themselves a reality in which the divine tangibly exists to them. this “province of meaning” that shapes their reality is distinct from a strictly secular or medical world, and yet is thoroughly integrated into it. as the nuns constitute the divine as an embodied figure 3: images of jesus with the disciples figure 4: image of sr. irma massaging her peer’s feet anthropology & aging quarterly 2012: 33 (4) 128 anna corwin let him hold you anna corwin let him hold you participant present in their lives, the social support the nuns receive from each other is dynamically integrated with the social and spiritual support they exchange with the divine. as they receive care and support from their human peers, they also experience the divine healing presence of god. the nuns describe experiencing the divine as a presence that accompanies them throughout the day. when they hold his hand or speak to him, they describe experiencing various embodied states including joy, peace, calm, and love. as the nuns engage with the divine, the phenomenological reality they constitute, in which they are enveloped in peace and love, impacts their psycho-emotional wellbeing. they describe feeling loved and calmed. these embodied engagements in which the divine becomes integrated into the nuns’ everyday interactions – through prayer, through an embodied presence, and through the nuns’ very bodies – shape the nuns’ experience of care and wellbeing. as the nuns superimpose this sacred reality onto everyday physical/medical care interactions, the nuns’ wellbeing, as well as their overall health trajectories are impacted these embodied rituals are central to the nuns’ enduring wellbeing at the end of life. as the nuns imbue everyday care-taking interactions with embodied engagements with the divine, medical interactions take on sacred meaning, and the nuns experience care, and comfort, and an enduring sacred presence. they are not engaged in a temporal healing trajectory that may or may not be successful and they thus avoid encountering failed healing events. instead, they are engaged in an ongoing (life-long) process of wellbeing, which shapes all encounters, whether medical or mundane, as sacred encounters with the divine. acknowledgments research for this article was supported by the national science foundation [#1026025]. i am grateful for the ongoing support and encouragement of elinor ochs, alessandro duranti, and jason throop. an earlier version of this paper was presented at the 2011 american anthropological association annual meetings. earlier drafts of this article benefitted from detailed comments and insights from keziah conrad, hanna garth, jennifer guzmán, and jessica hardin. any errors or oversights remain my own. notes 1 all names, including the name of the convent, are pseudonyms. 2 a note on style: the capitalization of pronouns referring to the divine is consistent with the nuns’ usage. 3 this concept of healing as temporally unbounded has been taken up by recent authors working on chronicity. for example, smith-morris argues that the acute/chronic dichotomy is not representative and can be problematic (smith-morris 2010). 4 of course, if the blessing occurs in a group setting with overhearers the blessing would be a multiparty interaction. references barsalou, lawrence w., barbey, aron k., simmons, w. kyle, and santos, ava 2005 embodiment in religious knowledge. journal of cognition and culture 5:14-57. bruder, kurt a. 1998 a pragmatics for human relationship with the divine: an examination of the monastic blessing sequence. journal of pragmatics 29:463-491. butler, steven m., and david a. snowdon 1996 trends in mortality in older women: findings from the nun study. journal of gerontology: social sciences 51b (4):s201-s208. cacioppo, john t, and william patrick 2008 loneliness: human nature and the need for social connection. new york: w.w. norton and company inc. cohen, robin s., balfour m mount, eduardo bruera, marcel provost, jocelyn rowe, kevin tong 1997 validity of the mcgill quality of life questionnaire in the palliative care setting: a multi-centre canadian study demonstrating the importance of the existential domain. palliative medicine 11(3):17-37. corwin, anna i. 2012 changing god, changing bodies: the impact of new prayer practices on elderly catholic nuns’ embodied experience. ethos 40(4): 359-389. corwin, jennifer haskin 2005 the fear of death and the fear of dying: possible barriers to altruistic behavior. masters thesis, department of sociology, anthropology, and criminology, eastern michigan university. csordas, thomas, and arthur kleinman 1996 the therapeutic process. in medical anthropology: contemporary theory and method revised edition. c.f. sargent and t.m. johnson, eds. pp. 3-20. westport, ct and london: praeger. goffman, erving 1979 footing. semiotica 25(1/2):1-29. 129 anthropology & aging quarterly 2012: 33 (4) anna corwin let him hold you grainger, karen 1995 communication and the institutionalized elderly. in handbook of communication and aging research. j. nussbaum and j. coupland, eds. pp. 417-436. new jersey: lawrence erlbaum associates. koenig, harold g., et al. 1997 attendance at religious services, interleukin-6, and other biological parameters of immune function in older adults. the international journal of psychiatry in medicine 27(3):233-50. koenig, harold g. 1999 the healing power of faith: science explores medicine’s last great frontier. new york: simon & schuster. lester, rebecca j. 2005 jesus in our wombs: embodying modernity in a mexican convent. berkeley, ca: university of california press. levy, robert, and douglas hollan 1998 person-centered interviewing and observation in anthropology. in handbook of methods in cultural anthropology. h.r. bernard, ed. pp. 333-364. walnut creek, ca: altamira press. maton, kenneth i. 1989 the stress-buffering role of spiritual support: crosssectional and prospective investigation. journal for the scientific study of religion 28(3):310-23. mcguire, meredith b. 2003 why bodies matter: a sociological reflection on spirituality and materiality. spiritus: a journal of christian spirituality 3(1):1-18. newberg, andrew 2006 why we believe what we believe: uncovering our biological need for meaning, spirituality, and truth. new york: free press. ochs, elinor, and lisa capps 2001 living narrative: creating lives in everyday storytelling. cambridge, ma: harvard university press. pevey, carolyn f., thomas j. jones, and annice yarber 2008 how religion comforts the dying: a qualitative inquiry. omega: journal of death and dying 58(1):41-59. reichstadt, jennifer, colin depp, lawrence palinkas, david folsom, and dililp jeste 2006 building blocks of successful aging: a focus group study of older adults’ perceived contributors to successful aging. american journal of geriatric psychiatry 15(3):194-201. schutz, alfred 1945 on multiple realities. philosophy and phenomenological research, 5(4):533-576. seligman, rebecca 2010 the unmaking and making of self: embodied suffering and mind–body healing in brazilian candomblé. ethos 38(3):297–320. smith-morris, carolyn 2010 the chronicity of life. in chronic conditions, fluid states. l. manderson and c. smith-morris, eds. pp. 21-37. new brunswick, new jersey: rutgers university press. snowdon, david 2001 aging with grace. new york: bantam books. strawbridge, william, cohen, richard d., shema, sarah j., kaplan, george a 1997 frequent attendance at religious services and mortality over 28 years. american journal of public health 87(6):95761. williams, kristine 2011 elderspeak in institutional care for older adults. in communication in elderly care: cross-cultural perspectives. p. backhaus, ed. pp. 1-19. london: continuum. film review review of bilsen, kristof. 2020. mother. limerick films. karen lok yi wong mount st. joseph hospital, vancouver karenwonglokyi2011@gmail.com anthropology & aging, vol 42, no 1 (2021), pp. 183-185 issn 2374-2267 (online) doi 10.5195/aa.2021.351 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. film review | wong | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.351 http://anthro-age.pitt.edu 183 film review review of bilsen, kristof. 2020. mother. limerick films. karen lok yi wong mount st. joseph hospital, vancouver karenwonglokyi2011@gmail.com what is the cost of caring? what is its rightful place? can we care at a distance? who is kin? in the documentary film mother, belgian director kristof bilsen does not so much answer these questions—but takes the time and the courage to ask them properly. mother is set in both switzerland and baan kamlangchay, a nursing home in thailand for german-speaking european people with dementia. shifting between skin-close shots of the practice of caressing, feeding, keeping quiet, humming, gazing, and breathing—to name a few—and the broader ‘landscapes’ of care in the international care market, bilsen witnesses the transformations of relations that dementia urges and invites for. baan kamlangchay is a private care center owned by swiss psychotherapist martin woodtly, who once sought and found appropriate care for his mother with dementia in thailand. he founded the center after she died, and it is now home to a small group of german and swiss men and women with dementia. they were brought here ‘on holiday’ by their family members who were looking for the best possible life for their beloved ones. this echoes a new global trend in elder care: as the global increase in life expectancy necessitates complex care, family members and kin need to rely on costly, professional caregivers to support them in this process. meanwhile, chronically underfinanced care institutions struggle to find the time, energy, and resources to give the care they perceive as ‘good.’ the outsourcing of eldercare to low-cost countries is one trend to meet these emerging care needs in a globalized world. while the movie contains many voices, one of the most pertinent and direct ones is that of pomm, a thai woman who worked as a caregiver in baan kamlangchay at the time of filming, and to whom bilsen “hands over the camera” (chalfen and rich 2007, 53) to document her life as it unfolds along multiple practices of care. she is one of the women at the facility that makes it possible for residents of the care home to have full-time company and receive one-on-one care day in and day out. as pomm, together with bilsen, reminds: in a capitalist economy, privilege for some often means the consolidation of existing disadvantages for others. in a particular scene, pomm poignantly reflects: every day when i see patients in this condition, i think to myself, “how lucky they are.” they are lucky: they have three caregivers taking care of them when they are in this condition. they’ve got money to pay for all of this assistance. i think to myself, “if one day, i get like this, what will i do? who will take care of me? will my kids do it? will they love me?” i don’t want to live a life that is a burden to other people. it made me realize the big difference between the rich and the poor. http://anthro-age.pitt.edu/ film review | wong | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.351 http://anthro-age.pitt.edu 184 pomm looks after patients in baan kamlangchay who are other people’s mothers (such as elisabeth and maya). she embraces patients so intimately, as if they were her mother, and mourns for them as a child. this is directly at the cost of ‘mothering’ her own three children, whom she has to leave with her mother, who faces health issues herself. caring as a professional to support her family financially, comes at the cost of caring for them as a mother and as a daughter. thus, the scenes of baan kamlangchay, which instinctively evoke limitless love and devotion, are also always drenched in guilt at multiple sides of caregiving: of pomm for failing her daughterly and motherly duties and of spouses and kin for letting their loved ones go. additionally, i would like to focus my reflections on pomm as a professional caregiver. the movie takes place between the last days of one patient, elisabeth, and the first days of a new patient, maya, both of whom are pomm’s responsibility in the care home. maya is a beautiful and intelligent woman with early onset dementia, who lives with her husband and daughters in a house in switzerland. bilsen showcases the family’s intimate struggles on what would be best for maya. one of her daughters talks about this difficult process of balancing their own needs and that of their mother’s, to ultimately decide on what would be ‘the best’: it was a process spanning several years, when we first talked about it and said ”no,” and then “ah yes, maybe it’s not bad after all.” and it was actually dad (maya’s husband) who said: “should we be selfish and keep her here because we want to see her? or should we think for her: where will she be better off? and that’s in thailand, where she receives all of the care, love, and attention she needs.” ultimately, we have to decide for mom. . . maya has difficulty adjusting to life in baan kamlangchay and has lost certain abilities that would allow her to communicate this in words. she can only express her frustrations through behaviors. martin, the supervisor of the center, and pomm discuss possible approaches to this issue and conclude that maya is still young compared to other residents and might feel uncomfortable being surrounded by them. this person-centred perspective, which focuses on her behavior as a meaningful expression rather than a marker of the disease, makes them decide to take maya out regularly. they do this to cheer her up, and eventually, take her shopping, which appeals to one of her previous modes of being a woman, being western, and being pretty. two reflections come to mind when considering such forms of person-centered care as good practice. firstly, such patient-centered care requires massive resources. maya is fortunate to receive the full attention of pomm, but these kinds of alternative practices would be impossible if she lived in a care home in which one caregiver looks after six or even more patients. another reflection is that although patient-centered care is ‘good,’ there should be a shift towards patient-directed care that would include maya in discussions of her care. since maya is not able to express herself in words, she can still exert control over how care is provided through facial expressions and gestures. bilsen uses expert film techniques to poignantly convey how senses may prevail when words fail, not only through forgetfulness and loss with dementia but also in moments of careful attendance, in distancing, in wondering, in mourning, in longing, in joy. we hear maya and her daughter’s last steps in the snow together, dampened by the distance of what is yet to come. we sense the loneliness of pomm at the end of the day, when she finds herself in bed, alone and defective, all the while surrounded by love. and we come skin-close to pomm’s massaging movements on the hands of elisabeth, who can only urge sounds and gestures—not words—to anchor herself in the world. elisabeth’s touch is subtle but conveys meaningful messages, such as her appreciation for pomm and her trust in the integrity of http://anthro-age.pitt.edu/ film review | wong | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.351 http://anthro-age.pitt.edu 185 their relationship. bilsen skillfully captures such significant moments and gives the word to pomm, who cares through touch. pomm says, “you have to use your feeling to reach her.” mother furthermore powerfully evokes the reciprocity of caring. while pomm and other caregivers in baan kamlangchay look after people living with dementia, they become care partners and share their lives. in the film, pomm expresses how elisabeth supports her and is the only one with whom she can share her frustrations, “because every time i talk to her, she shows compassion, and then she forgets it, and she won’t tell anyone about it either.” the “ethics of care” perspective (hankivsky 2004) supports pomm’s feelings about her relationship with elisabeth. it reminds us that we are interdependent and can be both caregivers and care-receivers, often at the same time. in pomm and elisabeth’s case, pomm is elisabeth’s caregiver most of the time, but elisabeth is also pomm’s caregiver and gives her emotional support when pomm is frustrated. caregivers and patients in baan kamlangchay develop close, intimate relationships. when patients pass away, caregivers mourn. in the film, there is a poignant scene in which pomm accompanies elisabeth by her bedside when she goes to bed. when elisabeth passes away later, pomm finds elisabeth’s empty room. using a method of audiovisual participatory ethnography (gubrium & harper 2016; jarrett & liu 2018; yang 2015), bilsen hands pomm the camera. pomm films the room and says, “an empty room. granny (elisabeth) is no longer here. it’s not the same.” bilsen then takes the camera back and films pomm—she is crying. not only does this depict the emptiness elisabeth leaves in space, but also the emptiness of pomm’s heart; due to pomm and elisabeth’s close relationship, it is as if pomm has lost her own mother. also, at elisabeth’s funeral, pomm is sitting next to elisabeth’s daughters as if she is one of them. to be a caregiver is extremely stressful, both physically and emotionally, as patients may show challenging behavior towards them due to dementia. still—and because of that—caregivers often form tight bonds with their patients, so losing them can be a painful experience, similar to that of losing a family member. mother is an extremely touching film. it is a film for everyone. more significantly, i believe that people who have experience looking after people living with dementia can particularly resonate with this film. it will also be of interest to scholars working in the field of transnational care, labor migration, and kinscapes. references gubrium, aline, and krista harper. 2016. participatory visual and digital methods. left coast press. https://doi.org/10.4324/9781315423012. hankivsky, olena. 2004. social policy and the ethic of care. ubc press. jarrett, michael, and feng liu. 2018. “zooming with: a participatory approach to the use of video ethnography in organizational studies.” organizational research methods 21 (2): 366-385. https://doi.org/10.1177/1094428116656238. yang, kyung-hwa. 2015. “participant reflexivity in community‐based participatory research: insights from reflexive interview, dialogical narrative analysis, and video ethnography.” journal of community & applied social psychology 25 (5): 447-458. https://doi.org/10.1002/casp.2227. http://anthro-age.pitt.edu/ book review review of yahalom, jonathan. caring for the people of the clouds: aging and dementia in oaxaca. norman: university of oklahoma press. 2019. pp. 231. price: $55 (hardcopy); $24.95 (paperback and ebook). cíntia engel federal university of bahia (ufba) cintiaengel@gmail.com anthropology & aging, vol 42, no 1 (2021), pp. 164-166 issn 2374-2267 (online) doi 10.5195/aa.2021.343 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | engel | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.343 http://anthro-age.pitt.edu 164 book review review of yahalom, jonathan. caring for the people of the clouds: aging and dementia in oaxaca. norman: university of oklahoma press. 2019. pp. 231. price: $55 (hardcopy); $24.95 (paperback and ebook). cíntia engel federal university of bahia (ufba) cintiaengel@gmail.com “but regardless of what concrete action one comes to take, caregivers teach that appropriate interventions are ones that meaningfully acknowledge individuals for their daily efforts. they are ones that honor caregivers’ dedication to maintain a sense of cohesion within parameters of contemporary life” (169). in caring for the people of the clouds, psychologist jonathan yahalom utilizes socio-anthropological research methods to shed light on the cultural specificities of dealing with dementia in teotitlán, oaxaca. he provides caregivers’ perspectives on alzheimer’s disease while also highlighting how the community of teotitlán understands forgetfulness in the process of aging, such as if and when forgetfulness is interpreted as a disease and how and why it should (not) be cared for. based on indepth interviews and observations, yahalom proposes that the reflexive potentialities of anthropological theory and ethnographic method can help alleviate the social ostracism dementia caregivers may experience and foster psychologists and other health professionals’ understanding of life with dementia from an emic perspective. yahalom incorporates social constructivism in part of his analysis, considering illness experiences and trajectories as social phenomena, and also relies on pragmatism to defend the multiplicity of lived realities. in the book, yahalom’s main objective is to urge psychologists, doctors, and other health professions to recognize the culturally and historically contingent spaces of and for dementia, alongside and together with biomedical approaches. based on interviews with family caregivers and analysis of local newspapers, street art, and public campaigns on aging, yahalom argues that older adults in oaxaca are traditionally admired and respected for being carriers of cultural knowledge. becoming forgetful, however, they begin to lose this status. for citizens of the community, forgetfulness in older adults can indicate the disintegration of kinship ties and a general decay of traditional ways of living. in oaxaca, alzheimer’s is a disease mainly related to stress and modern life. most of yahalom’s interlocutors would say that alzheimer’s is caused by a stressful way of life associated with the country’s modernization, and some would even add that families that do not preserve the traditional way of life are most at risk of developing the disease. caregivers manage these tensions between the traditional and the modern, as it plays out in the bodies http://anthro-age.pitt.edu/ book review | engel | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.343 http://anthro-age.pitt.edu 165 they care for and are at risk of being held responsible for the decay of tradition. following the current literature on care (e.g., buch 2015; parreñas 2015; yarris 2017), yahalom insists on the ambiguous, “segre-social” (20) character of caregiving: it’s an activity that reproduces and maintains social cohesion but is similarly entwined with social transformation, isolation, and conflict. in yahalom’s words, segresocial is “an admittedly clumsy term that attempts to capture how caregivers are simultaneously drawn into new familial relations centered on dementia but, in doing so, risk becoming misunderstood by and segregated from the larger community” (20). the introduction to the book’s five chapters contextualizes the community and the city and gives an overview of yahalom’s research methodology. chapter 1 discusses local perspectives on aging and forgetfulness: normally, an older adult will be treated as a mature and respectable member of society; experiences of forgetfulness, however, can change that perception and relegate older persons with dementia to the social space of children. yahalom argues that the ethics of caregiving in the region is rooted in social values of communitarianism and familism; referentially, care is done at home by family members. chapter 2 explores how forgetfulness among older adults is normalized when kin relationships are not endangered. on the other hand, however, caring for kin becomes problematic when those who suffer from memory loss forget who they are or stop recognizing their kin. in chapter 3, yahalom further explains the modern/traditional dichotomy in the etiology and treatment of diseases. since in teotilán, alzheimer’s is a disease associated with modernity and stress, it is thought to belong to the field of expertise of modern medicine. other episodes of forgetfulness are treated as traditional diseases, such as susto, a condition related to encounters with spirits. this chapter also mentions how historical and contemporary power relations, as well as structural inequalities, influence the choice between traditional healing or modern biomedicine. believing in traditional knowledge, for example, can be an act of resistance since those practices have a history of public persecution. seeing a specialist, on the other hand, is unsettled by the fact that health care provision in the community is limited to basic care; a specialist that could diagnose alzheimer’s is too expensive for most families. chapter 4 further explores this tension between traditional and biomedical treatment and observes caregivers’ strategies to negotiate ‘good care’ for forgetful older adults, caregivers tinker different values through socio-material practices (e.g., how to care, when to see a doctor, and how to divide the care tasks among family members) (mol, moser, and pols 2010). chapter 5 reflects on caring for people with memory impairment and the vulnerable position of caregivers in the community. those caring for older adults with memory impairment are constantly investigated by neighbors and are frequently targets of gossip. as forgetfulness might be viewed as the decay of social values such as supporting the family and the community, caregivers can be held personally accountable for the worsening of dementia symptoms in older adults and at the same time for the general decay of social cohesion. in the epilogue, yahalom synthetizes his plea for a pragmatic approach to dementia (research). according to him, doctors and psychologists must work to understand cultural concerns and disease categories and the social suffering of caregivers. this work provides interesting insights on forgetfulness and aging in dialogue with current literature on the cultural specificities of caring in mexico. particularly powerful, is this book’s attempt to open up a dialogue between anthropological research and clinical interventions. nonetheless, some aspects of this book leave room for further exploration. for example, the status that “familism” is given as a cultural aspect of social cohesion is problematic. of course, the centrality of family care is prominent in the interviews and literature about care in latin america, but “familism” is also a term used in critical latin-american literature on care to express a state ideology that justifies improperly investing care infrastructures (see for example debert 2012). the social and political implications of the centrality of http://anthro-age.pitt.edu/ book review | engel | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.343 http://anthro-age.pitt.edu 166 family in caring for dementia are thus far more complex than that of a cultural characteristic that reproduces social cohesion in the region. perhaps, a critical cultural sensitivity for the present politics of care in latin america could have steered the analytical attention away from social cohesion as a cultural concern towards more realist and speculative approaches to care for dementia in oaxaca. something that could have prevented this shortcoming is a more reflexive attitude towards the ethnographic methodology itself. in chapter 3, for example, yahalom describes the difficulty of accessing a specialist that could diagnose alzheimer’s. nevertheless, the author does not draw any conclusions from it for the everyday enactment of dementia. the book ends on a down note (169). understandably, yahalom advocates for a type of anthropological sensibility in clinical work. for the author, culture cannot be understood just as a general context for experiencing the disease; approaching culture requires an ethnographic mode of attention to include the complexity of sociocultural experiences of illness and caregiving. but, after the complexity of disease identity and caregiving was brought to the fore in ethnographic data, this conclusion seems a little too naïve, rationalist, and even apolitical: how exactly can this sensibility be a solution for caregivers’ dilemmas? despite these shortcomings, this is an important book for the study of dementia and caregiving in latin america and beyond. it showcases experiences that necessitate critical thinking and complex perspectives on caregiving and aging. anthropologists, researchers, and practitioners of psychology, geriatrics, and psychiatry will benefit from reading it. references buch, elana. 2015. “anthropology of aging and care.” annual review of anthropology 44: 277-293. debert, guita. 2012. “imigrantes, estado e família e suas vicissitudes.” in cuidado e cuidadoras: as várias facetas do trabalho de care. edited by helena hirata and nadya araujo guimarães, 216-233. são paulo: editora atlas. mol, annemarie, ingunn moser, and jeannette pols. 2010. “care: putting practice into theory.” in care in practice: on tinkering in clinics, homes and farms. edited by annemarie mol, ingunn moser and jeannette pols, 277-300. bielefeld: transcript verlag. parreñas, rhacel. 2015. servants of globalization: migration and domestic work. stanford, ca: stanford university press. yarris, kristin. 2017. care across generation: solidarity and sacrifice in transnational families. stanford, ca: stanford university press. http://anthro-age.pitt.edu/ book review review of vaughan, laurene, ed. designing cultures of care. new york: bloomsbury. 2019. pp. 243. price $100 (hardcover); $80 (ebook). richard zimmer sonoma state university razimmer41@gmail.com anthropology & aging, vol 41, no 2 (2020), pp. 271-273 issn 2374-2267 (online) doi 10.5195/aa.2020.300 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | zimmer | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.300 http://anthro-age.pitt.edu 271 book review review of vaughan, laurene, ed. designing cultures of care. new york: bloomsbury. 2019. pp. 243. price $100 (hardcover); $80 (ebook). richard zimmer sonoma state university razimmer41@gmail.com what does it mean to design care and how does one do it in diverse situations and venues? laurene vaughan, an artist and professor of design at rmit in australia, has compiled sixteen essays on these questions, from architects, planners, and designers. they range from visual design projects to configuring and reconfiguring physical spaces, including cities. the essays raise the issue of what it means to care beyond the ‘simple’ concern that the user will find the object or space convenient. ‘caring,’ as these essays suggest, must involve the user from the start, including planning, and throughout the implementation. the goal is loving empowerment, particularly for marginalized people. caring must also be flexible and should grow with the people it helps. the book should be important to designers, architects, city planners, community organizers, social and behavioral scientists, as well as to the people for whom care is necessary. the essays bring together a philosophy of caring that extends the dialogue of how to plan. because the volume was assembled before the covid-19 pandemic, the question of what constitutes ‘care’ in a world of contagion must be addressed in present and future design considerations. this will be discussed at the end of this review. the editor has brought together articles that primarily focus on australia and new zealand, although other areas of the world are covered, such as norway and sweden. this is refreshing for north american readers, who may not be familiar with developments in those places. furthermore, the intent of the collection is to broaden the notion of care. each essay addresses a different issue. cathy smith and suanne ware, in chapter 3, portray the underrepresentation of women in the architectural profession in australia. it further shows a women’s collective redoing and repurposing physical spaces for a women’s shelter, factoring in the specific emotional needs of the adults and children who will be staying there. brad haylock (chapter 4) displays how “caring” design – in this case, visual information – can be displayed in such a way that the observer not only can see what the information means, but also how to act to effectuate change. the observer here is the person who looks at the information portrayed in media, such as a poster. the author follows paolo freire’s empowerment writings – where the goal is to get marginalized and disempowered people to be their own activists. the visual presentation is simple and dramatic. it can easily lead to individual action and community organizing. one article (chapter 6), by laurene vaughan, shanti sumartojo, and sarah pink, reviews the redesign of a psychiatric care facility. the ‘old’ type of facility created a harsh space, where there were few amenities, http://anthro-age.pitt.edu/ book review | zimmer | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.300 http://anthro-age.pitt.edu 272 the medical power structure was visible, and the residents were put at risk for self-harm and suicide. the new design sees the resident as having needs to help her/himself and to enjoy life as much as possible – consistent with appropriate safety measures. surfaces are smoother, colors warmer, and there are real views of the outside. in addition, suitable space is made for the caregivers themselves, who are now no longer simply relegated to the back room. in simple words, the new space tries to care for all its people. there may be more diverse opinions as to what constitutes an agreement of a “caring” environment in such settings (see, for example, hunt and sine 2015, 2). neal haslem, keely macarow, guy johnson, and marcus knutagard, in chapter 9, write eloquently about ways to address homelessness. they bring together people who need housing and policy makers, suggesting that “homefulness” is the goal. contrasting the cities of melbourne and malmo, they find a more receptive audience in the latter. this idealistic reformulation of the goal of getting people to housing, however, may run into the stonewall of other neighborhood participatory groups blocking such housing, as other researchers have found (e.g., einstein, glick and palmer 2020, 311-2). caring is not necessarily a goal shared by everyone in the same way. of special interest to those people studying aging as well as disability are two essays. the first is by rachel clarke (chapter 7). clarke describes the tools developed and the meetings held by newcastle, australia stakeholders, including the elders’ council, to pursue an age-friendly city, a program encouraged by the world health organization. one major goal here, for example, is to promote mobility (95). the second piece (chapter 8), by yanki c. lee, niels hendriks, and albert tsang, features a dementia understanding kit. the kit includes exercises where people have to do activities that provide the experience of a person with dementia. one, for example, is putting on an oddly buttoning shirt (1023) people not familiar with dementia can use the kit to understand the needs of a person with dementia and incorporate accommodations into their planning. still, the question remains, whether one needs a “memory town” (where the resident sees structures [houses, streets, buildings] familiar from one's childhood or early adulthood) to help people with cognitive and memory loss to function at a higher level (see, for example, power 2019) or whether aging in place is most desirable (e.g., kalita 2017). in an ending dialogue between mick douglas and laurene vaughan, the issues of what constitutes the differences between empathy and care are addressed: “laurene: ‘. . . empathy is affect or emotive, where care is actionable’” (226). she later goes on to say: “‘design’s ability to take steps into uncertainty or the unknown underpins what designers do and they learn to do, either formally or informally’” (227). this last point is crucial, given the current pandemic because it is evident historically that both pandemics and epidemics have transformative influence over design. for example, the early twentieth century flu influenced the open spaces of the bauhaus created world (“modernist architecture: the bauhaus and beyond” 2020). it even influenced the creation of the modern bathroom (feldman 2020), while other epidemics have led, for example to the redesign of nursing homes (drinka et al. 1996). the covid-19 pandemic, because of its uncertainties in terms of intensity, surges, mutations, and asymptomatic people, raises serious design questions. medical and similar facilities must be designed to prevent infection among residents and caregivers. other spaces must be designed for periodic closures and distancing (chang 2020). it can best be surmised that the “watchword” for design in general may be “a more semi-permanent feel” (mcconahey 2020, d1). this semi-permanence, however, leaves room for more creative and empathetic designs and in turn, forms of care. this well written volume raises the important question of how to care in new and creative ways, and of how co-creating open-ended designs can support a bottom-up process of transformation of what ‘care’ can and should mean in particular situations. it is useful for anthropologists in almost every specialty. http://anthro-age.pitt.edu/ book review | zimmer | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.300 http://anthro-age.pitt.edu 273 it is also useful for social scientists, architects, designers, urban planners, artists, musicians, and community activists. lastly, upper division and graduate students will find it readable. references chang, vanessa. 2020. “the post-pandemic style.” slate. https://slate.com/business/2020/04/coronavirusarchitecture-1918-flu-cholera-modernism.html. drinka, paul j., peggy krause, margo schilling, barbara a. miller, peter shult, and stefan gravenstein. 1996. “report of an outbreak: nursing home architecture and influenza-a attack rates.” journal of the american geriatrics society 44(8): 910-3. https://doi.org.10.1111/j.1532-5415.1996.tb01859.x. einstein, katherine levine, david m. glick and maxwell palmer. 2020. “neighborhood defenders: participatory politics and america’s housing crisis.” political science quarterly 135(2): 281-312. feldman, david. 2020. “how a pandemic inspired your bathroom.” whyy. pbs: npr. https://whyy.org/articles/how-a-pandemic-inspired-your-bathroom/. hunt, james and david sine. 2015. “common mistakes in designing psychiatric hospitals: an update.” the facility guidelines institute. https://fgiguidelines.org/wpcontent/uploads/2015/07/fgi_commonmistakespsychiatrichospitals_1505.pdf. kalita, alexandra. 2017. “everything you should know about designing a home for aging in place.” architectural digest. https://www.architecturaldigest.com/story/aging-in-place-guide. mcconahey, meg. 2020. “pandemic design: rethinking architecture in the age of covid-19 when shelter-in-place has taken on a more semi-permanent feel.” the press democrat. july 20. d1-2. power, matt. 2019. “dementia villages evoke nostalgia for better and worse.” green builder media. https://www.greenbuildermedia.com/blog/dementia-villages-evoke-nostalgia-for-better-and-worse. victoria and albert museum, london. 2020. “modernist architecture: the bauhaus and beyond.” https://www.vam.ac.uk/articles/modernist-architecture-the-bauhaus-and-beyond. http://anthro-age.pitt.edu/ https://slate.com/business/2020/04/coronavirus-architecture-1918-flu-cholera-modernism.html https://slate.com/business/2020/04/coronavirus-architecture-1918-flu-cholera-modernism.html https://doi.org/10.1111/j.1532-5415.1996.tb01859.x https://whyy.org/articles/how-a-pandemic-inspired-your-bathroom/ https://fgiguidelines.org/wp-content/uploads/2015/07/fgi_commonmistakespsychiatrichospitals_1505.pdf https://fgiguidelines.org/wp-content/uploads/2015/07/fgi_commonmistakespsychiatrichospitals_1505.pdf https://www.architecturaldigest.com/story/aging-in-place-guide https://www.greenbuildermedia.com/blog/dementia-villages-evoke-nostalgia-for-better-and-worse https://www.vam.ac.uk/articles/modernist-architecture-the-bauhaus-and-beyond book review review of cao, fang. elderly care, intergenerational relationships and social change in rural china. springer. 2019. pp. 199. price: $17.36 (hardcover); $17.80 (ebook). mengxing ma university of melbourne mengxing.ma@student.unimelb.edu.au anthropology & aging, vol 42, no 1 (2021), pp. 170-172 issn 2374-2267 (online) doi 10.5195/aa.2021.346 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | ma | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.346 http://anthro-age.pitt.edu 170 book review review of of cao, fang. elderly care, intergenerational relationships and social change in rural china. springer. 2019. pp. 199. price: $17.36 (hardcover); $17.80 (ebook). mengxing ma university of melbourne mengxing.ma@student.unimelb.edu.au rapid population aging and rural-urban migration are two sociodemographic phenomena that strongly impact support systems for older adults living in rural china. these phenomena increasingly draw attention from researchers and policymakers who rely on quantitative data to make sense of the transformation of older adult support systems. in elderly care, intergenerational relationships and social change in rural china, fang cao traces the emergence of this transformation from 1949 onwards and combines ethnography and semi-structured interviews to shed light on the impact of socio-politicaleconomic changes on elderly care and intergenerational relationships in rural china. one of the great strengths of this book is its research methodology. cao spent around five months between 2014 and 2015 in dougou, a village in henan province in the middle of china, conducting participant observation and interviews. this immersive ethnographic approach allowed cao to delve into the everyday family life of villagers as a ‘member’ of the community. another strength of this book is its systematic attention to multiple perspectives across a broad historical scope. elderly care and intergenerational relationships in china’s rural families are discussed within the extended family system, communities, and broader structural contexts of china, covering the period from mao’s reign (1949-1978) to the post-mao period (1978-). the book is well-structured, which makes it easy for readers to grasp its content. the first two chapters introduce the background of the research, the methodology, theoretical frameworks, and the context of dougou village (including history, culture, geography, and governance). in chapter 2, cao provides a detailed introduction of dougou, illustrated with maps and photos. this is helpful, especially for readers who are not familiar with chinese geography and culture. chapters 3 to 7 report the ethnographic findings, with each chapter presenting one main theme. chapter 3 focuses on cultural guidelines for filial piety and filial behavior, and chapter 4 discusses the parental obligation to help sons establish their own families (e.g., building a new house, paying a bride-price, and providing material assistance to their own families). these two chapters together illustrate how mutual obligations between parents and children have changed since 1949 and how they are now practiced in the local community. for instance, although elderly care is consistently viewed as the adult sons’ and their wives’ obligation, the adult daughters’ roles in elderly care have changed considerably. in the past, it was considered a shame to be cared for by adult daughters because this would lead people to believe that sons are not filial. nowadays, however, it is normal that adult daughters contribute considerably to elderly care in rural areas, including through emotional and financial support. the author thus asserts http://anthro-age.pitt.edu/ book review | ma | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.346 http://anthro-age.pitt.edu 171 that filial piety is still a key norm for social behavior in rural china but is constantly reinterpreted in the context of china’s rapid socio-political-economic changes (e.g., if listening to parents indicated filial piety in the past, quarreling with parents is not seen as unfilial nowadays). chapter 5 demonstrates the effects of migrant work and economic change on elderly care and intergenerational practice. the material life of older adults has improved compared to their wealth during mao’s period because of increased family income from migrant labor. however, today, the geographic distance caused by migrant work creates new challenges for families providing elderly care. for instance, adult children may face the conflict between staying at home to care for older parents and doing migrant work to make money. in chapter 6, cao further analyzes the declining social status of rural elders and attributes it to their declining monetary contribution to the family in a migrant economy. the author concludes that despite the persistence of the moral obligation of filial piety, older adults in rural china are largely marginalized and more vulnerable to the negative side-effects of rapid socio-political-economic change. chapter 7 depicts the negotiations about elderly care practices among adult siblings and between adult couples (i.e., the son and his wife) in the era of urban-rural migration. the division of caregiving responsibilities among adult siblings is mainly based on their resource availability (e.g., adult children who work outside the village provide financial support, and children who live in the village provide instrumental support). the negotiation between the couples mainly depends on their marital relationship and their relationship with the older parents or parents-in-law. chapters 3 to 7 are well written, with ethnographic data presented in a narrative style. many vivid, sometimes opposite stories are presented in each chapter, immersing the reader into daily life in dougou. some comparisons between the lives of older generations and younger generations are particularly impressive. for instance, younger people nowadays have a much better living standard than older adults (see chapter 6.1), and the role of mother-in-law and daughter-in-law has been reversed (see chapter 6.4). these changes demonstrate that the uplifted social position of women and younger adults compared to the communist era parallels the marginalization of older adults, who are left-behind in the rapid socio-economic changes of contemporary china. the author uses local proverbs to indicate the changes that have occurred over the past decades. for instance, she contrasts the older proverb “a young wife finally becomes a mother-in-law after many years’ suffering” (多年的媳妇熬成 婆) with the more recent proverb “to wait on your daughter-in-law is like providing for and respecting your grandmother in old times” (伺候媳妇得像过去伺候奶奶一样) (123) to indicate how the social prestige of the mother-in-law and the daughter-in-law have been reversed in rural china. the use of proverbs provides readers with an accessible way to understand family practice and intergenerational relationships in dougou through its local language. chapter 8 analyzes the ethnographic data through three theoretical frameworks, namely social exchanges theory, carol smart’s (2007) personal life approach, and david morgan’s (2011) family practices approach. although the author convincingly motivates her use of three different theories, her analysis would have benefited from a tighter integration of data and theory. reading the discussion in chapter 8, close to the end of the book, one might disregard the connections between these theories and the rich ethnographic examples presented in the previous five chapters. in chapter 9, the author concludes with a comprehensive and constructively critical summary of the book’s key findings and offers some brief suggestions for policies and recommendations for future research. for instance, the author recommends exploring the intergenerational exchange between younger rural people (in their 20s) and their parents and the changes in their attitudes regarding caring for their older parents in the future. http://anthro-age.pitt.edu/ book review | ma | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.346 http://anthro-age.pitt.edu 172 in addition to the separation of theory from ethnographic data, there are other minor shortcomings in the book. regarding elderly care, i expected to see rural older adults’ experiences represented, but the author places adult children’s voices in the center. furthermore, the overall tone of chapter 7, which describes “caring for ageing parents in the migration era” (133) is very positive and optimistic about the ways adult children successfully adapt to a changing labor market and adjust their ways of caring for older parents according to new possibilities and demands. this is important to acknowledge, but it also leaves the voices of those who receive care unreported. older adults’ perceptions and needs that come with shifting intergenerational relations should not be ignored in a book on elderly care. despite these shortcomings, the book enriches the existing literature on family life and elderly care in rural china. this book will be of great interest to students and researchers working on intergenerational relationships and elderly care in rural china in the fields of sociology, anthropology, and social gerontology. in addition, it will be an engaging read for a lay audience interested in the lives and cultures of rural china. references morgan, david. 2011. rethinking family practices. london: palgrave macmillan. smart, carol. 2007. personal life: new directions in sociological thinking. cambridge: polity. http://anthro-age.pitt.edu/ book review review of robbins, jessica c. aging nationally in contemporary poland: memory, kinship and personhood. new brunswick, new jersey: rutgers university press. 2021. pp. 211. price: $120 (hardcover); $29.95 (paperback, epub, pdf). kimberly shay wayne state university kimberly.shay@wayne.edu anthropology & aging, vol 42, no 1 (2021), pp. 177-179 issn 2374-2267 (online) doi 10.5195/aa.2021.349 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | shay | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.349 http://anthro-age.pitt.edu 177 book review review of robbins, jessica c. aging nationally in contemporary poland: memory, kinship and personhood. new brunswick, new jersey: rutgers university press. 2021. pp. 211. price: $120 (hardcover); $29.95 (paperback, epub, pdf). kimberly shay wayne state university kimberly.shay@wayne.edu in her debut book, aging nationally in contemporary poland: memory, kinship and personhood, gerontological anthropologist jessica robbins imparts a vital and insightful examination of aging and the meaning and production of moral personhood in post-communist poland. through extensive and long ranging ethnographic fieldwork in the polish cities of worclaw and poznań, robbins provides new insight into the ways that meaning and moral personhood is created and maintained by older adults in the fluid and changing political world of modern poland. robbins first introduces the reader to the historical and physical realities that have shaped the contemporary socio-political situation of the country, as well as the lives of her aged ethnographic subjects, who lived through the massive political changes experienced by poland in the past decades. the author not only recounts the histories of the ethnographic field sites of warclaw and poznań, but also includes older poles’ perceptions of those spaces and their histories amidst migrations and occupations. ethnographic research for this book was conducted in three types of sites within these two locations: firstly, ngos that promote active aging, specifically, universities of the third age (uta) and the group @ctive seniors; secondly, institutions focused on medical purposes, including both rehabilitation centers, and a center for long-term care, and finally places where older poles congregate, such as allotment gardens, senior clubs, and parish clubs. the author examines how individual moral and relational personhood is created and maintained by older adults in these settings. moral personhood is here defined as an “analytical category that encompasses what it means to be a social person. . . . to feel valued and included” (4). she also highlights the distinction between the cultural category of “third age” as “a time in the life course when one has left the formal labor market, remains healthy and can thus contribute to society through activities” (3) and the socio-cultural subsequent “fourth age,” “characterized by decline, illness, dependency, isolation” (4). chapter 1, “histories of active aging: aktywność across eras,” foregrounds the historical, political and economic factors that have shaped governmental policy and social perspectives about aging in poland. particularly, the categorizing of independent versus dependent older people in the 1970s, together with poland’s political shifts from communism to a capitalist democracy, and the ways these shifts have http://anthro-age.pitt.edu/ mailto:f.diodati@campus.unimib.it book review | shay | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.349 http://anthro-age.pitt.edu 178 impacted the way utas today represent both active (aktywny) and independent (aktywność) aging. in chapter 2, “aspiring to activity: transforming aging through education,” the focus shifts to cultural perceptions of old age in poland, starting with the acknowledgment of the globality of negative stereotypes. robbins offers an insider’s perspective from the uta and @ctive senior programs, where participants refute these stereotypes by fostering lifelong learning for older people in a multigenerational setting. the ideas of sociality and moral personhood among the uta participants are also important, as they are reflected in the ways that these utas are distinctive, not only in poland, but regionally within poland as well. the book recognizes that the benefits of uta participation are not accessible to all older poles, noting the impact of socioeconomic class and disability in later life has on access to these services. the author demonstrates, through ethnographic examples, the ways in which the history of communism and post-communism in poland impacted the lives of seniors and the ways these lived histories and these new ways of learning in later life are inexorably linked, in the lives of these polish elders participating in utas and @ctive senior programs. chapter 3, “beyond activities: sustaining relations in institutional care,” contrasts sharply with the earlier exploration of features of active aging. the focus here is on how personhood is fostered and maintained in two centers of institutional care, namely a catholic rehabilitation center located in the city center that offers mostly short-term stays and a social welfare home, located outside the city and both geographically and socially more isolated, for long-term residence. these ethnographic accounts offer the reader insight into the ways that moral personhood is maintained, despite challenges in older age such as a lack of financial resources and health decline, by giving the reader insight into the social relationships and daily cycle of the practices of everyday care that contribute to maintaining moral personhood. in chapter 4, “remembering the polish nation: connections across the third and fourth ages,” the author combines ethnographic elements of the two previous chapters to examine older poles’ selfperceptions in relation to the dramatically changing history of poland. here she expands on the book’s earlier exploration of poland’s history, and integrates ethnographic accounts to include the lived history of change, and the evolving ideas of polish national pride many older polish people have experienced during their lifetimes. the author explores national memory as both a historical narrative, a lived past, and a relational practice that informs the formulation and maintenance of personhood as older adults aim for an envisioned future. chapter 5, “rethinking memory: everyday rhythms of dementia,” explores the ideas of maintaining personhood and life histories from the perspective of older adults who suffer from memory loss. here robbins gives us keen insight into the sociality of a day center. through interviews with the caregivers of those who attend the center, the author notes that relationships may become more tense with family members who suffer from dementia, and that the social relationships that are newly forged, in the day center, are of vital importance to maintain moral personhood for those with memory loss. chapter 6, “gardens of memory: reimagining home and nation,” considers ways that sociality and moral personhood are maintained by older poles, outside the constraints of the formal structures of the third and fourth age dichotomies. the chapter documents the ways some seniors in poland maintain their sociality through participating in activities outside the home, such as allotment gardens, parish clubs, and other volunteer groups. robbins here demonstrates that the ideas of home, family, and remembrances of the polish nation are an overarching framework through which older poles across all of the ethnographic sites in the book reproduce ideas of national belonging and maintain their sense of moral personhood. http://anthro-age.pitt.edu/ book review | shay | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.349 http://anthro-age.pitt.edu 179 the conclusion links the ethnographic findings to the larger field of aging studies and reminds us that aging is not a being, but a doing: a verb; aging is a generative enactment of the lived experience of time and place for individuals as social beings. these lived experiences include the broader political and social changes encountered throughout the life course, such as the transition from communism to a market economy in the case of older polish citizens. robbins foregrounds a dynamic, social, and narrative approach to aging as a valuable alternative for the dichotomies of third and fourth age and ‘good’ and ‘bad’ aging. this book skillfully conveys the difficult and complicated history of poland over the last century as it relates to the memories of aging poles. the rich and profound ethnographic interviews of robbins with her participants enable the reader to envision the settings of the interviews vividly, and the strong connection with her subjects is obvious. robbins’ theoretical engagement with modern aging research, particularly with ideas around active aging, memory, and moral personhood, offers new insight into these growing areas. overall, this book is an outstanding example of multilayered scholarship in the field of anthropology of aging and gerontology. it would be an excellent resource for those interested in the topics of personhood, the lived experiences of aging, and the sociality of memory work, particularly in the context of poland in the post-communist era. in general, this book would be useful as a teaching resource for upper level undergraduates, graduate students, and anyone working in the field of aging research, medical anthropology, and gerontology. http://anthro-age.pitt.edu/ afterword. situating time, futurity, and aging in the pandemic janelle s. taylor university of toronto janelle.taylor@utoronto.ca keywords: aging; time; future; life course; pandemic anthropology & aging, vol 41, no 2 (2020), pp. 90-92 issn 2374-2267 (online) doi 10.5195/aa.2020.321 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. taylor | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.321 http://anthro-age.pitt.edu 90 afterword. situating time, futurity, and aging in the pandemic janelle s. taylor university of toronto janelle.taylor@utoronto.ca how does time as a phenomenological experience relate to time as objectively measured? more particularly, how do people experience time when the time that remains is short? the authors of the articles collected here address these questions ethnographically, documenting how temporality, futurity, and purpose take shape in the context of aging across a range of settings. academic work itself also has, of course, its own rhythms and temporalities. during the relatively short time that this issue of aaq has been in press, questions about time, experience, and aging have suddenly become far less abstract for millions of people, due to changes brought on by the covid-19 pandemic. time feels different. a meme that began circulating on the internet in mid-april quipped that “2020 is a unique leap year: it has 29 days in february, 300 in march, and 5 years in april!” as of this writing, in august 2020, several more months have passed, and many now speak with wonder and longing of the once-normal, now-forbidden activities of everyday life in what some now call “the before time.” the pandemic thus invites reflection on the themes of time, meaning and aging that the essays in this collection address. lockdowns imposed in an effort to stop the spread of the virus have forced millions of all ages to share the experience that has long been common among older adults, of being homebound with limited mobility. infection-control measures that restrict hospital visits, funeral attendance, and flying have brutally transformed practices surrounding dying and mourning, with devastating effects on health workers as well as bereaved family members. the virus, which has proven particularly deadly for older adults, has also particularly affected health workers who care for them, especially in institutional settings – who tend, following fault lines of social inequality, to be people of color. massive street protests against police killings of black americans, meanwhile, make obvious how aging itself, in other words the very possibility of growing old, is a right denied to many. simultaneously, reports of otherwise healthy young people felled by the virus, also remind us that dying is not reserved for older people alone. with such thoughts in mind, these remarks touch briefly on just a few of the many themes running through these essays that seem to open particularly rich veins of insight and inquiry in this pandemic moment. one striking theme is simply the co-presence of radically different experiences of time. in march 2020, new york times reporter jessica lustig published an account of her experience of caring for her husband when he fell sick with covid-19. in this piece, lustig described the strangeness of realizing that her experience of time was radically unlike that of others: http://anthro-age.pitt.edu/ taylor | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.321 http://anthro-age.pitt.edu 91 it’s as if we are in a time warp, in which we have accelerated at 1½ time speed, while everyone around us remains in the present — already the past to us — and they, blissfully, unconsciously, go about their ordinary lives… (lustig 2020) in shattering previous senses of temporality, and revealing time to be newly multiple and malleable, our collective experience of the pandemic may perhaps position many of us to appreciate the variability of time as a central dimension of the experience of aging. similar disjunctions and differences in how people experience time appear throughout the articles in this collection. in some instances, the disjunctions may occur within a single person’s lifetime, as part of the experience of aging. some of the scottish older adults interviewed by jane elliott and j.d. carpentieri, for example, invoke an established self from the past, as a means of occluding the feared self of the future. for emily wentzell’s informants ricardo and itzel, meanwhile, a consciousness of themselves as aging in a deliberately “modern” fashion served both to create a disjunction from old age as experienced in generations past, and at the same time to situate their lives within an imagined trajectory of national progress. by contrast, in the south african frailcare home where casey golomski’s research was based, black and white residents’ profoundly different historical experiences of apartheid and its aftermath left staff and residents reluctant to situate their own aging within such national narratives, tending instead to invoke unique moments of personal transformation in the past and visions of divine transcendence in the future. indeed, aging very often brings together groups of people who experience time in radically different ways. with important exceptions (such as itzel and ricardo, and others similarly “busy” pursuing their visions of successful aging), many older adults experience time as involving a great deal of waiting. by contrast, their younger family members and others with whom they interact, including health care professionals, may experience time as a very scarce resource. in such situations, relations between older adults and others may be characterized by a striking difference in the experience of time, with a great deal of waiting or stillness on the one side, and much hustle and hurry on the other. the stillness or slowness of old age is not necessarily a negative or empty experience of time, however. as iza kavedzija argues, the “pauses” that punctuated conversations with her elderly osakan interlocutors emerged out of their orientation toward the present moment as infused with the past within an “attitude of gratitude” that supported a kind of “quiet hope.” similarly, susan orpett long describes how older adults approaching death in japan with whom she worked experienced time as narrowing, but at the same time expanding or collapsing, such that the present moment stretched both backward into the past and forward into the afterlife. if aging thus involves disparate experiences of time and meaning, let us also recall that aging is not unique to the old, but rather happens throughout the life course. in this perspective, the pandemic experiences of older adults isolated in their rooms or apartments might fruitfully be examined alongside those of young adults forced to return from university to live in their parents’ homes, or those of parents engaged in a seemingly-impossible struggle to reconcile the time of working from home, with the time of home-schooling young children. gerontological research into cumulative disadvantage, meanwhile, reminds us that chronological age conceals the embodied effects of inequalities that render the bodies of poor, disadvantaged and racialized people “older” at younger ages – with grave consequences for those infected with covid-19. the question of how people experience time when the time remaining is short, presumes that older adults don’t have much future left – but this is true only if we assume that the aging individual is disconnected from any larger entity that will continue. in fact, the articles in this collection offer many http://anthro-age.pitt.edu/ taylor | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.321 http://anthro-age.pitt.edu 92 examples of how people do experience futurity in old age through a sense of partaking in a larger whole. wentzell’s informants itzel and ricardo understand their own life and activities as partaking in and contributing to the historical development of the mexican nation – and their active participation in medical (and anthropological!) research also reflects this sensibility. for the south african frailcare residents with whom golomski worked, futurity resides in the framing of the individual’s life and death as part of the working out of a divine plan. older adults interviewed by elliott and carpentieri in scotland, meanwhile, identified futurity with a sense of generativity that linked their own lives to the ongoing lives of younger family members. in japan, as iza kavedzija argues, the practice of happiness and quiet hope express a forward-looking orientation that expands the fullness of the moment, and coexists with gratitude for the past, phenomenologically uniting past, present and future. finally, the sudden ubiquity and valorization of masks during the pandemic brings to mind questions about masks, faces, and more generally what erving goffman (1959) famously described as “the presentation of self in everyday life” as these pertain to aging. might we regard age, aging, even dying as a performance? to ask this is not to suggest that these phenomena are not real, but to draw attention to how they may be enacted with a consciousness of observing others and a concern for dramatic structure. indeed, ideas about the anticipated, expected, or hoped-for effects of older adults’ performance of aging and/or dying on other people run throughout these essays, highlighting what we might call the futurity of effects. thus, for example, we are introduced in these pages to japanese elders performing gratitude or goodness, mexican older adults performing happiness, activity, and modernity, scottish older adults performing a sense of what it means to be a good person in the context of research interviews, and frailcare staff and residents performing the presence of divinity in everyday life. in closing, let me simply thank these authors for their insightful and thought-provoking contributions, and express my good wishes for their health and safety and that of their interlocutors, as well as you who read this. references goffman, erving. 1959. the presentation of self in everyday life. new york: anchor books. lustig, jessica. 2020. “what i learned when my husband got sick with coronavirus.” the new york times. accessed on march 24. https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html. http://anthro-age.pitt.edu/ https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html microsoft word fall2020_wentzell_in pdf.docx aging well as activism: advancing the mexican social body through individually successful aging emily wentzell university of iowa emily-wentzell@uiowa.edu abstract in contrast to discourses of “successful aging,” which pathologize and individualize change in later life, this case study of a retired mexican couple highlights the pleasurable, political, and collective aspects of aging. here, i analyze the narratives of a couple who found aging “well” fulfilling in part because it served as an intervention into societal-level problems. i argue that their activist form of aging was enabled by local cultural understandings of the mexican populace as a biologically and socially interrelated whole. they hoped that the mexican social body would follow a particular life course – of maturing toward modernity – and they sought to model and promote such maturation in their own later lives. this included promoting a health “culture of prevention,” living out selfconsciously modern forms of gender and family, and active community participation. i assert that their happiness in older age, including their ability to cope with local crises of violence and corruption, stemmed partly from their belief that the attributes and activities, which enhanced their own lives simultaneously served as activist interventions into the broader populace’s ills. this discussion highlights the need to understand aging and later life as political arenas with collective rather than merely individual import. keywords: activism; healthy aging; mexico; preventative healthcare; successful aging anthropology & aging, vol 41, no 2 (2020), pp. 46-58 issn 2374-2267 (online) doi 10.5195/aa.2020.247 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 46 aging well as activism: advancing the mexican social body through individually successful aging emily wentzell university of iowa emily-wentzell@uiowa.edu i met ricardo and itzel through ricardo’s involvement in medical research. i was studying the social consequences of men’s participation in the cuernavaca, mexico arm of the “him” study, in which asymptomatic men in several countries were tested over time to reveal the “natural history” of the sexually transmitted infection human papillomavirus (hpv). after four decades of a marriage they characterized as happy and faithful, this couple in their mid-60s did not report any concerns about sexually transmitted infections. yet, they were excited for ricardo to join and then continue for years in the him study, along with several other medical research studies. ricardo often wore a cap with the him study’s logo, which he said demonstrated that he was “a faithful client” of the project. the couple said they understood their duties as retired health system workers to include promoting such opportunities to receive health screening and support possible medical advances. they reported telling friends and relatives to take advantage of research participation, although ricardo lamented that “a lot [of people] aren’t interested because it takes time.” itzel added “we give it time, because health is important.” they saw research participation as especially valuable because it helped both their individual health, and that of their broader society. ricardo explained, “i’m a person who likes to participate in programs that benefit health – individual or collective.” because of these commitments, and their quickness to befriend strangers, the couple also became enthusiastic participants in my anthropological study of him enrollment. they participated in a three year series of annual interviews with me at the clinic, while also inviting me to socialize with them at restaurants and their home. they were fit and always formally dressed, with stylish blouses for her and polo shirts for him. the couple also delighted in the dissonance between their dignified daily attire and the revealing sequined costumes that these senior citizen dance champions wore in the photos they showed me of their hobby. these varied forms of dress together reflected their personalities, which combined fun-loving civic engagement with a view of themselves as educated, forward-looking professionals who intentionally strove to model healthy and responsible living for others. itzel and ricardo explicitly sought to live in ways that were not just pleasurable, but would also aid their broader society by encouraging others to similarly engage in healthy and progressive aging and citizenship. they shared strong opinions about how living a good “third age” – or later stage of life – could do this. their vision of ideal later life included active participation in community events, exercise, socializing, preventative health care, and helping their community by supporting progressive political change. the couple participated in government offerings from medical research to pensioner vacations, took advantage of local cultural activities, kept an eye on local and international politics, and parented in ways they understood to promote desirably modern lifestyles for themselves and their adult children. they also vocally criticized the government and fellow citizens who were not engaging in positive behavior; in our conversations they railed against the violence, corruption, and lingering cultural wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 47 backwardness they thought were hampering national advancement. as a narcoviolence crisis befell cuernavaca, they expanded these critiques and continued their activities while adding safety precautions like dancing during the daytime. here, i discuss how their efforts to age well highlight the political possibilities of deciding how to live in later life. i argue that itzel and ricardo’s explicit efforts to achieve collective benefit from aging well drew implicitly on local cultural understandings of the mexican populace as a biologically and socially interrelated whole. elsewhere, i argue that people often implicitly understand the mexican populace as a “collective biology,” a group its members see as interrelated through shared physical and cultural experiences, and which they think can be tangibly influenced by the actions of those who form parts of the larger whole (wentzell 2019). in mexico, such visions of interrelatedness are rooted in cultural ideologies regarding post-conquest racial mixing, or mestizaje. since the mexican revolution, the government and public intellectuals have promoted the idea that a racially and culturally distinct mestizo (mixed) population has arisen from the intermixing of spanish and indigenous peoples, and that this population could continue homogenizing toward an ideal state over time (vasconcelos 1997; alonso 2004). the notion that mexicans are mestizos is a core national ideology (e.g., lópez-beltrán and deister 2013). yet, this concept is a cultural ideology regarding elite hopes for modernization which marginalizes indigenous peoples and erases other groups like afromexicans rather than a demographic reality (vaughn 2013). still, federal health and education programs continue to direct citizens to align their bodies and behaviors with ideally modern forms of mestizaje to embody an idealized, collective form of mexicanness hoped to fuel national modernization and progress (e.g., smith-oka 2012; stern 1999; schell 2004). this encourages people to see their own performances of health, gender and citizenship as potentially advancing or thwarting the collective mexican populace’s movement on the path toward modernity (braff 2013; moreno figueroa 2010). given this cultural logic, the experience of aging in mexico can represent an arena for engaging in personal practices intended to affect this societal-level trajectory. meeting local ideals for aging “well” in any context can confer both pleasure and moral authority (e.g., mcnally 2009; katz and marshall 2002; traphagan 2000). in mexico, it may include changing one’s behavior over time to reflect emerging societal visions of modernity. for example this could entail men’s later-life rejection of traits associated with machismo, the widely critiqued yet widely naturalized form of womanizing masculinity thought to be an inheritance from conquistador forefathers (núñez noriega 2007; wentzell 2013). here, i discuss how aging well can be a context-specific political act, intended to provide happiness and comfort in later life but which can also care for and advance society. i examine itzel and ricardo’s narratives of their life in and beyond the realm of medical research participation in order to examine how they framed meaningful aging as a morally significant form of social activism. this analysis is important because it highlights an activist politics of aging erased by western cultural marginalization of older people, and the medicalization of aging as a bodily pathology rather than a meaningful life change (lamb 2014). tatjana thelen and cati coe (2019:280) argue that “a focus on elderly care reveals how long-range temporalities and complex mutualities produce and reproduce forms of political belonging.” centering ricardo and itzel’s experience enables extension of this kind of analysis from care-giving for elders to older people’s own practices of providing care, for themselves, their communities, and the national populace. age-wise, itzel and ricardo were outliers in my study of mostly midlife him participants. they were also outliers in their own age cohort, both in terms of the easy access to healthcare they enjoyed via their status as health system retirees in a well-served urban setting, and, according to them, as active and civic-minded citizens in a peer group lazier and less civically engaged than themselves. yet their wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 48 experiences are worth studying precisely because of their unusually self-conscious, deliberate, and explicit efforts to live a good later life in order to help others as well as themselves. their narratives provide fertile ground for theorizing the collective benefits which people might seek by aging “well,” and for understanding how crafting one’s older personhood can be an ethical and political act. research from social gerontology and related fields in mexico has already illustrated the ways that forms of interpersonal interconnectedness shape local experiences of aging and how these mediate hardships like poverty and gendered forms of marginalization (gomes 2007; montes de oca zavala 2005; montes de oca zavala 2010; robles silva et al. 2006; salgado de snyder and wong 2006; sokolovsky 1997; varley and blasco 2001). inspired to understand aging as political by organized advocacy for older people’s rights (sanjek 2012), i aim to analyze how the political nature and possibilities of mexican ideologies of interconnectedness might enable people to frame their everyday activities in later life as activist efforts to address such hardships. this strategy might become more common as mexico’s currently small population of people aged sixty-five and over triples over the next three decades and faces increasing economic precarity (angel et al. 2017). i argue that ricardo and itzel’s explicit efforts to age well drew implicitly on a cultural narrative of mexicanness characterized by biological and social interrelatedness, which enabled their hope of advancing the mexican populace as a whole through their own actions. in the sections that follow, i analyze their narratives of their own experience to discuss how they hoped to promote a health “culture of prevention,” model modern marriage and gender behavior, and engage actively in their community in order to live well in later life in ways that would positively benefit others. i also analyze their hopes that such acts could contribute to modernization over time despite the violence, corruption and “ignorance” they identified as thwarting this advance. in short, this article examines the ways this couple used their own life courses to push the broader social body down the path they hoped it would follow over time. local changes and my research practices as mentioned above, the case study analyzed here comes from a research project that focused not on later life specifically, but on the social consequences of men’s participation in a longitudinal sexual health research study in the central mexican city of cuernavaca. this medical research project, the “him” study, sought to investigate the “natural history” of the extremely common and often asymptomatic human papillomavirus (hpv) in men by testing a large multinational cohort repeatedly over several years (giuliano et al. 2008). in research undertaken from 2010-13, i sought to understand how spouses incorporated men’s study experiences into shared daily life efforts to relate to changing gender and marital ideals during the course of him participation. the project expanded to address the ways people related these efforts to resistance to and coping with a narcoviolence crisis that unexpectedly emerged in cuernavaca during this project, as well as enduring government corruption and the ongoing ravages of the 2008-9 global financial crisis. amid this instability, many participants incorporated men’s medical research experiences into collaborative efforts to enhance the well-being of simultaneously biological and social collectives at the levels of the couple, family, religious congregation, and mexican populace amid societal instability (wentzell 2015). as with other participants, i performed a series of three annual, hour-long, spanish-language interviews with itzel and ricardo, identified pseudonynomously, at the cuernavaca him study site. these semistructured interviews addressed reasons for and experiences of medical research participation, but ranged widely beyond that to capture the ways that those motivations and experiences related to people’s life histories and experineces of marriage, family, health, work and citizenship. i tried not to introduce terms with specific political connotations regarding health and local politics; thus, phrases wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 49 like “culture of prevention” were introduced by the interviewees themselves. second and third interviews focused on changes over time in these experiences, as well as the ways that an unfolding narcoviolence crisis was changing participants’ lives. in addition to these interviews, ricardo and itzel invited me to continue our conversations in a visit to their home and another to one of their favorite restaurants. the data analyzed here comes from all of these interactions. this warm couple seemed to see me as a peer in terms of our work lives – since we all had done research, administrative or practice jobs in the world of healthcare – and also as a younger person whom they could teach about their experiences. their nickname for me, “doctorcita” (little doctor) exemplifies these relations. they seemed to think that i would understand their progressive views on health and politics given our shared sensibilities as health professionals, and they enjoyed the opportunity to share their ideas and activities related to these topics. their enthusiasm about interacting with me also seemed to simply be an extension of their general joy in human connection; they knew the names of all the servers in the restaurant we visited and stopped several times on the drive to their home to speak with neighbors of all ages. they also often recounted stories of making friends on trips or through their hobbies. in short, their enthusiastic participation in both the him and my research projects bridged their delight in interpersonal connection and their desire to support healthcare systems and knowledge production. as discussed above, they were different in age from the largely midlife him participants and reported feeling that their lifestyle was quite different from that of most of their age cohort. it is their conception of themselves as outliers who could serve as models, which makes their experience useful for analysis here. itzel and ricardo’s narratives of participation in the hpv study and beyond shed particularly bright light on the ways that people might use individual efforts to age well as social activism aimed at advancing a broader social body. living and promoting a health “culture of prevention” ricardo and itzel engaged enthusiastically in health care, often discussing the importance of frequent check-ups to achieving a healthy and active later life. as retirees from federal health systems, they qualified for cost-free healthcare which they used to the utmost. for example, ricardo noted that, “we go to the doctor monthly,” to control his hypertension. framing this as key to healthy aging, itzel added that as “third age” people, “we’re used to going.” the temporality of prevention – expressed in their efforts to forestall future illness through present action – was thus a key aspect of their own expected life courses and their hopes for the future of their society. their frequent participation in health research, which they saw as benefitting society in the future rather than their own immediate health, exemplified this timeline. ricardo described himself as “raw material” for medical studies, noting when we met that he currently had “two long questionnaires at home that i’m going to fill out and return” to see if he would qualify for new research projects. the couple told me that they hoped their visible and enthusiastic healthcare participation would promote a “culture of prevention” which they thought mexico lacked. in a typical statement, itzel explained their frequent check-ups by noting that, “we have the culture of health,” which ricardo clarified meant, “of prevention.” they said that they had passed this culture on to their children in ways including getting them vaccinated, modeling exercise, and helping them learn to “ignore the ads for unhealthy foods.” they had continued to pass health information on to their adult children, by informing them of new information – like the finding that gum chewing reduces rather than promotes cavities – which they read in newspapers or saw in science documentaries. they also frequently told me stories of trying, and usually failing, to get their friends to participate in preventative health care. they would often conclude answers to my questions about their own wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 50 healthcare experiences with discussions of their efforts to encourage their friends to do the same. they said that they consistently invited friends to free health screenings or suggested that they get check-ups. however, itzel said their friends never wanted to go. they said things like, “i don’t want to know what i have” or that they “don’t feel anything” bad happening in their bodies so they must not need checkups. she bemoaned this willful ignorance, saying that eventually when they do discover a problem, “it’s too late.” the couple understood the lack of the “culture of prevention” to be both gendered and classed. both said that they saw men as “more resistant” to engaging in prevention. ricardo said that his male friends often “prefer not to know” what is wrong, and itzel agreed that “people, especially men, don’t want to know. which is idiocy.” itzel also mused that, “i think that if one has education, more education, one tries to take care of them self. unfortunately, ignorance leads one to not care for themself.” the desire to promote a cultural change away from ignorance toward a modern focus on self-care was shared by other highly-educated hpv study participants, especially health professionals and educators. it reflected long-standing mexican government and public health service efforts to promote hygienic behaviors as desirable because they would not only enhance individual’s health, but also further national modernization. middle-class itzel had been enculturated in this health ideology since her childhood, noting that her “educated” parents had taught her to care for her health. yet ricardo, born into poverty and given the same health care “as the animals” his family kept, said he “didn’t have that education as a kid.” instead, he adopted this way of thinking along with his upwardly mobile career trajectory. ricardo’s narrative of his own health trajectory mirrored the changes over time that he and itzel hoped for in a modernizing mexico. he recounted that when he was able to achieve an education and came to work for the secretariat of health as an accountant, “that made me conscious of having the culture of health in mind. it’s better to prevent than to cure.” he came to this understanding through the direct intervention of people like his boss in the cancer control program, who induced him to quit smoking by taking him to the general hospital to see a “museum” of diseased organs including lungs with cancerous tumors. through such experiences, he said, “i began to understand the importance of self-care,” while at the same time “my wife induced me to get checkups, to care for myself, and so i assimilated to that attitude.” this assimilation was also a demonstration of ricardo’s adoption of forms of masculinity and marriage seen as quite new and modern at the time; an egalitarian relationship in which a husband talked intimately with his wife and took her advice, and a form of masculinity predicated on self-care rather than invulnerability. when ricardo looked back on his life, he saw himself as having deliberately adopted a culture of prevention along with his rising educational level and socioeconomic status. he summed up his change by noting, “my economic situation was very humble, and they cared for me with home remedies. but now that i’m older i try to do the things that will enable me to have an adequate quality of life.” yet, rather than understanding this attitude as a sign of elite difference, he and itzel saw it as a tool for pushing others up the same path. this was exemplified by their efforts to recruit others into research studies and health care and to combat the “ignorance” which prevented such participation. this collectivist orientation towards health care was highlighted by ricardo’s habit of understanding his own health and life course in relationship to that of the mexican populace. for instance, ricardo understood himself through population statistics, often citing the average mexican male life expectancy of seventy-three. in one representative comment, he said, “it worries me that the life expectancy of the man is less than the woman’s, on average. but i want to break the record!” moving immediately from his individual body to the collective social body, he concluded, “we men need to be careful of our health.” wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 51 these desires reflected the couple’s simultaneous understandings of themselves as part of a collective mexican body which they could influence from within, and their belief that they were different from that body’s norm – positioned by education on the leading edge to modernity. through modeling selfcare as well as specifically incorporating medical research participation into that care, they hoped to monitor their own health, to support medical advances that would help others, and to exemplify a “culture of health” to a populace plagued by “ignorance.” modeling modern marriage, masculinity and family the couple’s marital and gender practices also reflected ideals of mexican modernity. they had been married for thirty eight years when we met and were early adopters of both companionate marriage and anti-macho masculinity. describing their history, itzel began with the comment that, “i really didn’t want to get married” because she had seen friends’ marriages fail and her life “wasn’t missing anything.” she had planned to focus on her career and enjoy the independent life it would finance. yet, ricardo jokingly interjected, “when she met this doll, she couldn’t resist!” after meeting when he taught a statistics unit to her nursing class, ricardo explained that he had known she was worth waiting for and had been happy to support her career aspirations. he “worked to convince her” that marriage was compatible with her individual goals during an uncommonly long courtship for the time. they dated for eight years while itzel finished her studies and mandatory year of social service and became established in nursing. they now described each other as true partners in all aspects – emotionally, economically, and in the shared pursuit of a “high quality” life. they reported that this happy partnership was based in large part on self-consciously open communication and the cultivation of shared interests. throughout their marriage, they recalled engaging in an emotional openness that they saw as not necessarily typical in their society, but ideal. she noted that if they fight, “we try to figure out why and not repeat the same mistake.” since retirement, they had also identified danzón as a new and important arena for both deepening their intimacy and seeking out the active health-maintenance that they believed characterized successful aging. danzón is an intricate partner dance popular with mexican seniors. they began to dance when a physician suggested it was a form of exercise that could help ricardo’s hypertension. yet as they took lessons, this shared health behavior became a way they worked together to deepen their emotional intimacy. roberto called dancing “emotional therapy,” which “helped me to get along with and better understand my wife.” itzel added that they had seen people their age divorce after growing apart once their children grew up. they sought to avoid that fate through shared activity and ever-deepening emotional intimacy. roberto explained, “when you have defects of intolerance, we need to try to forgive each other, to overcome that for a happier life, a healthier life.” he said dance facilitated that, because “if i’m mad, i have to calm down because we have a date to dance together!” through this hobby they pursued interlinked forms of physical, emotional and familial health. doing so enhanced their experience of later life; i argue that it also enabled them to continue modeling the modern health, marital and, gender identities they had long prized. this focus on maintaining their own relationship represented what they understood as a modern yet faithfully mexican take on the ideal of familial closeness. ricardo and itzel had two adult children in their thirties who had moved to other states to pursue professional careers. they both remained single and without children. laughing, itzel said “they haven’t married – they’ve resisted!” this comment captured both the reality that their children were following an uncommon life course in a society where wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 52 most people marry and have kids, as well as her delight in this evidence of their modern selfactualization. itzel was able to rejoice in her children’s life choices because while locally unusual, to this family they appeared to represent an evolution rather than rejection of what she and ricardo saw as inherently and ideally mexican familial closeness. this was because the family remained emotionally, though not spatially, close. itzel said that although their children had moved away, they’re all “very united,” speaking very frequently by phone. this was a relationship that maintained closeness while making room for personal growth and engagement with community as well as family. itzel noted that they would continue to reject the limiting aspects of closeness, saying that “i’ve even told my kids that if they get married, i don’t want them here in my house because i’m only going to care for grandchildren when it’s very necessary.” despite its differences from what they identified as a common but problematic pattern of extended families living together and depending on grandparents for continued care labor, they saw their family relationships as a modern version of the mexican emphasis on family. this was highlighted by the great pride they took in familial intimacy. for instance, ricardo’s mother was in her nineties and a major figure in his life. he took her out to eat weekly and expressed deepening concern over the years about the hole that would be left in his life after she died. he understood this close relationship to be inherently mexican. explaining this to me, as an “anglo,” he noted that, “you anglos have another culture, but we mexicans are really close-knit. once, i was talking to a woman from holland on a bus, she said she was going to visit her mother, who she hadn’t seen in eight years. i see mine every eight days! that’s one of our own latino customs.” the couple thus saw themselves as living out the positive aspects of inherently mexican orientations of family, while modeling and enjoying modern versions of these which enabled family members to engage beyond the family unit. active community engagement it appears that itzel and ricardo understood this mexican tendency of close-knittedness to ideally apply to the community-wide as well as family levels. as demonstrated by their constant modeling of and explicit discussion about the need for active community engagement, they viewed the physical and emotional health of individuals, families and communities to be interrelated. for them, engaging in thoughtful and progressive activities supported both healthy aging and the advancement and wellbeing of the broader populace. in our conversations, they emphasized the need to stay active and civically engaged as they aged. itzel said, “we’re not those people who retire and sit around, watching television.” ricardo explained that their main goal was to really enjoy “the years that are left of our lives.” for instance, when i visited their home they showed me stacks of free guides to local activities, judiciously dog-eared and annotated. beyond simply attending events, they also engaged with others – in ways that they hoped would advance their community – throughout their daily lives. for instance, in a typical conversation, they recounted attending a free concert promoting ecological conservation. this led to a conversation about the need to recycle, in which ricardo discussed itzel’s ambitious habit of sorting not only their recycling but picking up trash wherever she found it. itzel expressed frustration about neighbors who put their trash out early, not caring that street dogs would tear open the bags and spread it around. she explained that she was constantly trying to clean up and improve their neighborhood to counter such regressive acts. for them, upholding civic engagement and duty was a key part of deriving pleasure from later life. while we looked through those local event guides, itzel told me about her father who had worked hard wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 53 to support his family but had not been able to enjoy his own life. she explained that because of his unceasing labor, “it was his kids who enjoyed the benefits of his hard work, not him.” she said that she would not want to live like that. instead, she and ricardo appeared to simultaneously seek pleasure from their activities as retirees, enjoy it as part of their own experiences of class and social advancement over the life course, and use it to model and promote modern practices which would advance their society. this was the case for their danzón hobby. as we thumbed through the guides, itzel stopped at a picture of herself and ricardo, dancing among their friends, which was featured over a dance event listing. over our conversations about danzón, the couple explained that in addition to the fun of dancing, and its health and relationship benefits, it could be a way to help others enjoy later life. their dance group sometimes went to nursing homes in nearby rural towns to dance with the residents. their goal was to help them “have some fun,” since “those who are still in a condition to [dance] really enjoy it a lot.” they saw danzón as particularly well-suited to this task because it related to traits and talents they believed to be rooted in their mexican and broader latino heritage. ricardo explained the history of the dance form, saying that it was “an amalgam of african, european and latin music” developed in cuba and then “adopted” by mexico. while adopted, for ricardo it still spoke to something innately mexican; he noted that “our ancestors, before the conquest,” did both ceremonial and erotic dances which made spanish colonizers deeply uncomfortable. underlining the specifically mexican character of this innate disposition to dance well and seductively, ricardo both encouraged me to attend dance events and warned me not to be disappointed with my progress since “generally the anglo-saxon doesn’t have much [dancing] flavor.” dancing made ricardo feel as if he were expressing positive aspects of his interlinked biological and cultural inheritances in ways that promoted health and happiness. as danzón enabled them to draw on ideas of racial roots in order to promote modern goals for the society and its members, the couples’ participation in other healthy aging activities enabled them to draw on government resources to support this goal. they made extensive use of the excursions and activities offered to pensioners from federal employment. for instance, whenever they reached the top of the waiting list, they vacationed at a regional mineral water spa resort run by the health service from which ricardo had retired. they excitedly discussed the range of activities offered, like dinner dances with live music and the ability to befriend other seniors from around the region. they noted that such programs were also very inexpensive and overall, “a gift,” which itzel said she could not believe many other retirees were not interested in using. in a different year, they told me about an eagerly anticipated trip for retirees of the health system to mexico city. as the violence and economic crises facing mexico as a whole and cuernavaca specifically worsened, ricardo described the event in a way that also framed it as a respite from these concerns. he explained, they take all of us third age people, there will be an event in mexico city where we go for a week to a [federal health] organization hotel. we’ll go around, to the theater, the museums, in a group of thirty, forty people. with people to watch out for us. and we take advantage of all those kinds of spaces that enable us to enjoy ourselves. this trip combined promotion of healthy aging and community engagement with protection, which would enable them to safely seek and enjoy these goals. further, even planning for such trips served a kind of protective function; ricardo said that looking forward to their trip to the mineral spring resort “gives us the strength to respond to the problems” facing the nation. wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 54 the couple thus came to see these opportunities for active engagement as promoting both physical and societal health for them and the broader groups to which they belonged. in the most basic way, doing these activities made them healthier. for example, itzel said that on trips like the mexico city excursion, there are optional exercise classes each morning, for which “we’re the first ones waiting!” they similarly sought direct health benefits from a “healthy aging convention” they attended in cuernavaca, where they enjoyed learning from presentations about how to age vigorously and critiqued the low turnout of other third age people. itzel mused that many elders did not want to leave their houses or were spending all their time caring for grandchildren; she saw this lack of engagement in community-level healthy aging programs as anti-modern and thus harmful to individuals’ and the society’s ability to become more healthy over time. they believed that active participation in health programs and the cultivation of community ties were key antidotes to the regressive violence crisis and its health demoting effects. both were major proponents of biomedicine, who also subscribed to the pervasive cultural notion that negative emotions directly harmed one’s health. for instance, ricardo explained that being upset “affects your health.” he explained that after his sister’s recent stroke, which “devastated the family,” “i got a sore throat, a cold, i went downhill. now i feel better, but emotions affect health.” he then linked that example to the violence crisis, which was a rampant source of negative emotion for the society. he continued that because of the insecurity, “now, you go around looking behind you. it’s a major problem for the population.” they experienced such health effects of insecurity directly when their daughter was injured in a robbery. in our final interview, itzel said that she had recently experienced a bad asthma flare-up related to violence and environmental factors. because of their daughter’s brush with violence, the couple had just returned from the city of puebla, where volcanic ash from a regional volcano was heavy in the air, itzel explained, “our daughter, who lives in puebla was assaulted, and cut in the hand with a knife. that’s why we were there. so, i was really nerviosa, and the ash is really fine and gets in everything, and it affected me.” to be nerviosa is to experience a specific physio-emotional state – disruption caused by a bad scare – thought to cause specific health problems including increased vulnerability to biomedically-recognized diseases (poss and jezewski 2002). thus, their daughter’s attack not only harmed the family emotionally and put them in the way of dangerous volcanic ash, but also hurt their physical bodies through the incitement of negative feelings. the couple understood the widespread violence to be doing such harm on the societal level. after itzel concluded the story above, ricardo noted, “it’s the insecurity. emotionally it bothers us. not just for our daughter, but for our country.” he continued, “it’s a whole other situation, doctora, the insecurity. it has us all unbalanced [trastocados] emotionally, right?” as itzel’s discussion of nervios shows, this emotional distress could translate directly into physical ill-health. together with the direct physical harm done by widespread violence, this reduced the well-being of the mexican populace and pulled it directly away from a hoped-for, modern future where a functioning government could protect citizens. in this context, their active community engagement served as an effort to redress some of these societal harms and thus counter these negative trends. taking advantage of government-sponsored offerings for retirees was also a way to call on the government for support, even as they hoped to model healthpromoting modernity for a mexican populace affected by the failings of its government. they understood their frequent use of such programs to demonstrate the need for the government to offer them, and thus as an aid for making them available to others. yet discussing the health programs they supported, itzel noted, “we don’t see these projects really advancing until the government puts an end to this tremendous delinquency that has infiltrated everywhere.” wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 55 so, they also engaged politically, avidly reading the news and supporting leftist candidates who critiqued low pensions, rising food costs, and endemic corruption. for instance, in advance of the 2012 presidential election, ricardo said that their candidate lópez obrador “said we could buy fifty kilos of tortilla for a certain sum and today, with the same amount, we buy five.” demonstrating their understanding of their own modern health behaviors to be a protective revision of fundamentally mexican traits, itzel cut in with the joke that “luckily we no longer eat much tortilla!” ricardo returned to his support of the candidate’s critique – and the couple’s understanding of political failings harming their society’s health – by noting that basic needs have “gotten more expensive, in a brutal way.” as the local violence crisis worsened, the couple also voiced deepening mistrust of the corrupt government, while retaining faith in and hope for the population. for example, ricardo accused authorities of covering up violence but identified population-level knowledge as a source of accountability. he said, …we’ve heard, by word of mouth from the population, on twitter or facebook… the government says, ‘there were twenty assaults,’ and then some private or civil association puts, ‘no, there weren’t twenty, there were fifty.’ … the government minimizes or hides the reality, to the point where one no longer has confidence in their authorities. this insecurity had forced the couple to curtail some of their economic activities. they had made enough money from a side retail business to fund private education for their children but now needed to stop. in itzel’s words, “because of the insecurity – we had to travel all over with our products.” they also felt trust and engagement eroding in their own neighborhood. they sought closeness with community members by participating in events but also through micro-level daily life interactions with others, which ranged from always asking a restaurant server’s name to stopping their car to talk to everyone they encountered in their neighborhood (and, in the case of ricardo and some local kids, to engage in elaborate handshakes). yet, itzel recounted a recent act of violence which exemplified the threats to such ties. she said in their neighborhood, which “isn’t high risk, the person who does my hair was kidnapped. they just look her on saturday and returned her three days later because they paid.” ricardo added, “and no one dares to report it because they’re afraid. the scoundrels say, ‘ok, now i’ll shut you up!’” itzel continued that this reality rendered government requests to alert the authorities meaningless. she said, “they tell you, report, report. but then you see that the people who have dared to report… they do worse crimes to those people… they say, ‘it’s anonymous’… but then people know who said what…no one trusts anyone.” even as they felt their activities circumscribed and health threatened by this insecurity, they remained committed to active community engagement. itzel said that even though she now “walks around afraid,” we try to have a good time, and we also try to do it with all the precautions and the fears that we now have about going out. as little as possible in the night now, instead in the day. and to see the positives that you can find in the situation because if we were like ‘ay, what will happen to us?’ imagine how we would be living. noting that events for “older adults” had been moved earlier in the day for safety, they expressed their enthusiasm about continuing to take advantage of such activities. for instance, itzel said that by taking wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 56 advantage of events for federal retirees, “we still try to spice up our lives, looking for healthy diversions at prudent times of day.” ricardo added “that’s how we’ve survived this situation.” therefore, i argue that using and thus promoting positive government offerings while engaging in other ways with community members and groups became a way for them to seek to counteract the harms of government failings to protect citizens. the couple believed that meaningful change in the behavior of the mexican social body required government provision of basic security and resources. their efforts to lead the mexican social body toward a “healthy” life, despite the lack of a culture of prevention, were hamstrung by societal dissolution and government unreliability. so, they tried to lead the way forward for the mexican populace and the government by being modern, active seniors. how aging well can be activism overall, ricardo and itzel sought to have a happy and healthy older age by embracing self-consciously modern forms of marriage, gender, self-care and civic engagement. they implicitly adhered to the broader cultural notion of the mexican populace as a collective biology, which could become healthier and better off by embracing more modern behavior. to realize this hoped-for shift toward populationlevel modernity, the couple explicitly saw themselves as a part of a “third age” vanguard, modeling over their own life courses the changes they hoped to see the mexican social body as a whole adopt over time. by living out later life in ways intended to provide health and fulfillment for themselves at the individual, couple, and family levels, they sought to push mexican populace and nation down a hopedfor path to modernity despite the backward pull exerted by crime, corruption, and persistent “ignorance.” health behaviors in general involve aligning one’s body with material and social expectations for change over time. thus, peoples’ embodied life courses are fundamentally shaped by the cultural norms and life possibilities available during their lives, which include local understandings of what are normal bodily and behavioral changes, healthy, and ideal at particular life moments. here, i have examined the possibilities this relationship affords for affecting one’s broader society. beyond simply living out emerging ideals for healthy aging and desirably modern personhood, ricardo and itzel sought to advance these ideals even further and then model and promote them for others. for instance, they understood themselves to bear innately mexican racial traits, from dance rhythm to emphasis on family, but wished to live these out in ways which would pave a path for population-level advancement, such as balancing family intimacy with active community engagement. this understanding of themselves as located on the forward-moving edge of a biologically and socially interrelated populace was highlighted by ricardo’s understanding of himself via population statistics. he saw himself through this collective lens but also hoped that through deliberate efforts at healthy aging he would not achieve average longevity but instead “break the record.” that itzel and ricardo sought meaningful aging on both individual and societal levels and timescapes adds nuance to our understanding of the ways people relate to seemingly individualizing discourses of “successful aging.” much public health, biomedical and gerontological work on “successful aging” presents aging as an individual and pathological experience to be ameliorated through pursuit of a young-appearing and acting body. in this model, ideas about one’s broader society only arise in the effort to keep older people from becoming economic drains by extending their youthful health and productivity (lamb 2014). yet, ricardo and itzel’s example shows that people can bridge ideologies of successful aging with collectivist understandings of society and the longer-than individual temporal path it can take toward wentzell | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.247 http://anthro-age.pitt.edu 57 desired advancement. they incorporated seemingly individualistic ideas of successful aging, such as participating actively in health maintenance, exercise, and events, into explicitly activist efforts to enhance collective well-being. from encouraging friends to get check-ups, to supporting scientific advancement, to demonstrating the need for the government to continue providing programs for retirees, the couple strove to model meaningful aging in ways that would benefit collective health and counteract violent crisis. they sought interlinked individual and societal change over time for the better, contributing their own improvements over time toward desired, population-level modernization. while future orientation is always a key component of health and self-improvement behavior, for itzel and ricardo this included attunement to a population-level future which would extend far beyond their own lives. for them, aging well was a source of pleasure in part because it was also an activist effort to advance their society, enabled by the interrelationship they perceived between their individual life courses and the mexican populace’s potential for enhanced well-being over time. this finding enhances our understanding of aging by highlighting how aging can serve as a political arena. that knowledge can contribute to scholarly efforts to develop concepts like “affirmative old age,” for theorizing forms of aging that derive benefit from embracing 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cliniques de montréal, université de montréal, mcgill university author contact: eric.racine@ircm.qc.ca abstract research ethics extends beyond obtaining initial approval from research ethics boards. the previously established person-oriented research ethics framework provides guidelines for understanding ongoing ethics throughout the tasks of a research project, in a variety of research contexts. it focuses primarily on the relational and experiential aspects of research ethics, organized around five guideposts: (1) focus on researcher-participant relationships; (2) respect for holistic personhood; (3) acknowledgment of lived world; (4) individualization; and (5) empowerment in decision-making. given the widespread impact of dementia and the ethical challenges dementia research presents, conducting meaningful, ethical research is of high importance. this review explores this person-oriented framework in the context of dementia by examining existing literature on ethics practices in dementia research. we use a critical interpretive literature review to examine publications from 2013 to 2017 for content related to the five guideposts of person-oriented research ethics. while there is much literature addressing the relational and experiential aspects of research ethics, there is a lack of unanimous conclusions and concrete suggestions for implementation. we compiled practical recommendations from the literature, highlighting tensions and suggesting furthering evidence-based ethics research fieldwork to construct an accessible, easy-to-use set of guidelines for researchers that will assist in putting person-oriented research ethics into practice in dementia research. keywords: research ethics; bioethics; dementia; selfhood; empowerment; autonomy anthropology & aging, vol 41, no 1 (2020), pp. 31-51 issn 2374-2267 (online) doi 10.5195/aa.2020.211 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 31 person-oriented research ethics and dementia the lack of consensus olivia silva1 the george washington university author contact: olivia_silva@gwu.edu m. ariel cascio1 central michigan university author contact: ariel.cascio@cmich.edu eric racine institut de recherches cliniques de montréal, université de montréal, mcgill university author contact: eric.racine@ircm.qc.ca the experiences of people with dementia has garnered significant academic attention in both the health sciences and social sciences. however, conducting research with participants with dementia, who may be a particularly vulnerable population, can be difficult from an ethical perspective. in this context, “vulnerable” typically refers to having an impaired ability to advocate for oneself (dempsey et al. 2016). research ethics, with respect to vulnerable populations and more broadly, is centered around protecting potential and actual participants and regarding them as agents with the right to self-determination. creating and conducting ethical studies is crucial for respecting participants’ wellbeing, autonomy, and rights; as well as collecting meaningful data. ethical research does not begin or end with an ethics board review. taking a broader review of everyday ethics, the framework of “person-oriented research ethics” (american anthropological association 2012; cascio and racine 2018) provides guideposts for understanding experiential and relational aspects of research ethics. this existing framework is applicable in diverse social fields. the purpose of this article is to use and expand the theory in the context of dementia research ethics through a purposive review of the current state of research ethics literature regarding studies that may involve participants with dementia. background according to the world health organization, approximately 50 million people have dementia, with 10 million new cases occurring each year (world health organization 2018). dementia is one of the leading causes of disability in older people, seriously affecting those with the diagnosis and their surrounding social networks (world health organization 2018). its degenerative symptomology and widespread impact have garnered significant academic attention and resources. during the 2017 fiscal year, the us national institutes of health spent approximately $1.4 billion on research in alzheimer’s disease and related dementias (us national institutes of health 2017). despite the considerable financial resources, conducting research on dementia is still logistically challenging. two of the most salient barriers to completing timely, meaningful research are low enrollment and high attrition (grill and karlawish 2010). in reviewing recent commentary on ethical practices in dementia research, we hope to understand the bases for these barriers and potential solutions to overcome them. currently, there is no biological diagnostic test for dementia. the syndrome is progressive in nature (mayo clinic 2018; world health organization 2018). although many people assume older adults generally develop dementia, the term is used to specify an experience that is not a normal part of aging. understanding how people delineate and qualify boundaries between “normal” and not has long been a central topic of study in anthropology (benedict 1934), including the anthropology of aging (cohen 1998; silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 32 lock 1993). dementia specifically has been and continues to be (e.g., antelius and plejert 2016, fetterolf 2015, young 2015) an important topic in the anthropology of aging. the expectations and milestones of aging are inseparable from their sociocultural contexts. although some may have biological bases, such as menopause, the expected experience is largely derived from both medical and social aging commentary (lock and kaufert 2001). historically, defining the boundary between normal cognitive aging and dementia has been a significant point of contention (george et al. 2011; lock 2013). the “entanglement of dementia and aging” (lock 2013, 9) challenges social categorization and the culture of diagnostic medicine developing discrete, reliable categories for degrees of age-related and pathological cognitive impairment has been an ongoing challenge largely because of its subjectivity and questionable correlation with biomarkers (lock 2013). frail older adults who show no symptoms of dementia can be subject to paternalistic healthcare because of the assumption that they necessarily have a lesser cognitive capacity (mcnally and lahey 2015). while we focus on literature specifically addressing participants with dementia, we do not exclude studies based on how the researchers defined dementia, and we recognize that other adults may be subject to similar considerations or stereotypes by researchers and research ethics committees (recs). we also acknowledge the variability of experiences included under the label of dementia, and the fact that participants with a diagnosis may also be subject to stereotypes based on ideas about dementia. indeed, stereotypes about diagnoses and implications about capacity are a problem across studies including participants with many types of cognitive disabilities or differences (cascio and racine 2018). like a large portion of society, recs can have biases. the purpose of recs is to ensure that research methodologies are ethical to protect the welfare of the participants (pachana et al. 2015). however, if recs operate under the ageist stereotype that older people generally have a lower cognitive capacity, they will be over-protecting a large portion of the population (forlini 2017). under this assumption, older people are unable to participate in research safely and ethically. this assumption can result in the rejection of these studies by recs, further limiting the opportunities for discovery and participation in research (pachana et al. 2015). it also discourages researchers from engaging in studies involving this population because of the bureaucratic hassle (holland and kydd 2015). despite there being a large population of older people and people with dementia who may wish to participate in research, they do not have the opportunity without accessible studies available (murray 2013). however, the impact of dementia symptoms on a person’s cognition can impair their ability to self-advocate, thus resulting in further exclusion from research on the basis of protection, paralleling for example social exclusion of people with dementia who do not “still recognize” loved ones (taylor 2008). recs are in a position where they can reduce this discrimination by understanding the value of research participation in older populations and questioning researchers who exclude this population (wood et al. 2013). they can also encourage researchers to shift away from viewing research ethics as only a regulatory requirement. reducing research ethics to a bureaucratic burden does not acknowledge the values that ethics guidelines promote (cascio and racine 2018). ethical research practices go beyond fulfilling regulations and receiving rec approval (lichtner 2014). they ensure that participants can have a safe and positive experience participating in the study, even in interactions that do not directly pertain to data collection such as recruitment, waiting periods, data analysis, and dissemination of the results. scholars have suggested ethical practices for implementation in addition to regulatory requirements, promoting the positive engagement of society in research (cascio and racine 2018). these practices promote the inclusion, and thus discourage discrimination against, participants who are vulnerable (ibid.). person-oriented research ethics embraces a view of ethical practices as complementary to regulatory requirements. it is inspired by principles of person-centeredness and patient-centered care as applied to a research context (cascio and racine 2018), and draws from anthropological theories and silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 33 methods including person-centered ethnography (hollan 1997; levine 1982) and relational ethics (meloni et al. 2015). in their recent work, cascio and racine have outlined five practical guideposts for implementing person-oriented research ethics (see figure 1): (1) focus on researcher-participant relationships; (2) respect for holistic personhood; (3) acknowledgment of lived world; (4) individualization; and (5) empowerment in decision-making (2018). focusing on the researcher-participant relationship is an effort to minimize the power imbalance inherent to this relationship. having respect for holistic personhood highlights that research participants are entitled to make their own decisions regarding research enrollment. acknowledging the participant’s lived world focuses on understanding factors external to the study that can impact the research process, as well as the unique trajectories the research can take with each participant. individualization emphasizes adjusting the research methodology according to each participant’s abilities and needs without compromising the integrity of the design. empowerment in decision-making maximizes the participant’s decision-making ability throughout the research process. the five guideposts are illustrated in figure 1 and further described and contextualized in the results and discussion section of this paper. guiding research by the guideposts of person-oriented research ethics in studies involving people with dementia requires consideration of both the participant and their caregiver, who may also be their research partner or proxy. in dementia research, the research partner oversees the study, acting as an informant for the researcher and an advocate for the participant (cary et al. 2015). the caregiver, research partner, or proxy will likely have their own set of values, abilities, and needs during the process (black et al. 2014). having a caregiver present can be necessary for more vulnerable participants; however, the presence of a caregiver does not necessarily remove all ethics quandaries. figure 1: five guideposts of person-oriented research ethics (adapted from cascio and racine 2018) silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 34 methods this study employs a critical interpretive literature review using systematic sample searching methods (mcdougall 2015). the purpose of this review is to examine the key themes of recent literature on ethical practices in dementia research and relate them to the five guideposts of the person-oriented research ethics framework. it aims to elucidate potential challenges that underlie difficulties in conducting research with participants with dementia. it also identifies tensions and suggestions regarding designing ethical studies that acknowledge the specific needs of older persons (>65 years of age) with dementia and their caregivers. the review is limited to articles published between 2013 and 2017 this five-year range thus represented an exploratory investigation into the cutting edge of dementia research ethics. our review is descriptive, not evaluative. we identify literature purposively, to define the contours of the person-oriented research ethics framework in the context of dementia research, not to evaluate the presence or absence of ethics discussions in the literature, although we do identify tensions within these discussions. our search strategy aims at finding sources that address research ethics and excluded others. our refinement and enrichment of the person-oriented research ethics framework in this context uses a bottom-up approach, building from existing discussions in the literature, and not a top-down approach that judges these discussions against a pre-existing standard. indeed, person-oriented research ethics is intentionally open-ended and amenable to this approach. selection of databases we selected ovid medline, web of science, and proquest philosopher’s index databases for the sample search. ovid medline is a database specifically for biomedicine, which allowed us to gather data on clinical research and practice. web of science is an interdisciplinary database that covers articles in both the medical sciences and social sciences. this database was useful to avoid potential biases of focusing on clinical literature and examine the social science research on relevant topics, such as meaningfulness, ageism, and lived experiences. proquest philosopher’s index is a database that covers philosophical and interdisciplinary research, which allowed us to gather literature from a philosophical perspective including philosophical ethics. proposed keywords for our study, an initial list of keywords was constructed based on preliminary searches on ethics and aging studies. the keywords were then divided into two main categories: ethics and target population. different combinations of the keywords were searched, including sometimes in conjunction with “research,” and the number of hits was recorded for each of the three databases. the quality of the results was evaluated vis-à-vis the purpose of this research. from there, the keywords were narrowed down based upon the number and quality of hits. for example, every query using “cognitive impairment” resulted in fewer hits than using “dementia,” but using “dementia” resulted in more articles relevant to our review. thus, “cognitive impairment” was eliminated from the final list of keywords. all possible combinations of terms were included in the final query. silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 35 ovid medline ethic* and dementia and research bioethic* and dementia and research neuroethic* and dementia and research ethic* and ag*ing and research bioethic* and ag*ing and research neuroethic* and ag*ing and research web of science2 *ethic* and dementia and research *ethic* and ag*ing and research proquest philosopher's index ethic* and dementia and research bioethic* and dementia and research neuroethic* and dementia and research ethic* and ag*ing and research bioethic* and ag*ing and research neuroethic* and ag*ing and research table 1: search queries, october 17, 2017 title and abstract review the title and abstract of each article from the initial query (n=1,836) were screened for relevance to ethical practices in dementia research. an article was included if it discussed the ethics of research in older people and end-of-life patients with dementia, a cultural perspective of autonomy in older people, or legal protocol regarding research consent in older patients with dementia. other topics that fell under the domains of person-oriented research ethics specifically and of research ethics more broadly were also included, for example an article that discusses optimizing patient-centered outcomes research (wadekar, sharma, and battaglia 2015) and an article that discusses sensitive interviewing (dempsey et al. 2016). the search was not limited to studies conducted in a specific geographic region. all titles of included articles were imported into a spreadsheet in preparation for data extraction. a source was excluded if it did not pertain to research participants with dementia or focused on patients that are under 65 years of age. all sources not involving human subjects or written in a language other than english were also excluded. from the primary search, 143 articles were questionable, and 256 articles were included from the original 1,836 articles. both questionable and included articles progressed to the full review (n=399). full review and data extraction after reading the full article, an article was excluded (n=341/399) if it did not fit the initial inclusion criteria, as discussed above (i.e., if it was not about research ethics or regarding the population of interest). if an article that discussed ethics of medical care did not involve discussion of the ethics of a research method, it was also excluded.3 an article was also excluded if it discussed ethics of research topics but did not discuss research participants themselves or ethical practices in methodologies.4 additionally, if an article did not discuss research ethics and did not address any ideas that are applicable to the personoriented research ethics framework, the article was excluded. the literature was reviewed for relevance to * = truncation silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 36 the five guideposts of the person-oriented research ethics framework (cascio and racine 2018). content was extracted and copied into a spreadsheet as quotes if they pertained to any of the five guideposts. figure 2: review flow chart silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 37 results and discussion the search yielded 1,836 individual papers. after the primary and secondary content reviews, 58 papers were included for data extraction (see figure 2). the following sections highlight common themes found in the literature that are relevant within the participant-oriented research ethics framework. each of the five guideposts of the framework are summarized under the context of dementia research and discussed using the search findings. a short discussion is included at the end of each of the five sections. table 2 summarizes practical guidance found in the reviewed literature. focus on researcherparticipant relationships • be aware of and respond to distress cues using a participant-specific predetermined distress protocol • maintain positive relationships with gatekeepers • provide gatekeepers with accessible information in advance • express concern for caregiver’s wellbeing and provide them with resources (e.g., social networks, accessible information) • establish positive closure between the researcher and participant at the end of the study • be mindful of language in communicating with the participant and publishing the study (i.e., the complexity of language used, how the participant labels and identifies their cognitive condition) • for interview-based research, schedule time and location according to participants’ preferences, use a conversational tone, and use engaging active listening skills respect for holistic personhood • refrain from implicitly and explicitly excluding participants with dementia in research unrelated to dementia • adjust communication techniques according to individual participant's needs, grounded in knowledge of dementia acknowledgment of lived world • identify relevant other parties (e.g., gatekeeper, caregivers, and proxy decision-makers) and engage with them as needed, following suggestions in “focus on research-participant relationships” above and “empowerment in decision-making” below • tailor messaging about study to balance the avoidance of stigma with valuing transparency individualization • adjust research schedules according to each participant's level of lucidity at different times of day • ask for consent during moments of peak lucidity empowerment in decision making • use ongoing consent • recognize the participant's agency to make a decision outside of their "best interest" • consider proxy consent, but use with caution • consider advance directives, but use with caution • adjust communication techniques to prioritize obtaining consent from the participant before resorting to a proxy or advance directive o present information in an accessible format to each participant o allow for participants to consent to some parts of a study and not others • allow the participant to leave the study at any point, even if a proxy gave consent table 2: practical suggestions extracted from literature silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 38 focus on researcher-participant relationships researchers have power over their participants due to the social structure surrounding recruitment in studies, and the potential for cognitive impairment in participants with dementia to heighten power disparities. focusing on the researcher-participant relationship is an effort to minimize this difference in power to ultimately help the participant feel at ease, comfortable, and safe throughout the study (cascio and racine 2018). being aware of the researcher-participant relationship is particularly important when the participants have dementia because they may be unable to communicate discomfort, may feel like they do not have the ability to do so, or may be structurally disadvantaged in doing so. researchers may have to rely on their awareness of the researcher-participant relationship to understand the participant’s comfort level and experience. additionally, the researcher-participant relationship in dementia studies requires an awareness of the experiences of both the participant and their research partner (who advocates for the participant), if they have one. in recent literature, researchers have discussed the researcher-participant relationship in detail particularly as it relates to interview-based studies. they have suggested numerous strategies for conducting interviews that are mindful of the participant (dempsey et al. 2016). for example, the location and environment of the interview seems to impact how the participant feels during the interview. scheduling the interview according to the participant’s schedule and location preferences diminishes the burden for the participant and caregivers. it gives the participant control of their environment, giving them a sense of security and safety (dempsey et al. 2016). allowing participants to be active agents in the research process can reduce the power disparity between the researcher and participant. for example, the researcher can allow the participant to direct the conversation instead of adhering to an interview schedule (novek and wilkinson 2017). conducting the interview in a private space may increase the participant’s comfort especially if the conversation may become more sensitive. providing refreshments and tissues may also contribute to the comfort of the participant when discussing difficult topics (dempsey et al. 2016). in addition to the setting, the manner in which the researcher conducts the interview can impact the participant’s experience. conducting the interview in a conversational tone can support the participant in maintaining their train of thought (murray 2013). similarly, engaging in the conversation with active listening skills may help the participant feel at ease, allowing the conversation to flow naturally (dempsey et al. 2016). both of these strategies can give the impression that the interviewer has an interest in the participant as a person, rather than just a source for data (dempsey et al. 2016; hughes and romero 2015). being mindful of these strategies during interviews that contain sensitive talking points may be beneficial because it is ethical for the researcher to avoid causing any excess psychological harm (novek and wilkinson 2017). providing comforting human touch and maintaining empathetic discourse can also be useful in more emotionally difficult interviews (swarbrick, sampson, and keady 2017). interviews require the participant to disclose information about the self, which may cause emotional vulnerability and turmoil that results in the participant experiencing some distress during the study (dempsey et al. 2016). distress cues can have a subtle or sudden onset, so being attentive to the participant may aid in addressing the participant’s distress (novek and wilkinson 2017). being reflexive during the study and adjusting the research protocol to the participant’s needs may help mitigate distress (west et al. 2017). this can include taking breaks as needed and potentially ending the interview prematurely for the day if the participant wishes (novek and wilkinson 2017). to more easily adjust to the wide range of emotions a participant may experience during an interview, researchers can prepare for these adaptations in advance. developing a distress protocol can take place before beginning interviews so interviewers can remain grounded if distress occurs (dempsey et al. 2016). asking research partners and silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 39 caregivers which topics may be more sensitive for each participant allows researchers to feel more prepared and mindful before entering the interview (novek and wilkinson 2017). the relationship between researchers and gatekeepers is a contributing factor for maintaining a positive researcher-participant relationship. in a research context, gatekeepers are anyone who can limit access to a potential participant, including caregivers and family members. thus, maintaining a positive relationship with the gatekeeper is crucial because gatekeepers can mediate the researcher-participant relationship. meeting the gatekeeper in person can initiate a trusting relationship, setting the groundwork for a smooth experience for all parties (dempsey et al. 2016). providing gatekeepers and participants with accessible information they can take home to read in advance can also encourage a positive relationship (holland and kydd 2015). caregivers can play an important role in the participant’s life and affect their research experience. facilitating participation in research can add burden to the already physically and emotionally taxing task of caring for another person (prusaczyk et al. 2017). expressing concern for the caregiver’s wellbeing may generate a more positive research experience for all parties. some caregivers’ motivation for enrolling participants in research stems from a need for information, especially if they do not have much experience caring for people with dementia. participating in research can provide them with a network of people who can empathize with their experiences (black et al. 2014). providing caregivers with resources and checking in on them can positively impact the relationships between all parties (assari and lankarani 2016; black et al. 2014). the research process can blur the boundaries between the researcher and caregiver roles (lichtner 2014). the researcher may care for the participant’s emotions during the interview session, and this can create a caregiver-like bond between the researcher and participant. thus, some have suggested that it is imperative that both the researcher and participant have positive closure at the end of the study. instead of a harsh end to the relationship, gradually withdrawing from the participant can take place (dempsey et al. 2016). asking the participant clarifying questions, following up with the final publication, and sending cards for birthdays are appropriate after the study concludes (poscia et al. 2017). being mindful of language choice when interacting with participants and their caregivers can enhance the researcher-participant relationship. in general, avoiding stigmatizing language can deemphasize the participant’s vulnerability and lack of power in the situation (novek and wilkinson 2017). for example, the term “dementia” can be stigmatizing for some participants, especially if the participants have forgotten or are unaware of their diagnosis (heggestad, nortvedt, and slettebo 2013; higgins 2013; novek and wilkinson 2017). thus, some have suggested using the term “memory problems” until the participant labels their difficulties as “dementia” (higgins 2013). this raises critical questions regarding consent and data dissemination. asking a participant to consent to a study on memory problems and later publishing the data as a study on dementia can be misleading and paternalistic, potentially causing psychological harm to the participant. therefore, researchers being mindful that the language they use to obtain consent requires reflection on how they would like to publish or promote their findings (novek and wilkinson 2017). focusing on the researcher-participant relationship can be beneficial for both the participant and the researcher. participants having positive experiences in research may lower attrition rates, thereby allowing the researchers to collect more meaningful data (poscia et al. 2017). yet, maintaining a positive relationship via some of the aforementioned strategies, such as following up with the participants after the completion of the study, requires both time and money auxiliary to the resource requirement of data collection. factors such as study design and methods could moderate the degree of caretaking the silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 40 researcher experiences during their interactions with participants. it also may be difficult to avoid blurring the boundaries between researcher and caregiver, if at all possible, making the research termination more difficult to navigate because of the additional emotional connection. thus, researchers could anticipate adopting a caregiver-like role and prepare to compassionately navigate this responsibility. the higher quality data may outweigh the costs of maintaining such a positive relationship. additionally, recs may be more inclined to approve of a study that positively impacts its participants by means of additional emotional support. respect for holistic personhood respect for holistic personhood recognizes the importance of including vulnerable participants in research and creating dementia-friendly accommodations to facilitate participation. in the context of research involving older participants, respecting holistic personhood values the enrollment of people with dementia and considers their needs throughout the research process. this includes allowing people with dementia to have access to research and not excluding them, while also acknowledging the selfhood of people with dementia despite having potential impairments in decision-making (cascio and racine 2018). in anthropology, “selfhood” is the idea that each person has individuality. it relies on the idea that people have a self, or a constant, permanent stream of consciousness throughout their lives (scheper-hughes and lock 1987). thus, a person contextualizes their continuous self within a temporal construct of their past, present, and future (cohen 1998). because dementia can compromise a person’s memory and cognition, and therefore impact their conscious continuous self, it can complicate decision-making (buller 2015b). a dementia diagnosis can divide the continuous self into pre-diagnosis and post-diagnosis selves (cohen 1998). navigating this duality can be difficult from a researcher’s perspective, especially if there is conflict between the past and present selves. however, respect for holistic personhood values the research contributions of people with dementia and recognizes their personhood by considering the appropriate accommodations to facilitate their participation (cascio and racine 2018). the articles that related to respect for holistic personhood typically fell into two main categories: medical research and social research. for research in either category, including people with dementia in studies can be beneficial for both the researcher and the participant, but the articles contextualized the benefits of research participation differently. by choosing to safely and ethically include this population, researchers are advocating for the population’s wellbeing. researchers have noted that because dementia symptoms vary drastically between people, there is also variation of communication abilities (murray 2013; novek and wilkinson 2017). to accommodate the specific needs of participants with dementia and to make research more accessible, communication techniques can be adjusted, ideally by providing supplemental media to aid in the individual’s understanding. this can be particularly useful during consent processes and the giving of instructions (hughes and romero 2015; murray 2013). an inability to communicate in a certain modality does not imply a lack of understanding or cognitive ability (murray 2013). adjusting communication according to the participant’s preferred modality can make the exchange of information easier (murray 2013; novek and wilkinson 2017). additionally, it helps in maintaining the person’s autonomy by inviting them to communicate their own decisions (murray 2013). communication barriers can lead researchers to underestimate a person’s cognitive capacity and sense of self (witham, beddow, and haigh 2015). having dementia presents challenges to a person’s selfhood because it limits the ability to express individuality (buller 2015b; oneill 2013). however, if a person cannot communicate in a manner that others acknowledge, they may not properly recognize that person’s selfhood or holistic personhood (oneill 2013). a person with dementia can still have a sense of silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 41 identity despite having bouts of confusion (witham, beddow, and haigh 2015). challenges to communication do not erase their selfhood, even if researchers are unable to fully comprehend it (novek and wilkinson 2017). people with dementia typically experience significant exclusion from both social and medical research (dowson, doyle, and rayner 2013; onyemelukwe 2013; prusaczyk et al. 2017 wood et al. 2013). there are several factors contributing to this exclusion, including administrative limitations, a lack of accommodation, comorbidities, and gatekeepers (prusaczyk et al. 2017). meeting the administrative requirements, such as obtaining rec approval and adhering to deadlines, is more challenging because of this population’s vulnerability. researchers cite having a negative experience passing recs and recruiting enough participants in a reasonable amount of time. additionally, some researchers incorrectly assume that including people with dementia is prohibited (henwood, baguley, and neville 2015). there is some uncertainty in conducting studies with vulnerable populations, creating additional challenges that researchers may not feel able to address. in the medical literature, there is a focus on the implications of exclusion for knowledge production. performing research with participants who have dementia can lead to discoveries of new treatments and therapies. inclusion of these participants would actively contribute to the treatment of future generations by producing new information through research (gilbert et al. 2017). many people who have dementia also have comorbidities, and including them in studies not focusing on dementia will increase external validity (prusaczyk et al. 2017). they may wish to participate in research pertaining to these other aspects of their life; however, the dementia diagnosis is a common exclusion criterion (gilbert et al. 2017; onyemelukwe 2013). researchers who do not typically conduct studies that focus on dementia may not want to engage in the uncertainty and challenges that come with including participants with dementia (onyemelukwe 2013). however, such exclusion from research can increase this population’s vulnerability (heggestad, nortvedt, and slettebo 2013). additionally, the participants’ caregivers may not wish to accept the burden of facilitating access to a study that does not focus on dementia if having dementia is the participants’ most significant health issue (dowson, doyle, and rayner 2013). in social research, both knowledge production and the personal significance of participating in research were discussed. involving participants with dementia in social research can reduce stigma and help advocate for this population. participating in research gives people with dementia a voice and recognizes them as active members of society. if the general population gains a more accurate and valid understanding of dementia, there may be a reduction of stigma. thus, including people with dementia in social research is a means of advocacy because higher inclusion rates lead to more information production and dissemination (heggestad, nortvedt, and slettebo 2013). in both social and medical research, scholars have largely cited navigating gatekeepers as a significant challenge to accessing people who have dementia. because this population is vulnerable, as defined by the world health organization, they typically have several gatekeepers that attempt to protect them from the potential burden or harm of participating in studies (world health organization 2015; hughes and romero 2015). several researchers have reported difficulties in recruiting participants with dementia because a gatekeeper denied access or asked for a specific participant to be excluded (dowson, doyle, and rayner 2013). gatekeepers also may be more likely to grant access if the potential participant is only in the early stages of dementia, which can result in a selection bias in the study (hughes and romero 2015). articles identified in this part of the review also paid significant attention to the ethics of exclusion. although the grounds for excluding people with dementia suggest that inclusion would be unethical, silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 42 excluding this population on the basis of their diagnosis can also be unethical in certain circumstances (dowson, doyle, and rayner 2013; monroe et al. 2013). denying this population the opportunity to participate in research solely because of the challenges their diagnosis presents, and not for the genuine safety of the participants, actively perpetuates discriminatory, ageist beliefs (hughes and romero 2015). additionally, participating in research can be a valuable way to be active in society, and automatic exclusion from research denies this experience (thorogood, deschenes st-pierre, and knoppers 2017). we found some disagreement in the literature regarding respect for holistic personhood. one of the primary issues is difficulty in navigating research administration. while researchers may wish to be inclusive of people with dementia, recs may reject the proposal and thereby devalue their participation. this can demotivate researchers to include a significant portion of the older population. a 2012 review examined the exclusion rate of those with dementia-related cognitive impairment, revealing a 29% explicit exclusion rate in the sample of studies (taylor et al. 2012). other studies included in the review employed recruitment strategies that likely reduced the participation of those with cognitive impairment (ibid.). however, having respect for holistic personhood in both medical and social research can have significant benefits. in medical research, including participants who have dementia in research that does not centrally focus on dementia can make the data more generalizable to the older population. for example, in studies regarding treatment efficacy, inclusion of people with dementia can highlight whether a treatment is accessible and therefore effective for people who may have memory difficulties. in social research, inclusion of people with dementia can allow their voices to be heard, thus raising awareness, which can be a valuable and empowering experience for the participants. acknowledgment of lived world acknowledging the lived world of a participant with dementia involves understanding the implications of both the diagnosis and the research study on the person’s day-to-day life. the lived world encompasses participants’ social experiences of illness (following kleinman 1988) or disability (following oliver 1983), and specifically the effect that participants’ experiences in a world outside the research context may have on their present needs and overall experience within the research context (cascio and racine 2018). likewise, participating in research can affect how they experience living with dementia. acknowledging the lived world of someone with dementia involves understanding how their own and their community’s beliefs and values can play a role in the research process. as several researchers have noted, participating in both social and medical dementia research could impose a significant social risk (west et al. 2017). society stigmatizes dementia, so those who begin to openly identify (or are identified by others) as having dementia may experience changes in how others treat them (novek and wilkinson 2017; witham, beddow, and haigh 2015). these changes can include making assumptions about the person’s cognitive ability, safety, and judgment, calling into question their identity as an autonomous adult (reed, carson, and gibb 2017). concepts such as relational autonomy, important in research ethics generally and person-oriented research ethics specifically, helpfully parallel long-standing anthropological skepticism towards the notion of a bounded, individual, egocentric self that underlies many discussions of autonomy in bioethics (see e.g., buchbinder, frank). additionally, these social risks can cause people to feel less inclined to participate in research, especially if they have friends, family, or employers who can become aware of their participation (west et al. 2017). identifying as a person who has dementia can negatively impact any and all relationships, including the relationship between the person and their self through internalized stigma. participating in a dementia-related research study asks the participant to confront and acknowledge their identity as a person with dementia, which may be stigmatizing to the extent of deterring them from participating in research. a similar concept exists among some of the hiv+ population who choose to not receive antiretroviral therapy because of the emotional silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 43 burden of having a daily reminder of their hiv status (persson et al. 2016). acknowledgement of lived world requires understanding that these risks can impact the participation experience and participating in research can validate a person’s status as a member of a stigmatized population. participating in a study may increase the daily challenges of having dementia, such as remembering additional appointments and following directions (black et al. 2014). people and organizations that support people with dementia in their daily lives are also involved in everyday issues of research. these significant other people include family members, caregivers, and assisted living staff. if the person with dementia has a caregiver, the caregiver needs to accommodate the research requirements in their routine (ibid.). this can be difficult and thereby discourage participation in studies because even if the person with dementia wishes to participate, they might not have access due to their caregiver’s schedule. long-term care facilities may be less willing to accommodate individual patients’ research schedules, and family members may live too far or may be unable to be free to facilitate these appointments (wood et al. 2013). the caregiver may also have differing views on whether the person with dementia should be engaging in research, so they could simply be noncompliant in providing access (dunn et al. 2013). however, it is worth noting that although most articles that discussed caregiver burden suggested it can inhibit participant enrollment, but cary et al. (2015) argue there is no association between willingness to participate in research and caregiver burden. the notable lack of articles in comparison to other guideposts could indicate a gap in research, an oversight by researchers, or a need for better strategies to discuss such an individualized topic. the major area in which a participants’ lived world is discussed in the literature is through discussions of gatekeepers, caregivers, and proxies which overlap significantly with content in the guideposts of researcher-participant relationships (researchers must also build relationships with third parties) and empowerment in decisionmaking (when researchers consider proxy decision-makers). although not discussed in the research ethics literature, there are also other significant persons who may have an impact on the research process. notably, people with dementia may frequently talk about deceased or absent loved ones who continue to have a profound influence on the daily lives of participants.5 observing the influence of absent or dead others in the lives of a person with dementia—whether the person with dementia experiences those others as dead or not—would be fully in line with longstanding anthropological engagement with the agential power and relational influence of the dead as ancestors, ghosts, memories, and so on. acknowledging the lived world of the participant is not always something that researchers can easily describe in their methods because it can simply be an empathetic attitude implicit in researcherparticipant interactions. it is also largely participant-specific, so addressing this guidepost explicitly in their methods would be difficult in studies with numerous participants. for example, some participants may go through periods where they forget the focus of the study or their dementia diagnosis, thus using the term “dementia” may be disturbing (bunn et al. 2012). entirely avoiding the term could also be dishonest and unethical. detailing these situations within the context of a methodology would be arduous but perhaps necessary, considering the current lack of resources in navigating dementia labels in research. similar to focusing on the researcher-participant relationship, acknowledging the lived world and exercising empathy can decrease attrition by making research more accessible and comfortable (poscia et al. 2017). understanding the social and lived implications of participating in research can allow the researcher to adjust the protocol to make it more accessible to a larger population and increase enrollment. individualization the guidepost of individualization in dementia research recognizes that even within culturally patterned social contexts, there are important individual differences in how each person may experience silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 44 their diagnosis, with both symptom presentation and day-to-day living. it considers these experiences throughout the research process and accommodates them as much as possible. individualization goes hand-in-hand with acknowledging the person’s lived world in that they both recognize how much variation there is within the dementia population. literature pertaining to individualization in dementia research largely focuses on the implications of the variety in symptom presentation. scholars have suggested that researchers, health care practitioners, and anyone in a position of power over a person with dementia may automatically infantilize them on the basis of their diagnosis. a dementia diagnosis does not imply the incapacity to make decisions, nor should it be the basis for assumptions regarding the person’s cognitive ability (mcnally and lahey 2015). in general, dementia is a progressive illness, but symptoms can vary from person to person. the progression is not necessarily linear, either, so knowing a person’s typical symptom presentation does not allow for a sweeping generalization of their cognitive deficit. there can be high variation day-to-day and even hour-by-hour, with some people experiencing sporadic bouts of confusion or lucidity (west et al. 2017). scholars have suggested it is up to the researcher to adjust their schedule accordingly. if a participant is typically more confused during a certain time of the day, the researcher can avoid performing the study at that time (prusaczyk et al. 2017). likewise, the researcher can ask for consent when the participant is most lucid, giving the participant maximal agency in the process (prusaczyk et al. 2017; west et al. 2017). similar to acknowledgment of lived world, there were notably few articles pertaining to individualization. per its title, this guidepost is participant-specific and difficult to discuss within an article that is not expressly discussing individualization. additionally, the progression of dementia may cause a participant’s needs to change throughout the study. we acknowledge that these details may be difficult to document within the confines of a research article. adjusting to each participant’s schedule and abilities can be especially difficult when dementia symptoms vary day-to-day (dempsey et al. 2016). however, these adjustments could make a formerly ineligible participant eligible for enrollment. accommodating individual participant’s needs allows more people to participate in research and can give participants a more positive experience throughout the process. additionally, adjusting a medical study that does not focus on dementia to the specific needs each participant with dementia, and thus allowing them to participate, generates a more representative sample of the older population. this can increase the external validity and make the data more meaningful (prusaczyk et al. 2017). empowerment in decision-making empowering a person with dementia in decision-making processes is an effort to retain their autonomy, and it allows them to act as their own agent as much as possible. specifically, in dementia research, empowerment in decision-making allows participants to make any decision they are cognitively able to and provides participants with assistance in the decision-making processes if they need it. in the literature pertaining to this guidepost, the discussion primarily focuses on consent practices. one strategy for empowering decision-making is the notion of ongoing consent already wellrecognized by anthropologists and established in the american anthropological association code of ethics (american anthropological association 2012; heggestad, nortvedt, and slettebo 2013; overton et al. 2013; thorogood, st-pierre, and knoppers 2017). it is a process where researchers continually ask for consent throughout the research project, thereby establishing a trusting relationship and providing many opportunities for dissent. likewise, it provides several opportunities for the participant to make informed decisions and renegotiate the terms of consent (heggestad, nortvedt, and slettebo 2013). these decisions silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 45 can be adjusted to the participant’s cognitive abilities (heggestad, nortvedt, and slettebo 2013; monroe et al. 2013). some scholars suggested that proxy consent is sufficient if the participant has decisional impairment, provided that the researcher allows the participant to leave the study if they wish (west et al. 2017). however, this is a point of contention. on the one hand, participant’s wishes are of primary importance even with proxies and assisted decisions (hughes and romero 2015; monroe et al. 2013). a participant’s decision-making capacity largely depends on the decision in question and the participant may not always need assistance (dowson, doyle, and rayner 2013). yet, on the other hand, other scholars suggest that advance research directives (a legal document written while a potential participant has consent capacity that allows the participant to express their preferences regarding research enrollment should they later not have consent capacity) more effectively preserve autonomy because it is still unclear why a proxy would be in a better position to determine the best interest for the participant over the participant’s previous wishes (jongsma and van de vathorst 2015a). participants in dementia research have the right to make informed decisions, despite their status as members of a vulnerable population (pachana et al. 2015). participants with dementia even have the right to make decisions that are not in their “best interest” (jongsma and van de vathorst 2015a). for example, it may not be in the “best interest” of the participant to enroll in a biomedical study that does not suggest the potential for treatment. the participant may wish to enroll in a randomized controlled trial out of altruistic motivation, despite its burden and lack of medical benefit. thus, a participant making a decision not in their “best interest” is not a sufficient basis to reject the decision (jongsma and van de vathorst 2015a). similarly, scholars have denied its validity as an argument for assuming that the participant has low decision-making capacity (ibid.). advance research directives are another strategy to empower the decision-making of a person with dementia. they preserve the person’s autonomy by allowing them to express their future wishes and desires before they become symptomatic (jongsma and van de vathorst 2015a; onyemelukwe 2013). although a person may not be able to explicitly reaffirm their previous decisions at the time of research enrollment, this does not indicate a change in preferences (ibid.). the wishes they outline in their advance directive are expressions of selfhood, and allowing them to make decisions about their future maintains their role as their own agent (buller 2015b). however, outlining future research decisions in an advance directive is relatively uncommon because advance directives are traditionally for healthcare (dowson, doyle, and rayner 2013). if a person with dementia does not have an advance research directive and is too symptomatic to consent, scholars suggest allowing them to appoint a proxy is another strategy for empowering their decision-making (black, wechsler, and fogarty 2013). it is the researcher’s responsibility to enable the participant to take part in decision-making to the best of their ability (heggestad, nortvedt, and slettebo 2013). additionally, caregivers can underestimate the abilities and strengths that a person with dementia retains; thus, presenting research information personally to the participant may reveal their higher decisional abilities (gilbert et al. 2017). participants with dementia who are unable to consent to the entire study may still be able to make other, smaller decisions in the study. for example, they may be able to understand and consent to parts of the project, exercising some agency in the consent process (dowson, doyle, and rayner 2013). empowerment in decision making is the guidepost that is most discussed in current literature, possibly because of its legal relevance in navigating the issue of the decision-making capacities of participants with dementia. although legal regulation is a significant component of ethics, it does not encompass the entirety of ethics practices. person-oriented research ethics focusses on everyday ethics, silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 46 which often exists outside of the legal realm. thus, in keeping with the person-oriented research ethics framework, the data extracted specifically focused on everyday ethics. we found contention about empowerment in decision-making, especially regarding the validity of proxies and advance directives. some scholars suggest that obtaining consent from proxies is a good strategy when the participant is unable to make decisions, but others have argued that proxies might not necessarily make the decision that the participant would have made prior to experiencing dementia symptoms. similarly, advance directives preserve autonomy, but the participant’s opinions may have changed since creating the advance directive. both of these strategies supersede obtaining consent from the participant, which may be paternalistic and unethical if they are still able to consent to any aspects of the research. documenting the consent process in publications would be a prudent step forward for dementia researchers. we found significant uncertainty in the literature regarding consent largely because researchers in the health sciences rarely describe their strategies or experiences in their final publications. beginning to record how they assessed their participants for capacity to consent and how they obtained consent could help the process in future studies. it could also improve the experience for both the researcher and the participants because the researcher will be more confident in the process. empowerment in decision-making for dementia research is complex from an anthropological perspective. the emphasis on facilitating the participant to make decisions and provide consent is deeply rooted in the notion that dependency is a loss of self and identity (cohen 1998; leibing and cohen 2006; taylor 2008). dividing the continuous self into pre-diagnosis and post-diagnosis selves is dubious because of the “entanglements” lock (2013) identifies between dementia and normal cognitive aging (lock 2013). additionally, advance directives challenge the post-diagnosis self and have the potential to invalidate it (bunn et al. 2012). this is problematic because, much like normal aging, dementia is irreversible (cohen 1998; leibing and cohen 2006). however, some individuals experience moments of lucidity, which complicate the progression from pre-diagnosis to post-diagnosis self. conclusion handling more conventional research ethics issues as well as more relational and experiential aspects of research ethics is of high importance considering the prevalence of dementia and the amount of resources allocated to research on dementia. the person-oriented research ethics framework offers five guideposts which help think about these relational and experiential aspects and tackle them. in our extensive review of ethics and dementia literature, we extracted significant content pertaining to these guideposts which demonstrates their relevance in both clinical and social research and the enrichment brought by a purposive literature review. we address not only the ethical issues involved in research about dementia, but also the desirability of including people with dementia in research on other topics that interest them. broadening the conversation in this way respects that people with dementia are not reducible to their diagnosis, but live full and complex lives that might involve research participation. despite the wealth of information on dementia research ethics, there is a distinct lack of explicit and consolidated dementia-specific guidelines available to researchers beyond the more conventional regulatory requirements about topics such as consent and confidentiality. person-oriented research ethics requires attention to ethics beyond the regulatory. dementia-specific guidelines in a person-oriented research ethics framework would provide details on day to day interactions between researchers, participants, and caregivers, research partners, or proxies. the literature also reveals that there are still significant barriers to conducting ethical, person-oriented, research with participants with dementia. the silva, cascio, and racine | anthropology & aging vol 41 no 1 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.211 http://anthro-age.pitt.edu 47 systematic exclusion of participants with dementia is largely rooted in ageist conceptions of cognition in older people and a lack of accommodations for those with dementia. by delving into the existing literature, we have extracted some guidance, summarized in table 2. however, these recommendations derive only from recent literature on research ethics, understood within the context of various tensions described in the narrative above. more targeted work needs to be done on the ground, to understand the everyday ethical issues that affect participants with dementia in research. such work would contribute to the empirical study of human research ethics and frameworks of evidence-based research ethics (kalichman 2009), which benefits immensely from anthropological work describing interand intracultural variations in the definitions, meanings, and experiences of ethics concepts. such further work would inform a stronger set of accessible, easy-to-use dementia-specific guidelines for researchers, informed by lived experience and ethnographic expertise, which will assist in operationalizing person-oriented research ethics in a variety of situations.5 acknowledgements we acknowledge support from angelo-pizzagalli and banting fellowships (ariel cascio) and a frq-s career award (eric racine). we wish to thank editors and reviewers for helpful suggestions on previous versions of our manuscript. we wish to thank the aage for a margaret clark award (olivia silva) and to the leadership of the association for anthropology, gerontology, and the life course for the opportunity to publish in anthropology & aging. notes 1 the work described in this paper was carried out at the pragmatic health ethics research unit, institut de recherches cliniques de montréal. 2 web of science allows truncation at the beginning of words so this database required fewer queries. 3 examples include an article that discusses the ethics of using monitoring devices for patients with dementia (hall et al. 2017) and an article that discusses the ethics of providing palliative care to patients with dementia (mahinbabaei, hilal, and hughes 2016). 4 examples include an article discussing the ethics of growth hormone replacement research (juengst 2002) and an article discussing the ethics of extending the human life span (partridge et al. 2009). 5 we are grateful to christine verbruggen for this observation. references american anthropological association. 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"notes from the hospital bedside: reflections on researcher roles and responsibilities at the end of life in dementia." quality in ageing and older adults 18 (3):201211. doi: 10.1108/qaoa-09-2016-0038. taylor, j. s. 2008. on recognition, caring, and dementia. medical anthropology quarterly, 22(4), 313-335. taylor, j. s., demers, s. m., vig, e. k. and borson, s. 2012. the disappearing subject: exclusion of people with cognitive impairment and dementia from geriatrics research. journal of the american geriatrics society, 60: 413-419. doi:10.1111/j.1532-5415.2011.03847.x thorogood, a., c. d. st-pierre, and b. m. knoppers. 2017. "substitute consent to data sharing: a way forward for international dementia research?" journal of law and the biosciences 4 (1):133-158. doi: 10.1093/jlb/lsw063. us national institutes of health. 2017. "estimates of funding for various research, condition, and disease categories (rcdc)." national institutes of health, accessed 04/03/2018. https://report.nih.gov/categorical_spending.aspx. van rookhuijzen, a. e., d. p. touwen, w. de ruijter, d. p. engberts, and r. c. van der mast. 2014. "deliberating clinical research with cognitively impaired older people and their relatives: an ethical add-on study to the protocol "effects of temporary discontinuation of antihypertensive treatment in the elderly (dante) with cognitive impairment"." the american journal of geriatric psychiatry: official journal of the american association for geriatric psychiatry 22 (11):1233-40. wadekar, m., a. sharma, and g. battaglia. 2015. "patient-centered outcomes research (pcor): how can we optimize outcomes in cns research?" innovations in clinical neuroscience 12 (3-4):27. west, e., a. stuckelberger, s. pautex, j. staaks, and m. gysels. 2017. "operationalising ethical challenges in dementia research-a systematic review of current evidence." age and ageing 46 (4):678-687. doi: 10.1093/ageing/afw250. whelan, p. j., r. walwyn, f. gaughran, and a. macdonald. 2013. "impact of the demand for 'proxy assent' on recruitment to a randomised controlled trial of vaccination testing in care homes." journal of medical ethics 39 (1):36-40. wildeman, s., l. b. dunn, and c. onyemelukwe. 2013. "incapacity in canada: review of laws and policies on research involving decisionally impaired adults." the american journal of geriatric psychiatry: official journal of the american association for geriatric psychiatry 21 (4):314-25. witham, g., a. beddow, and c. haigh. 2015. "reflections on access: too vulnerable to research?" journal of research in nursing 20 (1):28-37. doi: 10.1177/1744987113499338. wood, f., h. prout, a. bayer, d. duncan, j. nuttall, k. hood, c. c. butler, and paad study team. 2013. "consent, including advanced consent, of older adults to research in care homes: a qualitative study of stakeholders' views in south wales." trials [electronic resource] 14:247. world health organization. 2015. “dementia: a public health priority.” world health organization, last modified 2015, accessed january 5, 2020. ----. 2018. "dementia." world health organization, last modified december 2017, accessed march 23, 2019. http://www.who.int/mediacentre/factsheets/fs362/en/. young, b. 2015. “longing glances: photographs from the series ‘far from home.’” anthropology & aging 36(2):206-211. book review review of coe, cati. changes in care: aging, migration, and social class in west africa. rutgers university press. 2021. pp. 248. price: $120 (hardcover); $39.95 (paperback and ebook). swetlana torno heidelberg university swetlana.torno@hcts.uni-heidelberg.de anthropology & aging, vol 43, no 1 (2022), pp. 74-77 issn 2374-2267 (online) doi 10.5195/aa.2022.388 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | torno | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.388 http://anthro-age.pitt.edu 74 book review review of coe, cati. changes in care: aging, migration, and social class in west africa. rutgers university press. 2021. pp. 248. price: $120 (hardcover); $39.95 (paperback and ebook). swetlana torno heidelberg university swetlana.torno@hcts.uni-heidelberg.de in changes in care, cati coe provides a comprehensive, historically informed account of societal transformations currently happening around aging and eldercare in southern ghana. these changes occur within the context of decades-long internal and transnational mobility, rising socio-economic inequalities, and increasing longevity and population aging in the global south. coe’s ethnography documents how ghanaian senior citizens, their families, religious and state institutions, and actors on the emergent eldercare market grapple with caring needs of older generations and search for answers to adequately provide for elders under rapidly changing circumstances. the monograph focuses on rural towns of the eastern region and the metropolitan area of the capital city of accra. coe’s collaborators are mainly christian, educated, middle class, and elite populations, whom she met during her numerous research visits to ghana between 2013 and 2019 (eight months in total). this material adds to the author’s previous research experience in the country (since 1997) and publications on neighbouring topics (e.g., 2013; 2019a; 2019b), which expand the readers’ vision to interconnected processes such as child fosterage, transnational kinship relations, and temporality of migration over the life course. theoretically, the book advances the concept of “inscription” that coe began to develop in a collaborative work with erdmute alber (coe and alber 2018) and which she lays out in the introduction. the notion of inscription is situated on the continuum between societal norms and individual actions and foregrounds transience in social change processes. it describes newly emerging “practices and discourses that are shared by more than one individual” but have not yet become “standardized,” “institutionalized,” or “hegemonic” (3). the analytical value of the concept lies in its potential to capture “episodic and contingent ways” in which social change occurs as well as to understand the limits of such processes (3). coe notes that different types of inscriptions exist, such as gender roles or life-course stages. changes in care specifically focuses on “age and care inscriptions” (5). in the introductory chapter, coe places the notion of inscription in relation to other theoretical concepts and strands in aging literature. noteworthy is her use of bourdieu’s terminology surrounding social norms and coexisting alternative discourses and practices such as “orthodoxy,” “heterodoxy,” and “alterodoxy” (6–9). coe uses these concepts in the ethnographic chapters to identify the types of processes leading to the formation of inscriptions (11–14). she furthermore positions inscriptions in http://anthro-age.pitt.edu/ book review | torno | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.388 http://anthro-age.pitt.edu 75 relation to the agency of individuals by stressing that, for example, older adults are actively engaged in creating new age and care inscriptions by imagining alternative futures of care in old age (14–15). in like manner, institutions can drive the formation of new inscriptions. later in the book, the reader will also find a refinement of the “global care chains” concept (hochschild 2001) and “social remittances” theory (levitt 1998); coe posits that transnational migration does not directly translate into the emerging commercial care market but rather conjoins other influential social processes (122–23). chapter 1 (which provides a historical context for the book) outlines the “orthodox script” (30) of eldercare in ghana, which follows the narrative of “traditional family” and is upheld in state policies, by international ngos, and by the christian church. the focus on the nuclear family and children’s care responsibilities following this orthodox script leaves state, religious, and developmental institutions incapable of addressing the real problems many ghanaian senior citizens and their carers are facing today. drawing on archival materials of the presbyterian church dating back to the 1860s as well as on sociological and anthropological studies of older people by local and international scholars, coe shows how this ‘orthodoxy’ was never fully realized in the first place. these sources show that during the 19th and 20th centuries, eldercare was provided by different types of extended kin and nonkin such as slaves and foster children. the book’s ethnographic chapters are organized in two parts and focus on transformations of aging in rural towns (chapters 2–4) and in metropolitan areas (chapters 5–7) respectively. the changes in age and care inscriptions in both sites are mainly driven by migration to urban centres or abroad in search for work or higher education, increasing labour demands on women, and the consolidation of a middleclass with distinct life-styles. rural towns with their limited opportunities for education or employment become unattractive for young and middle-aged people. this consequently reduces the care possibilities of elders residing in these areas. driven by fears of neglect and abandonment, many seniors in coe’s study express their openness to the “heterodox possibility” (60) of residential facilities (discussed in chapter 2). they have become aware of this option via globally circulating images of nursing homes in the west. however, for the time being, such institutional facilities are an imaginary— not a real alternative for eldercare—and are rather used by ghanaian elders to critique the state and the church for neglecting their needs. in contrast, another institutionalized age inscription is on the verge of acquiring “the status of an orthodoxy” (117) in ghana: senior day centres and fellowship groups run by churches. these institutions primarily diagnose the problems of ghanaian older adults as caused by loneliness and lack of medical attention during the day (96) when other household members have left home for work or school. in chapter 4, coe examines the histories and activities of four day-care centres, which offer games, physical exercises, medical check-ups, seminars on health, and opportunities to earn some money. this is well documented in the accompanying ethnographic film making happiness: older people organize themselves. the major critique raised by the author in this chapter is that the centres mainly include the well-off and mobile older adults in their activities and exclude the bedridden elderly with chronic conditions. chapter 3 documents those age and care inscriptions that are not openly diverting from the “orthodox script” but are still becoming more common in the rural towns of the eastern region. these inscriptions comprise the adaptation of historically existing practices for eldercare purposes. in this carearrangement, children do not provide care directly and instead use a fostered adolescent, distant (often) female kin, or unrelated middle-aged woman to provide care for their parents. children supervise the care-work as “care managers” (78) from a distance and pay for these services in the form of schooling fees, remittances for living expenses, and work renumeration. coe argues that this care inscription http://anthro-age.pitt.edu/ book review | torno | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.388 http://anthro-age.pitt.edu 76 actually supports “the orthodoxy of kin care because adult children [are] viewed as caring for their parents by paying for their care by others” (79). a variant of this practice is when the elder moves in with one’s daughter, who might care for the parent herself or recruit a paid caregiver if she has a prestigious full-time job. in chapter 5, coe directs her attention to the newly emerging eldercare market in accra. this market consists of home care agencies and a small number of nursing homes, which cater to the needs of the growing urban middle-class and international migrants, who are able to pay for these services. the market is still small and highly volatile due to economic instabilities, lacking awareness of special care needs of older adults, and the reluctance of the state to regulate this field. nevertheless, the new demand for eldercare brought about changes in the field of higher education through the introduction of the new healthcare assistance study program, which is the subject of chapter 6. coe points out that the program was initially supposed to train home carers for the elderly but transformed its educational goals towards a stronger resemblance with nursing. drawing on bourdieu’s concept of cultural capital, she discusses the “social life” (147) of the new academic credential and reveals the disjuncture between the students’ “educational enchantment” (165) and actual employment possibilities. the lacking recognition of the healthcare assistance certificate in hospitals and by home care agencies leave most young graduates disappointed about their wages, the workplaces where they end up, and their concomitant social reputations. the last chapter deals with yet another aspect of the newly emerging care market and examines the confusion of home carers as a new inscription with “adjacent relations” (168). within the field of social and professional hierarchies in ghana, the novel occupation as home carer is placed between the employment as household help (no professional training) and nursing profession. coe finds that the introduction of a new occupation reflects and stabilizes existing social inequalities and is visible in home carers’ engagement in “symbolic boundary work” (168): they mobilize their academic certificate, medical knowledge, and similarity to the nursing profession to reassure their higher status in comparison to household help. however, their education and work do not possess cultural capital yet, which leaves them without the respect and social status they feel they deserve (186). summarizing her results in the conclusion, coe provides recommendations on how to improve eldercare education and enhance its status. changes in care offers a much-needed contribution to literature on population aging and accompanying social transformations in the global south. its insights on the emergent eldercare market in a context where commercial services and institutionalized facilities seem unprecedented are particularly relevant and invite for further discussion and comparison. the book is lucidly written, well organized, and would be interesting for students, scholars, and professionals working on aging, generations, transnational families, eldercare, and social change. references coe, cati. 2013. the scattered family: parenting, african migrants, and global inequality. chicago: university of chicago press. coe, cati. 2019a. the new american servitude: political belonging among african immigrant home care workers. new york: new york university press. -----. 2019b. making happiness: older people organize themselves, bethel presbyterian church, new tafo, ghana, july 2019. rutgers university. https://doi.org/10.7282/t3-thke-hp15. http://anthro-age.pitt.edu/ https://doi.org/10.7282/t3-thke-hp15 book review | torno | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.388 http://anthro-age.pitt.edu 77 coe, cati and erdmute alber. 2018. “age-inscriptions and social change: introduction.” anthropology and aging quarterly 39 (1): 1–17. hochschild, arlie russell. 2001. “global care chains and emotional surplus value.” in on the edge: living with global capitalism. edited by will hutton and anthony giddens, 130–46. london: vintage. levitt, peggy. 1998. “social remittances: migration driven local-level forms of cultural diffusion.” international migration review 32 (4): 926–48. http://anthro-age.pitt.edu/ respect, gratitude, and closure: a trip of honor and remembrance lynette m. castronovo matthew dalstrom lynette.m.castronovo@osfhealthcare.org matthew.d.dalstrom@osfhealthcare.org saint anthony college of nursing saint anthony college of nursing brandie messer brandie.l.messer@osfhealthcare.org saint anthony college of nursing abstract each year, more than 200 world war ii, korea, and vietnam veterans participate in the vetsroll program, a four day bus trip from southern wisconsin to washington, d.c. vetsroll is one of several organizations that bring veterans to war memorials in washington, d.c. to assist them in dealing with the socioemotional consequences of their time in service and return home. these programs specifically focus on older veterans who are at a high risk for developing and/or managing mental health problems as they age. some of these veterans have never had the respect, gratitude, and closure necessary to help them cope with their time in service. data was collected through participant observation and semi-structured interviews on the vetsroll trip in 2019 and after the trip. data was analyzed through thematic analysis. drawing upon the metaphor of a pilgrimage, this paper shifts the lens of analysis away from a myopic focus on memorials or peer support to how the journey itself affects veterans, the meaning it produces for them, and the lasting impact it has after the trip. keywords: veterans; memorials; pilgrimage; mental health anthropology & aging, vol 43, no 1 (2022), pp. 49-57 issn 2374-2267(online) doi 10.5195/aa.2022.358 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. castronovo, dalstrom, & messer | 49 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu respect, gratitude, and closure: a trip of honor and remembrance lynette m. castronovo matthew dalstrom lynette.m.castronovo@osfhealthcare.org matthew.d.dalstrom@osfhealthcare.org saint anthony college of nursing saint anthony college of nursing brandie messer brandie.l.messer@osfhealthcare.org saint anthony college of nursing “it is something you wouldn’t want to miss being a vet. being on the bus with all the other guys—they’re all vets, and you’ve got so many kinds of things to talk about. i had a really great experience because when i got on the bus, i sat down next to a guy… we just talked all the way out there and all the way back.”-vetsroll’s vietnam veteran introduction as we entered memorial park, flowers and photographs were visible along the length of the vietnam veterans memorial (the wall), and the light-hearted attitude during the bus ride gave way to a somber one. while looking at over 58,000 names on the wall, many of the veterans on the trip, organized by the non-profit organization vetsroll, experienced a variety of emotions. tears were shed as they traced the names of deceased friends with pencils and paper. one veteran stated, “that meant something to me just finding the six guys on that wall and some of them were my classmates.” small groups of men took pictures in front of the wall, especially near the names of those who they once knew, and one veteran saluted in remembrance of his deceased friends. for many, the experience of traveling to the memorial was more than a just trip, it was something deeper tied to both their past and the need for “closure and respect,” which according to one participant, began with the trip providing them with “the recognition we should have gotten 50 years ago…” he continued, “finally, somebody’s giving me a pat on the back for being there and doing what we did.” visiting the memorials in washington, d.c. was the culmination of a four-day bus ride with 220 veterans organized by vetsroll,1 a non-profit veterans organization located in southern wisconsin. vetsroll is one of several organizations that bring older veterans to war memorials in washington, d.c. to assist them in dealing with the socioemotional consequences of their time in service and their return home. aging has its challenges, especially for veterans. in the united states, 47% of veterans are 65 years or older, and this number is expected to increase to 52% by 2024 (o’malley et al. 2020). all veterans face a number of problems related to their military experiences and homecomings, especially regarding mental health issues. however, older veterans are at an increased risk for mental health disorders such as depression compared with similarly aged non-veterans (williamson et al. 2018). many older veterans also experience war related psychological distress; however, it is not clear, whether the problems existed since their time of service or if the distress emerged due to the aging process or retirement (hunt and robbins 2001). also, older veterans may find it increasingly difficult to intentionally suppress unwanted memories because inhibitory control declines with age (marini et al. http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 50 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu 2020). thus, retirement is a life event, which is potentially traumatic, because it can generate a sense of loss and loneliness which may act as a reminder of the war (hunt and robbins 2001). while it is well known that veterans suffer from combat related stress, their transitions back home have also been linked to mental health problems (johnson et al. 1997; riggs et al. 1998). according to sorensen (2015), homecoming is often daunting for veterans since they are compelled to develop a new social identity and find meaningful life in the civilian world. during this transition, veterans frequently report feeling socially isolated and detached from society as a result of the challenges of bridging the gap between military and civilian worlds (caddick, phoenix, and smith 2015). these problems are amplified when veterans do not have a positive homecoming and experience alienation from american society because they are often misunderstood and or disrespected. this alienation acts as a secondary trauma to the primary trauma experienced during war (watkins, cole, and weidemann 2010). moreover, boscarino et al. (2018) found that veterans’ homecoming experiences had an adverse impact on mental health even decades after deployment and suggested that supportive services to returning veterans might result in more positive homecoming experiences. in response, many veterans rely on peer groups for support to help them cope with the experiences of deployment and returning home. however, according to caddick, phoenix, and smith (2015), little research has explored how veterans make sense of peer relationships in their everyday lives and how these relationships might contribute to well-being. nevertheless, some research has shown that bonding with other veterans can satisfy a desire for camaraderie that civilian life is unable to fulfill (2015). military friendships are also important in helping veterans cope with the terror, horror, sadness, and sometimes boredom of military service (hinojosa and hinojosa 2011). veterans of different wars share similar experiences and therefore develop friendships and bonds. moreover, relationships between veterans are often fostered though veteran support groups and nonprofit organizations; these types of organizations are based on the idea that veterans feel more comfortable supporting and receiving support from other veterans. it has been suggested that these organizations can be particularly useful for older veterans because retirement may provide the time and opportunities to develop relationships with other veterans that might not have been possible earlier in life (marini et al. 2020). in addition to peer support, research has shown that war memorials can be therapeutic for veterans by providing them a sense of closure. a memorial is a symbol of the feelings of the social group (barber 1949) and public memorials provide a free, highly visible, yet anonymous, and publicly accessible means to begin the mourning process (watkins, cole, and weidemann 2010). war memorials, in particular, can signify a community’s recognition of and social support for veterans who struggle to deal with losses (watkins 2010). moreover, traveling to a memorial both legitimizes the feelings they elicit and reinforces the strength in those who gather together (barber 1949). for veterans and other visitors, war memorials can be emotionally intense spaces that promote catharsis and healing (beckstead et al. 2011), which is why it is suggested that they be integrated into veteran therapy programs (watkins, cole, and weidemann 2010). however, many veterans are unable or do not want to travel to war memorials that commemorate their time in service because of the emotional impact that they might have on them (beckstead et al. 2011). organizations such as vetsroll seek to overcome these barriers (e.g., personal, physical, economic) to visiting memorials by providing the trip free of charge and through offering veterans the opportunity to travel with other veterans, which fosters friendships and provides a type of social emotional support that would not have been available otherwise. organizations such as vetsroll help veterans deal with the negative impacts of combat and their homecoming experiences by highlighting the transformative nature of the trip itself. the trip can act as a spiritual and symbolic pilgrimage for some veterans (michalowski and dubisch 2001). the healing http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 51 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu and/or symbolic power of travel has been discussed in numerous contexts within the anthropological literature on religion (turner 1995) and healing (inhorn 1994). a pilgrimage can be described as the process of “going to a far place to understand a familiar place better” (turner 1995, 218), or “travel to, and communion with, a specific non-substitutable physical site that embodies and makes manifest the religious, cultural or personal values of the individual” (hyde and harman 2011, 1344). pilgrimages are more than just trips to some place, they are a type of travel that can have a powerful, even transformative, effect on its participants (turner 1995). in their research on veteran motorcycle clubs, michalowski and dubisch (2001), discussed how participants framed their journey to the war memorials as a pilgrimage to obtain closure and catharsis. importantly, their research, illustrates that healing does not come entirely from the memorials, but from the journey that prepares individuals for the experience. they also explain how the trip is a rite of passage for many veterans and through the journey itself, veterans enter a liminal state, allowing for various transformations to take place such as life-healing and connection. by discussing the vetsroll trip, this paper shifts focus away from an analysis of veteran memorials, to instead highlight how the actual journey to these memorials can be transformative and impactful. these trips act as pilgrimages that produce multiple meanings for veterans. methods this paper is part of a larger ethnographic project that examined veterans’ experiences traveling on the vetsroll may 2019 trip and their return home. the four-day trip to washington, d.c. began and ended in southern wisconsin in what month? the first author conducted participant observation during that time and took part in all aspects of the trip including riding on the bus, visiting the memorials in washington, d.c., mail call, and the homecoming parade. afterwards, all the field notes of the daily activities were transcribed from the written notes and used to develop a semi-structured interview guide. one month after the trip ended, semi-structured interviews were conducted with veterans who participated in the trip (table 1). the participants self-reported as white with ages ranging from 71 to 99 and all but one were male. interview participants were recruited before the trip through letters sent out to all veterans who were signed up for vetsroll 2019. interested participants gave consent during the pre-trip orientation meeting and agreed to participate in an interview one month after the trip. we called them to schedule the interviews, where some took place at local libraries and some at their homes located in illinois and wisconsin. each interview was audio-recorded and transcribed verbatim. interview transcripts and field notes were entered into dedoose, version 8.3.43. data was analyzed by the research team using the thematic analysis process that was established by ryan & bernard (2003). this research study was approved by university of illinois college of medicine in peoria, irb -1. http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 52 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu branch of service n army 14 army air 1 navy 5 air force 4 naval air 1 women’s army corp 1 war/conflict served wwii 4 korean 6 vietnam 16 draft drafted 8 volunteered 18 active combat yes 15 no 11 table 1: descriptive characteristics of veterans (n=26) from wisconsin to washington: a pilgrimage as with any pilgrimage, participants have to believe that the destination will be meaningful and the journey transformational. often, this begins with the development of shared expectations, meanings, and experiences as michalowski and dubisch (2001) note. however, some veterans have never traveled to war memorials and have no desire to because military culture does not support the expression of appropriate emotion subsequent to combat events. furthermore, affective responding to combat-related trauma may, for various reasons, be discouraged, ignored, or even punished (keane, zimering, and caddell 1985). moreover, those who were in combat often devalued the emotional impact that the war had on them. to this day, many vietnam veterans have yet to talk about their vietnam experiences with anyone; this prohibition of discussing traumatic events both in vietnam and upon returning home may have limited the desire to revisit war memories (1985). therefore, some veterans were not initially open to a trip such as vetsroll. as one vietnam veteran explained, “i’ve got lot of friends who are vietnam era people because of my age, and i try to convince them into going, and they said, ‘well, i’m not ready yet.’ i told them, ‘well, chances are if you wait till you’re ready, you’re never going to go...i think that if you go, you’ll be thankful that you did and there’ll be some closure for you.’” moreover, some veterans specifically emphasized the transformative qualities of the trip and the importance that all veterans know that they deserve respect, honor, and remembrance. “i know so many guys and gals both that have served in the vietnam conflict and just never got the respect or closure that they earned and should’ve been given,” one participant explained. others discussed how going on the trip was a way to show solidarity and support with other veterans who had the hardest time transitioning home. one wwii veteran exclaimed, “[the trip] was like a homecoming for the http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 53 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu vietnam war people…i signed up because i felt so bad about the vietnam guys. they didn’t get a decent homecoming. they had a miserable job. i was gung-ho to go for that and i did!” the importance and potentially transformative aspect of the journey was reiterated after they signed up, during the orientation meeting, and throughout the trip materials, which stated that the purpose of the trip was “to experience respect, gratitude and closure.” the trip began on a sunday morning, around 4:30 am as participants loaded onto their assigned buses. as we departed, family and friends waved flags and offered their well wishes to participants. the local police department escorted the buses out of town with lights and sirens, and the fire department had ladder trucks stationed along the bus route spraying water bridges over the traveling buses. the streets were lined with more than 200 american flags flying to honor each veteran departing on the trip. as we got further out of town, there were community members and fire trucks on the interstate overpasses celebrating the veterans by waving flags, honking horns, and blowing sirens. marquees were lit up along the interstate stating, “veterans thank you for your services.” looking around the bus, you could see the overwhelming emotion, and some tears, as veterans took in the excitement and support of the community as the journey began. we had many stops during the 4-day bus ride (e.g., restaurants, hotels, memorial sites) and they were all important components of the journey. these experiences enhanced the sense of camaraderie, catharsis, and healing among the veterans. as michalowski and dubisch (2001) note, the process of healing begins as they start the journey, not just when they reach the memorials. these shared experiences strengthened the bonds among the participants and enabled them to freely talk about their military service. for many, traveling in the bus, bunking with other veterans, and the focus on fostering relationships with other veterans was a critical component of the trip. as one vietnam veteran said, “just the camaraderie that we had on the bus and talking with the people and the guys, and heard the stories what they had to go through. it was nice.” after two days on the bus, many of the veterans were ready to visit the memorials in washington d.c. when we arrived, it was a beautiful morning. to set the tone of the day, the ride from the hotel to the war memorials began with a presidential escort that consisted of several police motorcycles that led the way into the national mall and memorial parks while other police forces blocked traffic along the way. “do you ever in your lifetime think that you would get a police escort to washington, d.c. to see all the sites?” one veteran commented. at the vietnam wall, one participant reflected, “well, i think it shows that we were not all forgotten even though some of us thought that’s probably what happened…it’s gratitude and thanks.” the experience at the wall was a source of emotional catharsis and a sense of healing for veterans, both vietnam and otherwise. while there, many of the veterans wanted to find names of friends and family listed on the wall. once a name was located, many had a piece of paper and pencil to trace over the names as a remembrance of their visit to the wall. this, perhaps, is a form of a votive, symbolizing the relationship between the pilgrim and the dead (winter 2019). this is exemplified by the vietnam veterans memorial’s website description which states that the wall’s provides visitors with the “ability to see his or her reflection at the same time as the engraved names, connecting the past and the present like few other monuments can” (washington.org 2021). at many of the memorials, participants also left objects such as medals, letters, photos, and flowers. such objects can have both personal and public meaning, for while they represent individual biography and individual grief, they also symbolize a collective loss and help maintain social memories of war (michalowski and dubisch 2001; winter 2019). for many dealing with the socioemotional impacts of military service, it is not about getting cured but rather learning to live with the pain. therefore, “many people come to the wall to be healed rather than http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 54 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu cured” (michalowski and dubisch 2001, 18) since sacred sites as such also have both inspirational and healing qualities. as one vietnam veteran said, it was a relief [visiting the wall] it was more closure, too… i wasn’t the only one. i had problems in getting back and adjusting a little bit and treated so badly. they had the same responses, same thing. it felt good to talk about it. we weren’t complaining about it. those are the facts. that’s what we experienced. echoing the emotional experience at the wall, another veteran commented, “yes, that support and attention that we got from people on the trip… when i got back from vietnam, you didn’t tell anybody you were in vietnam. you just kept your mouth shut.” this comment juxtaposes the experience of coming home from war to the cathartic experience of returning home from vetsroll trip. group photos were taken at our final destination, the world war ii memorial. many were in awe of the magnitude and beauty of it, which finally became a reality for many veterans who had waited years for “their memorial.” one vietnam veteran shared, “i don’t really know how to put it in words. it’s just that you get to see what people actually gave up. then you go and you see all the stars at the world war ii memorial, you don’t realize how many people lost their lives there.” a korean veteran said, “the world war ii memorial, it’s just spectacular. it’s just a really moving event.” “uh, i think every vet that i talked to thought it was one of the best memorials there,” stated a vietnam veteran. the feelings of respect were amplified when several groups of schoolchildren were encouraged by their teachers to reach out to the veterans as they visited the memorials. one veteran described the interactions with the children, “when we stopped … all the people and kids who came, they were saying, ‘thank you for your service,’…they would come and shake hands.” standing back and observing the interactions of the veterans with the memorials and also the children demonstrated the importance of gratitude and respect at both the macro and micro levels. on the evening before we left for home, participants were surprised when volunteers started a mail call, a time during military service when soldiers would receive mail. during the event, the founder of vetsroll called every veterans’ name and they received a package. as the names were called, each participant proudly stood and shouted out their military serial number and stated, “yes, sir” while saluting the podium. this recreation of mail call during military service spurred many levels of emotion since the tradition of receiving mail and having connections with home had significant meaning. some participants waited to open their mail in the privacy of their hotel room, and others waited to view their mail until they reached their own home after the trip. reflecting on the event, one vet said, “i thought the mail call was outstanding. that’s unbelievable. i had some letters, i’ve read through them three or four times now from my nephews, my daughters, my wife. i mean, it’s just unbelievable… brought back a lot of memories, and i was thankful.” another veteran shared this letter from a schoolchild during mail call, dear vet, thank you for your service and sacrifice of time you made for our country… you have also protected my rights and freedom and equality. there is no possible way for me to pay back for your sacrifice... but i hope that my letter can give my gratitude and thanks for your time in the military. as we arrived back home, the rain was pouring, but despite the rain, crowds of people lined the streets and covered overpasses of the interstate to celebrate the return of the veterans on ten buses. an escort of over 250 harley motorcycles led us to the conference center where we were greeted by hundreds of family, friends, and community members cheering, clapping, and waving flags as the buses pulled up. http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 55 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu a band playing military music was also there as participants entered the conference center looking a bit exhausted from the trip. yet, a newfound excitement was rising as veterans were celebrated and honored upon their return from the trip. one veteran said, “the welcome home was unbelievable, people standing on the bridges. it was raining out, for heaven’s sake. there were little kids and adults waving at you and waving flags. i thought that was an unbelievable reception.” others said the event was a “tearjerker” and that they “were finally shown respect.” the homecoming events were especially important for veterans who did not have a positive homecoming after their time in the war, especially vietnam veterans. while veterans may have had a personal welcome home by friends and family, many vietnam veterans never felt welcomed home by their country. having a negative or non-existent homecoming is a continuous theme within the vietnam veteran culture. one veteran shared, “the homecoming parade was one of the highlights of the whole trip. to think that people would do that, and all those overpasses had fire trucks and people saluting and it just—i couldn’t help but cry when i saw that. it just was awesome.” another said, “when i saw the kind of reception we were getting, i said, ‘thank god the vets, finally the vietnam vets, they’re finally getting their due.’” thus, traveling with other veterans to visit memorials, “may bind the veterans to a larger society through powerful rituals of reintegration—most of all, by speaking the words, ‘welcome home’” (michalowski and dubisch 2001, 185). this can finally provide veterans with an “idealized return” that can help them obtain closure. reflections on respect and gratitude travel can be a transformative experience as participants leave their everyday lives behind in search of something different. while the destination might be different, when the goal is healing (spiritual, mental, physical), the metaphor of a pilgrimage has been used to describe the experience of traveling (pfister 2018). each participant had his or her unique reasons and hopes for the journey, and there was a sense that traveling to the memorials with other veterans would bring a level of catharsis. on the surface, the trip was about visiting memorials, however, throughout our research, we learned the trip was much more than that. it was about generating profound change in the participants which was made possible through what was referred to as vetsroll’s “special pilgrimage” (montgomery 2020). as a pilgrimage, the goals of the trip were to promote respect, gratitude, and closure through visiting memorials and building friendships. at all stages of the trip, the importance of gratitude and respect was discussed and framed as a foundational aspect of the healing experience. the trip coordinators deliberately created the trip to promote these feelings, and veterans expressed them and used the same language to discuss the healing experience. according to avendano (2018), upon completion of the journey, pilgrims generally experience life as significantly more meaningful, and their psychological or spiritual woe is overcome. they write, “central to the healing power of pilgrimage is the sense of community forged by traveling together on a common mission” (2018, 106). as one veteran explained, “one was a korean vet and the rest of us were all vietnam. and we talked until quarter after two in the morning about vietnam, about family, we cried together, we laughed together, we hugged together, we shook hands, it was just a very, very, very emotional closure is where it really was.” this comment illustrated that the vetsroll trip fostered a meaningful sense of gratitude and respect to help facilitate closure for the veterans. for many, the vetsroll journey was an unforgettable and life-altering trip. however, gratitude extends beyond the veterans being thankful and includes the gratitude expressed to the veterans for their time in service through the mail call, the homecoming parade, and other symbolic gestures. according to kavedžija (2020), an “attitude of gratitude” (59) in older adults lends meaning to life, a diffuse sense of thankfulness for various forms of care and support that one has received from others over the course of http://anthro-age.pitt.edu/ castronovo, dalstrom, & messer | 56 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.358 http://anthro-age.pitt.edu life; “attitude of gratitude” encompasses the reflection on the past with attention to the present in its fullness and, kavedžija continues, “opens up a space for a particular kind of hope that is grounded in the moment”(68). overall, gratitude for older adults is a way of capturing the present, rather than dwelling in the past or leaping toward the future (2020). as one vietnam veteran explained, “the entire trip was such a blessing. i’m glad that i had the opportunity to go… it’s not only touching the lives of us guys and gals that go, but when we came home, i think we’re different people too, and it helps us to look at situations and people in a different light.” as veterans age, they are at an increased risk for developing mental health problems as a result of never fully dealing with the emotional and physical impact from their time in service. their problems can especially be amplified if they had a negative homecoming or have not been able to get support from veterans organizations. however, this research suggests that through the transformative process of traveling with other veterans to war memorials, older veterans can obtain some of the gratitude and respect that they were denied during their homecoming and begin the process of healing. acknowledgements the authors would like to thank mark finnegan, the vetsroll board of directors, volunteers, and participants for their support of the project. funding was received for this project from the june e. dilling fund and the stateline nurses network. 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https://washington.org/dc-guide-to/vietnam-veterans-memorial https://doi.org/10.1177%2f0013916510361873 https://doi.org/10.1016/j.jagp.2017.11.001 https://doi.org/10.1016/j.annals.2019.03.010 planning for old age in peru: count on kin or court the state? susan vincent st. francis xavier university svincent@stfx.ca abstract reciprocity among kin is central to peruvian livelihoods, including into old age. potentially affecting such family support, since 2011 peru has offered a non-contributory cash transfer called pensión 65 for seniors living in poverty. past negative experiences of state assistance, the limited sum, uncertainty about eligibility rules, and surveillance of recipients are weighed against the regularly paid income. this case study provides insight into how allpachiqueños strategize about livelihood across generations. it shows that, when children have prospects, parents will jeopardize their access to pensión 65 (for example, by co-signing loans), as they prioritize material reciprocity. in contrast, in families with the fewest resources, parents spare their children from supporting them economically and do all they can to ensure eligibility by foregoing their assistance and withdrawing from active work. this forced retirement reflects their understanding of the state’s rules of the fund and is at odds with local practice. this research addresses the recent trend for countries of the global south to offer cash transfers to older individuals by examining the implications of the terms of eligibility. keywords: peru; elderly; state pensions; social reproduction; reciprocity; poor anthropology & aging, vol 42, no 2 (2021), pp. 52-67 issn 2374-2267 (online) doi 10.5195/aa.2021.330 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. vincent | 52 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu planning for old age in peru: count on kin or court the state? susan vincent st. francis xavier university svincent@stfx.ca introduction how do peruvians prepare for their old age? by far the most important and longest-standing way is by having children. in addition, some have work pensions, which have required increased planning after the state implemented changes in the 1990s. also, since 2011, peruvians over the age of 65 living in extreme poverty have been able to apply for pensión 65, a very modest non-contributory cash transfer that provides a regular income that is greater than most have ever had. these options involve dependencies on reciprocity with family as well as on the state. this paper explores how people from allpachico,1 a small peasant community in the central highlands of peru, negotiate these dependencies as they take into account their own resources, those of their kin, and their experience and expectations of the state. the focus is on the third strategy listed above, those who receive or hope for eligibility for pensión 65 (p65). the discussion makes a unique contribution by considering how access to material and kin resources informs livelihood decisions around aging in neo-extractivist states.2 this case study also addresses the increasing trend for countries of the global south to offer cash transfers to aging adults by examining the implications of the conditionalities and targeted nature of p65. in stark terms, my argument is that aging peruvians with few resources must decide whether to secure p65 at all costs, and thus forego opportunities to improve their lives, or to engage in reciprocity with their children, which might risk their eligibility for the program. in both cases, family welfare comes first, whether it is to relieve adult children of the expense of helping their parents or putting parental resources at the children’s disposal. while the advent of p65 suggests that the state is providing necessary assistance, allpachiqueño experiences teach them that they cannot rely on the state to offer what they are due, and certainly not without a struggle. this is the case with p65, for which eligibility is far from straightforward. this means that those in the direst straits may forgo assistance that could make their lives more comfortable to ensure eligibility for p65. their dilemma also highlights tensions that arise from policy based on the idea of “retirement” itself. assumptions behind the design of p65 and its rules for eligibility imply age-related withdrawal from paid employment, a notion at odds with the realities of peasant agriculture and informal sector work. rather than risk losing p65, some recipients are forced into retirement. to pursue this argument, i have organized this article in two parts: the first lays out the contextual and conceptual groundwork, and the second explores the case study. in presenting the groundwork, i begin by describing allpachico and then explain my methodology. i also present an outline of the theoretical approach and a review of the literature on pensions and work that situates the peruvian pension system in a global context. the second part presents the ethnographic material and includes three sections: first, a description of the general patterns of social reproduction highlights the significance of kinship to people’s lives and livelihoods alongside the continuing failure of the peruvian state to meet its http://anthro-age.pitt.edu/ vincent | 53 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu obligations. then i present two sections that illustrate how allpachiqueños either prioritize their eligibility for p65, or jeopardize it, demonstrating the difficult decisions many older people must make as they strategize for their own and their children’s futures. introducing allpachico this paper is primarily based on research conducted in the peasant community (comunidad campesina) of allpachico. its economy has changed significantly over the last 100 years, reflecting very different prospects for allpachiqueños as they pass through life stages at distinct times. as a legally constituted comunidad, allpachico has its own territory with communal resources and an elected leadership that governs its own affairs and mediates with outside agencies. it has limited arable and land; however, its location in the central highlands, within 300 km of lima along the central highway, has provided other advantages. this placed it near regional mines and the central railway, where men from the community worked during the 20th century. because of the demand for unskilled labor and the growing power of trade unions, these came to be secure jobs that were well-paid by regional standards, offering benefits such as health insurance and pensions. women typically earned money through the informal sale of goods and services. currently, working age adults, especially men, face significantly different options. neoliberal reforms in the 1990s privatized both the railway and mining, which led to layoffs, forced retirement, and the rise of contract work. there are some jobs in the area in local rock quarries, mostly through contracts. many working-age adults have migrated to where they can find work, preferably formal jobs, but more often informal ones in what jan lust calls the ‘capitalist subsistence economy,’ in which people operate independent businesses that perform essential roles in the national economy but provide a meagre living (2018). as everyone complains now, “no hay estabilidad laboral”—there is no job security. instead of pro-worker policies, the peruvian government has opted to support the growth of small businesses, as people make work for themselves, or to bid for contracts or sub-contracts from larger corporations (lust 2018). creating businesses to get sub-contracts or carry out their own activities (such as driving taxis, setting up a store, producing things in small workshops) has become the path to potential success, replacing the secure jobs of earlier generations of men. smalland medium-size businesses employ the vast majority of the economically active population in peru, and the government has been active in promoting financial inclusion so they can access credit (oecd 2020). this makes people responsible for their own incomes. they are subject to exploitation through the provision of low-paid services to the formal sector and the payment of interest on loans (lust 2018; vaccaro, hirsch, and sabaté 2020). alongside all this, government support for peasant agriculture has all but vanished. outmigration and decline in family size mean that, from a population of about 500 or 600 in the 1980s, there are now slightly more than 200 people in allpachico. calculating the population with any precision is impossible as people move there and away frequently, usually in search of income or because they maintain houses in different locations to be near kin. while over the past thirty years, adults have tended to have only one or two children at most, current elders over the age of 65 had larger families, frequently with five or more children. an unusually high percentage, about 27% (according to my 2019 figures), of the community is over the age of 65, while over 33% is over the age of 60.3 in comparison, about 12% of the peruvian population is over the age of 60 (inei 2017). the percentage is higher in rural areas at 22%, although not as high as in allpachico (inei 2015). around a third of allpachiqueño elders receive p65, while most of the rest have work pensions or widow’s work pensions (half of what their husbands had received). in the current economic context, pensions constitute one of http://anthro-age.pitt.edu/ vincent | 54 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu the few stable sources of income available to allpachiqueño families. there is socio-economic differentiation in the community: a rough estimate of incomes, based on 2019 field data indicates that about 40% of adults are poor or extremely poor, while 13 % have stable pension income. the rest tend to have fluctuating incomes based on contracts or businesses. methodology the research presented here is based on long-term familiarity with the people of allpachico. i first went there in 1984 and have returned at least 16 times since then, which provides unusual historical depth. i have primarily carried out participant observation, living in the community and engaging in the daily life of people, households, and the community at large. this is supplemented by semi-structured interviews, census-taking, life histories, photographs, archival research, and similar methods. my interest in p65 arose as a result of earlier work on livelihood strategies and state policy. after the program was implemented in 2011, several allpachiqueños began to receive the benefits. my research also includes evidence from six students from the universidad nacional del centro del perú (uncp, national university of central peru) who worked in three other communities.4 professor aparicio chanca of the uncp assisted me in training them and supervising their work. their interviewees included p65 recipients. their research provides corroborating support for the findings from allpachico. social reproduction and the life course to analyse decision-making about livelihood in the current historical moment, this paper incorporates tamara hareven’s life course perspective, which links historical timing to people’s progress through the life cycle (1982, 1994). hareven recognized that what an individual did at distinct life stages depended on the opportunities available at that time, on contemporary expectations for their cohort, and on intergenerational dependencies and responsibilities. this framing draws attention to aging and work. this is particularly clear in her distinction between the “old old” who can no longer provide for themselves, and the younger old who are more active and independent. this approach also acknowledges that identity traits such as gender, ethnicity, and class affect the opportunities and barriers individuals confront at different stages of their lives. hareven’s approach combines well with a focus on social reproduction and the formulation of livelihood strategies. people negotiate livelihoods in terms of their historically embedded goals, and their ability to achieve them depends on the resources to which they have access. both goals and economic opportunities change over time, so any analysis of livelihoods must consider historical transformations. the concept of social reproduction was developed to analyse such dynamic processes through which livelihoods are sought (edholm, harris, and young 1978; mingione 1991; smith 2018). it focuses attention on how individuals, households, and collectives work to survive, get ahead, or defend their ways of life, depending on the case and according to the historical circumstances (vincent 2020). reciprocity among kin involving exchanges of support, resources, and information, is a central resource in social reproduction in allpachico. because of reciprocity, state pensions, as they are implemented and reformed over time, constitute another resource that can have repercussions throughout kin networks. in this paper, i draw upon this theoretical framework in my description of factors in social reproduction at this historical moment for individuals who are planning for their end-of-life stage. http://anthro-age.pitt.edu/ vincent | 55 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu understanding connections among pensions, work, and the role of the state often seen as part of the caring role of the state, public provision for older populations has long been associated with the conditions of labor supply and demand. in the late 19th century, poverty among aging people who were unable to work became a matter of concern for countries in the global north with growing economies and democratic governments (skocpol and amenta 1986; thane 2006). initially, many of these offered insufficient financial support and encouraged the recipients to work, albeit at levels that would not put them over the means thresholds. by the 1960s, due to a large youth population and immigration, withdrawal from the work force became more acceptable for older workers, employers, and governments alike (thane 2006, 47). however, as populations aged over the past three decades, state pension schemes have been framed as unaffordable. jessica greenberg and andrea muehlebach (2007) discuss the ensuing contradictory currents: workers, frequently facing inadequate pensions in financialized private schemes, have lobbied to work longer; employers want to keep experienced workers, but also want to hire flexibly rather than by seniority; states try to minimize the outflow of pension payments while implementing anti-immigration policies that could rejuvenate work forces (also, coole 2012; holzman and hinz 2005). these pension reforms in the global north are occurring as countries of the global south are beginning to establish state pensions. macro-economic analyses indicate that where the amount of the old-age pension is adequate, recipients tend to decrease their participation in the labor force and farming (de carvalho 2008; ranchhod 2006). irineu de carvalho concludes from this that restricting pensions to lowincome individuals would help prevent the reduction of the size of the work force in rural brazil (2008). however, means-testing may not have the expected result. writing about india, where there is a lowincome threshold for receiving a small pension, neeraj kaushal suggests that recipients may avoid earning income out of fear of losing the pension (2014). the case of allpachico provides qualitative evidence that supports this view, and shows that the relationship between pensions for which eligibility is limited by income and work-force participation is mediated by what is seen as best for the family as a whole. there are several pension systems in peru, all administered directly or overseen by the state. all are currently in flux, due in part to the tumult caused by the covid-19 pandemic, as well as for prior problems related to poor economic performance of invested funds and low population coverage, given the high proportion of informal sector workers who were ineligible (castilla et al. 2021).5 i briefly describe the pension plans relevant to the people of allpachico. the next section describes some of their experiences to explain their cynicism about depending on state support. two are contributory pensions for which workers are eligible. these assume retirement from the work force. in the generation that is currently over 65, only men had formal employment, which means that these pensions pertain only to them or their widows. even now, very few women have formal jobs. one pension, referred to as onp (for the government agency that oversees it, the oficina de normalización previsional), is a defined benefit plan that provides a fixed amount until the retiree dies, and then half of that amount to his widow. workers must have contributed for at least 20 years. workers who leave employment before 20 years receive nothing. the other employment pension, called afp (administradora de fondos de pensiones), is a defined contribution plan that has been forcefully promoted since the 1990s. it is structured by the state but involves private companies that invest the workers’ contributions into individual funds. upon retirement, the worker can withdraw up to 95% of the amount or leave it to be withdrawn monthly at a rate that depletes it by the time the retiree reaches age 80. the balance of the amount is kept to pay for seguro (officially es salud), the health-care system for employees. those in this system universally http://anthro-age.pitt.edu/ vincent | 56 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu complained about the high administration costs and the low returns as well as the fact that after age 80 they will be left with nothing. they told me about having been tricked into signing up for afp. apart from the onp and afp, retirees may receive an amount from their employer based on compensation for time of service (cts), while mine workers are eligible for additional amounts based on their exposure to toxic environments. since the state administers all of these funds—at least at the level of setting the rules in the case of the afp pension and the cts—it bears the brunt of the frustration when people do not receive what they feel is their due. while i did encounter some people who were satisfied with their pensions, more often i heard complaints and deep suspicion that retirees were being short-changed. i focus here on pensión 65, the non-contributory cash transfer that the peruvian state began to offer in 2011 to peruvians aged 65 and older who live in extreme poverty.6 p65 offers 250 soles every two months (about $us 35 a month) to recipients—a tiny amount. this fund aims to provide a level of economic security to improve the welfare of seniors (midis 2017). they apply via their local municipality, which has the responsibility of managing information and logistics about the application and distribution process. actual decision-making, however, is in the hands of workers hired by the state. thus, applicants have their houses and living conditions examined by sisfoh (the national household targeting system) to establish that they are in extreme poverty. this information is then sent to the head office, which evaluates it using an unclear set of local standards. monetary poverty is set by the cost of the canasta básica de insumos, a “shopping basket” of basic goods; however, many factors beyond this are recorded in the sisfoh—what materials the house is made of, whether the person owns, rents, or looks after the house, occupation, access to water and sewerage, appliances, education level, and so on. the form is complex and must be filled out correctly to be considered. further, the system has access to government data on an individual’s financial history through consultation with the sbs (sistema de banca, seguros y afp; banking, insurance, and pension system). this makes individuals legible to the state in detailed ways. as the case study shows, people fear this could affect whether they can get p65 in the future. p65 is both a cash transfer to aid in the reduction of poverty as well as a retirement pension. a peruviangovernment-sponsored evaluation of p65 uses statistical evidence to examine the effects on recipients’ well-being (bando, gertler, and galiani 2016). one of the elements it uses as a proxy for well-being is labor-force participation. bando et al. link a reduction in working hours to improvement in welfare since it is assumed that recipients will spend this time enjoying life (2016, 3). they derive this criterion from government directives that explicitly mention work hours (villalobos castillo, nd). this reference to work hours implies that p65 is intended to allow recipients to retire from active engagement in earning income. in the next section, i describe how p65 functions, highlighting operational practices that reinforce the idea that it implies retirement from productive work. in contrast, peasant work lives frequently extend well beyond the age of 65. men are required to serve 30 years as comuneros (members of the comunidad) before becoming eligible to be exonerated, while women must serve 25 years, and may serve longer so they can enjoy full membership rights (allpachico 2016, 7). importantly, the term used for withdrawal from the comunidad is not “to retire” (jubilarse) but to be “exonerated from further responsibilities.” the term “retirement” is limited to references to withdrawal from paid work, and there is no term for withdrawing from farming, caring for livestock, and other resource-generating activities. indeed, even extremely old and frail villagers tend to keep some poultry, work a small bit of land, and find stove fuel for themselves as long as they are physically http://anthro-age.pitt.edu/ vincent | 57 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu able to do so. both necessity and enjoyment of the work keep them active. there is, thus, a tension between official assumptions about p65 and the practical experience of allpachiqueños, a situation that gives rise to dilemmas for aging adults. achieving social reproduction in allpachico: reciprocity with kin, failed expectations of the state i now turn to the ethnographic case study. in this section, patterns of social reproduction showcase the deep affective and material significance of kinship, which is matched by a high level of cynicism about the state. in allpachico over the past century, the aspirational goal of households has gone from obtaining land for farming, then to using men’s wages to improve quality of life and educate children, and now to hoping that children will have professional training and careers. each of these involves distinct strategies with respect to income and family life for those in any position to pursue the ideal, which, of course, not all of them are (vincent 2000). livelihood strategies span both within and across generations. this inter-generational reach is of particular importance in the present case, which addresses how the resources, opportunities, and constraints of aging parents and their children inform strategies about old age. wealth or poverty is complexly constituted based on the amount of one’s income, its volatility or stability, access to other productive resources (agricultural or otherwise) and, significantly, the situation of others in one’s kin network. in this way, one’s own prospects are intimately interlaced with those of others. the family is of central importance in how allpachiqueños plan their economic, social, and affective lives. the childless are pitied, and the deliberately childless are viewed with amazement. my focus here is on parent–child relations, as those are the ones that most impact lifepath changes, but grandparents, aunts and uncles, and fictive kin (for example, through godparenthood) are all embedded in networks that influence how life is organized, what work is undertaken, how meaningful events such as fiestas are arranged, and so on. kin and kin care are integral to the processes of social reproduction. prime reasons for both leaving allpachico to live elsewhere and to stay concern kin. for example, one of the most common reasons for moving elsewhere is so that the children can study and gain access to better schools. also, people move to look for work so that they can provide the needs of their families. betteroff migrants build houses in allpachico to have a place to stay when they go back once or twice a year for fiestas. in 2019, one migrant was frantically building a new house and fixing up another one that had belonged to his father to prepare for a fiesta for which one of his children (one who has never lived in the community) is a mayordomo (person responsible for paying for and organizing key aspects of the fiesta). nephews, cousins, siblings have all been called on to help defray the costs (e.g., providing a breakfast or lunch, supplying coca, etc.). such mutual obligations are a core part of the social reproduction of individuals, households, wider kin networks, and the community. just as people move because of their responsibilities to kin, one of the reasons people stay in allpachico or move back is to care for aging parents. this again highlights life-course differences: in the past, elders were supported by children residing in allpachico. with a declining population of working-age adults in the community, families must make decisions about who lives where. in my previous research, i examined the socio-economic conditions of households that helped decide whether elders were able to demand the presence of their adult children, or would have to move to live with their children elsewhere when they could no longer live on their own (vincent 2016; also see 2014, 2018). retirees with good work pensions were much better positioned to decide where they would live, especially when they had at least one child in poor economic circumstances and on whom they could therefore make http://anthro-age.pitt.edu/ vincent | 58 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu claims. older adults without pensions or other resources found themselves without that option, and they frequently had to leave allpachico when they became “old old”; i.e., unable to look after themselves. other villagers generally keep an eye on those few elders without kin or those who stubbornly refuse to leave allpachico. many of the stories people tell are about children and parents who did or did not fulfill their responsibilities honorably—parents who were ill-tempered, drunk, or interfering and who thus alienated their children; there were also stories about children who did not make time for or send support to their parents. importantly, the pattern is one of reciprocity rather than a one-way flow. complete dependence and domination alike are to be avoided. there are gendered dimensions to this, as single daughters tend to make themselves available to their parents, especially when their parents have work pensions (vincent 2016). in general, parents and children help each other as they can, in whatever form they can. parents provide care for young children, support them economically and in services as they grow, educate them if possible, frequently look after their grandchildren, and so on. good responsible parents orient the younger generation to be good responsible members of the community. children contribute to household work; as they get jobs, they may support their parents economically and care for them in old age, as well as showing them respect. at the same time, when both sides are adults, there is a concern for independence and not overly interfering in each other’s lives. while adult children with families of their own may be granted some leeway regarding concern for their parents, the ideal is respectful mutual support. this, of course, is not always achieved, but stories of utter abandonment on the part of either parents or children are told with a great deal of disapproval, which suggests that proper conduct is deeply felt and expected.7 governments of all levels are also metaphorically considered to be subject to the norms of parent–child relations. mayors, presidents, and other political figures, whether men or women, are referred to as fathers (papá) who have an obligation to provide for citizens, just as citizens have their own obligations with respect to the state. stories of improper conduct appear here the most. projects and aid from the different levels of government are frequently absent or inadequate, and there is a litany of examples. an earthquake in the 2000s left cracks in many houses. state officials came to investigate the damage and determine compensation, but none arrived. in 2016, people complained that the mayor was not a good papá as he had provided no projects for allpachico. when there is excessive cold in june and july, governments organize handouts to those living in the highlands to help deal with it. in 2019, people told me about receiving cheap blankets, while children only got a piece of fabric. one woman got trousers that were much too large for her. there was not enough for everyone. similarly, aid for crops damaged by frost arrived too late to do any good and, again, there was not enough to go around, leading to resentment between those who received something and those who did not. stories such as these are rampant. few people expect government officials to comply with their proper obligations, although there is hope that it will happen. thus, skepticism that the government will help as it should is part of how people make decisions about their retirement futures. the skepticism is merited: there has been widespread denunciation of corruption in peruvian politics recently, with all five elected presidents charged, convicted, under investigation for improprieties or, in the case of alan garcía, committing suicide to avoid being detained (degregori and meléndez 2007; pari 2017; quiroz 2013). in late 2019, congress was dissolved by president vizcarra, who accused its members of blocking anti-corruption legislation. he himself was impeached a year later. not only are officials widely suspected of receiving payments from corporations seeking contracts, but many citizens believe that candidates buy votes. http://anthro-age.pitt.edu/ vincent | 59 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu related to this is the assumption that peruvians have come to expect that the state will offer handouts, widely called asistencialismo (welfarism; e.g., damonte et al. 2018). this is decried as promoting a clientelistic dependency on the state or politicians. however, discussions of asistencialismo sidestep the important issue of the difficulties peruvians face in receiving benefits from systems into which they have paid and to which they are fully entitled. this is frequently the case with worker pensions. as noted above, the state structures all of the available pension options and directly provides two of them, so interactions with it are significant for how people plan their retirement. some residents have pensions from either their own or their spouse’s earlier employment. the onp system is complex, however. for example, some of the men in allpachico worked for a period of fewer than 20 years in their youth, retiring before 1992. because the rules were different then, they might be eligible for a pension, but some have had to enlist lawyers on their behalf. toribio, for instance, started to seek a pension in about 2000 from his 10-year stint in the workforce in the 1980s, going through four lawyers. his children were worried about the cost and urged him to give it up but, finally in 2017, he was granted a little under 300 soles (about $us91) a month. this is more than twice than what is offered by p65, which he previously received. his wife still receives p65, apparently because the amount is so low. toribio claimed this allowed him to help his children instead of them sending money to him from time to time. lawyers have also been hired in other cases regarding how the amount of onp pension was calculated, and whether a worker might be eligible for additional funds. teodora has been paying lawyers for over eight years as she feels that, not only was her father’s pension amount below what he should have been getting, but he was denied other payments as well. she is outraged that the state-run workers’ health system, seguro, finally permitted a re-examination of his health the day after he died of cancer. teodora thinks the cancer resulted from his work in the smelter, but the seguro denied that he had it at all. if they can afford it, those signed up for seguro go to private clinics for diagnosis and then might use their seguro coverage for treatment. there is widespread suspicion that seguro has a vested interest in the deaths of insured people as a way of limiting costs. this prior experience of peruvian bureaucracy informs how allpachiqueños approach p65 with its complex system of forms and procedures. as mentioned, applicants must have their incomes and living conditions evaluated by government agents. there is much ambiguity and room for people, at various points in the process, to influence the outcome. a lazy or inattentive worker filling out a sisfoh form, for example, may incorrectly fill in some answers, which can affect the determination of economic status. furthermore, the applicant or their kin who are helping in the process may give false information. gabriela, the person responsible for overseeing the system in the piedra blanca municipality, described a case in which a daughter told the sisfoh worker that her mother had several appliances because she was ashamed that the woman actually had so little. gabriela explained the measures she had taken to try to make a case for some of the people in allpachico who were clearly in need but had not received the pension. according to a p65 worker who was visiting allpachico, the report sent by the municipality has to include an argument about whether a person should or should not receive the pension, although i cannot find this in the instructions. once accepted into the p65 program, the recipients must continue to comply with the requirements. through the program, the state hires workers on short-term contracts8 to make unannounced visits to the recipients in their homes; this is to ensure they are indeed living where they said they are and that http://anthro-age.pitt.edu/ vincent | 60 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu their conditions have not changed. assisting in this are local coordinators who are themselves recipients of p65. these people, or others in the community, might provide information (true or false) that can lead to a person being disqualified. few know exactly how the process works, and the form’s intended objectivity is undermined by the numerous steps in which personal lapse or malice can intervene. such uncertainty is augmented by people’s perceptions of how the program’s registry has functioned over the past several years. in 2015, there were 17 people registered for p65 in the community. some were clearly ineligible since they or their husbands had work pensions. these were winnowed out, but the number continued to drop. some died; others were removed from the list for one reason or another – it was not always clear why. there are now only 10 people on the list. about 10 others have not had their applications approved; some for three or four years. two of these are in extremely dire circumstances, and allpachiqueños at large decry the injustice: neither of the two has ever married or had more than casual work plus help from other villagers who have kept an eye on them. one is illiterate and has never had a state-issued identity document as his fingerprints are almost entirely worn off.9 while those who applied for p65 when it first became available experienced little delay, it is now common for applicants to wait for years, both in allpachico and in the three other communities in which students conducted research. there is no back pay for these people: their payments start only once they are approved, no matter whether or not earlier denials were the result of incompetence on the part of state officials. part of the problem seems to be due to the limited budget for p65 and the government decision to focus on zones in extreme poverty (clausen et al. 2018, 251). thus, beyond any individual need or efforts to ensure the eligibility of a particular person, applicants from allpachico may be denied because the district is not categorized as being in extreme poverty or due to a budgetary shortfall. cynicism about the willingness of the government to fulfill its responsibilities and uncertainty about how eligibility is determined inform how allpachiqueños plan for their old age.10 the context of intergenerational support in achieving social reproduction is central. if aging individuals wish to receive p65, they contrive to demonstrate their extreme poverty and maintain this image. this involves potentially exposing themselves to greater hardship, however. the following stories illustrate how aging allpachiqueños strategize with regards to their own needs and those of their kin as they decide whether to preserve independence and save their kin expense, or to help their kin and rely on material assistance in return. the possibilities available to the different generations at their life stages are critical to this planning. difficult decisions i: opting for the minimum all p65 recipients are living in extreme poverty, but some are worse off than others. the fewer resources p65 recipients and their families have, the more they need to ensure their access to the funds. this leads to cutting off or hiding resources, thus potentially condemning them to worse conditions than necessary. the p65 worker i spoke with described an incident she had just experienced in a neighboring community. she had visited a woman recipient, making note of her possessions and the condition of her house, and then met her later herding six cattle. the p65 worker congratulated her on being able to supplement her meagre income, saying that it was good to keep active and this would not affect her eligibility, but the woman insisted that the cattle were not hers. for many allpachiqueños, the only explanation for why some people have not yet been granted p65, or for why others have been kicked out, is that the p65 worker somehow discovered or was told that they had livestock, support from children, or other resources. it is not clear where the line is. a student researcher in the community of quero interviewed a woman who, even though she had many more resources than those i am considering in this section, felt herself poor because she had a husband with a disability and was http://anthro-age.pitt.edu/ vincent | 61 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu dependent on the sale of milk. however, she also had a tractor, and her migrant children sent her 200 soles (about $us60) a month. adding up her husband’s disability, the costs of the tractor, and the volatile price of milk, she considered herself to be barely getting by—yet she was rejected by both p65 and a program for people with severe disabilities who live in poverty. for those in even worse circumstances than this woman, the stakes are simply too high for them to risk losing the fund. they worry about ill-intentioned neighborly gossip, and, since there is a high turnover rate among p65 workers, they cannot know whether what the aforementioned p65 worker considered to be commendable would be viewed in the same light by her successor. the result is that some people severely limit their activities, in effect retiring, although they may still have the energy and will to continue to work. in 2015, when i started asking about p65, i was startled to hear complaints that it made “young people” lazy. at first, i thought this meant the money filtered down to younger generations, but it transpired that the “young people” were able-bodied people over 65. while some villagers at that age are frail, many are still robust and active in farming and herding cattle—one woman aged 78 is the sole resident of the most remote hamlet in the community, and daily herds several hundred sheep. others, however, are worried that word will get out that they are earning undeclared money, and they carefully calibrate how much paid work they might undertake. this removes some skilled agricultural labor from the local sphere. it has become increasingly difficult to hire workers for farm work, as the price they charge is frequently too high to make it profitable. thus, when pancho, who had long depended on helping others in the field, started receiving p65 and decreased his availability, many more fields were abandoned. a student researcher reported that an interviewee claimed that the state did not allow people to get ahead: if they invested their cash transfer in a productive resource, they were automatically kicked out, even though the business had not yet generated any profit. the risk of losing the secure income offered by p65 thus forces some recipients into inactive retirement. another strategy in which pancho engaged was to cease receiving help from his children. worried about whether the p65 surveillance might discover this, he ensured they no longer send him bank transfers. previously, they had sent him small amounts when they could. some can get around this by directly handing over funds or sending them via someone else. both in allpachico and in the student interviews with those from the other communities, there is evidence that informal and indirect delivery of cash to aging parents was common. in addition, some p65 recipients avoid co-residing with children who help them, unless those children are themselves living in poverty. one woman interviewed by student researchers related that her sister lived with her children and, for that reason, did not receive p65. the woman indicated that she continued to live by herself to ensure that her eligibility was not questioned. recipients may also make sure that any livestock or other resources are kept away from their own home or are clearly designated as belonging to others. forgoing activities and help that could provide additional income forces the p65 recipients to endure greater hardship than necessary. they complain that the amount is inadequate. anyone who can will keep a few chickens or guinea pigs and grow a bit of food, both carefully calibrated so as not to raise official suspicion. buying staples quickly exhausts the p65 sum. one woman interviewed by a student researcher said, “we buy from the store for the first month, and then get credit from the store for the second month.” many recipients require medicines for various ailments, but drugs are unaffordable without help from kin. those unable to supplement their p65 income and who have no one to help http://anthro-age.pitt.edu/ vincent | 62 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu them—and, for them to help openly, they too must be living in poor circumstances—live in extreme hardship. difficult decisions ii: relying on reciprocity another strategy used by older allpachiqueños is to rely on material reciprocity. this arises in part from the poor track record of the state in fulfilling its responsibilities towards citizens, as well as from the weight of normative expectations that kin should help one another. this tends to happen among people who are slightly better off or those with children who are trying to get ahead, rather than among those for whom the tiny p65 amount is crucial support. in many cases, the elders engaged in formal financial or property transactions, thus jeopardizing their eligibility. maykol, for instance, now in his 80s, and whose productive life was spent in very humble farming, signed ownership papers for a business for one of his sons. this allowed the son to advance his business but meant that maykol was denied p65. he is hoping that in the next business cycle his name will be removed. he lives in a rustic house next door to the daughter who cares for him rather than with her, perhaps in preparation for eventual eligibility. teodora is not yet 65. since separating from her husband almost 20 years ago, she has lived in lima, making a living by selling soup in the street. it is hard work: she gets up at 3:00 am to put the soup on to cook. at 6:00 am, she carries the heavy pots downstairs to her stall outside the house and attends clients until about noon. she faces much competition for customers, especially with the influx of venezuelan refugees who also sell food on the streets. at noon, she cleans up and goes to the market to buy produce for the next day. after a couple hours of rest, she starts preparing the ingredients until about 10:00 pm. her five children are all in precarious circumstances. two daughters have very volatile small businesses in lima, with some ups and many downs. two sons live in allpachico or nearby, and are trying to make a living from farming and whatever contract work they can pick up. her youngest son lives in a highland city. a few years ago, he bought two cars to be used as taxis, putting one in his mother’s name. she helps make the payments, but there were too many taxis and profits were low. her son decided that it was more cost-effective to keep her car garaged. he has now rented out his own and found another job. although she is longing to return to allpachico in her older years, teodora is aware that ownership of a car with an outstanding balance may harm her chances of eligibility for p65. but she can still earn a living in lima, while in allpachico “todo es salida”—there are only expenses with no possibility of income. she no longer has the strength to work in the fields to produce her own food. despite this, she did not hesitate when her son asked her to sign the car-purchase agreement. applying for p65 is still in the future, and she is well aware that it cannot cover her basic needs. for both the present and the future, her best bet for financial support is with her children. conclusion peruvian state reports celebrate the decline in the percentage of the population living in poverty and extreme poverty as a result of cash-transfer programs such as p65. while the recipients appreciate the unexpected income (“who would have thought the peruvian government would offer such a thing?” exclaimed one woman), the benefits are far from unequivocal. allpachiqueños living in poverty find themselves having to make extremely difficult choices about how to plan their futures and care for kin. the life-stage approach used here highlights the differences between generations according to the possibilities available to them in their historical context. men who came to adulthood in the 1950s to the http://anthro-age.pitt.edu/ vincent | 63 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu 1970s could get jobs with defined benefit pensions. the older among them could usually expect that their sons would also have this option. those workers were the mainstay of their family’s and the community’s economy. since the 1980s, however, working age adults have increasingly faced uncertain contracts or self-employment. for families in the greatest need, any stable income, even one as small as p65, is essential. with p65, the intergenerational caring that is so essential to social reproduction, and that patterns people’s sense of what is desirable and just, takes on new forms: the elders in the worst circumstances receive the pension but sacrifice support to spare their children; other elders whose children have financialized prospects sacrifice the pension to support them. this caring is not only material, but is embedded in mutual reciprocities of respect and concern. it entails the expectation that kin and community members will offer guidance to those for whom they care, in terms of presenting proper conduct as well as directions for future life and livelihood. these principles of care and guidance are also expected of government actors, but rarely found. while peruvian governments over the past two decades have begun to offer care of a sort, such as through p65, the manner of the provision, with its complex process, inadequate coverage and amount, and intrusive surveillance, falls short. for allpachiqueños, the state is far from being the concerned and willing papá they hope for, but rather a corrupt, neglectful and grudging force. the case study supports the argument kaushall (2014) makes for india that making such pensions universal, rather than meansdependent, would go a long way to ensuring that recipients can make the decisions about their other livelihood activities and living conditions that make sense to them and their families. a universal pension would prevent forced retirement and permit older adults to receive care without jeopardizing their income. but personal stable income in one’s older years is only one part of how aging allpachiqueños plan their lives. in addition to care, allpachiqueños look for guidance from government figures to provide the resources and security needed to support the social reproduction of families and communities. peruvians are not alone in taking intergenerational reciprocities into account in deciding their own livelihoods (e.g., hareven 1996). instead of policies that acknowledge such interdependencies, governments everywhere have offered instead the globally well-trodden neoliberal path of self-responsibilization (e.g., gledhill 2007; greenberg and muehlebach 2007; ong 2006). for example, peruvians are encouraged to develop their own small and medium businesses, shouldering all the risks while they serve the wider economy (lust 2018). these risks include taking on debt. in peru, as in the rest of the world, financialization is infiltrating everyday life (gago 2015; pellandini-simányi 2021). most work pensions in peru are now financialized, placing the burden of ensuring an adequate living in old age on the investment choices of the pensioners themselves. allpachiqueño condemnation of this accords with reactions elsewhere, as hadas weiss’ account of israeli pensioners shows (2015). further, the priority people place on establishing eligibility for p65 frequently hinges on their role in the debts incurred by their adult children in the service of their livelihood. even a universalized p65 cannot solve the real livelihood constraints of these households. at all life stages, people plan their livelihoods in the context of their intergenerational and other responsibilities, rather than as isolated individuals. because of this, beyond policy changes with respect to pensions, the lesson of the case study for peru, and around the world, is that more fundamental restructuring of economies to provide adequate and stable income-earning opportunities for working age adults is necessary. http://anthro-age.pitt.edu/ vincent | 64 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu acknowledgments this research received funding from the social sciences and humanities research council of canada (#435-2017— 245). the anthropology & aging editorial team and two reviewers provided feedback that helped strengthen this paper significantly. thanks to aparicio chanca and his students for contributing such useful complementary evidence. i am extremely and eternally grateful to the people of allpachico for whom i wish more secure futures. notes 1. “allpachico” and the names of all people are pseudonyms. all translations from spanish are mine. 2. see vincent (2020) for a discussion of neo-extractivism in peru. 3. women form over half of the adult population (56%), but only about half of the total population. oddly, 65% of the population under the age of 20 is male. 4. these students were: yerson acosta soto, judith lizet avila mendoza, esau noe guere crispin, nickol lucy salazar alvarez, leysel victoria urcuhuaranga sinche, angela fiorella villasana benites. 5. in response to lockdowns during the covid-19 pandemic, the peruvian government facilitated the withdrawal of funds from afp and onp. this will have serious implications for the future of aging workers. 6. there is a growing body of research on p65, most of it either quantitative or based on short-term qualitative methods such as interviews or focus groups. most of this literature focuses on the impact of the program on beneficiaries: did it reduce poverty; did it improve recipients’ quality of life, mental health, or physical health; how did people use the money; and so on. a few exceptions, using qualitative methods, cast a wider net. for example, cerna et al. (2017) examine the workings of the “street-level bureaucrats” who evaluate potential beneficiaries and deliver social programs, with case studies in the amazon and the southern sierra. this allowed them to encounter people who had not been accepted into various programs and to understand some of the problems with the process. damonte et al. (2018) included discussions of p65 in their study of how state social programs were perceived to help with climate change in four communities in the department of áncash. this study also enabled them to gain insight into local perceptions of why some people were granted p65 while others were not. 7. leinaweaver (2013) and zegarra chiaporri (2019) similarly note the importance of kin care in peru through their studies of its opposite, abandonment and ingratitude, with respect to children and elders. 8. the p65 worker i spoke with said she was hired on a one-month contract, but the p65 website advertises such positions on three-month contracts. either way, these contracts are short-term, and there is a great deal of turnover in personnel. 9. i am told that both finally received the pension in 2020, years after they had reached the age of 65. 10. leinaweaver et al. (2017) discuss the impact of unclear government evaluation standards on aspiring adoptive families in spain. uncertain about what might make them ineligible, they attempt to improve their chances by modifying their houses and their behaviours in ways that they imagine will be acceptable. references allpachico. 2016. estatuto, comunidad campesina de “allpachico.” [statue, peasant community of “allpachico.”] unpublished document. bando, rosangela, sebastian galiani, and paul gertler. 2016. the effects of non-contributory pensions on material and subjective well being. national bureau of economic research working paper no. 22995; jel no. 10. cambridge ma. accessed december 17, 2020. http://www.nber.org/papers/w22995. castilla, luis miguel, cristian rodriguez, mercedes aráoz, pablo antolin and pedro francke. 2021. “will peru’s pensión system undergo a major reform?” latin america advisor, february 17. accessed 24 may 2021. https://www.thedialogue.org/analysis/will-perus-pension-system-undergo-a-major-reform/. http://anthro-age.pitt.edu/ vincent | 65 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu cerna, diego, luis garcía, félix puémapa, paolo sosa, mauricio rentería and lucila rozas. 2017. acá no hay ventanillas: la burocracia de la calle en los programas sociales [there are no office counters here: streetlevel bureaucracy in social programs.]. lima: instituto de estudios peruanos. clausen, jhonatan, angelo cozzubo and johanna yancari. 2018. “desigualdades horizontales en la situación de pobreza multi-dimensional: un estudio a partir de la voz de los adultos mayores en el perú.” [horizontal inequalities in multi-dimensional poverty: a study based on the voice of older adults in peru.] in desigualdad y pobreza en un contexto de crecimiento económico, [inequality and poverty in a context of economic growth], edited by ursula aldana et al., 107-284. lima: instituto de estudios peruanos. coole, diana. 2012. “reconstructing the elderly: a critical analysis of pensions and population policies in an era of demographic ageing.” contemporary political theory 11 (1): 46-67. damonte, gerardo, manuel glave, karla vergara, and rafael barrio de mendoza. 2018. ¿protección social adaptativa? desafío para la política en el perú. [adaptive social protection? a challenge for peruvian policy.] documentos de investigación no. 88. lima: grade. de carvalho filho, irineu e. 2008. “old-age benefits and retirement decisions of rural elderly in brazil.” journal of development economics 86 (1): 129-146. degregori, carlos iván and carlos meléndez. 2007. el nacimiento de los otorongos: el congreso durante los gobiernos de alberto fujimori (1990-2000). [birth of the jaguars: congress during the governments of alberto fujimori (1990-2000).] lima: instituto de estudios peruanos. edholm, felicity, olivia harris, and kate young. 1977. “conceptualizing women.” critique of anthropology 3: 101131. gago, verónica. 2015. “financialization of popular life and the extractive operations of capital: a perspective from argentina.” the south atlantic quarterly 114 (1): 11-28. gledhill, john. 2007. “neoliberalism.” in a companion to the anthropology of politics. edited by david nugent and joan vincent. 332-348. malden, ma: blackwell publishing. greenberg, jessica and andrea muehlebach. 2007. “the old world and its new economy: notes on the third age in western europe today.” in generations and globalization: youth, age, and family in the new world economy. edited by j. cole and d. durham, 190-213. bloomington: indiana university press. hareven, tamara k. 1982. family time and industrial time. cambridge: cambridge university press. hareven, tamara k. 1994. “aging and generational relations: a historical and life course perspective.” annual review of sociology 20: 437-461. hareven, tamara k., ed. 1996. aging and generational perspectives. new york: walter de gruyter, inc. holzman, robert and richard hinz. 2005. old-age income support in the 21st century: an international perspective on pension systems and reform. washington, dc: world bank. inei (instituto nacional de estadística e informática; national institute of statistics and information). 2015. “3.21 población total al 30 de junio de cada año, según sexo y grupo de edad, 2005-2015.” [3.21 total population to 30 june of each year, by sex and age group, 2005-2015.]. accessed may 12, 2015. http://www.inei.gob.pe/estadisticas/indice-tematico/poblacion-y-vivienda/. inei. 2017. censos nacionales de población y vivienda. [national population and house census]. accessed october 17, 2019. censos2017.inei.gob.pe/redatam. kaushaul, neeraj 2014. “how public pension affects elderly labor supply and well-being: evidence from india.” world development 56: 214-225. leinaweaver, jessaca b. 2013. “toward an anthropology of ingratitude: notes from andean kinship.” comparative studies in society and history 55: 554-578. http://anthro-age.pitt.edu/ vincent | 66 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu leinaweaver, jessaca b., diana marre and susan e. frekko. 2017. “’homework’ and transnational adoption screening in spain: the co-production of home and family.” journal of the royal anthropological institute 23: 562-579. lust, jan. 2018. las condiciones laborales de los trabajadores y empleados en las microempresas en el perú: 1990-2018. [work conditions of workers and employees in micro-businesses in peru]. annual report on research, universidad ricardo palma, facultad de ciencias económicas y empresariales; escuela académico profesional de administración de negocios globales. midis (ministerio de desarrollo e inclusión social). 2017. “reformulación del plan operativo institucional 2017; unidad ejecutora no. 006’1441, programa nacional de asistencia solidaria ‘pensión 65’”. accessed december 23, 2020. https://cdn.www.gob.pe/uploads/document/file/305217/anexo-05-pension-65parte-1.pdf. mingione, enzo. 1991. “towards a theory of social reproduction: the meanings of different survival strategies.” in fragmented societies: a sociology of economic life beyond the market paradigm. edited by enzo mingione, 123-195. oxford: basil blackwell, inc. oecd (organization for economic cooperation and development). 2020. “peru.” in financing smes and entrepreneurs 2020: an oecd scoreboard. accessed may 21, 2021. https://www.oecdilibrary.org/sites/c0ca6e1e-en/index.html?itemid=/content/component/c0ca6e1e-en. ong, aihwa. 2006. neoliberalism as exception: mutations in citizenship and sovereignty. durham: duke university press. pari, juan. 2017. estado corrupto: los megaproyectos del caso lava jato en perú. [corrupt state: the megaprojects of the lava jato case in peru.]. lima: planeta. pellandini-simányi, léna. “chapter 14: the financialization of everyday life.” in the routledge handbook of critical finance studies. edited by christian borch and robert wosnitzer, 278-299. new york: routledge. quiroz, alfonso. 2013. historia de la corrupción en el perú. lima: instituto de estudios peruanos. ranchhod, vimal. 2006. “the effect of the south african old age pension on labour supply of the elderly.” south african journal of economics 74 (4): 725-44. skocpol, theda and edwin amenta. 1986. “states and state policies.” annual review of sociology 12: 131-157. smith, gavin. 2018. “rethinking social reproduction in an era of the dominance of finance capital.” in western capitalism in transition. edited by alberta andreotti, david benassi and yuri kazepov, 61-76. manchester: manchester university press. thane, pat. 2006. “the history of retirement.” in the oxford handbook of pensions and retirement income. edited by clark, gordon l., alicia h. munnell, and j. michael orszag. vol. 13. oxford university press on demand, 33-51. vaccaro, ismael, eric hirsch, and irene sabaté. 2020. “the emergence of the global debt society: governmentality and profit extraction through fabricated abundance and imposed scarcity in peru and spain.” focaal: journal of global and historical anthropology, 87: 46-60. villalobos castillo, josé.luis. n.d. “programa presupuestal 0097, programa nacional de asistencia solidaria pensión 65.” accessed december 17, 2020. https://www.mef.gob.pe/contenidos/presu_publ/ppr/prog_presupuestal/no_articulados/0097_asistencia _solidaria_pension_65.pdf. vincent, susan. 2000. “flexible families: capitalist development and crisis in rural peru.” journal of comparative family studies 31 (2): 155-170. vincent, susan. 2014. “why beautify the plaza? reproducing community in decentralized neoliberal peru.” journal of agrarian change 14: 522-540. http://anthro-age.pitt.edu/ vincent | 67 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.330 http://anthro-age.pitt.edu vincent, susan. 2016. “mobility of the elderly in peru: life course, labour and the rise of a pensioner economy in a peruvian peasant community.” critique of anthropology 36: 380-396. vincent, susan. 2018. “pensions, peasants, and the informal economy: family and livelihood in contemporary peru.” latin american perspectives 45 (1): 195-211. vincent, susan. 2020. “getting by or getting ahead: state social spending and financialization in peru.” focaal: journal of global and historical anthropology 87: 33-45. weiss, hadas. 2015. “financialization and its discontents: israelis negotiating pensions.” american anthropologist 117.3 (2015): 506-518. zegarra chiappori, magdalena. 2019. “growing old in the margins in lima, perú.” anthropology & aging 40: 6066. http://anthro-age.pitt.edu/ book review review of joy, meghan. the right to an age-friendly city: redistribution, recognition, and senior citizen rights in urban space. montreal and kingston: mcgillqueen’s. 2020. price: $37.50 (paperback); e-book (coming soon). yvonne wallace university of toronto, canada yvonne.wallace@mail.utoronto.ca anthropology & aging, vol 43, no 1 (2022), pp. 78-80 issn 2374-2267 (online) doi 10.5195/aa.2022.390 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | wallace | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.390 http://anthro-age.pitt.edu 78 book review review of joy, meghan. the right to an age-friendly city: redistribution, recognition, and senior citizen rights in urban space. montreal and kingston: mcgillqueen’s. 2020. price: $37.50 (paperback); e-book (coming soon). yvonne wallace university of toronto, canada yvonne.wallace@mail.utoronto.ca in 2007, the world health organization introduced its age-friendly cities (afc) framework as a resource for cities as they deal with the “challenge” of an aging population (who 2007, 3). the goal is to create accessible urban environments and programs for seniors so that they can remain active members of their communities. advocates focus on the benefits of counter framing an aging population as an economic burden. a positive framing of aging instead highlights that, with the right supports, seniors can continue to be independent and active members of their communities. yet researchers have argued that the impact of afc policy on the lives of seniors has been limited (buffel and phillipson 2016). in the context of toronto’s age-friendly policy, meghan joy addresses why and how this is so in the right to an age-friendly city. joy presents a case study of the toronto seniors strategy, the governing body of the city’s age-friendly policy. the author defines this policy as a “holistic, place-based approach claiming to tackle ageism by improving social, physical, and institutional environments based on the needs of senior citizens and their non-profit representatives” (162). the book begins by explaining the inception of the toronto senior strategy and the policy actors involved in the city’s age-friendly landscape within the themes of health, transportation, housing, recreation, and social planning. it is dizzying to follow the institutional organization of age-friendly policy. this is not because the author does not do well in sketching the institutional landscape but because of the organizational expanse and complexity of the policy apparatus. as joy notes, “there’s scarcely a realm of local government responsibility that is not relevant to the production of an age-friendly environment” (24). the analysis and the corresponding structure of the book follow the three pillars of engin isin’s (2008) “right to the city” framework. the first pillar is “redistribution” which addresses the needs and wants of different target groups of urban residents. the goal of redistribution is universal inclusion, which is notably achieved by “‘positive discrimination’ for certain groups so that they can achieve the same outcomes as others” (16). “recognition” speaks to the rights of urban residents to identify, through participatory decision-making, the inequities that redistribution will address. yet none of this can be achieved without local government and other policy actors having adequate financial and legal capacity to see it through. this, the third pillar, isin calls the “rights of the city,” and it is exactly this level on which joy’s research focuses. if neoliberal austerity is a limiting factor in effective afc policy, joy posits that by studying how afcs work through this “right to the city” framework, we might in turn better http://anthro-age.pitt.edu/ book review | wallace | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.390 http://anthro-age.pitt.edu 79 understand “how neoliberalism actually works” (joy 2021, 6). joy explores this through various actors involved in the creation and implementation of toronto’s age-friendly policy. her methodology consists of interviews with councilors, city staff, non-profit staff, politicians from federal and provincial governments, and senior citizens involved with the toronto seniors forum, a branch of the toronto senior strategy that works to ensure that voices of seniors are heard. the author finds in afc policy and local governance what newman in 2014 deemed a “landscape of antagonism” (quoted in joy 2020, 14): policy actors, whether institutional or individual within afc policy hold disparate ideas and challenge opposing political approaches (14). joy’s participants identified differences between non-profit and governmental approaches and navigated the tensions between their own ideas and the ideological and financial constraints of their institutions. for example, the city staff involved in increasing senior accessibility on transit are frustrated that their work is “measured…on ‘short-term cost effectiveness’ rather than ‘efficiency and equity’” (167). this can be seen in the 2018 version of the toronto seniors strategy which, rather than restructure city transit to increase accessibility to seniors, focuses on training seniors on how to use transit and on campaigns to encourage a “culture of civility” towards seniors (167). interesting, too, is how joy’s participants grapple with the tension between combatting ageism and the ‘active aging’ framework of afcs. indeed, joy shows how the goal of universal accessibility both obfuscates and moralizes the vulnerability of seniors, supporting her doubts on the claim that the toronto seniors strategy promotes a positive view of aging and effectively combats ageism. joy is a political scientist and does not introduce her interview participants beyond their policy roles, such as ‘academic’ or ‘representative of an agency.’ coming from an anthropological background, i was left wanting to know more about these individuals and what constitutes their experience of and relationship to this work. further, i could not help but wonder how seniors who are served by the numerous programs implemented by the toronto seniors strategy feel themselves about the efficacy of these programs. still, joy’s work would be instructive for anyone researching age-friendly cities in general, and the lives of seniors in toronto in particular, as it provides extensive groundwork for anthropological research into the mechanisms of age-friendly policy and concretely elicits questions as to how this policy affects the lived experiences of people (tate 2020). further, the book’s conclusions reflect many current anthropological conversations, such as the failure of positive aging frameworks to address ageism in a meaningful way (calasanti and king 2019). practically, joy warns that policies like afc that emphasize supporting and increasing independence may result in funding cuts to long-term care, despite the covid-19 pandemic revealing the urgency of the exact opposite. creating a city that can support seniors and their diverse needs shows itself by all accounts in this book as an immense task. furthermore, ‘age-friendly policy’ is problematized as an effective approach to reach this goal. still, this approach to urban aging has taken off globally; to date there are 1329 cities and communities in 51 countries that have adopted local policies following the afc framework (who 2021). understanding how it works, and why it doesn’t, is crucial if we take seriously the ambition to achieve a just and equitable city for urban citizens aging across the life course. references buffel, tine, and chris phillipson. 2016. “can global cities be ‘age-friendly cities’? urban development and ageing populations.” cities 55 (june): 94–100. https://doi.org/10.1016/j.cities.2016.03.016. calasanti, toni, and neal king. 2019. “1. successful aging, ageism, and the maintenance of age and gender relations.” in successful aging as a contemporary obsession. edited by sarah lamb, 27–40. rutgers university press. https://doi.org/10.36019/9780813585369-004. http://anthro-age.pitt.edu/ book review | wallace | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.390 http://anthro-age.pitt.edu 80 joy, meghan. 2021. “neoliberal rationality and the age friendly cities and communities program: reflections on the toronto case.” cities 108 (january): 102982. https://doi.org/10.1016/j.cities.2020.102982. isin, engin. 2008. “the city as the site of the social.” in recasting the social in citizenship. edited by engin isin, 261-280. toronto: university of toronto press. tate, winifred. 2020. “anthropology of policy: tensions, temporalities, possibilities.” annual review of anthropology 49: 83-99. who. 2007. “global age-friendly cities: a guide.” world health organization. https://www.who.int/ageing/publications/global_age_friendly_cities_guide_english.pdf. who. 2021. “age-friendly world.” world health organization. https://extranet.who.int/agefriendlyworld/aboutus/. http://anthro-age.pitt.edu/ of public spaces and laterlife amity in urban india: gerontological musings in pandemic times tannistha samanta flame university tannistha.samanta@flame.edu.in anthropology & aging, vol 41, no 2 (2020), pp. 147-154 issn 2374-2267 (online) doi 10.5195/aa.2020.313 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:tannistha.samanta@flame.edu.in samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 147 of public spaces and laterlife amity in urban india: gerontological musings in pandemic times tannistha samanta flame university tannistha.samanta@flame.edu.in introduction one of the common sights of early mornings in urban india is groups of elderly persons, mostly men, engaged in unhurried walking with non-kin peers. this walk is then followed by an outdoor congregation in community parks, neighbourhood benches and public gardens. these informal meeting sites offer spaces where greetings are exchanged and public opinions on politics and society are vociferously debated. in this piece, i imagine the gerontological possibilities of how this process – popularly referred to as ‘morning walks’ – while being quintessentially age-coded, can produce shared solidarities and nostalgia against the backdrop of an ongoing pandemic. as such, friendships that are forged through ‘routinization’ (e.g., daily walks and unfocussed interactions) have received sparse attention in the gerontological scholarship in india. specifically, i use bourdieu’s (1977) concept of “habitus” to approach the practice of adda1 (casual conversations among men, often perceived as a compulsory hallmark trait of bourgeois conviviality) in understanding how covid-19 unwittingly disrupts as well as reconfigures practices that are routinized. considering the enduring qualities of adda allows for theorizing aging bodies during covid-19 beyond ‘case counts,’ and for (re)focusing our gaze on the everyday practices, that are seemingly inconsequential (e.g., morning walks) but nevertheless carry the promise of reconfigured possibilities of how communities can make sense of the uncertain phenomenologies of pandemic living. overall, i offer, albeit speculatively, an intellectual invitation to study the sociology of age in (and after) pandemic times through the entanglements of older adult friendships (forged as practices of everyday life) and public spaces. to be sure, sociology of friendship (allan and adams 2006) reminds that non-kin peer networks are patterned not only by individual characteristics but by structural circumstances of social class, gender, age and debility. that is, both the personal as well as the social ecology interact to create a socioeconomic canvas against which the practices of “doing friendship” are forged. as covid-19 continues to rage relentlessly with high rates of fatality among older adults and this socio-economic canvas is shifting, the early mornings in india look different. this respacing and rescaling of older adults in indian community life raises several questions for the future. for instance, how is this intimate peer sociality now achieved or how are peer walks reconfigured when older bodies are suspect? given that the pandemic has rendered conviviality and other consummately cultural gestures (e.g., handshakes, hugs) potentially dangerous, will it reify the neoliberal rhetoric of individualization through self-care and self-governance (see cardona 2020), by emphasizing personal responsibility (e.g., hand-washing, physical distancing) – as opposed to governmental responsibility – as the only assured way to successfully combat the spread? also, since the elderly are often keepers of spatial memories which they http://anthro-age.pitt.edu/ mailto:tannistha.samanta@flame.edu.in samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 148 share through conversation and storytelling, what is the (possible) impact of this ‘deroutinization’ of older persons’ presence in public life for the community’s understanding of public places and its own sense of history? and finally, will the pandemic permanently alter the ways in which older persons consume and produce space? drawing from a rich but neglected body of work on friendships and later-life entanglements with public spaces, this piece examines the quotidian ties of non-kin friendships against the backdrop of a shrinking community life. in doing so, i argue that it shifts our gaze to two rather understudied dimensions on aging in india: first, on how bourgeois conviviality (or adda) is symbolic for youthfulness, and second, on the general neglect of the interplay of older adult amity and spaces, with ‘spaces’ understood as physical, built urban spaces as well as the “spaces between buildings in which everyday public life happens” (holland 2015). in what follows, i offer the intellectual and social possibilities of forging later life friendships (homosocial and romantic) in the times of the pandemic and then move on to describe how a resignification of the processual nature of “habitus” allows the discipline of gerontology to imagine ways in which the elderly might interact with public spaces post-pandemic. i conclude by reflecting on how focusing on the intersection of late life amity with the embodied and processual notion of “habitus” can serve as an epistemological vehicle to go beyond the instrumental understandings (e.g., design, material and technologies) of public spaces. later-life friendships in pandemic times to be sure, as sociologist graham allan (2010) notes, gerontology has a longer intellectual liaison with friendship than other social science disciplines. early pioneering studies (hess 1972; litwak 1989; townsend 1957) have paved the way for a formal investigation of the role of friendships in older peoples’ lives, particularly during life-course transitions such as widowhood, retirement, affliction and debility. this body of scholarship has thoroughly exposed the limits of the then influential “disengagement theory,” that states that disengagement from social life of people as they grow older is a natural and universal phenomenon (cumming and henry 1961). arguing against this theory, research has consistently demonstrated that although the nature of friendship or the size of a social network may alter with age, the value of companionship through sociality, carries force. for example, antonucci and akiyama’s (1987) notion of social “convoy” (519) beautifully illustrates the enduring significance of relationships for sociability. these convoys also act as an affective anchor for practicing intimacy and self-revelation. research on personal networks among older indians is limited, probably because the joint family is still idealized as the prime site of elderly care. hence, it is no surprise that later life (nonkin or intimate) relationships that are founded on ideals of selfhood and choice have received scant attention in this line of inquiry (exceptions include samanta and varghese 2019; samanta 2020). curiously, the pandemic has allowed our post-pandemic futures to be imagined differently, in a more socially permissive way, that acknowledges differing notions of living well. while companionship (or more generally, friendship) is a powerful trope that has been deployed to understand the critical role of this social resource in the face of crises in other national and regional contexts (regt 2015), this depiction is rather new in the family-centric culture of india. a recent television commercial epitomises the incipient habituation of this new sentiment. when india plunged into a nation-wide pandemic-led lockdown, colgate subtly opened up a conversation around new forms of companionship among older indians (see figure 1). these 35 seconds of advertisement offer an appealingly sanguine imaginary, where masks and social distancing are no longer the norm. featuring two older adults that grin from ear to ear, they present a future where new, unconventional beginnings can be actualized. the commercial begins with a visibly upper-middle class urban elderly woman, who is waiting in an upscale restaurant for her family to arrive. soon, she is lovingly greeted http://anthro-age.pitt.edu/ samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 149 by her adult children, their partners and her grandchildren. the camera swiftly moves to introduce the family (and the audience) to an elderly gentleman who casts his softly romantic gaze on his new companion – the family’s mother and grandmother – while the elderly woman shows them a new ring on her finger. the ad ends with a voiceover (in hindi) that calls to celebrate new post-pandemic freedoms that “begin again with a smile.” given the contemporary urban dystopia of desolation, anxiety and a severe contraction of community life, this ad is both personally and socially uplifting. it utilizes a clever visual-cultural metaphor of a mask-free future, to index the unmasking of social anxieties around older adult intimate companionships. although the tagline of “begin again with a smile” seems laboured, it makes sense from a marketing perspective of a multinational company specializing in the production and distribution of household provisions and personal care products (including toothpaste). moreover, stoking the third age-led consumerist turn (laslett 1987), the ad offers an optimistic portrayal of older adult companionships that thrive on the leisure economy (here, fine dining) while celebrating ideals of self-expression and free choice. figure 1: colgate (india) ad this television commercial is significant in two critical ways in shaping our understanding of amity in pandemic times. first, it goes beyond kinship ties and offers refreshing ways to think about mature age by recognizing a fluid network of intimates as friends and lovers. second, it invites us to ask: why can’t post-pandemic friendships be forged, maintained and nurtured in the face of contingencies, losses and old age? this is particularly important because researchers have shown later life friendships to be less instrumental (not goal-driven) and more resilient; an everyday resource that is capable of weathering both the mundane and the exceptional (allan and adams 2007; ha 2008). recognizing this is crucial, as i show in the next section, for understanding how practices of walking, adda and gathering in public places by middle class elderly is constitutive of social relations, practices and processes. the intersection of amity with “place-making” (massey 2005) offers a conceptual possibility of everyday urbanism that is captured by bourdieu’s notion of “habitus.” i use this concept to understand how covid-19 unwittingly disrupts as well as reconfigures practices and social identities that are regularized, thereby generating creative responses to transformed circumstances. finally, it is worth noting that given the definitional quandaries of who and what may constitute a ‘friend’2 (e.g., degree of commitment and closeness, duration, etc.), my use of this term is fluid and dynamic: i am concerned with the everyday practice of amity rather than with particular constructions of friendship (allan 2010). http://anthro-age.pitt.edu/ samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 150 friendship as habitualization: rethinking habitus in pandemic times hitherto, (environmental) gerontology has been preoccupied with practices and experiences of placeattachment, especially through memory (rowles 1978), with the multiple meanings of home and belonging (peace 2015), and of neighbourhood and community (peace, holland, and kellaher 2006). habitus, bourdieu (1990, 77) notes: . . . as a system of dispositions to a certain practice, is an objective basis for regular modes of behaviour, and thus for the regularity of modes of practice, and if practices can be predicted. . . . this is because the effect of the habitus is that agents who are equipped with it will behave in a certain way in certain circumstances. clearly, in bourdieu’s sense, habitualization and routinization connect persons to places in the present. in this way, the quotidian practice of “morning walks” is more than an accumulated experience; rather, it is a complex social process in which the interlocking of the individual and the collective (re)produces practices that justify individuals’ perspectives, values and social positions. the lens of habitus is fruitful in understanding not only the material geographies of space but also how public life occurs through the social relations forged during everyday practices (e.g., walks). certainly the gerontological scholarship on aging and place has significantly enhanced our understanding of aging in place, but has largely neglected places of aging (gardner 2011). while the former, gardner (2011) notes, is concerned with the cultural significance of older adults wanting to remain in their homes as they age, the latter illuminates the social context of aging, including the experiences and practices of sociality that make up ‘place.’ it is indicative of the focus on “aging in place” that walking as a form of middle class sociality and intergenerational communication, has received surprisingly little attention in gerontological studies. rejeski et al. (2009) note that walking is understood as one of the “successful/active” aging-inspired lifestyle behaviors of modern societies, part of a goal-driven, bio-moral project on the self. consciously breaking away from this lifestyle based post-traditional individualism, cultural anthropologist sarah lamb (2020) has ethnographically documented how everyday practices, such as domestic gathering with junior kin or attending neighbourhood laughing clubs (where the older adults meet each morning just to laugh) are also cultural spaces where middle class sociality happens in urban india, quite indifferent to the modern project of the self. similarly, unstructured morning walks in local neighbourhoods can be appreciated as an embodied process in which social relations and identities are forged. as noted earlier, these routine walks are often interspersed with shared greetings, collective reminiscing, lamenting about the futures of urban youth or unexpected meetings with a younger jogger. it is these in-betweens that make up both the social meaning of this everyday practice as well as of places where aging happens. this dynamic and spatial understanding of everyday walks is theoretically akin to bourdieu’s notion of becoming habitus: an embodied process that entails a practice in which the “social is inscribed in the body of the biological individual” (bourdieu 1985, 113), but that also involves “something historical, it is linked to individual history” (bourdieu 1990, 86). recognizing the process of habituation as central to the habitus allows for a more dynamic concept of habitus, as a continuously acquired disposition, that is hence prone to transformation. given that physical distancing will probably become a desired norm in the near future, will the pandemic offer newer ways of understanding the older indian’s habitus? again, the processual nature of habitus allows us to imagine ways in which the elderly might interact with public spaces in postpandemic times. by privileging the range of conceivable possibilities through which adaptations to a changed situation are realized, gerontology’s engagement with the sociological concept of habitus moves beyond, as reay (2004) asserts “the habitual use of habitus” (431). taken together, bourdieu’s http://anthro-age.pitt.edu/ samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 151 understanding of habitus as this complex mix of the embodied, processual and instinctual is a useful reminder to inform post-pandemic gerontological scholarship. he emphatically asserts: “. . . one cannot grasp the most profound logic of the social world unless one becomes immersed in the specificity of an empirical reality” (bourdieu 1993, 271). while “morning walks” may today be perceived as routes of contagion by public health experts, the partially sedimented social and physical attachment with places and people will most likely be re-lived through memories, conversations and story-telling, even from privatized spaces (balconies, lawns and gardens of residences) and solo-walks. rowles and ohta (1983) describe this as “insideness”: the sense of identification that comes along with long habitation in the same place (as cited in holland 2015). seen this way, the pandemic-led shrinking of community life need not inevitably usher a sense of loss, regret and alienation, but can rather allow post-pandemic futures a possibility of place-making that is cohesive, participatory and democratic. it is important to note that bourdieu is acutely aware that, while habitus is both agentic and collective, it reproduces social hierarchies of class and gender. the heterogeneity in social class positions that may lead to differential experiences (e.g., “morning walks” are a purely urban, middle class phenomenon) is captured in his examination of class habitus: “. . . interpersonal relations are never, except in appearance, individual-to-individual relationships and the truth of the interaction is never entirely contained in the interaction” (bourdieu 1990, 81). that shared adversities might not necessarily generate similar opportunities of self-actualization and experience is evident in his contention that individuals are embedded in their social structures. this has implications for older adults’ democratic participation in public or private spaces. with old age poverty (srivastava and mohanty 2012) and homelessness among the elderly on the rise, these imaginations around private/indoor place-making (when the public is deemed risky) is after all also a middle class phenomenon. although habituses, as i have argued, are permeable and responsive to changes around them, they are not immediately able to jettison the normative constraints of gender and social class distinctions. in the concluding section i reflect on how our understanding of habitus can help in (re)imagining postpandemic sociality in india. i contend that the embodied process of habitus, as an urban place-making project, will reify middle class identity and performativity. in the process, by returning to chakrabarty’s (1999) idea of adda, i offer a critique of the youthful tenor of this social activity where passing (surplus) time (or “timepass”) is a legitimate form of middle class sociality. adda, social class and gerontology: what does the post-pandemic future hold? although the link between adda (traditionally understood as unstructured form of public conviviality) and place-making is not immediately unequivocal, the notion of adda affords sociological reflections on gender, age and social class-dimensions of place that make habitus both embodied and processual. mapping the social history of adda in 19th century bengal, historian dipesh chakrabarty (1999) shows how adda offered a discursive site for self-presentation and identity formation in the face of british imperialism. significantly, adda holds an ambivalent history, where it is simultaneously celebrated (for birthing a democratic public sphere, an unavoidable cultural facet of bengali modernity) and socially condemned (as ‘useless talk’ achieved through dereliction of domestic duties). in this historical mapping, chakrabarty notes, adda is not just a distinct speech genre practiced by the middle class bengalis, but is also strongly associated with particular places (1999). notably, adda, as chakrabarty and others writing on friendship in indian public life would argue (e.g., jeffery 2010), was often performed by middle class young men in rawks (an architectural feature of a raised veranda in traditional bengali households) in urban neighbourhoods, of erstwhile calcutta. seen this way, adda becomes a middle class male prerogative to homosociality. it resonates with contemporary understandings of ‘passing time’ among young urban male cultures. jeffery’s (2010) anthropological work on educated yet http://anthro-age.pitt.edu/ samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 152 unemployed youngsters doing “timepass” in a provincial city of uttar pradesh (india), exposes the socio-temporal anxieties around middle-class masculinities, often attracting public disapproval of young male idleness. jeffery, like chakrabarty (1999) is acutely aware of how these urban cultures of debate and disappointment are deeply gendered. chakrabarty, for example, while commenting on the mid-twentieth century adda culture notes how the middle-class ideas about respectability barred women to participate in these practices of orality (1999). in fact, chakrabarty goes on to show how adda was popularly perceived to be predicated on (an imagined) wifely hostility that reinforced the tension between men’s “wordly responsibilities” and non-instrumental camaraderie or leisure (1999). similarly, jeffery (2010) notes the hypermasculine bravado in these oral cultures of sociality that appropriately domesticates young women through gendered ideals of obedience, safety and respectability. notwithstanding the important contribution of this line of research, what is missed is a general acknowledgment that ongoing demographic transitions are rapidly changing the social geographies of public spaces. older people are increasingly (re)claiming public spaces and are often creating and resisting age identities through their use of space and place. the plebeian practice of walking among the elderly allows us to think of age relationally (hopkins and pain 2007), thereby disrupting fixed-age geographies of urban spaces. hence, purposeless discussions that accompany the morning wanderings, can be appreciated for their capacity to reclaim urban sociality from its quintessentially youthful trappings and to refashion “new sentiments of intimacy” (chakrabarty 1999, 195) among older men. in this regard, hopkins and pain (2007) note how the scholarship on older people’s engagement with space rarely moves beyond mapping ill health and service provisions, thus ignoring the more situated, fluid and participatory dimensions of aging. i have argued earlier, that unless environmental gerontology actively attempts to broaden its focus to include the everyday – routinized and shifting – practices of social life, the pandemic-led scholarship runs the risk of reifying the triad of age-class-gender hierarchies. this unremarked practice (of walking and informal social talk) holds rich and often neglected modern oral histories of everyday social life that an instrumental focus on chronological age will lose out on. can adda and its constitutive dimensions of self-expression and identity form and reform the multiple meanings of ‘doing’ friendships in the post-covid era? will a return to more privatized spaces of adda (e.g., inside own homes) disrupt the gendered order of orality? or one may ask: how do serendipitous opportunities that quotidian walks entail, such as bumping into an old acquaintance or learning the news of a death in the neighbourhood, change in the new normal where the public basis of intimate conviviality is a recognized health hazard? how can older people reclaim public spaces in a “crisis” context that has put to test our fundamental understandings of the relation between people, communities and spaces? one of the ways in which the discipline of gerontology can meaningfully engage with these questions is to privilege the embodied, processual and agentic notion of “habitus” that goes beyond the instrumental understandings of public spaces. instead, as argued throughout this piece, the focus can be on the socio-spatial dimensions where public life happens. this is particularly relevant for a postpandemic gerontology since popular culture is rife with an alarmist narrative portraying older persons as being helpless victims of the pandemic. while there is no denying that older adults run higher risks of contraction and mortality, an attention to the entanglements of public spaces and non-kin amity can offer age-sensitive and realist visions of aging in the post-covid era. finally, by focusing on the everyday non-materiality of unfocussed interactions through senior walks, i open the possibility to appreciate the cultural practices of non-western societies in the making of multiple, contradictory modernities3 (of leisure versus labor, discipline versus laziness, shared solidarity versus self-care, and gendered segregation of spheres). this is significant since gerontology has often been critiqued for its arguably post-imperialist analysis (twigg and martin 2015). seen this way, older adult friendships http://anthro-age.pitt.edu/ samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 153 forged through social talk and routinized walks can proffer not only discussions on ‘adjusting’ to the new normal, but also further a culturally sensitive sociology of old age. notes 1. in his incisive historical critique of capitalism in late modernity, chakrabarty (1999) describes the homosocial practice of adda (a bangla noun) where friends get together for “long, informal and unrigorous conversations.” this form of social practice, as chakrabarty argues, is predominantly male and youthful; a marker of urban upper-caste, middle class identity. 2. see allan 2010, for a detailed discussion on the conceptual and measurement dilemmas of friendship. 3. see dube (2011): modern makeovers: handbook of modernity in south asia (oxford university press) for a series of persuasive essays on the cultural expressions of modernity and its experiences, conditions and limitations in the indian subcontinent. references allan, graham, and rebecca g. adams. 2007. “the sociology of friendship.” in 21st century sociology: a reference handbook. edited by clifton d. bryant and dennis l. peck, 123-31. thousand oaks, ca: sage. antonucci, toni c, and hiroko akiyama. 1987. “social networks in adult life: a preliminary examination of the convoy model.” journals of gerontology 42(5): 519-27. bourdieu, pierre. 1977. outline of a theory of practice (translated by nice, r). cambridge, ma: cambridge university press. bourdieu, pierre. 1985. “from rules to strategies: an interview with pierre bourdieu.” cultural anthropology 1(1): 110-120. bourdieu, pierre. 1990. in other words: essays towards a reflexive sociology. cambridge: polity press. bourdieu, pierre. 1990. sociology in question. cambridge: polity press. bourdieu, pierre. 1993. “concluding remarks: for a sociogenetic understanding of intellectual works.” in bourdieu: critical perspectives. edited by craig calhoun, edward lipuma and moishe postone. cambridge: polity press. cardona, beatriz. 2020. "the pitfalls of personalization rhetoric in time of health crisis: covid-19 pandemic and cracks on neoliberal ideologies." health promotion international, daaa112. https://doi.org/10.1093/heapro/daaa112. chakrabarty, dipesh. 1999. “adda, calcutta: dwelling in modernity.” public culture. 11(1): 109-145. cumming, elaine, and william e henry. 1961. growing old: the process of disengagement. new york: basic books. dube, saurabh. 2011. modern makeovers: handbook of modernity in south asia. oxford: oxford university press. ha, jung-hwa. 2008. “changes in support from confidants, children and friends following widowhood.” journal of marriage and family 70: 306-18. hess, beth b. 1972. “friendship.” in aging and society. edited by mathilda white riley and anne foner, 357-93. new york: russell sage. holland, caroline. 2015. “public spaces and age.” in routledge handbook of cultural gerontology. edited by julia twigg and wendy martin, 455-462. new york: routledge. hopkins, peter, and rachel pain. 2007. “geographies of age: thinking relationally.” area 39(3): 287-294. jeffrey, craig. 2010. “timepass: youth, class and time among unemployed young men in india.” american ethnologist 37(3): 465-481. http://anthro-age.pitt.edu/ https://doi.org/10.1093/heapro/daaa112 samanta | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.313 http://anthro-age.pitt.edu 154 laslett, peter. 1987. “the emergence of third age.” ageing and society 7(2): 133-160. litwak, eugene. 1989. “forms of friendship among older people in an industrial society.” in older adult friendship: structure and process. edited by rebecca g. adams and rosemary blieszner, 65-88. newbury park, ca: sage. massey, doreen. 2005. for space. thousand oaks, ca: sage publishing. peace, sheila. 2015. “meanings of home and age.” in routledge handbook of cultural gerontology. edited by julia twigg and wendy martin, 447-454. new york: routledge. peace, sheila, caroline holland, and leonie kellaher. 2006. environment and identity in later life. maidenhead, berkshire: open university press, mcgraw-hill educational publications. reay, diane. 2004. “'it's all becoming a habitus': beyond the habitual use of habitus in educational research.” british journal of sociology of education 25(4): 431-444. regt, marina de. 2015. "noura and me: friendship as method in times of crisis" urban anthropology and studies of cultural systems and world economic development 44(1/2): 43-70. rowles, graham d. 1978. prisoners of space? exploring geographical experiences of older people. boulder, co: westview press. rowles, graham d and russell j. ohta. 1983. aging and milieu: environmental perspectives in growing old. new york: academic press. samanta, tannistha. 2020. “aging in e-place: reflections on online communities for the aged in india.” journal of women & aging 32 (1): 114-121. samanta, tannistha and sini.s varghese. 2019. “love in the time of aging: sociological reflections on marriage, gender and intimacy in india.” ageing international 44: 57-73. srivastava, akanksha and sanjay mohanty. 2012. “poverty among elderly in india.” social indicators research 493514. townsend, peter. 1957. the family life of old people. london: routledge. http://anthro-age.pitt.edu/ book review review of cole, ellen and lisa hollis-sawyer, eds. older women who work: resilience, choice, and change. washington: american psychological association. 2020. pp. 282. price: $59.99 (paperback); $56.99 (ebook). urša bratun university of ljubljana, slovenia; alma mater europaea ecm, slovenia ursa.bratun@zf.uni-lj.si anthropology & aging, vol 42, no 1 (2021), pp.155-157 issn 2374-2267 (online) doi 10.5195/aa.2021.340 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:ursa.bratun@zf.uni-lj.si book review | bratun | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.340 http://anthro-age.pitt.edu 155 book review review of cole, ellen and lisa hollis-sawyer, eds. older women who work: resilience, choice, and change. washington: american psychological association. 2020. pp. 282. price: $59.99 (paperback); $56.99 (ebook). urša bratun university of ljubljana, slovenia; alma mater europaea ecm, slovenia ursa.bratun@zf.uni-lj.si the question “when will you retire?” is replete with social, economic, and cultural norms and expectations about the life course and its transitions. the edited volume, older women who work: resilience, choice, and change, is about women who delay this transition and thus disturb imaginaries of working life, gender, and aging. the book, edited and written exclusively by female scholars, is the latest addition to the american psychological association’s society for the psychology of women (division 35) book series. due to changing demographics and the relative longevity of women, the ‘silver workforce’ is increasingly female. nonetheless, women 65 and older who continue to work are an overlooked group. older women who work accounts for their experiences and gives them a voice. it introduces us to the diversity of women who are delaying retirement, covering topics such as resilience, lifespan development, meaning-making, identity, motivation, civic engagement, and economics, to name but a few. the tone is inclusive and personal, inspired by storytelling and (auto)ethnography and, apart from some notable exceptions, methodologically situated in qualitative research traditions. the thirteen chapters are divided into three parts, each with its own introduction. part i, “personal and career identities for older women,” has five chapters that deal with older women’s self-perceptions as related to later life work trajectories. the four chapters of part ii, “societal roles of aging women workers,” examine women’s roles in the workplace and in their communities, and specifically how they balance and navigate these roles. part iii, “diversity and personal grit in the workplace and beyond,” acknowledges the diversity of the female workforce and the individual differences between women living in different cultural, geographic, and socio-economic contexts that can contribute to health disparities. in chapter 1, ashley m. stripling and jodie maccarrone combine resilience research with the concept of successful aging to propose an original model that explains resiliency in the workplace as experienced by older women. this model acknowledges various stressors and challenges that women face in the workplace, for instance, bullying, interpersonal conflict, work overload, work-family conflict, and gender bias. usually, women can transcend these challenges by activating their resilience pathways. stripling and maccarrone suggest evidence-based training for those who struggle with the resilience process and stress the importance of addressing the non-supportive environmental factors within organizations. http://anthro-age.pitt.edu/ mailto:ursa.bratun@zf.uni-lj.si book review | bratun | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.340 http://anthro-age.pitt.edu 156 chapters 2 and 3 draw on different lifespan developmental theories to explain the meaning of work for women in late adulthood, recognizing that our perspectives and choices diverge at different stages of life. valory mitchell (chapter 2) describes how people who work in later life have the potential to generate things that may outlast them and serve to support other people. women also progressively learn how to include themselves in their circle of care to reflect their needs better. whilst gerotranscendence is mentioned as a part of this developmental process, i felt there was a lack of specific reference to tornstam's (1989, 2005) theory. this would have certainly added to the academic rigor of the argument. in chapter 4, nicky j. newton and katherine m. ottley are concerned with understanding the extent of women’s choice. i believe that their research explores two vital questions that might be at the crux of trying to understand older women who work: are they forced to continue working or do they choose to do so? are they forced to retire, or do they choose to? newton and ottley found that women who chose to either work or retire had higher levels of identity certainty than women who had less choice. freedom of choice mattered, regardless of the outcome of the decision. the final chapter of part i is an autoethnographic account by sociologist jackie goode in which she describes her lived experience of precarity work in british academia, which she entered comparatively late, and continues to inhabit post official retirement. this article highlights the strengths of autoethnography – a method that continues to face many criticisms from the positivists – documenting individual experiences in such a way as to raise issues that could apply to many. goode describes one woman’s life story and how it connects to the lives of others. she offers not only a reflection of a personal story but also an analysis of a larger social, political, and cultural context in which this, and other stories, take place. in chapter 6, mary gergen and ellen cole provide us with ten biographical vignettes of women who have no choice but to work and who represent the group of the ‘secret poor.’ the vulnerable position of these women is a reminder of the socio-economic and political systems that fail some populations and result in 16% of women over 65 living below the poverty line (u.s. census bureau 2017). in contrast, patricia o’connor writes in chapter 8 about women who continue to work despite being financially able to retire. one of the few non-us contributions in this volume is by lorraine radtke and janneke van mens-verhulst (chapter 7). they explore two contexts, canada and the netherlands, that are socioeconomically similar as they can both rely on a relatively solid welfare state. for both countries, the authors review the relationship between work and other activities in a woman’s life, specifically how women negotiate many responsibilities and roles not only in middle age, but also later in life. in this context, they identify flexible working environments as essential if women are to be supported in preserving the work-life balance as they age. some of the articles also explore how ageism can go hand in hand with other -isms, such as sexism. for example, in chapter 9, ruth v. walker and alexandra i. zelin look at gendered sexism in the workplace, considering both men and women’s experiences. while both genders experience ageism, the age at which women are perceived as ‘too old to work’ is generally lower than their male counterparts. the authors remind us that ageism also consists of benevolent discrimination, such as offering to take out someone’s trash because their physical abilities are believed to have diminished. additionally, in chapter 12, jasmin tahmaseb mcconatha and frauke schnell explore the cumulative disadvantage pertaining to race, class, immigration status, age, and gender, as experienced by older latina workers in the us, who often face additional challenges as they age far from their home countries and families. throughout this volume, we are again reminded that ‘growing’ old is an ongoing process that allows and invites working women to find ways to continue making valuable contributions and to derive meaning from their unique situations. since most of the material comes from the us, this book http://anthro-age.pitt.edu/ book review | bratun | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.340 http://anthro-age.pitt.edu 157 predominantly focuses on women in the us who are considered “baby boomers.” it might be interesting to have some additional contributions from other geographical, cultural, and political contexts. i concede, however, that a more international review of this topic might be the scope of another book, yet to come. older women who work: resilience, choice, and change makes an important contribution to the discourse and research on working women from a women’s perspective. it provides research materials and practical insights that can benefit a wide professional and academic audience, including social workers, psychologists, social gerontologists, occupational scientists, healthcare professionals, and social science researchers, as well as undergraduate and graduate students in these fields. i hope the book will also reach hr managers, work consultants, and policymakers, so they can consider the real-life implications of some of their decisions, such as tolerating gender bias, labeling workers as ‘old,’ perceiving certain age-gender combinations as ‘poor investments,’ and failing to protect vulnerable groups of workers. references tornstam, lars. 1989. “gero-transcendence: a meta-theoretical reformulation of the disengagement theory.” aging: clinical and experimental research 1 (1): 55-63. tornstam, lars. 2005. gerotranscendence: a developmental theory of positive aging. new york, ny: springer. u.s. census bureau. 2017. the supplemental poverty measure: 2016 (current population reports no. p60-261). http://anthro-age.pitt.edu/ book review review of coe, cati. the new american servitude: political belonging among african immigrant home care workers. new york: nyu press. 2019. pp. 304. price: $32 (paperback). lisa krajecki american university lk9829a@student.american.edu b. a. paxton american university bpax812@gmail.com alana lee glaser st john’s university glasera@stjohns.edu anthropology & aging, vol 42, no 2 (2021), pp. 177-179 issn 2374-2267 (online) doi 10.5195/aa.2021.370 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:lk9829a@student.american.edu mailto:bpax812@gmail.com book review | krajecki, paxton, & glaser | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.370 http://anthro-age.pitt.edu 177 book review review of coe, cati. the new american servitude: political belonging among african immigrant home care workers. new york: nyu press. 2019. pp. 304. price: $32 (paperback). lisa krajecki american university lk9829a@student.american.edu b. a. paxton american university bpax812@gmail.com alana lee glaser st john’s university glasera@stjohns.edu anthropologist cati coe’s ethnographic monograph the new american servitude: political belonging among african immigrant home care workers, provides a powerful narrative of intimate labor and its attendant inequalities. the focus here is on home healthcare agencies and their employees’ relationships with elderly clients in the washington, d.c. metro area and offers an account of how west african immigrant workers are funneled into home healthcare sectors in the united states. coe argues that these job positions are an important site for african immigrants’ political belonging and identification. she successfully builds a political anthropological argument regarding the dehumanizing implications of these occupations, illustrating how these marginalized job positions exclude african immigrants from the broader circle of us political incorporation. this insight alone effectively updates existing scholarship on african immigrants in the united states and provocatively extends the author’s previous work on transnational family forms (coe 2013). coe’s ethnography also contributes to the wellestablished and rich literature on immigrant women of color employed in the caring economy in the united states and across the world. she includes a trenchant and accessible description of home healthcare and the policies that shape it across the united states and at the state level, explaining how this industry racializes the immigrant women drawn into it. for example coe’s first chapter, aptly subtitled “the racialization of the care workforce,” discusses how some jobs are seen as “immigrant jobs,” or jobs that do not receive respect and benefits exactly because immigrants are the main workers (43). coe’s focus on the perspectives of care workers who care for upper-class elderly people in their homes allows her to explore the “practical kinship” (134) forged among care workers, patients, and their families while attending to the pervasive, harmful effects of elderly employers’ anti-black racism. building on pierre bourdieu (1977), the author observes that care workers’ practical kinship with their elderly employers “rarely leads to political belonging, both officially and through social practice, because of its temporary and contingent quality” (134). http://anthro-age.pitt.edu/ mailto:lk9829a@student.american.edu mailto:bpax812@gmail.com book review | krajecki, paxton, & glaser | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.370 http://anthro-age.pitt.edu 178 coe draws on an impressive array of more than 100 interviews to understand how african immigrant care workers and their elderly clients interpret their intimate—if alienated—interactions. the introduction provides a succinct summary of the increasing demand for in care work in the united states, its legal protections and loopholes, as well as its prevalence as a job niche for african immigrants. chapters one through three describe the racism that african immigrant home care workers experience and how these work positions complicate their political belonging. in chapters four through the conclusion, coe describes home healthcare’s compensation structure and details the limits of labor protections for this sector. she then details home healthcare workers’ responses and interpretations of these subpar working conditions, racist treatment, and the resulting sense that as a community, african immigrants, thus remain outsiders in the united states. throughout the text, coe places interludes that illuminate some of the stories and culture of the care workers. through detailed descriptions of workers’ experiences, this book gives readers a sense of the daily indignities women (and some men) encounter while working in these roles, which coe refers to as “dignity threats” (126). her discussion of african immigrant workers’ perceptions of these threats in their workplaces alongside their strategies for recuperation of their dignity are among the most powerful and vivid sections in her book. through portraits of individual workers that offset the chapters as stand-alone interludes, she provides a detailed, full account of the everyday lived experiences of women working in this sector. for example, in one such interlude, coe tells the story of an interaction between herself and a care worker as an example of the powerful relief that care workers’ plans to build a house in ghana provide, arguing that their “feelings of humiliation can be lessened through trying to attain the culturally designated goal of one’s own house in ghana” (126). in other instances, caregivers brush off racist verbal abuse as a symptom of dementia, but the abuse is still painful, and sometimes violent (2019). throughout the text, coe’s voice is justifiably and compassionately concerned about the poor treatment of the people who take care of a vulnerable population—providing ample quotes and rich anecdotes that make for a rich and textured interpretation of her interlocutors perceptions. the new american servitude is an important and engaging contribution to our understanding of the relationship between eldercare labor and america’s widening racial, economic, and social inequalities. despite the difficulty of care work positions, workers tend to see little payment for their efforts. the book contains descriptions of numerous instances when caregivers—who work to provide care to aging americans—cannot afford care in the united states themselves (2019). meanwhile patients (and their relatives) frequently express dissatisfaction, complaining about the cost of care (174). home healthcare agencies profit significantly from the labor of care workers who have very few labor protections (2019). coe concludes the new american servitude by entertaining the possibility of care workers joining social movements and labor unions to improve their circumstances—a possibility that the exigencies of covid-19 have hopefully hastened (2019). the author deftly combines her impressive research with the stories of the care workers in a way that is accessible to researchers and the public in general. this book is a must-read for anyone interested in the plight of those working for home healthcare agencies. this work comes at a time when its themes— race, labor, immigration, and efforts to reform the asymmetries inherent in these systems—are at a crucial juncture in the united states. researchers, activists, and allies will recognize the struggles that coe delineates in her ethnography. for example, she describes several instances when her ghanaian interlocutors, underemployed as home healthcare workers, are unable to materially benefit from the advanced degrees and academic credentials that they brought with them to the united states—a vexing and familiar issue facing immigrant workers across the country. similarly, coe’s accounts of workplace injuries, lapses in healthcare and unemployment coverage, and exploitative working conditions will http://anthro-age.pitt.edu/ book review | krajecki, paxton, & glaser | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.370 http://anthro-age.pitt.edu 179 resonate with scholars of labor as well as those who work in the myriad—and increasingly—precarious employment sectors. references bourdieu, pierre. 1977. outline of a theory of practice. cambridge: cambridge university press. cati coe. 2013. the scattered family: parenting, african migrants, and global inequality. chicago: university of chicago press. http://anthro-age.pitt.edu/ microsoft word fall2020_obituary_ready for pdf.docx aage obituary for madelyn (micki) iris, phd rebecca berman, margaret perkinson, robert schrauf, and ellen ziegemeier anthropology & aging, vol 41, no 2 (2020), pp. 46-58 issn 2374-2267 (online) doi 10.5195/aa.2020.323 aage obituary for madelyn (micki) iris, phd rebecca berman, margaret perkinson, robert schrauf, and ellen ziegemeier this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. berman, perkinson, schrauf, and ziegemeier | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) http://anthro-age.pitt.edu 250 madelyn (micki) iris phd, fsfaa, fgsa, passed away on january 7, 2020 in chicago, illinois at age 73 after having been diagnosed with cancer in 2017. micki received her ba in english from northwestern university, ma in medieval studies from university of toronto, and phd in cultural anthropology from northwestern. her dissertation on language acquisition among navajo children on the navajo nation reservation in the four corners area was supervised by advisor and life-long friend, ossy werner, whom she eventually succeeded as director of northwestern’s summer field school in anthropology on the navajo reservation. an applied anthropologist specializing in aging, her professional career began as a research scientist on northwestern’s medical school faculty, then as acting director of the northwestern buehler center on aging. she later served as associate director and then director of research at schanfield research institute at the council for jewish elderly. grounded in real-world problems, she masterfully applied qualitative and ethnographic methods to address thorny issues. her lifelong research on elder abuse and guardianship was book-ended by two major grants, funded early in her career by the retirement research foundation to investigate limited guardianship (“an ethnographic examination of the probate court and decision-making process”) and late in her career by the national institute of justice to develop a “computerized decision support system in the investigation of elder abuse.” in recognition of this body of work, she received the rosalie wolf memorial award from the national committee for the prevention of elder abuse and national protective services association. however, her interests ranged widely, as reflected in her numerous publications, over 20 grants, and countless community involvements: including the ethnography of aging in urban chicago, protective services, financial exploitation of older adults, self-neglect, disability studies, and alzheimer’s disease. as noted, she was especially skilled at bringing applied anthropology to the development and improvement of community agencies devoted to older adults. while at northwestern, she developed a research and evaluation training program – entitled aging services support for education, research, and training (assert) – for social service providers, and she worked with numerous social service agencies in the chicago area to implement the program. her peers in anthropology recognized her leadership in berman, perkinson, schrauf, and ziegemeier | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) http://anthro-age.pitt.edu 251 electing her president of the national association for the practice of anthropology (2004-2006) and president of the association for anthropology and gerontology (1998-1999). with rebecca berman and robert schrauf, micki hosted the first aage conference, held at northwestern and focused on the anthropology of dementia. the mother of a son with developmental disabilities, micki was deeply involved in keshet, a non-profit organization in the chicago area that provides educational, recreational, and vocational programs for children and young adults with developmental challenges. she put her skills, energy, and dedication at keshet’s disposal, served on its board of directors, and became its co-president for four years. for those of us who were blessed with the great good fortune of working with micki, this estimable body of academic work and these many years of community service reflect her eminently collaborative style. she had an uncanny ability to pull people together around a project, forefront each person’s unique contribution, and create an atmosphere of shared accomplishment. her warmth, humor, encouragement, and wisdom brought out the same qualities in her many colleagues. indeed, each one of us find ourselves in her cv. preceded in death by her son, david, we mourn her passing with mark, her husband of 44 years, son ari, daughter-in-law julia, three grandchildren, a sister and many friends and colleagues. anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 77-78 issn 2374-2267 (online) doi 10.5195/ aa.2014.37 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review pelto, pertti j. applied ethnography: guidelines for field research. left coast press. 2013. isbn # 978-161132-208-8, pp 351. price $34.95 (paper) paul g. ward, ph.d school of advance studies, university of phoenix online http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.37 http://anthro-age.pitt.edu book review pelto, pertti j. applied ethnography: guidelines for field research. left coast press. 2013. isbn # 978-161132-208-8, pp 351. price $34.95 (paper) paul g. ward, ph.d. the aim of this book is to provide information and guidelines for applied ethnographic research, updating previous texts written by the author with new examples and research situations from the international scene. as one of the books in the developing qualitative research series, edited by janice morse and intended for mid-level to advanced researchers and advanced students, this book will make a significant addition to any qualitative researcher’s library. the guidelines for field research in applied ethnography cover, in some detail, research preparation, data collection, and data analysis with additional chapters on ethnographic mapping and participatory or social mapping. the early chapters provide an introduction to ethnography with a summary of the major steps of applied ethnographic field research including the process of gaining entry to research sites. helpful descriptions of the terminology in ethnography cover topics such as: realism and positivism versus relativism and interpretivism; inductive, deductive, and abductive research; and ideographic and nomethic theory. the author devotes chapter 6 to a discussion on capturing and managing data, reminding researchers of note taking and recording protocols. described as a key building block in explaining field work, this chapter reminds readers of the critical importance of photographing, recording field data in detail, transcribing digital voice recordings where used, entering data into the computer, and organizing files for data analysis. note taking by the researcher or a dedicated note taker are critical tasks in ethnographic data collection although dictating field notes can be helpful when note taking in the field is challenging. capturing data in the field is not easy but this chapter provides valuable guidelines for the novice and the advanced ethnographic researcher. participant observation, often considered the foundation of ethnographic research, is discussed noting criticisms of the unstructured nature of this data collection technique. a separate chapter expands on explorations using more structured forms of direct observation. these two chapters, chapters 7 and 13, are surprisingly not sequential or even combined into a single chapter but provide the reader with valuable insights into the various observation techniques. when available samples are large enough, quantitative data can be collected though systematic direct observation of behaviors and events adding richness to the qualitative data of participant interviews and less structured participant observations. the author also highlights an important question about the extent to which participant behavior changes during direct observation. although common in studies that use direct observation, research indicates that these reactivity effects often have minimal impact on validity. the single chapter on data analysis felt insufficient and, although much of the data analysis in ethnographic studies is integrated into the data collection process, qualitative data analysis software, which as becoming an increasingly valuable tool, was not described. the section on writing ethnography identified three valuable writing rules and many useful tips for ward | book review anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.37 http://anthro-age.pitt.edu 79 writing up ethnographic research. more detailed explanation of data analysis processes would have made the book exceptional. noting that ethnography is one of the varieties of mixed-methods research and that most of the examples in the book can be regarded as mixed methods, this book will also be of interest to the mixed methods researcher. ethnographic research as a mixed method versus a mixed methods research design incorporating an ethnographic component remains an interesting debate. this book provides an important contribution to that debate. this book embraces ethnographic research in education, marketing, community health, nursing, and more. the examples, although mostly from developing countries and not focused on gerontology, describe and illustrate applied ethnography very effectively. anthropologists and gerontologists will find the examples and descriptions relevant and interesting. pencil sketches drawn by dunja pelto, the author’s daughter, add wonderful insights into the research examples. the extensive reference list, with nearly 250 unique references, is valuable although only a few of the sources would be considered recent scholarly references. although primarily intended for applied research people in the field, advanced researchers and graduate students planning to conduct ethnographic research for their dissertation could learn much from this book. book review book review book review review of katz, stephen, ed. ageing in everyday life: materiality and embodiments. policy press. 2019. pp 230. price: $115.00 (hardcover); $45.95 (paperback) theresa southam selkirk college/ fielding graduate university tsoutham@email.fielding.edu anthropology & aging, vol 41, no 2 (2020), pp. 262-264 issn 2374-2267 (online) doi 10.5195/aa.2020.301 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | southam | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.301 http://anthro-age.pitt.edu 262 book review review of katz, stephen, ed. ageing in everyday life: materiality and embodiments. policy press. 2019. pp 230. price: $115.00 (hardcover); $45.95 (paperback) theresa southam selkirk college/ fielding graduate university tsoutham@email.fielding.edu stephen katz’s aging in everyday life [emphasis added], demonstrates how the experiences of older adults are in fact unique from other times in the life course. twenty years ago, aging and everyday life [emphasis added] (gubrium and holstein 2000) was published. the latter has been received as a book that shows that the “triumphs and trials experienced in later years are not unlike those confronted at other points in life”(wiley 2020). the difference between “and” and “in” in these two titles is worth explaining. for katz, older adults are in relationship with things [part 1 materialities] and in their bodies [part 2 embodiments]. there are no claims of sameness throughout the life course as there are in gubrium and holsteins book, neither is there an “and” that separates older adults from their everyday life. katz and the authors of the twelve chapters in this volume, follow deleuze's (1993) notion that the inside and outside are folded together (9). i first read stephen katz during my explorations of ‘successful aging.’ he has, throughout his career, challenged the idea of successful aging and critiqued the measures taken in this regard (southam 2020). katz has numerous books and articles on aging bodies, related technologies, critical gerontology, and ageism including cultural aging (2005), and a new book forthcoming on age, mind and body in later life. a fellow canadian, katz is a professor at trent university and well-known internationally. the authors of this volume have backgrounds in “social gerontology, geography, feminism, the humanities, social work, sociology, health, and dementia”(10). they use ethnographic approaches to explore the “terrain of commodity capitalism and the potential resistance to it”(4). the twelve chapters in this edited volume are divided into two parts. in part 1, “materialities,” readers will find research and reflections on: older adults’ relationships with their ‘stuff’ over time; contemporary portrayals and future directives for care homes; the negotiation of cityscapes, leisure activities, and family; the silvering screen; and older adults navigating online dating systems. in the second part of the book, “embodiments,” the authors still focus on relationships, but here in closer proximity to older adults’ own bodies. readers will find enlightening explorations of older adults’ relationship to constructs like sexuality, fashion, dance and religiosity. where readers once thought of sameness for humans throughout the life course, they may now see how differently older adults relate to consumables like wearable tracking devices and high tech automobiles. although the volume embraces critical gerontology, most of the authors do not address power imbalances. only the afterword, briefly, addresses power imbalances. at this time, when awareness of http://anthro-age.pitt.edu/ book review | southam | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.301 http://anthro-age.pitt.edu 263 racism has been heightened by george floyd’s death, the lack of diversity and inclusion in this volume is glaring. what of the older adults who do not have the means to purchase fitbits and self-driving cars or are marginal to the narratives of dress and fashion in the book? only chapter 5 highlights the underrecognized themes of colonialism and privilege and “insidious racism” in film (87). the author, sally chivers, here points to country elder care in places like india and thailand, where western privilege is maintained through relatively cheap labour. chivers wonders why the particular potential for self-transformation in these parts of the world, is not recognized in a film like the marigold hotel (2011). she reminds that less can be more in india, and that this should be truthfully represented, instead of glorifying western older adults who are pursuing a life “with the dull bits cut out”(96). there are many real life stories shared in this volume. for example in chapter 4, authors gavin j. andrews and amanda m. grenier explain non-representational theory (nrt) with a story for each of its five elements. in chapter 7, linn j. sandberg focuses on diverse aspects of sexuality in older men’s lives (including touch, vulnerability, laughter, and freedom) with a story for each aspect of sexuality from different men. i did react to using each story to emphasize only one aspect of a theory. in the everyday, clearly, everything is more knitted together. a similar remark can be made on the two parts of the book: to distinguish between materiality and embodiment downplays the complexity and texture of most older adults’ everyday experience, making their narratives exemplary for analytics, and not the other way around. each man’s stories of sexuality clearly embodied all of the aspects identified by the authors, and more. the chapters of ageing in everyday life are highly readable, with authors bringing their research and academic knowledge to a potentially wide ranging audience, including older adults themselves. i have shared various chapters with older friends who are working in the arts, with community groups advocating for change in long-term care, and with a few who are interested in technologies like selftracking and high-tech automobiles. a friend advocating for a different approach to long-term care said susan braedley’s chapter on the nursing home renewed her commitment to care where the whole medical team forms a holistic understanding of people, nurturing their transcendent lives, as well as learning of their history, trauma, and culture (personal communication, lee reid, august 14, 2020). kim sawchuk’s focus in the afterword on the feminist notion of engtanglement best summarizes the twelve chapters in this book. she says, “if i had to characterise ageing in everyday life in one sentence i would say that it was a lively contribution to a cultural and relational study of aging for the present moment” (216). in despite of its shortcomings, in all the chapters i learned more about how older adults mediate culture with their bodies and enmesh themselves with places, technologies, other things and their designs. chapter 4 authors gavin. j. andrews and amanda m. grenier encourage an “academic form of mindfulness.” mindfulness can be focused attention while still having a broad awareness of how everything is connected. author patti lather might call the scientific election of these entanglements of older adults “counter practices of authority” (lather 1993, 677). lather has also called these types of research findings crabgrass in the lawn of academic preconceptions (1993, 680). by moving from “and” to “in,” katz has provided readers with pockets of wildflowers all over the lawns of a diverse set of disciplines. the chapters in this volume sow the perspectives of actual older adults including the multitudinous ways these older adults present in the places they live. references deleuze, gilles. 1993. the fold: leibniz and the baroque. translated by tom conley. london: athlone. gubrium, jaber f., and holstein, james a. 2000. aging and everyday life. wiley-blackwell. http://anthro-age.pitt.edu/ book review | southam | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.301 http://anthro-age.pitt.edu 264 lather, patti. 1993. "fertile obsession: validity after poststructuralism." the sociological quarterly 34(4): 673-693. southam, theresa. 2020. 27,000 sunrises: everyday contributions of grateful and giving age 70+ adults. human and organizational development, fielding graduate university, proquest. wiley. 2020. "description: aging and everyday life." https://www.wiley.com/en-us/aging+and+everyday+life-p9780631217077. http://anthro-age.pitt.edu/ https://www.wiley.com/en-us/aging+and+everyday+life-p-9780631217077 https://www.wiley.com/en-us/aging+and+everyday+life-p-9780631217077 book review review of clack, beverley and michele paule, eds. interrogating the neoliberal lifecycle: the limits of success. switzerland: palgrave macmillan. 2019. pp. 268. price: $112.02 (hardcover); $102.43 (kindle edition). jagriti gangopadhyay manipal centre for humanities jagriti.g@manipal.edu anthropology & aging, vol 42, no 1 (2021), pp. 186-188 issn 2374-2267 (online) doi 10.5195/aa.2021.344 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | gangopadhyay | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.344 http://anthro-age.pitt.edu 186 book review review of clack, beverley and michele paule, eds. interrogating the neoliberal lifecycle: the limits of success. switzerland: palgrave macmillan. 2019. pp. 268. price: $112.02 (hardcover); $102.43 (kindle edition) jagriti gangopadhyay manipal centre for humanities jagriti.g@manipal.edu in this edited volume, beverley clack and michele paule interrogate the conceptualization and realization of the “good life” (6) across the life course under the gambit of neoliberalism. exploring the intersections between success and failure, this volume illustrates how “the successful self is achieved at the cost of the failing other” (6). throughout the essays, which cover different stages of the life course, the capital importance of paid work and career orientation is highlighted and explored: it is argued that ‘work’ is the cornerstone of processes of individuation and is the indicator for the “successful life” (6) in a neoliberal era. based on the life cycle, this volume is divided into four major thematic segments: “childhood, youth and schooling,” “the university under neoliberalism,” “work, success and failure,” and “death and dying.” the book brings together contributors from a range of disciplines such as philosophy, theology, sociology, criminology, gerontology, anthropology, education, psychology, and psychotherapy. apart from having contributors from different disciplinary backgrounds, this volume has contributions from academics as well as practitioners and regional government officials in the introductory chapter, through a discourse analysis, the editors scrutinize how the neoliberal framework in school and educational policies formulates the ‘self’ among children and younger adults. across the chapters in part i, the contributing authors establish that values such as individual responsibility, agency, autonomy, and choice are inculcated as cultural ideals throughout school education. critiquing these ideals of “selfhood, choice and rationality” (19), philippa donald, (chapter 2) argues that the neoliberal paradigm pushes the autonomous self to make the right choices, namely those that foster one’s own mental well-being. as a result, donald asserts, children and young adults are burdened with this task and face mental health concerns (anxiety and stress) over making the right choice from the very beginning to guarantee a happy and successful life. in chapter 3, patrick alexander draws from ethnographic research conducted in a public high school in the bronx, new york city, to explore how the articulation of aspirations for adult life among boys at the end of secondary schooling is permeated with ideals of masculinity. the author demonstrates how the students considered the bronx to be a “dead-end” (61) and felt that their dreams could only be realized in “the city” (61). in particular, the imaginary of masculinity for these students is shaped by ideals of competition, selfactualization, and self-improvement. for them, the only way to materialize these aspirations is to escape their school environment. in the final chapter of this section (chapter 4), michele paule analyzes the http://anthro-age.pitt.edu/ book review | gangopadhyay | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.344 http://anthro-age.pitt.edu 187 figure of the “successful girl” (67) as she is constructed in the “gifted and talented policy of the english educational system in the early twenty first century” (67). this chapter relies on interviews conducted among 46 girls (aged 13 to 15), drawing from the “gifted and talented” registers across a range of state comprehensive schools in england. based on this study, the author highlights how “parenting, class backgrounds and self-responsibility” (80), become key determinants in developing the “hard-working girl” (81) identity. the next section (part ii) examines how neoliberal discourses shape academic institutions. louise livesey (chapter 5) highlights how academia is tailored to “fit white, male, heterosexual, abled-bodied and middle-class existences” (117). bob brecher (chapter 6) relies on media reports to explain how universities, instead of disseminating knowledge, focus more on preparing students for the job market. in particular, the author argues that in the neoliberal era, universities aim to provide an “educational experience beyond excellence” (128) that will prepare students for a successful future. the third section (part iii) is dedicated to certain determinants (gender and age) that risk correlating negatively with working lives and concomitant successes under the flag of neoliberalism. louise grisoni and sonia ruiz (chapter 7) illustrate how austerity policies have negatively affected gender equality in spain. the authors suggest that, economic crises in spain often lead to setbacks in gender equality and anti-discrimination policies. sharing her own experiences from within the academic world, susan crozier (chapter 8) depicts how she has come to love and accept failure. crozier highlights that she rejected the normative path of having a full time job and traditional marriage bonds to retain her freedom. the author demonstrates how important it is to maintain strength and resilience when failing the demands of the neoliberal ecology because of these choices. jason danely (chapter 9) closes this section with an account of the everyday navigations by japanese older adults to “achieve a successful old age” coping with “their anxious sense of failure for living too long” (189). danely demonstrates how home visits by doctors, nurses, therapists, and care managers, as well as tracking technologies, help older people retain their independence. the author’s conversations with older women, however, also show that these amenities have facilitated a self-sufficient life but have not correspondingly enriched their lives. the final section of this book analyzes how very old age and death are constructed under a neoliberal regime. in chapter 10, susan pickard, in line with the works of chris gilleard and paul higgs (2011), highlights how neoliberalism has led to the development of the “third age” (222) and has pushed frailty and bodily decline to the “fourth age” (225). emphasizing the need to move away from a model which primarily constructs aging as a medical condition, pickard urges for an alternative framework of old age, which acknowledges frailty as part of the aging process, and is more inclusive of diverse experiences of aging and of the inevitability of death. in the final chapter (10), co-editor beverley clack draws from the death manuals of philip gould and kate gross who were involved with the new labor project of the labor party under the leadership of tony blair (236) and both urge their readers to go beyond the neoliberal framework and to locate meaning within their families and social network. drawing from these memoirs, the author suggests that, we as individuals cannot control the inevitability of death, hence instead of focusing on self-sufficiency, success, and rationality (ideals of neoliberalism), it is important for us to nurture individual bonds and connections that lead to more solidarity among human beings. this book makes for an important read as it urges readers to look beyond global neoliberalism and remember more humane inspirations and aspirations—such as solidarity and collectivism—throughout the life course and thus reconsider the meaning of success and failure. though this edited volume makes for an important contribution in the fields of gerontology, sociology, philosophy, and psychology, the http://anthro-age.pitt.edu/ book review | gangopadhyay | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.344 http://anthro-age.pitt.edu 188 main focus of this volume was the first world. as the authors identify neoliberalism as a global phenomenon, an analysis of neoliberalism in third world countries would add to this intellectual conversation. however, this volume would benefit both academics as well as policymakers from a range of disciplines as it provides various alternative perspectives to the “good and successful life” (259). references gilleard, chris and paul higgs. 2011. “frailty, disability and old age: a re-appraisal.” health 5 (5): 475-490. lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. new jersey: rutgers university press. http://anthro-age.pitt.edu/ anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 64-66 issn 2374-2267 (online) doi 10.5195/aa.2014.41 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review parkes, colin murray, and holly g. prigerson. bereavement: studies of grief in adult life. 4th edition. new york: routledge, taylor & francis group. 2010. isbn 978-0-415-45118-5, pp. 368. price $59.80 (hardcover) linda j. keilman, dnp, gnp-bc geriatric education center of michigan college of nursing, michigan state university http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.41 http://anthro-age.pitt.edu book review parkes, colin murray, and holly g. prigerson. bereavement: studies of grief in adult life. 4th edition. new york: routledge, taylor & francis group. 2010. isbn 978-0-415-45118-5, pp. 368. price $59.80 (hardcover) linda j. keilman, dnp, gnp-bc it can probably be said that most human beings experience loss at least once in their lifetime, to be possibly followed by grief and/or bereavement. perhaps the words, concepts and theories associated with these life experiences cannot be articulated by the individual, but the emotion and feelings that arise from the event can be described in a kaleidoscope of words and symptoms that may help the reader understand that the process of bereavement can impact physical and psychological function and may lead to psychological stress. this book focuses on the many ways loss can occur, how people are impacted differently based on the circumstances of the loss, how the process is uniquely individual, the interventions available for the bereaved person, and how one gets to the other side of grief through the bereavement journey. generally, a 4th edition book should indicate to the reader that the information contained within the pages are pertinent and readable; updating is necessary to relate the emergence of new ideas, empirical research findings, theoretical advancement, and improved understanding of the topic. in the 4th edition of parkes classic work, readers will not be disappointed as the chapters are filled with greater depth, implications, and understanding of bereavement based on newer research findings and advancing scientific technology. dr. holly prigerson, from harvard university and researcher on the acclaimed yale bereavement study, serves as the new coauthor. some of the new developments in the study of grief and bereavement included in this edition are findings related to: magnetic resonance imaging (mri) and mapping of neuroanatomical grief, cellular chemistry and physiological technologies for studying living cells of grieving individuals, finding meaning and purpose after recovery from a significant loss, attachment theory implications, resilience, transitions, recovery, and effective interventions. research statistics and findings have been placed in a series of 19 appendices so as to make the book more readable to lay individuals as well as professionals. the reader is reminded that grief is a normal response to stress. the characteristic states of grief (the term phases of grief is no longer utilized) overlap and individuals can move back and forth over a non-defined timeframe, including years after the loss. grief can be viewed from an orientation perspective involving loss (looking back) and restoration/change (looking forward) which cannot be carried out simultaneously. the impact of major life stresses of limited duration can be explained through application of crisis theory principles. how a human being reacts to a particular stressor varies widely and depends on: any inherited sensitivity to stress, characteristics of the stressor, coping mechanisms, application of previous life experience to the current event, ability to handle powerful emotions, and self-esteem. shield| book review anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.41 http://anthro-age.pitt.edu 65 determinants of grief covers chapters 9 – 12 and includes: kinship, gender, age, mode of death, accumulated or multiple losses, personal vulnerability (dependency, avoidance of grief, ambivalence, helplessness), and social and cultural influences. the authors do concede that “a complete explanation for any psychosocial event would be possible only if we knew everything that had preceded it – which clearly can never be the case” (p. 138). over the past few decades, a multitude of services have emerged to assist bereaved individuals in the process of their recovery. the authors conclude that over time, most bereaved improve with or without formal interventions. statistics from some of the reported research indicates that “referral for counseling or other interventions may do more harm than good” (p. 195). this assumption is explained with the caveat that family and friends are the first and most significant form of help for most people. chapters 13 – 15 offer solid information on helping the bereaved through understanding the multitude of events surrounding loss. this book is a relevant resource for individuals living with bereavement, their family and friends, health care professionals, and students. when reading this information, one cannot help but think of the life losses experienced by self and others. a new understanding emerges in realizing that loss is an individual experience based on many factors that may or may not lead to grief and bereavement. seeing things in a different perspective may help self and others in living through another event with a more holistic range of understanding and empathy. book review book review thinking about ‘completed life’ euthanasia in the netherlands from the generativity perspective: a reflexive exploration sjaak van der geest priya satalkar university of amsterdam ghent university s.vandergeest@uva.nl priyapramod.satalkar@urgent.be abstract in this reflective essay, we explore the concept of generativity and propose it as a more positive interpretation of the experience of ‘completed life’ and its bearing on the wish to die. in 2010, more than 100,000 people in the netherlands signed a petition requesting an extension of the existing euthanasia legislation. they asked the government to grant euthanasia to older persons who feel tired of life and who regard their lives as complete, in the absence of physical or psychic sickness. debates about ‘completed life’ euthanasia have continued since then, but the various factions in these debates have been unable to reach consensus or conclusion. in this paper, we analyse the concept of generativity and use this to interpret statements by supporters of ‘completed life’ euthanasia. next, we disentangle common idioms that people use when they grow older and feel that death is approaching yet still out of reach. the aim of this article is to invite readers to reflect on the wish for ‘completed life’ euthanasia as a meaningful end-of-life reaction. keywords: completed life euthanasia, generativity, loss of meaning, the netherlands. anthropology & aging, vol 42, no 1 (2021), pp. 128-139 issn 2374-2267 (online) doi 10.5195/aa.2021.286 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 129 thinking about ‘completed life’ euthanasia in the netherlands from the generativity perspective: a reflexive exploration sjaak van der geest priya satalkar university of amsterdam ghent university s.vandergeest@uva.nl priyapramod.satalkar@urgent.be introduction in 2010, 116,871 dutch citizens signed a petition asking the national government to amend the existing legal framework for euthanasia to create the possibility of a dignified death for older citizens who consider their lives to be complete (uit vrije wil 2010). the petitioners proposed that new laws regarding euthanasia should be based on the principle of self-determination and free will and should apply to people age 70 and older who have a consistent and well-considered wish to die in the absence of unbearable suffering due to illness (peters et al. 2011). the petition prompted widespread debate about the ethical, medical, and legal implications of ‘completed life’ euthanasia, both within professional circles and among the dutch population. this reflexive essay aims to contribute to the ongoing discussion by examining the concept of ‘completed life’ from the perspective of generativity. experts on the art of growing old often use adjectives like ‘successfully,’ ‘gracefully,’ ‘vitally,’ or ‘actively’ to emphasise the crucial importance of finding meaning in later life – of having a purpose. following this logic, should we thus regard those who say that their life has no more meaning as depressed or emotionally unstable? rather, we argue that – paradoxically – choosing to die because life no longer has meaning or purpose may actually be a sign of a deeply-experienced sense of meaning and purpose at the end of life. using the concept of generativity, we examine what some people may mean when they state that their life is complete. furthermore, we explore the contextual significance of common dutch expressions such as “i don’t want to be a burden on my children (or others)” and “i’m waiting for the big boss to call me.” this essay aims to invite readers to consider the wish for ‘completed life’ euthanasia as a simultaneously rational and emotional decision once a person has determined that their life has lost its generative capacity. through our reflections, we hope to encourage colleagues in various professions and academic disciplines to consider ‘completion’ as a meaningful experience among older people who believe that continuing to live no longer serves a purpose – either for themselves or for those to whom they were devoted in life. background the aforementioned petition, ‘of free will,’ was set forth eight years after the dutch government issued the ‘termination of life on request and assisted suicide act,’ which stated that euthanasia would not be punished if the attending physician acted in accordance with the criteria of due care (dutch ministry of security and justice 2002). this law stipulates in part that, in order to allow euthanasia, there must be unbearable suffering without the prospect of improvement as well as an explicit, voluntary, and wellconsidered request from a critically ill patient who is capable of expressing their will. a second, independent physician must be consulted, and the euthanasia must be carried out with due medical care and attention. patients, however, do not have a right to euthanasia (de jong and van dijk 2017). http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 130 the 2010 petition was based on the principle of self-determination, and it introduced the concept of ‘completed life’ as a valid reason for requesting euthanasia. at the same time, the petition recognised the existential encumbrance of making the decision to end one’s life and emphasised the importance of a ‘dignified death.’ the petition’s three central tenets were as follows: self-determination our constitution guarantees every dutch citizen the freedom to organise their life according to their own insight and preference, and to make decisions about it. this freedom also includes the final phase of life and decisions about dying and death. no one has an obligation to live. self-determination, an essential principle of our civilisation and anchored in our culture, is the foundation of this citizens' initiative. uit vrije wil (of free will) focuses on the self-determination of the elderly. it is up to the free person, who regards their life as complete, to decide for themselves how and when they want to die. completed life we are all getting much older than before, usually to our pleasure. but at some point, we may reach the conclusion that the value and meaning of our lives have decreased so much that we would choose death over life. the reasons for this vary. sometimes, we no longer see opportunities to continue our lives in a meaningful form, and we have the feeling of outlasting ourselves. everything of value is behind us, and only emptiness remains. sometimes, we become completely dependent on the help of others, and we lose any form of control over our own lives. sometimes, we are also confronted with physical abuse and an irreversible loss of our personal dignity. self-chosen end of life the decision to end one's own life is far-reaching; our attachment to life is great. this makes it difficult to balance the continuation of a life experienced as unliveable, and death. however, when it becomes clear to us that our circumstances can no longer be changed, we may reach the conclusion that our life is complete. we want to die, die in dignity and peace, and preferably in the presence of loved ones. in many cases, help is needed. this also prevents suicide attempts from failing and/or having terrible consequences, also for others. (uit vrije wil 2010) the dutch government reacted to the citizens’ petition with hesitation, stating that it did not relate well to the current euthanasia legislation but that further consideration of the issues raised was important. medical professionals were mostly critical and saw the petitioners’ call for completed life euthanasia as an intrusion into their professional tasks and responsibilities. even more, they perceived it as a threat to the quality of medical care. religious organisations were squarely against the petition, calling it a step toward the weakening of respect for the value of human life. legal experts concluded that extending the present euthanasia legislation to include completed life euthanasia would require drastic changes to the law. ethicists pointed to the diversity of interests and views among the various participants in a potential completed life situation. the reaction of the wider public is not well known, but the central bureau of statistics (cbs 2019) later reported that more than half of the dutch population was in favour of a new law to make completed life euthanasia possible. the government decided to conduct a study of the legal possibilities for – and the social and ethical dilemmas of – euthanasia for people who deem their life to be complete. an advisory committee was http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 131 established to conduct the study, and in january 2016, the members returned with their advice, recommending against any modifications to the current law (schnabel et al. 2016). the committee also remarked that the number of people who may wish to die while still in a relatively good state of health is probably quite small. furthermore, the committee argued that the wish for euthanasia usually comes with a serious accumulation of physical and/or mental complaints in old age; as such, they recommended further research about the existing possibilities within the current law to allow for euthanasia in such cases. in january 2020, the results of this research were presented in an extensive report to the dutch ministry for health, welfare and sport (van wijngaarden et al. 2020). the purpose was to explore in more detail the size, characteristics, and circumstances of elderly people with a desire to die, without serious illness. more than 21,000 older adults age 55 and over had completed a comprehensive questionnaire, and the researchers had conducted in-depth interviews with dozens of older people. over 200 requests for euthanasia, both fulfilled and rejected, were also analysed. finally, 1,600 general practitioners from across the netherlands participated in a survey. from this investigation, the researchers estimated that 0.18% of all people age 55 and over have a wish to end their life in the absence of serious illness (van wijngaarden et al. 2020, 79-85). this amounts to just over 10,000 people. the researchers also found that slightly more than one-third of this group would like to receive help to die while two-thirds would prefer to end their life by themselves. similar to the previous advisory committee, the 2020 report emphasises that the term ‘completed life’ (as described in the petition above) is problematic – primarily because it presents a too-rosy picture of the state in which an older person might request euthanasia, but also because it obscures the reality leading up to such a request. this reality includes, for example, emotional suffering, loneliness, poverty, and the fear of total dependency and an undignified death. the overall policy suggestion that the media drew from the report is that it would not be a good idea to adopt a new law that would facilitate completed life euthanasia. nevertheless, the d66 political party announced that it would present a proposal for such a new law in 2021. generativity and a completed life the term ‘completed life,’ as described in the ‘of free will’ petition, reflects a person’s wish to die with dignity. we examine this wish from the perspective of generativity. the concept originates from the work of developmental psychologist erik erikson (1997 [1982]), and it refers to the human drive for continuity. inspired by erikson, psychologist john kotre further defined generativity as “a desire to invest one’s substance in forms of life and work that will outlive the self” (1984, 10). the basic assumption is that people hope to ‘live on’ in their children or others who will continue their work and take care of their properties in the future. these children, friends, or students will remember them for their ideas, personality, achievements, activities, or gifts (including money). kotre distinguishes four types of generativity: biological (bringing forth), parental (bringing up), technical (teaching skills), and cultural (passing on ideas, values, and symbols) (1984, 11-16). we could add a fifth type: economic, i.e., the drive to continue a business or enterprise that would be the materialisation of emotional and symbolic values. as erikson suggests, generativity occurs in all stages of life (except, perhaps, the first) but it becomes more acute towards the end of life when the biological self is approaching its natural end. this threat to continuity thereby produces a sharper awareness of the need to look for alternative forms of continuity. developmental psychologist feliciano villar (2002) has called for the addition of generativity to the concept of ‘successful’ ageing, thus moving it to the social level (instead of the strictly personal level). he draws attention to the contributions that older people can make to the well-being of http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 132 family and others in their social network in addition to the intrapsychic processes that are usually seen as characteristic of ‘successful’ ageing. following erikson, kotre indicates that people attempt to give meaning to their lives by creating continuity through the next generation (1984, 7). if everything that a person has produced over their lifetime were to stop with their death, this would probably be considered to be a derogation of the meaning of their life. generativity therefore has two complementary but also somewhat conflicting meanings. on the one hand, according to kotre, it is about care for the formation and management of the next generation (‘communal mode’); on the other hand, it is the older person’s desire to produce something through which they will live on after their death (‘agentic mode’) (1984, 16-18). while the first thought’s emphasis on investing in the well-being of the next generation can be understood as altruistic, the second is self-centred and focuses primarily on the desire of an older person to ‘live longer’ through the memory (and admiration) of their successors. rubinstein et al. remark that “both narcissism and generativity might be thought of as forms of self-fulfilment that can be, for some, closely related in that generative action provides distinctive personal gains” (2015, 549). we also acknowledge these – potentially conflicting – nuances of difference and their moral implications but, following other scholars, we simultaneously believe that altruism and self-fulfilment or self-gratification are nearly always intertwined (ambrose 2009; dawkins 1976; rand, greene, and nowak 2012). interpreting quotations in this essay, we explore the concept of generativity through our analysis of the personal narratives of nine people who signed the 2010 petition for completed life euthanasia. the quotations included here are taken from interviews by priya satalkar, in which these interlocutors explained why they supported the idea of completed life euthanasia (satalkar and van der geest 2019). it should be pointed out that, at the time of these interviews, none of the study participants had yet turned 70, the age at which they could obtain completed life euthanasia. however, as they explained, signing the petition was a way for them to take a stand in the public discussion and express their views on the issue of completed life euthanasia. several of them made it clear that they might never arrive at the point where they feel their life is completed, but they strongly believed that it should be possible to request euthanasia and die in a dignified way for those people who do reach such a point. the signatories of the petition have tended to be the most outspoken proponents of the proposed law that aims to avoid what they regard as a gloomy and miserable end of life. they hope that the completed life law will prevent them (and others) from enduring a situation of useless living, loneliness, and total dependency. in our interviews, two interlocutors expressed their resistance to total dependency, abiding by the decisions of others – particularly doctors: i do not want to be dependent on doctors who keep me alive when my body wants to die. but the medical profession doesn’t want me to die. i want to decide that for myself. i want to be more in balance, instead of doctors having a total say over how my life should continue or end. (mjg, f, age 64) it’s crucial to not just look at technical ways of keeping people alive but also to think whether life still has meaning, a sense of belonging. your body might be fixed, but your mind can’t cope with life anymore. you’re tired. your energy to go on is depleted. but you’re expected to go on living because your body is still functioning thanks to http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 133 technology. your body is alive, but you’ve lost the meaning of life – you’ve lost the energy and spirit to go on living. (jvb, f, age 65) the concept of generativity – and its loss – help us foreground what remains unsaid in the above quotations. as seen from a generativity perspective, these two interlocutors imply that their own parents had reached a point where they (the parents) felt they had become useless. they had worked hard to raise successful children, and their own ‘successful’ ageing was demonstrated in the successes of their children (cf. villar 2002). but at a certain point, the tables turned. the older people became unable to continue their parental task of helping their children and grandchildren. instead, they realised that they might become an obstacle to their children accomplishing what they hoped to achieve. these are painful considerations that may be hard to express openly, particularly by the younger generation. from the perspective of generativity, living on while depending on the help of one’s children or other members of the next generation is the opposite of what many older people wanted their life to be: i.e., passing on their most precious material properties and spiritual values to the next generation. for some people, the ultimate act of generativity would be leaving the scene and ‘making room’ for others. instead, the end or loss of generative living may correspond to an experience of uselessness and a loss of meaning. when people consider the slow, interminable decline experienced by some older people, they may project themselves into the future and develop various concerns. for example, they may feel determined to no longer live when their life has become ‘useless’ and they have become a burden to others. they may also worry about their life ending in misery and total dependency, a condition that would be the opposite of what their life has otherwise been. completed life euthanasia would prevent this and allow their end to be a confirmation and a reflection of the quality of their life. moreover, it would support their wish to be remembered for their achievements and vitality, rather than for prolonged suffering and dependency at the end. one signatory of the petition, btk, who is severely disabled due to multiple sclerosis, explained his views on this matter: until this point in time, i feel that i’m useful to others; i’m able to do things for others. i can see what my contributions are. i’m able to connect and influence situations around me. [but] the minute that connection and ability to influence is gone, my purpose in life is gone. i need a purpose to live. when that purpose is lost, however small or big that may be, i want to call it an end. (btk, m, age 61) in the interview, he explicitly linked his condition of progressing disability to a sense of diminishing purpose in life; he related this to his future wish for death after a completed life. ‘completed’ – a misleading term? as research specialists in care ethics and perspectives on death and dying, els van wijngaarden and her colleagues emphasise that the term ‘completed life’ suggests a too-rational and well-considered view about end-of-life quality (e.g., 2015, 2016). in their most recent report for the dutch government (2020), they repeat this claim in even stronger terms: the concept of completed life includes feelings of depression, loneliness, and anxiety about dying without dignity. in an earlier paper, van wijngaarden et al. (2019) explored ten disparaging metaphors about aging used by 25 older people who wished to die; these metaphors include ‘emptiness,’ ‘breakdown,’ ‘redundancy,’ ‘burden,’ and ‘return to http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 134 childhood.’ let us look more closely at one such metaphor, which is directly related to our reflections on (lost) generativity: participants also talked about the process of aging in terms of being a burden to themselves but even more to others and to society. they felt [they were] foisting [themselves] upon others, putting pressure on their children, and costing too much (money or time) (van wijngaarden et al. 2019, 257, italics in original). we argue that such negative qualifications of a life that does not enhance but rather obstructs other people’s lives (particularly children and successors) are the logical consequence of a deeper wish to promote others’ well-being and quality of life. as one of van wijngaarden et al.’s interlocutors said: “you know, that’s not the reason why we live on this earth: to greatly complicate each other’s lives” (2019, 257). such emotions regarding others seem to make the feeling of ‘life completed-ness’ more intense and unbearable for some people. as we suggested earlier in this essay, a person’s decision that life has lost its meaning and the subsequent decision to end their life before it becomes (more) unbearable – for both the person and those around them – is in itself a meaningful conclusion. in other words: expressing the experience of ‘meaninglessness’ can be a demonstration of meaningfulness. making room for the next generation – and no longer being a burden to them – is an act that is repeatedly required from older people during their lives. for example, a farmer hands over their farm to a child or another family member and withdraws from their leading position. the farmer may remain available to do odd jobs but should not interfere with the successor’s way of management. everyone praises the farmer for this act of making room. the same thing happens in countless other businesses, institutions, and family settings. asking for euthanasia because one’s life feels complete could be seen as a logical and final step in this process of withdrawal. such withdrawal is a laudable principle, especially with respect to other issues that are at play in today’s debates about the older generation’s legacy (e.g., the rising costs of pensions and care institutions, the responsibility for climate change and the environment). ‘completing life’ should be more than a sense of ‘i have accomplished what i had to do.’ it should also include a feeling of ‘i won’t stand in the way of the next generation.’ many contemporary western societies are already at their breaking point due to the care and support that the working generation is supposed to deliver to its elders (cf. foner 1993; salazar 2017) – with some researchers even speaking of an ideology of ‘apocalyptic demography’ (gee, thomas, and gutman 2000). falling birth-rates in countries such as japan, canada, italy, and south korea are leading to an imbalance between available caregivers and care-receivers. in italy (among other southern european countries), families have started to employ informal caregivers from lowincome countries to take care of their older relatives (da roit 2007). in ghana, where older people are respected and typically cared for until death, there is also a growing belief that they should not go on living longer and longer at the expense of the young. when young people die and the old refuse to die, suspicions and accusations may arise that the old are witches who are reversing the normal course of life. as we have described in earlier work, these elders may be considered to be selfish evil people who destroy others to increase life for themselves (van der geest 2002). the end-of-life discussions in dutch society may contain different terms and metaphors but, in some ways, they resemble the ghanaian reaction. there is a certain egoism in the desire to live long and burden others with the practical and emotional consequences of that desire. even when children assure their parents that they want them to ‘stay’ and that they are not at all a burden, we must realise that such words are not only terms of endearment but also a performance of respect. contexts differ greatly, http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 135 but it would be naïve to simply assume that the continuing care and attention that older people expect (or demand) from the young is not a burden that may eventually break up the younger generation. the expression said by some older people – “i don’t want to be a burden to my children” (or to society as a whole, we could add) – should be taken seriously and be understood in its specific context. another expression that older dutch people sometimes say is: “i want to die, but i must wait until the ‘big boss’ (or ‘the lord’) calls me.” this expression brings us to religion as a mitigating factor that affects views and decisions regarding completed life euthanasia. there is a widespread assumption in the netherlands that religious views prevent older people from voluntarily asking for euthanasia. some people view euthanasia as not only forbidden but also unnecessary, e.g., “the lord will take care of me; he will reward me for the suffering i go through.” completed life euthanasia, in particular, is believed to be far less acceptable to religious people than to non-believers (cip 2019). however, religious worldviews seem to be becoming more fluid, leading to a blurred distinction between so-called religious and non-religious thoughts (cf. fortuin, schilderman, and venbrux 2019). the term ‘spirituality,’ which embraces a wider spectrum of creeds including religious as well as humanistic ideas and nature-linked cosmologies, is also increasingly being used. among the older dutch adults who asserted that they should be allowed to determine for themselves if and when to receive euthanasia, research indicated that they were almost as ‘religious’ as others who held the opposite view (fortuin, schilderman, and venbrux 2019). how can we understand this finding? first of all, the tenets of some christian churches are often less ‘strict’ than is commonly believed. some churches, for example, may state that discontinuing lifeprolonging treatment, “is not only permitted, but might in fact even be required as an element of proper care and compassion for a seriously, irrevocably, or terminally ill patient” (fortuin, schilderman, and venbrux 2019, 2-3). but, as we mentioned before, completed life euthanasia is not considered acceptable according to official declarations by many church authorities (although individual priests/ministers and church members may take a different view). second, if there is rationality in faith – and we believe there is (cf. evans-pritchard 1937) – then why should believing in a godlike creator oblige people to continue to live when they have decided that they have finished what they had to do? why should the ‘sanctity of life,’ a term often used by religious authorities and ethicists (kelly, magill, and ten have 2013), or ‘respect for life,’ a term popular among both religious believers and medical professionals, lead to the disapproval of completed life euthanasia? why should continuing to live until ‘the bitter end’ be considered meaningful, while wishing to die signals a loss of meaning? from the viewpoint of generativity, as we discussed above, it makes sense for a person to choose death if they believe their life no longer has any meaning. this sense-making is, however, double-edged. for the person making the choice, it may entail ending feelings of physical and existential fatigue, being superfluous, unneeded, and lonely. but it also implies making room for the next generation, which is the ultimate act of generativity. in a personal communication, a catholic brother wrote to one of us, saying that he believed . . . that the world would be richer if weak [older] people are willing to make room for those who come after them. . . . accepting suffering without complaining and thus adding a deeper value to life deserves our respect. but giving your life for others to live deserves our respect as well. http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 136 interestingly, “giving your life for others to live” is perhaps the most christian phrase one can imagine, as it refers to jesus christ giving his life for the goodness (‘salvation’) of humanity. in this way, the catholic brother used one of the most fundamental ideas of the christian faith to defend completed life euthanasia. this illustrates that acceptance of and support for the idea of euthanasia on the basis of a completed life experience may be found among highly devout people and is thus not exclusive to a secularised society. conclusion this essay attempts to examine the wish for completed life euthanasia from the perspective of generativity. namely, ending one’s own life is a contribution to continuing the life of the next generation. we suggest that at a certain age, an individual may feel that their life has lost its meaning, but that this awareness is a meaningful and valuable insight in and of itself. this loss of meaning may be combined with an experience of loneliness as well as the fear of impending dependence and a slow, unpleasant, and undignified death. but such feelings do not detract from the significance of a person’s realisation that generativity has stopped. it connects to reflections on why one should go on living and continue to consume personal, familial, and (perhaps scant) social resources when one could make space for others. of course, not all older people think this way. however, if a small minority do, then this should not be trivialised and pathologised (cf. richards 2017). their intentions or thoughts about future generations and the realisation that their life may have become less meaningful due to decreasing generativity should be included in debates on completed life euthanasia. we are aware that this perspective was rarely explicit in the quotations of those who explained their support for completed life euthanasia. most of our interlocutors conveyed a strong opposition to prolonged living and drawn-out dying and pleaded for the possibility of a dignified death. as we have emphasised, however, these statements cannot be regarded as clear-cut predictions of what these people will actually decide when they approach the end of their lives – and we did not intend to suggest such a thing. studies about the end of life have found that prospects and decisions may change as health worsens (e.g., schwartz et al. 2004). when this happens, paradoxically, continuing life may be seen as preferable to death. the quotations from our interlocutors were used as typical examples of the debate that is taking place in dutch society about the idea of completed life euthanasia. the purpose of this essay was to explore a deeper dimension of the concept of ‘completed life’ by using generativity as a heuristic tool. the idea of (failing) generativity is certainly implied in the expression that some older people use when they pronounce that they do not want to be a ‘burden’ to the next generation. furthermore, we argue that a person’s conviction that their life has become meaningless is a lucid and convincing – and therefore meaningful – conclusion, particularly when analysed from the point of view of (a loss of) generativity towards the end of life. postscript when we were writing this essay, the covid-19 pandemic erupted, and we hesitated to publish our views. we wondered: would it be appropriate to defend voluntary death while thousands of people, particularly older people, were fighting to live? arguing for a recognition of the deeper layers of generativity with respect to euthanasia could be interpreted as an implicit pressure on older people to accept death in order to make room for younger people and to unburden medical professionals. despite these reservations, we decided to submit this essay as a contribution to discussions about how we should live face-to-face with the pandemic. http://anthro-age.pitt.edu/ geest & satalkar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.286 http://anthro-age.pitt.edu 137 at the same time, as the public-health crisis worsened and hospital facilities in some countries threatened to collapse under the overload of covid-19 patients, the taboo on questioning whether older people should be given prioritised hospital access and admission seemed to diminish. some older people even raised the issue themselves, suggesting that their medical privileges should be given to younger people. a research study among general practitioners in 2,331 of the 5,020 clinical practices in the netherlands showed that 59% of older people with covid-19 did not want to be referred to a hospital. the survey also indicated that their reasons for that decision were a combination of the fear of being isolated in the hospital, a potentially devastating outcome of a lengthy treatment in the intensivecare unit, and the existence of an advance end-of-life declaration (cals, derckx, and blanker 2020; weeda 2020). our central argument in this essay has been that recognition of meaninglessness opens the door to new meanings related to growing old. these could imply accepting – or even asking for – death. such acceptance carries a precious lesson for the younger generation – the wisdom at old age that society 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sociological institute of the russian academy of science kgalkin1989@mail.ru anthropology & aging, vol 41, no 2 (2020), pp. 187-198 issn 2374-2267 (online) doi 10.5195/aa.2020.316 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 187 “the body becomes closed and squeezed up in a narrow frame”: loneliness and fears of isolation in the lives of older people in rural areas in karelia during covid-19. konstantin galkin sociological institute of the russian academy of science (ras) kgalkin1989@mail.ru introduction this article examines the experiences of infrastructure deficits and changes in bodily practices for older adults in rural areas of south karelia, russia, during the covid-19 pandemic. the focus is on how crisis-bound bodily sensations, anxieties and fears from older people living in this area reflect their loss of agency to overcome immanent features of the socio-geographical circumstances that make up aging lives in peripheral settlements. for individuals, the body is the locus through which world cognition takes place and through which we are able to determine our place in the world (csordas 1990, 1993). through the practice of caring for one’s own body, and for the social body through caring for other human and non-human others, a person comes to know the world around him and immerse himself in it (csordas 1990, 1999). the body, as donna haraway states, is located: it both originates from and makes up particularly patterned sociobiological locations that either allow or prevent certain experiences and actions (haraway 1991, 197198). the voices of older adults in karelia remind us of the socio-materiality of this location, where geography, infrastructure, social relations and imaginaries of the future coalesce. as arthur frank (1991) argued, the body is not a constant in flux – an object, but an epitome of flux – an agent (as cited in csordas 1997, 2). as “the existential ground of culture and self” (csordas 1990, 4), modes of embodiment alter when cultures undergo radical transformations, such as during the covid-19 pandemic. csordas has rightfully warned for the disappearance of ‘bodiliness’ in a phenomenological anthropological approach, yet my informants do not even allow such a disappearance (1997, 4). as the older body is deprived of the ability to choose where to go, to care for the physical body and for the self in a rural setting, they witness how the material body becomes present, as much as it gets locked up and disappears (csordas 1997, 4; leder 1990). this social nature of bodily and psychological well-being is largely invisible for individuals, until usual modes of embodiment get violated (chao 2020), such as when serious illnesses or permanent disability take hold of the body, and even more so – or anew – in cases of an epidemiological threat that enforces a new normality (csordas 1999). although my http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 188 participants were used to being unhealthy before the pandemic, contemporary changes in habitualized practices and comportments make their older bodies “dys-appear” again (leder 1990), and thus become present, obstructive, and alien. a focus on bodily agency and sensations is more than just a methodological tool adding yet another dimension to data analysis (csordas 1997, 6). the fact that informants semiotically use the body to express their feelings, does not reduce it to a mediator or a site for cultural symbolism (csordas 1997, 12). the body is both a thing one has and what one is (leder 2004, 60) and as such allows the researcher to transcend the dualism between space and location, between body and mind, between self and other, and particularly in moments of transformation. a phenomenological lens allows us to examine closely both the habitual affective dispositions and the psychosocial and somatic consequences of their distortion (chao 2020, 2; csordas 1990). research over the last six months has shown how body techniques and body care practices have changed (arregui 2020; chao 2020; sear 2020). for example, many people have noticed that they use special sanitizers to clean their hands and surfaces more frequently and also the practice of medicated body care, such as the intake of dietary supplements, has changed (chao 2020, 3). in general, what elisabeth behnke calls the “habitual body choreography” has undergone dramatic changes, that often have to do with distancing, cleaning, monitoring, and waiting. such changes not only impact the immediate senses of freedom, agency, and well-being, but concomitantly influence the imaginary of the future (behnke 1997, 181). worries about one's psychological and physical well-being, together with fears about getting infected by the virus, might provoke depressive states linked to the loss of futurity that is already endemic in rural areas. here, the isolation of the body in space is an immanent feature of the landscape, and even more so for older people. the ethnographic material on older bodies in karelia presented in this article, clearly shows how the changes in habitual practices required by the covid19 pandemic, result in a compressed body: a body locked-up in space, time, and the self. methodology unlike the bulk of gerontological works which analyze the loneliness of older adults during a pandemic in large cities or nursing homes, i consider the narrative shifts in the lives of older adults living in rural areas (berg-weger et al. 2020, 457; krendl and perry 2020; van tilburg et al. 2020). these narratives tell of isolation, of the dependence on the few contacts with ‘unlikeable’ neighbors to see to their basic needs, and of the impossibility to care for oneself and of a lack of futurity (bascu et al. 2014, 2; hinck 2004). this piece is based on an ethnographic study conducted in two villages in the south of the republic of karelia. the ten informants of this study range in ages from 66 to 99, have various chronic diseases, and live alone. their education and professions vary, but most of them have worked in agriculture. they are also well versed in other skills, such as fluency in german, welding, driving, and sewing and embroidering national karelian costumes. some also participate in the national karelian ensemble. based on a previous study with the same informants in 2019, in the context of an oxford russia fellowship program, i was able to have them keep a diary of observations on the peculiarities of their daily lives during the covid-19 pandemic, which allowed for comparisons of their current situation with their situation a year ago. during interviews by phone, i asked participants questions about the peculiarities, difficulties, and changes during the pandemic and about the problems associated with living in rural areas at that time. these interviews served to supplement the information gained from the diaries. http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 189 setting: rural infrastructure deficits the field site is located in the south of karelia on the shores of lake ladoga. the approximate distance between the villages is 15 km and the distance between the villages and the nearest town is 103 km. the names of the villages are anonymized for ethical reasons under the pseudonyms, renelle and pyatnoye. the number of residents in renelle is 20 people in the winter, whereas in the summer it increases due to tourism. in the village of pyatnoye the number of residents increases to up to 50 people in the summer for the same reason. as carrie henning-smith (2020) argues about the effects of the pandemic on older adults living in rural areas in the us, a generally lower standard of living – the fact that rural residents commonly have less financial resources and low access to health care – makes them more vulnerable to the consequences of the covid-19 pandemic per se (396). the same can be argued about the living conditions in karelia. houses are heated with wood-burning stoves, as there is no gas supply in the villages. there is also no centralized water supply and the inhabitants have to carry water from the wells that are usually dug on their sites. there is no regular bus service to the city (petrozavodsk) or to the district center, where the outpatient clinic is located. medical care is limited to the primary health care point that all rural areas in russia have. the only means of transportation for older people, for example to a hospital in the city or an outpatient clinic, is a taxi. aging in rural areas in russia is hence characterized by the gradual loss of mobility. the lack of transportation between villages and the regional center, prevents older adults from traveling to relatives over long distances and seeking the medical help they need (barnes et al. 2006; hoff 2008). furthermore, older adults in rural areas generally do not have a computer and do not have access to the internet. apart from sergey, my informants are exceptions in this regard, as they all have access to the internet. as in many peripheral, rural areas, karelia thus faces a lack of infrastructure. while this lack is normalized in the inhabitant’s lived world, when a person develops a chronic illness or grows older, the embodiment of this infrastructure also changes: an unhealthy body becomes aware of an imperfect landscape at the sensory level, as the modes of performing routine tasks change (arking 2006; carel 2018;tanner 2001, 261). brian larkin notes, as socio-material infrastructures allow control over the environment, breakdowns in these facilities and the structural imperfections of infrastructures, provoke a sense of loss of agency (2013, 337). i use the term ‘infrastructure deficit,’ to indicate the discrepancy between the desired performance of everyday routine actions and practices of the self, and the defective state of infrastructures on the conjuncture of age, chronic illness, and pandemic restrictions. every object and action in an inadequate infrastructure can affect the difficulties in maintaining "human status" (hillman 2014, 499; buse and twigg 2014, 14; lovatt 2018, 366). in my work, i analyze how this threat of ‘inhumanity’ becomes articulated in a body that becomes ‘squeezed’ and locked up due to physical conditions associated with infrastructure deficit on the one hand – which was in the villages before the covid-19 pandemic – and due to restrictions and isolation caused by the pandemic on the other hand. karelia has a large proportion of older adults. it is hence no coincidence that all of my informants are more than 65 years old. yet, aging well in karelia is difficult. in russia, both legally and at the level of care provision, priority is given to family care for older adults as well as for people with chronic diseases and impairments (bogdanova 2019; popova 2009, 179). family and informal networks of support (e.g., neighborhood care) gain particular significance in peripheral settlements, since alternative care centers or volunteer organizations are simply absent in these areas. over the past 15 years there has been a pronounced outflow of the younger population to cities, which has left many older adults living in the villages without family care. this has also led to an increase of the role of neighborly care (“russia the land of dying villages” 2016, 11-15). at the moment of research, because of the security measures taken http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 190 to control the pandemic, relatives of older people – who live in cities far away from the villages – were not allowed to visit, and the aged inhabitants found themselves cut off from their networks, relying even more on neighborly care. in this article, i focus on three interviews with informants, which i call, for reasons of confidentiality, marina, ekaterina and sergey. i have chosen these three cases out of ten collected during fieldwork, as the informants have different histories of embodying village life. for example, marina has lived in the village all of her life, while ekaterina has been living in the village for 18 years. sergey has been living in the village for only five years. also, sergey's case is particularly different in that this story recounts family life, in contrast to the cases of marina and ekaterina, who live alone. while they have a different relation to living in the village, their stories of living through the pandemic show striking similarities. stories of remoteness marina marina is a 73-year-old woman, who has lived in renelle for almost all of her life. seven years ago, marina was diagnosed with a severe spine disease for which she underwent an operation a year ago. now, she can barely walk without her cane. she has a stooped posture, and takes careful steps, especially on surfaces that are slippery from ice or rain, so as not to injure her sore legs. she is nevertheless engaged in farming and gardening to keep herself active. in the springtime, marina is busy working in the yard and preparing the necessary seedlings for planting. she loves to talk about her life with me and tells me during an interview: if i wouldn’t have this backyard, i would get very bored, sitting here all day. that’s why i asked seasonal workers to take care of the garden, and we pay them for it, because the pensions will not increase. and, of course, the garden allows me to escape from everything. marina lives alone in renelle. as she notes: i used to live here with my son, but everything changed when he died, five years ago. now i need to do everything by myself. that’s actually pretty easy, because i have my neighbors that live in these three other houses here, and there are still some younger people living here too. once a week, marina usually takes the bus into town to buy groceries and to go to see her friend whom she met when they were together in the sanatorium, “to communicate.” marina clearly differentiates between live interaction and the “communication notebook.” “no one and nothing can replace a live chat, i don’t feel this satisfaction of being close to someone when talking on the phone, or via the internet,” she says. she stresses how much she loves chatting with her close friend who lives in the city. communicating with her friend became especially important for marina during the pandemic, when offline contacts became as limited as possible. with the beginning of the covid-19 pandemic, marina’s life dramatically changed and her ‘pandemic’ life became the diametrical opposite of her ‘normal’ life. the most important change was the feeling of a gradual increase in physical and social distance, she told me. while she tried to hide these feelings for herself, and not let them get to her or reflect on them too much, she did share that she literally feels the effects of this isolation. when she looks in the mirror, she sees “how aged this body is, and it has nothing to do, because it just sits here, at home and doesn’t see any need to make herself look better, to go out.” http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 191 this feeling came gradually and grew stronger with each passing day. during an interview marina said this feeling was due to the fact that she could no longer drive into the city. on april 10, 2020, she writes in her diary: i only have the shop trailer [who passes by the village every day], but he does not take the products i want. now that i cannot go to the city, i just sit here, at home, and can only hope for myself. if it would only be possible to ask the other neighbors, but we just don’t get along very well. during a subsequent interview, marina also emphasizes that the feeling she has in this situation is associated with “being locked up”: “with this epidemic, i have lost almost everything: the ability to communicate or even to visit a friend in the city. they locked me in here and now we all seem like neighbors that are voluntarily imprisoned.” the emotional discomfort of loneliness, which is the consequence of this feeling of physical isolation and being stuck or “locked up,” is compounded by the aggravated fear of being isolated from civilization and of not receiving the necessary assistance, when, for example calling an ambulance. marina recalls: before, i was also afraid that ambulances would not come in time, or wouldn’t drive at all, but now i am even more afraid of what we have here [in karelia] … so now these viruses are circulating, and this means that just waiting for them to come is useless. so, i could just as well sit here waiting until i die. fears about her health and the provision of medical care are not only related to deficit medical infrastructures, but also point to how informal care infrastructures have changed during the pandemic. on april 19, 2020, she writes: … it is better not to go there [the city], but now it has also become impossible to buy medications. so, i have to ask the neighbor who lives there, in the last house, whom i have a good relationship with, to buy them and bring them to me. that’s life around here now. marina is not only afraid that she will have to buy the cheaper drugs – not the ones ‘from the city’ – and that this will affect her physical health, but also regrets that she is now forced to deal with the neighbors in such a way that makes her dependent on them. marina reports that she used to have little contact with neighbors, and did not even very much like talking to them, but that the circumstances have developed in such a way, that now she has to talk to the neighbors and ask for their help. as she told me during an interview: in the past, the contact with my neighbors was limited to ‘hello’ and ‘goodbye.’ ok, you know that they have some problems, but now even all this communication is reduced to zero. but now that i am isolated, all hope rests on the neighbors and other people, because they are the only ones who are still there. all this contributed to what marina found the most difficult in this pandemic life: a bodily experience of isolation and closedness. this feeling resonates with the existential fears of other informants, who clearly associated the fear of isolation and the lack of communication with a loss of agency. for marina, who was used to being ‘restricted’ in a particular way, such fear is associated with the inability to go where she needs and wants to. as marina noted in an interview: http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 192 i used to always go somewhere here, but now, to sit here, in a confined space and within four walls, you can hardly call that pleasant. i'm afraid this is how i’ll sit here for the next year and that my brain will ultimately give up, that i will forget everything and go completely mad here. marina’s fear of isolation is infused with fears of psychological and physical deterioration, of the loss of joy and freedom in life (through travel and communication with friends) and of a general loss of agency. in this situation, where she feels deprived of high-quality physical care, of her privileged social contacts and of her daily activities, the body, as marina notes in her diary, “becomes closed and squeezed up in a narrow frame.” she doesn’t feel safe or protected in renelle, but feels herself aging rapidly through the ‘squeezing’ of the body, which she sees reflected in her mirror image of an old woman, locked up in a small village, with a lack of communication. not being able to go and see her friend in the city increases her sense of isolation, and the poor relations with her neighbors only further affect the fact that marina feels alone in the countryside. ekaterina ekaterina is a 79-year-old woman, living in pyatnoye. two and a half years ago she suffered from a heart attack and, after a period of rehabilitation she returned to live in the village. ekaterina has two children, a son and daughter, who live and work in st. petersburg. as she told me during an interview before the pandemic, her health problems were gradually developing into the “right direction,” but anxieties around her health and well-being have remained: yes, i’ve degenerated already, but i can say that i’ve gotten used to living with the disease like this. still some problems remain: there are the pains in my back, but most of all i suffer from the fear that there are problems with my lungs. especially in the current situation i don’t have peace of mind about my lungs, especially since, when the virus hits me, it can immediately stick to them. ekaterina’s fear is legitimate, because about a year ago she suffered from pneumonia. in despite of these physical discomforts, ekaterina’s life before the pandemic consisted of constant traveling: i’m not used to sitting still and i don’t like it either. it is important for me to go somewhere. i go to the children almost every week or i go to my friends. one friend of mine lives in pskov and a second friend lives in moscow. i mostly take off for three to four days a week and now what!? i wanted to go to sochi in april, but everything got cancelled. then i planned on going to abkhazia in the summer, but maybe that won’t happen either. for ekaterina, it’s vital to have the possibility to be mobile and to constantly be in different places: when i am at home, i always think about where to go next, for a weekend, or on a trip somewhere for just a day or to petrozavodsk by bus, that’s not so far away and not expensive. sometimes i even go there for a long weekend, like it was the eighth of march, or i go for two or three days to the children in peter [saint petersburg]. ekaterina often refers to the space of the village as an unfriendly and unhomely place, that she doesn’t like, and often adds: “what's there to do?” the isolation due to covid-19 security measures have http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 193 violated the future plans of ekaterina, who also experiences the loneliness as closely related to closedness, reticence and sitting in one place. in an interview i had with her before the pandemic, she said: for me, to sit here would be a death penalty. in the summer there may be some work in the garden, something to plant or to take care for the vegetable garden. but in autumn, and especially october, when at four or even three it's already dark, it is like death. therefore, i don’t love this time of year, and i want to go somewhere, and not sit here all the time. i would die of boredom if i did. little did ekaterina nor i know that this dreaded life in the village would soon become an everyday reality. now, during self-isolation, ekaterina feels her daily life gives her a sense of uselessness and of being unable to exert control over her life and her time. as she told me: what they have now invented [self-isolation] is essentially just to restrain people. i can’t tell you how many movies i sent in whatsapp, saying that it's all invented, and that there really is another story, that’s not being told. but what is there to do about it?! in the meantime, i am just sitting at home, not knowing when this will eventually end up in complete degradation. like marina, ekaterina felt the solitude physically: she feels that the ability of her body to move, to act, to socialize, has become redundant. as she cannot dispose of her own body, and cannot control its movements, isolation affects her emotions and sense of self, articulated in a bodily sensation of being obsolete. physical isolation – the restraining of the (social) body – has contributed to the depersonalization or anonymization of ekaterina’s body. if, previously, ekaterina’s body was skilled in navigating her social terrain, and able to exert agency and claim independence (for example, through choosing the right medical treatment or going to the city and communicating with relatives and friends), the current restrictions limit her personal agency and thus affect her bodily sensation of self. she feels her particularity being dissolved into the general situation of quarantine. whereas, before, she could take up the power over how to live with her disability, even when basically restricted by the space of the village and its deficit infrastructure, this is no longer the case. these changes in daily routines and sense of self both marina and ekaterina experience, are primarily associated with how the immanent restrictions of living in a peripheral settlement were now exacerbated. the psychological and health consequences of the pandemic make salient how isolation is a constant threat for older adults living in these rural areas, and how easily they can lose the possibility to overcome this threat. sergey sergey, a man of 82-years-old, has always worked as a truck driver. he used to live in the south of russia with his wife, but when he developed cancer in the soft tissues of the hand, they had to move up north. they had already bought a house in renelle five years ago, and now they live there permanently and rent an apartment in the city for sergey to stay for two to three days when he needs to go to the oncologist in st. petersburg twice a month. sergey and his wife live alone as their son died in the war in afghanistan. sergey’s cancer is now in remission, yet he also had cataracts for which he had surgery just a month before the outbreak of the pandemic. for sergey, the greatest difficulties of life in isolation are caused by his relationship with his wife. if, earlier, he had the opportunity to go somewhere and http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 194 spend time away from his wife, now, during the period of isolation, sergey notes in an interview, life with his wife causes him a lot of problems: before the pandemic, i could decide to go to the city, for two or even three days, but now what happens?! now i am here, with her, constantly, within these four walls. we are just sitting here, day in day out, and do nothing. that’s why this isolation is hard labor for me: i am constantly seeing her. in this case, family relationships and interactions, in the form of communication with his spouse, become a limiting factor that suppresses agency and brings to the fore the immanent restrictions of the village for him. these relations appear to be insignificant and unfulfilling for sergey. as he mentions in an interview: we sometimes don't talk for two or three days here, and just sit, in silence. so, in the end, i don't know what’s worse: being infected with the virus or being forced to put up with her. the situation of the pandemic that forced many people to constantly be in the company of the family, has affected the quality of life in many households. family relationships have become a burden for people, and this leads to numerous quarrels and scandals in the intimate sphere. an important factor which changed the life of sergey with the advent of the pandemic is the loss of the ability to communicate and be mobile: life has always been like in prison here [in the village], and now it's even worse. it has really become even harder now, as involuntary imprisonment; you are expelled from the real life; you just have to walk when you have to and otherwise sit still. physical distancing and the fear of contracting the virus from neighbors have become the main satellites of sergey's life. he feels he leads “some kind of maniac life; when you can only think about ‘distance’ and how to consider keeping this distance.” for sergey, as for marina and ekaterina, the inability to travel during the pandemic is highly problematic. as he tells me during an interview, he can't even go to the grocery store anymore. before, he notes, he stayed in the village for two or three days, but not more. then he wanted to go somewhere “to party or just relax, even just to go to the city.” now the question arises as to the possibility of making such a trip. besides the fears of being locked up with his wife, unable to “relax” or go to the city, sergey also faces the fears associated with the inability to receive any medical care. sergey writes in his diary (april 29, 2020) that he fears catching the virus: two weeks ago, i had a splinter in my arm which causes me pain. now, next week, we have to go to the doctor’s, and it will most likely have to be cut out. but who knows if there’s not an infection in the clinic, because generally there is where you pick it up. so, i will just sit here and suffer to the last. sergey, thus, says that he will not go to the doctor to seek medical help unless for example, the pain in his hand would become intolerable: “if it’s absolutely necessary, as with the hand, then yes, you have to,” he tells me, “but of course you will try anything not to go, because otherwise you also risk to catch something there, and die.” coronavirus changed the life of sergey completely. he feels being “put in a situation where every day you have to deal with the same neighbors.” distanced from the city and http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 195 forced to share the house with his wife, sergey is increasingly lonely. on top of that, he faces the fear of contracting the virus. while relatively safe in the village on the one hand, he suffers from “the space of boredom.” for sergey too, these bodily restrictions negatively impact his ability to manifest agency and autonomy. this lack of agency might have been immanent before the outbreak of the pandemic, but is felt primarily now, as he loses his previous ability to escape these constraints. sergey reflects what appears to be the characteristic plot of an isolated body in karelia: a body deprived of the possibility to choose its own leisure or to move where it is needed – for either physical or psychological well-being, to purchase necessary medicines or “to relax.” enclosed and entrapped, he feels he is without future perspective. conclusion these ethnographic cases consider the experiencing older body in karelia, as it hampers and suffers to transition from one mode of isolation and impairment to another. they highlight how, as social and material resources necessary for an older person to live a life worth living here are changing due to physical restraints and a concomitant loss of agency, multiple, interlocking sensations of enclosedness become prominent. the fear of losing out on ‘proper’ health care and ‘proper’ communication, impact the physical and mental health of older adults living here, and both are felt in the perception of space. these specific changes make rural areas the most dangerous and disadvantaged for older people. “it’s even worse than prison,” sergey notes, while marina and ekaterina feel they are left to die. analyzing incarcerated lives in the us, drew leder notes that phenomenological approaches are dedicated to “investigating and describing the structures of human experience: time and space as lived, movement and perception, the embodied self in its encounter with objects and others” (2004, 52). the pandemic has revealed that, today, the village is experienced as “worse than prison” because the village as a lived spatio-temporality, appears to be only ‘homely’ due to the ability to overcome its boundaries, to escape it and nourish the future that comes from outside the village space (leder 2004, 56). the space as lived is made up of possibilities and realizations that, due to the pandemic, are altered and shortcut (2004, 57). as the participants witness, this not only means that space becomes condensed, but also that the body itself feels “squeezed up,” left to the passage of time and to degenerating due to a lack of futurity. leder remarks that the spatial constraints of the prison are capable of creating a direct opposition between body-self and the embodied self in space (2004, 60). the stories of older adults in south karelia similarly remind that our bodies do not live in abstract spaces but in meaningful spaces, defined by a house, village or city where our life unfolds (leder 2004, 56), and by the possibility to leave that space. as such, the space itself can be said to be made up of the possibility to meet friends who live far away, but with whom important emotional moments of our life are connected. the disorientation of the self in the rural spaces of karelia demonstrates that the sheer spatio-temporality of the village changes as these possibilities are curtailed. covid-19 restrictions have affected exactly these strategies, relations, and movements, that made up the village as a lived and livable space. however particular, the stories of karelia from marina, ekaterina, and sergey are no exception. this situation is quite typical for many russian regions, where the pandemic has further aggravated the inaccessibility and isolation of peripheral territories and has especially impacted the agency of older adults living there (galkin 2020, 75; zvyagincev and neuvazhaeva 2015). sociological and anthropological work on the effects of covid-19 restrictions on older adults living in the city has also noted that the pandemic primarily affects the sense of space, with familiar spaces becoming alien and inaccessible to older people and the very orientation in such spaces is lost (van dorn, cooney, and sabin 2020; furceri et al. 2020). yet where there might be similarities in sensed freedom and belonging, this ethnographic analysis shows a particular pattern when ‘emergency’ restrictions expand on the usual http://anthro-age.pitt.edu/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 196 infrastructural deficits of rural areas and impact the habitual comportment of older adults in overcoming these limitations. various anxieties about one’s physical health (e.g., the inability to go to a hospital in the city or an outpatient clinic in the district center) have a severe impact on the mental health of older adults. furthermore, one is not only limited in exerting agency over one’s physical health, social well-being is affected due to covid-19 related restrictions. the participants tell about the burden of communicating with their neighbors and the loss of a live chat. the space of the village becomes not just closed, but disorienting for people, as the cities where relatives and friends live are inaccessible, and the living space that held such promises for escape has lost this promise and has become limited to the spaces of the garden, the streets and the forests that outline the village (philo, parr, and burns 2003, 259; skinner, andrews, and cutchin 2017). fears that characterize the pandemic episode can be represented on a continuum, with on the one end the fear of isolation and the contingent psychological and physiological effects, and fears of possible infection on the other. while this toxic combination is crisis-bound, the sense of uselessness and a complete loss of agency and self is immanent to being “stuck” in the village, which, also before the pandemic, the informants described as unfriendly and not inviting for staying long in this one place. with the effects of infrastructural deficits exacerbated by the increased loss of mobility there is also the fear that the sick, older body will become completely invisible to the medical world. whereas this was a structural threat before the pandemic, the older body that could buy the necessary medicines and dispose of his or her own body, self, and freedom, could escape this fate. in pandemic times, due to physical and social constraints, this option is increasingly less likely. while health decreases, the fear of contracting the virus increases day by day. squeezed in between two poles, dangers lurking from both sides, the participants report the fear of becoming essentially nobody, with nowhere to go. references “rossiya — strana umirayushchih dereven.” 2016. centr ekonomiche-skih i politicheskih reform. [russia is a country of dying villages]. accessed november 18, 2020. http://cepr.su/2016/12/09/россия-странаумирающих-деревень/. arking, robert. 2006. biology of aging: observations and principles. oxford university press. arregui, anibal garcia. 2020. “viralscapes: the bodies of others after covid-19.” allegralab march 31, 2020. https://allegralaboratory.net/viralscapes-the-bodies-of-others-after-covid-19/. bascu, juanita, bonnie jeffery, sylvia abonyi, sylvia johnson, nuelle novik, diane martz, and sarah oosman. 2014. “healthy aging in place: perceptions of rural older adults.” educational gerontology 40 (5): 327-337. barnes, sarah, merryn gott, sheila payne, chris parker, david seamark, salah gariballa, and neil small. 2006. “characteristics and views of family carers of older people with heart failure.” international journal of palliative nursing 12(8): 380-387. berg-weger, marla and john morley. 2020. “loneliness and social isolation in older adults during the covid-19 pandemic: implications for gerontological social work. nutr health aging 24 (5): 456-458. behnke, elizabeth. a. 1997. “body.” contributions to phenomenology 18: 66-70. bogdanova, elena. 2019. “the care regime for elderly people with limited mobility in peripheral settlements: successes and failures in overcoming social exclusion.” critical sociology of care. intersections of social inequality. european university press. buse, christina, and julia twigg. 2014. “women with dementia and their handbags: negotiating identity, privacy and ‘home’ through material culture.” journal of aging studies 30: 14-22. carel, havi. 2018. illness: the cry of the flesh. london: routledge. http://anthro-age.pitt.edu/ https://allegralaboratory.net/viralscapes-the-bodies-of-others-after-covid-19/ galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 197 chao, sophie. 2020. “health, harm, habitus: techniques of the body in covid-19.” https://thesiseleven.com/2020/07/07/health-harm-habitus-techniques-of-the-body-in-covid-19/. csordas, thomas j. 1990. “embodiment as a paradigm for anthropology.” ethos 18(1): 5-47. csordas, thomas j. 1993. “somatic modes of attention.” cultural anthropology 8(2): 135-156. csordas, thomas j. 1997. “introduction: the body as representation and being-in-the-world.” in embodiment and experience: the existential ground of culture and self edited by thomas j. csordas, 1-26. cambridge: cambridge university press. csordas, thomas j. 1999. “embodiment and cultural phenomenology.” in perspectives on embodiment: the intersections of nature and culture. edited by gail weiss and honi fern haber, 143-162. frank, arthur. 1991. at the will of the body: reflections on illness. houghton mifflin. furceri, david, prakash p. loungani, jonathan david ostry, and pierto pizzuto. 2020. “will covid-19 affect inequality? evidence from past pandemics.” covid economics 12(1): 138-157. galkin, konstantin. 2020. “rezhimy zaboty i samozaboty pri otdel'nom prozhivanii pozhilyh lyudej v periferijnyh poseleniyah” [modes of care and self-care when elderly people live separately in peripheral settlements] sociologicheskie issledovaniya [sociological research] 9: 70-78. haraway, donna j. 1991. simians, cyborgs, and women: the reinvention of nature. new york: routledge. henning-smith, carrie. 2020. “the unique impact of covid-19 on older adults in rural areas.” journal of aging and social policy 32(4-5): 396-402. http://orcid.org/0000-0002-0273-0387. hillman, alexandra. 2014. “‘why must i wait?’ the performance of legitimacy in a hospital emergency department.” sociology of health & illness 36(4): 485-499. hinck, susan. 2004. “the lived experience of oldest-old rural adults.” qualitative health research 14(6): 779-791. hoff, andreas. 2008. tackling poverty and social exclusion of older people: lessons from europe. oxford: oxford institute of ageing. krendl, anne c., and brea l. perry. 2020. “the impact of sheltering in place during the covid-19 pandemic on older adults’ social and mental well-being.” the journals of gerontology series b. larkin, brian. 2013. “the politics and poetics of infrastructure.” annual review of anthropology 42: 327-343. leder, drew. 1990. the absent body. university of chicago press. leder, drew. 2004. “imprisoned bodies: the life-world of the incarcerated.” social justice 31(95-96): 51-66. lovatt, melanie. 2018. “becoming at home in residential care for older people: a material culture perspective.” sociology of health & illness 40(2): 366-378. philo, chris, hester parr, and nicola burns. 2003. “rural madness: a geographical reading and critique of the rural mental health literature.” journal of rural studies 19(3): 259-281. popova, daria. 2009. “transformaciya semejnyh cennostej i vtoroj demograficheskij perekhod v rossii: kto v avangarde?” [transformation of family values and the second demographic transition in russia: who is in the vanguard? ] in roditeli i deti, muzhchiny i zhenshchiny v sem'e i obshchestve [parents and children, men and women in the family and society] edited by sergey zaharov, tatyana maleeva, and oksana sinyavskaja, 163-184. sear, cynthia. 2020. “porous bodies: corporeal intimacies, disgust and violence in a covid-19 world.” anthropology in action, 27(2), 73-77. skinner, mark, galvin andrews, and malcolm cutchin, eds. 2017. geographical gerontology: perspectives, concepts, approaches. new york: routledge. tanner, denise. 2001. “sustaining the self in later life: supporting older people in the community.” ageing & society 21(3): 255-278. http://anthro-age.pitt.edu/ https://thesiseleven.com/2020/07/07/health-harm-habitus-techniques-of-the-body-in-covid-19/ http://orcid.org/0000-0002-0273-0387 galkin | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.316 http://anthro-age.pitt.edu 198 van dorn, aaron, rebecca cooney, and miriam sabin. 2020. “covid-19 exacerbating inequalities in the us.” lancet 395(10232): 1243. van tilburg, theo g., stephanie steinmetz, elske stolte, henriëtte van der roest, and daniel h de vries, 2020. “loneliness and mental health during the covid-19 pandemic: a study among dutch older adults.” the journals of gerontology: series b. zvyagincev, vasiliy and maria neuvazhaeva. 2015. pereselency iz goroda v sel'skuyu mestnost': fenomen «obratnoj migracii» v sovremennoj rossii [the migrants from the city to the countryside: the phenomenon of "return migration" in contemporary russia] . mir rossii. sociologiya. etnologiya [world of russia. sociology. ethnology] 24(1): 101-135. http://anthro-age.pitt.edu/ book review review of hauderowicz, dominique and kristian ly serena, eds. age-inclusive public space. berlin: hatje cantz verlag. 2020. pp. 237. price: $32 (hardcover). patrick devlieger ku leuven patrick.devlieger@kuleuven.be marc dujardin ku leuven marc.dujardin@kuleuven.be anthropology & aging, vol 42, no 1 (2021), pp. 173-176 issn 2374-2267 (online) doi 10.5195/aa.2021.347 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | devlieger and dujardin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.347 http://anthro-age.pitt.edu 173 book review review of hauderowicz, dominique and kristian ly serena, eds. age-inclusive public space. berlin: hatje cantz verlag. 2020. pp. 237. price: $32 (hardcover). patrick devlieger ku leuven patrick.devlieger@kuleuven.be marc dujardin ku leuven marc.dujardin@kuleuven.be age-inclusive public space is edited by dominique hauderowicz and kristian ly serena, owners of ‘dominique + serena,’ a young copenhagen-based architectural firm that operates at the crossroads of architecture, art, and politics. the book documents conversations with 19 other architects, geographers, psychologists, philosophers, and social scientists, each of them writing with a very clear perspective of using, designing, and transforming public space into age-inclusive space. this book speaks to us, the authors of this review, who are an anthropologist and an architect with a clear pedagogical purpose, namely, to teach our students in architecture and anthropology in a cross-faculty course that we have called design anthropology. this course bridges disability design studies and architectural anthropology and would benefit from utilizing this book as a major reference tool. age-inclusive public space is a timely and engaging book for students and practitioners alike, and will stay relevant for years to come. the book is attractively produced with a cover in tissue, a very clear outline, references throughout the pages, and connections between the different chapters. it follows a logical framework that carefully manages to benefit from many disciplines, including architecture and anthropology. the book is organized into five parts. each part is introduced with an introductory essay and followed by short illustrative chapters. the included color photographs in the book are not merely illustrative; they require and invite readers to study them. the last part is the longest and ensures that readers will not only be able to think about what they learned but also to put this knowledge into practice. this makes it a very enchanting and inspiring publication that may appeal to a wide audience. the editors work through a simple yet fundamental thesis, namely that age-segregated spaces are not likely the solution for the challenges of an aging population. they assert that spaces that are created for particular age-groups, such as playgrounds (whether they are designed for children, adults, or elderly people), are rather limiting. again and again, somewhat in theoretical terms, but surely in examples and some nicely executed drawings and photographs, the authors provide many practical tools that help the thinker and the practitioner. http://anthro-age.pitt.edu/ book review | devlieger and dujardin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.347 http://anthro-age.pitt.edu 174 the theoretical tools to think through the central thesis of the volume are provided throughout the book. they comprise of four introductory thematic chapters headed by design stimulating and inspirational keywords “ageing (& public space),” “elasticity,” “agency,” and “belonging.” elaborations on elasticity of space, borders and borderlands, in-between spaces, landscapes, bodies and senses, and affordances provided in these thematic chapters are insightful and practical. these concepts surely highlight the central thesis of the book, but also provide ample evidence that they can be translated in useful and microlevel design interventions, such as the implemented design for a polyvalent landscape of south zealand in denmark (196-199). throughout the different contributions, there are both positive cases and cases that introduce the limitations of designing age-inclusive public spaces. three cases are particularly noteworthy. firstly, in chapter 2, “elasticity” (68-71), the editors focus on ‘seeing’ sites of elasticity. elastic in-between space, as can be seen in amsterdam, from the work of dutch architect aldo van eyck, is space that is initially not intended or lost space, such as the side-walks and other areas that van eyck created. in-between spaces provide space in which nothing should be happening, but in which brief social contacts, encounters, and exchanges could occur between people. in-between space increases the landscape of affordances. secondly, in chapter 4, “belonging,” the editors explore the japanese facility, aoi care (130-137). it is a ‘rare’ example of a small-scale multifunctional care home or takurosho that is embedded in the local community. the key intervention here was tearing down the walls that previously surrounded the facility, so that everyone could enter and leave the space freely. the facility thus became inclusive because it allowed and enabled more connection. the space could come to life and be constantly thickened and redesigned through the trajectories of various people of different ages and thus enhanced the potential of intergenerational contact. thirdly, chapter 5, “play street, the transformation of a copenhagen play street” (168-173), shows another interesting case study in two photographs: one of the situation of a playground street in the 1950s, when it was closed to traffic, and a photograph by dominique + serena of 2019 when the street was again adapted and certain areas fenced off for ball games. creating such user-specific spaces seems counterproductive to the idea of advocating and creating age-inclusive layouts of public space. this example shows how the potential of spaces to be elastic can also limit their inclusivity. in this case, fencing off an already car-free playstreet was an unnecessary intervention, curtailing the possibilities for social contact between the primary users (children) and passers-by. part 5, “designing for agency & belonging” (152-230) is the most elaborate. interestingly, the concept of agency was already introduced in chapter 3, by presenting active lives through movement and participation, but is here used to denote design attitudes. hauderowicz and serena argue for abandoning the idea of public space as a “performance landscape” and adopting the attitude of the “gardener responsible for setting the conditions for favorable practices to emerge” (153). this enabling attitude involves eliminating significant elements from public spaces to create openness, to allow ingoing and outgoing movement, and to make space for people to fill in the potential and to engage in place-making, thus creating the road to belonging. “polyvalence,” “atmosphere,” “reminiscence,” and “urban wilderness,” then become design practices that not only hold the potential for intergenerational contact, but more importantly enhance vibrant and interactive moves between designing and undesigning culture-specific public spaces. however, reading this book with experiences and perspectives from design anthropology teaches us that some of the keywords would better be substituted to prompt more and differently inclusive design http://anthro-age.pitt.edu/ book review | devlieger and dujardin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.347 http://anthro-age.pitt.edu 175 approaches. for instance, “age-neutral” (160) sounds weird and does not celebrate life in all of its diversity, and “age-inclusive,” as mentioned in the title of the book, invites for a more affirmative intergenerational approach to people-centered design and can hardly ever be ‘neutral’ in the way carbon-neutrality is discussed. similarly, in contemporary discourses, ‘boundaries’ refers to geographical and geo-political issues of closure and exclusion. “inclusive boundaries” (177) thus still emphasizes segregation rather than spatial and cultural mediation of human-environment relationships. on the contrary, the concept of ‘inclusive thresholds’—from gradual trespassing to inbetween and transitional concepts of public space—is far more inspirational to work with as a designer or to communicate what the more intrinsic (tangible and intangible) properties and qualities of the proposed design are all about, as they are put to work to embrace the widest spectrum of all-inclusive human ability. finally, the term “polyvalence” (178) is far too generic to explore as a triggering design approach. designing for ‘multiplicity’ and ‘sequential temporariness’ would have served the chapter better. but, the terms “atmosphere,”(200) “reminiscence” (214) and “urban wilderness” (230), on the contrary, are great entry points to inspire designers to produce more elastic space-time concepts. a concept in general not only implies a range of ideas, but also articulates a design intent to address a spatial and cultural question that seeks a solution, through the process of designing. architecture is here approached as a four-dimensional entity (of line, plane, volume and time); space and time are inseparable conditions when it comes to the experience of the built environment and this complexity is aptly captured in the aforementioned concepts. the term “atmosphere” as a design tool is inherent to any user-centered design process from the perspective of multi-sensoriality or what is referred to as haptic experience of space, taking all five senses (seeing, hearing, touching, tasting, smelling) into account as parameters for inclusive designing. following this inspiration, public space design takes all senses into consideration as a structuring principle to guide and reconnect people in a more convivial way (200-209). the usage of the term “reminiscence” in landscape design becomes obvious when the editors touch upon the metaphorical relationship between characteristic natural landscapes and abstracted versions of it, inherent to japanese design approaches. two self explanatory pictures (228229) show how the gravel courtyard with random rock (dry landscapes) temple compound in kyoto acts as abstracted rememberance of the japanese inland sea (wet landscape). the term “urban wilderness,” may well be the most convincing keyword to over-design or to un-design all together when it comes to reconvert public space vacancies. the tokyo playpark as “intergenerational wilderness” is a striking example (234-237). indeed, the elasticity of space could be profitably linked to the making and undoing of non-space, a concept that anthropologist marc augé (1995) introduced to characterize supermodern society. however, against augé’s arguing that places predominantly transform into non-places (augé 1995, 75115), we presume that supermodern societies such as in copenhagen, amsterdam, and tokyo too are capable of transforming non-spaces into spaces and places. furthermore, the idea of in-between space requires connecting with in-between time, which can be made possible through introducing other time regimes, through play, the cinematic, and the performative. the book is of interest to design anthropologists but could also have been of interest to architectural anthropologists if it delved into a much deeper examination of the body and the multi-sensorial (see also devlieger et al. 2006), the human, and the nonhuman in the environmental landscape. in his book, making, tim ingold (2013) examines the forces and processes by which bodies, tools, and materials connect into a craftlike activity. ingold argues that the four disciplines of anthropology, archaeology, art and architecture (the 4 as), are all or could be approached as ways of “thinking through making,” thus reminding of the shared modes of being in the world and knowing about it as theorists and practitioners (2013, xi). http://anthro-age.pitt.edu/ book review | devlieger and dujardin | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.347 http://anthro-age.pitt.edu 176 the book also has some limitations when it comes to the intercultural intent of the book. the bestpractice interventions to designing and building more age-inclusive public spaces may well have directed the reader towards different places in the world. the micro-level scale of each intervention, on the one hand, and the reciprocity in terms of environmental conditions between the cases presented, on the other hand, may well evoke a cross-cultural approach to the topic of “designing for agency and belonging.” however, aging people, disabled people, or otherwise excluded and marginalized people may practice alternative ways of belonging that emphasize more culturized models of inclusion than through design. in vertical countries, such as bhutan in the himalayas, the wheelchair is not a designed product fitting an adapted environment, but a person carrying disabled people up and down the hills, in natural and man-made environments (dujardin 2000, 2021). this requires thinking of the possibility of variation in inclusive practices, the landscape of care, and the cultivation of the vulnerable designer. bringing vulnerability more squarely into the design process might provide an opportunity of bringing into the discussion the process of design itself, with a body, senses, and mobility. an approach geared towards disability as ‘enabling’ human conditions could profit from an approach that looks at bodies as affordances and people-as-affordance (dokumaci 2019) and that looks to age-inclusive design as a vehicle to reconnect people at various levels of spatial and cultural interaction. references augé, marc. 1995. non-places: introduction to an anthropology of supermodernity. london, new york: verso. devlieger, patrick, frank renders, hubert froyen, and kristel wildiers, eds. 2006. blindness and the multi-sensorial city. antwerp: garant. dokumaci, arseli. 2019. “people as affordances: building disability worlds through care intimacy.” current anthropology 61 (s21). https://doi.org/10.1086/705783. dujardin, marc. 2000. “bhutanese architecture and the dynamics of tradition: an architectural study of identity and change in traditional dwelling culture and built environment.” leuven, phd. ku leuven. dujardin, marc. 2021. elg1 universal design course, ku leuven, faculty of architecture, campus sint lucas, ghent, ppt – lecture week one. ingold, tim. 2013. making: anthropology, archaeology, art, and architecture. london: routledge. http://anthro-age.pitt.edu/ https://doi.org/10.1086/705783 book review review of pasveer, bernike, oddgeir synness, and ingunn moser, eds. ways of home making in care for later life. london: palgrave macmillan. 2020. price: $125 (hardcover); $101 (ebook). francisca yuenki lai national tsing hua university laiyk@mx.nthu.edu.tw anthropology & aging, vol 43, no 2 (2022), pp. 102-104 issn 2374-2267 (online) doi 10.5195/aa.2022.430 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | yuenki lai | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.430 http://anthro-age.pitt.edu 102 book review review of pasveer, bernike, oddgeir synness, and ingunn moser, eds. ways of home making in care for later life. london: palgrave macmillan. 2020. price: $125 (hardcover); $101 (ebook). francisca yuenki lai national tsing hua university laiyk@mx.nthu.edu.tw ways of home making in care for later life examines the intersections of home, care, and older adults. in the introduction, the editors set the stage by encouraging the reader to understand home as a verb and to envisage how home intersects with care in later life as a making. the book covers different types of families in these home making practices, including adult children living with their parents (chapters 2 and 11), families who have members with the diagnosis of dementia (chapters 4 and 14), and transnational families (chapters 3 and 12). in addition, the book also focuses on different loci of home making and covers this process at different (semi-)institutional settings, such as co-housing initiatives, nursing homes, and residential dementia care institutions (chapters 7, 8, 9, 10, and 13). although all the chapters focus on western societies—mainly australia, the netherlands, norway, spain, and the united kingdom (uk)—the book also contains chapters that touch on transnational families (including karen and italian migrants in australia and sudanese migrants in the uk and the netherlands). at the intersection of two protean concepts like ‘home’ and ‘care,’ the editors reveal a wealth of practices, relations, and affects that push contemporary research on care and belonging forward. the book is organized in three thematic sections: “moving imaginaries,” “negotiating institutions,” and “shifting arrangements.” the “moving imaginaries” section investigates the home imaginaries held and performed by older adults, older migrants, and people with dementia, as well as by government authorities and students in architecture. a central lesson from this part is that these imaginaries are not fixed but continuously transform and make (new) interpretations of home with care possible. the second section, “negotiating institutions,” contains rich discussions of the ideals of homeliness and care practice in institutional contexts. this part shows that the intersections of home and care are ongoing experiments that disrupt as well as open up places of care. the chapters in the last section, “shifting arrangements,” argue that home need not to be a place but is first and foremost a quality of shifting arrangements of people, things, places and affects. this perspective allows the reader to understand care in later life as circulating and reciprocal, especially when home is not bounded to a singular place. as the editors explain in the introduction, the purpose of using verbs (moving, negotiating, and shifting) instead of nouns in the section titles is to “deeply uproot the trope of home and care as somehow fixed and stable repository” (6). the book shows how the meanings of “home” shift across various boundaries in the home making process, namely national boundaries (e.g., the experience of transnational families), the boundary between public and private (e.g., who defines and maintains boundaries between public and private life at care institutions), and the boundaries between safety and homeliness (e.g., dealing http://anthro-age.pitt.edu/ book review | yuenki lai | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.430 http://anthro-age.pitt.edu 103 with issues such as whether stairs should be removed or surveillance cameras installed at home). the volume offers ample examples of different ways in which boundaries are negotiated for home making. loretta baldassar, raelene wilding, and shane worrell (chapter 3) articulate the concepts of “local home making,” “community home making,” and “digital home making” to analyse the different ways the karen and italian older migrants in australia sustain their ideals of home when some of their kin members are living overseas. they pay particular attention to how care is done in a transnational setting with the help of digital technologies. wiring money (financial support) and making video calls (emotional exchanges) have become important means for older migrants to provide care to their overseas family members and sustain the ideals of home. with the concepts of “tinkering” (204) and “breaching experiments” (203), bernike pasveer (chapter 10) captures how boundaries of home and care, private and public, and life and death are negotiated at the hospice. she uses the ethnographic example of mrs. a, who was very ill with metastasized breast cancer and wanted to bring her sewing machine into the hospice to use after her condition would become relatively more stable. for mrs. a, this would allow her to feel at home in the hospice. however, for the hospice staff this particular desire of mrs. a demonstrates her unwillingness to face death, which runs counter to the aim of hospice care which is to make residents acknowledge and accept death in order to be able to achieve a “good death” (214). while the hospice encourages residents to bring in personal items to make themselves feel at home as a care technology, decisions on which items are welcome and which are not have become “breaching experiments” (203)—there are no clear guidelines, so both residents and care staff are tinkering with the specifics of care, while altering the meanings of ‘home’ and ‘good care’ in this process of negotiation. the book also includes a significant contribution to understanding the dynamic interplay between the caregiving role of older adults in a reciprocal care relationship and the meanings of home in later life. in chapter 14, christine ceci, ingunn moser, and jeannette pols, ethnographically document “shifting arrangements” in home making for older couples, where one partner has dementia and the spouse takes up a caregiving role. the case of ken and marla documents very well that “what home means in concrete situations is the result of the relationships that organize those situations” (309), a process that equally implies the organization of “stuff” (309). at a certain point in the disease process and their life trajectory, ken reports feeling that his home is disturbed as there is ‘no activity’ in the house, with daily activities becoming too complicated for marla. caring for marla 24/7 also makes him feel “trapped” at home (307). acting upon these feelings, marla was admitted to a long-term care institution. interestingly, after the move, ken witnesses that he is working hard to organize activities and build up a new life to fight being “trapped at home,” now that he doesn’t have to take care of marla anymore. the shifts in this story clearly show that for older adults—particularly when intensive caregiving is involved—‘home’ can come to mean different things in different circumstances, as relations, practices and “stuff” are rearranged along and across care. as the case of ken and marla illustrates, both permanent caregiving and the absence thereof in the home can cause a sense of entrapment with the primary caregiver. how does gender matter in the process of home making and care provision? in chapter 8, daniel lópez gómez, mariona estrada canal, and lluvi farré montalà show how care work is both gendered and de-gendered, by comparing two senior co-housing initiatives in spain, el hogar and la comunidad. the majority of the residents at el hogar are single or widowed women. these women report appreciating that external staff at el hogar is responsible for the housework because this leaves them with more time for their hobbies. in contrast, the majority of residents at la comunidad are married couples and 45% of the residents are men. la comunidad emphasizes mutual support rather than taking over care, leaving the residents fully responsible for hands-on daily tasks. it is common for the women to do informal care http://anthro-age.pitt.edu/ book review | yuenki lai | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.430 http://anthro-age.pitt.edu 104 while the men run errands. as the authors note, these two co-housing initiatives produce two different gendered modes of home making. frode f. jacobsen (chapter 5) similarly investigates the intersections between care in later life and home making in analysing the politicization of aging-in-place in norwegian public policy papers, with a focus on the diversity of older adults with regard to gender, social class and ethnicity. jacobsen argues that the aging experience is shaped by culture; therefore the meaning of home and public policy on home care should take full consideration of social factors, such as gender and social status, as they shape the needs and preferences of different older women and men. gender matters in the aging process. it could be as subtle as the daily division of labour between women and men at their place of residence or as significant as the public policies on service provision for women and men. trained in the anthropological tradition, i find this book to be very engaging and a delight to read because most of the chapters provide solid case studies, interview quotes, and fieldnotes that unravel the relationship between the notions of home and care for older adults across the globe in different living situations. the book makes a valuable contribution to aging studies and care research, and is suitable for graduate students and researchers who are interested in aging subjectivities, meanings of home, care practice, and personhood. http://anthro-age.pitt.edu/ role of cultural capital and cultural reproduction on youth development in india: a generational perspective simran ganjoo sunil k. verma ganjoosimran9@gmail.com verma.sunil77@gmail.com vivekananda college, university of delhi vivekananda college, university of delhi abstract the present study endeavored to understand the perceptions of indian older adults (age 60 and above) from urban centres of new delhi, kolkata, and mumbai, about the state of youth development in india through applying a generational perspective. drawing from our understanding of bourdieu’s concept of cultural reproduction of values, the study explored older adults’ thoughts about the current state of indian youth concerning their civic participation and contribution to the development of indian society. additionally, it sought to find familial roles that the elderly would like to undertake to support their younger family members. thematic analysis revealed that the older adults in this study perceive that youths are not completely engaged in positive youth development and need to contribute more towards their civic societies. additionally, the older adults expressed their interest in occupying the role of secondary socializing agents in the family due to their perceived intergenerational differences with youth. keywords: cultural capital; cultural reproduction; positive youth development; india anthropology & aging, vol 42, no 2 (2021), pp. 137-149 issn 2374-2267(online) doi 10.5195/aa.2021.326 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. ganjoo & verma | 137 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu role of cultural capital and cultural reproduction on youth development in india: a generational perspective simran ganjoo sunil k. verma ganjoosimran9@gmail.com verma.sunil77@gmail.com vivekananda college, university of delhi vivekananda college, university of delhi introduction india, the second-most populous country and democracy in the world, is continuously changing and evolving to contend with the many outside forces and challenges it may face. such changes are either in the form of significant developments meant to benefit citizens, while other changes prove to be maladaptive, leading to violence, disruption, communal riots, poverty, and unemployment, amongst others. for example, in 2019, india witnessed the citizenship amendment act – national register of citizens protests. students actively participated in these protests and advocated for societal and political change. youth power was utilised by many different political parties like the national student’s union of india in both constructive as well as destructive manners. the entire country witnessed students emerging as leaders (shankar 2020). protests and similar types of unrest caused by social issues demand attention through effective citizen civic engagement. youth, specifically in india, have been at the forefront of many past and recent movements. in this regard, ‘youth unrest’ is a term that refers to the collective dissatisfaction faced by an entire youth population of a country and the youth population also has the potential to initiate civic engagement in the country. the concept of civic engagement can be understood as a broader concept including political, social, and moral involvement (berger 2009). in berger’s (2009) view, social engagement is understood as a part of civic engagement, which is not necessarily related to political activity. at the local level, civic engagement includes membership in local organizations, involvement in various programs, or involvement in making and managing municipal policies. a robust civic society has developed in india, with organizations providing civic opportunities for youth and governmental frameworks that strongly support youth participation. lerner, almergi, theokas, and lerner (2005), building on previous data about positive youth development (pyd), proposed a model linking pyd with civic youth engagement. they define the former as a “strength-based conception of adolescence.” this model states that the strengths of young people align with resources(education, employment, security, skill-building) and are bilaterally strengthened to develop relationships with people and social institutions. civic engagement is defined as a person’s commitments and contributions towards the community and society through leadership, social entrepreneurship, media, and community development welfare programs. civic engagement is defined as a person’s commitments and contributions towards the community and society through leadership, social entrepreneurship, media, and community development welfare programs. in sum, civic engagement includes a wide range of actions and behaviors that work towards the development of society and the nation as a whole rather than for private investment. the present study focuses on the generational perceptions about the present state of youth as contributing members of http://anthro-age.pitt.edu/ ganjoo & verma | 138 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu indian society; the role of older adults in youth’s civic participation, and how this leads to positive youth development; how the elderly perceive youth behavior and use a cultural capital and reproduction approach to aid in positive youth development. the following section presents a brief review of literature on the theoretical concepts used in this paper. role of family, grandparents and value-transmission in youth development a family is considered the primary socializing institution and a vital source of social capital for an individual starting from birth (bourdieu 1977). social capital is amongst the three dimensions of capital as proposed by bourdieu (1986) in addition to economic and cultural capital. bourdieu (1986) called capital multidimensional, wherein the varied kinds of capital are not evenly distributed throughout the society. family serves as a vital agent in reproducing social, cultural, and biological values towards the child. parents and other guardians play an important role in providing the younger generation with a secure platform from where they can explore and operate in their social worlds. there are several competencies, skills, and values that the family wants their future generations to behold and practice. this, in turn, determines the young person’s participation in the civic culture of their country. the concept of mediation between practices followed in an institution is called habitus (bourdieu 1990). it is a valuable tool for the analysis of relationships within family lifestyles as well. the dispositions created inside an individual embodied through their speech, behaviors, attitudes, and manners when reproduced by the family practices is called family habitus (tomanović 2004). it predicts the daily lifestyle and choices of the child. cultural reproduction the concept of cultural reproduction was coined by french sociologist pierre bourdieu in the early 1970s. this concept was initially utilized to understand education as a socializing tool that helps in reproducing a set of values, usually held and released by the dominant class, which is then transmitted to students. however, the cultural part of this concept concerns transmitting traditional cultural values and traditions to succeeding generations. it also examines the time frame in which these values are sustained and used across time. the term ‘reproduction’ refers to a form of copying that is exactly done by a culture that amalgams a passed-on value system. even behaviors that individuals learn mannerisms, body language, way of talking, and facial expressions are all part of a reproduced knowledge that the hegemonic forces in charge have disseminated since times immemorial. families are the primary venues where values are transferred, and relationships are exhibited and negotiated. in india, elders in the family are considered an enriched reservoir of values and morals that are appreciated as an important source of guidance, enabling the younger generation to better understand their world and swim through the hurdles and challenges in life (tripathi 2014). identity is formed by the availability of awareness with different opportunities in life that require the individual to make choices, these choices are provided by the family. as the individual grows up and their lifestyle becomes diverse and less dependent on their family members, differences in their thinking patterns and choices start showing. they may start making choices on their own, but the baseline identity remains the same as seen through childhood in the family environment. however, the key influence that family habitus provides is defining the everyday life for the individual by providing them with and by culturally reproducing this information (morrow 1999). http://anthro-age.pitt.edu/ ganjoo & verma | 139 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu according to previous psychological research (vauclair 2009), the most common definitions of “values” contain the following features: i. concepts or beliefs ii. the desirable end states or behaviours related to it iii. guidance or evaluation of behaviours iv. the relevance or importance of these based on vauclair’s (2009) research, values must be understood as desirable and trans-situational in guiding peoples’ lives. values add meaning to individuals’ ways of perceiving the world, shaping individuals’ ways of behaving, the choices they make, and the ways they evaluate and understand their surroundings. family value systems act as assets future generations are expected to inculcate. the present study focuses on how the older population often wants the youth to include them in their own daily functions. values often constitute the family members’ socio-moral interest in transmitting them intergenerationally. the grandparent’s generation is also under continuous change. today, older adults are more involved in a multitude of activities even after retirement, as compared to the past ten years (takashima et. al 2020). grandparents volunteer to stay involved in the lives of their grandchildren, which often leads to a symbiotic relationship between grandparents, parents, and grandchildren. the grandparents in the family provide emotional and financial support, thereby decreasing the stress, pressure, and burden on parents to provide a nourishing healthy environment for the young generation. on the other hand, grandchildren also develop deep emotional attachments with their grandparents. this provides them with essential emotional support and allows them to stay updated on their grandparents ’ongoing activities, which increases the satisfaction level for the grandparental role (peterson 1999). dunifon and bajracharya (2012) explored and discovered both understudied and mixed findings on the level of involvement of older generations in their families. the researchers indicate high involvement of older generations, while other research indicated a lack in such studies. understanding these familial involvements are instrumental in bringing shifts in family dynamics as well as producing a mix of positive and harmful consequences for the young generation. these shifts in the family are expected to impact the cultural reproduction of values amongst the youth. youth in india and its positive development india, being one of the largest demographic countries in the world, comprises 22.1 percent of the youth population worldwide. young people consist of ages15-29 years and comprise 27.5 percent of the total population. at present, the youth contribute to 34 percent of india’s gross national income (gni). the total youth population is divided into urban, which is 10,95,58,848 crores and rural, which is 22,38,05,788 (parmasivan and kumaresan 2016).1 youth being the country’s future in itself, reserve a considerable portion of india’s resources to reach greater heights. thus, being an active and productive population of india, they should not be debarred of earned avenues, growth, and opportunities. as quoted by the ministry of youth affairs, “we must rekindle the imagination of our youth so that the nation surges ahead with added strength and vigor” (2014). india is turning into a more capitalist society, and they are also driven by conflicts and tensions http://anthro-age.pitt.edu/ ganjoo & verma | 140 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu stemming from the past (sau 1984). within such a contemporary society, the powerful hold dominant status and rich value systems that suggest ways of behaving, that are passed on as knowledge and wisdom. positive youth development (pyd) focuses on the active promotion of optimal human development. the concept of positive youth development (hamilton 1999) and civic youth participation posits that young people are resourceful, and their caliber can be guided to develop them as positive contributors to society. this framework is based on developmental concepts of resilience plasticity and competency building. roth, brookes & gun (2016) state that youth require opportunities and avenues for positive growth, including positive relationships with caring adults, challenging experiences, and skillimproving practices. a generous view of human capacity and capabilities are the underlying factors involved in positive youth development because these are positive actions and productive contributions made towards the community and society as a whole. moreover, youth can construct avenues for the nurturance of society. for example, using social media to initiate a business and collect funds or spreading awareness regarding an issue. thus, to attain their aspirations, the place where they live should provide them with such resources for positive growth. an exploratory paper by hameed and mehrotra (2017) found an unprecedented growth in the concern for the mental health of youth in india (chadda 2018). the intersection between positive youth development and mental health promotion among youth is becoming evident in recent times. such interventions would become helpful in making the youth of india a potential contributor to the country. the present study derives its impetus from the relatively scarce literature on the role of family in the social, cultural, (and biological) reproduction of values by its younger generation (ginsborg 2008; howell 2006). with this backdrop, the present study endeavors to delve into the perceptions and roles of older adults in influencing youth’s civic participation and how this leads to youth’s positive development. it seeks to answer how older adults in the family aim to transmit these values to the younger generations, and how they perceive changing familial roles (if any) today. the objectives of this study are to (1) explore older adults’ perceptions of indian youth in terms of their level of development, (2) describe how older adults want to transmit their existing value systems to younger generations, and (3) explore any changing roles older adults may want to pursue while interacting with the youth in their family. methods sample and sampling technique a total of 20 people, 10 men and 10 women between 65 years and above, participated in this study. the participants, primarily from middle to upper-middle-class households, belonged to the urban sections of the cities from where we collected data. a majority of the participants practiced hinduism and lived in delhi ncr and other metropolitan cities of india like mumbai and kolkata. we utilized a purposive sampling method, with older people who were grandparents to younger adult grandchildren (aged 20 years and above) selected. the average educational attainment of the respondents was post-graduation (5 years). they were employed in the government sector, some in private, and the rest were self-employed. http://anthro-age.pitt.edu/ ganjoo & verma | 141 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu interview location and settings all interviews were collected by only one author in hindi, english, or both based on the individual respondent’s comfort level and articulation. the participants were allowed to use both hindi and english to provide answers. before recording the entire interview, participants were briefed on the study, and they provided consent and permission. data collection occurred during the onset of the global pandemic (covid-19). therefore, we witnessed a few challenges regarding conducting close-contact interviews. the interviews were collected through the on-call mode or inside the houses of the participants who allowed, but with increased safety precautions. due to pandemic restrictions, a majority of the interviews took place over the phone. participants who were located in cities other than new delhi participated on-call. all the in-person interviews were collected in new delhi. method of data inquiry a semi-structured interviewing technique was used. using semi-structured interviews, the researcher holds the opportunity to mend the session according to the responses provided to him/her. such interviews are carried out in the form of ongoing dialogues, or questions can be asked between the narratives as well. this provides the advantage of getting numerous perceptions and reasons on a single shared situation. the interview schedule constituted nine open-ended questions which were flexibly followed to elicit respondents’ perceptions (listed in appendix i). the questions were simple and lacked any jargon to be understandable and accessible to all participants. the questions mainly focused on their perceptions regarding youth of india and the concepts used in this study like positive youth development and civic youth engagement. data analysis thematic analysis we utilized a thematic analysis approach to understanding the data collected in this study (braun and clark 2006). in this, the narratives were first recorded on a recorder, transcribed, and then analyzed using the coding technique. the study was not objective-based and did not generalize phenomena; instead, it discovered causes and differing perceptions of certain situations. some theoretical concepts explored in the study were kept as a baseline when coding. the specific dialogues were selected and coded according to the reasoning given by the respondents for the concept or theory that had to be discovered. the codes were made on the basis of common answers in the dataset. results after analyzing the data, different themes emerged regarding older adults’ perceptions of youth behaviour and efforts regarding youth development in india. table 01 below displays the codes, themes, and operational definitions of the themes as a result of the study, developed with reference to thematic analysis (braun and clark 2006). seven themes were made from the responses provided by the subjects. under each theme, some codes were prepared after transcribing and analyzing the interviews, these were as follows: http://anthro-age.pitt.edu/ ganjoo & verma | 142 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu table 01: themes, including operational definition of themes and codes themes codes operational definition of themes 1. youth contributing to development of india 1. doubtful as lesser percentage 2. both positive and negative contributions 3. need more guidance understanding whether the youth of india is an asset to the progress of the country. it could be both constructive and negative. 2. positive youth development 1. exploitation of youth 2. indulging in deviant activities“dange fasaad”(violence) an approach to understand the youth in terms of their engagement in school, communities, organizations, or peer groups in productive and constructive forms. 3. civic youth engagement 1. promoted by educated youth 2. conscious of their duty 3. raising the youth with money 4. corruption 5. away from social obligations 6. some are contributing 7. should be more civically active in rural areas 8. volunteering work going well at community level making a difference in the civic life of one’s community involving skills, knowledge, values, and motivation in forms of volunteering, awareness generation or service-learning. 4. cultural reproduction of values 1. early childhood inculcation 2. older adults themselves first need to follow them 3. guided by parents as well 4. youth should be good listeners 5. respect the guidance 6. going back to joint families 7. spirituality matters 8. education and literacy used 9. open discussions and expression of what they want mechanisms by which existing forms of culture, values or belief systems, understandings and practices are transmitted from generation to generation. this helps in sustaining the continuity of those concepts across time. 5. older adult’s intervention: retirement role for pyd. 1. institute run by older adults 2. helped in education field 3. would guide them 4. provide them monetary, social, and emotional support improving the outcomes for the youth of today by guiding, discussing, and helping them in some strategic manner. 6. restrictions to pyd 1. youth needing guidance and motivation 2. no moral values respected 3. diversions and distractions risk factors or elements that would not promote pyd or can create a constraint on the youth to use their potential or abilities. 7. comparison with older adults as youth 1. youths have more opportunities 2. older adults as ‘youth’ more civically engaged 3. youth today running a ‘rat-race’ 4. gave more importance to values a contrast drawn on the basis of the circumstances seen by the older adults when they were young adults and how within those circumstances they lived and grew. http://anthro-age.pitt.edu/ ganjoo & verma | 143 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu discussion this study explored the perceptions of older adults using bourdieu’s (1977) concept of a cultural reproduction of values. our study revealed that there is a shift in the ways older adults express their value system. they provided several reasons with respect to the changing trends in family dynamics and youth’s own decision-making processes. according to the study, the concept on which elderly’s perception was known as youth’s positive development. a rapid change has been predicted in the population of elderly all over the world as well (ingle and nath 2008). we utilized the concept of youth engagement to understand trends in positive youth development. lastly, we explored the role elderly people want to take in transmitting values to youth. the results were as follows: 1. youth contributing to development of india the codes under this first theme were doubtful, positive contribution, negative contribution, need more guidance, direction & training. from the codes, we interpret that youths are not contributing much to the development of india. moreover, codes like need more direction and opportunities are supported by research. for instance, the reason youth of metropolitan cities participate in volunteering activities more than suburban youth might be due to more availability and exposure to different opportunities in developed cities. lerner’s (2004) study supporting youth engagement and contribution suggests that there is not only a lack of opportunities but also the lack of awareness about available opportunities that pose a major barrier for youth’s engagement in development-based activities, which may contribute to perceptions that the youth are not contributing to india’s development. 2. positive development of the country’s youth the codes under this theme were exploitation of youth and indulging in wrong things like – unrest in youth. these codes indicate that the elderly participants in our study do not firmly believe the youth of india is developing in a positive manner. some of the reasons our participants gave for this include youth being exploited by the unnecessary and ill-intentioned power play in the country, getting caught in crime or violence, and unrest. responses also show how the older adults in this study think youth are being manipulated through politics. as one respondent mentioned, “many political parties of india may force the youth directly or indirectly to indulge in violence.” as supported by the studies suggesting that younger people engage in more violence because it is a disease that develops mostly from environmental contexts and circumstances (elliot et al. 1998). the prior research on youth and violence often entrails the way they are portrayed and reasons for the deviance of youth (rhodes 2000) but hardly reports on how younger people might see the world around them as problematic and wrong, which can lead to violence. this violence, in turn, makes adults concerned about youth behaviour, as demonstrated in the findings of the current study. 3. civic youth engagement the codes under this third theme were as follows: promoted by educated youth more, some youth wasting their time, conscious of their duty, raising the youth with money, corruption, away from social obligations, some are contributing – education field, can be more civically active in rural areas, interested in solving social problems researched well and studied well, volunteering work going well at community level. hart (1992) found that young people take initiatives and make decisions which helps them to participate better. they also play the role of leadership and decide the processes that lead to positive youth development as well as positive social changes. they may want to collaborate, govern, and change to existing conditions of the society. therefore, in light of hart’s (1992) study, civic engagement should include roles of leadership along with the social changes in the community. thus, it can be expected that civic engagement is a concept where the youth organize, youth empower, and their participation is seen important. civic http://anthro-age.pitt.edu/ ganjoo & verma | 144 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu engagement involves the effect and activity of youth involved in and influencing foundations impacting their lives (checkoway & richards-schuster 2006). kirlin (2002) stressed the importance of development of civic engagement skills of youth and adolescence in her study. as mentioned by a respondent, “they are associated with many ngos, providing financial assistance and platforms where funds are being generated for those who are in need. over the years, youth’s financial backup has become better and through this they help others as well.” also, our research suggests that the elderly do want to help the youth and want them to engage in social services. many of those who were interviewed had grandchildren who were actively involved and civically engaged in forms of teaching or helping poor people. the respondents believe that every youth should be civically engaged, the youth who engages in such activities will develop positively. 4. cultural reproduction of values codes that emerged under this were early childhood inculcation, elderly themselves first need to follow values, guided by parents as well, respect the guidance, going back to joint families, spirituality matters, education and literacy used, open discussions and expression of what they want. grandparents expressed the reasons behind values that are being passed on to youth. spiritual books and explanations help with this transfer of knowledge. when discussing the sharing of values, many of the respondents mentioned the phrase “practice what you preach,” where these values must be shown to youth through older adults’ own behaviors. young people, therefore, are more likely to successfully reproduce values and become responsible adults if they see their older family members practicing the values as well. it was analyzed (apple 1977) that in modern industrial societies, there is an increasing gap between the world of the child and that of the adult. the need for a joint family(in india the joint family also known as the extended family. it comprises of two or more generations living together)has been emphasized enough by the elderly who participated in this study, in order to successfully transmit these values to the younger generation. in the previous times in a joint family, the relationship between father and son was based upon respect, fear, and affection between the two. what the child felt towards his/her elders was so powerful that it used to create a bond between them. the chief values of the family resided with the males of the older generation, who had the power and authority to make decisions about the type of education imparted on the young, the type of occupation that the youth should engage in, and even selecting a mate (ahuja 1994). in summation, it could be said that understanding the theory of a cultural reproduction of values is applicable to our current study on intergenerational perspectives. however, modes of expression and transmission of values have undergone a shift. for example, one participant mentioned that they are the ones who can share their experiences and wisdom with the youth but cannot force them to follow a particular path in life. the youth is their best decision-maker. it seems that they do not necessarily want to enforce these values on the younger generation of their family by strictly ordering them to do so, rather incorporating those values within their behaviour through indirect and practicing what they preach it can also be understood that the concept of family habitus (bourdieu 1977), which highlights the family’s role in reproducing values, is also shifting. based on participants’ answers, they no longer want the youth to follow a particular lifestyle or repeat exactly what previous generations did. the older generation understands the constraints and requirements of the time the youth live in. reasons such as the changing nature of joint families and the influence of technology can unbound the youth from following a lot of practices that their previous generations did. 5. older adult’s intervention: retirement role for the fifth theme we found, certain codes that emerged were as follows: institute run by elderly – helps in personality development, helped in education field, would guide them, provide them monetary, social and emotional support, motivation, experiential learning, make them understand them concepts of morality. http://anthro-age.pitt.edu/ ganjoo & verma | 145 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu older adults want to be actively engaged with the youth in forms of guidance. some of the older adults have already engaged in interventions which provide youth with opportunities. mentioned by one interviewee, “[the] best way to teach the youth is with providing them clear pros and cons of something and also personal experiences. every advice should be a suggestive advice to the youth by providing them reasons. “therefore, it can be seen that the older adults do want to help and guide in the youth of the country and provide support in different forms. they have mentioned already how they think that the youth lacks guidance which can be covered with older adult’s guidance. 6. restrictions to positive youth development this sixth theme regards the positive development of indian youth. codes formed under this were as follows: diversions, need guidance, no moral values respected. 7. comparison with older adults as youth codes formed under this were more opportunities with today’s youth, youth today not risk-taking, we as “youth” were more active, more civically engaged, we had lesser avenues still were developing positively, rapidness in lifestyle, youth today running a ‘rat-race,’ we gave importance to family values. studies support that the elderly, or the boomer generation, complain that the millennial generation is tough to progress with, this younger generation focuses on the faults. (deal, altman, and rogelberg 2010). such perspectives on young adults come from millennials always expressing opinions and creating more opportunities than their elder generation and “experienced” equivalents (levenson 2010). they see them as a dynamic workforce as well as always communicating their needs (myers & kamyab 2010). the elderly also expressed why they do not view young people as particularly responsible. they see them as progressing, yet still learning, and many respondents gave the answer of “no comment” on questions asked in relation to how much responsible they are as compared to the when the older adults were young adults. overall, it was discovered that the elderly do not see themselves as the reasons for socialization now in the current indian society’s scenario. the elderly want to be the source of secondary socialization. socialization is being distinguished as to why and when during the life course the socialization occurs (handel et al. 2007). primary socialization occurs during the early days (usually, the span between being born and puberty) and is done by the parents. socialization does not stagnate at a fixed age however, but rather flows over one’s lifetime. this other half of socialization has been referred to as secondary socialization because it may be less influential than that which occurs during childhood. our elderly participants do not want to hold complete responsibility for training and guiding the youth, especially since they view today’s youth as more self-sufficient. they want parents to play a more active role in the transmission of value systems and give them greater importance in comparison to their own role in the family. also, the older adults want their children to switch to joint families, especially for value transmission to occur. another important concept of socialization can be taken from bronfenbrenner’s ecological model (1977), in which an individual has to develop within processes of assimilation and has to accommodate to his/her environmental and cultural contexts, specifically each step of the model of socialization influence beginning from family (microsystem) to neighbourhoods, to schools (mesosystem), then to cultural institutions (exosystem) in the society. findings place the socializing authority on the parents; the elderly want to remain the secondary socialization agent inside the family and let parents be the primary source. the elderly see education as a relevant aspect in socialization and development as well. the education system plays a role in the cultural reproduction of the foundations that enhance one’s cultural capital. the amount of cultural capital one has can also determine one’s level of education and http://anthro-age.pitt.edu/ ganjoo & verma | 146 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu the kind of education they receive (bourdieu 1990, 1984; bourdieu and passeron 1990). according to the findings of the present study, this is the type of youth which is currently viewed by the older adults in india which is viewed as contributing less towards the country. it can also be seen that whether traditional values of the family are accepted or rejected with the modern values of socialism (being self-producing of something) and individualism (becoming self-reliant) depends on the existential realities experienced by each of the families. there is a shift seen in the family structure. the change in the family type from joint to now becoming nuclear is due to the influence of socialism and individualism as they support autonomy of the individual, this has been seen to impact the traditional decision-making process which was done majorly by the elders of the family (oomen 1982). these emerging trends in the family’s structure can be seen to impact the reproduction of the values-system. a reason as to why today’s youth, even after being passed down with the traditional values of the family, still cannot adhere or conform to them, is that the realities and contexts of the current scenarios in indian society are different as compared to when these values were initially developed. concluding remarks the present study explored the perspectives of the older population in order to understand how they view the young adults in their family as well as india in general. the study was done through collecting data in the form of interviews with the older population. the theoretical framework of cultural capital and cultural reproduction theory given by bourdieu (1977) was used as a baseline for forming the content of the interview questions as well as analysis of our findings. the findings reveal that the current older population, those aged sixty-five years and above, have seen a shift in their intergenerational relations with younger adults. they do not necessarily want to use authority and the position of being an “elder” in the family to have relations with their youth or forcefully transmit values upon them. they do think that the youth of today is growing at a rapid rate, but their positive development has not happened yet. since they are both within a more technologically advanced world, this helps them perform tasks easily and creating better opportunities than their “experienced” generations. this is one motivating factor for the development of india, our country. overall, the older population thinks that the youth is very independent and does not require much interreference or guidance from them. they realize that their values cannot be forced upon younger people, as they were forced on themselves as youth. india’s youth have potential, which needs to be channelized in correct directions. the older adults in this study also mentioned that any support on behalf of the indian government should be provided to the youth. this study contributes to the existing body of intergenerational relationships as it signifies the changing ways of transmission of values by older adults to their younger generations. notes 1. a crore (cr) also called as karor, karod is equivalent to 100 lakhs in the indian numbering system denotes ten million (10,000,000 or 107 in scientific notation). appendix-i q 1. viewing the current scenario of india in terms of how it has changed positively and/or negatively, how much do you think that the youth is becoming a contributing member in this? (good & bad). q2. what are your views about the level of involvement of youth being civically engaged in india? http://anthro-age.pitt.edu/ https://www.sciencedirect.com/science/article/pii/s0049089x1400221x#b0020 https://www.sciencedirect.com/science/article/pii/s0049089x1400221x#b0030 ganjoo & verma | 147 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu q3. do you have a young adult in your home, if yes how much is he/she civically engaged (if so) in the ongoing social issues or likes to volunteer for it? do you support him/her and how? q4. according to you, are youth’s involvement in behaviors related to civic engagement leading to their positive development? if not, then why? q5. being guiding figures with rich experiences, values and wisdom how would you like to help them? q6. there are lot of risk factors that youth usually face when they want to be civically more active, how would you like to remove these barriers through intervention strategies. (e.g.restrictions, arrests, substanceuse, unemployment, etc.) q 7. do you want to be more involved in these discussions with the youth? how would involvement at this stage in life act as a turning point for you? q8. people of your age have seen and experienced a lot, how would compare and contrast on the opportunities provided to you as a youth and for today’s youth? (in terms of pyd)? q 9. is this a good retirement role using all the knowledge to help the youth of today? how would this help you somewhere in life at this stage? references ahuja, ram. 1994. indian social system. jaipur: rawat publications. apple, michael w. 1977. “reproduction in education, society and culture. pierre bourdieu , jean-claude passeron, richard nice.” the school review 86 (1): 144–47. https://doi.org/10.1086/443401. berger, ben. 2009. “political theory, political science and the end of civic engagement.” perspectives on politics 7 (2): 335–50. https://doi.org/10.1017/s153759270909080x. bourdieu, pierre, and jean claude passeron. 1990. reproduction in education, society, and culture. london: sage publications. bourdieu, pierre, and jean claude passeron. 1997. reproduction in education, society and culture. london: sage publications in association with theory, culture and society. braun, virginia, and victoria clarke. 2006. “using thematic analysis in psychology.” 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https://doi.org/10.1007/s10869-010-9170-9 https://pubmed.ncbi.nlm.nih.gov/23050333/ https://doi.org/10.1111/1467-954x.00194 https://doi.org/10.1007/s10869-010-9172-7 https://doi.org/10.2190/gudm-6ce3-17wf-7n96 https://doi.org/10.4103/ijmr.ijmr_1585_18 https://www.goodreads.com/book/show/693193.why_they_kill https://www.news18.com/news/opinion/as-students-become-warriors-of-change-amid-caa-nrc-protests-onus-is-on-politicians-whore-riding-tigers-2454125.html https://www.news18.com/news/opinion/as-students-become-warriors-of-change-amid-caa-nrc-protests-onus-is-on-politicians-whore-riding-tigers-2454125.html https://doi.org/10.1371/journal.pone.0242859 https://doi.org/10.1177/0907568204044887 https://doi.org/10.1177/0971685813515598 ganjoo & verma | 149 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.326 http://anthro-age.pitt.edu cross-cultural value research.” ram. revista de administração mackenzie 10 (3): 60–83. https://doi.org/10.1590/s1678-69712009000300005. witte, james c., and susan mannon. 2010. the internet and social inequalities. new york: routledge. https://doi.org/10.4324/9780203861639. http://anthro-age.pitt.edu/ https://doi.org/10.1590/s1678-69712009000300005 https://doi.org/10.4324/9780203861639 anthropology & aging quarterly 2012: 33 (4) 130 peripheral spaces and frail elders abjection or liminality? the problem of spatial seclusion, caregiving, and boundaries among the “old/old” in tamajaq-speaking communities of semi-nomadic, muslim, traditionally-stratified tuareg, sometimes called kel tamajaq, (after their amazigh language) of niger and mali, many frail elders are lodged separately: outside or adjacent to the household compounds of their married adult children. their primary visitors and caregivers are small children, who bring them food cooked by the adults. they are rarely mistreated or neglected. yet most persons of advanced age do appear to experience, on the surface, some social, spatial, and political marginalization in their seclusion. on closer scrutiny, however, there emerge more complex meanings to their predicament, explored in this essay. the seclusion of young women has received considerable a r t i c l e s a little to one side caregiving, spatial seclusion, and spiritual border-crossing in frail old age among the tuareg (kel tamajaq) susan rasmussen department of anthropology and comparative cultural studies university of houston attention in anthropological studies of gender. less understood is the seclusion of “old/old” persons in aging studies. it is now recognized that age and aging, like gender and sexuality, are culturally constructed, rather than essential categories and experiences, (cohen 1998; lamb 2000; rasmussen 1997; sokolovsky 2009). this essay examines the expression of aging constructions through residential spaces where frail elders are cared for, how they are cared for in these spaces, and their relationship to their often-primary caregivers—young children usually their grandchildren. fundamental to understanding the patterns of caregiving and the meanings of seclusion of frail “old/old” persons in tuareg society, i argue, are intergenerational relationships and spiritual and economic forces, both longstanding and emergent. longitudinal data from my field research reveal some disengagement, even reversal, of roles of frail elderly physically and economically (cumming and henry 1961; gutmann 1987), but also their active engagement spiritually. the goal here is to detach frail elderhood from its abstract this essay examines the meanings of the seclusion of frail elders and the roles of small children who act as their primary caregivers in rural tuareg communities of northern niger, and explores the implications of these arrangements for intergenerational relationships. data suggests that both cosmological and socioeconomic forces shape the seclusion and caregiving of frail elders. it is argued that, despite some physical decline and social withdrawal in these circumstances, particularly on approaching death, nonetheless there is enhanced spiritual power in which these elders and their small caregivers cross thresholds toward new sources of meaning. more broadly, the essay contributes to debates over the meanings of disengagement over the life course and the semiotics of peripheral and secluded spaces. keywords: aging and the life course, religion, symbolism, disengagement theory, household cycle, africa 131 anthropology & aging quarterly 2012: 33 (4) susan rasmussen a little to one side exclusively passive, “deficiency model” connotations. another goal is to offer critical refinements of disengagement and “old/” old concepts in anthropology of aging. more broadly, the analysis links the semiotics of space and social practice to age and intergenerational relationships. historical and ethnographic overview in cultural terms, tuareg communities display both unity and diversity (bernus 1981). today, most are semi-nomadic, and reside in rural, semi-sedentarized, agro-pastoral oases and small towns in the saharan and sahelian regions of niger, mali, burkina faso, libya, and algeria.1 relations between the pre-colonial stratified social categories of nobles, tributaries, smith/artisans, and former slaves are much modified, and are breaking down in the towns (bouman 2003; claudot-hawad 1993; nicolaisen 1997).2 occupations—of combined livestock herding, oasis gardening, islamic scholarship, artisanry, caravanning and other itinerant trading, and labor migration—are no longer based strictly upon descent or social stratum affiliation. there is much social interaction between the sexes, and most women enjoy high prestige and independent property ownership.3 regional confederations and smaller descent groups and clans are headed by traditional leaders whose powers were modified first by french colonial and later independent nation-state administrations. most tuareg groups now tend toward bilateral succession, inheritance, and descent, with varying degrees of matrilineal influences pre-dating central state and qur’anic-sponsored patrilineal property laws, rituals, and mythico-histories.4 brothersister relationships remain strong, frequently enduring beyond spousal relationships into late life. ideally sisters, daughters, and mothers reside near each other, but now some follow husbands to the latters’ distant work sites. most property is controlled by elders through gradual preinheritance gifts and endowments. there are threats from recurrent droughts, locust invasions, and armed conflicts between tuareg separatist dissident rebels and the central state governments of niger and mali (bourgeot 1994; boilley 1999; dayak 1992; keenan 2003; oxby 1990).5 these wider forces have not completely obliterated longstanding property arrangements, social relations, or communal local ritual roles, but have prompted their creative negotiations and modifications. many widelyheld ideals in caregiving still suggest a poetic cosmology of intergenerational complementarity and continuity, and these ideals persist in much practice. home alone: a closer look the perspective of sidi (pseudonym): from hidden space and muted voice to active engagement upon my return to a rural community of my long-term research in northern niger, i noticed that an elder, whom i shall call sidi, the aged father of a research assistant in my host family, was now much more enfeebled, perhaps terminally ill. he occupied a one-room, adobe mud building formerly used as a guest bedroom in the cold dry season and for storage in the hot season , when tents or the open were used for sleeping. this now-dilapidated small building was located in the now-deserted compound that had once been home to sidi’s extended household. i, too, had stayed there as the family’s guest on other visits in the past. but now that compound was abandoned; there were no more tents of married women inside it (though several of his daughters resided nearby). the roofs of a few remaining empty adobe houses had caved in. the central courtyard had become overgrown with weeds, discouraging entry. a broken tin door had been erected in a gap on one side of the back mud wall—perhaps from fear the elderly occupant might wander off, and/or harm himself. yet few adults made prolonged visits. his married daughters in neighboring compounds cooked his food and occasionally looked in on him. his young grandchildren almost always took the dishes to him, and spent far more time with him than his adult children. during my visit, sidi recognized me, warmly taking my hand, but he sat rather dejectedly upon his mat inside the crumbling edifice of what had once been a well-maintained grass building used for guests (imagaren—also a term for newborn babies, strangers, and foreigners, such as myself). was sidi now in some way a “guest,” “stranger,” and/or “foreigner?” the physical facts of fragility and illness are undoubtedly significant here, and partly explain the reclusiveness of these “old/old” elders; but they do not explain entirely why they are lodged apart, secluded, and encouraged to be close to, not their grown adult children, but their small grandchildren. in tuareg communities, persons at opposite poles of the life course—frail elders and young children—are vulnerable, yet powerful. they, not others, tend to congregate inside a frail elder’s residential space. thus there is a connection between seclusion, marginality, and thresholds across the borders of life and death. what sort, exactly? here i show that spatial and spiritual transformations in elders’ caregiving derive from both cosmological and domestic forces. there are social and anthropology & aging quarterly 2012: 33 (4) 132 susan rasmussen a little to one side susan rasmussen a little to one side symbolic parallels, and ritual and mythico-historical complementarity between persons of alternate but not adjacent generations. in semi-nomadic rural communities, chronological age is difficult to ascertain precisely, due to lack of birth records (rasmussen 1997). many local residents define age according to not strictly biological or literal markings, but rather, according to social and ritual criteria: for example, one is defined as “old” (masc. amghar, fem. tamghart) when one’s children are ready to marry or are married (rasmussen 1997,2000). for many elders, there tends to be increasing emphasis upon participating in both islamic and paraor pre-islamic rituals. there are also hints of another age category approximating the western academic category of “old/ old”: many refer to persons of advanced age who are frail by a different tamajaq term: wa wachere (fem. ta wacheret; plural, win wacharen), rather than amghar, which as noted, denotes a still-vigorous older adult with married children and also “chief” and “leader.” in other words, elders who are frail and/or ill have already passed through their earlier social and ritual elder status of still-vigorous, authoritative and active parents of marriageable or married children. there is also a term in tamajaq, takhal, approximating conventional notions of “dementia” associated with old age. this is very different from anubzug, permanently insane, which may be applied to persons of any age, who, as noted, may also become secluded at home, but whose seclusion has very different meanings from the seclusion of frail (though sane) elders (bernus 1969; rasmussen 2001b). gender constructs are also relevant here, though not the sole determinant of sidi’s predicament. in most rural communities, one can still count the number of households by counting female-owned tents: the married woman brings her tent (ehan) as dowry, which she owns, to the household upon her wedding. elderly female relatives of the bride construct it during the week-long wedding celebration (brett and fentress 1997). since tents are owned by married women, who retain them even on divorce, men can be without their own home in more nomadic communities, though in more sedentarized communities, men build and own most new adobe houses they construct next to the wife’s nuptial tent. sidi was not divorced, however, and his compound earlier had contained both his house and his (now deceased) wife’s tent, a typical pattern in that semi-nomadic community. whether more or less nomadic, very elderly (especially widowed) men and women alike often withdraw from their previous residence, and occupy separate domestic spaces. houses are usually passed to sons. tents are usually destroyed and the land beneath them left vacant for a year as “sacred” space (ag soliman 1999). later, a marrying granddaughter’s nuptial tent is constructed there. thus, gender constructs do not explain all meanings of frail elders’ secluded space. although aging men are more often without a tent upon widowhood or divorce, once frail, elderly women are also, often, secluded and in advanced age; both tend to move away into similar peripheral spaces. as lawrence cohen (1998) observes in his study of urban hindu indian frail elderly persons, dying spaces are not static “things,” but are contested, and interpreted from different vantage points. i agree that we need to move from third-person frames to second-person positioned and contested accounts of the “familiar body” in the firstperson construction of experience, and to the voices of old people (cohen 1998:183). i also caution against taking too literally the surface attributes of spaces and built-forms, for example, inferring from them rigid social correlates (goody 1958). one also cannot ignore personal emotions such as grief (rosaldo 1991). within these spaces, do individuals experience their own advanced aging as frail or powerful, and if powerful, in what sense? the first-person voice is difficult to elicit here. sidi managed to smile weakly, and greeted me warmly by my name. when i inquired how he was, he chuckled somewhat ruefully, and did not give a direct verbal reply, but gestured vaguely toward himself, and shook his head. he slept intermittently. sidi’s adult children were evasive when i asked about his welfare. although his adult daughters continued to cook for him in their neighboring kitchens, and occasionally looked in on him directly, they did not linger, enter, or approach, but stood briefly in the door-frame, nodded a greeting, and then retreated. notably, they did not avoid pausing in the doorframe here, in contrast to their strict practice of this taboo while holding babies. they usually sent small children instead to stay with him longer. in the presence of these children, sidi, when not too ill, held conversations with his grandchildren on everyday work situations, the weather, and more general concerns such as local history. thus there was a juxtaposition of living and dying in the same space. other fragile elders more explicitly discussed their feelings with me, recognizing themselves as “very old now…lacking strength.” several frail elders lamented that “no one takes me seriously now…i see things i do not like, 133 anthropology & aging quarterly 2012: 33 (4) susan rasmussen a little to one side but i can only watch.” one younger adult woman (i.e., married and of childbearing age) commented, “an elder does not do work or make any decisions. when one is very old, one follows the children.” some explained that, when they want to shield an elderly person, they say he/ she is senile (takhal), even if not really the case. dementia, in fact, is often disputed. a wife, for example, disagreed with her husband after he described an old chief to me as senile; she insisted, “no, he is not senile, only his feet are incapacitated, that is why he does not go out.” as anywhere, illness and injury prevent motility. yet even infirmity does not fully explain frail elders’ secluded, peripheral residential space, since such a space is highly formalized and involves specifically very young visitors. why did adults of the adjacent generation shun entering this space? persons suffering from noncontagious diseases are not usually secluded; rather, they are surrounded by close relatives and friends who try to heal them. by contrast, persons suffering from contagious infectious diseases and persons undergoing healing of spirit-related illnesses are secluded for varying time periods. what social engagement takes place in this peripheral space? death could not be entirely polluting, since young children were permitted, indeed encouraged to enter this space. local definitions of fragility related to age usually merged unspecified bodily and/or mental decline, disability, and illnesses, or simply advanced senescence. many tuareg, for example, described the life course to me with resignation, metaphorically as “like a canopy (abarkan) that gradually loses its supports for men, from about fifty years old, for women, earlier.” others asserted that “the body bends.” a few organic disabilities—whether they strike at birth, in midlife or old age—are viewed as punishment for past sins (e.g., blindness without a discernable cause), or as the manifestation of parents’ breaking of sexual taboos (e.g., babies born with disabilities may have been conceived outside the nuptial tent, under the moonlight, or stolen by the kel essuf spirits and replaced with a changeling) (rasmussen 2000). age-related “mental” decline was alluded to in specific contexts, rather than philosophical generalizations. takhal, denoting approximately “senile,” (a problematic term) is usually applied to those elderly persons who tend to lose their orientation in the desert, to forget mythico-histories, and lose conversation skills, important in local cultural values. hence the challenge of translating illness meanings and terms across cultural settings is compounded by age. several older persons i interviewed were pointed out to me, away from their presence, as suffering from takhal, but not sidi and not everyone in seclusion. most people treated the sufferers of takhal with respect to their face. when they are fragile, the old/old are ideally respected and cared for by their daughters who should cook for them, or at least make sure they are fed. no one ever described sidi as suffering from takhal to me. the dying space of frail, dying, but otherwise normal elders can be spatially peripheral to the household while remaining in some ways central, but not marginal. for example, in india, the knotted rope and wood frame bed are often placed near the threshold of the house, or in a courtyard. this suggests a simultaneously liminal and exemplary position of its aged occupant (cohen 1998:182). several brief “negative case” examples show how the tuareg threshold (temilelt) can indeed become a place of either alterity and abjection, or, as in the present case of sidi and many other frail elders, a place of crossroads and becoming. another frail elder, a woman who appeared suffering from the beginnings of dementia, became much more isolated in her secluded space because of her social disaffiliation. she had disputed with her brother and female cousin over the disposal of their livestock property, and also became estranged from her nephews (brother’s sons). they did not linger in the space of her tent or bring her food. she tragically became insane and tried to beat them when they approached. another woman, though cared for, diagnosed as permanently “insane” (tanubzug), remained tied up inside a tent inside her uncle’s compound. no small children brought this woman, food, either— in fact, she allegedly seized a small kid goat and ate it whole—thereby indicating possible neglect and hunger (rasmussen 2001b). thus there are distinctions within the category of “frail” elder and variable meanings of seclusion. seclusion is qualitatively different for those who are considered antisocial or insane. sidi’s and others’ residential arrangements were, therefore, more “typical” or “usual” for those elders locally defined as “normal” though frail ( i.e., those with declining social and economic powers). how and why? there is a notion, in seclusion, of some special condition, “pollution,” “holiness,” and/or “profane,” status, or perhaps “sacredness”—concepts notoriously difficult to translate and sort out. as shown in anthropology of religion, these concepts may have both positive and negative connotations (douglas 1966; gottleib 2004). as radcliffe-brown pointed out long ago, the body of a polynesian chief is tapou: at once holy and profane (radcliffe-brown 1939). the meanings of tuareg frail anthropology & aging quarterly 2012: 33 (4) 134 susan rasmussen a little to one side susan rasmussen a little to one side elders’ seclusion and their consequences in caregiving are different from those frequently noted in other cultural settings, for example, urban and rural india (cohen 1998; lamb 2000). in contrast to what lamb reports in rural hindu india (2000), most tuareg do not consciously attempt to formally become ascetic renouncers in order to prepare for eventual death and/or rupture ties, or detach from the pleasures of life, even those who pursue more intensive qu’ranic study. nor is the tuareg arrangement equivalent in meaning to installing a frail elderly parent in his or her own room in many middle-class us households for the purpose of individual privacy, replicated for other family members when affordable. nor do these meanings exactly correspond to those of the us hospice. nor is there an exact parallel to cumming and henry’s (1961) classical disengagement theory, which argues that upon aging, there is conscious withdrawal from active participation in life in preparation for death. certainly, the tuareg case does approximate withdrawal in some respects. but this process is very selective, and moreover, in the partial seclusion of frail elders, there is also a new engagement in the spiritual domain of life: in between humans, the islamic allah, and spirits and ancestors, in between alternate and adjacent generations—as in effect, new parents of grandchildren (actual or classificatory, including nieces and nephews— particularly those on the maternal side, children of sisters and daughters, referred to as “children of the stomach”). in effect, one lives with one foot in the social community and one foot in the realm of the afterlife. but how is this tuareg case liminal and death-denying at once? upon advanced and frail aging, the public face of household authority over sons and sons-in-law in managing the domestic economy becomes more difficult to maintain. frail elders who are respected come to occupy a status very similar to the sacred or “divine” kings analyzed in african ethnography in their ritual status and political succession conflicts and conundrums. in other words, tuareg elders’ declining powers must be hidden, since they are connected to the fertility of humans, herds, and crops. on another level, frail elders and young children come to occupy symmetrical and complementary statuses in their mediating positions between the spirit and human worlds. these dimensions—socioeconomic, political, and religious—are all at play in the caregiving of frail elders. in other words, there is fragility and weakening, but also, ideally, alternative forms of empowering and connection, embodied in seclusion as a threshold and crossroads. liminal spaces in aging symbolism and their practical consequences in caregiving healthy tuareg elders and their authority have received some ethnographic attention (claudot-hawad 1993; dayak 1992; rasmussen 1997,2000a,2000b). frail elders have received less attention. the latters’ physically fragile, often ill and dying, state alone, does not completely explain the significance of their seclusion. many tuareg believe that frail elders, like very young infants and possessed adults, live in or have close ties to solitude or “the wild” (essuf) and its spirits (kel essuf). it is tempting to posit an equivalence between these social categories based on their shared similar symbolic imagery, but in other ways, they are not equivalent, but complementary. frail elders’ adult children seldom speak to or about them directly, visit them only briefly, and never pronounce their names. out of respect, tuareg never mention the names of deceased ancestors. very young children; however, can pronounce names of parents, but as they mature, adults discourage them from doing so. these practices of spatial segregation and name teknonymy suggest not just respect, but also transformation of social and spiritual personhood. there are cultural efforts to make advanced, frail old age and early childhood symmetrical by situating them on complementary spiritual border-crossings. as important caregivers of frail tuareg elders, small children also often tend the fire during the cold, dry sandstorm season. food to satisfy hunger, and warmth to protect against cold are, of course, physically necessary material resources, but they are also channels of symbolic, ritual, and social communication. caregiving of frail elders is most closely related to alms offerings or sacrifice, focused on specific age groups: the very young and the very old. one purpose of alms is to promote the satisfactory outcome of a wish or goal. as earlier noted, alms should be given to small children on fridays in order to avoid misfortune or compensate for a misdeed (rasmussen 2001a). other situations require that alms be given to impoverished and/or frail elders in order to ensure their al baraka (blessing) protection from dangers such as thieves and lightning storms. children also receive food in many ritual contexts, defined as “alms offerings” (takote), also denoting the commemorative mortuary feasts held at intervals following deaths. as they weaken physically, elders are ideally cared for, and receive, but also give, alms—both before death, in gradual pre-inheritance gifts, and following death, in the islamic scholars’ distribution of their remaining uninherited property to the poor. many tuareg, upon my 135 anthropology & aging quarterly 2012: 33 (4) susan rasmussen a little to one side inquiring what most comes to mind when thinking of old age, immediately and emphatically exclaimed, “takote!” both forms of caregiving and almsgiving—to the very old and the very young—are necessary, in local viewpoints, in order for the givers to obtain islamic blessing or benediction. like frail elders, tuareg babies and very young children are considered closer to the pre-islamic spirit world, thus approximating beng babies’ “arrival” from the afterlife (gottleib 2004). there are also hints that tuareg frail elders occupy special, respected status as pre-ancestral, as mediators between humans and ancestors. but here, in contrast to the beng, these connections are less explicit or direct; for mainstream (“official” qur’anic) islam discourages too-overt focus on the ancestors as distracting from the monolithic god, allah. also, the islamic paradise is qualitatively distinct from other (pre-islamic) spiritual abodes: essuf, the wild or solitude; idebni, the graves of recently deceased persons; and ibedni, ruins of more genealogically remote people of the past. frail elders’ secluded residence partly reflects, i argue, their position partially in paradise and partially in the wild and the other related spaces, thereby reflecting tuareg dilemmas over islamic and pre-islamic cosmologies and rituals surrounding the life course. many emphasize the need to sever a newborn’s ties to the spirit world, fearing that spirits may pull him or her back into their realm of essuf. to prevent this fate, a week-old infant’s hair is shaved off on the nameday ceremony. the new mother and her infant remain secluded to protect against these jealous spirits (rasmussen 1995, 1997), only emerging at the baby’s nameday held one week following the birth. the newborn baby, like the frail elder and the recently deceased, is not addressed or referred to by a personal name, but is called “stranger” or “guest” (amagar, fem. tamagart) until the nameday. at weaning age, some mothers style their firstborn male children’s hair into a small tuft on the top of the head to enable the prophet to pull him up into paradise (notably, not to enable the kel essuf to pull him into essuf). this idea is the islamic interpretation of the threat of child mortality. the small boy must now embark on the path to becoming a mature muslim male. for both very young and very old, therefore, thresholds and crossroads are ritually significant. some birth defects, such as mental disabilities, are widely attributed to a mother having paused in a doorframe while holding her baby momentarily in it. both very young and very old persons are liminal, standing at the interstices of life and death, and have uncertain, disputed and ambiguous ties to the living and other worlds. in some contexts, both age groups experience literal, as well as symbolic spatial seclusion and similar linguistic marking and tropes. what are the meanings of these approximately (though not exactly equivalent) symmetrical images and practices surrounding the very young and the very old? how do these beliefs affect caregiving of frail elders in their apparent solitude of residential seclusion, and how do socio-economic predicaments— longstanding, recent, and current—of many tuareg households interact with these spiritual predicaments? in some respects, these spatial, ritual-symbolic, and social patterns of frail tuareg elders living “a little to one side” suggest pre-emptive social death—but i never encountered practices glascock (2009) has termed “death-hastening” as a conscious, overt intention in this seclusion. adults do appear, however, not to wish to see frail elders. yet death denial occurs in efforts to preserve living-deceased communication in beliefs, practices, and stories concerning living-dead interaction through almsgiving and other interactions between graves, ancestors, and spirits, as these practices are interconnected. although there are some hints of “social death” in the spatial and caregiving arrangements for tuareg frail elders, there are also counter-forces here: in the complementarity and parallels between cosmology and ritual surrounding babies, very young children, and “old/old” frail elders. but tuareg never expressed an idea of a circular “return” to infantile dependency upon advanced frail old age. although elders and very young children and babies are all similarly believed to be closer to the spirit world, in other respects, they are not treated as equivalent, in every context. as cohen (1998), kaufman (1986), and vatuk (1980, 1990) point out, we need to consider the “becoming” as well as the “being” aspects of old/old age. we also need to detach aging from its solely literal frame, not to deny its very real effects, but to understand the cultural means of coping with them (rasmussen 1997). to some extent, being frail and old/old becomes a source of positive meaning and empowerment in seclusion under children’s watch, (or are these child caregivers under frail elders’ watch?). inside secluded space, the mutual gaze and reciprocal voices between these alternate generations collapse living and dying times and spaces. relevant here are the changing meanings of crossroads, interstices, and thresholds in a play of power and symbolism, as well as personal sentiments. as stoller and coombs (1994) have pointed out, crossroads in many african societies and cosmologies signify danger, but also anthropology & aging quarterly 2012: 33 (4) 136 susan rasmussen a little to one side susan rasmussen a little to one side opportunity, and a kind of transformative, indeterminate, and suspended identity. liminal thresholds, entries and exits, and crossroads thus suggest mediation and transition, and offer possibilities of re-inventing the person in ways that empower the person spiritually, if not physically or socially. for example, on the eve of the official nameday, babies are carried by elderly female relatives around the mother’s tent, though not through its doorframe. at weddings, on the final evening, the bride enters the tent through the front door, rather than through a side flap in the tent as on previous evenings in the week-long wedding. smiths accompanying the bride to the nuptial tent enter through its left side. graves and tombs are located well outside, but on roads connecting villages and camps. the place where a person died is covered with tree-branches, and its ground is considered sacred or taboo, al hima (ag solimane 1999). some, but not all cases of placement in outside but connecting nonstandard spaces convey pollution. entrances, exits, and liminal times, spaces, and actions in ritual time and space ritually mark some dangerous state, situating persons in ambiguity, but not always abjection. thus, in one respect, the tuareg data approximate cohen’s findings (1998) in urban india, in the sense that there are more nuanced meanings involved in the placement of dying spaces than marginality or abjection. but in another respect, the tuareg case markedly differs from the india case in its social consequences and implications. in india, according to cohen, although this space (of the frail and dying elder) is not quite part of the household, nonetheless, the old person on the threshold is the first person one would encounter in visiting. in india, the charpoy bed-platform is “simultaneously that of confinement and repose, restriction and respect” (cohen 1998:182). in other respects, there are contrasts between tuareg spaces and indian spaces. as observed, frail, disabled, and/or dying tuareg elders tend to be lodged away from public scrutiny and greetings, and do not often receive many adult visitors. the secluded tuareg old person is often hidden from view. from whom and why? in the case of the elderly local chief of that community early in my research who was variously described as suffering from dementia (takhal) or from a disabling foot ailment, i never saw him, rather, i saw only his still active son, who had taken over his duties. similarly, after the (now deceased) traditional anestafidet (leader) of the kel ewey confederation in agadez became blind in his advanced age, no one visited him; he and his wife always sat alone inside their home. yet the secluded frail elder’s powers of evoking memory should not be underestimated. children absorb much oral history, for television is not yet a feature of rural saharan communities. moreover, small children acting as intermediaries and caregivers can listen and observe fragility, thereby conferring some empowerment through empathy and communicating wishes indirectly through messages. sidi’s dilapidated and nearly-abandoned compound, though it mirrored the frail elder’s physical state, also evoked memories of contrasts there some fifteen years earlier, when it had been a center of lively sociability and storytelling. although this compound now metaphorically represented the old man’s bodily fragility, it also prompted people to remember a happier time of his past “prime.” when my research assistants and hosts (now a married couple) had planned to marry years before, the soon-tobegroom was constructing this compound nextdoor to that of his father sidi and mother tanou. both were at that time considered imgharen with their children grown and marriageable or married, but still vigorous and active. sidi had been an accomplished islamic scholar, in a clan of prominent marabouts closely related to the local chiefly family. in his youth, he had gone caravan trading. he owned several oasis gardens and a few livestock, though the latter were diminished from droughts. the older couple had enthusiastically recounted folk tales and legends to me, several with themes of elder/children/ alms relationships. in one tale, small children visit and give offerings to the tombs of their patrilineal ancestors. sidi and his wife explained this tale as reminding youths to visit relatives on a muslim holiday (rasmussen 1997). their voices in the foregoing narratives, though part of the past, continue to “echo” in current cultural knowledge and practice in contexts of ritual, if not secular power. many tuareg explained that “spirits fill places that were once full of people and are now deserted and full of nostalgia (another meaning of essuf),” for example, abandoned campsites, sacrificial terrains, and razed markets. there are efforts not to upset these spirits in such practices as almsgiving to obtain al baraka blessing. essuf is not in every respect a negative place, but is also a place of creativity, for example, the best poets are said to compose their verses in the wild, and herbalists gather their tree medicines there. spirituality is therefore relevant, indeed fundamental, to the meanings of frail elders’ seclusion and their consequences in caregiving. 137 anthropology & aging quarterly 2012: 33 (4) susan rasmussen a little to one side attitudes toward frail old age in relation to household dynamics also relevant here are the economics and politics of caregiving. what does the current tuareg household predicament imply about household “exclusion” in advanced aging? albert and cattell (1994) have pointed out that modernization and globalization have had enormous impacts in africa and elsewhere. in niger and mali, economies have declined in recent years, poverty has increased, and daily struggles for survival have intensified. unemployment, monetarization, ecological disasters, and wars have diminished livestock, and propelled many young tuareg men into labor migration and political exile abroad.6 many young men skip the traditional male rite of passage and socialization: the now-disrupted trading caravans for salt and dates across the sahara under the authority of elderly male relatives, who conduct tests transforming youths into men (claudot-hawad 2002). these processes have consequences for frail elders’ authority patterns and intergenerational relationships. yet elders are not excluded from family support systems. there remains great emphasis upon outward public reserve toward, and on the part of, still-vigorous older parents whose children are of marriageable age or recently married, and their own dignity (imojagh), and others’ strict respect/ reserve/distance/avoidance (takarakit) toward them are necessary for adapting to household transformations and transitions. following children’s marriages, one should increase one’s time devoted to prayer and islamic rituals, for example, in the mortuary alms feasts and in chanting liturgical music, and one should withdraw from more “secular” or “frivolous” festivals, especially in communities where islamic scholars and icherifan clans claiming descent from the prophet are numerous and influential. these orientations ideally reinforce still-vigorous elders’ important authority positions as household heads: as decision-makers (for example, where to move a nomadic camp), as namers of children and grandchildren, and as prominent participants in rites of passage, and healing specialists (rasmussen 2006). married persons practice a reserve or “shame” or “avoidance” (takarakit) relationship toward their parentsin-law involving name teknonymy and refraining from eating in their presence. new bridegrooms must wear the men’s faceveil-turban high on the face (over the nose and mouth) before the mother-in-law, bring back food goods and cash from oasis garden produce, trading and labor migration products and cash for their parents-in-law, and must refrain from looking into the latters’ grain storehouse. by contrast, confirming radcliffe-brown’s classic observations long ago, as in many other cultural settings, playful joking relationships are frequently practiced in public between alternate generations: namely, grandparents and grandchildren. grandmothers often mock breastfeed their daughters’ babies, and grandfathers—even chiefs and marabouts—often allow young children to play with their face-veil, normally taboo to other persons, as this is a symbol of adult male gender modesty and respect. household residential changes, domestic subsistence patterns, and kin relationships also powerfully affect later caregiving of frail elders. many of these practices respond to wider changes outside the household; in the past, related to pastoral nomadism, and currently related to global pressures, namely (predominantly young men’s) labor migration and kin relationships (especially fatherson and parents-in-law and children-in-law) impacted by this, state and ngo-engineered pressures on tuareg nomads to sedentarize, droughts, and sporadic armed conflicts between tuareg dissidents and national armies in the saharan region. in semi-nomadic and sedentarized communities, occupations are now diverse within a single household, regardless of the family’s social stratum origin. one child may become a gardener, another a herder and caravanner, another may depart on labor migration, and yet another may operate a market stall or small boutique in a town. these patterns cause lengthier, less predictable separations than the older seasonal fission and fusion of households in nomadism and caravanning. many youths, returned from travels, but unemployed and unable to raise bridewealth, marry, or reintegrate into tuareg society, form a post-tuareg rebellion wave of an age cohort known as ichumaren (denoting approximately “the unemployed”). many elders lament that “reserve (respect) has been abandoned,” and relate stories of children refusing arranged marriages with close cousins and/or endogamously within the same social stratum, discarding the men’s face-veil, and neglecting islamic prayers and other rituals (boilley 1999; rasmussen 2000a, 2000b). as a result, intergenerational and kinship roles are becoming more fragmented. this trend is double-edged in its consequences. youthful men, once dependent upon the mother-in-laws’ approval for establishing independent married households with their wives, now enjoy greater freedom if they are able to successfully benefit from the increasingly monetarized economy beyond subsistence anthropology & aging quarterly 2012: 33 (4) 138 susan rasmussen a little to one side susan rasmussen a little to one side work for parents and parents-in-law. for those youths who are unemployed, by contrast, elders’ authority may be less contested. but even these youths still hold many “cards” since they cannot support elders so generously in late life, and elders know this. in rural, more nomadic households, many older women and men still assert much control over their children and children-in-law. but these sources of authority are dependent upon the older nomadic livestock economy, in which inheritance of herds acted as a powerful source of leverage over youths; and this economy is now threatened by droughts and wars. in sedentarized oases and towns, residents are moving toward farming, labor migration, and cash-based markets. caravan trade goods—traditionally bartered—are no longer sufficient to support the household and elderly parents. wider political events are also relevant here, though not the primary cause of sidi’s and others’ residential arrangements. sidi’s predicament is typical in many respects, but atypical in one respect. traumatic regional violence and dispersal of refugees may have accelerated his physical and mental decline, and also undermined, rather than reinforced, his potential to continue some aspects of the ideal authority role over the heretofore seminomadic, seasonally unified household. in the late 1990’s, he and his family were forced to evacuate with other refugees from an attack by government army soldiers, who accused local residents (falsely or accurately, i do not know) of supporting and sheltering dissident rebel fighters. this catastrophe undoubtedly traumatized sidi further, whether he had been frail before that event or not, though he did not mention it to me himself, friends and assistants away from his presence related sorrowfully, “we had to place our old and sick people on donkeys and camels…until we arrived safely at a distant oasis higher up in the mountains many people died. one woman spent two days in hiding with her children without food.” my long-term hosts in that region joined refugees in flight who temporarily resettled in that mountain oasis, where they had to start new gardens, occupy smaller residential spaces, or camp out in the dried riverbed and rely on local assistance for food and water. upon return to their village after mediation of that conflict in algiers, they found that some soldiers had stolen medicines, grains, livestock, and household valuables such as women’s jewelry. there were also gardening land shortages from these demographic upheavals. so sidi’s son (my assistant/host) had decided to farm back in the mountain village where he had fled, where his wife’s parents still resided. he left his aging father inside that compound back in his village, since his sisters and their households were located just adjacent to it. that is how i found him. how far did the local religious cosmology and how far did the local political-economic trauma each contribute to the seclusion and youthful caregiving of frail elders? it is tempting to attribute much causal connection to the traumatic violence and their aftermath. yet it should be noted that, except for the refugee flight and return, sidi’s caregiving situation was not new, aberrant, or atypical; for as already observed, during peaceful times, as well, frail elders are almost always housed in removed spaces; recall that even the former (now-deceased) local chief and the anestafidet were earlier in my research, during more peaceful and prosperous times. sidi would have occupied such as place “a little to one side” in the distant oasis, as well, had he gone there, but the compound of his son and his wife there was considerably smaller; thus it made sense to house him back in their village of origin near his daughters. indeed mobility and upheavals are not entirely novel; for many tuareg have longstanding experience of travel in nomadism and caravanning, and suffering from battles in raids. thus these wider pressures affect, but do not overturn completely, local strategies of caregiving. even prior to these far-reaching recent upheavals, moreover, even still-vigorous elders’ authority was never uncontested. some youths, for example, opposed parents’ choices of a marriage partner; others accepted this as a first marriage, but later divorced and re-married according to their own choice. others departed on travel, never to return for years. there is not, and never has been, a guarantee of late-life unified household, support, companionship, or caregiving. many gossip about (supposedly) rare cases of dire neglect of frail elders, for example, a marabout related disapprovingly how “one invalid elderly parent wanted water, but his family denied him sufficient quantities of this, and they will surely not go to paradise!” perhaps adults rely on young children as caregivers in part because they can most easily delegate this responsibility to them, and also because alternate generations need not conceal shameful conditions of both very young and very old (i.e., of weakness, illness, dirt). children are also sent to look in on sick persons. these practices have to do with the important tuareg value called takarakit, which denotes reserve and shame, in addition to respect. relevant here are longstanding tensions, contradictions, and dilemmas surrounding youth-elder and intergenerational relationships, both past and present, and their modifications. the ideals of reserve 139 anthropology & aging quarterly 2012: 33 (4) susan rasmussen a little to one side and dignity can mask a tension between what it means to be an elder as a leader (amghar) and simultaneously be a spouse, (if not widowed), grandparent, parent, affine, and pre-ancestor. still-vigorous elders can and do hold these roles simultaneously, but they must mask this simultaneity in public: they must, in effect, maintain a distance in order to retain authority, but remain visible to exercise that authority. later, upon decline and senescence, there is the need to conceal elders’, particularly chiefs’ and islamic scholars’, waning physical strength and official authority. for if this is revealed too openly, their al baraka risks being doubted. these frail elders need to be kept separate from still-fertile young childbearing women. small children are ideal buffers since they, too, occupy liminal status. thus socioeconomic and political factors, cosmology, and ritual are all powerful in shaping the interior space and psyche of frail elders’ predicament. interior psychic border-crossing frail elders stand, as it were, at the confluence of mutually-incompatible physical, cosmological, ritual and sociopolitical powers. in this, their spatial separateness and social withdrawal convey their simultaneous disengagement, frailty, but also their newly active spirituality and alternative powers. they are both mediators and bystanders, but risk becoming neither as abject “anomalies.” notwithstanding these dangers, in withdrawal from worldly authority, some active aging may nonetheless take place indirectly. most old/old persons continue some light handiwork—for example, men often make ropes for household and travel uses. frail elders who are comfortable enough to speak relate tales and reminiscences to children, thereby commenting on local mythico-history. a few remain very alert, and sometimes reveal important healing knowledge (rasmussen 2006). the peripheral residential space thus bears some resemblance to a “time-capsule” and to the australian aboriginal “dreamtime” as a time/ space where past and present meet. the close relationship between children, elders, spirits, ancestors, graves, and the afterlife involves a kind of “beforelife” or becoming, perhaps a life review as well. sometimes, ancestors in graves and spirits near them are believed to greet people on the road or even ask for belongings, especially from children. children are also believed to often stumble upon kel essuf spirits playing miniature tende mortar-drums in empty riverbeds. there is a tale about spirits stealing babies, upon mistaking them for goat-hide waterbags. moreover, the spatial symbolism of frail elders’ seclusion recalls, but also diverges from, the symbolism of tuareg smith/artisans’ marginality. both figures are mediators, though smith/artisans are social mediators. smith/artisans act apart from, but also centrally as go-betweens for other tuareg, lack dignity and reserve, and convert natural into cultural substances. frail elders nearing death are, their physical seclusion notwithstanding, also mediators, albeit in a different sense: the old/old convert cultural persons into spiritual beings (living and deceased)—for example, in their participating in naming of children and in telling histories to and about small children portraying ideal values of heroes’ resistance to oppression, protection of life, and generosity between the generations. in feeding the frail elder, small children in effect are giving them alms— the reciprocal counterpart of many other occasions when adults give alms to small children. conclusions the space of the frail old/old is not shrinking. rather, it has always been peripheral and central at once. this article reveals more nuanced and dynamic multigenerational relationships, semiotics of space, ritual and social practices on advanced aging. the essay also challenges some representations of frail, even dying elders as entirely disengaged or passive. the tuareg data indicates that, although there occur some physical and politicaleconomic disengagement and withdrawal from official political authority contexts, there also occurs, despite pain and suffering, alternative empowerment of the person— not always realized by everyone, but available as cultural possibilities. secluded space can isolate elders from family and production, as in the peripheral hospices in western europe, the united states, and urban india. in many “occidental” societies, segregated physical space and built form can disempower persons and erase memory. the tuareg data suggests that elders’ association with both ancestors and children in a space of creativity forges a subtle power that, when not radically disrupted, confers meaning to declining physical and social personhood. notes 1 most tuareg remain predominantly rural, but many have been pressured toward sedentarization and migration to towns, first by french colonial administrations and later by some independent central state governments and aid programs. 2 in the past, social stratum affiliation was inherited, based on descent. aristocatic imajeghen controlled most large livestock, weapons and the caravan trade, tended to be more nomadic, anthropology & aging quarterly 2012: 33 (4) 140 susan rasmussen a little to one side susan rasmussen a little to one side and collected tributes and rent from more sedentarized farming and other peoples of varying client and servile status (ighawalen and iklan). iklan were owned, often war captives, and were liberated on independence at mid-century. tributaries, imghad, some former nobles defeated in battle, raided and traded for imajeghen in exchange for military protection, usufruct rights, and part of the booty in war. inaden, smith/artisans, manufactured tools, jewelry, recited oral histories, officiated at rites of passage, and acted as important go-betweens for their aristocratic patron families. islamic scholars (ineslemen, popularly called “marabouts”) interpreted the qur’an, and continue this role as well as divination, counseling, and medicoritual healing. 3 there are some challenges to these gendered arrangements in groups more influenced by qur’anic law, islamic scholars, and islamist-reformist movements, as well as in sedentarized oases and large towns more influenced by nation-state family code laws and other ethnic groups. 4 many tuareg groups now practice bilateral or “double” descent, combining to various degrees, matrilineal and patrilineal legal systems of inheritance and secession. but in most groups, most women inherit property through endowments called akh ihuderan or “living milk” intended to compensate them for the male bias of qur’anic inheritance in which two-thirds of property go to male heirs and one-third go to female heirs. most women go about unveiled, may travel and visit freely and receive unrelated male visitors, even after marriage, and may initiate divorce. 5 the post-colonial tuareg armed rebellions began in 1963 in the northern kidal region of mali over food distribution and taxation, and have recurred in both countries sporadically between 1990-1996, in 2007 in the northern arlit and iferouan regions of niger over uranium mining contracts, and most recently, in january 2012 in northern mali. until recently, the northern and more nomadic regions of these countries were marginalized politically and economically. peace accords promised semi-autonomy, greater economic aid for these regions, as well as greater integration of tuareg into the national armies, higher education, and jobs in the new infrastructures. but national budgets are limited, and control over policies and events in the peripheral border regions has been uncertain. 6 there have been a series of droughts: in 1913, 1969-1976, 1984, and more recently, also locust invasions around 2005, as well as resurgences of the tuareg rebellion against the central state governments of niger and mali and national unemployment problems throughout these countries, as well, which have propelled refugee flight and exile out of tuareg regions. most recently, the 2011 war in libya caused an influx of refugees into some tuareg regions, particularly niger. references ag solimane, alhassane 1999 bons et mauvais presages: croyances, coutumes et superstitions dans la society touaregue. paris: l’harmattan. albert, s.m. and m.g. cattell 1994 old age in global perspective : cross-cultural and cross-national views. new york : g.k. hall. bernus, edmond 1981 touaregs nigeriens: unite culturelle d’un people pasteur. paris: orstom. boilley, pierre 1999 les touaregs kel adagh. paris: karthala. ouman, annmarie 2003 benefits of belonging. utrecht: university ph.d. dissertation. bourgeot, andre 1994 revoltes et rebellions en pays touareg. afrique contemporaine: etudes 170, no. 2: 3-19. claudot-hawad, helene 1993 touareg: portrait en fragments. aix-en-provence: edisud. 2002 voyager d’un point de vue nomade. cohen, lawrence 1998 no aging in india: alzheimer’s, the bad family, and other modern things. berkeley: university of california press. cumming, elaine and william f. henry 1961 growing old: the process of disengagement. new york: basic books. dayak, mano 1992 touareg, la tragedie. paris: editions jean-claude lattes. douglas, mary 1966 purity and danger. london: routledge and kegan paul. glascock, anthony p. 2009 when is killing acceptable: the moral dilemma surrounding assisted suicide in america and other societies. in the cultural context of aging: worldwide perspectives, jay sokolovsky, ed. pp.77-93. westport, ct: bergin & garvey press. goody, jack 1958 the developmental cycle of domestic groups. cambridge: cambridge university press. gutmann, david 1987 reclaimed powers: men and women in later life. evanton: northwestern university press. kaufman, sharon r. 1986 the ageless self: sources of meaning in late life. madison: university of wisconsin press. keenan, jeremy 2003 the end of the matriline? the changing roles of women and descent amongst the algerian tuareg. the journal of north african studies 8 (3-4): 121-162. lamb, sarah 2000 white saris and sweet mangoes: aging, gender, and body in north india. berkeley: university of california press. nicolaisen, ida and johannes nicolaisen 1997 the pastoral tuareg. copenhagen: rhodos. oxby, clare 1990 the living milk runs dry: the decline of a form of joint-ownership and matrilineal inheritance among the tuareg (niger). in property, poverty and people. p.t.w. baxter and richard hogg, eds. pp. 222-228. manchester: manchester university press. radcliffe-brown, a.r. 1938 taboo. the frazer lectures. cambridge uhniversity press. 141 anthropology & aging quarterly 2012: 33 (4) susan rasmussen a little to one side rasmussen, susan 1995 spirit possession and personhood among the kel ewey tuareg. cambridge: cambridge university press. 1997 the poetics and politics of tuareg aging: life course and personal destiny in niger. dekalb: northern illinois university press. 2000a between several worlds: images of youth anhd age in tuareg popular performances. anthropological quarterly 73(3): 133-145. 2000b alms, elders, and ancestors: the spirit of the gift among the tuareg. ethnology 39(1): 15-38. 2001a healing in community: medicine, contested terrains, and cultural encounters among the tuareg. westport, ct: greenwood/bergin & garvey. 2001b wedding of calm and wedding of noise: aging performed and aging misquoted in tuareg rites of passage. journal of anthropological research (57):277-303. 2006 those who touch: tuareg medicine women in anthropological perspective. dekalb, il: northern illinois university press. rosaldo, renato 1989 culture and truth. boston: beacon press. sokolovsky, jay, ed. 2009 the cultural context of aging. westport, ct.: bergin & garvey/greenwood. stoller, paul and rosemary coombs 1994 x marks the spot: the ambiguities of african trading in the commerce of the black public sphere. public culture (7):249-274. vatuk, sylvia 1980 withdrawal and disengagement as a cultural response to aging in india. in aging in culture and society. christine fry, ed. pp. 126-148. new york: praeger. 1990 to be a burden on others:” dependency anxiety among the elderly in india. in divine passions: the social construction of emotion in india, owen lynch, ed. pp. 6488. berkeley: university of california press. 165 anthropology & aging quarterly 2012: 33 (4) anthropology & aging quarterly the official publication of the association for anthropology & gerontology information and submission guidelines book reviews aging and the indian diaspora. sarah lamb. bloomington, in:indiana university press. 2009. isbn 978-0-253-35343-6, 360 pp. price $65/$24.95 (hardcover/ paper) sarah lamb’s ethnography, aging and the indian diaspora, critically explores changing systems of aging and care provision in india and among indians in the u.s. by examining the needs and desires of indian older adults across three constructions of aging: living in an old age home, living alone, and migrating to the united states, the ethnography reveals how understandings of the person, family and the state also are shifting in contemporary india. lamb unpacks cultural assumptions regarding the “proper” way to age and probes deeply into the multiple meanings of “modernity.” older adults in india traditionally reside in multigenerational households. lamb’s earlier ethnography, white saris and sweet mangoes, explores the conflicts surrounding aging in such settings, particularly for women. although multigenerational households remain a cultural ideal, india’s economic liberalization, the employment of women outside of the home, and increasing global ideological, financial, and human flows have sparked the development of other forms of aging. most alarming of these trends to the general public is the growth of private “old age homes” for the urban middle class and the increasing number of older adults living alone, i.e., independent of their adult children. although old age homes and living alone are commonly presented in the indian media as symbols of western immorality and as “unnatural,” many of lamb’s interlocutors view living in an old age home as “liberating.” old age homes provide a sense of security, social support, and the opportunity to engage in culturally valued roles, including extending blessings, receiving “seva” or service, and entering a “forest dwelling life,” the third of four life stages in hinduism that requires a withdrawing from worldly ties. living alone similarly provides a sense of freedom and an opportunity to form new friendships. as old age homes carefully employ cultural tropes and maintain a construction of seva as a non-economic exchange, lamb argues that old age homes are not simply a u.s. export, but have become uniquely indian phenomena. one of the strengths of lamb’s writing, both here and in white saris, is her ability to capture the complex, and at times contradictory, viewpoints of her interlocutors. for example, even as interlocutors explain the benefits of living in an old age home or living alone, lamb makes clear the presence of unresolved feelings regarding such living arrangements. her interlocutors are disturbed by the disconnect between their long-held expectations of aging in the context of their family, and their present situation of aging seemingly outside of the family. lamb also successfully captures the emotional conflict surrounding migration to the u.s. although parents often view their children’s migration as important for material advancement, they lament that migration frequently results in children no longer having time for intimacy and service, even in the form of a simple cup of tea. joining their children abroad can require inverting traditional exchange flows, with older adults being expected to care for the family, e.g., in the form of childcare or housework, rather than receiving care, and when needed, accepting social service and economic support from the state. aging and the indian diaspora makes important contributions to understandings of aging and globalization. lamb challenges conceptualizations of aging as passive, arguing instead that older adults “craft” the aging experience and the meaning of modernity. by revealing the multiple forms of modernity that exist, lamb further questions assumptions that globalization is leading to the cross-cultural rise of a generic, free-market, western-styled, form of aging. as in her earlier work, lamb employs language that is accessible to undergraduate audiences. she clearly operationalizes her major concepts (e.g., modernity; agency, intergenerational reciprocity) at the outset of the text. i would have liked to have seen more discussion on human subject protections, for example, the reasoning surrounding the inclusion of mr. datta, who indicated that he did not want his information recorded (p. 107). such a reflection would be useful for classroom discussions on ethics in qualitative research. however, this is a minor point. the ethnography’s solid theoretical grounding also would make it appropriate for graduate courses on cross-cultural aging. sarah e. chard, ph.d. associate professor of anthropology, umbc anthropology & aging quarterly 2012: 33 (4) 166 anthropology off the shelf: anthropologists on writing. alisse waterston and maria d. vesperi. malden ma: wiley-blackwell. 2011. isbn 978-1-4443-3879-9, 232 pp. price $34.95/$79.99/$94.95 (paper/e-book/hardcover) i was a writer long before i became an anthropologist. i wrote my first story when i was eight, turned to poetry in my teens, majored in english literature in college. anthropology came in midlife. so this exploration of anthropological writing is especially intriguing—no, exciting! for me. the book’s big question: how can we write so that our books fly “off the shelf” into the hands of informed readers? into the hands, that is, of readers who don’t (and won’t) read the sometimes impenetrable dialect of academe, with its citation conventions and dense language (“too many syllables and not enough content,” brodkin, 22). the short answer: tell readable stories and avoid “academic high jargon” (introduction, 4). the dilemma: if you tell stories this way, your academic audience—the “judges of epistemology” (nordstrom, 36)—may scorn you. but this book’s authors do not want to abandon anthropological writing, so there is always tension between writing to impress other academics and writing for the informed reader. so, another big question: how can we be both anthropologists and writers? writing anthropology also involves ethical issues: how do we represent those about whom we write? what is our responsibility to them? are we trying to bring about change, or even, should we think in terms of bringing about change? is it okay to just tell our stories, “to document carefully and clearly what is happening” (farmer, 188)? the book is organized into three parts. part i, conceptions, puts forth basic ideas. we can’t trace the impact of most writing, but changing the consciousness of individuals is the first step to change (political scientist zinn). avoid “lardballs of jargon” with polysyllables galore and “genuflection-by-citation” (brodkin, 21). write like the bard “…who translates the unfettered wilds of raw experience and human interaction into philosophical story” (nordstrom, 36). try to reach understanding through anthropological concepts such as race and culture (baker). write well, tell stories, use specifics–and publicize (what?! the “m” word? marketing???– see journalist barnes). the authors in part ii, creations, tell stories about writing particular books and their struggles with the academic canon and publicizing (to no avail: waterston). signithia fordham tells of being forced to write “out of voice” and developing her “counternarrative voice.” arthur spears relates his difficulties in publishing a book about racism in america and how the university press which published it subtly sabotaged it. ruth behar used to write for teachers, now writes for her mother “so i could write for the world” (111). and sharon ball reminds us of her friend octavia butler’s advice: “write your passion”— something anthropologists are likely to do because “our imaginations are in service to real communities we know firsthand” (behar, 115). part iii, reflections, considers the impact of our writing. we write. then what? mostly dull thud. paul farmer and eben kirksey combine their writing with advocacy and activism. for them, just writing isn’t enough. but don’t expect your activism to change the world. it rarely does. the final chapter by maria vesperi, journalist and anthropologist, serves as an epilog which sums up themes threaded through earlier chapters. think about style, voice, audience. tell stories. give details. use dialog. make statements (as a friend of mine says: “save your anxieties for your shrink”). stay away from jargon. get critiques from others, join a writer’s group, take workshops. and above all: write! write regularly, for a defined time—then walk away for that day. and write creatively, daringly: take chances, leap and soar. blessedly, all the chapters are short and non-jargony. they tell stories, mostly without footnotes and minimal or even no references. they are easy to read but offer much food for thought. so, if you’re wishing or hoping to become a better writer of ethnographies (or anything else), i recommend this book. i’ll be thinking about the issues these authors raise as i work on current writing projects, which include my spiritual autobiography and family memoirs. how does anthropology enter them? i’m sure it does. i am, after all, an anthropologist and a writer. but that’s another story. meantime, let’s all become better writers of ethnographies which might have at least a chance of flying off the shelf. anthropology off the shelf gives us plenty of inspiration for that kind of good writing. maria g. cattell, ph.d the field museum of natural history book reviews 167 anthropology & aging quarterly 2012: 33 (4) book reviews alzheimer’s from the inside out. richard taylor. baltimore, ma:health professions press. 2007. isbn 978-1932529234, pp 224. price $19.95 (paper) dr. richard taylor, trained as a psychologist, was diagnosed with early onset alzheimer’s type dementia at the age of 58. he opens by stating that the book was not originally intended for commercial consumption, rather, he writes for himself to process his experiences (or as he calls it, “therapy without co-pay”)(pg xvii). what is produced reads more like an autoethnography than an autobiography. while he acknowledges that his own experience will not capture nor reflect everyone’s experiences with the disease, he offers these writings to provide insight from an “insider’s perspective”. through the use of voice recognition software, dr. taylor shares his experiences, ranging from the limbo of the diagnosis process (which took over a year of testing), through the loss of his identity as an academic, and eventually, the loss of his status as an independent adult. though this is only one man’s experience with the disease, his work touches upon powerful themes that have appeared elsewhere in the literature (though other sources are commonly from the caregiver or researcher’s viewpoint). this book addresses the need for more research that incorporates the direct voice of those with alzheimer’s and related dementias. the book is divided into four parts: 1) what is it like to have alzheimer’s disease?; 2) from the inside out; 3) from the outside in; and, 4) dear doctor. also worth noting is the appendix, which is titled: what you can do. each section includes essays, wherein dr. taylor reflects on his experiences, thoughts, and emotional interactions with his caregivers and his environment. interwoven throughout dr. taylor’s collection of essays are several themes that an anthropologically minded reader might identify and find useful. some examples of these themes are the following: 1) the role of technology; 2) curing versus healing; 3) the social construction of the disease; 4) changing social roles, identity, personhood with a diagnosis of alzheimer’s or a related dementia; 5) recognition and advocacy. the role of technology anthropologists have long been interested in humans and their evolving use of technology over time. use of online sources is prevalent throughout the book. the use of online sources emphasizes the internet as a powerful source of information and understanding of the disease for both caregivers and persons with the diagnosis. not only is the internet used to cite statistical trends, but it is used as means of communication with online support groups, and literature from which he finds context, connections, and meaning. though some of the online sources for information on alzheimer’s disease may have become dated, even in the short 6 years since the book’s first publication, the quotes used are often timeless. even the references from dante’s inferno (used to define purgatory and limbo as dr. taylor waits for test results) are attended by an online citation. curing versus healing dr. taylor emphasizes the inability of science to “cure” his disease and the complexity of the treatment of his symptoms. in one essay entitled “we have a pill. alzheimer’s can be treated!”(41), dr. taylor distinguishes between treating an illness and curing it. while there is no “cure”, dr. taylor refers to writing the book as a “therapy”, to sort the painful experiences that accompany “what is going on between [his] ears” (3). in this way, he is treating himself by reflecting on his personhood, (“am i my brain? or is my brain me?”(113)), his spirituality (“my flesh is weak(er) but my spirit is (still) strong (108)), and the shifting social roles played by himself (“am i to be my spouses son?”), his caregivers (“my champion or my hero?” (163), and his doctors (“from my heart to my m.d.’s ears” (233). the social constructions of the disease dr. taylor illuminates the limits of science when explaining the causes and halting the symptoms of alzheimer’s disease. he writes, “there are no accepted norms for people with alzheimer’s on these tests. there is no agreement on the exact number of stages of the disease. there is no agreement on how long each stage lasts…” (38). in another essay, he describes the variation in the number of stages the disease might have (ranging from three, seven, or nine stages) (21). this variation highlights the contested construction of the disease, as graham (2006) argues that “[a]nthropologists underline how scientific activity is not always about uncovering ‘nature’. it is a fierce fight to construct reality” (83-84). changing social roles, with a diagnosis of alzheimer’s or a related dementia social roles and productivity: early in the book, taylor describes the loss of his career as successful psychology professor (who continued to work for three years before he was politely asked to retire) (22). he writes about the transition from being an academic to “wandering around the lobby (my house)” (22). there is a genre of anthropology & aging quarterly 2012: 33 (4) 168 anthropological writings examining disabilities and/or the life cycle that have connected the ability to work and acquire income with social roles such as “adulthood”, “personhood” “valuable citizen” in american society. taylor’s book is an interesting addition to this genre because it is evident from his writings that he also sensed the loss of his identity as not only an “academic”, but that of “adult” (186). dr. taylor explores the loss of his social roles as he begins to require more and more help with his daily activities. he recounts the frustration of losing his highly valued autonomy in essays such as, “give me your money, your car and…” (181). social roles within the family: dr. taylor’s writings add to the concept of social roles; he observes his shifting role (and those of his caregivers) an insider’s perspective as he describes his growing dependence upon his wife and adult children. he writes, with much chagrin that he feels that his spouse and children are taking on a parental role (164; 189). he writes several essays pleading with his caregivers to see the person that remains within him, such as “a silent, one-sided conversation with my caregivers” (174) and “once again, my children believe they know more than i do” (166). recognition and advocacy the framework, of “recognition,” has been recently applied in medical anthropology (see janelle taylor 2008) to explore the shift in a person with dementia’s ability to recognize family and friends, as well as a person’s recognition within the socio-political arena. this framework argues that when a person with alzheimer’s disease or a related dementia loses their ability to recognize their caregivers, it is often equated with an inability to reciprocate, express affection, or have a voice. likewise, dr. taylor writes about his family’s search for mutual recognition; that his family, friends, and doctors are seeking to recognize the person he used to be before his memory loss: “physicians, friends, and family are forever asking me, ‘how is it going? do you still feel ok?...the measures used to evaluate my answers seem to grow from the unstated questions, ‘are you still like me?’” (176). dr. taylor insisted upon recognition in the political arena, where people with alzheimer’s disease or related dementias are often neglected. he remains an active member of the dementia advisory committee of the u.s. alzheimer’s association, “looking at how to better integrate individuals living with the diagnosis in the leadership; program development, and delivery function of the association and its local chapters” (xiii). dr. taylor continues to be a speaker at professional conferences. he also gives informal talks to caregivers, organized chat rooms for people with dementia and caregivers alike. in addition he publishes his own newsletter of, by, and for people with dementia. this is significant as there have been questions about the number of organizations that actively include people with alzheimer’s disease or a related dementia in their decision making and advocacy process. dr. taylor, through this book and the aforementioned, brings recognition of the person behind the diagnosis. this book is relevant for anthropologists, students in healthcare professions, gerontologists at both the undergraduate and graduate level. this book can be used to augment the more scientific or heavily theoretical writings that present ideas about this disease in a more distanced manner. it might be especially helpful outside of the classroom as a resource for support groups, for families affected by alzheimer’s disease and related disorders (including a person in the early stages of dementia). dr. taylor brings a very human element to the disease experience, which might offer a more complete perspective of those experiencing the disease. janelle j. christensen, phd, mph university of south florida references graham, janice 2006 diagnosing dementia: epidemiological and clinical data as cultural text. in thinking about dementia: culture, loss and the anthropology of senility. annette leibing and lawrence cohen eds. rutgers university press, new brunswick. taylor, janelle s. 2008 on recognition, caring, and dementia. medical anthropology quarterly 22(4):313-335. if you are interested in writing a book, film, journal or exhibit review for anthropology & aging quarterly, please contact the book reviews editor, joann kovacich jkovacich@rochester.rr.com. include your name, areas of expertise, current affiliation (research, professor, graduate student, e.g.) and any titles you would be interested in reviewing from the last three years. aaq does not accept unsolicited reviews. portfolio academics as allies and accomplices: practices for decolonized solidarity theresa southam teaching and learning centre, selkirk college tsoutham@email.fielding.edu anthropology & aging, vol 42, no 2 (2021), pp. 150-165 issn 2374-2267 (online) doi 10.5195/aa.2021.366 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 150 portfolio academics as allies and accomplices: practices for decolonized solidarity theresa southam teaching and learning centre, selkirk college tsoutham@email.fielding.edu introduction in canada, the colonization of indigenous people began in the 1400s with european explorers and traders imposing laws and making policies that have separated indigenous people from “their traditional culture, languages, spirituality, economies, systems of governance and other important parts of their identity” (schiffer 2016, para 2). today, colonization “remains embedded in the legal, political and economic context of canada” (clogg 2020) and, in particular, through the seizing of land, control of resources, and the child welfare system (wilson 2018). colonialism also imposes social control by means of force and laws which suppress indigenous worldviews. also, during the last decades, there is a growing awareness that both non-indigenous and indigenous people are disadvantaged by the continued “marginalization of indigenous knowledge, particularly its use in research” (jones, cunsolo, and harper 2018, 1). i am a non-indigenous college administrator, author, and researcher working on the territory of indigenous people. i have benefitted from the privilege of the colonizer and lost opportunities to learn from indigenous people when i was unaware of indigenous ways. i am decolonizing my mind so as to learn from indigenous knowledge and ways of being. indigenous knowledge can help non-indigenous people solve some of the wicked problems we all face today. in this portfolio i tell a little of my journey towards allyship and of my efforts to move beyond allyship towards practicing decolonizing solidarity and being an accomplice. the portfolio is full of advice from indigenous authors, elders, and academics about practices that can lead to the decolonization of and allyship in academia both as indented quotes from my personal communication and as quotes from published indigenous works embedded in the text. my own experiences are included in italics and indented quotes to signal they are from me. this portfolio draws from two recent learning resources by indigenous authors. the web-based open access version of as i remember it: teachings (ɂəms tɑɂɑw) from the life of a sliammon elder provides the teachings of elder elsie paul and her team of indigenous and non-indigenous collaborators. fatty legs – a true story is a collaboration between mother-in-law and indigenous elder margaret-olemann pokiakfenton and her daughter-in-law christy jordan-fenton. jordan-fenton’s curiosity about her mother-inlaw’s life led to her devotion to understanding colonization for herself, her children, and others. in fatty legs – a true story the two have recounted pokiak-fenton’s years at a residential school run by the roman catholic church in aklavik, northwest territories. the story explains how indigenous children were shamed into renouncing their culture. although pokiak-fenton has recently passed jordan-fenton continues to write and present on the residential school experience. http://anthro-age.pitt.edu/ http://publications.ravenspacepublishing.org/as-i-remember-it/index https://www.annickpress.com/books/f/fatty-legs-10th-anniversary-edition https://www.annickpress.com/books/f/fatty-legs-10th-anniversary-edition https://www.annickpress.com/books/f/fatty-legs-10th-anniversary-edition https://www.annickpress.com/books/f/fatty-legs-10th-anniversary-edition portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 151 a way forward for academics: decolonization and the two-way wampum belt as i remember it and fatty legs are part of a significant trend in the last decade towards indigenous people telling their own stories. yet, both books similarly disrupt the concept of allyship as it has been understood by non-indigenous people until this day. the books teach that what allyship is and what it is not is often misunderstood. for example, i cannot even count the number of times in the last few years that a colleague or student has said, “i want to incorporate indigenous ways of knowing, but i don’t want to tax, already overtaxed, indigenous academics and communities.” they are here referring to the fear of ‘extraction,’ when mistaking allyship for merely visiting indigenous communities for the collection of their oral histories. i used to share this fear myself for years, until indigenous elder, donna wright offered me a way to move forward by saying: it is a great honour for indigenous people when their work is cited, so don’t stop doing that. however, this does not mean you can begin applying indigenous knowledge or practices that you learn about out of context. dialogue must continue and relationships must be maintained. (donna wright, message to author, 2020) referencing indigenous academics and people, wright argues, can thus be a part of the process of appreciating indigenous ways of knowing, as long as this practice is embedded in a continuous dialogue. the same accounts for non-indigenous people learning about indigenous peoples solely through reading their works: this approach can lead to inaccurate interpretations of indigenous ways of knowing, and the mere reading will never involve learning if it is not embedded in an ongoing relational practice. i remember my early days working on the cultural centre, nattinak in pond inlet, nunavut. after two years interviewing elders and other community members in this arctic community i began to see how ‘content’ could not be extracted for interpretive panels or dioramas in the planned centre as has been done in so many cultural centres in the south. nattinak needed to be built for the people who were communicating these topics through their stories, their hide scraping, and their food preparation. the two: teaching and learning and everyday life cannot be separated. the difference between the often content-driven methods of teaching and learning in western culture and the embodied nature of indigenous teaching and learning is just one difference that helps us see that learning about indigenous people cannot be achieved by just reading books – either as academics or general interest readers. misunderstandings stemming from differences like these can quickly turn into racism if one way is pronounced ‘better’ than the other, or worse if the ‘other’ is disregarded entirely. a brief detour into what constitutes racism bears consideration. racism cannot be separated from issues of power. according to ashley doane (2006), in one end of the spectrum of the concept, racism is viewed as prejudice and discrimination carried out by individuals. at the other end of the spectrum racism is linked to institutional power of dominant groups, i.e. white males living in the united states. in this portfolio, racism is discussed across the spectrum, i.e. both in relation to individual academics such as instructors and as in popular culture or ‘academia’ where white male power continues to pervade. doane aptly defines these mechanisms of racism: discourses of dominant groups work to legitimize and reproduce dominance by minimizing the extent of inequality, marginalizing claims of subordinate groups, and http://anthro-age.pitt.edu/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 152 moving to make dominant group understandings normative for the larger society. (doane 2006, 262) this portfolio is a call to academics and academia to be antiracists by challenging racism both individually and as members of institutions and society, in classrooms, their discourses, community forums, publishing, and popular media. for example, in popular culture elected official alan lagimodiere, manitoba, canada's new minister of indigenous reconciliation and northern relations, said just after being sworn in, that the residential school system was meant to give indigenous children the skills they needed to fit into society (petz 2021). such statements reveal a lack of historical awareness and the banalization of the complexity of racism. if individual academics were to reference a pronouncement such as this, without discernment, or any other statement that constituted hatred, stereotyping, or unequal treatment, then they would be contributing to ongoing colonization in the institutions where they work and, if they published such remarks they would be acting as a racist in academia as well. indigenous children in residential schools in canada were for long verbally and physically abused. recent identification by non-indigenous people of mass graves for these children (indigenous people always knew the graves were there) attest to the fact that these were not schools but places of cultural genocide (van den akker 2021). however, the common sensical racism that comes so natural as to become opaque to non-indigenous people—in literature cited and literature absent, methods used, writing style and findings—is far from evident to indigenous people, who are often unheard in academia and thus continue to face systemic racism (bonneau 2021). it is exactly because academia often mirrors oppression and discrimination in mainstream culture, that it has an important task in diagnosing and remediating it in her own practices. this means becoming uncomfortably aware of blatant forms of racism that seem innocent and are covered in discourses and practices that are ‘wellmeant.’ while in academia the racism today may be subtler, universities and colleges certainly are not safe or decolonized places. for example, in a recent study by mohamed & beagan (2019, 344) on the experiences of indigenous scholars in canadian universities, one indigenous scholar said: i just don’t feel part of the conversation, generally. i think the topics that we’re talking about are not necessarily ones that i think are the most important things to be talking about. you know? a lot of meetings are like that. i feel like they’re just air. racism can thus also mean to feel detached from the hegemonic discourse, not to feel represented, to feel absent while formally ‘included’ (eisenkraft 2010). this portfolio shows alternative paths forward for the academy: the way of the beaded two-row wampum belt (see figure 1). in dialogue with the indigenous teachings from as i remember it and fatty legs, i here discuss five practices that constructively invite academics to actively counter these racist tendencies, namely, allyship and decolonized solidarity, relationship-building, right action, unsettling our colonized minds, and being of service. later in this portfolio, we’ll explore what adopting these practices means for an academic and the academy as a place of knowledge production, learning, and teaching. until recently, i thought about myself as an ally, but in speaking with indigenous people and reading their work, i became acutely aware that allyship can actually become a shrugging of responsibility when allyship stops there, and that it is important to, like the wampum signifies, act on solutions mutually discussed and agreed upon in recognition of one’s different situatedness. to explore this further, i will first pause on the difference between allyship and standing in decolonized solidarity. http://anthro-age.pitt.edu/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 153 figure 1: the wampum belt signifies “that each nation will respect the ways of the other as they meet to discuss solutions to the issues that come before them” (onondaga nation 2021). courtesy: darren bonaparte who made the wampum replica above and to tara pringle-block for making the beads allyship and decolonized solidarity many middle school children have become allies after reading fatty legs. the author, margaret pokiakfenton, “endured bullying by caregivers, separation from her family and an education aimed at erasing much of her inuvialuit knowledge” (smith 2012, para 4). children are inspired by the young pokiakfenton’s ability to fight back against authority while maintaining her personal dignity. after book readings pokiak-fenton says she noticed her stories “resonated with aboriginal and non-aboriginal adults, and residential school survivors too” (smith 2012, para 9). when first visiting the web-based version of as i remember it: teachings (ɂəms tɑɂɑw) from the life of a sliammon elder, you will be asked to agree with the “protocol for being a respectful guest.” this consent to a protocol of respectful learning, may be a prompt to be remembered by all academics who are interacting with indigenous people—whether an explicit protocol as it is in as i remember it or not— and as such could be an academic’s first step towards allyship. allyship is here understood as “an active, consistent, and arduous practice of unlearning and re-evaluating, in which a person of privilege seeks to operate in solidarity with a marginalized group of people” (british columbia teachers’ federation 2021, 1). although there are no validated measures of allyship, there is agreement on broad categories of behaviours that constitute allyship, namely: individual advocacy, awareness of racism, and institutional advocacy (williams and sharif 2021). as i remember it is such a serious invitation to transformative learning from the sliammon. transformative learning, as a constitutive part of allyship, is a slow and embodied process, and in my own experience with learning about indigenous ways of knowing and being, it has been both awkward and humbling. in the following memory i learned about why regalia is not costume (lara-cooper and cooper 2016; biber 2016; begay 2019) i remember one powwow i was invited to at twin lakes near inchelium. even though we were late in arriving, arrow lakes cct cultural liaison virgil seymour had reserved some chairs near the dancing and in shade. after a while, i remarked on the beauty of the “costumes.” thankfully my indigenous colleague kicked me and whispered that these were regalia. regalia are sacred and have cultural meaning. how could i have mistaken this event for the many nonsacred celebrations of western society? i blushed to my temples and have not made that mistake again. http://anthro-age.pitt.edu/ http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/index portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 154 yet kluttz, walker, and walter (2020) argue that allyship is not going far enough. allyship tends to entail a more passive learning, such as reading indigenous work, visiting indigenous community events, and inviting indigenous people to speak. although learning can be unsettling to our minds and souls (i.e., personal values and beliefs may be challenged), in allyship we may not go beyond personal change or advocacy within our institutions. effectively involving ourselves in indigenous resistance, issues, and rights on the other hand, moves us “from performative partnership to an unsettled, insistent commitment to something different.” this “something different” is not the logical next step of allyship, because. . . “(i)t’s harder to own the uncomfortable nature of a colonial past and continued colonial present beyond the performative” (kluttz, walker, and walter 2020, 61). this unsettled state may lead us to act in solidarity rather than leaving all of the resistance to indigenous people themselves (amnesty international australia 2021). fatty legs may never have been written if christy jordan-fenton, who is not indigenous, didn’t pester her mother-in-law to publish her stories of residential school. jordan-fenton didn’t only want to learn herself, but wanted her children and others to learn about residential schools as well. she supported her mother-in-law to publish and went on the speaking tours with her. in a personal conversation, indigenous colleague and post-secondary educator jessica morin shared her positioning in moving towards decolonized solidarity. although morin speaks about being invisible in the quote below, i’ve watched her put hundreds of hours into building relationships so that significant events can occur. the events have required institutional changes in policy, etiquette, and processes that must happen in advance. at the event morin does not speak for the nations present but she is not afraid to continue making changes at the institutional level so that indigenous ways of knowing and being can be honoured. she needs courage because her decolonized perspective may not be popular or well understood by the institution or the non-indigenous participants who are also her colleagues: for me, i ask where i can stand so that i am not in front, but rather guided from (be)side. i am ‘beside’ in presence, understanding, courage, commitment. i also try hard to be as invisible as possible. (jessica morin, email to author, 2021) in another personal conversation, dianne biin, manager, indigenous education and engagement at selkirk college clarifies how decolonized solidarity means being an active part of an often-unsettling effort: a metaphor that focuses me is theatre production; those who are behind the curtain wear black so the audience is not distracted and yet they work to support the production. without the stage crew those who try to portray the story struggle. as indigenous women and educators, morin and biin extend the more personal reflective learning of allyship to engage in the more active and public resistance of decolonized solidarity. activist and author brittany packet (2019) further describes the difference between standing in solidarity as an ally and being an accomplice. she says, knowing that our freedom is connected is the first step in living by the concept of solidarity. beyond that is the willingness to take risks in the service of justice. this is the difference between an ally and an accomplice. all three of these women would agree that these processes call for the, often uncomfortable, process of unlearning. one aspect of unlearning is the ways in which we consume and share knowledge. visitors to as i remember it, are asked to adhere to traditional knowledge (tk) protocols. the concepts of open http://anthro-age.pitt.edu/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 155 education and creative commons licensing form an introduction to tk labels (antónio andrade 2011). however, tk labels go much further than open education (local contexts 2021). as i remember it has adopted specific tk protocols for attribution, outreach, non-commercial use, and cultural sensitivity. these protocols form “a counter-narrative to incorrect and inappropriate interpretations previously drawn by settlers” (paul et al. 2021). ally accomplice (involves decolonized solidarity) process of unlearning dominant ideologies often leading to individual advocacy, awareness of racism, and eventually institutional advocacy individual or institution takes risks in the service of justice, more active and often results in public resistance figure 2: differences between allyship and being an accomplice a person who has agreed to traditional knowledge protocols and is engaging in allyship and/or decolonized solidarity must also be building relationships. we will discuss building relationships next. the other three practices: right action, unsettling colonial mindset, and being of service will be discussed subsequently. however, even though in this article the practices follow each other, academics should consider all practices in tandem, essential in decolonizing knowledge and academic practice. there must be relations… figure 3: slocan river eventually joins the kootenay river and finally the columbia river which flows into the us and then the sea near portland, oregon. pictured is frog mountain a sacred place to sinixt people. slocan in the sinixt dialect means “speared in the head”. selkirk college’s nine campuses are located on the traditional territories of four nations: the sinixt (lakes), the syilx (okanagan), the ktunaxa, and the secwépemc (shuswap) peoples. these lands are important to all four nations. courtesy: mike graeme http://anthro-age.pitt.edu/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 156 twenty years ago, when there was first talk of ‘indigenizing’ selkirk college where i work, our first step, on the recommendation of experienced indigenous educators janice simcoe and dianne biin (then at camosun college), was to visit and build relations with the four nations whose traditional territories selkirk operates on: sinixt (lakes), syilx (okanagan), ktunaxa, and secwépemc (shuswap). at first, this meant selkirk staff attending council and education-related meetings of the four nations. as time went on, college representatives were additionally invited to powwows,1 funerals, and other ceremonies. the friendships between individuals that grew from these repeated visits grew into enduring relationships between nations and the institution over time. the relationships between nations and selkirk college employees were, according to our memorandum of understanding, forged for the betterment of students. as relations continued to deepen, college employees learned about the particular challenges each nation faced, such as negotiating land developments, maintaining a privately run post-secondary institution, and generating sustainable economic development. the college maintains agreements with each nation to acknowledge their separate sovereignty. becoming gradually better informed about their priorities as relations continue to deepen, the college and its employees can act accordingly. for example, one of the nations, the sinixt who are represented by the colville confederated tribes (cct) were declared extinct by the government of canada until an important supreme court judgement this year (stefanovich, 2021). the judgement found the sinixt, who live south of the us/canada border, have constitutionally protected indigenous rights to hunt in their ancestral territory north of the border in canada (see figure 4). figure 4: in this photo, sn̓ʕay ̓čkstx (sinixt arrow lakes) spokeswoman and cultural coordinator shelly boyd waits for a judgement on the steps of the supreme court of canada building located in the country’s capitalottawa. the decision she waits for will either facilitate or deny her people hunting rights in canada (ctv news 2021). courtesy: derrick lamere http://anthro-age.pitt.edu/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 157 every presentation, workshop, or change in curriculum that the college and the cct collaborated on had the potential to affect their court case, which urged the college to be continuously reflexive and critically aware of the impact of teaching and research practices. careful considerations are also made in relation to collaborations with the syilx (okanagan), ktunaxa, and secwépemc (shuswap) peoples. although the focus of indigenization remains on recognizing indigenous ways of knowing and helping non-indigenous students learn about colonization and the lands on which they are studying, college employees also endeavour to remain aware of the political and economic implications of their actions. figure 5: author with colleague jessica morin (another selkirk college employee at the time) in front of the offices of the colville confederated tribes (cct) during a visit in 2018 where approval was sought from cct council and members for a course that would introduce indigenous people in the region selkirk college operates, including sinixt people. courtesy: theresa southam right action like the cookie pop-ups that appear on many websites when you first visit them, the request to accept protocol for being a respectful guest on as i remember it: is a choice: if you don’t agree you are sent back to the world wide web without entering the worlds of a sliammon elder. in agreeing with the protocol, you have acknowledged that the site is situated in local contexts, that teachings are to be treated with cultural sensitivity, and that you commit to respect and attribution. you have agreed to “come ashore” and visit the four chapters “territory,” “colonialism,” “community,” and “wellness”—at your own pace. in essence, you agree to right action. reflecting on the difference between allyship and decolonized solidarity, right action in this context is more like the former—where the reader/viewer resists western cultural norms that do not make sense such as the linearity of reading. decolonized solidarity would involve challenging linearity in academic texts as the only ‘correct’ form. http://anthro-age.pitt.edu/ http://publications.ravenspacepublishing.org/as-i-remember-it/index portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 158 unlike cookies on other websites that are meant to direct your use of the internet based on decisions you have made in the past, the as i remember it protocol agreement is not used to personalize your visit: you do that on your own by viewing any section of the website in any order. with as i remember it, i started with “an invitation to listen,” which begins with one of the many video and audio recordings that can be found throughout the site (each media usually run 15-30 minutes in length). in the “invitation”, elsie paul, the primary author of the related print book and an elder of the sliammon nation, explains her purpose for the collaboration that led to as i remember it, all while ravens fly in the background, a fire burns, salmon cook, and a child plays. her purpose, she tells, is to provide teachings, especially for members of her nation that no longer live in close geographical proximity to their community. however, paul, does not limit her audience, academics can choose to act on these teachings and perhaps approach their research or interpret their results in different ways. next, i jumped to “our process,” because i was curious about the collaborators and why they had chosen this medium. i’ll say more about that in the section of this portfolio titled “being of service.” after reading and listening amongst the chapters, i visited “features and resources” where, under “additional readings,” i found one of the most comprehensive bibliographies on cross cultural understanding i have ever come across. engaging deeply in this bibliography while continuing to create relationships with indigenous people might lead to right action as decolonized solidarity. in this practice western cultural norms do not always form the basis of decisions, in fact the academic might make decisions based on indigenous ways of being. “the sliammon language,” section is not only about speaking the language but understanding sliammon ways of being so as potentially to enact these ways. learning an indigenous language is an excellent way of discovering an indigenous people’s worldviews and perhaps changing your own way of being in the world. fatty legs too has something to teach us about right action. in the section “a note on the writing process” jordan-fenton says that first pokiak-fenton would tell her a story, then jordan-fenton would replay those stories over and over, she would ask pokiak-fenton question after question and do research to learn more. she finally writes a story and then goes back to her mother-in-law with what she has written to find out if she has misunderstood. the book editor’s advice leads to more research by jordanfenton and more reviews by both. i suspect not all oral histories are as dialogical in nature. jordanfenton demonstrates right action by proceeding with such care, attention, and respect. unsettling colonial mindset although as i remember it challenges colonial mindsets in many ways, the unsettling is often subtle. for example, a viewer could agree to the protocol and yet not fully understand the implications of this agreement until they have formed deep and lasting relations with indigenous people. fatty legs – a true story is far less subtle. the residential school experience for most indigenous people was painful and traumatizing. as explained above, residential schools were places of cultural genocide where children were tortured, abused, and died due to the conditions of the schools and neglect. christy jordan-fenton helped her mother-in-law share these experiences in this (children’s) book. in the foreword, debbie rees, founder of american indians in children’s literature, says fatty legs is rare because it is written by an indigenous person. rees says that “(p)eople who are not indigenous have been writing biased stories about indigenous people for hundreds of years” (jordan-fenton, pokiakfenton, and amini-holmes 2010, ix). here’s a story about some steps i took to decolonize my mindset. i first really learned about the residential school experience by taking aboriginal worldviews and education from the university of toronto and reconciliation through indigenous http://anthro-age.pitt.edu/ http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/index https://www.coursera.org/learn/aboriginal-education https://www.coursera.org/learn/aboriginal-education https://www.edx.org/course/reconciliation-through-indigenous-education portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 159 education from the university of british columbia. both courses were facilitated by indigenous teachers. listening to survivors’ stories was so upsetting that i sought counseling from an elder who worked for the college. i didn’t know where to put the grief and shame i felt as a white settler. an elder helped me not be frozen by this learning. to get some sense of who is effectively writing indigenous memoirs, biographies, histories, and teachings, i explored the website of strong nations, an online retailer and a publishing house that specializes in indigenous literature and art. most publishers are part of colonial structures that can make indigenous people feel like they can't publish. under the section, “non-fiction biographies,” 46 memoirs are written by indigenous women and men. however, under the section, indigenous histories and teaching, approximately half were written by non-indigenous authors and many titles were coauthored by non-indigenous and indigenous authors, further continuing along the colonial mindset, which holds that indigenous people cannot teach about themselves, by themselves. there is still a long way to go towards indigenous history and teaching being written by indigenous authors. figure 6: far left book cover for elsie paul’s book and far right another book by indigenous authors mary louisa plummer and ma-nee chacaby (strong nations publishing 2021). in the middle, photos published on the tenth anniversary of jordan-fenton and pokiak-fenton’s book release of fatty legs (canadian broadcasting corporation 2021). pokiak-fenton has since passed away. edosi (judy) thompson, an indigenous researcher and instructor at the university of northern british columbia (unbc), has developed a rubric for instructors to use when introducing indigenous knowledge and wisdom into the curriculum. she asks that six criteria be considered: elders and community members are involved at all stages; indigenous languages are recognized as being an integral part of indigenous ways of knowing and worldview; focus of curriculum is on one particular indigenous group; it is recognized that there are protocols to be followed and these protocols are clearly stated; the land, plants and animals are incorporated; and traditional ways of learning and teaching such as observation, practice, participation, active involvement, and formative evaluation are incorporated (first nations education steering committee (fnesc) 2016). hogan, mccracken, and eidinger (2019) are non-indigenous historians and researchers who write about decolonizing post-secondary instruction. they give several recommendations to academics who want to teach indigenous history including that “the resource was developed and validated by a qualified, reputable, indigenous source. . . (such as) indigenous organizations, elders, knowledge keepers, authors, or scholars” and that “the resource includes appropriate strategies, activities, or visuals that support teaching and learning of indigenous storytelling traditions” (para 15). as i remember it certainly meets these criteria, going further than many by extending from print into multimedia. the same http://anthro-age.pitt.edu/ https://www.edx.org/course/reconciliation-through-indigenous-education https://www.strongnations.com/gs/show.php?gs=3&gsd=5683 https://www.strongnations.com/gs/show.php?gs=3&gsd=5683 https://www.strongnations.com/gs/show.php?gs=3&gsd=5682 portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 160 accounts for fatty legs: margaret-olemaun pontiak-fenton passed away this spring, but her daughterin-law christy jordan-fenton has continued developing teachers’ resources (jordan-fenton 2020).2 at selkirk college we once asked for advice on ‘indigenizing’ the college. ktunaxa representative and academic dr. christopher horsethief was contracted to give advice. horsethief spent an entire afternoon carefully laying out why people from his nation struggle today. he described individual and collective trauma from the residential school system and the trauma that continues today through racism, for example, politically, educationally, and the child services system. the vice-president at the time admitted later that he wasn’t listening closely because he was waiting for the advice on ‘how to’ indigenize. then much later he realized that the stories he heard were the advice for “indigenizing”. he was being asked to be an ally and an accomplice. more importantly he was being asked to bring an institution, one in which he held a lot of power, along with him as an ally and an accomplice. figure 7: a free downloadable teachers’ resource from christy jordan-fenton’s website where students may dress margaret in traditional clothing or in the stockings residential schoolteachers used to shame her. (jordan-fenton 2020) as the title as i remember it: teachings (ɂəms tɑɂɑw) from the life of a sliammon elder implies, the book and the site are principally about teachings, but as paul points out, not as scoldings, but as fictitious and real life stories that are meant to be enjoyed. as i remember it collaborator davis mckenzie adds that paul’s stories are suggestive but not bossy. paul refers to her teachings as offerings of her memories, not as the only truth. when we reflect back on the six criteria that thompson recommends when introducing indigenous knowledge and wisdom into curriculum, as i remember it meets all of these. it’s almost as if elsie paul and her collaborators are encouraging readers to embrace cognitive and social dissonance (festinger 1962; maddamsetti 2020) as a conscious strategy rather than slip back into unchallenged belief and knowledge systems they already hold. actively experiencing and responding to cognitive dissonance is one aspect of what i consider the unsettling of the colonial mind. http://anthro-age.pitt.edu/ http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/index portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 161 i have many memorable teachings from reading this book. for example, that each person is responsible for themselves, including to be well from the inside (from the “invitation to listen” and affirmed in other sections). however, as i reflected on this teaching, i was also acutely aware of as i remember it’s non-indigenous scholar paige raibmon’s warning to watch for confirmation bias and false equivalency while experiencing as i remember it (from the page transformational listening embedded in the larger section “our collaboration”) because that might lead to misunderstanding of the work. being of service another practice, for scholars, according to raibmon,3 is to be of service on projects that arise from and are directed by indigenous families. for example, in as i remember it, collaboration did not end with non-indigenous led interviews, but interviews were then followed by community consultations. the meanings of elsie’s teachings, when they were expanded on by the team with text, visuals, or explanations on video, were checked by elsie paul’s community collaborator harmony johnson. one of johnson’s jobs is to care for paul, to make sure she is respected and cared for during the production process. the first transcripts were discussed by sliammon community members for their accuracy historically as the community remembers and today. johnson was central to this process while taking care of paul at the same time. new interviews were conducted by johnson where the meanings weren’t clear, and punctuation was debated by her. raibmon says that although she wasn’t trained to implement historical research in this way, she learned a lot about issues of representation and translation and also about how history is created, in this case not by one researcher, but a researcher in close contact with a community. for after all, as i remember it isn’t primarily a resource for scholars but for sliammon people as well. paul also says in the video, “life history of this project” in as i remember it, that there are so many sliammon living away from home that don’t have access to their teachings. she wants sliammon everywhere to have access to teachings through a project that grew from solidarity. like raibmon, who learned being a historian can include being of service, i too have learned that education can include being of service. when selkirk college first ran indigenous 100 – regional perspectives on indigenous cultures and practices, i felt nervous as a non-indigenous course facilitator. dianne biin had suggested that selkirk’s first step was to have the nations in the region where the college operated introduce their history. the first offerings of the course were taught by representatives of the sinixt, syilx, ktunaxa, and metis peoples. metis are descendants of first nations and european unions and have been residing in british columbia as early as 1793 (metis nation of british columbia 2021). the metis module was taught by an instructor who was also willing to speak for indigenous people living off reserves. a reserve is a geographical place that has been allocated to a nation by a government. almost 900,000 indigenous people lived in canadian towns and cities with a population of 30,000 or more in 2016. this accounts for more than half of indigenous people in canada (bc campus 2021). selecting instructors involved new human resource practices including requiring applicants to have letters of recommendation from their nation. the selkirk college faculty association agreed to waive a requirement for a master’s degree to teach, acknowledging that knowledge keepers might not have gained their status from post-secondary institutions which they had much right to distrust due to systemic racism and disregard, but rather have gained their status in their communities through means dictated there. agreements amongst the nations about order of modules was tricky as it could have indicated territoriality. we agreed to rotate order year to year. although instructors for the four modules were able to agree on course outcomes, their histories of the land varied widely. before the course, http://anthro-age.pitt.edu/ http://publications.ravenspacepublishing.org/as-i-remember-it/transformational-listening?path=our-process http://publications.ravenspacepublishing.org/as-i-remember-it/our-process portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 162 elders from two of the nations had very different stories related to one plant, camas. i had to facilitate conversations with these differences and stand in solidarity with each nation’s worldview. this is like the two-row wampum belt where non-indigenous and indigenous worldviews are both respected. breaking the course into four modules allowed us to meet thompson’s criteria: “focus of curriculum is on one particular indigenous group.” the instructors also met the other criteria that thompson lays out including involving elders and community members, teaching indigenous languages, stating and following protocols, incorporating land, plants and animals, and using traditional ways of learning and teaching. in the end, the course included a meal with all instructors and students present. i was so fortunate to have facilitated the first offering of this course. the course continues today with indigenous facilitators. figure 8: camas is a significant food source for the sinixt, syilx, and ktunaxa peoples. the location of large camas fields is in sight of anyone standing on the castlegar campus of selkirk college. these fields were utilized by sinixt people before colonization. courtesy: mike graeme being of service means considering who the project will serve. the as i remember it team moved from print to multimedia to be of service to off reserve community members, especially youth. the collaborators said that they had to “undo the process” and “show the seams” (paul et al. 2019). by showing the seams, they mean they wanted to reveal not only the final product as in the book, but also the processes that lead to elsie’s sharing, the context that she works in, and why she shares her teachings. while creating the multimedia site, the team considered the sliammon people first, as well as what information could be made into what they call “snacks.” by snacks they meant the teachings that could stand alone. they debated the frames they would use in the online version, aiming to avoid http://anthro-age.pitt.edu/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 163 appropriation and to support sliammon culture and ways of knowing and learning. they considered accessibility. here’s what production team member davis mckenzie has to say about how accessibility informs the team’s choice to go from the book to multimedia. the internet is … undeniably one place where ɬaʔamɩn people now live. for example, more than half of our ɬaʔamɩn people live outside ɬaʔamɩn territory, and most are in cities. we also have a very youthful population, with over half of our people under the age of twenty-five. digital spaces hold the potential to keep us connected to the territory, the teachings, and each other across physical distances and generations. chichia [elsie paul’s familiar name] herself joined facebook at the age of eighty-four with some of these intentions; (paul et al. 2019) elder elsie paul says in “our process”: “i never thought in a million years it would go this way” (paul et al. 2019). but if it reaches more people, especially younger sliammon people that are living away from home and don’t have access to elders, then paul believes the project has been worth it. at selkirk college we once had dr. jeannette armstrong, a scholar, powerful okanagan elder, once director of the private indigenous-led post-secondary enowkin and once canada research chair on indigenization give a lecture. at that lecture she was rudely asked why she was lecturing on sinixt territory. armstrong in fact has sinixt heritage and so this was a highly unsettling charge from a non-indigenous ‘local.’ instead of challenging the untutored questioner she told stories that would elucidate the complex relationships between sinixt and sylix peoples. i believe the questioner went away entrenched in their righteous uneducated allegation, thinking it a courageous act. armstrong, gracious and kind, even in such a circumstance, left the lecture shaken by the depth of racism in the community. paul describes as i remember it as a “ripple in the water” of change (paul et al. 2019). given the evidence from the inventory of the retailer strong nations, the tide is indeed turning. in the future, we may see not only more histories and teachings by indigenous people, but their format may also change to be more accessible and representative of indigenous cultures. this will both reflect and require a decolonizing solidarity: an affirmative relation not only sensitive to the content of teachings, but also of the ways teaching is done and of the potential of indigenous teachings for ways forward in the future. in summary there is a growing trend over the past two decades to reaffirm and recognize indigenous voices and worldviews as valid and authentic scholarship. publishers like ubc press are pushing those boundaries with sharing indigenous stories and knowledge in the way of as i remember it. indigenous people are telling their own stores as pokiak-fenton does in fatty legs. non-indigenous academics can expand their own worldviews by familiarizing themselves with this scholarship while embracing decolonization. decolonization practices scholars might adopt allyship and solidarity, engaging in relationship-building, right action, unsettling our colonized minds, and being of service. these are important practices that further contribute to decolonizing the western mind, one of the most important, profound, and transformative tasks of academics today. acknowledgements for the acknowledgements, you are kindly invited to watch: https://youtu.be/dnuiyvemn2g . http://anthro-age.pitt.edu/ https://youtu.be/dnuiyvemn2g portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 164 notes 1. powwows are “gatherings where you’ll find multiple generations coming together to enjoy food, honour traditions, forge a sense of community, and practice spiritual healing” (indigenous tourism association of canada (itac) 2021). 2. follow jordan-fenton on twitter: https://twitter.com/cjordanfenton. 3. in the video life history of this project in as i remember it raibmon describes how other history projects have been her idea, as the historian. in this project she learned how to listen better, especially amongst all of the possible priorities for what was wanted and needed most by the community. references amnesty international australia. 2021. “10 ways to be a genuine ally to indigenous communities.” https://www.amnesty.org.au/10-ways-to-be-an-ally-to-indigenous-communities/. andrade, antónio, ulf-daniel ehlers, abel caine, roberto carneiro, grainne conole, anna-kaarina kairamo, tapio koskinen et al. "beyond oer–shifting focus to open educational practices: opal report 2011. (2011). bc campus. 2021. “indigenization guide: urban indigenous peoples and demographics.” https://bccampus.ca/2019/12/06/indigenization-guide-urban-indigenous-peoples-and-demographics/. begay, danny. 2019. “why you shouldn’t ‘dress up like an indian’.” https://voicesofnativeyouth.com/why-youshouldnt-dress-up-like-an-indian/. biber, francois. 2016. “regalia as a costume is insulting, sask. indigenous author says.” canadian broadcasting corporation. https://www.cbc.ca/news/canada/saskatoon/regalia-costume-regina-indigenous-oct-182016-1.3811022 british columbia teachers’ federation. 2021. a guide to allyship. vancouver, bc. https://bctf.ca/uploadedfiles/public/socialjustice/equityinclusion/allyship%20handout.pdf canadian broadcasting corporation. 2021. “margaret pokiak-fenton and christy jordan-fenton talk about the 10th anniversary of children's book fatty legs.”. https://www.cbc.ca/radio/thenextchapter/full-episodedec-12-2020-1.5832383/margaret-pokiak-fenton-and-christy-jordan-fenton-talk-about-the-10thanniversary-of-children-s-book-fatty-legs-1.5832387 clogg, jessica. 2020. “colonialism is alive and well in canada.” https://www.wcel.org/blog/colonialism-aliveand-well-in-canada. ctv news. 2021. “older than the crown.” https://www.ctvnews.ca/canada/extinct-tribe-optimistic-thatsupreme-court-will-reverse-hurtful-declaration-1.5145733/shelly-boyd-1.5145738. doane, ashley. 2006. “what is racism? racial discourse and racial politics.” critical sociology 32 (2-3): 255-274. https://doi.org/10.1163/156916306777835303. eisenkraft, harriet. 2010. “racism in the academy.” university affairs. https://www.universityaffairs.ca/features/feature-article/racism-in-the-academy/. festinger, leon. 1962. “cognitive dissonance.” scientific american 207 (4): 93-106. first nations education steering committee (fnesc). science first peoples teacher resource guide. accessed september 15, 2021: http://www.fnesc.ca/wp/wp-content/uploads/2015/08/publication-61496science-first-peoples-2016-full-f-web.pdf gwenlaouen le gouil, dir. killing the indian in the child. tv presse production, 2021. documentary. retrieved july 7, 2021 from: http://www.clpbrights.com/en/documentaires/killing-the-indian. hogan, skylee-storm, krista mccracken, and andrea eidinger. 2019. “appropriation vs. incorporation: indigenous content in the canadian history classroom.” https://activehistory.ca/2019/07/appropriationvs-incorporation-indigenous-content-in-the-canadian-history-classroom/. http://anthro-age.pitt.edu/ https://twitter.com/cjordanfenton http://publications.ravenspacepublishing.org/as-i-remember-it/our-process https://www.amnesty.org.au/10-ways-to-be-an-ally-to-indigenous-communities/ https://bccampus.ca/2019/12/06/indigenization-guide-urban-indigenous-peoples-and-demographics/ https://voicesofnativeyouth.com/why-you-shouldnt-dress-up-like-an-indian/ https://voicesofnativeyouth.com/why-you-shouldnt-dress-up-like-an-indian/ https://www.cbc.ca/news/canada/saskatoon/regalia-costume-regina-indigenous-oct-18-2016-1.3811022 https://www.cbc.ca/news/canada/saskatoon/regalia-costume-regina-indigenous-oct-18-2016-1.3811022 https://bctf.ca/uploadedfiles/public/socialjustice/equityinclusion/allyship%20handout.pdf https://www.cbc.ca/radio/thenextchapter/full-episode-dec-12-2020-1.5832383/margaret-pokiak-fenton-and-christy-jordan-fenton-talk-about-the-10th-anniversary-of-children-s-book-fatty-legs-1.5832387 https://www.cbc.ca/radio/thenextchapter/full-episode-dec-12-2020-1.5832383/margaret-pokiak-fenton-and-christy-jordan-fenton-talk-about-the-10th-anniversary-of-children-s-book-fatty-legs-1.5832387 https://www.cbc.ca/radio/thenextchapter/full-episode-dec-12-2020-1.5832383/margaret-pokiak-fenton-and-christy-jordan-fenton-talk-about-the-10th-anniversary-of-children-s-book-fatty-legs-1.5832387 https://www.wcel.org/blog/colonialism-alive-and-well-in-canada https://www.wcel.org/blog/colonialism-alive-and-well-in-canada https://www.ctvnews.ca/canada/extinct-tribe-optimistic-that-supreme-court-will-reverse-hurtful-declaration-1.5145733/shelly-boyd-1.5145738 https://www.ctvnews.ca/canada/extinct-tribe-optimistic-that-supreme-court-will-reverse-hurtful-declaration-1.5145733/shelly-boyd-1.5145738 https://doi.org/10.1163/156916306777835303 https://www.universityaffairs.ca/features/feature-article/racism-in-the-academy/ http://www.fnesc.ca/wp/wp-content/uploads/2015/08/publication-61496-science-first-peoples-2016-full-f-web.pdf http://www.fnesc.ca/wp/wp-content/uploads/2015/08/publication-61496-science-first-peoples-2016-full-f-web.pdf http://www.clpbrights.com/en/documentaires/killing-the-indian https://activehistory.ca/2019/07/appropriation-vs-incorporation-indigenous-content-in-the-canadian-history-classroom/ https://activehistory.ca/2019/07/appropriation-vs-incorporation-indigenous-content-in-the-canadian-history-classroom/ portfolio | southam | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.366 http://anthro-age.pitt.edu 165 indigenous tourism association of canada (itac). 2021. “vibrant celebrations of indigenous life.” https://canadianpowwows.ca/. jones, jen, ashlee cunsolo, and sherilee l. harper. 2018. “who is research serving? a systematic realist review of circumpolar environment-related indigenous health literature.” plos one 13 (5): e0196090-e0196090. https://doi.org/10.1371/journal.pone.0196090. jordan-fenton, christy. 2020. “teaching resources for fatty legs & when i was eight.” https://www.cjordanfenton.com/teacher-resources. jordan-fenton, christy, margaret pokiak-fenton, and liz amini-holmes. 2010. fatty legs. toronto: annick press. kluttz, jenalee, jude walker, and pierre walter. 2020. “unsettling allyship, unlearning and learning towards decolonising solidarity.” studies in the education of adults 52 (1): 49-66. https://doi.org/10.1080/02660830.2019.1654591. lara-cooper, kishan, and sammy cooper. 2016. ““my culture is not a costume”: the influence of stereotypes on children in middle childhood.” wicazo sa review 31 (2): 56-68. doi: 10.5749/wicazosareview.31.2.0056. local contexts. 2021. “grounding indigenous rights.” https://localcontexts.org/about/about-local-contexts/. maddamsetti, jihea. 2020. “analyzing elementary teachers' advocacy for emergent bilinguals as identity dissonances from cognitive, emotional, and social perspectives.” journal of language, identity, and education 1-17. https://doi.org/10.1080/15348458.2020.1791710. metis nation of british columbia. 2021. “british columbia’s métis history.” https://www.mnbc.ca/about/metishistory/. onondaga nation. 2021. “two row wampum – gä•sweñta’.” https://www.onondaganation.org/culture/wampum/two-row-wampum-belt-guswenta/. paul, elsie , davis mckenzie, paige raibmon, and harmony johnson. 2019. as i remember it: teachings (ɂəms tɑɂɑw) from the life of a sliammon elder. http://publications.ravenspacepublishing.org/as-i-rememberit/index. paul, elsie, davis mckenzie, paige raibmon, and harmony johnson. 2021. “what are tk labels?”. http://publications.ravenspacepublishing.org/as-i-remember-it/respecting-traditional-knowledge. petz, sarah. 2021. “new manitoba indigenous minister says residential school system believed 'they were doing the right thing'.” https://www.cbc.ca/news/canada/manitoba/alan-lagimodiere-commentsresidential-schools-1.6104189. schiffer, jeffrey j. 2016. “why aboriginal peoples can’t just “get over it”: understanding and addressing intergenerational trauma.” bc partners for mental health and substance use information. https://www.heretohelp.bc.ca/why-aboriginal-peoples-cant-just-get-over-it. smith, robyn. 2012. “‘fatty legs’: a residential school story kids love.” the tyee. https://thetyee.ca/books/2012/07/30/fatty-legs/. strong nations publishing. 2021. “strong nations.” retrieved may 15, 2021: https://www.strongnations.com/. williams, monnica, and noor sharif. 2021. “racial allyship: novel measurement and new insights.” new ideas in psychology 62:100865. doi:. https://doi.org/10.1016/j.newideapsych.2021.100865. wilson, kory. 2018. pulling together: foundations guide: bc campus. retrieved april 11, 2021 from https://opentextbc.ca/indigenizationfoundations/. http://anthro-age.pitt.edu/ https://canadianpowwows.ca/ https://www.cjordanfenton.com/teacher-resources https://doi.org/10.1080/02660830.2019.1654591 https://localcontexts.org/about/about-local-contexts/ https://doi.org/10.1080/15348458.2020.1791710 https://www.mnbc.ca/about/metis-history/ https://www.mnbc.ca/about/metis-history/ https://www.onondaganation.org/culture/wampum/two-row-wampum-belt-guswenta/ http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/index http://publications.ravenspacepublishing.org/as-i-remember-it/respecting-traditional-knowledge https://www.cbc.ca/news/canada/manitoba/alan-lagimodiere-comments-residential-schools-1.6104189 https://www.cbc.ca/news/canada/manitoba/alan-lagimodiere-comments-residential-schools-1.6104189 https://www.heretohelp.bc.ca/why-aboriginal-peoples-cant-just-get-over-it https://thetyee.ca/books/2012/07/30/fatty-legs/ https://www.strongnations.com/ https://doi.org/10.1016/j.newideapsych.2021.100865 https://opentextbc.ca/indigenizationfoundations/ anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 27-52 issn 2374-2267 (online) doi 10.5195/aa.2014.27 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. dressing the older woman in post-mao china perspectives from official feminist mass media and ordinary chinese women jeanne l. shea department of anthropology, university of vermont author contact: jeanne.shea@uvm.edu abstract this article examines chinese discourses on dressing the aging female body as a window into the tensions involved in the historical transformation of habitus in early post-mao china. drawing on chinese media articles and ethnographic interviews conducted with chinese women in their 40s-60s, the analysis compares depictions of new official ideals for older women’s dress that appeared in chinese government-sponsored feminist mass media with ordinary older chinese women’s personal sensibilities about dress. assessing the applicability of dominant western feminist theories of gender, dress, and age, this article provides a historicized culture-specific application of practice theory, examining older women’s struggles with competing moral logics associated with past and present, and with official media versus personal experience. overall, it documents experiences of ambivalence and compromise accompanying lifecycle adjustment in embodiment in the context of rapid social change. keywords: china or chinese, women, aging, dress, feminism. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx mailto:jeanne.shea@uvm.edu anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.27 http://anthro-age.pitt.edu dressing the older woman in post-mao china perspectives from official feminist mass media and ordinary chinese women jeanne l. shea in my experience, american students often assume that since traditional chinese culture emphasizes respect for the elderly, that contemporary china has few to no problems with ageism. those interested in women’s studies often assume that little attention must be paid to the appearance of older women in china, unlike in youth-worshipping, body-obsessed western culture. focusing on data from china on dressing the aging female body, this article shows how these assumptions are misleading -even for the early market-reform era. despite traditional ideals, china has experienced serious ageism for at least half a century. rather than stemming solely from westernization or capitalism, ageism in china can be traced back five decades to a time when western capitalist culture was banned. later, in the 1980s and 1990s, substantial attention began to be devoted to issues of the external appearance of women age 40 and older. stirred by the market reforms and opening up to the world launched by deng xiaoping, communist government-sponsored chinese “feminist” mass media signalled then that middle-aged and elderly women should start paying more attention to their appearance, including manner of dress, makeup, and hair dye. official chinese feminist mass media messages trickled into the awareness of ordinary chinese women through officially-backed magazines and newspapers and social interaction. initially, it may seem odd that government-sponsored media, and a feminist media at that, would devote attention to this issue in such early days of the reform era. after briefly introducing early reform-era chinese feminist mass media, this article takes an interpretive approach to explain how this attention to mature fashion made sense within the official media context, and to describe how some ordinary chinese women responded. china of the 1980s-1990s provides a window to the broader issue of gender, age, and dress in the context of rapid social change. during this period, maoist and cosmopolitan values, as well as competing visions of feminism and women’s rights, stood in vivid contrast (brownell et al. 2002), as people struggled to reconcile widely divergent ideals and practices (gilmartin et al. 1994). here, i bring together media-studies and lived-experience approaches to address several research questions: what did official chinese feminist mass media of the early reform era have to say about dressing the aging female body, and why? what did ordinary chinese women think about issues of women’s dress in middle and old age? how did these two perspectives interrelate? i argue ordinary chinese women’s everyday deliberations on dress after the age of forty in some ways resembles, and in other ways diverges from state-supported chinese feminist mass media discourse. whereas official chinese feminist mass media discourse emphasized the new age-positive, gender-differentiating, status-enhancing opportunities for bodily adornment opening up to chinese women in their middle and later years, local women tended to express shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 28 personal ambivalence toward these opportunities. overall, older chinese women’s talk of dress revealed unresolved tensions between the competing moral logics of lingering high-socialist minimalism and emerging market-reform consumerism and a generational need to forge creative compromise between past and present ideals for dress. significance i offer in this article a historically-situated analysis of chinese views on women’s dress in middle and old age, a topic to which little scholarly attention has been paid thus far. my main theoretical approaches include interpretivism and practice theory, focusing on emic meanings and on the relationship between prescriptive structures and personal experience. channeling interpretivism (geertz 1977), i provide thick description of instantiations of chinese cultural views on dressing older women’s bodies, from both government-sponsored feminist mass media and ordinary women. applying practice theory and notions of embodiment (bourdieu 1977), i examine the interactions, gaps, and tensions between official ideals and individual practice. like liu (2000), my goal is to provide a historically-situated culture-specific application of practice theory. in doing so, i focus on the early post-mao period, a period ripe for examining how older chinese women navigate a radical shift in moral valuations and normative expectations associated with bodily dress and habitus. after sketching local propagandistic pressures for fashion makeovers for mature women during that period, i describe older women’s struggles with competing moral logics associated with past and present and their experiences of ambivalence and compromise in facing lifecycle adjustment in embodied practices during this time of immense political and economic change. given the dominance of mainstream western feminist theory in scholarly discussions of gender, the body, and dress, i interlace my analysis with an examination of the limitations of such frameworks for explicating my china data. in comparison with other identity dimensions like gender, sexuality, race, and class, western feminism has paid sparse attention to age as a category of analysis, setting aside notable exceptions (e.g., de beauvoir 1970, greer 1991, friedan 1993). still, recognizing age as a key intersectional dimension of experience, a minority of western feminist scholars and activists of the “second” and “third” waves have provided important perspectives on gender, dress, and the aging body. here i engage two mainstream approaches to gender, age, and dress that have been dominant touchstones in western feminist analysis and activism. while they do not encompass all western feminist theorizing, they are widely referenced vantage points. the leading relevant second-wave western feminist approach (hereafter 2wwf) has focused on the ageist, sexist character of modern images which promote idealization of youthful bodies and feminine fashion directed toward the male gaze, all of which can perpetuate women’s second-class status and inflict double jeopardy on those both female and old (twigg 2013: 17, 41). feminist media studies from the 1970s-1990s showed how popular western media images objectified and subordinated young women, while rendering older women nearly invisible (41-43). activist extensions of this approach have urged women to educate themselves about, critique, and resist this patriarchal capitalist system by rising above restrictive gender norms to “grow old gracefully” (greer 1991: 4). such activists have called women to focus on their own inner well-being, by following nature and refusing “inauthentic” artifice (twigg 2013: 13) in order to protect themselves from the self-defeating illusion of age-defying consumption, thus shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 29 changing social norms and raising women’s status long term (ballard et al. 2005: 173, hurd-clarke and griffin 2008: 656). in countering fashion messages that devalue older women’s bodies and threaten self-esteem, such idealists have advocated resistance to popular fashion’s fixation on appearance. instead of the “mask-of-aging” dismay at disjunction between inner self and outer appearance (featherstone et al. 1991), this stance has encouraged release from “normative femininity,” allowing development of other aspects of self (twigg 2013: 48). the dominant related third-wave western feminist approach (hereafter 3wwf) has focused on issues of agency and utility, arguing that women should be able to choose whatever tools are available, including mainstream “beauty work,” to promote their individual, albeit often short-term, self-interests in the world as it exists (ballard at al. 2005: 173, hurd-clarke and griffin 2008: 654, twigg 2013: 24). they have reacted to 2wwf by demonstrating that individual women can, without being “dopes” (hurd-clarke and griffin 2008: 656-7; twigg 2013: 13) or damaging self-esteem, avail themselves of makeup, fashion, and surgery to project an image that will benefit them in competition for status. they have argued that feminists should not interpret this as false consciousness or “selling out,” but, rather, as a “balancing act,” iterating between “a critique of the technologies, practices, and discourses that define women’s bodies as deficient and in need of change, and an understanding of why women might view various forms of beauty work as the only tools they have to compete in the many social realms that extol youthfulness” (hurd-clarke and griffin 2008: 656-7). a realist position, 3wwf focuses on individual strategies in the world as it exists in the present, at a time when more technologies are available than ever for dressing up and altering the body. some note, however, the limits of strategizing within consumer culture given the continuance of strong pressures for “conformity and order” (twigg 2013: 24), as well as the inevitability of bodily aging (151). kathleen woodward’s (1988, 1991) notion of “masquerade” spans these instantiations of feminist theory. applied to american culture, “masquerade” refers to bodily practices involving dressing up, adorning, and altering the aging body in order to disguise it as young in response to the social threat to selfhood posed by a culture that devalues age (1988: 121). for older women, this involves displaying youthful femininity to protect the self in society’s patriarchal “economy of desire.” woodward has argued that such masquerade can lead down a path of either pitiful “pathos” (126) or admirable “resistance” (128). which path depends largely on whether one maintains a “critical distance” from the illusion one is creating (127), strategically manipulating the image while bracketing it as artifice. performatively, the difference involves moderation, avoiding too brightly-colored clothing or makeup so as to avoid making a public “spectacle” of oneself by exposing the distance between one’s aging body and a youthful ideal (122). similar concerns for moderation were observed in twigg’s (2013) cultural gerontological research in the united kingdom. twigg demonstrated that while older women in britain today dress more colorfully than in the past (142, 148), many still fear being judged as “mutton dressed as lamb” (16) and feel pressure to “discipline” themselves and “tone down” (18) their colors (136, 137) to avoid being “brash” or “dowdy” (138). extending woodward’s logic, twigg argued that “the sense that overtly feminine, pretty dress ‘no longer works’ and is inappropriate for women as they age” stems from how “it exposes the contrasts between the normative expectations written into the garment and the body that displays it… [thus,] age is experienced as a form of exile and exclusion from the feminine” (43). twigg qualified these remarks, saying that shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 30 anti-aging “beauty practices …are part of the process of producing an acceptable form of woman in later years – still feminine …yet in a toned-down way” (18). oyìwùmí (2014) and others have argued that mainstream western feminism has tended to assume a fairly universal vision of womanhood. examination of official chinese feminist media and interviews with ordinary older chinese women from the first decades of the market reform era belies cultural, historical, and generational assumptions underlying the frameworks above. likewise, in contrast to twigg’s (2007, 2013) related notion of society “disciplining the body” of older women, i show how older chinese women were portrayed in official chinese feminist media of the time as, instead, un-disciplining a body once constrained by maoism and poverty. i also demonstrate how the women i interviewed tended to prefer for themselves a style of un-disciplining that differed from official media prescriptions. materials and methods official feminist mass media and ethnographic fieldwork data this analysis is based on two sources of primary data: officially-backed chinese feminist mass media articles published in the chinese language in the 1980s-1990s and fieldwork data i collected through participant observation and interviews with aging women in china in the 1990s. in addition, for context, i use scholarly literature on the maoist and post-mao period with regard to gender and social life. government-sponsored chinese feminist mass media pieces of the early reform era were primarily produced by the all-china women’s federation (acwf), the official organization responsible for women’s issues in china since the communist revolution in 1949. while some reform-era scholars have contested its legitimacy in representing grassroots women, as opposed to serving governmental dictates (gilmartin et al. 1994), the acwf and its messages were considered “feminist” by many chinese scholars, activists, and ordinary citizens in the early reform era (ding 1995, guan 1995, zheng 1998), especially those born in the 1950s and earlier. whereas during the maoist era “feminism” had western bourgeois connotations, and “women’s liberation” from “feudal oppression” was the preferred governmental idiom, with the market reforms and opening to the west these two notions were increasingly merged. in the 1980s-90s the acwf, along with women’s scholarly and non-governmental organizations, began to align with global feminism, selectively borrowing from the west and articulating local chinese forms of feminism, both present and past (wesoky 2013). in this way, a government-sponsored feminist mass media emerged with china’s market reforms. this brand of feminism combined mao-era concerns with women’s economic opportunities outside the home with a new reform-era fixation on femininity and “women’s special characteristics,” as will be discussed later. he media pieces upon which i focus are drawn from the widely-distributed and broadly-read political bellwether magazine for women’s issues, china woman, the acwf’s main publication. china woman was the most influential mass-distributed women’s periodical in china from the 1950s-1990s. after skimming through all issues of china woman from 1980-1997, i selected several articles that epitomize early reform era trends in the shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 31 government-sponsored feminist stance toward older women’s dress. the authors were older chinese woman leaders in the acwf. the fieldwork data are drawn from 17 months of ethnographic research that i conducted in beijing municipality from 1992-1996 on women’s views and experiences of aging (shea 2006). i first focused on conversing informally with chinese women in their 40s, 50s, and 60s. after a year of participant observation, with the help of a local research team, in 1994 i conducted structured questionnaire-based interviews with 399 chinese women ages 40-65, divided equally between a neighborhood in beijing’s urban core and a rural village in its periphery. from these structured interviews, i analyzed responses to an item about women’s appearance in later life. in 1994 and 1996 i then conducted a series of semi-structured audio-recorded interviews in women’s homes with a subsample of twelve of those women, half urban, half rural, ages 40-67. here i examine interview material from three of those women to illustrate the ways in which women’s views and experiences of dressing the aging body converged with and diverged from both western feminist theory and acwf representations. while they cannot represent all older chinese women, the interview material presented here reflects widespread trends that i noticed in my extended fieldwork as documented in my fieldnotes. following twigg (2013), who argues that concerns about aging and appearance emerge by the thirties in many settings (36-37), in writing “older women,” i am referring to women age forty and older (129). while some may protest that women are not older until they are old and thus age 65, it is conventional in the aging body literature to refer to those aged 40 and older as “older women.” furthermore, the notion that being “old” begins at age 65 was rare in china up through the 1990s. then, women there placed old age at age 50, 55, or 60, all female retirement ages for various occupations. also, age 60 is the traditional chinese entrance into old age, as five cycles of twelve years. while some women knew that many westerners viewed age 65 as the entry point, it did not resonate. the distinction between middle and old age in china is far less marked than in western countries. in published literature and everyday conversations, middle-aged and elderly women are frequently lumped into the category zhonglaonian which means middle and old age merged together, or the fuzzy transition between them. sometimes i use the shorthand of “aging women.” by “later life,” i mean age forty and older. older women’s liberation through fashion official feminist mass media in the mid-1980s, the government-sponsored china woman magazine began to publish articles pertaining to middle-aged and elderly women’s appearance, makeup, fashion, hair, and skincare. from the 1950s-1990s, china woman set the tone for what was politically correct to say, do, or debate concerning women’s issues, spanning maoist and post-mao eras. while not read by all women, china woman, up through the 1990s, served as a prescriptive touchstone for neighborhood cadres and seeped into public consciousness through newspaper and newsletter articles, neighborhood bulletins, community activities, and local gossip. while articles on older women’s grooming in the 1980s-1990s were a quotidian continuation of a long-standing trend in shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 32 western settings, in china they were a landmark change from the last decade of the maoist era, at which time such concerns were bourgeois infractions for women of any age. during the maoist era (1949-1976), communist party chairman mao zedong ruled, and the status hierarchy was flipped on its head from pre-revolutionary times. people with land, money, white-collar professions, conspicuous consumption, cosmopolitan habits, foreign ties, or patriarchal gender roles were socially demoted (gao 1987). values shifted to favor the broad masses of peasants and simple consumption habits, and efforts were made to reduce gender inequalities by showing that “women can do anything men can do” (gilmartin 1994). while rapid modernization in farm, factory, and scientific work meant that some older people had difficulty keeping up, during the 1950s the widespread expectation remained that elders should be respected. early on, women whose families had means still wore elaborate brocade qipao dresses at special occasions like weddings, but in everyday life, a new proletarian aesthetic and continuing poverty meant that most people wore simple homespun clothes and hand-made shoes. for females, this could include clothing with flowery patterns and shoes with embroidery, if time and budget allowed. while some older women cut their hair short, one was allowed to keep long hair, with girls plaiting it into two braids and women putting it back in a braid or bun. over time, family life became increasingly subordinated to the communist work unit, with the sway of families reaching low ebb in the great leap communes (1958-1961) and cultural revolution. during the cultural revolution (1966-1976), political conformism deepened, and men and women of all ages were expected to wear mao suits in almost every social occasion (honig 2002). mao suits were simply-cut button-down cotton shirt-jackets with fold-down collars and baggy cotton pants in military colors of dull blue or green (figs 1, 2). often a mao cap topped the outfit (see photo below left). the contours of the design originated with the “father of modern china,” sun yatsen, in the early 1900s, and thereafter were rendered more peasant-like by mao during his guerrilla years before the 1949 revolution (xin 2009). in the cultural revolution, beyond mao suits, women had to cut their hair into short straight bobs, as more fig.1-2: cultural revolution-style clothing from the early 1970s. photo: unknown shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 33 “feminine” hairstyles like braids, ponytails, and perms were disallowed. “feminine” clothing such as dresses, skirts, patterned cloth, and bright colors also became taboo. dressing men and women and people of all occupations alike was designed to underscore the ideal of gender equality and socioeconomic egalitarianism under socialism. ageism in china is often traced back to the late mao period. during the cultural revolution, a campaign to “smash the four olds” was unleashed by mao zedong (gao 1987). although it explicitly targeted old customs, culture, habits, and ideas, in practice middle-aged and elderly people themselves were potentially-suspect reservoirs of outdated ways from lingering traditional chinese or bourgeois foreign influences. thus, many mature adults, especially in positions of local leadership, were subjected to public criticism, beating, and other indignities by teenage activist “red guards.” during my years in china in the 1980s-1990s, it was common to hear acts of disrespect toward the aged attributed to the cultural revolution. while some, especially younger women were early adopters of more colorful figure-accentuating feminine clothing, variations on cultural-revolution-style dress lasted into the late 1980s for many people and into the 1990s for some. this was especially true of members of the older generations, partly out of political caution, partly out of habit, and partly out of poverty, priorities, and little availability of affordable alternative clothing options. men of lower socioeconomic status (ses) were the longest holdouts for wearing military style clothing and mao suits. for women of lower ses, modification came earlier than for men. however, at first the modification for older women was modest and mannish. for example, it often involved a simple button-down shirt in a subdued light color with dark roomy trousers (fig. 3). as late as my fieldwork in 2014, a minority of elderly folks still dressed in this manner at times. after mao’s death in 1976, the ensuing era of market reforms and “opening up to the world” invoked questions about and social change in women’s dress. by the 1980s, chinese feminists in scholarly and governmental circles began to argue that maoist gender egalitarianism had in fact continued to disadvantage women through gender blindness that forced them to look and act like men. mao’s egalitarian “androgyny” was actually an androcentric denial of “women’s special characteristics” (gilmartin et al. 1994: 10; honig 2002: 257). china woman’s attention to fashion in the 1980s-1990s was both intended and received as a signal that feminine and upscale dress was once again allowed. the message: “three years new, three years old, three years of patches” was no longer admired. differentiation by gender and class and borrowing from the west was once again acceptable. women of china needed to update their wardrobe for the good of both themselves and society. having spent a large part of their lives in worlds in which fancy dress and makeup were economically impractical or politically discouraged, older women were slow to respond. shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 34 of numerous period articles in china woman on older women’s appearance, i discuss three which are representative of the kinds of messages common in acwf articles at the time. these pieces illustrate how older women were now urged to cultivate an appearance that was feminine, cosmopolitan, attractive, and youthful, often in ways unanticipated by western feminist theory. making the case for understated elegance xue xiao’s 1987 article, “vitality can always accompany you: discussing appearance, makeup, and dress with middle-aged and elderly women” was an early acwf article on issues of dress in mature women in reform-era china. in contrast to 2wwf views of “beauty work” as artificial, xue argued that the “natural” tendency to beautify oneself was artificially suppressed in the generations of chinese women in their fourth decade and beyond at that time, not only in later life, but also in youth. it laid the blame not only on “historical reasons,” a euphemism for maoism, but also on “traditional customs” from before the communist revolution (1987, 42). xue (1987) entreated older chinese women to strive for “understated elegance” to keep up with modern times and project a “dignified” image on national and international stages (43). thus, in contrast to 2wwf and 3wwf, modernity and ethnic face were key. unlike woodward (1988) and twigg (2013), xue (1987) attested that “women from foreign developed countries” often thicken their application of makeup with age. while urging older chinese women to also use makeup, xue allowed that they can go lighter in order to suit “chinese ethnic psychology” fig 3: elderly beijing woman in early reform-era modified dress, mid-1990s, photo: jeanne shea shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 35 (43). xue also drew on nature and chinese tradition for legitimation. in urging chinese women to dye their hair, she attested to its naturalness with the saying “with hair like a crane and a face like a child’s” (42), invoking cranes’ lifelong black feathers. xue then advised that “as in nature red flowers go with green leaves,” a groomed head and face must be matched with appropriate clothing like modern western suit jacket sets, western dresses, or traditional chinese qipao. nowhere were mao suits recommended. xue further advised that the new body type of “having put on weight after getting rich” (43) was best suited to small flowers or patterns, or thin lines or stripes, all disallowed in late mao times. xue concluded by giving women the go-ahead to choose any form of dress appropriate for their individual circumstances, job, and hobbies. this portrayal differs in many ways from both 2wwf and 3wwf approaches. xue gave no precaution about an ageist, sexist patriarchal focus on appearance and the dangers of an outer focus for inner wellbeing. there was also no cynical appeal to playing the game of appearances despite ageist implications. instead, xue presented “beauty work” as a new life opportunity, foreign to these chinese cohorts, despite its being “natural.” xue stressed that attention to appearance was now a positive moral act, and that cultivation of a new urbane habitus, taking the best of the traditional, modern, chinese, and foreign, gave face to china as it re-emerged onto the world stage. unlike in traditional familial conformism and maoist collectivist asceticism, artful embellishment was now a reflection of one’s skill at self-care and tasteful presentation, thus simultaneously enacting self-expression and reflecting well on the nation. moving up to elder fashion shows ying xiao’s 1990 article, “today’s scene is just right” portrayed fashion as key for later-life enjoyment and elevated the level of taste to which elders could aspire. the focus was a fashion show in beijing in 1990. a first in china, the “capitol city middle-aged and elderly fashion model competition” was billed a “major advance” on the world stage in featuring mature fashion models, demonstrating the “level of cultural attainment” of the chinese nation and people, and enacting a giant leap in the “liberation” of china’s older population from past constraints (1990, 1). the show emerged from volunteer performance groups headed by current or retired female neighborhood administrators in their fifties and sixties looking to enrich older people’s lives. the forty contestants, gleaned from 360 applicants, ranged from 40-72 years of age, with a majority being women, but with a few husbands drawn in. the main reasons for participating were to make their lives more interesting and to come into step with modern times. like xue’s article, xiao’s piece diverged from western feminist approaches in being overwhelmingly positive about present affairs. it signaled official approval of this new fashion “elderscape” (katz 2005) (figs 4-7) by detailing participants’ respectable professions, including teacher, professor, military veteran, party leader, and neighborhood bureaucrat. xiao conveyed how this scene fulfilled participants’ longing for recognition as “talented” and “vital.” reflecting mature, ageless, youthful, and high-status descriptors, praise included: “mature,” “refined,” “cultured,” “well-off,” “elegant,” “attractive,” “inner depth,” “confident,” “boundless energy,” “enthusiastic for improvement,” “optimistic,” “broad-minded,” “outgoing,” “in good taste,” and “heart of a child” (1990, 1-2). even neighborhood functionaries like mrs. du, a shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 36 58-year old retiree “whose prime years were spent in a mao suit,” could now achieve fashion acclaim. through the musings of a communist cadre who won “most stylish couple,” xiao portrayed older people as models for adapting to social change and “aging gracefully” through high artistry and historical progress, rather than acquiescing to biological destiny, thus glocalizing graceful aging (cf. 2wwf). “for a long time our generation saw hard labor and plain living as glorious, and we were very inattentive to dressing up, makeup, or clothing. … in fact, though, there are a variety of different manifestations of socialism, and it is possible to advance to new forms. times are different now, and we need to research aesthetics. fashion is a kind of cultural phenomenon, and fashion performances are an external manifestation of the spirit and cultural attainment of a nation and an ethnic group.” (1990, 2) once a political crime, cosmopolitan fashion was now a cultural “skill of costume and makeup” that came with a “new kind of socialism,” not capitalist excess (1990, 2). mature fashion had become a sign of social progress, elder liberation, and, keeping with modernity, bringing “glory” to age-mates and to the nation (1990, 1). according to xiao, fashion was now equally by and for men and women, young and the old, and unlike 2wwf, the gaze was that of oneself and admiring contemporaries. fulfilment outside work or family through material and leisure pursuits and self-care in the company of peers was now an approved social good. xiao ended with a contestant’s poem: “we have leisurely refinement and are contented with ourselves. white-haired venerable elders, we now serve as guides, follow our inclinations, and go with the dao. here, now, the scene is just right to inspire the wind and lift figs.4-7: 1990’s chinese magazine photos of middle aged and elderly fashion. traditional chinese qipao (far left) photo: paiji li, 1991; “western-style” upscale dress (middle) photo: ying xiao, 1990; western suit sets and bold color (right) photo: peiji li, 1991. shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 37 our sails” (1990, 2). in referencing the “dao,” not only was the naturalness of fashion highlighted (cf. 3wwf), but the view that elders were veterans of change and natural leaders, not blind followers of youth. as in xue’s article, inner inclinations and outer manifestation, and pleasing oneself and society, were pictured in sync, unlike in 2wwf. rather than losing their prime in maoist times, mature adults were pictured poised to enjoy their prime in a glorious present, thus boosting the reforms’ legitimacy and downplaying past excesses. xiao signs off: “dear middle-aged and elderly friends, your life’s journey has just reached golden autumn. …grab onto this perfect scene!” (1990, 2). bold pursuit of beauty with bright colors xuan jin’s 1991 article “there are no ancient women here!” began with the premise that both pre-mao and maoist china had suppressed natural human inclinations to cultivate personal appearance in the attempt, first, to contain women to domestic life and, then, to socially engineer a proletarian citizen. the example of australia was used to illustrate the alternative minus such suppression. this piece raised the bar in calling for older chinese women to go on par with western women by dressing in bold colors and thick makeup and increasing their informal community engagement. it even challenged them to consider eventually surpassing western women in beauty and youthfulness. jin began by recounting how during years on work assignment in australia she learned that “inner love of beauty” and desire to look “younger and more beautiful” was a natural human universal for all women throughout life. while abroad, she was impressed by how “middle-aged and elderly women” there were “bold in their pursuit of beauty” and wore more colorful clothing and thicker, brighter makeup than younger women, unlike in china. jin recalled realizing the sense of this, because younger women were like “lotuses emerging from clear water,” requiring no adornment. jin urged chinese women to follow western women’s lead, saying that rich adornment makes one “look younger” and “brings out a liveliness” while “leaving your maturity intact” (1991, 10). in contrast to cautious or cynical western feminist models, jin celebrated synergy between bold bright makeup and dress, and high spirits, self-realization, and social efficacy. declaring that “in australia, whatever young women can do, elderly women can do too,” jin argued that “westerners” were less ageist than chinese people. jin asserted that not only in appearance, but also in their lively spirits, individual self-expression (“no two are dressed alike!”), and continuing community engagement, older australian women outdid their chinese counterparts. in contrast to chinese women retiring to domestic work within the family, australians showed how older women can do so much more: “they can sing and dance, go on a diet to lose weight, get together and laugh, and when excited, shout out and cause a ruckus.” jin related how australians form large voluntary associations for older people for continuing education, socializing, leisure, and entertainment. she stated that unlike in china, she never heard any old person in australia say anything like, “i’m old! i’m of no use any more!” instead “everyone did their best to continue contributing through their ever-youthful heart” (1991, 11). unlike in western feminist approaches, jin’s article focused on older women’s “rights” in relation to younger women, rather than a male-dominated system. this was common in china shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 38 woman articles on aging women’s dress at the time. the point was to combat ageism, not double jeopardy. this emphasis was related to how rapid change in reform-era china had rendered the distance between opposite-sex contemporaries pale beside the gap between different generations. liberation through fashion as ideal versus practice the ethnographic material from my fieldwork in 1990s beijing in some ways echoes themes from china woman, and in others goes beyond by presenting nuances of chronology, experience, and resistance. the theme of recognition of competing moral systems is clearly reflected in my interviews in ways that are more fraught than the prescriptive, celebratory media pieces. ambiguity, self-contradiction, ambivalence, and lack of clarity were not qualities desired by acwf editors aiming to prescribe a new ideal. the ethnographic material, by contrast, shows women grappling with competing moral logics and their complex articulation with past and present experience. although many women agreed with the acwf ideal of older women dressing up in fancy feminine clothing, they often did not feel that this new option was a priority for them, or something that they wanted, or were personally able, to pursue. as per below, outward appearance was not a prominent concern for many women in the communities i studied. other things to worry about … in structured interviews conducted in 1994, we asked 399 beijing chinese women aged 40-65 if they worried about losing their physical attractiveness with advancing age. the majority stated that they did not worry about declining appearance in later life, and less than six percent said that they had such worries. some of these women explained lack of worry by saying, “why, i was never good-looking in the first place!” others indicated that older women were not expected to make themselves physically appealing to men. most indicated that physical appearance was of far less import than the ability to make ends meet financially, get their daily work and chores done, and get along with other people. similarly, maintaining cognitive clarity was a worry for twice as many women as deterioration in appearance. this ethnographic data is congruent with the acwf representation that older women at the time did not place a high priority on their current physical appearance. it counters, however, western feminist concerns that all too many older women, once in an environment open to potential western influence, may become consumed with anxiety over their appearance or join in a cynical struggle to appear younger. shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 39 ethnographic case 1: subtleties of timing and resistance chun zhiping was a factory worker in her early forties in the mid-1990s. chun gave a finer chronology than acwf articles did, distinguishing early, mid, and late mao periods and the reform era. now dressed in loose blue cotton trousers and a white button-down shirt, chun talked about how she was able to wear pretty homemade clothes and keep her hair in long braids when she was a young girl in the early 1950s, but had to dress and wear her hair in a de-feminized manner when the cultural revolution came during her teen years. going further in splicing history, chun said that during the great leap forward (1958-61), at which time agronomic mismanagement compounded by drought led millions to starve, clothing was old and worn. when i was young, we just wore regular ordinary clothes. it wasn’t like now where we’ve got every kind of clothes you can think of. … before the cultural revolution, it was all homemade cotton cloth, flowery patterns, and white cotton pants. i wore that to school when i was little. … [then] there were the three years of natural disaster [great leap]; those years were hard, and our clothes got worn out. at that time, the household head was given a ration of grain, oil, and such, and our parents ate little to leave as much as possible for us kids. then there was all that cultural revolution stuff, and we didn’t have high expectations. …back then there were no schools open, so all you could do was work. i started working at 16. my generation’s teen years were totally wasted. ... back then, what did people wear? green shirts, green pants, blue shirts, blue pants! …now it doesn’t matter how tough your situation is or how low your wages are, you have every kind of clothes you can think of. back then, if you wanted to buy something, there was nothing to buy... before the cultural revolution, i wore long thick braids. i was young then, but they [red figs 8-9: while bright patterned clothing was fine, black, gray, white, and dull blues were still common color choices (far right). women tended to opt for inexpensive casual comfortable clothing; although heels were available, more wore flats (right). photos: jeanne shea shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 40 guard teens] were determined to make me cut off my braids. when they did it, i cried. it was a real pity. now my hair is thin, and i can’t pull off long hair anymore. although she discussed clothing at length, mourning the chance to preen in her teen years and expressing approval at reform-era variety, chun added, however, that she has always valued eating more than clothes. a strong healthy body trumped its trappings. like most women her age in the 1990s, chun took a position toward present-day dress somewhere between uniform maoist androgyny and fancy feminine fashion, valuing the choice to wear cheap casual clothing. we are not like some families, who when they have a bit of money, they buy an item of clothing. i feel that those kinds of things are all secondary. eat well and have good health, right? if you don’t eat well, then your body will get sick. if you’ve spent your money on clothes, then you won’t have money for medicine. and buying medicine isn’t as good as having eaten well to avoid sickness in the first place. anyhow, this is how my family thinks about this. ...now we are a bit more particular about what we eat than in the past. it’s not like in the past where it was monotonous and you just ate whatever was there. but, in terms of wearing things, we just wear regular ordinary clothing. our family doesn’t choose to wear fancy stuff. at our house, we wear casual clothing. in contrast to acwf portrayals, chun spoke of not just the reform era but also the early 1950s in terms of freedom to choose one’s clothing. stressing personal preference, thrift, and function over social image, chun positively characterized the kind of clothing that she wore during both periods as “regular, ordinary clothes.” while the reforms offered more variety and availability, the periods were similar in that material means and taste guided what one wore in everyday life, rather than politics. the choice that chun valued, however, was not the status-enhancing choice that 3wwf emphasized. chun appreciated the ability to choose inexpensive casual clothing, not age-defying luxury apparel. furthermore, in contrast to 2wwf, chun was not seeing fancy feminine fashion as socially oppressive, but, rather, as beside the point as a lower priority than food, thus echoing global minority feminisms that judge mainstream western feminism as elitist. ethnographic case 2: nice to have the options but… unlike the assumption in acwf articles that women’s attitudes and behavior tend to align, this case illustrates further how liking the availability of cosmopolitan goods in the abstract did not necessarily translate into dressing up one’s own aging body in the early reform era. song jingling was a retired textile factory worker in her midto latefifties when i interviewed her in 1994 and 1996. dressed in a short-sleeved blue blouse over loose-fitting black trousers, song shared how much better things were now in terms of eating and clothes than in the past and for her compared with her parents’ generation. like the acwf pieces, song showed a tendency to stress change over historical time in generational context, rather than personal chronological aging and its bodily effects, as mainstream western feminist theories tend to do. shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 41 song mirrored in many ways but also went beyond china woman articles by stressing further that the current wealth of goods and clothing available to buy was not just a function of “foreign influence,” but was a combination of global and “local” chinese forces. here song was referring back to the radical maoist notion that certain kinds and styles of clothing, regardless of whether they were manufactured in china or elsewhere, were considered to be “foreign” and thus suspect in nature, and how that concern had since dissolved. song was also countering the radical maoist idea that production and distribution of a wide variety of clothing through market mechanisms was alien to communist china. in so doing, she was affirming deng xiaoping’s blended “socialist-market” economy which had raised standards of living without, as mao would have feared, ruining people’s lives or china’s integrity. song’s stance also contrasts with western feminism that tags cosmopolitan fashion as predominantly capitalist and western. song went on to contrast her generation to her children’s, by saying that her cohort was still conservative, felt awkward in colorful patterned clothing, and did not like to spend money on clothes. in what she said, there was a tension between her generation’s inclinations and what the present ethos claimed as the better way to live. song, like many others her age, found herself partially enveloped by the moral sensibilities of a former era. she allowed herself to enjoy some of the present’s material comforts, but only to a point. while she admired younger people’s clothing consumption, she felt that she herself could only strike a partial compromise by buying clothing more often than in the past, but nothing really fancy and no more than a few outfits. unlike 3wwf, this realism was based on economic constraint, not realpolitik. in comparison with acwf representations, song was less concerned with comparing her cohort of chinese women with peers in western countries than with comparing herself to her children within the chinese context. she did not opt for brightly-colored adornment. rather than striving to surpass western women, song accepted that she would never even come close to her children. there is no way to compare us with our children’s generation. there is no comparison. because we are old conservatives. we don’t dare to wear colorful patterned clothing. we are too reticent and embarrassed. we don’t dare try to compare/compete with young people. ever since i was young, i didn’t like to wear colorful patterned clothing. now my daughter and son are already so grownup, it would be a sore sight if i now started to wear colorful patterned clothing. young people today are very fortunate. even a piece of clothing that costs several hundred yuan, they dare to buy it. we can’t bear to part with the money. the clothes we buy are all very inexpensive. in our daily lives, we are still pretty thrifty. it’s not like my daughter and her generation, they are very chic. we don’t dare. we are still pretty conservative. we are not as outgoing as the younger generations. unlike us, they are all people who are open [as in reforms and opening]. song’s “sore sight” comment stemmed less from self-esteem-related western concerns, and more from local ideas about cohort differences and the awkwardness and impracticability of sudden later-life change. a large part of song’s reticence to dress up in the reform era rested in her concerns about her generation’s limited access to income. throughout the reforms, pensions of older retired workers have been much lower than younger workers’ wages, and inflation adjustments have been modest. agricultural workers typically had no pensions in the early shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 42 reform era, and today they remain low in most places. while the social safety net has improved from the 2000s on, older people of modest means to this day are reluctant to spend on consumer goods, fearing needing money later for subsistence or health emergencies. in the early reform era, health coverage was limited to certain urban employees, and although now there is some coverage to rural dwellers and unemployed urbanites, it is still inadequate. older adults continue to be reluctant to ask their children for money, preferring to invest in their children’s lives, educations, careers and progeny. i can’t bear to part with money to buy clothing. i am used to living a thrifty, arduous life. in summer, i have just two outfits that i alternate. i say, i’ve bought two good outfits, that’s enough. i’ll just wear these. …because we earn very little money, we need to keep our belts tight. when you earn as little as we do, you can’t take big handfuls and large footsteps. ...you need to live within your means. you can’t compare your lifestyle or try to compete with other people. other people earn more, you earn less. you need to pass the days according to your own means. so we look at our own situation, and change our lifestyle over time according to that, not what other people are doing. living within one’s means and eschewing conspicuous consumption continues to elicit great pride in many older folks in post-reform china. despite its importance, however, budgetary constraint was not a focus for either acwf or mainstream western feminist analyses of later-life dress, both of which tend to cut far from the bone of survival. ethnographic case 3: making up for a cultural revolution wedding the last case illustrates some older chinese women’s ambivalent feelings about aging and issues of dress in an elderscape not mentioned in china woman. peng lingxiang was born in 1942. when i interviewed her in 1994, she was in her early fifties and a teacher at a local elementary school. peng was absorbed most of the time with teaching and making sure her daughter excelled at her lessons. we met in their cramped apartment one summer afternoon. in addition to me and peng, a woman friend surnamed du, who was a retired neighborhood clinic worker, joined us. dressed in a loose-fitting button-down shirt and a plain a-line skirt, peng began the interview by saying how pleased she was with the respectful way in which her colleagues treated her at work now that she was an experienced senior teacher. yet, she also revealed aspects of getting older that brought up feelings of deep regret as well. she expressed a common feeling among older chinese women at this time of having been “born too late” in time “to fully enjoy the prosperity of the reform era,” as she was no longer able to eat with the abandon of youth or to make anything she wore look good, having acquired a paunch. so her regrets were not a mere matter of chronology, but chronology in tandem with the vagaries of history. like in the last china woman article, du and peng expressed their sense that in foreign developed countries, older women dress in brightly-colored elaborate fashions, lending such legitimacy as a modern world-class ideal. their dialogue contrasted what they felt they should do based on this ideal and what they felt comfortable doing, given their age, socialization, and changing bodies. unlike 2wwf, they located their feeling that their aging bodies were no match for the new ideal not in the influence of western ageism, but in homegrown chinese conservatism. shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 43 channeling acwf ideals, they imagined that if they could bring themselves to do it, dressing up would not just enhance their aging bodies, but also lift their inner spirits. peng: i am not willing to get old. … sometimes i feel very pessimistic. ah, yes, sometimes i casually say to people, ‘yup, i’m old!’ but, in fact, deep in my heart-mind, i am not willing to get old. sometimes i think, when i was young and the kids were little, everything was bitter hardship and plain living -especially during the cultural revolution. when we got married, we all held up a book of chairman mao’s quotations as we crossed that threshold. now that living conditions are better, you look -our children are already grown up. i should enjoy the prosperity and enjoy a life of ease and comfort in later life, but at the same time, i’m old. if i wanted to eat, well, i can’t eat much of anything anymore. if i wanted to wear something, i can’t pull off wearing much of anything anymore. sometimes i feel like it is a terrible pity! [sigh] du: yes, but in fact, it shouldn’t be too late for us! we can still pull off wearing things. people in developed foreign countries are all like, the older you are, the more patterned and brightly-colored the clothing they wear. young people have natural beauty, so they can dress more plainly. so, the older you are, the more you should dress up. peng: yes, developed foreign countries are like that. du: whenever someone dresses up, they immediately cheer up. the same article of clothing (pulls at her patterned shirt) -you change into a gray one and wear it, you’re going to look even older. but if you wear a little brighter shade, then your spirit will shine forth again, and you’ll look just like you did when you were young. so you should dress up. peng: i’m with you! peng recounted how her biggest regret in life was her cultural revolution style wedding which had not allowed fancy feminine wedding garb. like for chun, peng’s wedding was her key fashion focus. couples marrying during the cultural revolution had to dress in mao suits and had few to no wedding photos. beyond resolving to do her children’s weddings “right,” peng was considering going for a makeover and photo shoot at a “middle-aged-and-elderly-people’s wedding photo shop,” a recent innovation in china. stemming from 2wwf assumptions, this plan initially came as a surprise to me in that peng had shown strong self-esteem and social respect. at her age in her line of work, why masquerade as a young bride? it became clear, however, that peng’s focus was not on pining to look young and stylish as an older woman in the present for other’s approval, and more on being born too early to have been allowed to dress in fancy feminine style when young. she wanted to reenact her wedding to get “proper” photos to materially memorialize the occasion. however, peng also expressed deep ambivalence about whether it would work. she worried that their attempt to pretend to be back in time at their wedding, but with the freedoms and amenities of today, would not prove convincing, even to themselves. the photos of their attempt to make up for the past risked failing to deliver the aesthetically-pleasing new mementos they desired. the excerpt below depicts peng’s feelings about her cultural revolution wedding and the tension between the prospects versus the risks of the new compensatory elderscape. peng: from my heart, i feel like it was especially unfortunate that i got married during the cultural revolution. sometimes i look at how things are now – like soon my youngest sister is going to get shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 44 married, so naturally i started thinking about it. when i got married, even what my maternal uncles and aunts gave me were all quotations of chairman mao [books]. all the gifts were like that – lots of mao pictures …and mao badges. ...back then, could you perm your hair? no way! if i wanted to just brush my hair into long braids, even that was not permitted! really! my braids were really long, but …they cut my hair short, and all i could do was comb it flat against my head. peng: for clothes, who could wear fancy clothes? no one! that was entirely forbidden. shoes couldn’t have even a little bit of a heel! ...so my wedding was under those kinds of circumstances. sometimes i think about it, and i feel really full of regret! so, when my daughter and son get married, i am definitely going to get them some good wedding photos! i say, “my own life just hasn’t been up to par, but we can at least do it for the next generation.” then my husband jokes, ‘hey, soon we’ll have our 25th wedding anniversary, right? so let’s start anew and get our photo taken at one of those places where you can get makeup applied and get dressed up!’ and i say, ‘that’s chillingly pathetic! at this advanced age!’ du: no, that’s really neat! i think that would be really fun and meaningful! mom and dad together, and your children can play best man and maid of honor! peng: they say that tianjin has a photo studio that specializes in taking photos of middle-aged and old people. du: even right here (in beijing), we also have this sort of thing. peng: but if you got your picture taken here, if you ran into someone you knew, it would be a very strange and ugly sight for them to see. yeah, if i’m still worked up over this a while from now, we can go to tianjin to get a compensatory photo taken. nobody would recognize anybody, and when we were finished with the photo-shoot, we’d come back to beijing. there [in tianjin], nobody would recognize us. if the photo turned fig 10: reform-era contemporary wedding photo. photo: jeanne shea shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 45 out good, then we’d let people look at it, and if the photo turned out bad, then it wouldn’t matter, because no one would know we had done it. as illustrated above, peng did not express 2wwf reservations that this later-life glamour shoot may be buying into sexist and ageist patriarchal objectification of women. but she was equally not aligned with a 3wwf model about whether and how to dress the aging body for optimal social impact. peng saw sharing the compensatory wedding photos with others as more of a risk than an opportunity for social status. she was considering the shoot primarily for her own personal consumption. instead of masquerading as her young self in the present, she was considering reenacting the wedding of her youth at a better, future time. discussion here i further examine misalignments across mainstream western feminist perspectives, official chinese feminist messages, and ordinary women’s experiences. i begin with the mismatch between these western and chinese forms of feminism, and then advance to divergences between acwf messages and chinese women’s personal views. comparing feminisms in cross-cultural context the early reform-era situation in china does not dovetail well with dominant western feminist approaches to dressing the aging body. it fits neither with the 2wwf notion that older women should resist age-defying fashions due to origins in sexist ageist capitalist patriarchal oppression, nor with the 3wwf notion that older women can opt to strike a devil’s bargain for short-term personal benefit. western feminist theory has been constructed in reaction to notions of past and present restraint different from those stressed in acwf articles. both address resistance and liberation, but referencing different targets. the dominant imagined audience, notions of self and society, relation of behavioral practice to inner experience, and visions of naturalness all differed in mainstream western feminist versus acwf discussions. whereas western feminist sources have focused on a local heterosexual male gaze, acwf pieces have stressed the platonic gaze of an international audience, one’s own self, and other local women. the relation of body, self and society were configured differently as well. in western discourse, focus on women’s self-esteem was common, whether the negative effect of the sight of one’s aging body on self-esteem (featherstone and hepworth 1991), or the effect of society’s dominant evaluation of aging bodies on women’s self-concept. acwf pieces, by contrast, focused on how dressing well could lift one’s inner spirits and reflect well on the cosmopolitan progress of nation and cohort. the 3wwf emphasis on individual competition for men, jobs, or status was absent. naturalness was deployed differently in each context. in 1990s america, canada, and england, western feminists portrayed as “natural” the act of forgoing makeup in later life, whereas in china going along with a “normal” lifelong female desire to decorate oneself was depicted as “natural.” shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 46 while both mainstream western and acwf feminists in the 1990s pitted two competing moral regimes for older women’s dress against each other, one minimalist with less gendered differentiation than before the 1960s, and the other consumerist stressing youthful femininity, these two feminisms had distinctive historical emplotments. on the western side, the 1960s was typically represented as a time of personal liberation of teens and young adults from formal fitted conformist feminine clothing of the past (ballard et al. 2005: 172-73; also hurd-clarke, griffin, and maliha 2009: 720). on the chinese side, the 1960s was a time of social constraint of teens and young adults no longer permitted to wear fancy feminine clothing of traditional chinese or western style and forced to wear baggy masculine military-style clothing. both chinese and western feminism used a progress narrative, but focusing on different forms of evolution: in the western case, the progress was located in women either adopting and thus legitimating the natural look of unadorned aging, or realizing the right to choose “beauty work” while recognizing its long-term societal limitations. in the chinese case, the progress was found in becoming liberated from radical maoist constraint and in the novel ability of these older generations of women and men to express individual panache. acwf and western feminist discourse likewise had different stances toward what was modern. while dressing in a fancy feminine style was seen as modern and novel to in 1990s china, it was seen in 2wwf as retrograde reversion, and in 3wwf as continuing utilitarian concession. acwf pieces in the 1990s did not portray fancy feminine dress as spawning from societal “ageism, sexism, and commercial interests” with a “negative value on female ageing” as common in 2wwf literature in which progressive “women are urged to reject age-resistance” (ballard et al. 2005: 173). instead, acwf articles depicted gender-marked cosmopolitan dress as a new age-positive opportunity for older men and women, countering ageism that might place such nice clothing out of bounds for mature adults. the early reform-era focus was on overcoming ageism within gender and on combatting earlier gender blindness that had denied “women’s special characteristics.” it centered on liberation of older women from a narrow historical box of mannish proletarian dress and being able to wear the same sorts of clothing that younger women in present-day china and western women wore. further differences in stances on aging women’s dress reflect these divergent historical trajectories. in western feminist discourse, fancy consumerist dress was constraint or utility; the question was whether to forgo it to defy oppression, hoping for a world as it should be (2wwf), or to use it to gain the advantages of appearing youthful in the world as it was (3wwf). in chinese discourse, it was liberation, freedom, access, and play; the question was whether one had the means and dared. unlike in western depictions, in 1990s china, there was typically no 2wwf option to “retire from beauty work” (hurd-clarke and korotchenko 2011: 499) as the majority of older women had little chance to do beauty work as young adults. for them, the option of beauty work had just opened up in middle or old age. likewise, instead of seeing fancy feminine dress as a means to combat a social threat to the self as in woodward’s (1991) “masquerade,” acwf pieces depicted it as a new opportunity in a less threatening social order than before, in which older adults now could live a better life than previous generations. as such, chinese was depicted as un-disciplining a body once bound by maoist masculinist asceticism and economic deprivation, in contrast to twigg’s (2007, 2013) “disciplining.” of course, there are alternative interpretations outside of the acwf exegesis. threatened with the ageism of encroaching capitalist consumerism on top of the late maoist form shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 47 of ageism, beyond the veneer of propaganda, fashion may be a desperate attempt at clawing back some social capital. even when some new freedoms are involved, twigg (2013) argues that: “new cultural freedoms impose new requirements, new disciplinary demands in relation to appearance and the body” (146). in the interviews, we hear women both praising the new options, but also feeling the need to resist new pressures toward status-seeking consumerism. acwf representations in the 1980s-1990s belie limited access to western materials at the time. whereas chinese representations of liberated older western woman focused on the ideal of heavy makeup and flamboyant dress, neither 2wwf nor 3wwf theory did. empirically, research studies in england, canada, and the us have all found older women feeling pressure to tone down makeup and clothing compared with younger women and younger selves (fairhurst 1998: 1, ballard et al. 2005: 180, hurd-clarke, griffin and maliha 2009: 716). official feminist discourses versus women’s experiences just as western feminist theory simplifies the history and diversity of women, so too does chinese feminist portrayal of chinese history and women. the abstract ideals featured in acwf representations were regularly extoled by ordinary older chinese women in the 1990s as good progress for older people as a group. however, at the same time, ordinary chinese women emphasized that these same ideals were not a good fit for their own personal preferences, priorities, means, or generational habitus. for themselves, they came to a casual compromise somewhere in between maoism asceticism and consumerist splendor in the form of inexpensive casual clothing. despite fixation on external appearance in acwf articles, ordinary older chinese women usually prioritized health, function and thrift over projecting a cosmopolitan image. their focus belies neglect of such bare bones issues in mainstream western and official chinese feminisms. in the middle-aged-and-elderly wedding-photo phenomenon that arose in 1990s china, the logic is different from what mainstream western feminists might assume. it was not about trying to look young as an older woman in the present in order to boost self-esteem, personal status, or national dignity. instead, it was about pretending to go back in time to do one’s wedding over with the amenities of today, while keeping a semi-private memento of the compensatory mission. peng was trying to recapture beauty work lost in the past; rather than attempting to reverse the aging clock, she was vying to turn back the historical clock. this dress-up was different from woodward’s (1991) masquerade in that the primary audience was oneself, and the purpose was not to masquerade as young now to fend off a current social threat, but, rather, to pretend to be one’s young self in a fictive past stripped of former political constraints. the ambivalence that clouded this mission was not tied to feeling guilty about selling out to sexist ageism, but, rather, rooted in worry that this game of pretend was unlikely to feel personally convincing because one’s present body would strain to look the part. whereas 2wwf has pitted itself squarely against and reform-era acwf has triumphantly championed consumerist fashions, ambivalence as a theme was shared by 3wwf and ordinary older chinese women in the 1990s. but the form of ambivalence was different. in 3wwf, one was caught between the moral duty to resist ageist sexist consumerism for the long-term good of oneself and others, and the selfish utilitarian temptation to go for makeup, plastic surgery, and sexy clothing in order to individually compete in the world as it exists. shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 48 with older chinese women, the ambivalence was located in a different place. it was lodged in between the feeling that it would be ideal, as acwf then asserted, for the image of older women in china in general if they donned bright makeup and fancy clothing, and the feeling that in practice that didn’t fit their own inner tastes, comfort zone, socialization, habitus, budget, or present body. thus, they came to a kind of compromise between the past and present ideals, with a few sets of cheap casual clothing. compromise as a theme has also arisen in interviews with older western women in recent decades. similar to my interviewees, british women in their fifties have expressed that they cannot simply dress in “cosmo” fashions, because it would feel like a “false image” that did not reflect “their inner sense of ageing” and not pass as socially authentic (ballard et al. 2005: 280). in discussing interviews conducted with older canadian women, hurd-clarke, griffin, and maliha (2009) argue that concerns about social judgments of older women and their dress in the context of financial constraints and limited market availability of appropriate clothing (721-24) force women to walk a fine line, “juggling many concerns,” including: wanting to appear to be a “smart, independent person,” show that “you can take care of yourself” (723) and have not “let oneself go” (721-22), but also to choose something “age appropriate” and “not dowdy, … frumpy, or over-casual” (723). women in 1990s china were also juggling many concerns, but the constellation of concerns and their backdrop was distinctive. rather than focusing on limited choices, older chinese women observed a vastly increased availability of attractive choices. however, while my interviewees liked the existence of alternatives, they saw these new options as fitting for older western women, younger chinese women, and a few daring chinese elders, rather than themselves. personal budget restrictions and early-adult aesthetic socialization made them personally uncomfortable buying or wearing them. while such considerations are important for many western women (e.g., some british women in twigg 2013: 146), mainstream western feminist theory has not focused attention here. these generations of chinese women were aware in the 1990s of issues of objectification and sexualization of women’s bodies through fashion. however, in an arguably ageist fashion, they saw these as applying to younger, not older women. while agreeing with an abstract ideal for older women to dress in a refined feminine fashion, my interviewees personally struck only a modest compromise in updating their wardrobe and altering their dress. this does not preclude the possibility that they were beginning to buy into a tale spun by the ageist sexist marketing of global capitalism. that global flow, however, was being filtered through a lens in which this kind of clothing was a novel opportunity. conclusion in the early reform era, government-sponsored chinese feminist mass media and ordinary older chinese women expressed a different constellation of moral tensions with regard to dressing the older female body, as compared with either mainstream secondor third-wave western feminists. this chinese evaluative repertoire was based in differing visions of history, constraint, resistance, and liberation. unlike the presumption in dominant western feminist approaches, government-backed chinese feminist media and older chinese women were both shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 49 focused on opportunities for breaking free of ascetic maoist androgyny. official and grassroots commentary on older women’s dress was based on ageism and sexism as independent factors, rather than on the interactive double jeopardy featured in many western feminist accounts. there were also important differences between state-supported chinese feminist media and ordinary women. while acwf articles focused on the positive status-enhancing possibilities of cosmopolitan gender-differentiating clothing for older women and the nation, ordinary older women tended to see these opportunities with ambivalence, as good in the abstract, but not well-suited to their own sensibilities, priorities, means, aging bodies, and generational habitus. they came to a compromise between maoist asceticism and conspicuous consumption by buying a few inexpensive sets of casual clothing. while elaborate figure-accentuating feminine dress was still salient for these women in relation to bygone weddings of their youth, it held little personal significance for their daily lives in the present. their everyday clothing was more feminine and individualized than during the cultural revolution, but in a subtle modest way. future studies could re-examine these issues within the contemporary mass media landscape and with new generations of older women, as well as with my original cohort. while the acwf and china woman still exist, they no longer have such a central role in defining women’s issues, as the government has loosened its grip on such matters and market-oriented mass-media venues have multiplied geometrically. my experience returning to china over the years since 2000 tells me that due to increasing globalization, new generations of older chinese and american women, now in their forties and fifties, have had more similar experiences of things such as feminist discourse, fashion media coverage, and lifelong dress norms than past generations did. although there is growing concern about ageism in china, it is lodged more in concerns about whether children will care for their elders in old age, than it is in appearance or dress. with regard to my original cohort, now in their sixties, seventies, and eighties, my follow-up visits have showed that they have many more outfits than they did in the 1990s, but most still prefer inexpensive casual clothing, though with more color and patterns than in the past. many have adopted hair coloring and facial creams, but few wear visible makeup. they still tend to be far more concerned about eating well and saving money for future exigencies than with appearance-based self-esteem or social status. their resistance is still primarily related to a compromise between mao-era thrift and asceticism and reform-era indulgence and conspicuous consumption, rather than couched in terms of double jeopardy or a devil’s bargain. later-life shifts in habitus, embodiment, and dress practices must be viewed not only through standard western lenses pertaining to gender and age, but also through the frames of cultural variation, local historical trajectories, and cohort differences. cultural and generational location in history has a large influence not only on women’s personal experiences apropos gender, age, and dress, but also on local feminist approaches to these issues and on the ways in which women’s practices interface with feminist frameworks and prescriptions. ageism and resistance to ageism may take unexpected forms in different socio-historical circumstances, sometimes making it difficult to tell which is which. acknowledgments: the research for this article was supported by the committee on scholarly communication with china, the national science foundation, and the university of vermont asian studies program. i am grateful to the reviewers and the editors for their insightful feedback. shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 50 references ballard, karen, mary ann elston, and jonathan gabe 2005 beyond the 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featherstone, mike, and hepworth, mike 1991 the mask of ageing and the postmodern life course. in m. featherstone, h. hepworth, and b.s. turner, eds., the body: social process and cultural theory. pp. 371– 389. thousand oaks, ca: sage. friedan, betty 1993 the fountain of age. new york: simon and schuster. gao, yuan 1987 born red: a chronicle of the cultural revolution. stanford: stanford university press. geertz, clifford 1977 the interpretation of cultures. new york: basic books. gilmartin, christina k., gail hershatter, lisa rofel, and tyrene white 1994 engendering china: women, culture, and the state. cambridge: harvard university press. greer, germaine 1991 the change: women, aging, and menopause. new york: alfred a. knopf inc. shea | dressing the older woman in post-mao china anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 51 guan, tao 1995 china's women's studies and policy making at the present stage (中国新阶段的妇女研究于妇女决 策). in xiaolan bao, ed., a collection of theses on women's studies in china (妇女研究在中国专 题讨论会论文集). pp. 2-20. beijing: institute of women's studies. honig, emily 2002 maoist mappings of gender: reassessing the red guards. in susan brownell and jeffrey n. wasserstrom, eds. chinese masculinities, chinese femininities: a reader. pp. 255-68. berkeley: university of california press. hurd-clarke, laura, and alexandra korotchenko 2011 aging and the body: a review. canadian journal on aging 30(3): 495-510. hurd-clarke, laura, & griffin, meredith 2007 the body natural and the body unnatural: beauty work and aging. journal of aging studies, 21(3): 187-201. hurd-clarke, laura, meredith griffin, and katherine maliha 2009 bat wings, bunions, and turkey wattles: body transgressions and older women’s strategic clothing choices. ageing and society, 25(5): 709-26. jin, xuan 1991 there are no ancient women here!” (这里没有年老的妇女). china woman (中国妇 女), 3: 10-11. katz, stephen 2005 cultural aging: life course, lifestyle, and senior worlds. peterborough, ontario: broadview press. liu, xin 2000 in one’s own shadow: an ethnographic account of the condition of post-reform rural china. berkeley: university of california press. oyìwùmí, oyèrónké 2014 the invention of women. in henrietta moore and todd sanders, eds., anthropology in theory: issues in epistemology. pp. 448-54. san francisco: wiley. shea, jeanne 2006 cross-cultural comparison of women's midlife symptom-reporting: a china study. culture, medicine, and psychiatry, 30(3): 331-362. twigg, julia 2013 fashion and age: dress, the body, and later life. london: bloomsbury. 2007 clothing, age and the body: a critical review. ageing and society, 27(2): 285–305. shea | dressing the older woman in post-mao china anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.27 http://anthro-age.pitt.edu 52 wesoky, sharon 2013 chinese feminism faces globalization. new york: routledge. woodward, kathleen 1991 aging and its discontents. bloomington: indiana university press. 1988 youthfulness as a masquerade. discourse. 11(1): 119-42. xiao, ying 1990 today’s scene is just right (今日风光正好). china woman (中国妇女): 5: 1-2. xin, xin 2009 wearing history: chinese dress since 1949. women of china english web (中国妇女英文网): http://www.womenofchina.cn/womenofchina/html1/culture/costumes/9/7637-1.htm xue, xiao 1987 vitality can always accompany you: discussing external appearance, makeup, and dressing up with middle-aged and elderly women (活力将与您长久相随：谈中老年妇女的外表保养与修 饰 ). china woman (中国妇女), 9: 42-43. zheng, wang 1998 research on women in contemporary china. in gail hershatter, emily honig, and susan mann, eds., guide to women’s studies in china. pp. 1-43. berkeley: institute of east asian studies. dressing the older woman in post-mao china perspectives from official feminist mass media and ordinary chinese women abstract dressing the older woman in post-mao china perspectives from official feminist mass media and ordinary chinese women jeanne l. shea significance materials and methods official feminist mass media and ethnographic fieldwork data older women’s liberation through fashion official feminist mass media making the case for understated elegance moving up to elder fashion shows bold pursuit of beauty with bright colors liberation through fashion as ideal versus practice other things to worry about … ethnographic case 1: subtleties of timing and resistance ethnographic case 2: nice to have the options but… ethnographic case 3: making up for a cultural revolution wedding discussion comparing feminisms in cross-cultural context official feminist discourses versus women’s experiences conclusion references book review review of clotworthy, amy. empowering the elderly? how ‘help to self-help’ health interventions shape ageing and eldercare in denmark. bielefeld: transcript verlag. 2020. pp. 263. price: $50 (paperback). ellen ahlness education maksad, seattle, us eaahlness@gmail.com anthropology & aging, vol 43, no 1 (2022), pp. 70-73 issn 2374-2267 (online) doi 10.5195/aa.2022.389 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | ahlness | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.389 http://anthro-age.pitt.edu 70 book review review of clotworthy, amy. empowering the elderly? how ‘help to self-help’ health interventions shape ageing and eldercare in denmark. bielefeld: transcript verlag. 2020. pp. 263. price: $50 (paperback). ellen ahlness education maksad, seattle, us eaahlness@gmail.com empowering the elderly relies on an excellent combination of qualitative research methods—integrating ethnography, participant observation, and interviews—to articulate policy recommendations that can help empower citizens, particularly elderly citizens. the further development of practical guidelines and policy frameworks to advance the empowerment of (older) citizens is a noteworthy goal in health service provision, particularly as aging populations continue to increase exponentially across the globe. this book emerged from amy clotworthy’s phd project and is heavily rooted in ethnographic work on home health visits and re-ablement programs for older adults in denmark, more specifically the municipality of gentofte. the preface and introduction do an excellent job sketching the sociopolitical and sociocultural landscape in which aging is defined by drawing from global institutional data on the cost of aging populations and outlining the development of discourse on aging in the past hundred years. moreover, each provides a great deal of detail about the actual practice of doing fieldwork and the training that shaped clotworthy’s work and affected her as an individual. during fieldwork training, she encountered practical applications of body-mind holism, such as nurses going beyond physical activity prescription, connecting patients to community health resources, and having prolonged, social dialogues with them (14). these experiences made the author fully realize that the body and mind may experience health—and deterioration—at varying rates. clotworthy’s articulation as an active participant in the gathering and analyzing of data (14-15) sets the stage for one of the central tenets of good qualitative methodology—self-reflexivity on the emotional compulsions, biases, assumptions, and commitments the researcher as apparatus brings to the field—a pursuit that is grounded even further in chapter 2. throughout empowering the elderly, clotworthy repeatedly references the process by which western societies came to frame later life as a period of poor health that positions the elderly as a high risk, yet ‘burdensome’ segment of society (e.g., 21, 209). this framing later became challenged by the notion of a “limited yet limitless” aged consumer (21): someone who may have physical and mental limitations brought on by age, but who can still contribute to society. counter-framing older adults through a positive discourse about the chances for healthy aging, she argues together with other scholars in the field (see e.g., gilleard & higgs 2009; lamb 2019), cannot undo this marginal position of conditional inclusion, since this frame similarly relies on a specific kind of citizen: one who is still a productive member of society. by the end of the introduction, clotworthy convinces readers of the necessity of incorporating local studies that conduct in-depth ethnographic examinations into the lived experience of health policies and the particular forms of knowledge that are being exchanged in the interactions http://anthro-age.pitt.edu/ book review | ahlness | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.389 http://anthro-age.pitt.edu 71 between citizens and health professionals. her scientific efforts to gain more insight into the social worlds that developed through home health encounters led to more extensive formally structured life interviews beyond her visitation ethnography (81). chapter 1 provides a cultural historical perspective on factors that led to denmark’s current public health system and elder care. this is a useful background for readers who want to learn more about the specific health care systems of northern europe and similar welfare states, area studies scholars that are interested in understanding the aging philosophies of scandinavian countries, medical anthropologists, or scholars of medical history. chapter 2 discusses the author’s methodological decisions to best gain insight into home health visits. clotworthy defines herself foremost as an ethnographer examining interactions to better understand ongoing (re)constructions of concepts and discourses, an individual who is located in an “intersubjective, situated position” (87). she discusses her ethnographic practice over a course of fifteen months, comprising dozens of site visits, informal interviews with professionals, and five life history interviews with elderly citizens. this chapter provides a lengthy discussion of how and why she chose the municipality of study, namely due to its varied demographic profile, geography, economic resources, and social challenges. this leaves the reader confident in the considerable thought clotworthy put into evaluating the strengths and weaknesses of her case selection. after the first two stand-alone chapters, the book is organized into three sections, with each section focusing on a different facet of 1-on-1 encounters between health professionals and older adults in denmark: “labor: activity related to the biological process of the human body”; “work: activity related to the artificial world of structures and objects”; and “action: activity related to the human condition of plurality.” in part 1, clotworthy effectively integrates political philosophy, discourse analysis, and phenomenology into the case studies and vignettes. she here introduces her focus on ‘embodiment,’ an analytical lens through which the individual’s body is understood as the site of experiences with culture, health, power relationships with others, with the state. this part most intently documents the status quo of rehabilitation and visitation programs. clotworthy asserts that municipal health professionals follow the dominant local and state discourses about aging (i.e., the individual as a “limited yet limitless consumer”) as they assess how their elderly patients can be rehabilitated from an individual who is “dependent” to one who has “particular health limitations but who still has unlimited value as a contributing member of society” (124). in the context of these visitations, the body becomes a resource: a tool through which self-help habits, knowledge, and competences can, and should be performed (116-117). witnessing how bodies are assessed in health evaluations reveals their imbuement with political discourses. part 2, “work,” examines cultural meanings associated with the home, privacy, and security. clotworthy asserts that work done by healthcare professionals unsettles the home as a place of privacy, primarily by undermining the authority of the older individual in their ‘private space.’ based on her ethnographic experience, the author argues that home visits need to be restructured to better acknowledge the ways that older citizens are at home in their surroundings. one such way to minimize the ‘unsettling’ of everyday routines, might be to have therapists work with individuals to “re-stabilize” the home (147). the argument of part 3 builds on the prior two sections: that everyday ‘re-orienting’—the process of grounding new routines into an existing space and promoting aging in place—is an inherently relational http://anthro-age.pitt.edu/ book review | ahlness | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.389 http://anthro-age.pitt.edu 72 practice. elderly individuals with their unique identities shape what their re-orienting looks like, leading to potentially positive but also complicated relationships, dynamics, and aging mentalities. for example, interactions between caregivers and their clients can result in “messy subjectivity” (171). this can complicate a care provider’s work and make the promotion of individual autonomy less ‘efficient.’ the contemporary danish context presumes that municipal health professionals are expected to help citizens remain ‘self-helping’ for as long as possible. however, crises that resist a “bearable way of living with, or in, reality” (190) can greatly affect health professional’s relationships with their patients. the rhetoric of ‘shared responsibility’—a mentality of “we will help you as long as you help yourself” (189)—further complicates relational dynamics between the patient and health professional. yet clotworthy does maintain the assertion that while care is contextual, humans always seem to find a way to care for one another (190). the final chapter summarizes the key analytical points on the conceptualization of a “limited limitless aging consumer”—someone who has been “invested in” by the state to take responsibility for their own care in order to “stay socially engaged for as long as possible” (206)—and on how this model can complicate the work of health services for the elderly. the neoliberal notion of the productive and responsible aging consumer suggests that the good citizen should want to achieve the limitless promises of aging well. consequently, they should be encouraged to feel a desire to take responsibility for their own physical and mental fitness for as long as possible. yet as people age, they may lose their ‘natural’ capacity to be the rational, active agents that they have been told they must be. this can cause tensions and mismatches between these individuals’ desires and capacities and the health professionals’ expectations. clotworthy finishes by suggesting how a more caring response to individualism may produce alternative forms of empowerment in health services (213-215). the take home message of the text is straightforward and sobering: the design of many health and social policies does not consider the lived experiences of the people whom the policies affect. in retelling fieldwork experiences where she witnessed interactions (sometimes subpar) between elderly citizens and visitation staff, nurses, or helpers, clotworthy paints a portrait of how vital connections between people are often undermined by unhelpful or deficient policies, a point she continues to articulate throughout the text. the book analyzes the intricacies of power-based relations between older adults and health professionals through these specific encounters where the state, through local actors, enters older people’s homes to evaluate, offer, or rescind health services. this book is also then, more generally, a study about dynamics in highly power-based relationships, which makes it particularly relevant for political scientists and sociologists; clotworthy’s empirical analysis is influenced by michel foucault and hannah arendt’s political philosophies on the “tacit forms of governmentality” that permeate political discourses of health policy (9). she effectively integrates political philosophy, discourse analysis, and phenomenology into her ethnographic materials by using vignettes and case studies to articulate otherwise abstract political science, sociology, and anthropology concepts. while clotworthy excellently weaves the historical context of today’s image of an elderly citizen, the text could have paid even more attention to municipal health professionals’ status as ‘big fish in the little pond’. counter to the neoliberal power relationships that are analyzed throughout the text, this psychology-based argument suggests that individuals who are drawn to positions where they can exert power over others lose touch with the practice and aims of health care. that some individuals are attracted to power in health care spaces is, in itself, a topic that has garnered much attention in academia, media, and journalism (magnuson & norem 2009; marsh et al. 2008). care and power dynamics, under these circumstances, would undoubtedly undermine efforts toward the self-help model in significant ways. http://anthro-age.pitt.edu/ book review | ahlness | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.389 http://anthro-age.pitt.edu 73 practitioners and citizens who want to better support older adults by understanding the political discourses and philosophical complexities associated with giving up autonomy in a particular context will certainly find value in this book. they may find, however, fewer applicable lessons in the earlier sections’ heavy theoretical lens of governmentality and power relations. these earlier sections will particularly appeal to anthropologists, sociologists, and political scientists who have a greater fluency in the vocabulary of aging and power discourses. references gilleard, chris, and paul higgs. 2009. “the power of silver: age and identity politics in the 21st century.” journal of aging & social policy 21 (1): 277-295. lamb, sarah. 2018. “on being (not) old: agency, self-care, and life-course aspirations in the united states.” medical anthropology quarterly 33 (2): 263-281. magnuson, sandy, and ken norem. 2009. “bullies grow up and go to work.” journal of professional counseling: practice, theory & research 37 (2): 34-51. marsh, herbert, marjorie seaton, ulrich trautwein, oliver lüdtke, k.t. hau, alison o’mara, and rhonda craven. 2008. “the big-fish–little-pond-effect stands up to critical scrutiny: implications for theory, methodology, and future research.” educational psychology review 20 (3): 319-350. http://anthro-age.pitt.edu/ what older prisoners teach us about care and justice in an aging world jason danely jdanely@brookes.ac.uk oxford brookes university abstract over the last two decades, there has been a rapid rise in the proportion of older adults in prisons across the world. while the cause for this trend depends on local demographic, legal and social circumstances, ethnographic attention to this issue remains sparse. this commentary examines the contributions of two recent books on older adults in prisons in order to highlight key questions and findings that might provide a foundation for future research for the anthropology of aging and the life course. despite focusing on different national contexts, both works reveal the disproportionate harm to older adults as a result of incarceration, as well as the ways individuals cope, even in very restrictive institutional environments. i conclude by stressing the need for more ethnographic attention to the growing overlap between aging and the carceral (in and out of prisons), and the importance of this research for questioning our broader assumptions about aging, care, crime and justice. keywords: older prisoners; incarceration; confinement; justice; ethnography anthropology & aging, vol 43, no 1 (2022), pp. 58-65 issn 2374-2267(online) doi 10.5195/aa.2022.395 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 58 what older prisoners teach us about care and justice in an aging world jason danely jdanely@brookes.ac.uk oxford brookes university in 2020, a us man named james frazier was 79-years-old and living with dementia, incontinence, and frailty that had advanced to the point where he was unable to walk or do most everyday tasks without an aide. he was also ohio’s oldest death row prisoner. in november 2020, frazier’s lawyers filed legal papers arguing that he was incompetent to be executed (according to state law, prisoners must understand what they are being punished for). the execution, which had been scheduled for october 2021, was deferred to 2022 while the request was being considered. in november 2021, however, frazier died of covid-19 at franklin medical center, still in custody, awaiting his execution. reading about james frazier’s case, i was struck by what seemed like a tenacious drive not only to incapacitate but to punish. his was not an isolated case. the last quarter of the twentieth century saw not only a rapid proliferation of prisons and an increase in the number of prisoners, but also an intensification of the prison’s retributive function, including “zero-tolerance” policies and the increased use of ‘control units’ (rhodes 2004). these two trends are connected and deeply worrying, particularly when we see older and disabled people increasingly caught in this carceral crush. when it comes to older prisoners, particularly those who pose little threat due to age-related physical and cognitive frailty and who will not benefit from rehabilitation, such continued punishment would be in breach of human rights principles, if not law (fellner and vinck 2012, 88). nonetheless, cases of older individuals, like frazier, becoming frail and dying while in custody are quickly becoming normal rather than exceptional. in 2007, fewer than 6% of those on death row in the us were over the age of 60, but today, they account for more than a quarter (death penalty information center 2020). this same rapid aging trend is seen in the general us prison population, where a third of prisoners are projected to be over the age of 55 by the year 2030 (a doubling in the span of a decade) (austin, irwin and hardyman 2001), driven by stricter sentencing laws and longer mandatory prison terms (maschi viola and sun 2013, 544). this trend can also be observed elsewhere around the world. already in the uk, for example, the number of prisoners over 50 tripled between 2006 and 2016, and the prison system became the largest residential care provider for frail and older men (prisons & probation ombudsman 2017). in belgium, the number of prisoners over 60 doubled between 1997 and 2007 and has continued to rise slowly. in japan, where crime rates are at their lowest in decades, 22% of all crimes are committed by people over the age of 65 (yagi 2020), around 15% of whom are living with symptoms of dementia (ichimiya 2020). between 1999 and 2019, the number of individuals 65 and older in japanese prisons tripled, while their proportion of the overall prison population quadrupled (from 3% to 12%). specialist facilities are being built to accommodate the large numbers of frail, disabled and cognitively impaired prisoners, prompting comparisons to nursing care homes (nhk 2019). how did this happen? when prisons emerged across europe in the eighteenth and nineteenth centuries, they were imagined as humane and rehabilitative institutions that would replace the use of harsh corporal punishment and execution (fassin 2017, 15). as we know from foucault’s (1977) extensive http://anthro-age.pitt.edu/ danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 59 genealogy of state sanctioned punishment, however, prisons, and the administrative infrastructure of criminal justice that developed with them, resulted in a more diffuse, “muted, less visible form of violence” (fassin 2017, 16). but although prisons have always facilitated the modern transformation of violence and state power more broadly, the more recent expansion of the prison’s size and scope as a place of punishment remains remarkable. public support for ‘tough on crime’ or ‘law and order’ policy approaches remains popular in most countries, while the rehabilitative function of prison has steadily eroded over the last half-century. this trend mirrors the advancement of neoliberal welfare retrenchment outside prisons, and the worsening of conditions inside prisons, from overcrowding and violence to the catastrophe of the covid-19 pandemic. conditions in prison are so poor that prison health researchers have long considered incarcerated people to reach ‘old age’ (in biophysical and emotional terms), at around, on average, ten years earlier than non-incarcerated people (aday 2003). because of this accelerated aging, ‘time served’ is much longer than the length of sentence would seem to indicate. this increase in the number of older prisoners around the world is not merely a reflection of aging populations, nor is it likely that the current generation of older people are somehow more prone to criminal behavior than they were in the past. yet, if we look for answers to the puzzle of the global increase of older people in prison on an institutional level, it becomes difficult to draw strong conclusions. cross-national comparisons are complicated by differences in laws, police enforcement, sentencing, parole and other elements that make up the criminal justice system. cultural models of aging and access to social welfare support also vary widely across national contexts. while the reasons for the increase in older prisoners vary considerably across societies, prisoners’ experiences of growing older, being abused or neglected, and finding ways to care or be cared for in prison, seem to resonate across cultural contexts. two recent books on the subject of older prisoners make significant contributions towards closing the gap in our understanding of older adults and prison life, and while each one represents the culmination of extensive research and exhaustive review of prison studies, each pursues the topic in its own way. diete humblet’s (2021) the older prisoner is based on fieldwork she conducted in two prisons in belgium, one where the older prisoners are integrated with the general prison population and another where they were separated in a specialist wing. although not an anthropologist by training—her degrees are in law, criminology, and gerontology—humblet’s research follows a conventional ethnographic approach of long-term observation, interviews, shadowing and conversing with various actors during the flow of their daily routines. tina maschi and keith morgen’s (2021) aging behind prison walls, by contrast, combines findings from over a decade of qualitative and mixed methods studies conducted in the northeast us. again, neither author is an anthropologist: maschi’s disciplinary background is in social work, while morgen’s is in psychology. what holds their book together is its provocative “call to action” to bring about what the authors describe as a “new age of caring justice” based on “mercy, compassion, unconditional love, transparency (truth), and accountability” (3). while humblet’s writing belies a sensitive approach that produces a rich and full picture of each person’s humanity, it retains a more conventional academic distance when it comes to addressing ways to take action based on the research. both approaches, i believe, deserve our consideration, since on the one hand, it might be better to stay neutral and allow the reader to come to their own conclusions, and on the other hand, one might argue that subjects like power and carcerality demand new, bolder forms of writing that engage with both the possibilities and limits of normativity. despite their differences, however, i found it striking that both of these books were structured along a very similar narrative arc: beginning with an emphasis on the diversity of older incarcerated individuals and the need for their voices to be heard; then moving on to the stress and difficulties endured by older http://anthro-age.pitt.edu/ danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 60 adults (both before and during incarceration); and finally, reflecting on the ways older incarcerated individuals are able to develop and achieve some measure of a ‘good life’ in prison. across this arc, both books advance the compelling argument that the treatment of older adults in prison is predicated on broader social beliefs about not only criminality and justice but also age. there is a persistent tension, for example between assumptions about age-related vulnerability and the image of the dangerous criminal, or between the recognition of differences in care needs of frail older people and the routines and uniformity of prison institutions. by highlighting these intersections and contradictions, the authors of these books challenge the solidity of the prison walls, showing us how ageism on the inside is continuous with institutional and structural ageism on the outside. while it has been recognized for decades that inequalities based on race, class, and citizenship are reflected in and perpetuated by criminal justice and penal systems (alexander 2010; wacquant 2009), these books are two of the most significant works to extend the argument to age and disability. in aging behind prison walls, tina maschi and keith morgen (2021) argue that older prisoners’ lives are marked by cumulative disadvantages and a lifetime of traumatic experiences. despite the demographic heterogeneity of older adults sampled for their research, nearly three-quarters of those surveyed had three or more incidences of trauma, such as abuse or assault, in their life histories. in order to illustrate the particular contexts and effects of these incidences over the life course, the authors use detailed personal narratives, some extending several pages, either written by incarcerated individuals or collected through interviews. several of these portraits of individuals are rich and evocative, and firstperson format creates the sense that the individuals are speaking directly to the reader rather than to a researcher. in most cases, the authors leave these narratives to speak for themselves, without extensive interpretation or commentary apart from a few topic headings. together with the black and white photographs of older incarcerated men and women taken by ron levine appearing throughout the book, the aim of connecting and humanizing research subjects is palpable. in contrast, the life-history of 56-year-old ‘pedro’ appears not as a first-person narrative, but as a table running over two full pages (maschi and morgen 2021, 68-69). glancing at the table, the reader can quickly scan across the neat, evenly arranged columns, like a doctor reading a patient’s chart, noting everything from malnutrition in childhood, to prostitution and addiction in his teens, to cancer in his fifties. pedro’s life, or at least the traumatic aspects of it, lie spread out, exposed and dissected over the table. the authors present pedro’s case in this way in order to illustrate the “life sources systems power analysis,” a tool for assessing and planning intervention strategies in complex cases (68). perhaps, for those trained in social work, pedro’s chart would be an example of an effective tool for developing individually tailored care, but for anthropologists, the shift in approach from first-person narratives to clinical analysis can be jarring. if we were we able to read pedro’s words or hear his voice, how might he have described his life journey, and what was important to him? how might his case shed light on immigration, inequality and criminalization in ways that spill over the borders of the table? for maschi and morgen, this rather stereotypical analysis of pedro and others like him had a particular aim: it helped them translate complex individual cases into the authors’ universal twenty-five-point plan of action that they argue will “dismantle the oppression experienced by older people in us prisons and aging people in prisons across the world” (71). although only one of these points (the development of geriatric services) is specific to older adults, all of them have potential for improving the lives of older adults both inside prison and in the community, including developing better policies, community services and greater public awareness. these are bold proposals, but perhaps the boldest claim of aging behind prison walls is that “it is the aging prisoner who has awakened the general public to the possibility of a form of justice that cares” (maschi and morgen 2021, 5). “caring justice” (120) is a response to the neglect of aging prisoners and http://anthro-age.pitt.edu/ danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 61 arises on an institutional and collective level as the result of individual betterment: if i care, my community will care, and justice institutions will care. in other words, by gaining a “new place of awareness and inner knowing” (120) regarding both the traumas and the resilience of aging prisoners, society will no longer be able to stand aside and will be compelled to act. resilience, or “adaptive coping,” (109) is an ability to bounce back from negative experiences, and in some cases, to find opportunities for “biopsychosocial spiritual” (115) development. examples of resilience create hope for change, allowing the reader to see older prisoners as more than just passive victims of oppression, incapable of ever having healthy relationships or controlling their actions and emotions. the fact that some individuals do develop resilience, however, should not be mistaken for evidence that prisons are fulfilling their responsibility to rehabilitate. in one example of “coping resilience” one incarcerated individual wrote, “prison is tough, prison is bad, prison is everything you’ve heard and more, but it’s nothing to [sic] the reality of the pain i carry for my careless actions” (117). in another case, an individual wrote, “if all this get tough on crime worked, your prison system would not be exploding. are we the evilest society on this third rock from the sun, or are our criminal justice policies just out of control and oppressive?” (102). the frustration of being caught up in a world that is “exploding” is a vivid reminder that even while individuals must find ways to survive and adapt to life in prison, this does not legitimate the institution’s authority and use of power. building on these examples of resilience, maschi and morgen go on to provide additional recommendations for change, including ways to build a more supportive community and to address the specific needs of older lgbtq+ individuals in prison and older prisoners living with addiction or mental illness. prison abolitionists such as angela y. davis (2003), savannah shange (2019), and ruth harrison gilmore (2022), who draw heavily on anti-racist and feminist theory, might argue that as long as prisons continue to occupy the same space in society, and criminalized communities continue to be reproduced by structural modes of oppression and violence (that include prisons), then there is still a long way to go before anything like “caring justice” can be achieved. while maschi and morgen do not use the term “abolition,” they are often strongly critical of the status quo, which renders it a little surprising that they haven’t engaged with the critical abolitionist literature further. similarly, their model of “caring justice” is not based in the extensive body of literature on the ethics of care (see tronto 2020; held 2006 and many others), nor is it grounded directly in their own data. part ii of the book, which is dedicated to elaborating the notion of caring justice, is a dizzying blend of jungian archetypes, quantum physics, and “eastern philosophy,” exemplified by “energy centers and levels of consciousness” (194-209). the overall effect of this part was a slightly uneasy sense of disconnection between the life stories of the incarcerated older people in the initial chapters and the array of consciousness enhancing ideas laid out in lengthy lists, diagrams, and tables in this second part that, for me, never quite came together into a coherent model of practice. the final chapter of aging behind prison walls, “realizing a caring justice world,” briefly profiles thirdsector organizations in the us, uk, and elsewhere, that assist older adults in prison and after, as models of the caring justice paradigm. these include prison hospice, outpatient services and non-profit or charity organizations, which together represent a vast amount of experience and insight about older people’s interactions with the criminal justice system. the directory does not include case studies of individuals who were helped by these groups, nor does it explain how these groups address broader questions of race and inequality that have been at the forefront of prison abolition and transformative justice activism in the us. given the recent revival of these issues in the wake of the #blacklivesmatter movement, their omission in a book about imagining caring justice in the us is conspicuous. while the work of consciousness-raising is crucial, readers may be skeptical of the notion that deeply entrenched power structures and institutions will “die a good death” (maschi and morgen 2021, 3) if more people worked on balancing archetypal energies. in the midst of the covid-19 crisis, when the virus was http://anthro-age.pitt.edu/ danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 62 spreading like wildfire through the us prison system, killing dozens of older prisoners in the first few months, maschi and morgen write in their afterword, “the power inside each of us can influence us all. the older adults in prison taught us much. let’s let their love for us go viral. by releasing ourselves, we will release them” (234). while these pithy statements, at first, struck me as out of tune with the reports of neglect coming from prisoners at the time, i also appreciate the value of leaving the book on a hopeful note. although there is no lack of research demonstrating the negative effects of incarceration on older adults, maschi and morgen have dared to go beyond conventional academic and disciplinary boundaries to build their own aspirational vision for liberation. despite differences in approach and geopolitical area, diete humblet would likely agree with most of the general observations in aging behind prison walls, from the importance of the life-course approach to the human costs of confinement, to the recognition of adaptive coping that provides prisoners some means for achieving feelings of purpose and comfort. humblet’s the older prisoner is not shy about the often-disturbing details of harsh treatment or neglect in belgian prisons, but while maschi and morgen frame these experiences in terms of general psychological notions of trauma, humblet’s approach is to ask how the prison, as a material, social, and cultural environment constructs ‘old age.’ in this sense, humblet’s work resonates with ethnographic studies of nursing homes or communities of older people where rituals and activities can work to both integrate and ‘other’ the older person (e.g., myerhoff 1976). the older prisoner begins by unpacking the many ways we reckon age (chronological, biological, functional, social, psychological) before taking a critical look at notions of “prison harm” and “accelerated aging” (humblet 2021, 25) as a result of the prison environment. this review is meticulous, picking apart the assumptions about the ‘older prisoner’ as a subject in ways that expose their special treatment or marginalization to be rooted in ageist assumptions. prisons, much more so than other places in society, demand order and conformity, severely restricting prisoners’ capacities to have their individual needs recognized, let alone to create a space for personal expression and meaning. this is a technology of control necessary for a small number of staff to keep order in the prison environment, but for frail and disabled older prisoners, this ‘management’ easily crosses a threshold into punishment. through frank conversations with prisoners and staff, humblet reveals a predominant ethos of what british criminologist elaine crawley (2005) calls “institutional thoughtlessness,” that is “rooted and sustained by the prison praxis” (humblet 2021, 137). institutional thoughtlessness is more than the just the neglect of prisoners’ age-related needs. humblet argues that it also places older prisoners in a kind of double bind. on the one hand, integration of older and younger prisoners often led to additional physical and psychological burden for the older prisoners. on the other hand, when separated in a specialist geriatric ward, ageist assumptions about older prisoners as incapable, senile, or dying led to similar exclusions and discrimination. either prisons try to uphold the value of equity and just retribution by ignoring age-related needs, or they restrict older people from opportunities to work, exercise, or having intergenerational relationships based mainly on ageist and essentializing categories of frail old age. both cases inflict violence through repeated misrecognition that instills and reproduces a response of passivity and compliance with authority. having laid out this argument as a foundation, humblet (2021) takes us to the “lived space” (101) of the two prison settings where she conducted research, detailing not only the physical conditions but the ways they are felt and experienced by older incarcerated individuals and prison officers. here, the heterogeneity of the older subjects is clearly demonstrated, as both the integrated and segregated settings produce their own set of limitations and affordances. the various boundaries and openings in different spatial settings is not surprisingly also reflected in the social relationships of prisoners. humblet (2021) separates relationships into “vertical” (inmate-staff) and “horizontal” (fellow inmates). http://anthro-age.pitt.edu/ danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 63 a key figure moving between the vertical and horizontal relationships is the “fatik,” “prison-porter” or “prison-servant” (162), who provides various forms of care for prisoners but who is not part of a formal framework. while this sometimes puts prisoners in an uncomfortable position, it is also an opportunity for developing a positive sense of meaning and value, and many older prisoners take on this role. the last two chapters in the older prisoner discuss the ways older incarcerated individuals “survive” (humblet 2021, 189) “cope” (212) and even “thrive” (229) while in custody. like maschi and morgen, humblet has found that in many cases, older incarcerated individuals develop the capacity to write their own narratives and assign their own meanings and values to their experiences. interestingly, humblet adopts developmental psychologist erik erikson’s concept of “generativity” to characterize the ways incarcerated individuals seek not only to control or avoid bad feelings but also to invest in “forms of life and work that outlive the self” (229), including participation in humblet’s ethnographic research. in the highly restrictive environment of prison, generativity must be broadly construed, often taking the form of subtle acts of resistance. in one case, humblet describes the case of a prisoner who would tear up underwear that had been already worn out so that it wouldn’t be passed on to other prisoners. this behavior might appear at first to be merely destructive, but for this individual, removing the old underwear from circulation was a meaningful form of care for other prisoners, who would have to be given new underwear instead. the older prisoner is replete with memorable anecdotes like the underwear cutter, who represents both the limits and possibilities for practicing care and generativity in prison. humblet’s careful analysis is supported by a breathtaking range of scholarship in sociology, criminology, and age studies (in several languages). given the relative dearth of research on older incarcerated individuals in continental europe, humblet draws mainly on research conducted in us and uk prisons, but throughout the book she is also careful to note where her data confirms or contrasts with findings from elsewhere. humblet’s writing is committed to the ethnographic data such that there is hardly a page in the main body of the book that does not contain a moment captured concisely in a scrap of field notes or an excerpt from a conversation. this close attentiveness to the words and worlds of older prisoners captured in the moment of the ethnographic encounter has not only yielded outstanding research but it also conveys a powerful sense of humblet’s own care and humility, which anyone who has worked with socially marginalized older adults will deeply respect. while the book does not engage directly with anthropological theory, it is an exemplary piece of fieldwork-based ethnographic research that would fit easily into any anthropology course related to aging. in both the older prisoner and aging behind prison walls, we stay, for the most part, within the confines of the prison institution. a full analysis of the conditions that increasingly criminalize older people, or that prevent them from fully reintegrating after release, remain beyond the scope of these studies. questions remain about policies and practices meant to address the aging prison population issue, such as compassionate release for terminally ill older people and how these are being discussed at local, state, or national levels. despite the extensive access all of these researchers had, their findings, like the subjects of their books, remain confined, but the implications do reach far beyond the prison walls and will be of interest to anyone interested in questions of aging, intersectionality, marginalization, confinement, and justice. future research will no doubt broaden the frame even further, linking the prison system to other concerns for today’s aging world, such as changes in the family, social isolation, and precarity in social care. as the voices of historically criminalized groups calling for prison abolition, transformative justice and community revitalization grow louder, research on aging must also move beyond the concerns of the mainstream, to critically engage with abolition from an anti-ageist perspective. the vulnerability and neglect that was revealed so tragically in the early days of the http://anthro-age.pitt.edu/ danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 64 covid-19 pandemic ought to make us question whether conditions of “institutional thoughtlessness” are also at work in nursing homes and other institutional settings used to securely confine and surveil older people (badone 2021). in this way, these books will be formative for the body of work on aging, care, and carcerality that is sure to grow rapidly in coming years. references aday, ron h. 2003. aging in prisons crisis in american corrections. westport, ct: praeger publishers. alexander, michelle. 2010. the new jim crow: mass incarceration in the age of colorblindness. new york: new press. austin, james, john irwin and patricia l. hardyman. 2001. “exploring the needs and risks of the returning prisoner population.” the urban institute: u.s. department of health and human services. badone, ellen. 2021. from cruddiness to catastrophe: covid-19 and long-term care in ontario. medical anthropology 40(5): 389-403. doi: 10.1080/01459740.2021.1927023. crawley, elaine. 2005. “institutional thoughtlessness in prisons and its impacts on the day-to-day prison lives of elderly men.” journal of contemporary criminal justice 21 (4): 350–63. https://doi.org/10.1177/1043986205282018. davis, angela. 2003. are prisons obsolete? new york: seven stories press. death penalty information center. 2020. “case of 79-year-old ohio death-row prisoner with dementia highlights legal issues exacerbated by the aging of death row.” april 21, 2020. accessed february 28, 2022. https://deathpenaltyinfo.org/news/case-of-79-year-old-ohio-death-row-prisoner-with-dementiahighlights-legal-issues-exacerbated-by-the-aging-of-death-row. fassin, didier. 2017. prison worlds: an ethnography of the carceral condition. malden, ma: polity press. fellner, jamie, and patrick vinck. 2012. old behind bars: the aging prison population in the united states. new york: human rights watch. http://www.hrw.org/sites/default/files/reports/usprisons0112webwcover_0.pdf. gilmore, ruth wilson. 2022. abolition geography: essays towards liberation. edited by brenna bhandar and alberto toscano. london: verso. held, virginia. 2006. the ethics of care: personal, political, and global. oxford: oxford university press. humblet, diete. 2021. the older prisoner. london: palgrave mcmillan. ichimiya shunsuke. 2020. “‘more than 10 per cent of those entering prison have “likely dementia.’” mainichi shinbun. june 27, 2020. accessed feb 28, 2022. https://mainichi.jp/articles/20200627/k00/00m/040/159000c. maschi, tina and keith morgan. 2020. aging behind prison walls: studies in trauma and resilience. new york: columbia university press. maschi, tina, deborah viola, and fei sun. 2013. “the high cost of the international aging prisoner crisis: wellbeing as the common denominator for action.” the gerontologist 53 (4): 543–54. https://doi.org/10.1093/geront/gns125. myerhoff, barbara g. 1980. number our days. new york, n.y.: simon and schuster. nhk. 2019. “keimusho, marude kaigo shisetsu ni. nhk seiji magajin.” august 21, 2019. accessed february 28, 2022. https://www.nhk.or.jp/politics/articles/feature/21325.html. prisons & probation ombudsman. 2017. “older prisoners. london: prisons & probation ombudsman.” https://www.scie-socialcareonline.org.uk/learning-from-ppo-investigations-olderprisoners/r/a110f00000nehldaan. rhodes, lorna a. 2004. total confinement: madness and reason in the maximum security prison. berkeley, ca: university of california press. shange, savannah. 2019. progressive dystopia: abolition, antiblackness, and schooling in san francisco. illustrated http://anthro-age.pitt.edu/ https://doi.org/10.1080/01459740.2021.1927023 https://doi.org/10.1177/1043986205282018 http://www.hrw.org/sites/default/files/reports/usprisons0112webwcover_0.pdf https://mainichi.jp/articles/20200627/k00/00m/040/159000c https://doi.org/10.1093/geront/gns125 https://www.nhk.or.jp/politics/articles/feature/21325.html https://www.scie-socialcareonline.org.uk/learning-from-ppo-investigations-older-prisoners/r/a110f00000nehldaan https://www.scie-socialcareonline.org.uk/learning-from-ppo-investigations-older-prisoners/r/a110f00000nehldaan danely | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.395 http://anthro-age.pitt.edu 65 edition. durham, nc: duke university press books. tronto, joan c. 2020. moral boundaries: a political argument for an ethic of care. london: routledge. wacquant, loïc. 2009. punishing the poor: the neoliberal government of social insecurity. durham nc: duke university press books. yagi takuro. 2020. “senior citizen crime: 10 fold increase in 30 years, 2020 police white paper.” asahi digital. july 22, 2020. accessed feb 28, 2022. https://digital.asahi.com/articles/da3s14558185.html?iref=pc_ss_date_article http://anthro-age.pitt.edu/ https://digital.asahi.com/articles/da3s14558185.html?iref=pc_ss_date_article book review review of basting, anne. creative care: a revolutionary approach to dementia and elder care. new york: harperone. 2020. pp. 280. price: $23 (hardcover); $17 (paperback); $15 (ebook). joy ciofi the gerontology institute, georgia state university joy.ciofi@gmail.com anthropology & aging, vol 42, no 1 (2021), pp. 158-160 issn 2374-2267 (online) doi 10.5195/aa.2021.341 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | ciofi | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.341 http://anthro-age.pitt.edu 158 book review review of basting, anne. creative care: a revolutionary approach to dementia and elder care. new york: harperone. 2020. pp. 280. price: $23 (hardcover); $17 (paperback); $15 (ebook). joy ciofi the gerontology institute, georgia state university joy.ciofi@gmail.com creative care is anne basting’s reflection on her decades of work facilitating joyful creativity and meaningful engagement with older adults, particularly those with dementia. the book brings together myriad techniques refined over more than two decades of research (basting 2009) and couples them with stories of the transformative experiences of persons with dementia and their care partners to offer a new, practice-oriented primer to apply creativity to dementia and elder care. her emotive, accessible writing style invites readers to follow her creative engagement process, and the book provides ample prompts and tips for engaging with the older adults in our lives, regardless of diagnoses or disability. divided into three sections, the first part, “finding creative care,” recounts basting’s journey with creative expression and caregiving. she takes readers through key moments in her life history, which propelled her to explore the potential of the arts in long-term care settings: from grade school painting lessons to dissertation development. one especially poignant story describes an exchange with her grandmother, alice, whose communication had dwindled to only “three tools”: a single sound, a pointed finger, and widening eyes (18). yet with these tools, alice made basting decide: “[e]nough with this arts stuff; i would help people” (18). as the book reveals, this advice ultimately made her mobilize the arts as a way to help people. part two, “defining creative care,” outlines the fundamentals of creative caregiving. each of this part’s chapters presents a perspective or approach to engage older adults meaningfully and creatively and is followed by a brief, open-ended ‘how-to’ guide for readers, which can be used at home or in formal care settings, one-on-one or with a group. for example, chapter 5, “beautiful questions,” explains a communication technique designed to “invite a person into contemplation without worry over right or wrong” by asking questions in a different way (76). rather than seeking a conclusive answer, a beautiful question “gives the creative power to the listener, not the asker,” and as such opens the door for continued creativity and expression (79). a beautiful question might ask, “what do you treasure in your home and why?” or “what is your safe harbor?” (79). these sorts of questions, basting argues, communicate the belief “that the listener can do this and that the asker will receive and honor the listener’s answer” (77). “changing care through creativity,” the third and final section, describes the emotional successes and logistical challenges encountered during basting and her team’s most notable projects and performances through the years. some were full-scale theatrical productions, like the penelope project http://anthro-age.pitt.edu/ book review | ciofi | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.341 http://anthro-age.pitt.edu 159 (basting et al. 2016), a re-interpretation of homer’s odyssey performed inside a care home. the play had a role for each resident, as well as for staff, students, and professional actors from a local activist theatre company. the team navigated the limitations of the setting, such as physical space constraints and scheduled mealtimes, by being flexible and fully collaborative. ultimately, the success and power of both the process and final performance moved many to tears, resulting in what basting describes as “a seismic shift for the care community” (158). not all of the creative care described in this section was so grand in scale, however. in chapter 11, “from islands to archipelagos,” basting outlines the piloting of a program for elders living alone at home or who were “‘underconnected’ to their communities” (162). through meals on wheels deliveries, “question of the day” prompts were dropped off with meals. a team of researchers and volunteers collected over two thousand responses on these questions in eight months, both written and via a voice mail line. through this seemingly small action, these elders were able to connect to others and share their experiences, knowing “they were being honored and heard” (169). the variety and scope presented in these final chapters illustrates one of basting’s key tenets: everyone can be creative, and everyone can incorporate creativity into care. the positive tone and inspirational stories shared in this book contrast sharply with many of the medicalized, market-based realities of dementia care in the united states and elsewhere. media discourse, driven by a mix of public health data and demographic predictions, has framed dementia as an impending epidemic of enormous proportions (lock 2013). in the absence of an effective treatment or cure (though the search for both is only intensifying), advocacy organizations such as the dementia action alliance have sought to change the narrative and combat the stigma associated with a dementia diagnosis by focusing on “living fully with dementia” (dementia action alliance n.d.). research funding is also diversifying, and the national institute of aging is dedicating a greater percentage of its resources to studies which focus on caregiving and quality of life for persons with dementia in the us. creative care contributes to this ongoing dialogue between research, advocacy, and practice by presenting research-based approaches to dementia caregiving which can be easily understood by a variety of readers and care partners and implemented in any care setting. it is an excellent illustration of the potential impacts of accessible applied research, as evinced through the successes of basting’stimeslips program, which has now trained over 900 creative storytellers around the world (timeslips n.d.). the truly interdisciplinary approach of the book, merging research and methods from anthropology, gerontology, performing arts, disability studies, and psychology, among others, is both a key strength and a significant challenge, as these disciplines are often at odds. yet, in focusing on the possibilities for creative action and the attainability of the ‘good life with dementia,’ the book avoids the most difficult aspects of care and only minimally acknowledges those care tasks which exist beyond the reach of playful creativity. in recounting a conversation with her parents about the future physical care needs of her mother, recently diagnosed with alzheimer’s, basting concedes that “physical and emotional care are entwined” (51). she briefly touches on the deeply gendered and potentially exploitative nature of care work, to then quickly return to her argument for the power of positivity. she writes, “creativity is the place we want to be. care is the place we’re forced to go, sometimes kicking and screaming. yet when we bring them together, the tension between them vibrates with possibility” (55). the subsequent chapters are intended to guide readers into this realm of ‘vibrating possibilities,’ largely through the adoption of a new perspective on the part of the caregiver. she argues: at its heart, creative care is not really about painting or singing, although those things certainly happen. creative care is an agreement between people to imagine themselves, each other, and their worlds a little differently. it is an invitation to shape the world together. (57) http://anthro-age.pitt.edu/ book review | ciofi | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.341 http://anthro-age.pitt.edu 160 although this invitation is extended to all readers, it is unfortunately not one that all are able to engage. optimism is powerful, to be sure, but not omnipotent, and choosing to shift focus away from loss and towards creative possibilities requires a willingness and cache of resources (temporal, emotional, and financial) that many caregivers do not have access to for very different reasons. there are elements of care that exist beyond the reach of creativity; creativity does not reduce medical debt, for example, nor is it necessarily welcome in all care tasks, such as toileting or bathing. creative care does give family and other care partners a new and colorful toolkit to meaningfully engage persons with dementia, but these colors can sometimes render invisible those darker realities of care, such as grief, exploitation, and exhaustion. references basting, anne. 2009. forget memory: creating better lives for people with dementia. baltimore: johns hopkins university press. basting, anne, maureen towey, and ellie rose, eds. 2016. the penelope project: an arts-based odyssey to change elder care. iowa city, ia: university of iowa press. dementia action alliance, n.d. “vision, mission, values.” accessed january 30, 2021. https://daanow.org/visionmission-values/ lock, margaret. 2013. the alzheimer’s conundrum: entanglements of dementia and aging. princeton: princeton university press. timeslips, n.d. “our network.” accessed february 12, 2021. https://www.timeslips.org/our-network http://anthro-age.pitt.edu/ https://www.timeslips.org/our-network book review review of leahy, ann. disability and ageing: towards a critical perspective. bristol, uk: policy press. 2021. pp. 240. price: $139.95 (hardcover); $45.95 (paperback and ebook). yvonne wallace university of toronto yvonne.wallace@mail.utoronto.ca anthropology & aging, vol 43, no 2 (2022), pp. 114-115 issn 2374-2267 (online) doi 10.5195/aa.2022.433 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | wallace | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.433 http://anthro-age.pitt.edu 114 book review review of leahy, ann. disability and ageing: towards a critical perspective. bristol, uk: policy press. 2021. pp. 240. price: $139.95 (hardcover); $45.95 (paperback and ebook). yvonne wallace university of toronto yvonne.wallace@mail.utoronto.ca ann leahy’s book disability and ageing: towards a critical perspective is a welcome addition to emerging scholarship that interrogates the intersections of aging and disability. both are obviously “fundamental aspects of humanity” (2), but there are paradoxes between scholarship, policy, and popular understandings of how they intersect (3). for example, while the economic ‘burden’ of impairment in old age is a key focus of public policy, little is known about those older adults at the centre of these policies—those living with disability or chronic illness. further, while impairment is associated with old age, it is rarely considered a disability at this stage in life, and as this reading audience is likely aware, research into age and disability have been overwhelmingly siloed. the limited scholarship that attends to this ‘aging-disability’ nexus has focused on policy approaches to and experiences of care between those aging with and those aging into disability (see the edited volume by aubrecht, kelly, and rice 2020). leahy’s book addresses these paradoxes by exploring how social processes of aging intersect with disablement in old age, paying particular attention to the experiences of people aging with and into disability. understanding how these experiences converge and diverge is an important step in creating policies, programs, and discourses that accurately reflect the complexity of aging and disability. the book is divided into two sections. the first section is a comprehensive literature review, spanning three chapters, that students, scholars, and policymakers engaging with questions of aging and disability will find useful. in chapter 2, leahy covers variable definitions of disability, noting that she follows a relational approach to disability as a product of both social and biological processes. in chapter 3, she reviews intersections and differences between scholarship in critical gerontology and disability studies, and in chapter 4 discusses the separation of public policies on aging and disability and its consequences. one of the main arguments of her literature review is how disability is understood and approached changes as people get older; in old age, structural approaches to disability are replaced with medicalized approaches to impairment. in response to this tendency, leahy’s study explores aging through a disability lens. in the second half of the book, the author presents an empirical study based on interviews with individuals who are aging with disability (awithd) and those who have experienced disability with aging (dwitha) in ireland. she explores not just how older people experience physical and sensory impairment, but how they interpret their increasing disablement, whether as ‘aging,’ ‘disability,’ ‘success,’ or ‘decline’ (chapter 5). adding to the interpretation piece, she explores how disability and aging are impacted by the environment, which her participants experienced variably as both disabling http://anthro-age.pitt.edu/ book review | wallace | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.433 http://anthro-age.pitt.edu 115 (compounding their bodily limitations) and enabling (mitigating their bodily limitations) (chapter 6). foregrounding this balance, between the limitations of the body and the environment but not allowing either to foreclose possibilities of self and meaning is a commitment of leahy’s book. leahy’s findings are illuminating in their challenging of the assumptions that tend to separate understandings of age and disability. for example, individuals who experienced disability onset with aging described being disabled, but not necessarily because of their bodily limitations. at least for those with resources, impairments could be mitigated through environmental adaptations such as ramps and canes (though those who lacked economic resources expressed being disabled by their bodies). instead, disablement was experienced through the exclusion that occurs with being othered or disregarded as ‘old’ or incompetent (116-117). for these individuals, disability in later life meant a loss of social status having “crossed a boundary into a discredited social category due to ableist norms” (139). in contrast, those aging with disability tended to reflect positively on aging because they felt more included as they got older. leahy notes, as have others (grenier, griffin, and mcgrath 2020) that the structuring of disability policy and programs separates disabled individuals from peer groups. in later life, the lives of those awithd became more aligned with normative expectations of the life course (136) and they felt less othered than they had in their younger years. this is not an ethnography of aging and disability.. rarely does leahy identify the particular disability of her participants. though sometimes references to wheelchairs, hearing loss, or conditions such as post-polio syndrome are included, she does not “consider the cause of impairment important” (179). yet certain disabilities have strong community identification, such as deaf communities (friedner 2015) that would affect the social processes that shape the experiences of deaf older adults. by leahy’s own admission, more research is needed to understand the specificities and complexities of aging and disability. exploring the particularities of aging within disability groups seems an important next step. on this point, i was surprised that in her extensive literature review she did not reference samantha solimeo’s (2009) study of older adults with parkinson’s disease. though not specifically from a disability perspective, it is in my mind an important early work on how impairment is experienced in later life. further, i found a fair amount of redundancy throughout the book as leahy routinely offers extensive roadmaps of what is to come as well as extensive reviews of what has already been covered. still, policy makers and academics will find this book an excellent resource and will likely feel inspired, as i was, to contribute more anthropological perspectives to research on disability and aging. references aubrecht, katie, christine kelly, and carla rice, eds. 2020. the aging-disability nexus. vancouver bc: ubc press. friedner, michele. 2015. valuing deaf worlds in urban india. london: rutgers university press. grenier, amanda, meredith griffin, and colleen mcgrath. 2020. “aging and disability: the paradoxical positions of the chronological life course.” in the aging-disability nexus, edited by katie aubrecht, christine kelly, and carla rice, 21–34. vancouver, bc: ubc press. solimeo, samantha. 2009. with shaking hands: aging with parkinson’s disease in america’s heartland. london: rutgers university press. http://anthro-age.pitt.edu/ book review review of keimig, rose k. growing old in a new china: transitions in elder care. new brunswick, new jersey: rutgers university press. 2021. pp. 208. price: $120 (hardcover); $27.95 (paperback and ebook). shuting li new york university sl6142@nyu.edu anthropology & aging, vol 42, no 2 (2021), pp. 180-182 issn 2374-2267 (online) doi 10.5195/aa.2021.371 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | li | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.371 http://anthro-age.pitt.edu 180 book review review of keimig, rose k. growing old in a new china: transitions in elder care. new brunswick, new jersey: rutgers university press. 2021. pp. 208. price: $120 (hardcover); $27.95 (paperback and ebook). shuting li new york university sl6142@nyu.edu as modernization, urbanization, and marketization pervade everyday life, tensions between the confucian tradition of filial piety and new socio-cultural structures arise in post-reform china. despite the fact that family care is still central to filial piety, today, demand for institutional care is increasing rapidly. in her first book, growing old in a new china: transitions in elder care, anthropologist rose k. keimig sheds light on this complex transition from home-based to institutional elder care in post-reform china and the various challenges that come with this change for all parties. previous ethnographic research on elder care in china has primarily focused on practices of care conducted in the family sphere in rural areas. social scientific studies on institutional care, in turn, mainly focus on elders’ attitudes towards the prospect of growing old in institutional settings instead of the family sphere. this book ethnographically examines institutional care in china through the everyday experiences of elders actually living there. keimig conducted 13 months of fieldwork in kunming in the province of yunnan between 2013 and 2015. she started her research in hospital-based geriatric and palliative care wards, and then shifted to elder care facilities. the primary site of her fieldwork, jade hills elder care home, is a private care institution in kunming that represents the average care institution in kunming, yunnan in terms of cost, scale, and types of care offered. from her fieldwork in jade hills, keimig documents how elders cope with the current shifts in settings of care from family contexts to institutional care. findings are structured around five central aspects in this book: the parent-child relationship in filial piety, elders’ personal stories within a larger historical context, place-making in elder care institutions, entanglements of care, and discussions about end-of-life interventions. in post-reform china, the effects of the one child policy, a decrease in intergenerational living habits, and urban migration make more adult children opt into institutional care for their parents. however, as keimig clearly demonstrates in this book, parents still think of their children as filial. in chapter 1, “filial children, benevolent parents,” the author examines confucian texts on filial piety and existing scholastic literature that discusses the relation of filial piety with issues of power, obligation, reciprocity, and expectation in the family structure, and thus explores how filial piety shapes and informs social structures in china. she also notices that in research on the “parent-child dyad” in filial piety, more attention goes to care work conducted by children in parents’ old age than to emotional and social care from elderly parents to children (29). drawing from stories of grandpa zhang and song xin, keimig http://anthro-age.pitt.edu/ book review | li | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.371 http://anthro-age.pitt.edu 181 highlights that this kind of neglected care and benevolence from parents to children continues, even when parents step into the life stage that demands children to take care of them. chapter 2, “bodies in history, embodied histories,” shows how experiences of aging vary among three generational cohorts that are here named “pre-consolidation (born in the 1930s and early 1940s), consolidation (as youths in the 1950s and 1960s), and cultural revolution (born in the late 1940s to 1960s)” (49). keimig argues that elders’ subjectivities are shaped by their embodied experiences of historical transformations from the establishment of the people’s republic of china, over the reform period and the cultural revolution, to the present. their memory of different historical realities not only impacts their mental and physical health, but also provides them with the resources for forming their senior selves. in chapter 3, “place and space, rhythm and routine,” keimig’s detailed descriptions of diverse institutional care settings, ranging from private elder care homes, rural public welfare homes, and hospitals, to retirement real estate, give readers a glimpse of the landscape of professional care in china. from a place-making perspective, keimig argues that lived spaces of elder care institutions are created through the movements, rhythms, sounds, and smells of staff members, hugongs (care workers), and residents. her ethnographic materials convey how elderly residents play a vital role in creating places out of the institutional space. for example, some elderly residents have lost control of certain body functions and may discharge excreta that traverses the containing margins of the body and hybridizes private and public space. others, who still do control their bodily boundaries, compete with hugongs or other residents to otherwise draw the lines of their personal space. the space of the nursing home is also imagined and built against the backdrop of unequal wealth distribution in post-reform china. economic conditions play an invisible but vital role in the process of place-making in nursing homes in china: wealthy investors see elder care as a lucrative market; elderly in a good financial situation imagine nursing homes in southern provinces as a place to escape to and age better; and poor and rural migrant workers see nursing homes as a potential workplaces. chapter 4, “entanglements of care,” further explores the informal and unpaid forms of care to show how people’s expectations of care in filial piety change during the transitions to institutional care. today, filial care that adult children should conduct can be substituted by various forms of care, such as community care, self-care, spousal care, and institutional care. discussing these alternative forms of care in post-reform china, keimig underscores the importance of gendered and unpaid spousal care that is usually neglected in elder care practices of filial piety. chapter 5, “care work,” on the other hand, examines the complicated and intangible quality of care from the different perspectives of management personnel, elderly residents, and hugongs. whereas management personnel value efficiency and profits, when talking about the quality of care, elderly residents see “attentional energy” as indicative of good care in institutional settings (125). keimig also observes that elders deploy various tactics to maximize the level of “attentional energy” they can receive from care workers, including showing care and kindness to hugongs. however, hugongs are constantly balancing scarce time with an overwhelming demand for care, resulting in less attention to person-centered care. the flow of “attentional energy” in the nursing home is likely to be blocked or damaged by the precarity of nursing home business and complicated interpersonal relations. in the last chapter, “chronic living, delayed death,” keimig discusses an unavoidable issue in elder care institutions—death. a good death in chinese culture means balance, harmony, and reciprocity through continuing worship in kinship. therefore, proper rites and ceremonies should be held to ensure the continuing bond in kinship and the exchange between the living and the dead, although funeral rituals and burials are replaced by cremation now. however, end-of-life interventions complicate how http://anthro-age.pitt.edu/ book review | li | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.371 http://anthro-age.pitt.edu 182 institutionalized elders experience living and dying. keimig highlights that many elders find themselves suspended in a state of “chronic living,” which “refers not simply to the undesirable state of living with a disease but also to what happens when living itself becomes undesirable.” (131-132) the elderly may appeal for the right to die under conditions of chronic living. although this act conflicts with filial piety in chinese tradition, palliative care and the right to die will become a controversial but important topic in the future. this book not only depicts the historical and social contexts in which chinese adults age but also foregrounds voices of residents of elder care institutions in china. keimig also provides readers with information on issues familiar to those working with elderly adults or vulnerable research subjects, such as applying for institutional review board approval. the combination of surveys, interviews, and participant observation in her ethnography offers readers a wealth of diverse ethnographic data, while the methodology part is helpful for both undergraduate and graduate students seeking practical tips on doing ethnography. moreover, keimig’s ethnographic writing is a good example of engaging with audiences from different cultural backgrounds through empathetic storytelling. she weaves her family story of figuring out the care plan for her mother, who had suffered a hemorrhagic brainstem stroke, into stories of other chinese families. to conclude, this book centers elders’ voices about their lives in the institutional setting of a transforming china, and it will be of interest to everyone working in the field of anthropology and aging, in terms of content, methodology, and writing style. http://anthro-age.pitt.edu/ narrating future selves: perspectives on ageing from a scottish cohort born in 1936 jane elliott university of exeter jane.elliott@exeter.ac.uk j.d. carpentieri university college london j.carpentieri@ucl.ac.uk abstract in this paper we investigate the perspectives individuals take on their future at a particular chronological age, the late 70s. we seek to provide insights into the diverse ways that older people incorporate narratives about possible future selves into their decision making and planning for the future, and how this supports wellbeing. this paper is based on detailed analysis of qualitative biographical interviews conducted with 33 men and women who were all born in scotland in 1936. these individuals were chosen because they formed part of a longitudinal cohort study called the ‘6-day sample study’ that was initiated in scotland in 1947. the material we draw on enables us to examine individuals’ biographical narratives as recounted in a research interview alongside insights into individual capacities and wellbeing derived from more structured quantitative questionnaires. we are interested in the presentation of the ageing self in the context of an ethnographic interview, and how these presentations may complement or conflict with insights from the structured quantitative data collected in the study. keywords: scotland; cohort; narrative; future; generativity; planning anthropology & aging, vol 41, no 2 (2020), pp. 72-89 issn 2374-2267 (online) doi 10.5195/aa.2020.245 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:jane.elliott@exeter.ac.uk mailto:j.carpentieri@ucl.ac.uk elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 72 narrating future selves: perspectives on ageing from a scottish cohort born in 1936 jane elliott university of exeter jane.elliott@exeter.ac.uk j.d. carpentieri university college london j.carpentieri@ucl.ac.uk …a good definition of marking the ageing watershed? that moment when you realize quite rationally, quite unemotionally that the world in the not-so-far-distant future will not contain you: that the trees you planted will continue growing but you will not be there to see them. from william boyd’s any human heart (2002) introduction in the conclusion to his novel, any human heart, william boyd skilfully explores one of the central dilemmas for the ageing individual: it is surely better to die before one loses physical capability and is no longer enjoying life. however, at this stage of the life course one may not yet feel ready for it to end. william boyd’s epic novel centres on the life of a fictitious british writer (logan mountstuart) born in 1906 and living through the twentieth century, and explores wider societal themes through him. the present paper focuses on the experiences of a single generation, now in the last decades of life, all born in scotland in 1936. these are individuals whose parents’ early lives were often marred by the first world war, but who themselves benefited from the improved educational opportunities and health care of the 1940s and 1950s. in this paper we explore the perspectives and orientations to the future of these individuals using the lens of narrative gerontology (kenyon, clark, and de vries 2001). this approach views the self in terms of a story that one seeks to develop continuously. narrative has been conceptualised as a mechanism through which individuals can understand themselves as having a self that endures over time without being immutable or rigid (ricoeur 1991; bruner 1987). this interweaving of constancy and change may have particular salience in the study of ageing, as individuals strive to maintain a “good strong story” about themselves and their lives in the context of loss of physical capability (carpentieri and elliott 2014). narrative gerontology emphasizes the importance for wellbeing of avoiding ‘narrative foreclosure’ (freeman 2000; bohlmeijer et al. 2011), that is, the sense that one’s life story has come to a conclusion, that there are no further opportunities for individual development and growth, and that one has therefore moved into “epilogue time” (morson 1994). our analysis is underpinned by an attention to the narratives within interviews as a way of understanding the meanings that individuals make of their experiences of growing older, and specifically their thoughts about the future. however, we do not seek to impose a normative expectation that everyone should have a coherent narrative encompassing the whole of life (strawson http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 73 2004). indeed, we are as interested in the ‘small stories’ that individuals recount about events and episodes as in the ‘big stories’ of their life course (phoenix and sparkes 2009). linked to the potential threat of narrative foreclosure, for those nearing the end of life, is the notion of a feared future self who lacks autonomy and capability. the psychologists markus and nurius (1986) conceptualise ‘possible selves’ as including the ideal selves that we would very much like to become, the selves we could become, and the selves we are afraid of becoming. the range of possible selves available have a narrative element in that they “derive from representations of the self in the past" (1986, 954). in narrative terms, the maintenance of a meaningful existence towards the end of life may thus be seen as involving the continued pursuit of goals, and the ongoing development or unfolding of one’s life story, even in the presence of physical decline and other losses (andrews 2009). through the selection and construction of possible selves, individuals can be viewed as active producers of their own development. although an individual has the freedom to create their own possible selves, the "pool of possible selves derives from the categories made salient by the individual's particular sociocultural and historical context" (markus and nurius 1986, 954). possible selves thus shed light on the individual, but also on society’s opportunities and constraints. for example, lassen and moreira (2014) examine the ways in which, over the past two decades, the concept of ‘active ageing’ within policy has informed what is seen to constitute a ‘good late life.’ indeed this policy focus, which could be understood as aiming to improve the experiences of older people by removing ‘structured dependency’ (townsend 1981), can also be interpreted as imposing a normative expectation about individual responsibility to stay both physically and socially active and engaged. as higgs and gilleard (2014) have argued, there is a sense in which the frailty which was historically associated with later life has been banished to the very end of life a ‘fourth age’ of decline and dependency, which should be postponed for as long as possible. following retirement, individuals are therefore expected to desire and strive towards an active and engaged ‘third age’ of self-actualisation and investment in the community and family life. in our analysis we therefore aim to attend to the possible future selves that are presented by the individuals we spoke with. these provide insights into the way that these individuals seek to foster their wellbeing in later life and make plans for the future. the concept of the ‘feared self’ also chimes with work by facchini and rampazi (2009) on the problems of uncertainty through the life course. arguably, increases in longevity can be seen both as a welcome addition of years to life, but also as a site for anxiety as the individual fears decline and dependency. in our analyses we are therefore particularly interested in how individuals express these fears and the narrative strategies they use to discuss their future death and their potential future frailty. as kaufman has discussed, whereas sixty years ago medicine was characterised by waiting, today it is characterised by risk calculation. and for those in later life, this results in the need for ‘reflexive longevity’ (kaufman 2010). when “augmenting time left seems always to be a possibility” (2010, 233) greater responsibility is placed on the individual to decide how to value ‘more time’ and to face the risks of lack of capability and a diminished quality of life. in other words, individuals are expected to perform informal cost-benefit analyses of their own remaining time, taking account of the risks of lack of capability and diminished quality of life. whereas kaufman’s focus has been on exploring the experiences of individuals in the context of the medical setting, our interviews were with individuals living in their own homes and therefore in a community setting. the idea that a person has the capacity for individual development at all stages of the life course can be traced back to the work of erik erikson (1963; 1982). building on erikson’s conceptual framework, villar (2012) argues that in later life personal development can be understood as taking a tangible form by http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 74 using the concept of generativity. this is defined as encompassing, “helping and supportive activities which people develop as parents, grandparents, friends or mentors, at the same time as accepting the help of others and expressing their interest in perpetuating and transmitting knowledge and values to the next generation” (2012, 1096). two main types of generativity have been distinguished: communal generativity focused on nurturing and caring for others, and agentic generativity focused more on the strengthening of the self through leadership and creative activities (kotre 1995). the key elements in both cases are the opportunity to act in a prosocial way and contribute to wider society. as kotre summarizes, “in generativity, an investment in life is transferred from the self to something that has come forth from the self” (1995, 37). the benefits of a focus on a cohort whereas many studies of ageing draw on the experiences of individuals from a broad age range, we focus on a purposively selected subsample of 33 scots all born in 1936. in previous analysis of these interviews, our use of this cohort has allowed us to draw on quantitative data collected as part of the larger cohort study (carpentieri et al. 2016a, 2016b). in this paper we investigate the perspectives individuals have on their future in their late 70s—a time well after the state retirement age in the uk. it is a stage when many adults may be in transition between an active retirement, marked by opportunities for independence and self-actualisation (often termed the ‘third age’ [laslett 1989]), and later old age characterized for many by physical decline and growing dependence on others (which has been termed the ‘fourth age’). we seek to provide insights into the diverse ways that older people incorporate narratives about possible future selves into their decision making and planning for the future, and how this supports wellbeing. in this paper we therefore use a three-pronged approach to explore the meanings that individuals make of their lives and their futures. first, we provide a brief summary of the study and document the diversity of cohort members within it. second, we focus on two case studies in detail. third, we pull back again to provide an overview of key themes and sentiments regarding future planning across all the interviewees. mixed methods informed by ethnography an investigation into older people’s hopes and fears for the future will necessarily have interdisciplinary features. the perspective here is led by ethnographic considerations of how people make sense of their lives in social context, and specifically in an interaction with the researcher. however, as discussed above, it is also informed by the work of psychologists and narrative gerontologists, who highlight the links between wellbeing and the ability to construct a positive and coherent narrative about the self. in turn, this work draws on the philosophy of the self and debates about whether the self can indeed be understood in narrative terms (strawson 2004). the nature of the material we draw on for this paper enables us to examine individuals’ biographical narratives as recounted in a research interview, alongside insights into individual capacities and wellbeing derived from structured quantitative questionnaires. it is of interest to consider how individuals portray themselves using these different vehicles for self-expression. there is no single account of how later life is experienced, rather individuals may construct different accounts depending on the context. within a medical interview an individual may understandably be motivated to stress the difficulties they are experiencing, whereas in a social conversation may wish to minimise them. the scottish cohort this paper is based on detailed analysis of qualitative biographical interviews conducted with 33 men and women who were all born in scotland in 1936 (see appendix 1 for key characteristics). these http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 75 individuals were chosen because they formed part of a longitudinal cohort study called the “6-day sample study,” initiated in scotland in 19471. the existing quantitative data allowed for purposive sampling to ensure a group of interviewees with heterogeneous experiences of ageing, but with slight oversampling of those with low physical capability. the interviews were conducted by carpentieri and a research colleague. each interview was carried out in an informal setting, usually over a cup of tea in the interviewee’s home. the length of interviews varied considerably from one that lasted forty minutes to one that lasted over three hours. interviewees seemed relaxed and welcomed the opportunity to talk about their lives. although the main focus of each interview was on the life experiences of the cohort member, in a few cases a spouse was present—so at times the interview became a three-way conversation. a set of openended questions, grouped into six main themes, was used to guide a conversation with each interviewee. the design of the 6-day sample study, including the development of the qualitative strand of the project, is described in carpentieri et al. (2016a). the interviews aimed to elicit narratives and concrete descriptions of individuals’ lived experiences (hollway and jefferson 2000; chase 1995) on topics such as health, physical capabilities, interests and activities, and plans for the future. in keeping with an ethnographic, narrative approach we avoided abstract questions. the aim was for respondents to view the interviews as discussions of their lives and experiences, rather than investigating their attitudes on the topic of ageing. we aimed to take a phenomenological approach to the understanding of ageing from individuals’ subjective perspectives (kaufman 1988). the questions asked were designed to allow us to focus on the autobiographical work done by interviewees as they sought to present themselves in the context of the interview. the narratives elicited were not assumed to be pre-existing descriptions of individuals’ life experiences but rather coconstructed in response to the open-ended questions that formed the topic guide (frank 1979). of particular relevance for this paper, alongside questions about future plans, the topic guide included questions about what individuals were looking forward to in the future, whether they had any worries about the future, and any plans they had made for the future. the flexible, conversational nature of the interviews meant that there is not complete consistency in the questions asked. all interview transcripts were anonymised, and all cohort members were given pseudonyms (see appendix 1)2. the semistructured nature of the biographical interviews allows for some systematic comparisons to be made but, as will be demonstrated below, it is important to understand a response to an individual question in the context of the whole interview. a particular strength of the current study is the ability to examine how cohort members portray their experiences in these interviews alongside the more structured (quantitative) elements of the study. indeed, the more quantitative information acted as a lever for analysis in allowing us to identify two individuals with particularly low levels of physical capability for more in-depth analysis as case studies. in addition, qualitative biographical interviews allow for tensions and ambivalences to emerge, which are often obscured by a more quantitative approach (carpentieri and elliott 2014; neale 2019). these are most likely to become apparent as we conduct analysis which focuses on individual cases in detail. the analysis which follows therefore attempts to look both across and within cases to form a picture of the resources and strategies that individuals use to make sense of their life in their late seventies. the heterogeneity of older people and ageing experiences our focus on a specific cohort, all born in 1936, allows us to examine the heterogeneity of people’s experiences of ageing despite sharing a year of birth. whereas some older people are “lucky agers,” http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 76 who suffer minimal physical decline, the majority of older people must adapt to physical loss in order to maintain wellbeing (kahana, kahana, and lee 2014, 469). quality of life and health status can be understood as distinct constructs. it is well established that it is possible for those with poor health and poor physical capability to have a high subjective quality of life (farquhar 1995; smith, avis, and assmann 1999). similarly, those with physical impairments or specific disabilities should not necessarily be designated to the ‘fourth age’ (higgs and gilleard 2014), as they may be able to manage activities of daily life autonomously and have a good level of health and capability. within our group of 33 individuals there were perhaps six of these “lucky agers” with high physical mobility and few health problems. in contrast, eleven individuals reported substantial physical decline and were in the lowest 25% of the total sample for a measure of physical capability.3 for example, agnes, (p005) in a joint interview with her partner, said that she already has a stair lift, but tries not to use it to get upstairs, most of the time. she explained: as long as i can hold on to something. i go up one [step], one, one, one, i can’t do it any other way, i come down the same way. but as long as i’ve got a bar to hold on to, to pull myself up. but i’m starting to lose the power in my muscles, i can’t open a can now, you know, i can’t open a bottle and i’m getting lots of cramp, oh, my whole body, every night i’m awake with cramp for half an hour and it’s so painful. agnes also explained that she had a hip replacement and two knee replacements and cannot hear without her hearing aid. however, when asked about the age that she feels she gave a more equivocal response: i’ll be 78 on wednesday and i certainly don’t feel it in myself, you know, i feel i could still get up and do things but my legs are stopping it and my hands, you know, i’ve got no power in my hands. and when i see myself as i get out the shower and everything i’m frightened ‘cause i think i look like somebody out of [auschwitz] i’ve never been like this. the effort agnes vividly describes can be interpreted in terms of identity construction and maintenance. she drags herself upstairs despite the pain because she does not want to be a person who is dependent on a stair lift. this level of dependency would represent an identity shift that she is not yet willing to accept. in the quantitative survey, agnes reported having slow walking speed and that her health was worse than a year ago. this data also suggests that her wellbeing is low, but her satisfaction with life is above average. there is therefore a tension between the version of herself that agnes constructs in her interview narratives and the picture that emerges from an examination of her questionnaire. the efforts to remain mobile described by agnes represent a level of stoicism which echoes in the accounts of other individuals. this perhaps is someone navigating, negotiating, and indeed fighting against what others have termed the transition from the third age to the fourth (laslett 1989; higgs and gilleard 2014). in this paper we do not seek to classify individuals as belonging within the third or the fourth age, and arguably these are not life stages with clearly delimited boundaries. however, all interviewees were still living independently within their own homes and had not reached a stage of physical decline where they had become completely dependent on others for their care. as reported above, around a third of the sample had experienced a substantial loss of physical capability and could potentially be described as in process of transition from the third to the fourth age. in the next section of the paper we look in detail at two individuals, who are also in this group with particularly low levels of physical capability. we focus on the narratives they use within the interviews http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 77 to make sense of their lives and of their orientations to the future. following discussion of the case studies we turn to the analysis of the larger group of 33 individuals. this enables an exploration of how individuals with very different levels of health and capability conceptualise the future the ends of life. two case studies: narratives and future orientations of individuals with low levels of capability case study 1: eleanor (p036) carpentieri interviewed eleanor in the living room of her one-bedroom ground floor flat, for just over an hour and a half. throughout the interview her statuesque cat looked on. once the recorder was turned off, eleanor explained how she had always been a dog person and roamed far and wide with him, but now that it is so difficult to get around she had adapted to having a cat. several times through the visit, eleanor used her handy tablet to show carpentieri photos of her extended family, enjoying a burns’ night supper together, and at a family wedding. like many other interviewees, eleanor wore comfortable slippers, but strikingly did not change out of her slippers, even when kindly driving the interviewer back to the station. eleanor appeared relaxed and engaged in conversation. she readily explained that she had discovered at fourteen that she had been adopted by her grandparents and that one of her sisters was actually her mother. however, rather than dwelling on her relationship with her sister/mother, or on the potential scandal around her birth in the 1930s to a young unmarried mother, eleanor focussed the narrative of her early life on her ‘wonderful’ father (i.e. her biological grandfather) as she explained: my father--, my adopted father’s family had all been boarded out in glasgow during these early days, and he came down from the farms to go to war at 17 and lost the arm and leg then. so he was completely disabled but during the second world war he worked in the fire services and was in the fire services for 23 years, so he did very well, he did all his own decorating and everything in the house, he was a wonderful person really….very, very clever man. eleanor went on to explain that her father had died in his mid-sixties of a cerebral haemorrhage but had managed to work for more than two decades despite his debilitating wartime injuries. eleanor worked as a hairdresser in her early adulthood and married at 22, but divorced just six years later as a result of her husband’s alcohol problems and physically abusive behaviour. by briefly recounting how she left him, she skilfully establishes her strength of character at an early age: “the first time he lifted his hands i just walked, that was it, simply. so, i went north to my aunt in [scottish northern town].” eleanor then moved to ireland where she worked in a hotel and met a chef whom she married. however, just after their second child was born, she was widowed. once again eleanor underlines her resilience in the interview explaining: eleanor: “and that was it, i’ve just made my way ever since.” researcher: “without remarrying after? raising the kids on your own?” eleanor: “no, i just brought them up myself. i decided when i--, you know you kind of lose your place for a while and then when you come round you say, ‘well i really don’t want anybody else to rear my kids,’ so you just do it yourself.” http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 78 eleanor explained that she had taken work in a school in order to be able to work as a single mother, and also emphasised that both her son and daughter have had successful lives. in addition, for many years she has had a very close friendship with a slightly younger woman and helped her to bring up her two children after her divorce. through the interview, a vivid picture is painted of an extended family who enjoy travelling, eating, and celebrating together. during her middle years eleanor has supported the next generation and now they visit often and provide company for her. for example, eleanor responds to the question about what she is looking forward to in the future by saying: well [friend] takes me over to ireland, she’s been adopted by my family, i’m adopted by her family, that is her first niece being married there, that was the first of her family that’s been married. i said, “well you’ve a long way to go to catch up with us, [friend]!” you know, and she has, you know, we’ve got these great grand nieces and nephews and honest to goodness, it’s such a big family. a first reading of this indicates that a visit to ireland is planned. however, further reading in the context of the whole interview suggests that the present tense or ‘habitual’ formulation “takes me over to ireland” is suggestive that the question is being avoided. eleanor skilfully provides an example of what has been a highlight in the past, but may not necessarily happen again in the future, due to her mobility difficulties. in the early stages of the interview, at the end of a section explaining the strength and extent of the family network, eleanor explains: “my sisters and my sisters in law and my friend [name] who’s been adopted into the family, and i go back and forward to ireland with [name]” the use of a visit to ireland as that which is ‘looked forward to’ could therefore be seen as a symbol of connection to a network of family and friends. it is perhaps employed to reinforce eleanor’s overall satisfaction with her life and sense of self rather than necessarily being a planned future event. interspersed with eleanor’s narrative of resilience, characterised by generativity and sociability, is a more troubled narrative about her considerable pain and mobility difficulties. the first elements of this second narrative appear about a quarter of the way through the interview: eleanor: “i can’t walk very far, i can’t get about, the arthritis is in my hands and in my feet, it’s like walking on glass all the time.” researcher: “does it hurt or is it difficult?” eleanor: “yes, it’s very painful. i’ve got a new knee, which is wonderful. the shoulder was done—that wasn’t so well done, i can’t get the arm up anymore because the tendon had snapped, so that’s a bummer [laughs]. but no, i’m fine, i’m all right.” it is striking here that eleanor ends her response about her health by stating that she is ‘fine,’ she is ‘all right.’ however, this second narrative of health-related loss and decline resurfaces throughout the rest of the interview. eleanor vehemently explained how frustrating it is that she can no longer go swimming because she cannot get into the pool and does not want the indignity of using the winch. also, it is frustrating that she cannot open a can of food because of her arthritic hands, and no longer drives on the motorway because it is too busy for her. in addition to weaving together these two narratives about generativity and age-related decline, eleanor is reflexive about her approach to life. she positions herself as someone who is resilient in the face of adversity, who can always adjust to difficult circumstances, and who plans for the future: http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 79 i’ve always had to think ahead for the family, with being left on your own you have to think ahead. so, i thought, well i’d best get something i can cope with, so i’ve got my one bedroom flat and at the moment i’m still coping, so that’s fine. asked what she would do if she could no longer drive, eleanor provides a further example of her adaptability and good-humoured resilience: “well i would just adjust again, i’ve got my tablet and i can order my shopping through the internet and that kind of thing, you know, there’s always a way round [laughs].” when asked about any worries that she has for the future eleanor skilfully introduces her friendship with an older woman (her close friend’s mother). by describing this ninety-year-old’s fear of dying, eleanor allows herself indirectly to speak of her own fears without allowing them to overwhelm her, or to disrupt her presentation of self within the interview as resilient and rational. eleanor: “yeah, i know from my friend who’s 90, she’s afraid at the moment, she’s frightened.” researcher: “frightened of what?” eleanor: “frightened of death. [yes] because you do have to do it on your own.” researcher: “what do you mean, do it on your own?” eleanor: “well you have to die alone. [yeah] there’s no one can do it for you. we do get a bit of help nowadays but there’s no one can do it for you. you come in and you go out, and as you get nearer that time i think things could play on our mind, you just don’t let them.” when she is asked about whether she has any plans if her health declines, eleanor responds: i’ve already organised that i’ll be here in my flat for as long as possible and i have my money saved for the funeral of course, and i’m having either fish and chips or steak pie, that’s typical glaswegian--, we always loved fish and chips and steak pie, so that will be available. i’ve already spoken to my husband’s brother about that, he’s doing that for me, i’ve made him executor. it is striking that eleanor moves so quickly here from the notion of health decline to a discussion of her careful plans for her funeral. as we will discuss below, this was a strategy across many interviews, namely, to avoid dwelling on potential decline. as raised in the opening discussion of boyd’s novel there is a common desire for the end of life to precede debilitating physical decline. case study 2: david (p024) david was one of the very few individuals who was not interviewed in his own home. due to his wife’s poor health he opted to be interviewed in an office at the university of edinburgh. the interview was one of the longer interviews, lasting nearly two and a half hours: david was keen to provide lengthy stories about incidents relating to his health and his career. from the structured questionnaire data, david was definitely not a “lucky ager.” he had the lowest score for physical capability and the highest score for health problems of those interviewed (see appendix 1). he described his health as “fair” rather than good or excellent, and also said that his health was worse than a year ago. his walking speed was slow and he had a low score on the warwick edinburgh mental wellbeing scale. he had high levels of anxiety and depression (on the hads) and http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 80 scored low on the satisfaction with life scale. david lived with his wife, who had a serious stroke three years before, and their unmarried son, who was in his mid-fifties. in the early part of his interview, david described how his three sisters and his father had all died in their fifties and sixties. like eleanor’s father, david’s father had been badly affected by the first world war. he had been gassed and had serious emphysema. david emphasized that these early family deaths had not made him worried about his own mortality. instead he said: “that’s what life is, it’s a lottery really,” and went on to describe how his grandfather had lived to be 99, and then had died as a result of an accident rather than old-age. despite severe health problems with angina and arrhythmia and two stents in his heart, and in contrast to the way he had responded in the structured questionnaire, throughout the interview david was keen to emphasise his physical capability. about a third of the way through the conversation he was asked about his own health and stated: david: well the way i feel i think my health’s pretty good. researcher: pretty good? david: for my age, aye, as far as i’m concerned i can still do things, i can still do the garden, i can still do painting in the house and i can still do the cleaning and the cooking and all that so i mean i’m capable of carrying on the way i’m doing, i’m not finding it a stress. when then asked explicitly about changes in his health, david replied: “well i would say it hasn’t changed, it hasn’t really changed much, but i feel younger as i go along rather than older, yeah.” in the first half of his interview david talked mainly about his career and physical capabilities. this included a vignette about how he had managed to move a heavy sack of concrete from the front of the house the previous week. he also explained how to hoover without causing any physical strain. through his narratives, david invoked the perspectives of others, such as co-workers and management, to establish himself as competent and resourceful. this first section of the interview included extended narratives about how he had excelled at work and been promoted from labouring roles to supervisory roles and had received bonuses for doing well as a mature student at college. about halfway through the interview, david explained how he liked to keep his mind active by learning new things and moved on to develop a second key theme his abilities as an artist, specifically a painter. david recounted how he had attended an art class when he retired: i mean i just started painting and before i knew where i was i was doing portraits of animals and children, yeah. landscapes, just about everything that you could think of, you know, i’m painting a river scene at the moment, i’ve just got to put a fisherman into it, casting his line and it’s finished. the conversational style of the interview gave him the opportunity to provide extended narratives demonstrating that his artistic skill was appreciated by others. for example, david explained how he had once been commissioned to paint a portrait of a local bank manager and been surprised to be paid nearly £400. indeed, when he was asked what he was looking forward to in the future, david avoided the question, but instead provided a narrative about his regret over missing the opportunity to do an art degree http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 81 when offered the chance by a tutor who was impressed with his work. one interpretation here is that david’s low levels of wellbeing (as recorded in the structured data) are consistent with his inability to look forward to a desired future. however, an alternative reading is that david was determined to complete his narratives about being an artist and was not interested in engaging with the specific questions asked by the interviewer. despite the positive tone of his interview, david also discussed the difficulties he and his wife were facing as they aged. for example, when asked about the disadvantages of being in his late seventies he explained: david: “the other thing is we cannot always go to the places we want to go to because we cannot--, we’re at an age where you cannot sort of depend on each other for to do it by yourself, you know.” researcher: “yeah, so like what sort of places?” david: “well if you were going on holiday, you wouldn’t go too far if you had to travel, you know, by the car or that. and if it was maybe just shopping or something like that there is certainly a restriction you get with the fact that you’ve got to go around and you cannot carry too much.” this response contrasted sharply with the positive answer to a question about any advantages about his current age, to which david replied: the main advantages, well ... oh i think just looking back on my life, i feel like i’ve had a fantastic life, i've done that many things that a lot of people couldn’t do, you know, i’m quite happy with having done them all and the things i could do at the time, you know, and i’ve not been horrifically changed to make it miserable for me to finish my life off, i feel i’m satisfied because i’ve done more than i thought i could have done, you know, been better at things and done things. when he was asked about any worries he had for the future, david responded candidly by explaining that he was worried about losing his sight: i wouldn’t like to lose my sight, i’ve had a few occasions when i’ve had an ark on each eye, a bright ark that comes up and it really brings--, you lose the clarity of the things around about you, and it’s almost like going blind, and i wouldn’t like that to come to a point where it just switches off, you know, because my life is based on everything i see and everything i do, you know, i’m really--, i love to go out and see a beautiful sunset or gardens … so, i would say that would the worst thing to lose would be my sight. of course, loss of sight would also mean losing his artist identity. one way of interpreting this interview is that the main identity david narratively constructs for his past is of a physically capable and strong ‘jack of all trades,’ whereas now his identity centres on being a painter and well-regarded mentor. taking up painting in midlife seems to be an excellent strategy for identity development in the face of physical decline. as the physical capability part of his story recedes, another (the artist) grows. rather than holding onto old chapters and stretching out those chapters to avoid narrative foreclosure, david has a new chapter (painting) that (as long as he maintains his sight and a bit of dexterity) he can continue to develop. http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 82 in the context of these biographical interviews then, eleanor and david, while among the least physically active and healthy of those in the study, were both able and eager to portray their lives as successful and having meaning. just as eleanor used two main narratives (generativity and physical decline) linked by an overarching narrative of adaptability in her interview, david’s narratives centred on physical capability and painting with an overarching theme: being held in social regard. neither were well-educated or had professional careers and both had retired in their fifties due to ill health. however, there is a quiet dignity in the way they interacted with the interviewer and appeared eager to share narratives about their experiences. both seem to rely on a self-conception as capable, resilient, and appreciated by others, to help them through any difficulties ahead neither takes the opportunity to talk in detail about plans for the future. a key trope in each of these case studies therefore is that of stoicism and resilience. despite the indignity of losing mobility, independence, and strength in later life, dignity can be preserved by forging a narrative of self that is able to withstand the difficulties that life brings. however, this trope is emphasised in the qualitative interview encounters much more forcibly than in the collection of the quantitative, structured data. for both eleanor and david, therefore the fear of a future self who might have even more severe health problems and lack of capability is occluded by a vivid portrayal of the established self from the past. eleanor’s ability to foster relationships with others and to remain resilient in the face of domestic violence and early widowhood exemplifies ‘community generativity.’ whereas, david’s skill and prowess at work and then as a painter forms the foundations for his secure sense of identity and exemplifies ‘agentic generativity’ (kotre 1995). we now turn to explore the theme of future orientations across all of the interviews. specific questions about the future will be discussed, before moving to a broader exploration of orientations to the future. what are you looking forward to in the future? about half-way through the interview, respondents were asked, “is there anything you are looking forward to in the future?”4 there were four main themes in the strategies that individuals used to respond. the most common was for individuals to focus on their relationships with their children or grandchildren. this is suggestive of the previous discussion that shows ‘generativity’ to be a key element in the positive wellbeing and identity of older people (kotre 1995; villar 2012). nine respondents employed this theme. some gave a brief response e.g. “getting to know grandchildren better” (edward, p069). while james (p117) explains his goal is to be able to dance at his granddaughter’s wedding. she is ten years old and james also talks extensively about regularly caring for her each week and spending many hours together.5 another very common response was for individuals to talk about looking forward to going on holiday, or going abroad to see family and friends, especially if they had a major trip planned. for example: holidays. we go every year. i’m going away on holidays in a few weeks, actually, a golfing holiday. er, and {wife} and i will probably go away over the winter, we usually do over the winter. (brian, p006) of the seven individuals who responded in terms of travel, five had mid or high levels of physical capability. however, two of them (eleanor and irene) had low levels of physical capability. further analysis of these interviews shows that, as discussed above, in eleanor’s case it is not completely clear whether a specific trip to ireland is planned. in irene’s case the likelihood of a further major trip was also far from certain: http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 83 well i don’t think about it very much, i don’t, i don’t know, you know, god willing we’ll still be able to have maybe just one more trip to new zealand, but if we don’t we’ve had a lot of--, my daughter and my son will come over and see us, you know, i know that. (irene, p059) this demonstrates the way that individuals have socially acceptable strategies for talking about the future, but that these do not necessarily map straightforwardly onto concrete future plans. a third, frequent, response was to explain that there was nothing major was anticipated, but that the individual was contented with life and looking forward to continuing as they are. this could be interpreted as a way of denying narrative foreclosure by keeping the current chapters going. there were seven individuals in this grouping. for example: “more of the same [laughs], and a bit more….you only get one kick at the ball” (colin, p022). what is striking in this group of responses is that they are not overly positive or optimistic but in avoiding the question about a specific hope for future they are also keen to emphasise contentment with life. this contrasts with the strategy employed by the final nine individuals who responded that they weren’t really looking forward to anything, or appeared to avoid the question altogether. for example, “no, nothing” (rosemary, p145); “no, not really” (fiona, p046). another individual, grace, seemed to ignore the question by offering more coffee, but then went on to say: “well we’ve just finished the building and doing no more” (grace, p055). one way to read this response is that grace is content with a completed project, and looking forward to no further disruption from building work. this major renovation had taken twelve years and resulted in a major rebuild of the house. clearly someone at any stage of the life course could respond to a question about the future by discussing a completed project. but, in common with the other responses discussed above, this is reminiscent of freeman’s notion of narrative foreclosure (2000). strategies for discussing future worries towards the end of the interview individuals were asked if they were worried about anything in the future.6 the majority of individuals appeared keen to stress that they were not unduly worried using phrases such as: “no, no worries no, things usually sort themselves out” (doreen, p028); “no, many people have, i just haven’t let it bother me” (edward, p069); “i let the future take care of itself” (martin, p167). eight individuals provided a consistent answer that they had no real worries. however, a further nine gave a slightly more equivocal answer, stating they had no real worries but then hinting at concerns over dying or their spouse dying, or future ill health. for example, as linda (p038) said: i don’t have any worries, i just expect it to continue the way it is just now, which is all lovely, not really. i think the thing that you think, when i think about the future is, i cannot believe that i will actually die. i can’t believe that it’s possible that i could actually die [laughs], it’s a really strange, me, you know, it can’t happen to me! of the nine individuals who did talk more candidly about worries for the future, three focussed their response on their children rather than concerns for their own future (helen (p057), joyce (p119) and kenneth (p156). for example, as joyce said: “yeah. well, when i think about the future, i’d like to know that my daughters were fine and they were going to have a good life when i go. i worry about my youngest daughter.” http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 84 two individuals said they were worried about death or about dying before a spouse (grace, p055 and james, p117). only five individuals focussed their answer on worries for their own future capability; as discussed above, david spoke about losing his sight, two spoke candidly about their concerns about dementia (george, p098 & len, p159), while two spoke of their concern about losing their independence and capability and not being able to continuing to live in their own home (rosemary, p145 & sylvia, p146). sylvia responded: “no, apart from having strokes and horrible things like that, not really. and just being able to live in our own house as long as we can. we hope we don’t have to go into a care home.” an interpretation of this lack of focus on decline in answer to the question about future worries is that older people are reluctant to reveal the ‘feared self,’ which is the self that has so lost its capability that it loses its identity. for several interviewees this was expressed briefly as not wanting to end up in a care home. planning for the future during the interview, individuals were encouraged to discuss any future plans, and in particular what they might do if they, or their spouse, experienced health decline. it was striking that, in line with the responses discussed above, there was an avoidance of dwelling on the possibility of loss of capability. indeed, several interviewees joked that they were deliberately not thinking about what might happen. for example: rosemary: well, i just don’t want to think about it [laughs]. i just . . . i do think about it and i think, oh, i don’t know what will happen to me, and then i think, oh, what will be will be and that’s it. i don’t know. researcher: so, you do think about it but don’t sort of do concrete plans. rosemary: no, i don’t. well, i’ve got--, you know, i’ve got arrangements for power of attorney and things like that. i’ve done that. i think business wise i’m alright, you know. i’ve done what i can do. in rosemary’s case and as noted in relation to eleanor, individuals appeared much more comfortable talking about having made a will (20 individuals) or their firm funeral plans (nine individuals) rather than discussing plans for any deterioration in their health. whereas everyone knows about the inevitability of death, physical decline is much more uncertain, and it is this uncertainty which threatens the integrity of the self (facchini and rampazi 2009). this reluctance to discuss potential decline and responses to it, may stem from avoidance of conceptualising the dependent incapacitated self as a possible future self because of the fear it invokes. this also chimes with higgs and gilleard’s conceptual work on the, “othering of the fourth age” (2014). they suggest that this final stage of life represents ‘a state of unbecoming. the result is a location seemingly stripped of those forms of agency most valued by contemporary consumer society namely choice, autonomy, self-expression and pleasure’ (2014, 13). these insights are also consistent with those from a previous study of twenty chronically-ill housebound individuals living in the united states (carrese et al. 2002). their research suggested that for those in the last stages of life there are three distinct future phases. first, there is an uncertain future that may be accompanied by chronic and serious illness, which they are reluctant to consider. second, it is a time when death is near and certain, which they are somewhat more likely to discuss and plan for. thirdly, there is the inevitability of death, for which many have made concrete arrangements. as can be seen in the interviews discussed above, the ability to talk about funeral plans, and wills allowed individuals to convey a rational ‘plan-full’ self while still resisting discussion of the uncertain ‘decrepitude’ of the fourth age. http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 85 conclusions it is clear from this study of older people in scotland that there is considerable heterogeneity in the experiences and capabilities of older adults (even when they are almost exactly the same age). for those with low levels of measured capability, some tensions and disparities can emerge between the sense of self established in a qualitative biographical interview and that portrayed via more structured quantitative data. this is not to argue that either version of the self has greater veracity, but that the self in later life can be experienced in different ways. for example, eleanor and david, individuals with low physical capability and low scores on an established measure of wellbeing, both do a very effective job of portraying themselves as living lives rich with meaning and ageing successfully. to accomplish this there is a strong reliance on narratives of their former physically competent selves. in both cases the quantitative data tells a different story from the qualitative data –within the biographical interview the priority is to present a self that is stoical and in control, however within the structured questionnaire an appropriate presentation of self may be understood to be more aligned with reporting physical capabilities and medical conditions as accurately as possible. it is noteworthy that all of the interviews discussed above were more focused on the past than the future – it is unusual in british culture to talk to those in later life about the future, and yet important if we want to respect older people’s wishes in helping plan future services or individualised care. the tendency in interviews is to demonstrate competence with respect to the future by talking about arrangements that have been made for funerals and wills but not to voice concerns about physical decline or dependency. the fact of dying is perhaps easier for many to plan for because it is guaranteed. in contrast, the possibility of frailty and/or the loss of physical or mental capability is all the more challenging because of its uncertainty (facchini and rampazi 2009). in order to demonstrate competence in later life and present as a ‘good old person,’ individuals in our study tended to talk in rational, un-emotional terms about the plans they had made for their death but were not comfortable discussing the losses they might experience in the next few years. in line with earlier british work, and traphagan’s work on ageing in japan, individuals in our study were keen to stress that they did not feel old and that they did not wish to become dependent on family or to go into a care home (thompson, itzin, and abendstern 1990; traphagan 1998). this may in part be influenced by larger cultural narratives about, and conceptualisations of, successful ageing. there are parallels here with the ‘two-pathways’ conceptualisation of ageing advanced by some researchers, and which have been criticised for contrasting ‘successful’ ageing with ageing which involves multi-morbidity, frailty and care needs (tesch-romer and wahl 2017; katz and calasanti 2015). under this two-pathways model individuals hope to remain independent throughout later life; inability to do so is seen as failure. however, as tesch-romer and wahl persuasively argue, “it is very likely that both facets of aging (aging in good health and aging with care needs) are consecutive segments in the same course of life,” therefore the concept of successful ageing needs to be broadened to include frailty and dependence supported by good provision of care (2017, 313). arguably this broadening needs to take place both within the research community and within broader society. however, in our own study, individuals were more comfortable talking about death than decline and future care needs – it would appear that for them the end of life is easier to contemplate and to narrate than the ending of life. acknowledgement the research was supported by a grant from the research councils uk's life long health and wellbeing programme which supported je and jdc (mrc g1001401/1). the ‘scotland in miniature’ study, of which this work was a part, was administered by professor ian deary (principal investigator on mrc g1001401/1) and dr caroline brett (research associate) at the university of edinburgh’s http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 86 centre for cognitive ageing and cognitive epidemiology which is funded by the mrc and bbsrc (mr/k026992/1). the authors thank professor deary and dr brett for access to the quantitative data collected by them in the study. thanks are also due to iza kavedzija and two anonymous reviewers for their very helpful comments on an early draft of this paper. notes 1. the 6-day sample of the scottish mental survey 1947 follows a cohort of individuals born in scotland on the 1st day of the even-numbered months of 1936 (sms1947) (scottish council for research in education, 1949; deary et al. 2009). the study first ran from 1947-1963 as a study of education; following a lengthy period of abeyance, the study was relaunched in 2012 as a study of ageing. of the 1208 original members of the 6-day sample, extensive quantitative data have been collected from 171 individuals, (brett and deary 2014; deary and brett 2015). the structured data included measures covering key domains frequently cited as constituting successful ageing (depp and jeste 2006). 1) physical functioning was represented by a capability score based on 6 physical capability questions in the sf-36 (ware and sherbourne 1992). 2) social engagement was represented by a derived variable based on cohort members’ responses to a range of questions regarding the frequency with which they saw friends and/or family and engaged in a range of social activities. 3) wellbeing was represented by the warwick edinburgh mental wellbeing scale which incorporates affective-emotional aspects, cognitive-evaluative dimensions and psychological functioning (tennant et al. 2007). the structured questionnaire data also included a satisfaction with life scale and a 24 item attitudes to ageing scale (laidlaw et al 2006). 2. these names are consistent with those used in other papers using the same interviews 3. physical functioning was represented by a physical capability score based on six physical capability questions in the sf-36 (ware and sherbourne 1992). the survey did not include an explicit question about disability or identifying as disabled, but did have a series of questions about serious health conditions including diabetes, arthritis, heart problems, cancer, stroke, and dementia. the survey also asked about joint replacement. 4. the aim was to ask this consistently in each interview, and in practice it was asked of 31 of the 33 respondents. 5. interestingly he was one of the few individuals who was wearing running shoes for the interview. 6. due to the conversational nature of the interview and sensitivity around the interaction, this question was actually only directly asked of 26 of the 33 individuals. references andrews, molly. 2009. “the narrative complexity of successful ageing.” international journal of sociology and social policy 29(1/2): 73–83. http://doi.org/10.1108/01443330910934736. bohlmeijer, ernst r., gerban johan westerhof, w. randall, t. tromp, and g. kenyon. 2011. “narrative foreclosure in later life: preliminary considerations for a new sensitizing concept.” journal of aging studies 25(4): 364-370. brett, caroline, and ian deary. 2014. “the long road to realising data linkage: obtaining permission for the 6day sample study.” longitudinal and life course studies 5: 283-298. http://dx.doi.org/10.14301/llcs.v5i3.266. bruner, jerome. 1987. “life as narrative.” social research 54: 11–32. carrese, ja., mullaney j.l. faden r.r., finucane, t.e. 2002. “planning for death but not serious future illness: qualitative study of housebound elderly patients.” bmj 325: 1-5. http://anthro-age.pitt.edu/ elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 87 carpentieri, j.d., and jane elliott. 2014. “understanding healthy ageing using a qualitative approach: the value of narratives and individual biographies.” in a life course approach to healthy ageing. 118-130. edited by d. kuh, r. cooper, r. hardy, m. richards, & y. ben-shlomo. oxford university press. carpentieri, j.d., jane elliott, caroline brett, and ian deary. 2016a. “adding narratives to numbers in a mixed methods study of successful aging: the 6-day sample of the scottish mental survey 1947.” sociological research online 21(2): 8. http://dx.doi.org/10.5153/sro.3926. ----. 2016b. “adapting to ageing: a mixed methods study of the role of selection, optimisation and compensation in the maintenance of high wellbeing.” journals of gerontology, series b. chase, susan. 1995. “taking narrative seriously: consequences for method and theory in interview studies.” in interpreting experience: the narrative study of lives. edited by r. josselson & a. lieblich, vol. 3. thousand oaks: sage. deary, ian j., l.j. whalley, and j.m. starr. 2009. a lifetime of intelligence: follow-up studies of the scottish mental surveys of 1932 and 1947. american psychological association, washington, dc. deary, ian, and caroline brett. 2015. “predicting and retrodicting intelligence between childhood and old age in the 6-day sample of the scottish mental survey 1947.” intelligence 50: 1-9. http://dx.doi.org/10.1016/j.intell.2015.02.002. depp, colin a., and dilip jeste. 2006. “definitions and predictors of successful aging: a comprehensive review of larger quantitative studies.” american journal of geriatric psych 14: 6–20. erikson, erik h. 1963. childhood and society. norton, new york. erikson, erik h. 1982. the life cycle completed. norton, new york. facchini, carla, and marita rampazi. 2009. “no longer young, not yet old: biographical uncertainty in lateadult temporality.” time & society 18(2-3): 351-372. farquhar, m. 1995. “elderly people’s definitions of quality of life.” soc. sci. med. 41(10): 1439-1446. fontana, andrea, and james h. frey. 2005. “the interview: from neutral stance to political involvement.” in the sage handbook of qualitative research. edited by n. k. denzin & y. s. lincoln, 695-727. thousand oaks, ca: sage publications ltd. frank, gelya. 1979. “finding the common denominator: a phenomenological critique of the life history method.” ethos 7(1) (spring 1979): 68-94. freeman, mark. 2000. “when the story's over, narrative foreclosure and the possibility of self-renewal.” in lines of narrative. edited by molly andrews et al. london: routledge. gubrium, jaber f., and james a. holstein. 1997. the new language of qualitative method. oxford university press on demand. higgs, paul, and chris gilleard. 2014. “frailty, abjection and the ‘othering’ of the fourth age.” health sociology review 23(1): 10-19. hollway, wendy, and tony jefferson. 2000. doing qualitative research differently: free association, narrative and the interview method. london: sage. kahana, eva, boaz kahana, and jeong eun lee. 2014. “proactive approaches to successful aging: one clear path through the forest.” gerontology 60(5): 466-74. katz, stephen, and toni calasanti. 2015. “critical perspectives on successful aging: does it “appeal more than it illuminates”?” the gerontologist 55(1): 26-33. https://doi.org/10.1093/geront/gnu027. kaufman, sharon r. 1988. “illness, biography, and the interpretation of self, following a stroke.” journal of ageing studies 2(3): 217-227. kaufman, sharon r. 2010. “time, clinic technologies, and the making of reflexive longevity: the cultural work of time left in an ageing society.” sociology of health and illness 32(2): 225-237. http://anthro-age.pitt.edu/ http://dx.doi.org/10.5153/sro.3926 https://doi.org/10.1093/geront/gnu027 elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 88 kaufman, sharon r. and l.m. morgan. 2005. “the anthropology of the beginnings and ends of life.” annual review of anthropology 34: 317-41. kenyon, gary m., phillip g. clark, and brian de vries. 2001. narrative gerontology: theory, research, and practice. springer publishing co inc. kotre, john. 1995. “generative outcome.” journal of ageing studies 9(1): 33-41. laidlaw, k., m.j. power, s. schmidt, and the whoqol-old group. 2007. “attitudes to ageing questionnaire (aaq): development and psychometric properties.” international journal of geriatric psychiatry 22: 367-379. https://doi.org/10.1002/gps.1683. lassen, aske juul, and tiago moreira. 2014. “unmaking old age: political and cognitive formats of active ageing.” journal of aging studies 30: 33-46. markus, hazel, and p. nurius. 1986. “possible selves.” american psychologist 41(9): 954-969. morson, gary s. 1994. narrative and freedom: the shadows of time. yale university press. laslett, peter. 1989. fresh map of life: the emergence of the third age. harvard university press. neale, bren. 2019. what is qualitative longitudinal research?. bloomsbury academic: london. phoenix, cassandra, and andrew c. sparkes. 2009. “being fred: big stories, small stories and the accomplishment of a positive ageing identity.” qualitative research 9: 219-236. ricoeur, paul. 1991. “life in quest of narrative.” in on paul ricoeur: narrative and interpretation. edited by d. wood, 20-33. psychology press. riessman, catherine k. 1993. narrative analysis. sage. smith, kevin w., nancy e. avis, and susan f. assmann. 1999. “distinguishing between quality of life and health status in quality of life research: a meta-analysis.” quality of life research 8: 447-459, 1999. tennant, ruth, louise hiller, ruth fishwick, stephen platt, stephen joseph, scott weich, and sarah stewart-brown. 2007. “the warwick-edinburgh mental wellbeing scale (wemwbs): development and uk validation. health and quality of life outcomes.” 5(1): 63. http://dx.doi.org/10.1186/1477-7525-5-63. townsend, peter. 1981. “the structured dependency of the elderly: a creation of social policy in the twentieth century.” ageing and society 1(1): 5-28. strawson, galen. 2004. “against narrativity.” ratio 17: 428-452. tesch-romer clemens, and hans-werner wahl. 2017. “toward a more comprehensive concept of successful aging: disability and care needs.” the journal of gerontology 72(2): 310-318. traphagan, john w. 1998. “contesting the transition to old age in japan.” ethnology 37(4): 333-350. thompson, paul, catherine itzin, and michele abendstern. 1990. i don’t feel old: experience of later life. oxford university press: oxford. villar, f. 2012. “successful ageing and development: the contribution of generativity in older age.” ageing & society 32(7): 1087-1105. ware, john, and c. sherbourne. 1992. “the mos 36-item short-form health survey (sf-36): i. conceptual framework and item selection.” medical care, 30(6): 473-483. http://dx.doi.org/10.1097/00005650199206000-00002. http://anthro-age.pitt.edu/ https://www.amazon.co.uk/s/ref=dp_byline_sr_book_4?ie=utf8&text=michele+abendstern&search-alias=books-uk&field-author=michele+abendstern&sort=relevancerank elliott and carpentieri | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.245 http://anthro-age.pitt.edu 89 appendix 1 cohort member scores on key measures pseudonym physical capability psychological growth self-rated health wellbeing decile (1=lowest) alan high medium high 5 agnes low medium low 2 brian medium medium high 10 brenda high medium high 10 colin high medium high 8 david low medium low 2 catherine low medium medium 10 doreen medium medium high 7 neil high medium high 8 eleanor low medium low 3 linda low medium high 5 owen low medium low 9 fiona medium low medium 6 grace medium low high 9 helen medium high high 9 irene low medium medium 2 peter medium medium medium 7 edward medium medium high 7 margaret low medium high 4 francis medium medium high 3 norma medium medium high 7 george medium high high 9 hugh medium medium high 10 patricia high high high 10 ian medium medium medium 3 james high low high 10 joyce medium high medium 1 rosemary low low low 3 sylvia medium medium medium 1 kenneth low low low 2 len medium medium medium 6 kathleen low medium high 9 martin high low medium 4 http://anthro-age.pitt.edu/ book review review of brainer, amy. queer kinship and family change in taiwan. rutgers university press. 2019. pp. 166. price: $100 (hardback); $29 (paperback and ebook). samantha l. grace santa clara university slgrace@email.arizona.edu anthropology & aging, vol 41, no 2 (2020), pp. 268-270 issn 2374-2267 (online) doi 10.5195/aa.2020.288 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | grace | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.288 http://anthro-age.pitt.edu 268 book review review of brainer, amy. queer kinship and family change in taiwan. rutgers university press. 2019. pp. 166. price: $100 (hardback); $29 (paperback and ebook). samantha l. grace santa clara university slgrace@email.arizona.edu amy brainer has produced a provocative and concise ethnography on queer kinship in taiwan. through curated clusters of family vignettes, we meet t (butch) and po (femme) lesbians and their husbands, mothers, and brothers; we laugh as deer’s grandmother confounds the neighbors with her cheerful acceptance of the beautiful woman who is her “grandson”; we feel the love of a gay son and his mother finding freedom in a family of two as they sing karaoke together for new year. there are more stories, and they are well-told enough to appeal to students and activists and nuanced enough to speak to a broad audience of social scientists. writing reflexively from the position of a white queer femme, brainer’s emphasis on feminized kinship roles and queer family dynamics shows just how important queer taiwanese are to their families without shying away from their vulnerability. while brainer situates her analyses in queer studies and family studies, her life course approach to queer subjectivities and her attention to intergenerational queer kinship make this ethnography a necessary addition to the anthropology of aging. it is easy to understand why this book won the ruth benedict prize for outstanding contributions to anthropology on lgbt topics: brainer’s documentation of queer relationships in taiwanese families successfully challenges the models that have long framed queer subjectivity as a process of individualization. she starts with a major shift in the politics of coming out: away from a preoccupation with global homonormativity and towards a novel emphasis on changing parenting styles. starting in chapter 2, brainer takes carlos decena’s “tacit subjects” (decena 2011) and fran martin’s “tactical masking” (martin 2003) to argue compellingly that queer “elders” and queer youth have such different perspectives on coming out because of a generational shift in norms of communicating family intimacy. in short, the younger generation of taiwanese queers “come out” because their parents aspire to be very involved in their children’s personal lives, whereas queer elders employ strategic silences because parenting norms used to prioritize a quieter form of intimacy resting on tacit obligations. although “queer elders” generally refers to adults in their thirties, forties, and fifties, in this text brainer includes a story that a t in her 50’s told about her mother, a t in her 70s, that provides a satisfying introduction to the existence and significance of older queer elders as well. brainer’s anthropological inquiry into what constitutes “generation” in the context of queer subjectivities showcases the value that queer anthropology and the anthropology of aging can have for each other. this inquiry is somewhat limited by its omission of interviews with grandparents or “queer elders” older than 60. nevertheless, brainer’s shift away from naturalizing “generation” as progression of ideologies of the self and towards http://anthro-age.pitt.edu/ book review | grace | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.288 http://anthro-age.pitt.edu 269 investigating “generation” in the negotiation of vertical ties is a significant contribution to the anthropology of aging. following the discussion of intergenerational aspects of coming out, each chapter analyzes queer experiences in relation to feminized family labor. chapter 3 examines the labor taiwanese lesbians and trans men do to “carry on” their families, offering a feminist critique of those studies of patrilineality that take normative fatherhood as their primary guidepost. chapter 4 considers the aspirations of parents and grandparents for their queer (grand)children in ways that bring gender and class back into conversation with the production of generations. chapter 5 links the normative performances of queers to families’ navigation of public institutions, exploring the possibilities and constraints of strategies for accumulating wealth and power as a buffer to the social penalties of being publicly queer. chapter 6 completes the analytical shift from “queer self” to “queer kinship” by focusing on the connecting role played by siblings. throughout, brainer inquires into both queer experience and kinship roles as emergent and interdependently transforming throughout the life course. brainer’s training as a family sociologist and her professional affiliation with sociology and with women’s and gender studies show throughout the book, but so does her turn toward anthropology. the absence of queer anthropological citation is noticeable (e.g., blackwood 2011 and sinnott 2004 on butches and femmes in southeast asia), but her citation of contemporary east asian (and particularly taiwanese) scholarship is a strength. her attention to a wide variety of family relationships also complicates any treatment of life stages as straightforwardly sequential identities in ways that may be particularly valuable for queer anthropology. the book’s introduction and conclusion include a discussion of the methods of data collection and their limitations. brainer’s recruitment through ex-partners/lovers was a clever way to contact queers outside of the overrepresented taipei-based queer activist scene, and her joking reference to this method as “the lesbian snowball method” is a delightful example of how this book situates its knowledge from her standpoint (9). she is correct in noting that her conclusions are limited by under-representing working class families and transnationality, although chapters 4 and 5 provide a valuable starting place for more attention to social mobility. she also laments not being able to effectively recruit grandparents, a reflection this journal’s audience will particularly appreciate. yet, her analysis treats grandparents as potentially nuanced stakeholders in the families of queer taiwanese, particularly in chapter 4’s critique of discourses that frame grandparents as mere vessels of family values. this book serves as a persuasive proof of concept that should spark the attention of anthropologists to continue to explore queer subjectivity and kinship across the life course. brainer’s analysis of queer possibilities across an interconnected life course raises important questions for scholars of gender and kinship. the clarity of her analysis, the brevity of each of the seven chapters, and the accessible way she narrates her informants’ experiences all make this a good choice as a teaching text. queer kinship and family change in taiwan leads life course ethnography to value how queer kinship deepens theories of aging. references blackwood, evelyn. 2010. falling into the lesbi world: desire and difference in indonesia. honolulu, hi: university of hawaii press. decena, carlos. 2011. tacit subjects: belonging and same-sex desire among dominican immigrant men. durham, nc: duke university press. http://anthro-age.pitt.edu/ book review | grace | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.288 http://anthro-age.pitt.edu 270 martin, fran. 2003. situating sexualities: queer representation in taiwanese fiction, film, and popular culture. hong kong: hong kong university press. sinnott, megan. 2004. toms and dees: transgender identity and female same-sex relationships in thailand. honolulu, hi: university of hawaii press. http://anthro-age.pitt.edu/ imagining possibilities: a conversation with dr. aaron t. seaman, president of aage brooke jespersen case western reserve university bvj7@case.edu keywords: aging; age; anthropology; aage; gerontology; fieldwork anthropology & aging, vol 42, no 2 (2021), pp. 3-5 issn 2374-2267 (online) doi 10.5195/aa.2021.381 66 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. jespersen | 3 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.381 http://anthro-age.pitt.edu imagining possibilities: a conversation with dr. aaron t. seaman, president of aage brooke jespersen case western reserve university bvj7@case.edu “[what] really excites me about anthropology… is it opens the imagination. it broadens the landscape of what could be.” one cannot help but be energized by dr. aaron t. seaman’s optimistic view of anthropology. i took to zoom in august 2021 to interview dr. seaman, the current president of aage. the theme of imagination—and anthropology as a tool to expand the possible—permeated our discussion of his career, research, and vision for aage and the anthropology of aging. dr. seaman is the assistant professor of internal medicine, with a secondary appointment in the college of public health’s department of community and behavioral health, at the university of iowa. he is a medical anthropologist with expertise in dementia, caregiving, implementation science, and cancer survivorship. dr. seaman holds an m.a. in communication from the university of illinois at urbanachampaign and a ph.d. in comparative human development from the university of chicago. it is a commitment to imagining possibilities, in part, that unites dr. seaman’s diverse research interests. for example, his doctoral dissertation research examined shifting relationality among family caregivers and individuals diagnosed with alzheimer’s disease. he undertook this project at a time when families living with alzheimer’s disease were increasingly medicalized. consequently, many scholars assumed that biomedical frameworks would obscure other possibilities for relationality. however, dr. seaman found that caregivers drew on biomedical and family models to make sense of their new interdependent relationships. for instance, caregivers often conceptualized spouses with alzheimer’s disease as childlike. dr. seaman reasoned: “our language for thinking about dependency is pretty anemic. so, the fact that somebody would move from a spousal dependency to a parent-child dependency only makes sense because we have so few other ways to conceptualize it.” he went on to explain that—while the infantilization of individuals with alzheimer’s disease had been widely criticized, and often rightly so—the reconceptualization of dependence in this way allowed families to cultivate intimacy and tenderness. indeed, this blending of critique and openness is representative of the type of scholar dr. seaman aspires to be: “my favorite anthropology doesn't stop with criticism. but offers that broadening… it broadens that imaginary in ways that let you come out of it feeling possible.” dr. seaman also brings this approach to his current work on cancer survivorship. he seeks to assess how care is provided to survivors of head and neck cancer and how that provision—and patients’ and providers’ experience of it—is shaped by the broader context of health care delivery, discourses of cancer, and understandings of survivorship. head and neck cancer is compelling to dr. seaman because it often requires invasive multimodal treatment, leading to long-term physical, psychological, social, and financial consequences that are quite different from those of more common cancers (e.g., breast, colorectal, prostate); these factors drive understandings of what survivorship care is, as well as its policy and practices. to this end, he has completed a multi-sited, mixed-method study which aimed to identify barriers to and facilitators of effective head and neck cancer survivorship care practices. in http://anthro-age.pitt.edu/ jespersen | 4 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.381 http://anthro-age.pitt.edu addition, he is currently working to identify those who discontinue their survivorship care in order to understand why and what their care needs, if any, still are. this work helps us rethink what cancer survivorship might look like while engaging the complexities of putting new care guidelines into practice. in the future, dr. seaman plans to grapple with the challenge of applying anthropological tools outside of anthropology, including his own work in clinical and team science settings. the challenge, for dr. seaman, is two-fold. the initial challenge concerns how to incorporate ethnographic methods across diverse disciplinary settings, where funding mechanisms, methods, writing styles, and requirements for promotion vary. dr. seaman wondered, “how do we keep that looking like ethnography?” the second challenge—and the most intriguing to dr. seaman—concerns incorporating an anthropological orientation to research beyond a particular method. he asked, “what does it mean to be a person who thinks like an anthropologist in this space [where colleagues tend to think clinically and epidemiologically]? what does it add?” dr. seaman considers anthropologists to be experts in “messiness,” who by virtue of anthropology’s nuanced and holistic approach are well-suited to understanding the “messiness of encountering real people” outside of the more tightly controlled environments where health care interventions often are developed. the challenge of applying anthropological tools outside of anthropology may spark new possibilities for anthropologists as well. noting the common assumption that anthropology happens alone, dr. seaman argues that working in teams has many advantages. he described his decision to pursue team science after completing his doctoral dissertation: “i like thinking across groups of people. other people make me a better thinker, and i think i make them a better thinker.” dr. seaman enjoys collaboration at every step of the research process—from research design to data collection and analysis. ultimately, he feels collaboration makes his research stronger. dr. seaman brings this collaborative spirt to aage. as president, he envisions a more inclusive and interconnected future for our organization. this entails being globally-minded as he builds on his predecessors’ efforts to facilitate dialogue among international scholars through the aage website, social media, and virtual conferences. dr. seaman also hopes to “encourage scholarship from nontraditional sources,” particularly those who have expertise but are not necessarily academically trained. he is enthusiastic about anthropology and aging being open-access and about the editorial team’s efforts to “increase the reach… and lower the barriers to submission to the journal.” dr. seaman elaborated that increasing the journal’s reach goes beyond offering more seats at the table; it is about finding new tables where the journal and its readership might take a seat, learn, and partake in conversation. ironically, the covid-19 pandemic and related constraints on socializing, for dr. seaman, revealed untapped potential for connection among aage members. the shift to virtual engagement—including the 2020 slow conference and the new aage book and movie club—motivates dr. seaman to reimagine the possibilities for connection. “i think it's made us more aware that we have the potential to be a group in conversation all the time and not just at the moment when a journal issue comes out or when a conference is occurring… these conversations can be continued among us.” the small size of aage is particularly advantageous in that it’s possible to have organization-wide conversations: “we have this kind of cool opportunity to engage every one of our members,” dr. seaman noted. the future is bright not only for aage, but also for the anthropology of aging. dr. seaman anticipates two exciting research directions in our field. the first concerns theorizing age as an analytic. inspired by the “aged-subjectivities: making and unmaking personhood across the life course” roundtable http://anthro-age.pitt.edu/ jespersen | 5 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.381 http://anthro-age.pitt.edu organized by elise berman and jason danely at the 2017 meeting of the american anthropological association, dr. seaman explained: one of the things that i think needs to happen to push things forward is to bring aging and age out of marginalized ends of the life course. if we think about aging as part of the human condition—or part of how we understand and interpret the human condition—then it is something that is happening all the time, so i would love to see it discussed more as a piece of what is happening all the time. the second research direction concerns moving beyond medical anthropology approaches to think more broadly about aging: i think aging happens in a lot of ways that have nothing to do with medicine, health, or illness… i'm interested in what we think about aging when we're not thinking about people who are sick… what does a good life mean as you age and move across these circumstances? and that can have nothing to do with health. of course, as a medical anthropologist himself, dr. seaman acknowledges that health and disease are salient to older adults’ aging experiences; but he is concerned that the focus on medical anthropology may inadvertently limit the types of questions we ask and the types of answers we are open to finding. he looks forward to what a broader approach might reveal about aging. for students interested in anthropology and gerontology, dr. seaman suggests that they consider what really excites and drives them. it may be an intellectual puzzle, a commitment to improving the lives of older adults, or teaching. for dr. seaman, it was the belief that “the most interesting things happen between people.” this belief has not only guided the topics of his research but informed his decision to pursue a career in team science settings. dr. seaman also highlights the importance of students expanding their professional networks through organizations like aage. these organizations provide support and expose students to the range of career options available to them. although the job market is competitive, dr. seaman is hopeful about students’ prospects: people are continuing to age and there are continued needs and questions out there, so i think there is great opportunity for thinking meaningfully about what it means to grow older and about how to… broaden the imaginaries around that. so, i definitely think there's exciting work to be done. anthropology—as a tool to expand the possible—will continue to be vital. students, like myself, would do well to follow dr. seaman’s example by engaging the anthropology of aging with optimism, openness, and imagination. about the author brooke is a ph.d. candidate in the department of anthropology at case western reserve university, specializing in the study of aging and migration. her dissertation research examines how im/mobility regimes—or power structures enabling, promoting, and restricting migration—relate to older puerto rican adults’ conceptualizations, pursuits, and experiences of “good” lives in old age. brooke’s previous work broadly examines inequality throughout the life course. she has published on intergenerational relationships, child well-being, and child maltreatment. http://anthro-age.pitt.edu/ book review review of cohan, deborah, j. welcome to wherever we are: a memoir of family, caregiving, and redemption. new brunswick, new jersey: rutgers university press. 2020. pp. 184. price: $26.95 (hardcover; ebook). christina barmon central connecticut state university cbarmon@ccsu.edu anthropology & aging, vol 43, no 2 (2022), pp. 105-107 issn 2374-2267 (online) doi 10.5195/aa.2022.429 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | barmon | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.429 http://anthro-age.pitt.edu 105 book review review of cohan, deborah, j. welcome to wherever we are: a memoir of family, caregiving, and redemption. new brunswick, new jersey: rutgers university press. 2020. pp. 184. price: $26.95 (hardcover; ebook). christina barmon central connecticut state university cbarmon@ccsu.edu currently there are an estimated 40.4 million family caregivers in the united states—the majority of whom are women (u.s. bureau of labor statistics 2019). their labor is usually invisible, often presumed, and makes a vital contribution to families and the economy. family caregiving can require a substantial amount of time and effort, even when it complements paid carework. although there is extensive research on family caregiving, there is a lack of work focusing on those who provide care for an abusive parent (kong and moorman 2018). deborah j. cohan’s memoir, welcome to wherever we are, is an important addition to this body of literature. the book merges the author’s experiences as a caregiver of an abusive father with discussions of the larger social context of both abuse and care, the history of emotional abuse she experienced from him, and her own personal journey of healing. welcome to wherever we are: a memoir of family, caregiving, and redemption is a feminist endeavor. writing about the personal is sometimes disparaged in academia, but the self is often the only subject in which marginalized people have been allowed to be experts and doing so can be an act of resistance (cottom 2018). while social scientists study and write primarily about other people’s lives, they rarely turn this focus inwards towards their own lives (simonds 2016). because talking about ourselves and our emotions is considered feminine, it is seen as self-indulgent (simonds 2016). in this memoir, cohan blurs the lines between academic research on family caregiving and family violence, and her own personal story. she and her parents are both subject and object—her experiences both personal and political. cohan’s book is fragmented—not quite chronological and not quite thematic. in her own words, it “is a story of brokenness—and wholeness—told in fragments” (233). it is a memoir structured as a series of personal essays that are short form creative non-fiction drawn from the writer’s lived experience that each use an object or idea as a prompt. for example, chapter one, “phone calls,” uses transcripts of voicemail messages from her father, to introduce him, illustrate his abuse, describe their relationship, and talk about how it impacted her relationship with her mother and partnerships with men in her adulthood. the messages show how the intense love and adoration her father expressed contrasted with his vitriolic anger. this abusive dynamic is analytically intertwined with a sociologically informed discussion of trauma and patriarchy. chapter two, “the diaries,” uses the author’s diary entries as a child to introduce us to her lived experience of abuse, and chapter nine, “the gold pen,” uses her father’s gold pen, to discuss her attachment to him, his pen, and how she wrote to heal from said abuse. http://anthro-age.pitt.edu/ book review | barmon | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.429 http://anthro-age.pitt.edu 106 cohan shares her life story as her father’s daughter, as a woman, and as a sociologist who studies family violence. the following quote describes how these different positions inform her work: as a sociologist interested in family violence and gender, i knew i had the capacity to see the following, among other things: how family secrets are maintained, how caregiving is gendered, and the myriad ways that individual issues we wrestle with in our private homes are actually connected to the larger issues of family as a social institution and to other social structures. (3) being socialized into an abusive family taught her coping mechanisms such as continually seeking approval via perfectionism. cohan understands this personal experience against the background of socialization into a patriarchal society that teaches women to serve, care, and nurture. the contradictory messages of anger and approval that taught her to always be vigilant in caring for her parents’ wellbeing over her own, ironically also taught her the vigilance required for caregiving in adulthood. additionally, cohan examines the intergenerational nature of abuse, including stories of the abuse her parents experienced in their childhood, as well as the complexities of loving someone who is abusive. she portrays her father as multidimensional and complex, describing him as abusive and manipulative, but intensely loving, giving, hurt, and broken. cohan similarly merges the personal and the political when accounting for her caregiving practices. she gives an in-depth and personal account of caregiving she engaged in—both hands-on care when visiting with her father in the earlier days of decline, as well as navigating the formal carework landscape after he entered a nursing home. in chapter four, “accidents,” she describes in gruesome detail something many family caregivers have dealt with but rarely talk about—incontinence. grappling with how to deal with it both physically and emotionally, she was forced to manage both of their humiliation within the context of a history of cleaning up her father’s metaphorical and, as a caregiver, actual shit. of cleaning up after his accidents, cohan says, when i was growing up, my dad was the only one allowed to make messes. however, when mark and i visited him at his apartment one february after the divorce, we noticed his desk chair had stains on it…my dad was critical of everyone else’s imperfections for so many years yet in his declining state allowed himself to make many messes. his harsh critique of others was so sadly frequent that i saw my father take perfectly nice things or potentially beautiful moments and contaminate them. (57) this illustrates that when it comes to family caregiving, especially in the context of abuse, you are never dealing with each moment of care in isolation but within the context of a relationship history. after cohan’s father moved to a nursing home, providing care became dominated by navigating the complex landscape of paid carework and the for-profit health care system of the united states. she intertwines her lived experience of communicating with careworkers and managing her father's care and finances with a background on the social context of paid carework. careworkers from the nursing home would contact her, sometimes daily, to inform her of everything from serious behavioral issues to when it was time for her to order more adult diapers. at times, the care was excellent. other times, he would be sent to the hospital by ambulance for a minor issue. cohan also worried that her father would direct abuse towards the careworkers, and placed her experiences within the context of a system that exploits careworkers. society relies on paid careworkers to care for the most vulnerable; however, they are often vulnerable themselves. careworkers are more likely to be women of color, older, and http://anthro-age.pitt.edu/ book review | barmon | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.429 http://anthro-age.pitt.edu 107 living close to the poverty line. while caring for those more privileged, they regularly deal with racism and other general mistreatment. cohan similarly weaves discussions of health, decline, and end-of-life with sociological discussions of medicalization and euthanasia. she wrestles with the desire to improve and encourage her father’s quality-of-life over quantity-of life while expressing what she would want for herself. she describes her interactions with an expensive bureaucratic for-profit healthcare system that seemingly continuously encouraged her father to take additional medications. with a sense of humor, she lists the multiple medications for the same ailment, the side effects, the interactions, and the medications to treat the side effects and interactions. at the end of the list, she says, on a visa bill from july 2005, my father paid $1280 just to the pharmacy. i see now how he was mortgaging his finances for a health he would never enjoy, a body he would never use, and a life that turned into a maddening combination of crushed powders, tablets with gelatin coatings, and liquids. one extra little something slipped into the mess, would be untraceable. (120) in sum, welcome to wherever we are centers the personal—the inner conflict that cohan had with wanting to provide good care, be a good daughter, and still love an abusive father through continued abuse. it is a book about the contradictions in relationships, in care, and in abuse. while it significantly adds to the research on caregiving and family violence, it does not do so from a distance but breaks down the barriers between academic literature and our own personal experiences by weaving together intimate personal stories grounded in the larger social context. it is up close, personal, emotional, and messy. finally, welcome to wherever we are is accessible and relatable, ideal for use in the classroom. it would be relevant to classes dealing with aging, death and dying, the health care system, caregiving or carework, families, and family violence. references cottom, tressie mcmillan. 2018. thick: and other essays. new york, ny: the new press. kong, jooyoung. 2018. “effect of caring for an abusive parent on mental health: the mediating role of selfesteem.” the gerontologist 58 (3): 456-466. simonds, wendy. 2016. hospital land usa: sociological adventures in medicalization. new york, ny: routledge. us bureau of labor statistics. 2019. “unpaid eldercare in the united states–2017–2018 summary.” retrieved on august 14, 2022 from https://www.bls.gov/news.release/elcare.nr0.htm. http://anthro-age.pitt.edu/ µ taming and timing death during covid-19: the ordinary passing of an old man in an extraordinary time sofie rosenlund lau university of copenhagen sola@sund.ku.dk nanna hauge kristensen nannahk@yahoo.dk bjarke oxlund university of copenhagen bjarke.oxlund@anthro.ku.dk anthropology & aging, vol 41, no 2 (2020), pp. 207-220 issn 2374-2267 (online) doi 10.5195/aa.2020.319 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 207 taming and timing death during covid-19: the ordinary passing of an old man in an extraordinary time sofie rosenlund lau university of copenhagen sola@sund.ku.dk nanna hauge kristensen nannahk@yahoo.dk bjarke oxlund university of copenhagen bjarke.oxlund@anthro.ku.dk photo from viggo’s funeral. published with permission from his daughter, edited by sofie rosenlund lau. http://anthro-age.pitt.edu/ mailto:bjarke.oxlund@anthro.ku.dk lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 208 audio recordings with our interlocutor, viggo in february 2020: ctrl + click on the play icon to listen. introduction: a quotidian living and dying “he was such a happy man,” lilly, viggo’s sister quietly recalls. while drinking coffee and eating danish pastry and cream balls – viggo’s favorites – the closest family is gathered in the home of viggo’s son peter, to talk to sofie (the ethnographer) about viggo’s death. the room is filled with grief and loss, but also with acceptance and a sense of alleviation. “i sometimes caught myself thinking, what a life! in a wheelchair, disabled, no one there with him on a daily basis, eating microwave meals,” lilly further reflects. after a short pause, she continues verbalizing her memories. “but viggo was always so cheerful when he called, talking happily about the delicious prepacked food or the latest visit to a clinic.” the others are laughing – “yes, he really liked food,” ann, viggo’s oldest daughter adds; “eating food, talking about food, no matter what he got served, he always enjoyed it.” despite a deteriorating body, viggo was still full of vitality. he had just been granted an electric wheelchair from the local social services and was looking so much forward to strolling around the city again. “he was not ready to die,” ann emphasizes. the other relatives agree. viggo expected to be at least 85 or older, the same as his parents. “but what a life,” ann continuous. “i am so pleased that i don’t have to see him decaying more.” lilly agrees. “an electric wheelchair is not much fun, if you can’t see,” she adds. ann nods. the conversation is brought back to the time around viggo’s death. “i am so glad he had no pains or symptoms at the end.” there was no breathing trouble, no aching or complaining. “i would not have swopped the final time with anything else in the world,” she continuous. “it was not ugly at all. and he knew we were there with him. all the time.” (sofie rosenlund lau, fieldnotes, may 2020) viggo was a danish man in his mid-70s, who had been a key interlocutor in an ethnographic research project on vulnerable seniors since june 2019. viggo also became the 25th corona-related casualty in denmark. this multimodal piece documents how on a chronological scale the ordinary rhythm of the everyday life of a chronically ill old man and the global crisis narrative of covid-19 intersected. surprisingly, the intersection seemingly provided the space for a worthy death for viggo, as well as a reduced pace in the undertaking of mortuary rites that was appreciated by his relatives. in text, audio and images we aim to document how viggo experienced what could arguably be called an ordinary yet dignified death amidst the global public drama of the covid-19 crisis. the audio piece that accompanies this text is based on recordings that were made in late february 2020. as noted by pink (2009), soundscape compositions are not just about ways of representing what places sound like; it is an invitation to listen in particular embodied ways to be able to hear the ‘sonic everyday’ of others (143 paraphrasing feld 1996). curiously, the sound bites provide glimpses into the trivial unfolding of the everyday rituals of care enacted between viggo, the home help and the nurse in viggo’s senior apartment. we hear the carer fetching water, elevating the bed, undressing, washing, smalltalking and turning viggo’s disabled body and eventually helping him be seated in his wheelchair. they drink coffee and chat. the nurse steps by to measure viggo’s blood glucose and give him insulin. viggo hums while preparing his morning pills. the sound of the many pills hitting the bottom of the glass stands out as significantly loud in the quiet room, acoustically bringing attention to the multiple http://anthro-age.pitt.edu/ https://youtu.be/kzwysest_n4 lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 209 diseases embedded in viggo’s everyday life. after the nurse and home carer leave, the silence is consciously disrupted by the radio playing mellow pop music and broadcasting the daily news while viggo eats his breakfast. this audio piece is the sound of the slow pace of ordinary care which takes up so much space and time in the life of many seniors in denmark (christensen 2020; grøn 2016; rostgaard and szebehely 2012). indeed, viggo’s life has not always been quiet. extraordinary events such as the sudden death of his first wife, the early onset of diabetes, which eventually cost him his job, the leg amputation and the presence of severe mental illness and alcohol abuse among some of his closest relatives have influenced viggo’s living and well-being in the past. today, the slow and peaceful activities present in the soundscape characterize the majority of viggo’s everyday up until the very end. nothing out of the ordinary is happening. yet covid-19 appears almost like background noise in the form of a news item presented by danish broadcast on viggo’s radio. the presence of the pandemic in viggo’s living room is a vivid reminder that individual time and space is always entwined with the ramifications of collective spatiotemporalities. the error! reference source not found. found at the end of this text serves to illustrate this interlinkage of personal and intimate time with national and global biopolitical chronologies. it provides an overview of significant events in relation to the pace of viggo’s dying combined with the medical and political taming of covid-19. at the time of recording, covid-19 was slowly but significantly moving into danish health politics and the everyday lives of people living in denmark. although, nobody expected it to end viggo’s life three weeks later. nobody knew that for viggo it had become a time to die. the fragments of viggo’s slow pace living and dying that we present in this piece serve as a counternarrative to the global public drama of covid-19 occurring in a much faster, intense and dramatic pace. the intersection of the unhurried ordinariness of viggo’s everyday existence with the chaotic and dramatic tempo of a global virus, provides an analytical space to scrutinize contemporary notions of worthy living and dying among frail seniors. we ask whether the way in which viggo died has something to offer when it comes to the practical art of “taming and timing death,” terms we borrow from danish anthropologists rane willerslev, dorthe r. christensen and lotte meinert (2013), who have elaborated on philippe ariès’ conceptualisation of the taming of death (1974). the authors remind us that death is a social phenomenon, reaching far beyond biological death as a point in time. hence, they suggest that the social enactments of death can be a window to human understandings of temporality and human ways of doing time. by narrating the peaceful dying of one old man in the context of a global crisis, we aim to trump the onesidedness of narratives that simply focus on dying in crisis. the ethnographic fragments presented in this article stem from fieldwork in a public home care in a municipality close to copenhagen between may 2019 and february 2020. during fieldwork, sofie (first author) followed the care professionals on home visits to care recipients. some were visited once, others several times. through these visits and conversations with the carers, sofie gained access to ten care recipients including viggo, whom she continued visiting on her own and conducted formal interviews with. viggo was visited four times and was followed one whole day including a visit to an outpatient diabetes clinic. in the end of february 2020, sofie brought nanna (second author) on to the fieldwork in order to produce audioscapes of the homes and lives of two of the seniors in the project, one being viggo. afterwards, nanna visited viggo on her own with audio equipment and recorded the material from which the audio piece presented here originates. shortly after, the covid-19 epidemic invaded denmark, setting the entire country including most research activity on hold. sofie used to keep up with viggo’s life by phone. at a certain point, she was surprised to find that viggo did not answer the phone anymore and then it became completely disconnected. as the only out of ten interlocutors, viggo was active on facebook. it was a post from viggo’s oldest daughter here, that made her aware of his http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 210 death. sofie reached out to his daughter on facebook, presenting the study and expressing her condolences. they talked on the phone and his daughter subsequently arranged for sofie to conduct a focus group with the closest relatives as a way to gain more insights into his final days and death of viggo. while viggo is present in much of the ethnographic material surrounding his living, obviously the accounts of his dying and funeral stem from the insights presented by his relatives. this tallies with how anthropologists have long emphasised that biological individuality and social collectivity are equally important in the study of death and dying (bloch and parry 1982; metcalf and huntington 1991). the fact that the very last experiences of the dead person remain a muted and intrapersonal phenomenon, therefore implies that it is the relatives who get to have the final say when it comes to evaluating and narrating his quality of living and dying. more than just a lacuna in ‘voicing,’ this underscores that the phenomena of death and dying are not just existential and individual matters of life, taking place in biographical time. as anthropologists, we often have access to the social processes surrounding death. in our analysis of viggo’s case, where covid-19 radically altered the flow of events and disrupted both the timing and the taming of his death, we do exactly that by approaching individual matters of life and death with a view to how they are embedded in interpersonal, sociopolitical and biomedical narratives and temporalities. perspectives on worthy dying in her book …and a time to die: how american hospitals shape the end of life (2005), american anthropologist sharon r. kaufman shows how the advent of medical technology, that is capable of sustaining life without restoring health, has changed the where, the when, and the how of dying. in a similar vein, james green argues in beyond the good death that modern end-of-life experiences are shaped by new medical trends, where people are kept alive sometimes against their will or the will of their family, with powerful medications and machines (2008). in viggo’s case, the life sustaining efforts identified by kaufman and green, have largely been absent: there was no proper covid-19 treatment available and viggo had asked not to be put on a respirator. overall, the fact that hospitals have been overwhelmed by covid-19 cases, combined with an absence of a successful cure or vaccine, has disrupted the modern regime of life sustaining efforts and has, in this sense influenced the timing of viggo’s death by making usual attempts to act upon causes of death infeasible. the absence of life sustaining treatment, we argue, may have allowed for viggo to both live and die in a more calm and dignified manner. the transcript excerpt introducing this article reveals that viggo’s closest relatives see it this way. viggo’s sister and daughter ponder the concept of worthy living. “he was such as happy man,” the sister says as a pretext for recounting memories on viggo’s vitality, especially his pleasure of food. the family also agrees that viggo was not ready to die. in fact, he expected to live at least a decade more, indicating that he was experiencing a life worth living. at the same time, viggo’s life was not pure joy and pleasure. the many chronic diseases, especially the diabetes and the complications following many years with uncontrolled blood pressure, significantly influenced his wellbeing and quality of life. he was dependent on daily help, lots of medicines and weekly healthcare appointments. in many ways, the management of chronic diseases was the main component of his everyday life, as is the case with many other people suffering from multiple chronic conditions (manderson and wahlberg 2020; mattingly, grøn, and meinert 2011). “what a life,” both lilly and ann state while pointing to the difficulties embedded in what manderson and wahlberg refer to as chronic living (2020). bound to a wheelchair with a declining physical and mental functionality, viggo was experiencing the burden of aging and his family was increasingly aware of his bodily decay. to them, his sudden death was tragic http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 211 and a great loss. but beyond the grief it is also conceived as a disruption of viggo’s declining vitality and anticipated deteriorated future living. the undramatic and peaceful circumstances surrounding viggo’s final time hence served as a reassurance that at least viggo died without unnecessary suffering now or in the future. the international spectacle of covid-19 viggo’s passing, more than being just a ‘consequence’ of the virus, happened against the backdrop of the spectacle of covid-19 in europe, which was unfolding at the exact same time. the contrast between viggo’s ordinary death and the extraordinary of the global pandemic bears testimony to an unpredictable consequence of the international health crisis, namely that the covid-19 disruption of normal procedures and biomedical practices may actually have paved the way for a comparatively calmer and more dignified process of dying for viggo, than he would have experienced under normal circumstances. according to willerslev, christensen and meinert the event of death demands that other humans deal with the body in a concrete and material sense; an intimate engagement that is dictated by the decomposing body (2013, 1). everything has to happen in time: death demands that the body has to be dealt with in what is considered as ‘appropriate time’ by society or a social group. by taking action on the dead body, we engage with ideas about time, such as eternity and repetition or duration and finality, through concrete timework. (2013, 2) for the european public, this point was hammered home by the footage coming out of the city of bergamo in lombardy, italy, on march 18 2020, just a few days before viggo got sick from the coronavirus. at this point, the city had become the european epicenter for covid-19. mortuaries were full and crematorium staff was working around the clock to keep up with the number of casualties. eventually, bodies had to be dispatched to neighbouring provinces, and therefore fifteen army trucks manned by soldiers were brought in to solve the task. on top of prior footage of italian hospitals on the brink of collapse and coffins stored in public gyms, the images of the army trucks shocked the world. media outlet, daily mail quoted a local italian to claim that: “this is one of the saddest photos on the history of our country” (stickings 2020). this quote is indicative of the horror and despair that is released when death and dying cannot be tamed through rituals and narratives in the appropriate manner. willerslev, christensen, and meinert argue that as humans, we try to tame mortuary time through timework such as phasing, scheduling and sequencing, in order to take control (2013, 3). in anthropology, the observation that the handling of corpses is crucial was underscored by william h. rivers more than a century ago, when he wrote that: “few customs of mankind take so firm a hold of his imagination as his modes of disposing of the bodies of his dead” (1913, 480). what the footage from bergamo revealed in one photo, was that death and dying had become untameable, as the handling of death had become industrious. arguably, the moral failure related to the inadequate handling of corpses influenced the actions taken to prevent this from happening in other places such as denmark. as willerslev, christensen, and meinert quote robert hertz: “the body of the deceased is not regarded like a carcass of some animal: specific care must be given to it and a correct burial; not merely for reasons of hygiene but out of moral obligation” (2013, 1). it is not overstating the point to claim that the handling of dead bodies by soldiers and army tracks in bergamo became the central image of the covid-19 crisis in europe in march 2020. it functioned as a modern memento mori, reminding europeans both of their own and others mortality, as well as shaping http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 212 an imaginary of the uncanny and unruly ways of dying during this crisis. this fear was not baseless: the spectacle in italy, could become the spectacle in other european countries within a fortnight. contrary to the situation in italy, the handling of death and dying in danish hospitals and crematories was never entirely untameable during march and april 2020. although viggo’s story bears testimony to a deathway that was out of tune: given that the time spent on life sustaining efforts was radically abbreviated, the covid-19 situation extended the time available to relatives for reflection, mourning and saying goodbye. in this manner, covid-19 reversed what james green has dubbed the future of dying: the stretched-out time of dying is a modern medical miracle that makes death different. we live longer, and when our time comes, death will more likely come from chronic rather than acute disease. this decline generates a preliminary social death, the long period of lingering made possible by icus, ventilators, and other medical regimes. (green 2008, 188). green further argues that relatives get to grieve modern day death prior to its occurrence, and that this may not be helpful for resolving grief (green 2008). as we will show below, viggo’s relatives would agree with this observation. the pace of viggo’s passing: insights from conversations with the relatives against the backdrop of the covid-19 crisis, the following narrates viggo’s time up until his passing and shortly beyond his death, following an analytical attention on pace. pace, in this sense, is perceived as defined in the cambridge dictionary as: the speed at which someone or something moves, or with which somethings happens or changes (cambridge dictionary, n.d.). while the audio piece brings forward the quotidian of viggo’s everyday life, the following aims to highlight the relatively slow pace of viggo’s passing and of the planning of the funeral and the relatives’ eventual goodbyes (in plural) to viggo. the material primarily stems from the five-hour long conversation with viggo’s closest relatives (viggo’s daughter, son and sister and their respective partners). it took place in may 2020, almost two months after viggo’s passing and one month after the cremation ceremony. the empirical insights from this meeting is supported by phone conversations with ann, viggo’s daughter one month before and after the joined conversation took place, together with sporadic chatting on facebook. all names are pseudonyms. the narrative is presented chronologically in order to account for the assemblage of significant events happening shortly after each other and together shaping part of the lived experience of viggo’s death. march 17 about a week after the danish prime minister announces the national lock down, viggo gets sick. he has a fever, his stomach aches and he feels dizzy and confused. he blames the new diabetes medication, which gives him uncontrolled bowel movements. one night he does not make it to the toilet and has to replace a dirty duvet with a blanket that is too short. viggo always sleeps with the windows open. it is mid-march, and the temperatures are low during the night, so maybe it is the cold nights that has made him ill. the next morning, viggo calls his daughter, ann, to tell her that he does not feel well. it is not the first time that viggo calls her sounding weak and confused. it can be the diabetes, dehydration or an infection. ann knows the drill and immediately contacts the home care nurse, asking her to pay him an extra visit. the nurse calls her back from viggo’s apartment confirming his poor status. “yes, he really looks bad! it’s worse than corona,” she jokes with a caring voice. in mid-march, covid-19 had http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 213 just started to make an entry into the danish hospitals, but has not yet made it into home care services. at that point, everyone believed that viggo was suffering from urinary tract infection, maybe caused by the freezing night. he is started up on antibiotics and stays in bed the whole day. the day after, thursday, the effects of the antibiotics have not kicked in and the nurse decides to admit viggo to the hospital. at the hospital, to everyone’s surprise, viggo tests positive for covid-19. ann is continuously in contact with the hospital staff and with viggo. viggo sounds better than yesterday, ann believes. everyone therefore expects him to come home again soon. march 22 on sunday, viggo’s condition has worsened and the physician asks the family to come in. ann, her brother peter and viggo’s sister lilly, come as soon as possible. viggo is isolated in a single room and everyone getting near him has to be protected from the virus by wearing gowns, gloves and masks. peter has a hard time coping with the protective gear and in the evening he decides to take a break and drive to viggo’s apartment to get the charger for his phone. ann and lilly stay on. lilly is not feeling well (she later tests positive for covid-19 herself) and is lying on the other hospital bed in the room most of the time. ann regularly talks to viggo and moistens his mouth with water using a small sponge. he sleeps a lot, but is conscious and has no complaints. “do you know, where you are?” ann asks him during the night. viggo mentions the name of the hospital where his leg was amputated four years ago as a cause of diabetes. “no, not there,” ann calms him down. viggo worked as a train conductor for 40 years and ann wants to encourage him by referring to his old passion. “so, if you take the train from the main station, then what is the next stop?” viggo names a train station on the mainline. “no, the other way,” ann laughs, impressed and relieved that viggo still recalls the train lines. the short conversation gives ann a feeling of certainty that her dad will be fine. it is just pneumonia. at this point in time, all the relatives still expect viggo to get well again. march 23 early in the morning, ann and lilly decide to go home. they are tired from being up the whole night and yearn for taking a break from the protective gear. viggo sleeps. a small tube in his nose supplies him with extra oxygen, but he does not receive any other medicine. he has, in consultation with the physicians, declined any life supportive care. not that he thinks it will be necessary, but the option of being put on a respirator scares him, and the physicians have said that it will most likely not cause him any good. the family is aware of the decision, but early monday morning, no one thinks of it as a relevant choice. the family leaves the hospital at 7:30 a.m. at 7:51 the physician calls ann. viggo is dead. march 24 the funeral director visits the family the day after viggo has passed away. in denmark, the funeral (cremation or burial) takes place no later than eight days after the time of death. under certain circumstances, the funeral can be postponed to a maximum of 14 days after the person died; however, this requires an approval from the authorities. due to this rather strict timeline, the planning of the funeral is initiated already the day after the person is deceased. at first, viggo’s family want the funeral to take place as soon as possible and they therefore agree on the first available weekend, two weeks from now. the ban on gathering is down to ten and the family negotiates the attendance – who should be able to participate in the church ceremony? march 25 the day after, the prime minister warns that the ban on gatherings might be tightened down to two, and the funeral director calls ann to discuss alternatives to the arranged ceremony. once again, ann calls the closest relatives and they all agree that they want viggo’s funeral to be a social gathering of all http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 214 family members and friends, and that an even more strict ban on attendees would fail to be in the spirit of viggo. at the same time, they cannot just wait forever with the handling of the body. luckily, viggo wanted to be cremated and they decide on an informal ceremony around the cremation service to be held in the chapel and a postponement of the formal funeral ritual until after the pandemic has settled. march 26 on thursday, viggo’s sister and her husband are both hospitalized with severe symptoms of covid19. the same day, the priest calls ann arguing that the funeral director has given wrong instructions and had no authorization to make changes to the funeral ritual. ann convinces the priest that the funeral has to be postponed due to the ban on gatherings. the priest is resistant. the plan interferes with the regular funeral ritual, which normally takes place before the cremation. during a regular ceremony in an evangelical-lutheran danish church, the coffin, containing the washed and dressed body, is placed at the altar. in a well-defined order, songs accompanied by the church organ are played, excerpts from the bible are read and the priest holds a memorial speech based on conversations with the relatives. then, if the body is cremated, the priest throws three handfuls of soil on the coffin while citing an ancient three-sentence phrase – af jord er du kommet. til jord skal du blive. af jord skal du igen opstå [from dust you are made. to dust you must stay. from dust you shall return]. in the christian tradition, this ritual, which in denmark is referred to as jordpåkastelsen [the throw of soil], marks a central part of the funeral that symbolizes the movements between life, death and afterlife. viggo’s priest was uncertain about how to perform this important part of the funeral if the cremation was to take place prior to the formal ritual. however, ann was determined and the priest promised to find a solution. due to the hospitalization of both ann’s aunt and uncle, they simultaneously decided to postpone the cremation until april 16. april 16 viggo’s “first farewell” is held on april 16th, which is also the 80th birthday of the danish queen margrethe ii. the family chose this day, as the danish flag would be waving from all public buildings and busses providing a sense of celebration and joy amidst the mourning. on that day, relatives and friends gather in the chapel. viggo’s coffin is placed in the middle, decorated with bunches and garlands of flowers. the doors to the parking lot are kept open so that people can move in and out of the chapel and say goodbye to viggo, without violating the ban on gatherings (which at this point in time is still limited to ten). ann has prepared a playlist on spotify, which is played in the chapel in place of the church organ music. the closest relatives stand together in small groups while they greet the people who move through the chapel. in advance they have chosen kim larsen’s song “om lidt bliver her stille” [in a while, it will be quiet here] as the last track. without prior arrangements, ann and lilly get eye contact and decide to play the song. together with the other brother, lilly and two grandchildren, they carry out the coffin to the hearse and see it driving away for cremation. july 31 viggo is buried on july 31st, 130 days after his death, with the formal church ritual and 36 attendees, including viggo’s youngest son, ole, and his two adult children. they have been absent from family gatherings for the past years due to heated conflicts between viggo, ann, ole and ole’s children, primarily concerning ole’s long-term alcohol abuse. however, the postponing of the formal funeral made it possible for the siblings to take the time needed to come to terms and make ole part of the planning and organisation of viggo’s final farewell. as a final act of reconciliation between a father and his son, ole is the one placing the urn in the ground. ann looks back at both ceremonies with joy and satisfaction. “everything was so beautiful, the flowers, people gathered there, everything.” she also expresses gratitude in relation to the timing of the final goodbye: “i am so glad that we had enough time to plan all the details, making the day so special and great.” http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 215 photo from viggo’s funeral. published with permission from the daughter, edited by sofie rosenlund lau. reversing the time of dying in this article, we draw attention to the unexpected possibilities for positive stories of worthy dying among chronically ill elderly in denmark, despite – or due to – the global covid-19 disruption of taming and timing death. interestingly, this speaks to green’s argument that modern deaths are stretched out in time in ways that may not necessarily be conducive to better processes of grievance, since most deaths now relate to chronic disease, where social death and grievance kick in prior to biological death (2008, 188). this raises important questions about the virtue of life-sustaining treatments of the physical body vis-à-vis the consideration of the adequate time and space for the social body to process grief and mourning. by using timing as an analytical lens to capture the intersection between the quotidian and the catastrophic, we have shown how the context of a global crisis resulted in the reversal of time spent on processes of dying and processes of mourning. from the perspective of the family, viggo’s death came unexpected and abrupt. up until the final minutes, the family expected viggo to return home from the hospital. in this perspective, viggo’s process of dying was almost absent – it appeared as a death without dying (timmermans 2005). yet, in the relatives’ reflection on viggo’s death, beyond the grief from losing a beloved father and brother, they also express a subtle feeling of alleviation – that death came timely and was tamed in the best possible way. we thus documented the reversal of two important socio-temporal spaces of dying; namely the brief time up until viggo’s biological death and the extended time available for the mortuary rites to be performed. http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 216 the first phase was characterized by the absence of medical treatment. viggo’s decision to shy away from intensive care and the prolongation of life through technological means prepared the ground for a close and intimate time between viggo, his daughter, his son and his sister in his final hours. this time was experienced by the family as peaceful and calm and they look back on viggo’s death as an ideal way of dying and saying goodbye: there were no essential decisions to be made and viggo was conscious and free from pain. it is important to note that not everyone has experienced a good death during covid-19. in fact, danish public media have been covered with stories from distressed family members not being able to say goodbye properly to their loved ones and from frustrated care professionals not being able to provide proper end-of-life care, and this especially for the elderly and the terminally ill (bank and andersen 2020; møller 2020). yet, this article bears witness to how the onset of covid-19 had the unlikely effect that an old man had a calm and dignified death without having to suffer from life-prolonging treatment, and that this gave him and his family the right time for dying. the second phase of planning and organizing viggo’s funeral was extended, because the formal ritual was postponed due to the ban on gatherings. the continuous negotiations around the planning of what should have been a formalized ceremony, bears witness to the ways in which the pandemic disrupts taming practices in the lives of individuals. after quite some negotiations between ann and the priest, the pandemic provided a possibility for transforming what is normally perceived as a rather conservative ritual and, shortly after viggo’s death – on april 2 – the evangelical-lutheran church in denmark, also known as folkekirken [the church of the people], publicly announced alterations to the formal funeral ritual in the time of covid-19. this comprised the possibility of changing parts of the ritual, including the throwing of soil, so that the time between the death and the burial could be prolonged, as happened in viggo’s case. here, this time proved essential for the family in order to come to terms with longlasting, painful conflicts and to prepare for a final farewell and satisfying closure. we argue that it is important to keep ethnographic accounts of lived (and ended) life in the picture when we try to make sense of what happened with the advent of covid-19. in line with hyde and denyer willis' call to “balance the quotidian” (2020) we aim to highlight the slow and undramatic dying and death of viggo as a way of pointing out what might often be overlooked yet deserves so much attention in the attempt to improve care at the end of life. the quietness of viggo’s life called for a sonic approach to dive deeper into the seemingly eventless. in line with steven feld’s (1996) emphasis of sound as a way of knowing, we have sought to show the sensory details the textures, tonalities, pauses and subtleties of viggo's routine based life in order to create insight into its pace and particularity. with the sound we aim to cultivate an ethnographic listening, not only to the outspoken, to actions and meanings, but also to the spaces in between. when it comes to the death of the 25th danish covid-19 casualty, it was not a horrific case at all. as a counternarrative to the disruptions and loss of freedom in the time of covid-19, for viggo’s family, the pandemic resulted in a situation of close and intimate connections between family members up until the final moment of death. in fact, the sociality surrounding viggo continued after his death as his mortuary time could, as a result of the lock-down, be tamed in a different manner. it made time and space for more negotiations of how to say goodbye to viggo in the most meaningful way for all involved, in their own time. http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 217 viggo now lies in the grave next to his first wife. published with permission from the daughter, edited by sofie rosenlund lau. timeline: intertwinement of global, national and local events 3 june 2019: sofie meets viggo for the first time and makes several interviews and appointments with him during the next two months. 31 december 2019: china warns the who about a new flu in wuhan 11 january 2020: china registers its first death due to corona 22 january 2020: the danish health authority deems the likelihood for corona to reach denmark “very limited” 24 january 2020: france registers the first incident of corona in europe 30 january 2020: the who declares an international emergency 5 february 2020: 14 danes evacuated from hubei province in china to denmark 7 february 2020: the danish ministry of foreign affairs alters 75 travel guidelines 19 february 2020: sofie brings nanna to meet viggo for the first time. they have a coffee in the building opposite viggo’s and see him leave his home in the new automatic wheelchair. 26 february 2020: nanna makes the audio recordings in viggo’s home 27 february 2020: first official case of covid-19 in denmark 28 february 2020: the danish health authority declares that “we must now expect to see incidences of corona in denmark over the coming days” http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 218 3 march 2020: quarantine measures are put in place if you arrive to denmark from a high-risk area 6 march 2020: first press meeting featuring danish prime minister (pm) mette frederiksen, who cancels events with more than 1,000 people in attendance and asks people to stop shaking hands. 10 march 2020: viggo’s 76th birthday 11 march 2020: press meeting where the pm declares a lockdown of danish society 12 march 2020: new test strategy launched by the authorities and emergency legislation passed 13 march 2020: press meeting where the pm declares that the borders will now be closed 14 march 2020: viggo’s sister and her husband pay him a visit 14 march 2020: first danish casualty due to corona 17 march 2020: viggo gets sick 17 march 2020: queen margrethe the 2nd addresses the danish public 18 march 2020: viggo’s daughter asks the home care nurse to pay viggo a visit 19 march 2020: viggo is submitted to the hospital 20 march 2020: 19 people now have died from covid-19 in denmark 20 march 2020: viggo’s daughter talks to viggo in the arranged phone call – he sounds better 22 march 2020: the family is called to the hospital and stays the whole night 23 march 2020: the family leaves the hospital early in the morning; a few minutes later, viggo passes away 26 march 2020: viggo’s sister and her husband admitted to hospital with severe symptoms of covid-19 (they survive) 27 march 2020: viggo’s daughter has contested arguments with the priest and the funeral director over viggo’s funeral, which is postponed 30 march 2020: in a press meeting the pm declares a gradual reopening of danish society after easter if things continue to develop well 31 march 2020: emergency law passed that allows government to criminalise gatherings of more than two people in public 2 april 2020: emergency law on corona-related crime passed 8 april 2020: wuhan reopens 10 april 2020: 260 people have died from covid-19 in denmark 16 april 2020: first farewell ritual held on the queen’s 80th birthday 18 april 2020: gradual reopening of the danish health system to allow treatment other than corona and critical illness 16 maj 2020: focus group discussion in the home of viggo’s oldest son 31 july 2020: the last farewell ritual – viggo’s official funeral 31 july 2020: 14,028 registered corona cases in denmark – 615 registered corona-related deaths 26 october 2020: 38,622 registered cases, 697 corona related deaths http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 219 references ariès, philippe. 1974. western attitudes toward death from the middle ages to the present. baltimore: johns hopkins university press. bank, marcus and peter bye andersen. 2020. “sandra kan dø inden for en uge: kan ikke sige farvel til familien på grund af coronakrisen.” dr. april 3, 2020. https://www.dr.dk/nyheder/regionale/hovedstadsomraadet/sandra-kan-doe-inden-en-uge-kan-ikkesige-farvel-til-familien. bloch, maurice and jonathan parry. 1982. "introduction: death and the regeneration of life." in death and the regeneration of life. edited by maurice bloch and jonathan parry, 1-44. cambridge: cambridge university press. cambridge dictionary. n.d."pace." https://dictionary.cambridge.org/dictionary/english/pace. christensen, loa kristine teglgaard. 2020. crafting valued old lives. quandaries in danish home care. phd dissertation. university of copenhagen. feld, steven. 1996. "waterfalls of song: an acoustemology of place resounding in bosavi, papua new guinea." in senses of place. edited by steven feld and keith basso, 91-135. santa fe, nm: school of american research press. green, james w. 2008. beyond the good death: the anthropology of modern dying. pennsylvania: university of pennsylvania press. grøn, lone. 2016. "old age and vulnerability between first, second and third person perspectives. ethnographic explorations of aging in contemporary denmark." journal of aging studies 39: 21-30. https://doi.org/10.1016/j.jaging.2016.09.002. hyde, sandra teresa and laurie denyer willis. 2020. "balancing the quotidian: precarity, care and pace in anthropology’s storytelling." medical anthropology: cross cultural studies in health and illness 39: 297-304. https://doi.org/10.1080/01459740.2020.1739673. kaufman, sharon r. 2005. and a time to die: how american hospitals shape the end of life. chicago, il: university of chicago press. manderson, lenore and ayo wahlberg. 2020. "chronic living in a communicable world." medical anthropology: cross cultural studies in health and illness 39: 428-439. https://doi.org/10.1080/01459740.2020.1761352. mattingly, cheryl, lone grøn, and lotte meinert. 2011. "chronic homework in emerging borderlands of healthcare." culture, medicine, and psychiatry 35, 347-375. https://doi.org/10.1007/s11013-011-9225-z. metcalf, peter and richard huntington. 1991. celebrations of death. the anthropology of mortuary ritual, 2nd ed. cambridge: cambridge university press. pink, sarah. 2009. doing sensory ethnography. london: sage publications ltd. https://doi.org/10.4135/9781446249383. rivers, william halse. 1913. "the contact of peoples." in essays and studies presented to william ridgeway. edited by e.c. quiggin, 474-492. cambridge: cambridge university press. rostgaard, tine and marta szebehely. 2012. "changing policies, changing patterns of care: danish and swedish home care at the crossroads." european journal of ageing 9: 101-109. https://doi.org/10.1007/s10433-0110209-1. stickings, tim. 2020. "coronavirus patients line the corridors in footage from inside italian hospital, as military trucks transport scores of victims’ coffins to be cremated." daily mail. march 19, 2020. https://www.dailymail.co.uk/news/article-8129959/military-trucks-transport-italian-coronavirusvictims-coffins-cremated.html. timmermans, stefan. 2005. "death brokering: constructing culturally appropriate deaths." sociology of health & illness. 27: 993-1013. https://doi.org/10.1111/j.1467-9566.2005.00467.x. http://anthro-age.pitt.edu/ lau, kristensen and oxlund | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.319 http://anthro-age.pitt.edu 220 møller, sebastian. 2020. "hospitalsansat: covid-19-død er et ensomt farvel." tv2 lorry. may 6, 2020. https://www.tv2lorry.dk/koebenhavn/hospitalsansat-covid19-doed-er-en-ensom-afsked. willerslev, rane, dorthe r. christensen, and lotte meinert. 2013. "introduction." in taming time, timing death: social technologies and ritual. edited by rane willerslev, dorthe r. christensen and lotte meinert. london/ny: routledge. http://anthro-age.pitt.edu/ book review review of giles, howard, jessica gasiorek, shardé m. davis, and jane giles. communication for successful aging: empowering individuals across the lifespan. new york: routledge. 2022. pp. 164. price: $139 (hardcover); $49.70 (paperback); $44.70 (ebook). aaron seaman university of iowa aaron-seaman@uiowa.edu anthropology & aging, vol 43, no 2 (2022), pp. 122-125 issn 2374-2267 (online) doi 10.5195/aa.2022.437 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | seaman | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.437 http://anthro-age.pitt.edu 122 book review review of giles, howard, jessica gasiorek, shardé m. davis, and jane giles. communication for successful aging: empowering individuals across the lifespan. new york: routledge. 2022. pp. 164. price: $139 (hardcover); $49.70 (paperback); $44.70 (ebook). aaron seaman university of iowa aaron-seaman@uiowa.edu communication for successful aging: empowering individuals across the lifespan by howard giles, jessica gasiorek, shardé m. davis, and jane giles is characteristic of the field anthropology & aging seeks to cover. the authors are primarily communication scholars, and the volume, a newly revised version published in november 2021, seeks to map the communicative context within which people age and how that context shapes the possibilities for successful aging. amidst a backdrop of aging demography and a brief history of theoretical approaches to aging, the authors here present how communication, as a discipline, complements biological/physiological, psychological, and sociocultural approaches to understanding aging. as they set out in the introductory chapter (chapter 1), the authors propose a communication-centric approach that analyzes aging as an interactive process that is both influenced by and influences communication. the first body chapter (chapter 2) turns the reader’s attention to ageism and age stereotypes in communication, outlining a discursive foundation to approach topics in subsequent chapters. ageism— the attribution of differences in age as meaningful and enactment upon that attribution—is here described across scale, from sayings such as “you can’t teach an old dog new tricks” to clinical decision making influenced by a patient’s age or diminished professional opportunities as one ages. the authors walk through the research on the ways that ageist ascriptions can consolidate into stereotypes that may affect communication, social relationships, and personal identity. stereotypes, as they describe them drawing from psychological theories, are used to evaluate people, especially unknown persons, along two dimensions: warmth, or a person’s temperament, and competence. these dimensions map onto two questions that people are looking to answer about people: what are this person’s intentions, and what is this person capable of doing? particular to communication, the authors detail the consequences of stereotyping on perceptions of a person’s communicative abilities and interpretation of their communication. across these discussions, the authors are careful to remind the reader that ageism and age stereotypes happen across the life span. in one example, for instance, of an automobile accident, the authors contrast questions for a 22-year-old, focused on speeding or drinking, with those for a 72-yearold, focused on cognitive competence. finally, while the majority of the discussion centers on the negative and the deleterious effects of ageism and age stereotypes, the authors also look to present both as value neutral, discussing, for example, financial incentives that are triggered at a certain age. building on insights from the previous chapter to focus on the ways that a person’s self is shaped by their age and how they and others perceive that age, chapter 3 introduces the concept of an age identity, or an identity based upon a person’s understanding of themselves as part of a social group defined by http://anthro-age.pitt.edu/ book review | seaman | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.437 http://anthro-age.pitt.edu 123 age. the discussion draws upon social identity theory to describe how people feel a part of a group in contrast to other groups and that they seek to maintain a positive conceptualization of the groups with which they feel affinity. in communicative interactions, participants often draw upon their understandings of social groups to make inferences about their interlocutor rather than the person’s individual characteristics, a tendency here described as a “communicative predicament model of aging” (46). the authors stress that people have multiple intersecting identities that influence each other and that become salient in different ways at different points. race, class, and gender, to name but a few social identities, impact the way a person experiences their movement through the life course and the identity they take on as a result of those experiences. those who have been systematically disadvantaged often bear the greatest negative impact of age identification. of note, the authors also point to one’s age identity as often different from many other possible identities because people move through different—and differently understood—age groups across their life course. the discussion brings to mind the large body of sociological and anthropological work on generations, age cohorts and mates, and different conceptualizations of the life course and how one progresses through it (e.g., bledsoe 2002, kaufman 1986, lamb 2000, mannheim 1952, neugarten 1996). a communication-centric approach directs attention to how such identities become salient and their meanings negotiated through conversation and other communications, such as birthday cards (and, by extension, the birthday industry writ large) with tropes of over the hill and the like. the authors acknowledge that such messaging is often offered in jest but is based upon ageist imagery and that the impact on identification of this messaging is pervasive and accumulates. chapter 4 tightens the lens around age identities to center on “the ingredients of intergenerational communication.” it begins from the understanding that many western societies are age-segregated and that segregation shapes the way that people understand and communicate across generations. the authors draw upon communication accommodation theory—the notion that people adjust their communication in different social contexts—to account for potential mismatches in communication, and herein acknowledge both overand underaccommodation while noting overaccommodation occurs in both directions across generations, they describe younger people overaccommodating when speaking to older adults—think of people talking with exaggerated volume or slowness to older adults—and identify elderspeak as an especially damaging form of overaccommodation. they find underaccommodation primarily in instances where older adults overshare, focusing on what they term “painful self disclosures” of highly personal information often around health, loss, and isolation (63). the authors argue that in the face of these disclosures, the younger person can tend to understand the older person in particularly negative ways, harking back to the discussion of agist stereotyping in chapter 2. after detailing these differences in communication tendencies, the authors discuss similarities across generations and reinforce the importance of listening with care. in chapter 5, “the media, agism, and anti-aging,” the authors once again widen the lens to consider how broader discourses around aging impact people across the life course. they draw on one study examining colocations in a large online corpus that identified the words “infirmed,” “handicapped,” “disabled,” “sick,” and “poor” as those most often occurring with “elderly.” elsewhere in the chapter, they discuss the rise of marketing life course niches (e.g., tweens); and the lack of media representations of older adults, especially older persons of color. when older adults are represented in the media, these representations most often are negative: ageist jokes toward characters, self-deprecating older adults, the burden of the “silver tsunami,” and anti-aging marketing. the few positive representations disproportionally account for the exceptional—the marathon-running super ager, for example, often reinscribing the very tropes they ostensibly look to subvert. in the final section of the chapter, the authors look to complicate our understanding of media’s effect on older adults, discussing research that situates older adults’ media consumption in their broader social contexts. how does the quality of older http://anthro-age.pitt.edu/ book review | seaman | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.437 http://anthro-age.pitt.edu 124 adults’ social circles impact what kinds of representations resonate with them? what about people for whom the predominantly white, middle to upper class, cisgender, heterosexual presentations are not representative? how do they experience media coverage of ‘aging’? turning the lens back to interpersonal interactions, chapter 6 examines the topic of end-of-life communication, notably among family members. the chapter begins from the notion that, in the us especially, people often are uncomfortable with death and this discomfort limits meaningful discussion of death and dying. while people encounter a great volume of fictional death in the media, those deaths are often devoid of context or emotional depth, and real conversations on dying are rare. briefly acknowledging less uncomfortable engagements with death in other geographic regions, the authors advocate for “communication about and at the end of life, which is an important element in successful aging” (92). they mention communication research with cancer patients, who were found to want qualitative and not quantitative information from medical providers about their prognosis. they also discuss the unwillingness of family members to discuss a person’s illness and death. the authors embed people’s discomfort in a communicative tendency to not discuss negative matters more broadly and argue that effective communicative strategies to discussing death are not avoidance or false positivity, but rather realistic hope and assurance. they also offer some guidelines, grounded in communication research, for having these conversations, but are quick to note that these strategies are not prescriptive and, once again, that listening is perhaps the most key communicative action a person can take. in the final two chapters, the authors turn from a descriptive survey of multiple topics across communication and aging studies to focus on successful aging, centering what they view as critical for moving forward. successful aging is here conceptualized as a communicatively engaged “embracing [of] one’s age, taking advantage of opportunities, and building healthy relationships with friends and other loved ones in a way that fosters contentment with a person’s current stage of life” (109). they stress that successful aging is subjective: it’s about how one feels about aging rather than about a particular physical trajectory or set of checked boxes. to that end, they offer three age ideologies: motivated acceptance (to not just accept but strive to relish), studenthood (to never stop learning), and appreciation of the life course as an “interculturing process” (113), wherein people move through and across age cultures. building on these ideologies, they detail communication strategies for striving to embrace and enact the ideologies they proffer. in the conclusion, they discuss what they feel is the importance of resilience, hope, and empowerment to successfully navigating and fully embodying the aging process. the giles et al. volume offers a solid introduction to several topics on aging (e.g., successful aging, ageism, life course and lifespan), and the focus on communication across multiple scales is a welcome one. the authors deftly situate a person and the process of aging within a matrix of different relationships that can influence or are influenced by communicative interactions. they illustrate the cumulative nature of communicative events, big or small, on people’s understanding of aging and their own life course. while there is some attention given to non-us perspectives on aging, the volume is primarily focused on the us (and to some extent other western nations) and, as such, offers a textual artifact of aging discourses within the us. it would be useful in an undergraduate class, especially if paired with other work such as sarah lamb’s (2017) edited volume, successful aging as a contemporary obsession. its inclusion of practical strategies also gears it to a popular audience, where it offers a necessary counterpoint to the very media images and conversations it details. http://anthro-age.pitt.edu/ book review | seaman | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.437 http://anthro-age.pitt.edu 125 references banja, fatoumatta, and caroline h. bledsoe. 2002. contingent lives: fertility, time, and aging in west africa. chicago, il: university of chicago press. kaufman, sharon r. 1986. the ageless self: sources of meaning in late life. madison, wi, university of wisconsin press,. lamb, sarah. 2000. white saris and sweet mangoes: aging, gender and body in north india. oakland, ca: university of california press. lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. brunswick, nj: rutgers university press. mannheim, karl.1952. “the problem of generations.”. in essays on the sociology of knowledge: collected works, volume 5. edited by paul kecskemeti, 276-322. new york: routledge. neugarten, bernice l. 1996. the meanings of age: selected papers. chicago, il: university of chicago press. http://anthro-age.pitt.edu/ professional women and elder care in contemporary japan: anxiety and the move toward technocare anne aronsson anne.aronsson@yale.edu yale university abstract the elder population in japan is increasing drastically, causing a number of issues that have not yet surfaced in most western countries. demographic data from japan reveal that the japanese have the longest lifespan globally, resulting in the world’s highest population of older adults. concurrently, the country has a rapidly declining birth rate. as the population ages, the workforce is shrinking and leaving a high number of elders with fewer caregivers to meet their needs. at present, the japanese government is developing robotic care solutions to overcome the elder care labor shortage and implementing a new agenda to introduce social robots into the field. this article discusses professional women in japan and their burden of caring for aging relatives and how introducing robotic care devices might reduce current anxieties regarding the provision of elder care. it analyzes the elder care strategies of 12 white-collar professional women in their forties and fifties and examines the extent to which gendered, expected at-home caregiving affects their professional commitments and associated anxieties. the findings below provide crucial insight into the most effective strategies that can be used by japanese women to balance their careers with responsibilities to care for older relatives, particularly when it is impossible to predict the intensity of caregiving in the future. keywords: hyperaging; japan; lifecourse; robotic care; social robots anthropology & aging, vol 43, no 1 (2022), pp. 17-34 issn 2374-2267(online) doi 10.5195/aa.2022.360 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. aronsson | 17 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu professional women and elder care in contemporary japan: anxiety and the move toward technocare anne aronsson anne.aronsson@yale.edu yale university introduction: the move toward robotic elder care substantial and ongoing growth in the number of older adults in japan has resulted in a range of issues that have not yet surfaced in most western nations. demographic data from japan reveal that the japanese have the longest lifespan globally, resulting in the country having the world’s largest population of older people (cabinet office 2020). at the same time, the country has a rapidly declining birth rate. as the population ages, the workforce shrinks, leaving an increasing number of elderly japanese with fewer caregivers to meet their needs. because caregiving represents a long-standing social expectation of women in japanese society, they are increasingly forced to choose between pursuing careers and meeting familial obligations, particularly those relating to caring for aging parents, in-laws, or spouses. changes in the japanese labor market are fraught with serious challenges because the pursuit of professional careers by women upends conventional gender roles and expressions of femininity (cabinet office 2016, 2020; ho 2018; nemoto 2016; ogasawara 2016; roberts 2011). the significant influx of women into the workforce and the transformation of the work they perform have led to growing concerns about how women can balance professional careers with familial obligations, including the work of caring for children and aging family members. in this paper, i focus on professional women in japan, their burden of caring for aging relatives, and how the introduction of robotic care devices—both service and social robots—may potentially alleviate anxieties about the provision of elder care. technology plays a key role in many areas of life. it can offer solutions to care work issues and provide new ways for people to interact and connect with others (aronsson 2020; aronsson and holm 2020; parks 2010; pols and moser 2009; wright 2018), potentially alleviating the heavy burden that caregiving places on women, particularly those with careers. the professional women who were interviewed as part of this research indicated that despite the potential of technological care devices to relieve some of the pressures and anxieties they experienced around elder care, these new technologies still had limitations. in this paper, i analyze the elder care strategies of 12 white-collar professional women in their forties and fifties to examine the extent to which gendered expectations of japanese women as caregivers affect their professional commitments and associated anxieties. i briefly explore the japanese government’s robotic solutions to elder care in both institutional settings and private homes. i then examine how such solutions affect the anxiety experienced by professional women and whether they feel comfortable with entrusting older relatives to robotic care. this study’s aims are (1) to shed light on the best strategies japanese women might adopt to balance their careers with caring for aging relatives, especially when the extent and intensity of future caregiving cannot be predicted, and (2) to consider how technological devices and anthropological approaches to human-robot interaction are imagined to serve as surrogate caregivers1 and might offer elegant solutions to the challenges of care work by streamlining them and providing older adults with a steady or constant form of companionship (see http://anthro-age.pitt.edu/ aronsson | 18 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu also aronsson 2020). such care devices represent new epistemic possibilities of caregiving that contrast with the actual human companionship for which they serve as a replacement. in the case of some older people, their relatives, and caregivers, these devices may be perceived as offering more authentic experiences than some human interactions (aronsson 2020). the japanese ministry of health, labor, and welfare (2018) has predicted a shortfall of approximately 400,000 care workers by 2025. in response, the government has launched a two-pronged initiative to tackle this crisis in elder care. the first prong consists of admitting more foreign guest workers into the country, even though immigrant labor is not generally viewed in japan as a desirable solution (although this position is gradually changing).2 in 2019, a new immigration law opened the door to foreign workers in 14 sectors of the economy, including healthcare, by ensuring that visas were granted to meet japan’s employment needs (hamaguchi 2019). as a result, some 60,000 visas were approved in the healthcare sector (2019). however, despite the fact that healthcare represents the largest percentage of visas granted, the required number of staff to care for the country’s aging population still falls short. the other prong in the initiative comprises increasing the number of robotic devices used in the nursing sector. as the situation has worsened, the government has turned to the idea of using service and social robots to provide a range of services in the elder care field. former prime minister shinzo abe was behind japan’s state project to “roboticize” japan. in 2007, during his first term as prime minister, abe introduced innovation 25, a retro-visionary blueprint for turning japan into a nostalgia-tinged “robotopia” by (among others) restoring the traditional multi-generational household. all of this was supposed to occur by 2025. this timetable is now unrealistic; currently, the plan is referred to as innovation (minus the 25), or society 5.0, the smart society (robertson 2018, 2021).3 it has been argued that developing robots with voice and facial recognition capabilities will close the gap between human needs and staffing shortages (headquarters for japan’s economic revitalization 2015); in response, care centers have set about introducing an increasing number of robots to help with both service and social care tasks. service robots [saabisu robotto] can assist in everyday tasks, such as eating, bathing, and toileting, while social robots, as the term implies, provide companionship for the elderly by listening and talking to them, as well as helping them feel like they are receiving attention and consideration. social robots, defined as robots that are “able to communicate and interact with us, understand and even relate to us, in a personal way” (breazeal 2004, 1), are equipped with artificial intelligence (ai), high-resolution cameras, and voice and facial recognition capabilities that help them interact with humans at social and emotional levels. a body of literature on ai and social robots emerging from various fields, including anthropology and philosophy, contextualizes the concepts of technoliberalism and “surrogate humanity” (atanasoski and kalindi 2019) and outlines some of the anxieties surrounding intelligent technologies that are relevant for the discussion here. as social historians simone müller and heidi tworek (2016) note, imagined uses of technology can structure the political framing of technological research, thereby influencing the physical development of technologies.4 some research has pointed to an agenda behind industry and state deployment of robotic agency: reinforcing sexual and gender divisions in the labor field and strengthening the model of the traditional multi-generational patriarchal household (robertson 2021; see also aronsson 2020). these considerations deserve a fuller discussion that is beyond the scope of this paper. as a result, automation has been racialized and gendered since the early days of the industrial revolution because the tasks that were considered automatable—manual labor, factory work, and care work—were perceived as unskilled and noncreative work dominated by the uneducated, the colonized, and women (atanasoski and kalindi 2019, 156). as a result, “surrogate humanity focuses on how engineering projects that create the robots, program the ai, and enhance the digital infrastructure http://anthro-age.pitt.edu/ aronsson | 19 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu associated with a revolutionary new era are in fact predetermined by techniques of differential exploitation and dispossession within capitalism” (2019, 174). technoliberalism allows for an aspirational representation of humanity in relation to technological transformation, but this representation obscures the uneven gendered relations of labor, power, and social relations undergirding the current conditions of capitalist production. that is, “technological futures tied to capitalist development iterate a fantasy that as machines, algorithms, and artificial intelligence take over the dull, dirty, repetitive,5 and even reproductive labor performed by racialized, gendered, and colonized workers in the past, the full humanity of the (already) human subject will be freed for creative capacities” (atanasoski and kalindi 2019, 174). in other words, engineering imaginaries may aspire to a revolutionary status for the techno-objects they produce to improve human life, but they reinscribe gendered imaginaries of what kinds of tasks separate the human from the lessthanor not-quite-human other. in principle, technoliberalism underlies humanity’s fascination for, as well as its fear of, robots through symmetrical anti-humanism, which has placed humans and nonhumans on par with each other, meaning that humans have no unique qualities or features that make them distinct from other agents. namely, the robot symbolizes surrogate humanity and has long been associated with dehumanization and the rise of nonhuman agents (richardson 2015, 5). actor networks, companion species, and assemblages have generated an ontological turn in anthropological theory where human and nonhuman agents are now considered interrelated and even somewhat enmeshed (richardson 2015, 6; see also haraway 2003; ingold 2012; latour 2005). in addition to the “surrogate humanity” framework, i present a comparative perspective between the more technologically conventional robots used for elder living and care—mainly service robots—and the more recently introduced social robots. the former tend to generate anxieties related to elder care, while the latter appear to mainly alleviate those anxieties. service robots—for instance, bed sensors, the lifting robot hug, lumbar devices6 worn by caregivers to lift elders in and out of bed or the bathtub, and the resyone wheelchair (to cite only a few)—were introduced in nursing homes before social robots. as wright (2018) notes, “across several different ministries, the government has spent over 15 years planning and funding large-scale public technology research projects and investing in the domestic service robotics industry (wagner 2010), most notably in the ongoing ¥12.5bn (approx. us$112 m) ‘project for the development and promotion of the introduction of robot care devices’ run by aist [advanced industrial science and technology] under guidance from amed10 from 2013–17” (25). nevertheless, social robots are accepted at higher levels than service robots. one reason appears to be their humanoid form, which allows for anthropomorphic projection or the human tendency to attribute human traits to nonhuman entities. this response can be understood as intersubjectivity in action. as dumouchel and damiano (2017) argue, intersubjectivity is the “result of rational analysis of the behavior of others, and it rests on an analogy with—which is to say that it is worked out on the basis of—what the subject himself feels and his own reactions in similar circumstances” (127–128). intersubjective knowledge of emotions, for example, is just like knowledge of others’ minds since descartes, it is never direct. in 2010, relatively few service robots were in use in japanese nursing homes (wright 2018), but by 2019 they were increasingly introduced as part of the innovation 25 project. as i demonstrate in this paper, the impacts of these technological changes in elder care on japanese professional women’s thinking and experiences are related to the extent to which particular forms of technocare alleviate or exacerbate anxiety associated with caring for elder people. contextualizing the implications of care work in an aging japan http://anthro-age.pitt.edu/ aronsson | 20 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu in japan, aging has a considerable impact on family members and those responsible for elder care, and the role of caregiver is typically filled by women (buch 2015; jenike and traphagan 2009; kavedžija 2016b). cultural traditions of familialism and filial piety are deeply rooted in japanese society, whose social values are based on the traditional stem family system (danely 2014; jenike and traphagan 2009). this family system presupposes that the eldest son, together with his wife and children, lives with his parents until they pass away. even today, a relatively high percentage of older japanese people live in such family units, highlighting the country’s strong tradition of vertical social relations and the confucian doctrine of filial piety. however, the development of public welfare programs, such as care services, has contributed to crucial changes in perspectives and attitudes. these changes have subjected the japanese family system to negotiation, contestation, and improvisation by men and women who have proposed new ways to solve old problems. one solution is the provision of elder care within the framework of the stem family system (danely 2014). family members’ involvement in and responsibility for the provision of care are embodied in the “japanesestyle welfare society.”7 this is more efficient and comprehensive than the western welfare state model because it offers better economic benefits through reduced welfare spending, which lowers taxes and accords with japanese cultural values. however, since the demographic structure of japanese society has changed and the population has aged, the provision of care has increasingly been regarded as a social, and not exclusively familial, concern (peng 2003). moreover, a decline in traditional intergenerational cohabitation has occurred in japan. the proportion of people aged 65 and over who lived with their children decreased from 49.1 percent in 2000 to 43.2 percent in 2009, while the proportion of the elderly living alone increased from 14.1 percent to 16 percent over the same time period (takagi and saito 2019). these declines have occurred despite “negative mobility,” “downward mobility,” and uncertain futures, which have led younger people to increasingly opt to live in multi-generational households (fujita 2015). in contrast to previous generations, the generation of millennials is less interested in cohabitation and caring for aging parents and grandparents and more focused on personal goals, such as career building. due to this trend, obligatory cohabitation is shifting toward strategic cohabitation. in other words, cohabitation and the provision of elder care have become less of a “natural duty” and more of an arrangement and a convention. the high cost of housing and the inadequate supply of childcare facilities play particularly important roles in this normative shift. this reflects that, although some demographic characteristics, such as marital status and number of children, are important factors of cohabitation, socioeconomic and geographic variables, such as education, home ownership, and region of residence, are the primary predictors of cohabitation. harsh economic conditions have forced many people to accept cohabitation (ochiai 2003; wu 2004). aging is a particular concern in contemporary japan because of the country’s growing proportion of older adults. glenda roberts (2014) argues that the future of elder japanese people, and perhaps the future of japanese society as a whole, may be restricted due to the rapid growth in this segment of the population. in particular, increased longevity has led to an increase in the number of dependent adults. one quarter of the japanese population is now over 65 years old, and one third of these individuals require daily assistance owing to frailty, dementia, or other chronic geriatric health issues (ministry of health, labor, and welfare 2018). as a result, stress and anxiety are occurring at multiple social levels: at the national level, there is increasing concern about the aging population’s contribution to japan’s shrinking economy; at the community level, issues related to the aging population affect individuals within neighborhoods;8 at the family level, immediate family members and close relatives face challenges in dealing with the increased need for elder care and support; and at the personal level, individuals must cope with issues associated with caring for aging relatives in addition to their other family responsibilities and career-related obligations (kavedžija 2016b, 214). http://anthro-age.pitt.edu/ aronsson | 21 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu individuals experience anxiety when they perceive that something they value is under threat, but anxiety is also a culturally informed response to perceived loss (i.e., the causes of anxiety vary by culture), such as feelings of unease when social stability and security are threatened, as is the case in japan (kavedžija 2016a, 2016b; see also danely 2014; long 2000, 2014). since the 1990s, this threat has rapidly increased worry and anxiety among the general japanese population. until the 1970s, families were entirely responsible for providing care and support for the elderly, as established by traditional values and beliefs (traphagan and knight 2003). social programs for the elderly were intended to relieve that burden, but increased longevity in japan has overwhelmed their development, and consequently, the younger population bears an ever-increasing responsibility for elder care. john traphagan and john knight (2003, 150) note that as the number of people aged 65 and over has increased, so has the number of those aged 75 and over, an age group known as the “old old.”9 historically, older people have always been financially and personally dependent on their children, but financial and personal dependence have not evolved simultaneously (yamato 2006). from 1945 to the mid-1960s, parents’ financial dependence on their adult children was taken for granted, but this arrangement started to become less desirable in the 1960s. between 1945 and the early 1980s, the public pension system was largely unavailable or unreliable but has since become increasingly efficient and useful. however, the personal care situation has remained mostly the same. dependence on adult children has continued to be taken for granted, and women are expected to be the primary caregivers. public care services were exclusively for the poor until the 1980s, but since then, such services have become more viable and less socially stigmatized. nevertheless, it can be argued that although men— and in some cases women—have been liberated from the financial responsibility of supporting their elderly parents, women continue to bear the responsibility of providing physical care because public care services have not developed in pace with the population’s needs (yamato 2006). methodology this paper is based on interviews i conducted in 2010 as part of my doctoral research, with follow-up interviews conducted in 2019 during a six-month research stay in tokyo and email exchanges with the interviewees throughout the summer and fall of 2020. i explore how the lives of professional women have changed owing to elderly relatives’ increased dependence and altered living circumstances in light of the growing use of robotic care in institutional and private settings. the process of recruiting these women for my research in 2010 was mainly undertaken through snowball sampling, and in 2019, i recontacted the same women. at the time of recruitment, inclusion criteria for participants stipulated that they had to be employed full-time in a career-track position and that they were currently caring for or had previously cared for elderly relatives. the research was based exclusively in tokyo, where all of the interviewees lived. the research participants were middle-class women in their forties (38 respondents) and fifties (19 respondents). for the interviews in 2019, i emailed all 57 women. in some cases, the emails were returned, or i was unable to reach the participants; some of them never replied to my emails or answered that they had no time for follow-up interviews. in total, 12 respondents agreed to a subsequent interview and met the recruitment criteria. therefore, the sample for the 2019 interviews was much smaller than the one used in 2010. from the previous total of 57 interviewees, i worked with a sample of 12 to explore how professional women struggled with anxieties about elder care duties while pursuing their careers. the interviews followed the same format in both years. http://anthro-age.pitt.edu/ aronsson | 22 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu of the women in their forties, two worked in finance and two in the industrial sector (one each in the secondary and tertiary sectors); one worked in academia and one in the government, while another one was self-employed. four were married, and three were single. of the married women, two had one child each, and all the other women were childless. of the women in their fifties, each one worked in finance, industry, and academia, and two worked for the government. three were married and two women were single, but one of them had a partner. of the three married women, two had two children each and one had one child. the interviews were conducted in both japanese and english, depending on the participant’s preference. all questions were open-ended and focused on daily work routines, anxieties about elder care, engaging with care work, and perceptions of robotic care. the interviews ranged in duration from two to three hours. in some instances, i spent several hours with a participant, mainly on weekends, and all interviews took place in coffee shops, restaurants, or nursing homes. all interviewee names mentioned below are pseudonyms. shouldering the burden of care although all the interviewed women belong to the middle class and are financially secure, their aging relatives present an increasing caregiving burden despite the presence in the home of some hired help (e.g., cleaners and caregivers).10 as kumiko (aged 42) explained, “i feel the financial burden, as well as the personal care burden of looking after my aging mother” (september 26, 2019). this dual burden of financial responsibility as well as personal care was voiced by several of my informants. thus, as the interviews confirmed, concerns regarding elder care arise from the imperfections of the pension system, the prospect of future pressure caused by allocating financial resources to long-term elder care, and the general burden of taking care of older adults. elder care in japan also encompasses deeper existential issues, especially for full-time employed women. sacrificing careers to care for elder relatives creates uncertainty concerning future career prospects. “i do worry about financial security during my retirement,” hoshi (aged 44) explained. “i still have to pay off our mortgage on the apartment. my husband was recently diagnosed with cancer, so he might have to retire early. he is in his mid-fifties, so the financial burden is entirely on me” (september 5, 2019). remaining employed is essential for women to ensure security in their own retirement, especially if they are unmarried. thus, elder care comes with increased social anxiety, and there are multiple causes of such anxieties. the mental burden placed on japanese career women who must take care of aging relatives triggers feelings of unease and intensifies many forms of fear and insecurity, such as those voiced by hisa (aged 43): “i’m single and my prospects of getting married do not look promising at this age. soon, one of my parents might start requiring support, and one thing is certain—i will not send them to a nursing home. i would like to have a caregiver look after them in their own apartment, but this is an additional financial burden” (september 30, 2019). many of my informants have encountered the expectation that they should leave full-time employment to care for aging relatives. concern about elder care partially results from uncertainty over being able to continue one’s career until retirement. further, the tendency to relate the expectations of extended career aspirations to a sense of growth provides a logical explanation for the steady rise of career-specific anxiety post2000 (kawano, roberts, and long 2014; lukács 2020; nemoto 2019; ogasawara 2019). the concept of lifetime employment is in direct conflict with the duties of filial piety, which may require individuals to abandon their careers. even though lifetime employment in japan is overall declining (mathews 2014), one of the most relevant social contracts used to be the one between a large company and their employees, in which the company provides a secure lifetime employment in exchange for the employee’s total dedication. thus, the time commitment required from these employees is diametrically http://anthro-age.pitt.edu/ aronsson | 23 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu opposed to what care duties might require, and this potential conflict negatively affected the work experiences of my informants. margaret lock (1993) writes that according to traditional views, japanese housewives have no need to ponder or reflect on their ikigai—purpose and core concept of the meaning of life (holthus and manzenreiter 2017; mathews 1996, 2017)—because it is already determined by their role in the family. this conception of women’s purpose in life no longer reflects reality. my informants no longer performed roles that were predetermined in the social universe, and most were grappling with the meaning of their lives. this issue became especially acute when life events derailed their plans, as in the case of mayumi (aged 47) and michiko (aged 55), who suddenly found themselves caring for elder relatives, experiencing burnout, and having to quit their jobs because they could not cope with the demands of both work and caregiving. professional women face uncertainty not only because of having to fight social norms to pursue careers in the first place but also in their hesitation to take on the care of aging family members (see also kikuzawa 2016; niimi 2016). everyday trials and triumphs: robots alleviating anxieties about elder care to illustrate how robots might be able to alleviate feelings of anxiety over caring for elder relatives, i present the case of yoshie (aged 44), married and childless, who was working as a full-time civil servant when her father, a widower, started showing signs of dementia and required constant support and care. since yoshie’s husband also worked full-time, the family had to find a care solution for her father. as yoshie explained, “i had to struggle to overcome this conflict with my inner commitment to look after my father. my parents were very devoted to us [their children] when we were young, and now that they depend on our goodwill to provide care, we push them away. something in me says that this is deeply wrong” (march 5, 2019). her worries reflect the inner turmoil of my informants. yoshie initially considered organizing a home-care solution for her father, but she discovered that this option was far too expensive in the long run. additionally, her employer offered no option for part-time work. she began to research different options for institutionalized care and finally chose a community nursing home. yoshie felt stigmatized by her family and circle of friends for making this decision, and she found their judgment emotionally taxing. as this example demonstrates, there is a lingering sense in japan that elder care should be done by women at home. alternatively, spouses should do so if they are healthy and up to the task. however, this does not apply equally to men and women. wives are expected to care for their husbands, but husbands caring for their wives are less common. if an older wife needs care for both herself and her husband, this work is likely to be delegated to their daughter or daughter-in-law, and outsourcing such help still draws censure. employment trends show that an increasing number of japanese women are pursuing careers that do not allow them to quit when care work becomes a necessity; furthermore, they may in fact not wish to quit. in a follow-up email during the summer of 2020, yoshie explained that her father, rintaro (aged 76), was still a resident in the nursing home and now required round-the-clock care. she now felt relieved that she had made the decision five years earlier to move him to a nursing home. “i’m glad i did that, since his care was getting progressively more intensive, and it would have become too much for me to handle on my own, let alone continue working full-time. i would have needed to sacrifice my career without the chance of coming back. my family would have approved of that choice, but what would i have been left with? i couldn’t return to my job” (august 20, 2020). to justify her choice, yoshie explained that the nursing home had introduced robotic devices to assist with the care work. “i have seen these devices myself,” she wrote. “rintaro is lifted onto the bed from his wheelchair by the robotic http://anthro-age.pitt.edu/ aronsson | 24 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu device hug. he told me that it hurt him less under the arms when being lifted by the robotic arm than by a human arm” (august 20, 2020).11 yoshie’s anxieties were eased by the knowledge that her father experienced lower levels of discomfort when being assisted by a robot. even though rintaro and yoshie felt positive about hug, my other informants were more inclined to describe service robots as providing “cold care” (parks 2010; pols 2012; pols and moser 2009) since they only emulate the mechanics of care providers—that is, lifting and moving bodies. now let us turn to an example with a social robot. yoshie explained that on her latest visit to her father, the nursing home had introduced pepper, a social robot. figure 1. – picture of pepper in the japanese nursing home (© anne aronsson). pepper is produced through the collaborative efforts of aldebaran robotics and softbank mobile, which sought to develop a robot capable of emotional response. pepper’s design enables it to replicate human facial expressions, voices, words, and body movements and to react naturally and appropriately in different interactive situations. on the market since 2014, pepper costs 198,000 yen (usd 1,650) and has been purchased by nearly 1,000 households in japan, with worldwide sales totaling approximately 25,000 units in 70 countries. the robot is about 120 cm tall, with a shiny white plastic body.12 it has a human torso and a curved and solid lower half that can move easily on a wheeled base and large, wideset eyes that blink at its interlocutor. it also has other neotenous features that humans typically consider “cute.” additionally, pepper has a high-pitched, childlike voice that is meant to convey trustworthiness and safety. cameras in pepper’s mouth and eyes enable it to collect the information needed to process data in order to “assess” human emotions. pepper also has an interface that clearly sets it apart from humans: a tactile screen on its chest. yoshie’s father followed pepper’s 30-minute exercise session and seemed to enjoy this activity. “there were about fifteen people in the common room, most of them in wheelchairs, including my father. the caregiver pressed some buttons on the robot’s chest display, and it started playing sing-along songs, followed by some light physical activity” (september 5, 2020). when i asked yoshie how she felt about robotic care devices, especially social robots, she replied that she felt that her father was receiving what would be the future of care, a combination of human and robot care. given rintaro’s positive experiences of being lifted to and from bed and engaging in exercise with a robot, yoshie felt positive http://anthro-age.pitt.edu/ aronsson | 25 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu about the use of both social and service robots in her father’s care. “the nursing home lacks staff, and i prefer to have my father engage with a robot than nobody at all, with an emotionally distant caretaker, or with someone who does not speak the language properly. at least, the robot is even-tempered and predictable” (september 5, 2020). this answer immediately raises many questions such as: why is a robot perceived to be a more adequate choice than an emotionally distant human? why is a robot’s still limited communication ability deemed to be better than that of a migrant care worker? further questions have to do with the marketing and public perceptions of these robots, as well as the concept of robotic care in general. i acknowledge these as questions that need further research and address the topic of care elsewhere (aronsson 2020; aronsson and holm 2020). here, instead, i focus on older adults’ and their family caregivers’ overall perceptions of what it means to interact with these devices. yoshie was adamant that she had made the right decision. however, when questioned further, she expressed some nagging self-doubts: “i struggle with a bad conscience; i feel selfish. maybe it would have been different if i did not have a career, as i would not have this other option to consider. if i was available ‘on-call,’ i might not have these doubts; my role would have been clear. also, i am not really used to hands-on care. i have no children, and my husband and i have a domestic helper. it is a pity that society still expects this type of care work to be carried out by women. i just do not have it in me” (september 5, 2020). the provision of elder care presents a significant hurdle for most professional women in japan, especially if they have not previously cared for someone in that capacity. it is unreasonable to expect all women to have this capacity, especially in the face of shifting attitudes toward gender roles. therefore, it may not always be in the best interest of the care recipient to be cared for by a family member. additionally, as yoshie’s experience demonstrates, not all women can be expected to possess the skills, mentality, and attributes to successfully provide care or to have the time, inclination, or financial ability to do so. the issue of long-term care has had a significant impact on yoshie’s life. six other women in the sample of 12 informants suffered varying degrees of anxiety about elder care.13 for example, natsuki (aged 49) said that a robotic device would ease her anxiety about moving her mother to a nursing home. “i would not mind having such a device at home if it helps me take care of my mother for a longer time before moving her to a nursing home. if i had a robotic device that would help me lift her from bed to bathtub and back, it would save me time” (june 16, 2020). according to another informant, michiko (aged 55), her mother eriko (aged 75) “interacts with pepper in a nursing home and does so with ease and seems to enjoy it. it almost feels like she’s interacting with an oversized doll. how different would that be? i think her comfort shows that there is nothing to worry about” (november 22, 2019) (see also aronsson and holm 2020). michiko did not seem informed about the precise nature of these human-robot interactions, but when further probed, she remained steadfast in her opinion. better provision of care through the use of robotic devices helped lessen overall anxieties about moving relatives into nursing homes, and having such a device at home helped one respondent postpone her mother’s transfer to institutionalized care and alleviated her immediate feelings of anxiety. therefore, robotic devices can be regarded as having the potential to enhance the quality of care, thus decreasing women’s anxiety about moving their relatives into institutionalized settings. the interviewees felt that robotic care would improve care provision overall, and it gave them reassurance about remaining employed and pursuing their careers. as i argue elsewhere, the perceived robotic agency in social robots such as pepper is exactly what the developers are aiming for when they model these robots after people: http://anthro-age.pitt.edu/ aronsson | 26 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu “rather than seeing in the computer the model of the human mind, social robotics uses human social and cognitive competences as a model for the social and cognitive performances of artificial social agents” (damiano and dumouchel 2018, 3 quoted in aronsson and holm 2020). behind the unthreatening exterior of pepper is an emotionless machine whose functions are based on sophisticated algorithms that evoke various feelings and responses in people (aronsson and holm 2020). notably, this process appears to work because people are fond of pepper and enjoy interacting with it—as seen in the cases of rintaro and eriko among others (aronsson and holm 2020; white 2018). as for service robots, even though rintaro had positive experiences with hug and natsuki expressed an interest in having a robotic device at home for her mother, these devices, as i will argue in the next sections, tend to generate anxiety among elders and even more in their family members. the ”cold” touch: robots exacerbating anxieties about elder care late one evening, mayumi (aged 47), the managing director at an investment bank, was going through the tasks she needed to accomplish in the week ahead. these included preparing meetings, writing a client report, and submitting human resource evaluation forms from her team members. she also had to find time to look after her mother-in-law, tamako (aged 89). her husband was the eldest of four sons, and as traditional japanese values dictate, his wife was obligated to look after her in-laws (see also long 2008; long et al. 2009). mayumi’s father-in-law had passed away several years earlier, and she considered it her obligation to take care of her mother-in-law. her own parents remained independent and did not require care, but the impending necessity of caring for her own parents in the future, in addition to her mother-in-law who lived with mayumi and her husband, weighed heavily on her, causing her sleepless nights. at that time, mayumi’s daily schedule included looking after tamako early in the morning before leaving for work and caring for her again in the evening. tamako required a relatively low level of assistance because she could still manage her usual daily routines, such as going to the toilet, bathing, and eating on her own. nonetheless, she had begun to show signs of dementia, and mayumi started to feel the burden of her obligation as tamako slowly became less independent. mayumi developed a sleeping disorder, and her work also became more of a burden. at times, she feared that she was beginning to suffer from burnout because her resilience, the source of the inherent energy that she could always rely on, had started to decline. in her interview, mayumi confided that she had spoken with her husband about this, assuring him that she would prioritize tamako over her work, but she wanted to be respectful. mayumi feels confused about her own feelings and she would prefer not to give up her job only to provide care for her mother-in-law at home since she worked hard to establish a career. she also thinks about her own aging parents and is overcome with anxiety since she is an only child. i could not send them to a nursing home and choose to look after tamako instead; it would break me. so far, tamako is still quite independent, but she has been showing signs of dementia, and at some point, she will need help with basic tasks, like going to the toilet and taking a shower. i am now living with the constant fear that this situation will come sooner than expected, and then what? i would have to quit my job since, at my stage, i cannot work part time. but what is the point of working to get where i am now and then just giving it up? maybe, in the beginning, i could look after tamako, but once she requires more intensive care, i would look for other options and maybe put her in a nursing home. i know of friends who suffered burnout after years of elder care; the job is tough, both physically and mentally. these women endured, but there inevitably comes a breaking point. secretly, i have already checked out nursing homes to ease my anxiety but have not shared it with my husband yet. i feel so guilty about it, but why are we women even in this situation in the first place? (may 16, 2019) http://anthro-age.pitt.edu/ aronsson | 27 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu mayumi’s reflections on elder care are similar to those of the other women in this age group, who expressed a combination of uncertainty and fear, concerns about the lack of institutionalized care, and worries about putting aging parents and in-laws in nursing homes. i met mayumi again later in 2019. tamako’s care situation had rapidly worsened, and she and her husband decided to move tamako into a private nursing home (in downtown tokyo) that provided robotic care in the form of both service and social robots. “you know, from the beginning, i was hesitant to have tamako taken care of by ‘artificial hands.’ it felt unnatural and cold to me. but then i saw the device that lifted tamako in and out of the bathtub. she didn’t complain, and she seemed in no pain or discomfort, but i felt this guilt resurfacing. i felt so lonely when i saw this” (september 17, 2019). as for the social robot group activation exercise, tamako seemingly enjoyed the activity with the humanoid robot palro, but she was more hesitant to participate in following along in physical exercise and singalongs. “one of the caregivers told me that my mother did not follow the exercises,” mayumi explained, “and one day i witnessed the interaction. i must say, what i saw was both encouraging and frightening at the same time. tamako cannot articulate how she feels about palro, but i find singing along with a robot less troublesome than being lifted in and out of bed” (august 26, 2020). when i asked her why, mayumi replied that even though service robots were adopted in nursing homes prior to the introduction of social robots, the latter seem more technologically advanced and, because of their friendly demeanors and gentle gestures, they appear less “cold” than the former, which only emulate human mechanical functions. three other interviewees were similarly skeptical and uncomfortable over the use of robotic devices in care work. their doubts and heightened anxiety over using technological assistance in institutional care were even causing them to question their career choices. hanako (aged 54) made her concerns clear: “i feel inadequate. i was taken care of by my parents, and now, i not only rely on institutional care, but my mother is also a guinea pig of robotic care devices. it makes me even more stressed out as i feel guilty about my life choices” (september 17, 2019). a few months later, she said, “i think these devices do not improve care. they actually decrease the quality of care. in an automobile factory, you can have a robot assemble a car. but care work is intimate; nothing overrides human care” (december 2, 2019). other interviewees perceived robotic care as “cold care” rather than the “warm care” (parks 2010; pols 2012; pols and moser 2009) provided by human caregivers. in other words, these women and their charges seemed to perceive care robots as “cold,” “mechanical,” and generally inferior to humans. their reservations were leading to a particular strain of anxiety over the idea that robotic care is undignified and a poor replacement for human care. the deep-seated anxiety these professional women experienced had to do with the conflict between caring for aged relatives and fulfilling their professional obligations. the interviewees described feeling torn between their career obligations, which felt self-indulgent, and their socially based obligations to their older relatives. this conflict reveals the lack of a straightforward solution to this problem because institutionalized care remains unconventional in japan, despite its increasing availability and the lower levels of social stigma now attached to it (yamato 2006). furthermore, this type of care is now increasingly enhanced through the use of robotic care devices in both nursing homes and, to a lesser extent, private homes (hatano 2018; ishiguro 2018; robertson 2018; šabanovic 2010; wright 2018). more research is needed to understand the introduction and use of these devices in noninstitutionalized settings, where guidance and surveillance involve more coercion.14 robotic elder care as a way out of anxiety http://anthro-age.pitt.edu/ aronsson | 28 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu changing norms affect all aspects of the social fabric, including the social roles of the elderly and those who care for them. the interviewees reflected on the role of family caregiver as one that had become diminished and less clearly defined in modern japan. as such, they tended to perceive themselves as having been placed in “role-less roles” (burgess 1960). in addition to the issue of changing and blurred social roles, caregiving is associated with isolation, fear of losing one’s purpose in life, and a loss of freedom. the strong grip this issue has on people’s minds has to do with its tangible presence in modern japanese society and its correlation with several deep existential questions the country faces. the larger and most acute question for society is how to care for a growing aging population in the face of a declining workforce. however, on the level of individual caregivers, the primary issue is how to address anxieties over the ability to live a good life while still ensuring that their elders receive good care. a possible way to address family caregivers’ anxieties over the use of technologies to care for the elderly is to examine the levels of anxiety associated with the use of service and social robots. robotic devices can be viewed as part of a package of solutions that could potentially help japanese women make decisions regarding their lives, careers, and caregiving obligations. solutions of this kind expand the available range of public care services and nursing home facilities available and serve as options for a society dealing with increased dependency while also adjusting to new norms around women’s roles in the workforce. exploring care robots and anxiety over their use as intertwined concepts underlines an important aspect of what it means to lead a good life in japan: caring for aging relatives is a central value for the majority of people of all generations. understanding caregivers’ anxieties on an individual level first entails recognizing the values that individuals believe are under threat.15 the interviewees in this study valued their careers and social status, and they expressed concerns that these were under threat because of their expected role as caregivers. their anxieties also related to a general sense of insecurity connected to japan’s general reevaluation of its core values and direction, a source of unease across the society. as the ethnographic vignettes illustrate, robots have the potential to both alleviate and increase anxiety among those in need of care, their families, and their caregivers. as a result, the introduction of new technologies is associated with both anxiety over the failure to fulfill caregiving roles and the expectation of improving lives and relieving people of some of the indignities of aging. in the case of professional women, although the introduction of care robots can help alleviate some feelings of anxiety, it may aggravate others by creating feelings of personal inadequacy. while technological innovations appear to have the potential to restore the status of both older adults and their family caregivers, it is too early in the use of such technologies to draw any firm conclusions. elder care could play a leading role in social change since technoliberal logics attach notions of freedom and feeling human to technological developments (atanasoski and kalindi 2019, 407). thus, robot-assisted care might help working women continue to pursue their careers, certain in the knowledge that their relatives are receiving the best care possible, and if these devices are used in private homes, they may allow the elderly to continue living autonomously for a longer period. confronting the personal and societal anxieties and insecurities around the use of robotic care devices might lead to the creation of clearer social roles that can remove the burden of caregiving from the shoulders of women alone. nevertheless, critics argue that robots and ai-assisted technological devices cannot meet the deep human need for genuine contact with other human beings. in other words, robotic devices can only provide “shallow care” (coeckelbergh 2010, 182), and even the most sophisticated robot cannot provide the kind of authentic, honest, human relationship that older people need to thrive. however, advancements in intelligent machine technology are redefining how people interact with technology (aronsson and holm 2020; lukács 2020), and as anthropomorphic robots proliferate, growing numbers http://anthro-age.pitt.edu/ aronsson | 29 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu of people in japan are becoming emotionally attached to these machines. as the availability of sophisticated electronic devices continues to increase, this phenomenon will likely expand in japan and globally. social robots such as pepper16 currently cannot act based on either inner states or outward expressions, and service robots such as hug can only emulate the mechanics of human movements. indeed, these machines highlight new epistemic possibilities for caregiving that are in contrast to actual human companionship and care work, which is widely considered a more authentic experience. but as robotic care devices become more accurate in simulating the semantics and gestures of human interaction, people might begin to accept their authenticity in the same way that they accept the idea that their human partners are emotionally devoted to their well-being. those receiving care might be just as likely to question the sincerity of those offering care out of a sense of duty as they are to believe in the sincerity of social robots (aronsson 2020). furthermore, the interviews uncovered another crucial aspect of anxiety over using technological devices for elder care: a comparison of the 2019 interviews with those from 2009, when social robots had not yet been introduced, revealed that much of the anxiety around care technologies focuses on the use of service robots. although one might expect the newer technology, social robots, to be the source of the most anxiety among professional women who find themselves responsible for the care of older relatives, this study found the opposite to be true. care robots step in to function as surrogates for humans in labor and social contexts, enabling the formation and consolidation of neoliberal subjects—in this case, japanese professional women—whose freedom is only made possible through the gendered unfreedom of the surrogate, the robotic device (atanasoski and kalindi 2019, 188). in their current stage of development, robots might contribute to feelings of anxiety over the adequacy of the care they provide; however, over time, robot imaginaries might become increasingly accepted since technological objects comprise a “shorthand for what the future should look like [as they] inherit liberalism’s version of an aspirational humanity such that technology now mediates the freedom–unfreedom dynamic that has structured liberal futurity” (atanasoski and kalindi 2019, 377–378). as demonstrated here, the use of social robots proved helpful in alleviating anxieties associated with balancing careers and a caretaking role, while service robots tended to exacerbate these anxieties. nevertheless, more research is needed to determine whether this distinction holds over time in connection with changes in technologies, such as the possibility of new technologies that combine the roles and abilities of service and social robots to overcome distrust over “cold care.” notes 1. see also robertson (2007) on household robots that are imagined to serve as surrogate housewives. 2. for media reporting on this change, see <https://www.nytimes.com/2018/12/07/world/asia/japan-parliamentforeign-workers.html> and <https://www.washingtonpost.com/world/2021/11/18/japan-labor-shortageimmigration/> 3. the ministry of economy, trade, and industry is promoting development of care robots and has provided 4.7 billion yen (usd 45 million) in subsidies since 2015. the labor ministry has spearheaded the spread of robots and in 2017 introduced them into 5,000 facilities nationwide at a cost of 5.2 billion yen (usd 50 million). there is no government data on how many care facilities use robots. the robotic therapy seal paro costs 400,000 yen (usd 3,800) in japan and about eur 5,000 in europe. panasonic’s robotic resyone bed costs 900,000 yen (usd 8,600), and cyberdyne’s hybrid assistive limb (hal) exoskeleton costs 100,000 yen (usd 950) a month to rent. http://anthro-age.pitt.edu/ https://www.nytimes.com/2018/12/07/world/asia/japan-parliament-foreign-workers.html https://www.nytimes.com/2018/12/07/world/asia/japan-parliament-foreign-workers.html aronsson | 30 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu 4. even though technoliberalism connects technological development to a future-oriented humanity in which gender, race, and labor might be overcome, this ideology hides the way it operates through a hidden grammar, that which atanasoski and vora (2019) term the “surrogate human effect.” 5. as james wright (2018) writes, care workers often complain of back pain related to their job’s “3 k” conditions (kitsui, kitanai, kiken: difficult, dirty, and dangerous). 6. bed sensors (mimamori) are widely used throughout nursing homes in japan. especially in the evenings, when nursing homes tend to be understaffed, bed sensors help care workers to complete their work. a hug robot costs 1.44 million yen (usd 12,700) over five years (see also wright 2018), and cyberdyne’s lumbar device costs 158,400 yen (usd 1,400) to rent for three months. 7. the concept of the japanese-style welfare society was developed by policy advisors close to prime minister masayoshi ōhira during his administration (1978-1980). as ito peng (2003) explains, in the 1990s, the japanesestyle welfare society became increasingly incompatible with the reality of japanese family life. given the decline in multi-generational households and the increase in the number of elderly people living alone or with only their spouses, japanese families were in the process of “defamilializing,” contrary to the rhetoric of the japanese-style welfare society. thus, the combination of demographic aging and changes in gender relationships significantly affected shifting understandings of social care and the role of civil society in social policy development. 8. even in japan, individuals living in disadvantaged neighborhoods—characterized by an increased level of poverty—might be associated with weaker social ties, reduced physical activity, health problems, mobility limitations, increased levels of stress, and problems accessing health care. 9. between 1950 and 1975, japan’s working-age population increased from 50 to 75 million before peaking at 87 million in 1995. since then, it has decreased by 1 percent per year, a pattern typical of an aging society (ministry of health, labor, and welfare 2018). between 1970 and 2000, the life expectancy rate at retirement increased by one third for both japanese men and women. in comparison, in 1935, only one third of japanese people survived to reach the retirement age of 65. the average life expectancy at birth has steadily increased and is now approximately 88 years. by 2010, 30 million (23 percent) of japan’s 127.5 million citizens were over the age of 65, while the fertility rate was only 1.2, making japan the most aging country in the world. by 2050, more than one third of the japanese population is projected to be 65 years or older (coulmas and lützeler 2011). this population pyramid is unprecedented (hirayama 2010). japan’s working population must pay increasingly higher taxes to support the growing elderly population, and by 2030, japan’s working population is predicted to be only 67 million (fujita 2015; hamada and kato 2007). 10. it is not uncommon for professional women in japan, china, hong kong, and korea to hire someone to clean their homes once or twice a week or to have part-time help with older relatives living at home. 11. see also wright (2018) in his discussion on tactile care and robot hug, “[t]he moment of lifting and being lifted can reveal physical discomfort as well as fear of inflicting or receiving injury for both carer and resident, particularly if someone either is not used to the operation or if the carer doubts his or her own strength” (8). 12. for more information about pepper see <https://www.softbankrobotics.com/emea/en/pepper> 13. four of these six had close relatives (a mother, father, or spouse) in nursing homes, and they were all relatively accepting of robotic care devices. 14. as i have discussed elsewhere (aronsson and holm 2020), in a group activity with the social robot palro, some residents required no additional encouragement to interact with the robot, while others required ongoing caregiver work to motivate them to interact and participate in the activities. 15. as i argue elsewhere, the elderly are less accustomed to using technological devices to substitute for in-person interactions than the younger generation. detrimental effects of these devices on the elderly may therefore be hard to assess (aronsson and holm 2020). 16. although sincerity in delivering care and companionship is something social robots merely perform, that does not rule out their ability to positively impact humans. humans are accustomed to pretense in their daily interactions and know how to treat expressed feelings as genuine in order to maintain social relations (goffman http://anthro-age.pitt.edu/ https://www.softbankrobotics.com/emea/en/pepper aronsson | 31 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.360 http://anthro-age.pitt.edu 1969). humans’ capacity to restore failed or imperfect presentations of the self by others may be at the root of accepting machines as intentional caregivers, despite knowing that these are machines programmed to act as if they care. references aronsson, anne stefanie. 2020. “social robots in elderly care: the turn toward emotional machines in contemporary japan,” in special issue “relations, entanglements, and enmeshments of humans and things: a materiality perspective.” japanese review of cultural anthropology 21(1): 421–455. https://www.jstage.jst.go.jp/article/jrca/21/1/21_421/_pdf aronsson, anne stefanie, and fynn holm. 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isolated from the outside world due to a lack of resources and because of cultural constraints. on january 22, 2020, the first confirmed case of covid-19 in taiwan was discovered. as of october 23, 2022, 7,476,478 confirmed cases have been reported; of these, only 64,298 were in taitung county, making it the region with the fewest cases in taiwan. in this ethnographic study, i visited indigenous tribes in taiwan that were less affected during the pandemic, conducted indepth interviews with tribal-care providers, and collected secondary data from reports and social media regarding pandemic prevention on tribes in taitung county. i also explored the difficulties created by the suspension of tribal-care services due to pandemic-related social distancing and isolation measures, and how care providers overcame these challenges. covid-19 is not the first and nor will it be the last virus to threaten humans. thus, it is important to gain insight into how care networks and connections were rebuilt through innovative measures that enabled tribal elders to receive culturally sensitive care and maintain their health during the pandemic. keywords: covid-19 pandemic; indigenous tribes; social networks; taiwan anthropology & aging, vol 43, no 2 (2022), pp. 67-78 issn 2374-2267(online) doi 10.5195/aa.2022.410 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:tammyliu@nttu.edu.tw liu | 67 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu reconstructing social networks and connections in indigenous tribes: an analysis of countermeasures to covid-19 among rural tribes in taiwan li-chuan liu tammyliu@nttu.edu.tw department of public and cultural affairs, national taitung university introduction since the first outbreak of covid-19 in december 2019, numerous countries have experienced waves of outbreaks and implemented various preventative measures in response. in general, physical distancing, isolation, and lockdowns have been the most effective measures to prevent the virus from spreading. “lockdown” is an emergency protocol that prevents the general public from freely moving from one area to another. “complete lockdown” further means that people should stay where they currently are, and no entry/exit movements are allowed. thus, lockdowns can be both a preventive and an emergency strategy to save the lives of vulnerable or at-risk people (grover et al. 2020). however, these measures have had social, economic, and political effects, and have led to stagnation. employees began to work from home and contact their co-workers through digital technologies such as videoconferencing. for older adults without digital competencies and/or access to technology, social distancing and home isolation have meant isolation from everyone except their family; this in turn may change their lifestyle, decrease their access to social support, and strain social ties. as a result, some older adults, who should enjoy their lives in place, begun to experience loneliness, which can lead to an increased risk of death (chang 2022); these problems may be even greater for older adults living in tribes. since the pandemic was first declared, some medical and anthropological studies have suggested that older adults in rural areas in the us and belgium may be more vulnerable and less financially solvent and that they often lack resources, which may exacerbate the challenges created by the covid-19 pandemic (verbruggen, howell, and simmons 2020; williams and mattos 2021). various rural tribes in mexico (de león-martínez et al. 2020) could not respond to and prepare for the pandemic because they lacked knowledge about the virus, infrastructure (e.g., water), and network resources, and experienced language barriers. as other qualitative studies have indicated (kaplan et al. 2020; suratana et al. 2021), they were forced to comply with the prevention, control, and lockdown policies implemented in their countries, which isolated many older tribal members from the outside world, thereby threatening their health. on january 22, 2020, the first case of covid-19 was confirmed in taiwan. as of october 23, 2022, 7,476,478 confirmed cases have been reported, of which only 64,298 were in taitung county, making it the region with the fewest cases in taiwan. in this ethnographic study, i visited remote indigenous tribes in eastern taiwan and investigated their community-care practices using in-depth interviews, ethnographic observations, and data analysis to determine whether the tribes’ core social networks were being weakened due to the pandemic—and to what effect—and to understand how certain measures prevented the pandemic from reaching the tribes. this report is based on qualitative interviews and observations conducted with care providers working with these tribes. i explore the http://anthro-age.pitt.edu/ mailto:tammyliu@nttu.edu.tw liu | 68 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu social implications of these effects and offer policy recommendations to address the isolation that many rural elders may experience due to climate change, natural disasters, epidemics, and other unprecedented and unforeseen events (verbruggen 2020). taitung county: historical-social context and its people as humans live longer, growth in the number of older adults worldwide is unprecedented. taitung county is a rural area located in eastern taiwan. it also known as ‘back mountain,’ which means that taitung county lags far behind other areas in all aspects of its development. in 2021, the population of taitung was 213,386 people, 16.65% of the taitung population was 65 years or older, which is higher than the average in taiwan. moreover, the average life expectancy (75.79 years) is the lowest in taiwan (lee et al. 2021). one-third of the population of taitung is indigenous (about 78,463 people), and there were 23,186 indigenous adults over 55 years of age. taitung has the highest proportion of indigenous people of any county in taiwan (council of indigenous peoples 2022a). there are seven ethnic groups (e.g., the amis, puyuma, bunun, tao, paiwan, rukai, and kavalan) and 183 tribes (liu, kuo, and lin 2018). the indigenous culture has been well preserved within the county because taitung developed relatively late. among the 16 townships in taitung, only one has no indigenous people (green island township), and the remaining 15 have indigenous tribes (taitung county government 2022). figure 1. map of taitung county (council of indigenous peoples. 2022b. https://www.cip.gov.tw/en/village/info.html?vid=d199ec951076fa3b&cumid=ca8286a69511c172) this drew my attention because taitung is a rural area, and about one-third of the residents are http://anthro-age.pitt.edu/ https://www.cip.gov.tw/en/village/info.html?vid=d199ec951076fa3b&cumid=ca8286a69511c172 liu | 69 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu indigenous; they are associated with relatively high levels of physical activity when compared with residents in other urban areas (wu et al. 2016). since 2015, the council of indigenous peoples in taiwan provides services that combine indigenous culture with elements from the local environment. these services integrate culture and health in one location, hence the name “culture and health station.” the indigenous culture and health stations (referred to as ich stations in the following) are funded by the taiwanese government together with local social-welfare groups, religious groups, and non-profit organizations to jointly provide services for the local tribal elders (han 2019). through the establishment of these stations, the local service network and professional organizations can be connected; this integrates the local service capacities and various resources (huang 2020). the ich stations support the daily life of indigenous older adults, including care visits, telephone greetings, consultations and care-service referrals, meal delivery, and spiritual, cultural, and healthpromotion services. these stations integrate eldercare, long-term care, after-school care and child care, and try to strengthen the care service and support systems for indigenous peoples and ensure that indigenous elders receive appropriate services and daily care (council of indigenous peoples 2020, 2021). as of january 2022, there are 433 ich stations in taiwan and 103 stations in taitung, which accounts for about 23.8% of all ich stations. under the indigenous policy, the ich station provides full-day services to support healthy aging in place (fang and liao 2021). many medical and anthropological studies indicate that taking cultural perspectives into account is an important factor in caring for older tribal adults (anderson et al. 2020; kirmayer, simpson, and cargo 2003; liu 2021; weaver 2004). the ich stations are a platform for providing services, promoting healthcare, and optimizing the service network for indigenous older adults. on the basis of this literature and taitung’s experience with indigenous tribes, i wanted to investigate how the tribes responded to covid-19, prevented the virus from entering their communities, and thus protected the people of taitung county materials and methods research framework and methods this report is not focused on the interviews with elders, but interviews with the care providers. i adopted two research methods. first, i recruited the tribes’ eldercare providers and, through videoconferencing, conducted in-depth qualitative interviews from june to august 2021. before the interviews, i directly contacted the person in charge of ich stations, invited and informed them of the purpose and topic of the interview, and received their consent. the main topics were the effects of the pandemic on eldercare, and how care providers responded. second, i collected secondary data from reports on pandemic prevention in tribes and social networks to understand the challenges to providing care, how the care system was adjusted, and the new methods adopted in response to the covid-19 pandemic. i also conducted participant observations, where i shadowed the service providers as they cared for indigenous older adults in order to gain insight into the process of careservice provision from january 2020 when the first covid-19 case was confirmed in taiwan. research participants and contents the goal of observing the interactions between the care providers and indigenous older adults was to understand how services were provided during this period. i conducted in-depth interviews with the care providers using semi-structured questionnaires to collect comprehensive data on the challenges they may experience, how they deal with them, and what they think would improve the process. the three main questions were: (1) “what are your challenges during the covid-19 pandemic?”; (2) http://anthro-age.pitt.edu/ liu | 70 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu “how do you cope with these challenges?”; and (3) “what suggestions do you have for the care process?” table 1 shows information about each interviewee. all five of the care providers i interviewed were women age 32 or above. four of the interviewees had a senior high school-level or junior college-level education. only two of the interviewees were not married. each of the five interviewees had no more than six years of experience as a care provider. table 1 interviewees’ demographics – care service providers code sex age (years) education marital status experience as care provider (years) a f 48 junior college married 3.5 b f 43 senior high school unmarried 1.5 c f 36 senior high school married 2 d f 32 university unmarried 4 e f 56 junior college married 6 findings challenges for care providers during the covid-19 pandemic eldercare in taiwan is mainly provided through community care and long-term care facilities. the community-care model offers various services (e.g., physical activity, nutrition, social support, and long-term care) through institutions such as the ich stations. an important feature of these facilities is that all of the care providers are indigenous; this ensures that the recipients and providers of care share the same cultural background. as i learned from my interviews with care providers at the ich station in taitung, the suspension of services at these stations during the pandemic strongly affected the tribal elders. elders felt disconnected from other tribal people because of the emigration of young people from taitung, most tribal elders live alone and rely on care from relatives and the community. due to the pandemic, many tribal people and the relatives of tribal elders who were heavily involved in tribal affairs and the ich stations were cut off from each other. without opportunities for interaction and communication, the tribal elders stayed home for long periods, which changed their everyday routines. with less social interaction, some elders began to experience depression and loneliness, which can negatively affect health (chang 2022; de leónmartínez et al. 2020; kaplan et al. 2020; suratana et al. 2021). the care providers described: the daily lives of tribal elders have changed. they have lost their focus and conversational partners, and they have no social lives [less language stimulation, cognitive activity, and muscle movement], which makes them lonely and accelerates aging. (a) in the tribes, few families took care of the elders. without a place to go, the elders stayed home for a long time, which made them depressed. (c) http://anthro-age.pitt.edu/ liu | 71 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu weddings, funerals, and the harvest festival are major events in tribes and not being able to attend made the elders feel lost. the restrictions on going to church and other religious sites deprived them of their spiritual outlets, which affected them emotionally. (b) the tribal elders had never taken classes over video, so keeping up their exercise habits was difficult. (d) because many tribal elders highly value social gatherings related to weddings, funerals, and religious events, the inability to attend such gatherings made them feel lost. in addition, because religion is a crucial part of their lives, they were distressed by the suspension of church services and other ceremonies. social isolation often leads to loneliness and depression, but it may be just the tip of the iceberg of harm (steinman, perry, and perissinotto 2020). in other words, reduced social activity and a lack of engagement with the outside world can worsen health and hasten cognitive decline in older adults. changes to routine daily activities and schedule a major function of the ich stations is to offer activities that can help indigenous elders maintain their physical fitness. however, these daily health and physical activities were suspended during the pandemic, which made it difficult for the elders to maintain their musculature and health. inadequate musculature can negatively affect balance and movement, which increases the risk of falls. the elders who lost muscle strength may have a higher risk of falling at home. (c) the care providers couldn’t monitor the elders’ health problems and medication use because of lack of regular physiological assessments. (e) furthermore, eating meals together is typically a daily routine that enables the elders to interact, and the meals are nutritionally balanced. when the ich stations were temporarily closed due to the pandemic, meals were instead delivered to individuals at home. however, maintaining food supplies and meal services was a challenge, and the risk of a supply shortage remained. this also made it difficult for the elders to consume a regular diet of healthful meals. during the epidemic, due to the shutdown of the ich station, the daily meal schedule was interrupted. (b) according to these interviews with the care providers, tribal elders may decline due to a lack of activity and proper nutrition. thus, decision-makers within the government and service providers should pay attention to the inequality within society and ethnic groups. from the perspective of ‘vulnerability,’ it is necessary to consider why indigenous peoples bear higher risks (huang 2020). lack of knowledge regarding pandemic prevention, medication, and assistance for medical treatment most of the indigenous elders had chronic diseases. but helping them visit physicians, fill prescriptions, and take the proper medicine was challenging during the pandemic. informing the elders about pandemic prevention was also crucial to maintaining their health. the care providers described: when elders who lived alone or did not have a phone required help, we couldn’t help them immediately because we couldn’t visit them. (a) http://anthro-age.pitt.edu/ liu | 72 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu the elders felt isolated, and they were embarrassed to ask for help because we didn’t see each other in person at the [ich] stations. (e) most research suggests that there was a lack of knowledge about infection-prevention measures for covid-19 during the first months of the pandemic. in this early stage, knowing that specific treatment and prevention options, such as targeted antiviral drugs and vaccines, were not yet available for covid-19 (yoshito et al. 2021; wu and mcgoogan 2020). therefore, service providers and caregivers had a general lack of knowledge regarding pandemic prevention, medication, and assistance for medical treatment. transformation and innovation of social networks and connections since march 11, 2020, when the world health organization declared the novel coronavirus (covid19) outbreak to be a global pandemic, governments worldwide have requested that citizens avoid unnecessary activities such as taking public transportation, participating in group events, and travelling, and have encouraged them to stay at home in response to the spread of covid-19. with the increase in cases and subsequent waves of infection, the end of the pandemic has become unpredictable, and the virus may become a part of daily life. as a result, lifestyles must change to live comfortably with covid-19 (suzuki 2020). based on my interviews on pandemic-prevention measures worldwide, in the following sections, i propose a method of rebuilding the networks and connections that were disrupted by the pandemic in order to ensure age-friendly care. strengthening communities and tribes, cooperating to care for elders although social distancing and isolation have been highly effective preventative measures worldwide, they preclude the provision of external assistance. as a result, the rural tribes in taitung county relied on the integrated strength of individuals, communities, and local institutions to prevent the spread of the covid-19 virus. for example, volunteers and tribal members measured body temperatures and sanitized the hands of visitors. when cases of infection were identified, village-wide screening was conducted through the cooperation of township offices, district public health centre community development associations, tribal youth unions, volunteer teams, and other groups. with regards to social connections and support, care providers from the community care centres and ich stations called the elders and interacted with them during meal delivery to evaluate their health condition and prevent them from feeling depressed or lost because of a lack of social interaction. as such, the eldercare network that had been dismantled by the pandemic was rebuilt through cooperation among community-care centres, ich stations, community residents, and members of the tribes. the strengths of the local government, community institutions, and tribes were leveraged to create a virus protection network to ensure the health and safety of the tribal elders. taking care of older adults by considering their culture the tribes themselves adopted several health-care practices to prevent infection; the care providers and volunteers evaluated the elders’ physical and mental conditions, identified problems related to medication, and reminded the elders of the virus-prevention regulations and practices through phone calls and home visits; this information was conveyed so that the elders could easily understand. for example, the regulations were translated into their tribe’s language, and posters were created with information written in large, easy-to-read fonts. images 1-2 show that different tribes used their tribe’s language to teach older adults how to protect themselves. image 1 is a poster for an amis tribe: “1. ano masadak kita ci tangoyosan/ tamokis” http://anthro-age.pitt.edu/ liu | 73 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu means “remember to wear a mask when you go out,” and “7. sungilaen/ halafineng a mananaw to kamay” means “wash your hands thoroughly for longer than 20 seconds.” image 2 shows a poster from a paiwan tribe: “pasusu ta ljinulesan a pinatatide tidean na caucau” means “maintain social distance,” and “nakuya matevetavel itjen asematalidu ta wma” means “avoid group activities.” these posters helped older adults understand more about covid-19, and ultimately served to protect them. image 1. pandemic prevention regulations in a’tolan amis. courtesy: li-hsien wang image 2. pandemic prevention regulations for a paiwan tribe. courtesy: li-hsien wang beside this, foods believed to have antiviral properties (e.g., onions, ginger, and chinese scallion) were collected in the tribes and added to meals. the tribal chiefs played music for cardiovascular exercise throughout the villages to encourage the elders to leave their homes and exercise. helping older adults stay physically active during the pandemic as mentioned above, most daily health and physical activities were suspended due to the pandemic, which made it difficult for the elders to maintain their musculature and overall health. care providers were assigned to help the elders exercise and perform simple activities. they brought bowling and ball equipment to the elders’ homes and played games with the elders to help them to engage in daily physical activities (see images 3 and 4). http://anthro-age.pitt.edu/ liu | 74 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu images 3 and 4. care providers playing bowling and ball games with elders in their homes during covid-19. courtesy: shu-ping liao several services were also offered during meal delivery; e.g., in order to maintain elders’ hand function, arts-and-crafts kits were delivered along with the meals. the care providers explained the crafts and arranged a date to collect the result; this was an example of suspending classes but not the learning process. using technology to help older adults stay healthy during the covid-19 pandemic, technology became an important tool for communication. first, care providers taught the indigenous elders how to use the technology so they could connect with service providers, relatives, friends, and other people. care providers also used technology to teach the elders how to use covid-19 rapid antigen tests, and how to keep exercising every day (see images 5 and 6). images 5 and 6. care provider used technology to help tribal elders maintain their health. courtesy: hsiao-chun hsu http://anthro-age.pitt.edu/ liu | 75 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu discussion: rebuilt tribal networks and connection during the covid-19 pandemic social connection creates a sense of belonging and enhances relationships with family members, friends, and neighbours; such relationships can even be established through volunteer work and community service. these connections are a source of happiness and support for many people. however, when individuals are disconnected from others, they may become socially isolated (wildevuur et al. 2013). because covid-19 is highly transmissible, especially in cases of frequent and long interpersonal interaction (cdc 2021), social distancing, isolation, and lockdowns have been the main countermeasures implemented worldwide during the pandemic. providing eldercare in this context without the required resources is thus a considerable challenge. the inability to provide eldercare as well as insufficiencies in terms of service providers, space, and materials during the pandemic have exacerbated health problems for many older adults and increased the risk of death (verbruggen 2020). an example of disconnect between service providers and care recipients and their families during the pandemic occurred at the life care centre in kirkland, washington, us, in february 2020. approximately 43 individuals died from covid-19 at the facility, which was locked down soon after the first confirmed case was reported. the countermeasures to the cluster infection in the community created physical and mental stress and were opposed by the care recipients’ families. similarly, on may 11, 2021, taiwan’s central epidemic command center (cecc) announced that visits to people staying at hospitals and long-term care facilities would be banned and only one family member would be allowed to enter the facility for accompany older adults or resident. this prevented the spread of the virus yet prevented interaction and connection between older adults and their families, which strongly affected their mental health. for remote indigenous tribes, a lack of resources has challenged their lifestyles and increased health disparities. during the pandemic, the tribal environment negatively affected older adults’ health, making them more vulnerable to covid-19 and its associated complications, which led to an increase of deaths (da silva et al. 2021; williams and mattos 2021). manderson and levine (2000) studied a tribe in south africa and revealed that isolation and distance from family members created loneliness and fear among the elder members, some of whom died because of a lack of proper care. in some indigenous mexican tribes, the community environment, lack of water, language barriers, and pollution had threatened members’ health and the tribal environment before the pandemic began. after the pandemic began, cultural traditions, such as group living and sharing daily necessities, facilitated the spread of covid-19 (de león-martínez et al. 2020). in another case, kaplan et al. (2020) discovered that, in bolivia, where half the population is indigenous, tribal sovereignty is crucial because it allows tribes to make decisions about food production and other needs. their study indicates that strong food-production capacities may have accelerated recovery and prevented deaths during quarantine. furthermore, suratana et al. (2021) conducted qualitative interviews to examine how tribal villagers in mae fah laung, chiang rai province, thailand, adapted to covid-19. their study revealed that the adaptation process was comprised of six phases: (1) feeling shock due to a lack of experience, (2) seeking help from health agencies and other groups, (3) considering adopting mainland thailand’s lockdown policy, (4) complying with preventative and control measures, (5) reducing stress and following new norms, and (6) solving problems at home and elsewhere. through these steps, the tribe began to gradually adapt to the pandemic. in summary, the most significant effects of the pandemic on the tribal elders in taitung county were the suspension of social events and feeling disconnected from their community. therefore, providing http://anthro-age.pitt.edu/ liu | 76 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.410 http://anthro-age.pitt.edu social participation channels was essential. another challenge caused by the pandemic was the use of digital technological tools. many of the challenges of isolation were overcome through the use of technology; however, most of the elders were not familiar with the technological tools. to construct a social environment that could coexist with covid-19 viruses, prevent isolation, and create an agefriendly environment, elders should be familiarized with technological tools. therefore, it is important to ensure that communities are not isolated, can gather safely, and are not deprived of privacy. national governments should reconsider which spaces are conducive to living and working in order to promote improved well-being during public-health crises and enable interaction without technology (suzuki 2020). conclusion in this report, i have outlined how care providers in taitung county, taiwan, changed their way of working to provide health services to remote indigenous older adults during the covid-19 pandemic. this included translating countermeasures and regulations into their tribe’s language, creating posters with information written in large fonts, bringing bowling and ball equipment to elders’ homes to play games with them, helping them to maintain daily health and physical activities, and teaching older adults how to use digital technologies and covid-19 rapid antigen tests. all these approaches served one central purpose: to keep older indigenous adults connected to their family members, friends, neighbours and their communities, which had a strong positive effect on their mental health. history suggests that covid-19 is not the first nor will it be the last virus to threaten humans. however, the mutation of the virus represents an opportunity to determine how to prevent loss of life while continuing to maintain health, work, and engage in leisure and social activities. in some rural tribes, several aspects of the traditional culture have facilitated the spread of covid-19 (de leónmartínez et al. 2020). however, as i have discussed here, considering the local culture and using tribal wisdom to educate elders about infection prevention can help them combat viral threats. humans must learn and improve from their experiences to create systems equipped to face the future. amid global change, such as that caused by the covid-19 pandemic, it is necessary for societies to create and support age-friendly environments. acknowledgements this research would not have been possible without the financial support of the ministry of science and technology humanities innovation and social practice project. the project was titled “the djalan (“road”) and tjekeza (“bridge”) to local communities: cocreating the subjectivity of the south-link region” (ministry of science and technology 108-2420-h-143 -001 -hs1). this article presents partial results of the second subproject of project a: construction and transformation—from modern health care to traditional tribal cultural care. i also thank 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https://doi.org/10.1371/journal.pone.0252326 https://www.taitung.gov.tw/en/cp.aspx?n=15117 https://doi.org/10.5195/aa.2020.325 https://doi.org/10.5195/aa.2020.277 https://doi.org/10.1093/ppar/prab017 https://doi.org/10.1016/j.orcp.2015.08.009 https://doi.org/10.1001/jama.2020.2648 https://doi.org/10.1016/j.jjcc.2020.07.029 book review review of he, longtao and jagriti gangopadhyay, eds. eldercare issues in china and india. 2022. new york: routledge. pp. 250. price: $158 (hardcover); $36.5 (ebook). ashwin tripathi indian institute of technology gandhinagar ashwin.tripathi@iitgn.ac.in anthropology & aging, vol 44, no 1 (2023), pp. 121-123 issn 2374-2267 (online) doi 10.5195/aa.2023.466 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | tripathi | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.466 http://anthro-age.pitt.edu 121 book review review of he, longtao and jagriti gangopadhyay, eds. eldercare issues in china and india. 2022. new york: routledge. pp. 250. price: $158 (hardcover); $36.5 (ebook). ashwin tripathi indian institute of technology gandhinagar ashwin.tripathi@iitgn.ac.in this edited volume highlights the topical issue of eldercare in india and china. the pairing of both countries in this volume is of course no coincidence; both countries have experienced rapid population aging and massive socio-cultural and political transitions that provide an interesting ground for analysis. these changes are here theorized through the lenses of family studies, sociology, and social gerontology, and empirical evidence is presented through concepts of social security, need for care(ing), family networks and the lack thereof. the chapters knit together similarities and differences in cultural ideals of filial piety towards older people in india and china and re-instate the challenges of health infrastructures and social care in both countries. they are grouped in five thematic sections: “eldercare and filial piety” (section 1), “family care for elders” (section 2), “institutionalized and formal elder care” (section 3), “care issues of marginalized elder groups” (section 4), and “eldercare research” (section 5). in the introductory chapter (chapter 1) longtao he explicates the importance of care in aging societies. interestingly, both india and china have experienced the consequences of population growth – an unbalanced age structure, growing disease burden and insufficient institutional arrangements to cater to the needs of older adults. for example, it was 2009 before china introduced universal health insurance in the context of a national health care reform. along with providing factual information (e.g., policies, official statistics) to demonstrate the consequences of a complete lack of coverage of health expenses, the author also points towards the absence of social security in the indian context. the latter half of this introduction outlines the volume’s content and broadly lists various issues affecting the older population in both india and china, such as the lack of socio-political infrastructures for older adults, rapid population growth, family nuclearization, urbanization, neoliberal marketization and consumerist individualism, to name a few. opening section 1 on “eldercare and filial piety,” chapter 2 by marius meinhof and yiming zhang engages with the mechanisms of filial piety in chinese families, as practised through xiao, a chinese philosophical ideology. the authors argue that accounting for xiao is crucial to make sense of care in contemporary china. an interesting angle in this chapter shows how xiao is being depicted in state discourse, where it is mobilized to promote the larger civilizational project. the authors explore the changing relation between citizens and the state/country across different generations and through changing public consciousness. for this, they elevate the principle of parent-child relationship to a metaphor for social relations. interestingly, xiao also is being discussed as a pillar of the “imagined community” (anderson 1983) across diverse cultural traditions in china. filial piety is similarly http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.466 http://anthro-age.pitt.edu 122 discussed in chapter 3 by jagriti gangopadhyay (also the co-editor of this book) through a discussion of joint indian families (i.e., where multiple generations stay in the same household). there has been a dearth of research on filial piety and on multigenerational families in neoliberal india. through her work, the author provides an understanding of filial expectations between adult children and their parents from an indian city and re-emphasises the idea of obligation within indian families. in section 2, “family care for elders,” longtao he and han wu (chapter 4), present a comparative analysis of caregivers of elderly cancer patients in china and india. the chapter provides a detailed overview of the prisma technique used for article selection in a scoping review and compares caregiving experiences in china and india. although the analysis is rather minimal, additional information on this technique can be useful for scholars who plan to do scoping reviews in any discipline. in chapter 5 zhuopeng yu and boye fang discuss filial piety-based family care in chinese societies and its health impact on both caregivers and carereceivers. they find that filial piety-based care has a positive effect on both older adults who are cared for and their family caregivers: whereas the former experience increased life satisfaction, psychological wellbeing? and decreased loneliness, the latter enjoy affective intergenerational intimacy and develop strong ties with their carereceivers. however, this is only true for individuals and families who practice filial piety, which is generally challenging because of competing social values, role conflicts and role strain within and across families. in section 3, “institutionalised and formal eldercare,” fei peng, mang he and nuermaimaijiang kulaixi (chapter 6) explore the stigmatization of older chinese adults through nimbyism, or the “not in my backyard” (nimby) effect. on the one hand, the government has been developing strategies to actively manage an aging population through community-based eldercare, an innovative model that “bridges the individual limitation of home, community and institutional care and effectively integrates eldercare resources from within and around the society” (107). on the other hand, citizens seem to actively protest against these interventions by the government. this friction between traditional values of chinese filial piety and contemporary attitudes towards older adults signals changes in sentiments around filial piety. in chapter 7 saheli guha discusses the growing acceptance of old-age homes in kolkata as a consequence of the growing older adults’ markets. this has prompted the popularisation of neoliberal notions of aging and the redefinition of the post-retirement lives of indian older adults. in section 4, ketaki chowkhani (chapter 8) explores an interesting trope of aging alone and self-care. arguing against the idea there is only one cultural ideology of successful aging in the global south, the author re-instates the multiple possibilities of aging successfully, prospects that are gradually being covered through the growing third age literature in india (samanta 2021; tripathi and samanta 2022). in chapter 9, ji wu and xue qiu discuss the experience of carework among yet another marginalised section of the chinese population, namely older adults that lost their only child and end up caring for their grandchild(ren). in doing so they address impacts of the one-child policy in china. discussing this phenomenon through an understanding of sudden health shock, the authors elaborate on the everyday experiences of chinese older adults and how they carry out a multistage process of social adaptation after their loss. that is, grandparents heal themselves and develop resilience through raising their grandchildren and ultimately creating an identity for themselves as caregivers. the final section brings it all together by shedding light on the research aspect of eldercare research in both india and china. in chapter 10 dona ghosh draws attention to the paucity of data available on older indians. she presents a detailed description of existing microlevel datasets on health and aging in the indian subcontinent. this chapter provides information for anyone interested in available survey data on the older indian population. a concluding chapter by jagriti gangopadhyay further reemphasises the comparative lens adopted in the book. she revisits the major themes that are discussed http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.466 http://anthro-age.pitt.edu 123 throughout the volume, highlights the drawbacks of existing policies on aging and calls for the active engagement of academics and policy researchers in debates about eldercare issues. all in all, the book presents us with some extremely critical questions on eldercare in india and china, keeping in mind the contemporary changes experienced by both the countries. adopting a mixed method approach, the chapters present readers with a diverse sets of methodologies ranging from qualitative interviews to secondary analysis through prisma to mining of datasets. however, a serious shortcoming of this book, published in 2022, is that it does not in any way engage with the consequences of the pandemic on families and older adults. moreover, the book presents some very interesting empirical evidence but lacks critical engagement with the theories to substantiate the arguments. to a great extent the book offers a strong example of comparative analysis and meaningful contributions by scholars from diverse disciplines such as health sociology, anthropology, social work, and social gerontology. as a reader, i believe that discussion in chapter 1 would have benefitted from more critical engagement with the concrete changes (e.g., longevity, elder market, growing consumerism) that affect eldercare. similarly, chapter 5 would have benefitted from empirical evidence for the health effects of filial piety on caregivers. there are editing concerns in numerous places across chapters (e.g., spelling for ageing/aging, proofreading in page 115: second paragraph, to name a few). as a gerontology student, i kept wondering if the trope of cultural gerontology could have been useful here in elaborating on the everyday experiences of contemporary aging vis-à-vis the rapidly changing societies and social networks of care and in understanding the shifting expectations of caregivers and carereceivers in india and china. although there is often little connection or dialogue between the different chapters, this comparative endeavour is worth reading. references anderson, benedict. 1983. imagined communities: reflections on the origin and spread of nationalism. durham: duke university press. gilleard, chris, and paul higgs. 2015. “the cultural turn in gerontology.” in routledge handbook of cultural gerontology edited by julia twigg and wendy martin, 51-58. london: routledge. samanta, tannistha. 2021. “living solo at midlife: can the pandemic de-stigmatize living alone in india?”journal of aging studies 56. https://doi.org/10.1016/j.jaging.2020.100907 tripathi, ashwin, and tannistha samanta. 2022. “leisure as self-care in the times of the pandemic: insights from a time-use diary study in india.” leisure studies, 1-11. https://doi.org/10.1080/02614367.2022.2121415 http://anthro-age.pitt.edu/ https://doi.org/10.1016/j.jaging.2020.100907 https://doi.org/10.1080/02614367.2022.2121415 embodied aging: everyday body practices and later life identities among the south asian indian gujarati diaspora in canada anusmita devi laura hurd anusmita.devi@iitgn.ac.in laura.hurd@ubc.ca indian institute of technology gandhinagar the university of british columbia, vancouver tannistha samanta tannistha.samanta@flame.edu.in flame university abstract this study explores how south asian indian gujarati older adults in canada (greater vancouver area) strive to maintain personal continuity, citizenship, and selfhood through everyday body management practices (exercise/yoga, medication/health supplements, skin, and hair care routines) and cultural markers such as food, sartorial choices, and community engagement. this examination, we contend, is noteworthy against the backdrop of contemporary north american academic and popular discourses of a burgeoning consumerist movement around the medicalization of bodies and anti-aging technologies. drawing on in-depth qualitative interviews of 26 older adults, we discuss how growing old in the diaspora is marked with moral ambivalence between ‘successful aging’ and ‘aging gracefully.’ based on an inductive thematic analysis, we identify four major themes in how the older diaspora negotiate aging and reorganise their lives through changing social relations and shifting cultural institutions. the first theme is the growing salience of both bodily and social changes in conceptualizing “old age,” and how the experiences of aging vary by gender. specifically, while most of the female participants visualized old age in terms of a loss of physical functionality, the male participants described agedness in terms of a loss of economic and social worth. the second major theme encapsulates the acceptable coping strategies for dealing with bodily changes and the associated reconfigurations of social roles. while a fit body and functionality were regarded as foundational traits for aging well by all participants, corrective measures or anti-aging products were not espoused as the most culturally appropriate “indian” way of growing old. the third theme highlights the apprehensions regarding growing old in a foreign country, including a foreboding anxiety of dependence and frailty in the absence of traditional familial care networks. the final theme, explores how for most participants, the notion of home evoked ambivalence in constructing their sense of belonging and identity, often expressed through everyday practices and memory-keeping. taken together, we ultimately show how age and embodiment are inextricably linked in the experience of growing old in the diaspora. keywords: diaspora; embodied aging; body practices; later life identities; india anthropology & aging, vol 42, no 2 (2021), pp. 86-104 issn 2374-2267 (online) doi 10.5195/aa.2021.304 devi, hurd, & samanta | 86 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu embodied aging: everyday body practices and later life identities among the south asian indian gujarati diaspora in canada anusmita devi laura hurd anusmita.devi@iitgn.ac.in laura.hurd@ubc.ca indian institute of technology gandhinagar the university of british columbia, vancouver tannistha samanta tannistha.samanta@flame.edu.in flame university introduction led by the “successful” (rowe and kahn 1987) and “active” aging (united nations 2002) paradigms, there has been a growing emphasis on individualism, positive affect, body image, and personal control over late-life outcomes in western industrialized countries. the socio-political expectations around growing old have moved away from a framing of aging as a natural process of decline to a more medical, preventive paradigm, characterized by the belief in physical and cognitive plasticity. these ideologies share the assumption that not only is there a general potential to positively influence the aging process, but there is also an individual responsibility to do so (davey and glasgow 2006). the expectation to take responsibility for aging well through (bodily) self-control is stronger for women (moore 2008). research in western industrialized countries has also demonstrated that femininity is inextricably linked to a youthful, healthy, and fit looking body (carter 2016; slevin 2006) and to a rejection of old age as an illness, that needs to be contained, controlled, and corrected (bordo 1993; brooks 2010; furman 1997; smirnova 2012). in contrast, growing old in india has often been culturally associated with an “appropriate dependence”1 (lamb 2013, 172), reduced physical capabilities, and a socially expected withdrawal from pleasure, sociality, and material possessions (lamb 2014). lawrence cohen, in his anthropological classic, no aging in india: alzheimer’s, the bad family and other modern things, argues that “old age in india is organized around an imminent ‘problem of aging’more old people and less desire and ability to take care of them… [such that] the language of gerontology (in india) is alarmist, often apocalyptic” (cohen 1998, 89). while this sentiment dominated indian gerontology for a considerable period of time (and still continues to govern questions of economic security and healthcare among aged), there is a slow and steady shift in the gerontological intellectual gaze (lamb, 2000, 2013, 2014; samanta 2018). arguably, the neo-liberal market has slowly ushered in a this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ devi, hurd, & samanta | 87 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu new-age experience of growing old among the middle class in india where a consumption-based retirement lifestyle can be purchased without a loss of a productive and vital self.2 taking into account these different forms of understanding aging and their merging through globalization we examine the resultant cultural tensions in aging by looking at the social experience of growing old among the south asian indian gujarati diaspora in canada. we attempt to understand how older adults in the diaspora navigate rapidly shifting realities of globalization and the multiple imaginations of home and feeling of nostalgia as they strive to maintain personal continuity, identity, and selfhood through everyday practices. to accomplish this, we address three interrelated research questions on the embodied experience of growing old in the diaspora. our use of the term embodiment draws on the post-structural, phenomenological approach that allows one to make and remake their bodies through routinization of practices (csordas 1999; turner 1995). first, we ask how does the older south asian indian gujarati diaspora perceive and experience aging? second, what coping mechanisms do they employ to navigate changes in later life? finally, how are later life identities shaped and reshaped in a transnational context? in what follows, we mine the sociological and gerontological scholarship (both theoretical and empirical) on the intersections of the body, consumerism, and aging whilst also paying attention to the literature on diaspora. literature review while aging, in general, is seen as a degenerative process leading to loss of physical vitality and cognitive abilities, this perspective on aging is especially damaging for women. women’s worth is inevitably related to their appearances, specifically their ability to embody youthful beauty ideals (sontag 1972; wolf 1991). “being physically attractive,” susan sontag (1972) asserts, “counts more in a woman’s life than in a man’s, but beauty, identified, as it is for women, with youthfulness, does not stand up well to age” (31). the “bio-medicalization of aging” (estes and binney 1989) and the cosmeceutical lens have further demonized the aging body; now, aging is perceived as a pathological condition, a disease that needs to be managed, or a problem that needs to be solved (clarke et al. 2003; conard 2007; katz 1996). in a similar vein, anthropologist susan greenhalgh (2015) highlights the emphasis that american society places on containing and correcting fat bodies, a phenomenon which equally reflects how the social responsibility of becoming good biocitizens rests singularly on individuals. michelle hannah smironova (2012) in her content and discourse analysis of magazine advertisements in the united states, argues that cosmeceuticals are positioned as drugs which assist with the curing, containing, or modifying of the disease of aging. she further asserts that the success of the cosmeceutical turn in the anti-aging enterprise is brought about by the increasing commodification of medicine coupled with the medical “life-extension project,” which she defines as a “combination of technologies, knowledges, and practices directed at the aging body which seek to prolong life through all available means (based on self-surveillance and preventative behaviours), and the consumption fields of cosmetic surgery” (1237). more generally, studies show how science, medicine, and consumer culture negotiate ‘acceptable’ appearances of aging through the prescription of various regimens of aesthetic maintenance (bayer 2005) for the aging woman. aging woman is portrayed to be able to recuperate an acceptable identity only through particular modes of consumption (davis 1995; holstein 2006; hurd clarke 2011). in a renewed interrogation of the “cultural turn,” julia twigg and wendy martin (2015) contend that the body have become the key sites for the operation of new kinds of “governmentality” (foucault 1991). older bodies are increasingly subjected to disciplining by various regimes of fitness and health (slevin 2008; slevin and mowery 2012). it is worth noting that while women’s bodies are more likely to be subject to social surveillance, men’s bodies and social roles in later life have received marginal attention http://anthro-age.pitt.edu/ devi, hurd, & samanta | 88 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu in gender scholarship. while there is no denying that the majority of men in most societies benefit from institutionalized forms of patriarchal privilege, the heterogeneity of that experience is worth investigating. as such, masculinity studies informed by critical theory note how gender practices and age relations form critical axes of inequality where the social category of male seniors are collectively viewed as degendered or genderless (thompson, jr 2019). this, in turn, homogenizes the vast differences among mature men and blurs older men’s distinctive and varied subjectivities. appearance, as noted above, is an important dimension of embodiment, specifically for the performance of age, gender, and identity (calasanti and slevin 2001; furman, 1997). older women are expected to engage in numerous forms of beauty work such as the use of hair dye, dieting, exercise, make-up, and non-surgical and surgical procedures in order to approximate youthful body ideals and arrest agedness (furman 1997; hurd clarke and korotchenko 2010). while some scholars such as sandra l. bartky (1997) view engagement in such practices as unquestioned submission to the patriarchal demands on the body, others have suggested that body practices may not always be oppressive but rather may be integral to building older women’s self-esteem and identity and fighting body dissatisfaction in later life (carter 2016; see also bordo 1995; fraser 2003; gange and mcgaughey 2002; heywood and drake 1997). susan bordo (1995), for example, sees body correction as a means by which individuals may reclaim control over their bodies and their embodied selves. aging across cultures: social roles and identity formation among older immigrants several studies have explored age-related changes in social roles and values in a variety of cultural contexts. for instance, in their recent study of rural tanzanian older women, sylivia karen rutagumirwa and ajay bailey (2017) found that aging led to a shift in familial responsibilities and status. tae-ock kauh (1999) found that older korean american adults in philadelphia experienced a loss of social status and power in their families. the participants in sabrina t wong, 1 grace j yoo and anita l stewart (2006) study of older chinese and korean immigrants in the united states reported feelings of both concern and relief with their participants, as they became peripheral members of the family, lost familial authority, and became more independent as they aged. in her discussion of aging baby boomers, naomi woodspring (2016) argues that social identities are carefully crafted through adaptations in appearance, roles, and health. likewise, margaret gullette (1997) discounts the idea of a core, singular, master identity and espouses the possibility of multiple, shifting identities that are contingent upon cultural beliefs, values, and practices. she places age in the centre of the social construction of identity. sociologist richard jenkins offers yet another useful conceptual entry point in understanding the contestations around the idea of identity. jenkins (2010) furthers the theory of multiple, integrated, relational identities by making embodiment the focal point of analysis. in fact, in his later analysis, social identity is considered as a “process-identification-not a thing” (jenkins 2010, 5), opening up the avenue to explore the continuous process of negotiations through which identities are shaped and reshaped in later life. noteworthy in this regard is the work of finnish sociologist, lena nare (2017), who points out that the gujaratis who live in north london still continue to have ties with not only india but also with the east african nations of tanzania, kenya, and uganda, countries from which they had emigrated to the uk. nare observes how ‘home’ often holds ambivalent references to multiple geographic sites. for example, for nare’s partcipant, the idea of home encompassed the everydayness lived in north london interspersed with the occasional escapes to extended family or to nostalgic memories of a childhood spent in india and/or east africa. finally, although there is a growing body of gerontological scholarship in south asia, discussion of the crucial link between culture and aging is often neglected. while the aging mind has received some http://anthro-age.pitt.edu/ https://pubmed.ncbi.nlm.nih.gov/?term=wong+st&cauthor_id=16399949 https://pubmed.ncbi.nlm.nih.gov/?term=yoo+gj&cauthor_id=16399949 https://pubmed.ncbi.nlm.nih.gov/?term=stewart+al&cauthor_id=16399949 devi, hurd, & samanta | 89 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu attention through the articulations of cultural anthropologists (see for example, brijnath 2014 and cohen 1998), few studies have considered the cultural construction of aging bodies in the indian context (exceptions include lamb 2000, 2002a, 2002b, 2014; samanta 2018). it is this lack that we seek to address by drawing attention to the salience of the body and everyday body practices in shaping the understanding of old age and later life identities in a transnational context. conceptual framework: body practices and embodiment we adopt a post-structural and cultural gerontological lens to understand the interconnected notions of body and identity in later life. in the poststructuralist school of thought, the body is seen as transcending its natural or biological existence and categorization to give way to culturally inscribed meanings and identities (alcoff 1988; bartky 1997; butler 2004; foucault 1978). the body is thereby considered both a product as well as an agent; both the embodied subject and the culture are produced, sustained, reproduced and changed simultaneously through dynamic social interactions. feminist poststructuralists often focus on everyday body practices and their relation to subjectivity, performativity, and the disciplinary demands of normative femininity. sociological scholarship concerning the body culture and body image have primarily focused on the younger population (particularly, younger and middle-aged women), while a growing yet still relatively limited number of studies have considered aging bodies. the recent cultural turn in gerontology (gilleard and higgs 2005; twigg and martin 2015) has brought the body and embodiment to the forefront in gerontological discourses. julia twigg and wendy martin (2015) suggest that developments in cultural gerontology have re-emphasised and reconfigured the meanings associated with aging. with its emphasis on agency, lived experiences, and the individuality of older adults, cultural gerontology has reconceptualised identities as plastic with the possibility of being made and remade through life choices, values, judgements, and discourses. seen this way, a cultural gerontological framework privileges the relational aspects of later life identities and the embodied3 experience of aging. for example, while arguing how clothing is age-ordered, julia twigg (2018) shows that the choice and presentation of clothing have a mediating, performative dimension thus bringing bodies, clothing, and culture together. our post-structural understanding of the socialized body allows us to appreciate the social construction of the disciplinary gaze (foucault 1979) where the individual becomes her/his own agent of surveillance and conforms to the normative constraints of the lived context. we do this by analyzing everyday body management practices (e.g., exercise, yoga, diet, medication/health supplements, and skin and hair care routines) as well as identity-making cultural markers (e.g., food and sartorial choices, social interactions, and community engagement) among older indians in the diaspora. method and data the study was supported by a doctoral fellowship from the shastri-indo canadian institute (2017-2018) awarded to the first author. ethical approval was obtained from the ethics review boards of both indian institute of technology, gandhinagar and the university of british columbia. study design between august and november 2017, 26 older adults aged 55 years and above (13 males and 13 females) were interviewed by the first author. the participants were recruited using snowball sampling methods and with the help of a gatekeeper who was a well-connected member of the gujarati immigrant community in the greater vancouver region where most of the indian immigrants in british columbia reside. the semi-structured interviews explored the meanings that people assigned to old age and the http://anthro-age.pitt.edu/ devi, hurd, & samanta | 90 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu strategies they adopted to cope with the age-related physical and social changes. as such, participants were asked whether they considered themselves old and about their perceptions and apprehensions regarding aging and the physiological and social changes they observed over time. interviews lasted between 40 minutes to 3 hours and were conducted in a variety of locations, including public places like restaurants and parks as well as respondents’ homes and workplaces. twenty interviews were tape recorded while six interviews, where the participants expressed reservations about recording the interview, were noted down by the interviewer. all of them used a combination of english, hindi, and gujarati to communicate with the first author. the gujarati and hindi portions of the interviews were translated after transcribing the audios verbatim. the first author took field notes about her observations of the surroundings and the body language of the participants, which were used to build further insights into the narratives. study participants all the participants were of gujarati hindu origin and had been living in canada for ten years or more. 4 they had a varied migration history 5 : 10 were former political refugees who had migrated in the early 1970s to escape the political unrest in african, 12 were first-generation labor migrants, and 4 were ‘zero generation’ migrants who had followed their migrant children in later life. although a sociological categorization of class (especially, the indian middle class) remains conceptually contested and empirically ambiguous (see for example, fernandes 2006; mazzarella 20116), for the purpose of our study, we defined social class positions based on visible economic markers such as property and car ownership, (independent) living arrangements, and socio-cultural distinctions such as english language proficiency, club memberships, social networks, and finally, self-perceptions of their social class. by this classification, all our respondents belonged to the middle class. all but one female participant, who had moved to a rental apartment following her husband’s death, owned their own houses. with the exception of six participants who lived with their adult children, one woman who lived with her mother as she was the sole care provider, and one man whose parents co-resided with his family, the majority of them either lived alone or with their spouses. table 1 presents descriptive information about the sample. table 1: descriptive characteristics of south asian indian participants (n=26) age(years) n 55-64 9 65-74 13 75-84 4 place of birth (continent) africa 10 asia 15 north america 1 marital status married 23 separated 1 widowed 2 living arrangement alone 1 with spouse only 13 with children/parents 12 migration type http://anthro-age.pitt.edu/ devi, hurd, & samanta | 91 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu twice removed 9 first generation 11 zero generation 5 second generation 1 analysis the data were analyzed thematically following previous work on reflexive thematic analysis in qualitative research (see braun & clarke 2006; terry, hayfield, clarke & braun 2017). after reading through the texts of all interview transcripts, tentative categories were assigned by the first author to perceptions and narratives of the participants. these categories helped in identifying common themes that emerged from the narratives. the themes were decided in consultation with her third author, dr. samanta, who also re-read the transcribed interview material. our analysis resulted in four overlapping themes which highlight how older adults perceive, experience, and cope with their aging bodies and how they negotiate their identities in later life through everyday practices. all names have been changed to protect the privacy of the participants. changing bodies, changing roles: gendered associations most of the participants, described old age in terms of changes to their physical bodies and social roles. they primarily used two parameters to map these changes in their bodies, namely physical appearance and functionality. while most of them expressed a sense of loss because of corporeal changes (e.g., loss of thicker hair and slimmer body), they also conveyed feelings of resigned acceptance to these bodily changes. for instance, nirmala (65), who had immigrated to canada post-marriage, said that though she was not happy with her weight gain and thinning hair, it was important to accept these inevitable changes: . . . obviously you are not as young as you were ten years back. . . when i was 55, i think i was more athletic. now . . . sometimes i really feel that pain can do that much damage . . . so, then i said, “oh wow! maybe i am aging.” and then obviously your body structure changes as well after a certain age. as i said, if i would have kept up walking and my own exercises it wouldn’t have bothered me. but yes, it does now . . . yeah you get a little slow, slow in work . . . you lose your hair so naturally i notice that it’s getting thinner. i used to have very thick hair and obviously it got a little lighter here so i said, “wow it shows” . . . (but) i should always love myself no matter what, it’s still me right!” another common vector that emerged during discussions about the meaning of old age was the experience of compromised body functionality. echoing the sentiments of many respondents, sangeeta (65), born and raised in canada, shared: i am aging, that’s for sure. i can't refute that. it is happening. . . i am 65, but i won't say i am old. i am still able to function, you know. when i reach certain age and all these things slow down and when i can't look after my self, do my own things myself. . . that will be old. i don't know when that will happen. i hope not too soon. although sangeeta acknowledged changes in her body, she did not feel she was old yet because for her, old age would mean diminished body functionality. http://anthro-age.pitt.edu/ devi, hurd, & samanta | 92 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu unsurprisingly, while most of our female respondents described old age in terms of their bodily changes, most of the older males defined aging in terms of changes in their professional and/or social roles. for instance, dilip (82) reported how his social roles had changed over the years. while he had remained actively engaged in his family business in canada until a couple of years ago, he lamented how age had slowed him down: well, it (role) has changed in last 5 years. . . change in role includes, when i started getting older, i gave almost everything to my son, like my savings, the house. . . he was really young when i bought this house. now i have added his name (to the ownership document) . . . if we both (he and his wife) pass away, then he should not face any legal or accounting problems. articulating the sense that his social value had diminished, dilip expressed his discontent with his changed role and status in his social circle: . . . when younger boys (men) come (to social gatherings) they get honoured. i have grown old now, so no one even wants to talk to me. . . people will just come and say “hello/ hi” and nothing much. . . before they used to discuss. . . “we have to do this, we have to do that” . . . because i was in a voluntary society for almost 15 years. now no one discusses with me. a majority of the participants (20 out of 26) expressed unhappiness at the prospect of changed social roles and status with advancing age. while five men and women expressed that they enjoyed the reduced social responsibilities, one older woman felt there had been no change in her social role with age. sushma (77), who resided with her extended family (spouse, adult son, daughter-in-law, and grandchildren), felt that she had more time for herself after her parental and grandparental responsibilities eased with age. she mused: growing old, no change as such. everything is like before. . . now i do not work that much. my daughter-in-law helps more in the kitchen. she comes home early, and we cook dinner together. . . also grandchildren are all out (in college) so not much work is there. . . i like it. i can nap in the afternoon. . . earlier, i would be busy with chores. . . the interview excerpts above reflect the participants’ feelings of ambivalence about the inevitability of age-related physical and social changes. while a yearning to hold on to the permanence of an enduring lifestyle and life-status was the common refrain, there were also exceptions undergirding the heterogeneity and hybridity (lowe 2005) of the diasporic experience. repurposing age: everyday body practices akin to earlier studies on aging and the body (bennett et al., 2017; hurd clarke 2002a), participants in this study reported a reprioritization of bodily attributes. for instance, on being asked about any physiological attribute that he would like to change, mohan (65) noted: m: i do not want to change anything about my body. . . nothing. i am happy the way i look. . . maybe the knees. yes, the knees; if i could, i would like to get new knees. not replaced, artificial but you know, like when i was younger, without pain and all. i could move around. ad: so, what would you like to change (about your appearance or body)? http://anthro-age.pitt.edu/ devi, hurd, & samanta | 93 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu p: get some more energy yeah; that’s it. use of body management practices such as following a diet and exercise schedule to arrest the somatic expression of aging has been widely reported in several studies (laz 2003; slevin 2010). our participants too, described efforts to manage their changing bodies through dietary changes, exercise and yoga regimes, and medications and health supplements. for instance, vanadana (74), who had migrated from tanzania in the 1970s, emphasized a positive association between fitness in later life and maintaining an active lifestyle: i am 74 years old. i still go to work. i also take care of the house. . . i go for walks during my lunch break and also attend yoga classes three days a week. . . do not stop working if you want to stay fit. she further mentioned that several other activities, such as taking public transit to work, looking after her grandchildren, and regularly driving to religious gatherings all formed an integral part of her active lifestyle. many male interlocutors also reported taking active care of their health with increasing age. for instance, nitin (64) took health supplements and carefully monitored his health status. he said: (i take) only supplements. . . as you get old you take 50+ one pill a day supplements or vitamins, proteins, and etc. we (he and his wife) are just careful with food. i mean we do have regular check ups at the doctors about our heart rate and blood sugar, cholesterol level and weight. at the same time, unaffected by the popular media propagation of beauty and body products, most of the older adults reported refraining from using any anti-aging topical products or surgical/non-surgical corrective measures. this finding aligns with earlier findings on indian diaspora (sarah lamb et al. 2018). the cultural belief in maintaining the sanctity of the body often influenced the age-managing measures adopted by them. several participants subscribed to the idea of aging ‘gracefully’ or ‘naturally’ as opposed to adopting invasive, age-corrective, clinical or surgical methods. for instance, vinita (62), who had migrated from east africa in the 1970s after her marriage, expressed her lack of trust in pharmaceutical products and a preference to age “gracefully”—a term commonly invoked by most of the older men and women. with her formal training in chemistry, she said that she had “scientific” reasons for not believing in the efficacy of these anti-aging products. she noted emphatically the following: i do not believe in it (anti-aging products). what pharmacies do is sell products. but i don't know, after certain years what’s going to happen. if they are not taking either that medication or injecting themselves, what could happen. it could be worse than natural aging. so, i don't like to do those things. i would rather age gracefully than do those things. growing old in a foreign land: dependence, isolation, and loneliness the biggest source of anxiety reported by the older adults was increased dependence with age. preeti (56) illustrated this “dependence anxiety”7 (vatuk 1990, 65). she had migrated from india after her marriage, and, at the time of the interview, both she and her husband were working professionals in http://anthro-age.pitt.edu/ devi, hurd, & samanta | 94 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu canada. she described herself as independent and ambitious since childhood and expressed her fears about becoming dependent in the future, especially for household chores: the only apprehension i have about growing old is having to depend on someone else. . . i go to vaishno devi8 (temple) every time i visit india. i ask my friends to join but they always have excuses: “who is going to look after the house?; i can’t leave the family unattended” and all. . . we are more independent here. for the eight women and two men who did not stay with an extended family, the prospect of becoming unable to take care of everyday household chores such as cooking and cleaning, was a major concern. even among older adults who resided with extended family, especially females, expressed concern about their inability to help with household chores/grandparental duties with age and increased dependency on younger family members. for instance, sangeeta (70), a zero-generation migrant, resided with her extended family. she enthusiastically mentioned that she kept herself busy with domestic chores and grandparental duties and did not like to sit idle. she said: i fear that i might not be able to help around in the house later. . . grand kids are there. they will grow up. but in the kitchen, there is work. i love cooking for the family. i make a lot of gujarati snacks and fritters even now. i don’t sit idle at all. four older women, nirmala (64), sushma (78), sangeeta (70) and mitushi (70)], two first generation migrants and two zero-generation migrants, respectively, drew a comparison of the ease of taking care of household work in india because of availability of cheaper labour and joint living arrangement. for instance, mitushi, who had migrated from india after the birth of her grandson, said with a heavy heart: it was easier there. . . a servant (domestic help) used to come everyday. i also had my elder sister-in-law (husband’s brother’s wife). we used to get things done together. . . sometime after coming here i developed cancer, she helped (daughter in law), but she has her work. she still helps in the kitchen. . . but. . . while the older females were mostly concerned with the inability to take care of domestic chores, most of the older men expressed a fear of increased dependency on others for taking care of their bodies and mobility or loss of cognitive capabilities. for instance, jethalal (65) and manohar (70) both feared the possibility of developing dementia in later life. jayesh (55) and bhagwan (69), both living with extended family, feared that they will not be able to take care of their bodies with old age and will have to depend on others for meeting their daily needs. interestingly, though most of the participants were anxious about the increasing dependency with age amidst the absence of strong familial support, long term institutionalization did not seem to be a widely chosen option for later life care. only a single female brought up institutionalized care facilities during her interview. her deceased husband had been put in a care facility, and she was not keen on finding her way into one. the rest of the twenty-five participants did not discuss the idea of assisted living as an option for later life support. at the same time, all the twenty-six older men and women mentioned that they were happy with the canadian health care system, old age pension plan, and the transportation service for older people with mobility restrictions. several participants also reported feeling lonelier with increasing age, especially after retirement. this feeling of loneliness, they believed, was more profoundly felt when being in canada than in india. for http://anthro-age.pitt.edu/ devi, hurd, & samanta | 95 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu instance, dilip (82), who loved traveling, but rarely did so anymore as he preferred not to do it alone, had this to say: if i go to india, i have lots of friends and relatives. so, it is not a problem. somebody will come and pick me up. if not, then i can go by taxi and go to their house. so, we are with the family. so, there is not a problem. but here if i have to go somewhere, then i have to stay in a hotel, then i would like to have somebody. . . because there is a fear if something happens, something goes wrong, you know health wise. though there is insurance and everything, and you cannot maneuver yourself. like you know, if i have to order a taxi, or kaha khana khane jayenge (where would i go for lunch/dinner), you know, to look for a restaurant and all these things, that information is there but still i feel alone, lonely. like all the others in this study, dilip too had great faith in the canadian healthcare system. he had narrated an incident where he believed a critically ill acquaintance of his in canada could not have been saved had he been in india. however, with increasing age, as evident in the excerpt above, he felt the need to be with familiar people in case of medical emergency to call for help and take care of initial official procedures. this reflects the tension that most of the respondents felt in navigating old age in canada. while they praised the government health care system, they also lamented the scarcity of readily available familial support to take care of them in case of medical emergency (which was believed to be available in india because of stronger network ties). twenty participants made comments similar to that of sangeeta (65), who described loneliness as an important concern for older persons in the diaspora, in the absence of strong familial support and limited social interaction with the larger community: the only. . . bad thing is, there is tremendous loneliness here. when people get into their senior ages, children are gone, they are doing their own thing, and nobody comes to visit them. . . in the last years of their lives, they need loving, caring people to look after them, to be there, to listen to them. their last memories and experiences that they want to relate. nobody is there to listen to them. . . whether it is true in india or no, i don't know. but here that is the biggest hurdle. interestingly, not linguistic barrier9 but weather was cited as a major cause in restricting social interactions. several older adults commented that the harsh winter and incessant rains in vancouver affected their social participation. distance also emerged as a deciding factor in fostering social interactions. since the gujarati community in the vancouver area was scattered, often, most of the them had to travel some distance to attend community events. six participants reported inability to drive (two had medical conditions; four did not own a car, did not know how to drive, and relied on public transport or their children for commuting). five of them stated that distance was a limiting factor for social interaction since they had to travel to meet people of their community. three other older men who had access to vehicles and could drive around also mentioned that their social interactions had reduced with increasing age because they started finding it difficult to drive long distances to attend community gatherings and events. two older women were enrolled in community centres/support groups for older adults and did not report feeling lonely. one of them, a zero-generation migrant (had no language barrier), interacted only with fellow indians at the old age centre, while the other participant, a first-generation migrant, had friends of canadian as well as indian origin. one older woman who was actively involved in a spiritual organization, did not report feeling lonely either since she mentioned being “busy with office work” throughout the day. additionally, two older men and one http://anthro-age.pitt.edu/ devi, hurd, & samanta | 96 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu older woman, who lived in a joint household setup with young grandchildren did not mention feeling lonely. in the face of these age-related apprehensions and fears, many participants stressed the importance of acceptance and preparedness. for instance, ten years ago after her husband in india passed away, nirupa (64) migrated to canada to be close to her only son. she lived in an apartment close to her son’s house and spent several hours every day at a seniors’ centre where she enjoyed spending time with other women. although there were non-indian older persons in the centre as well, nirupa’s group of friends comprised only of indian older females, mostly punjabi speaking. she liked coming to the centre not only for socialization and recreation but also because of the informative sessions on nutrition, exercise, and yoga for seniors by trained professionals, which could prepare her for physiological changes that accompanied aging. nirupa noted: i have had really bad knee pain and . . . felt like okay i have to look after this, i have to get it back on track that was my thought . . . fears are just another way of telling yourself to make sure that you have made arrangements for yourself . . . i joined this centre because of a punjabi lady near my house. she comes here too. she told me about the activities here . . . we have restorative yoga classes . . . medical experts come once a week to talk about handling things, you know, like fall, and pain. fitting into two worlds: the quest to belong in this final theme, we examine our participants’ everyday dilemmas of negotiating nostalgia, identity, and the sense of belonging. this is significant since the social process of growing old reflects the intersections of micro-processes and macro-level forces of individual aging experiences (estes, biggs, and philipson 2003). in our study, many older adults reported that with reduced familial and professional (post retirement) responsibilities, they had time to travel. this, coupled with the canadian winters, and reportedly reduced physiological abilities to cope with it (with advancing age), encouraged many of them to spend time in india from october-november through february-march to escape the biting cold. this resultant seasonal migratory pattern is not new in gerontological scholarship.10 several respondents mentioned that they owned residential properties in their “native place” (often in gujarat, india) which served as retreat homes as well as routes to forge local social ties. for instance, manohar (70) had bought a house in his hometown: (i go) every year because it's cold (in canada) and when you come back it would be nice again. so that’s the main thing. as soon as i returned (after retirement), we built a very nice house . . . it is not big and in the heart of city. it takes five minutes, rickshaw take five minutes to take us from my place to city. so, we built the house and this house like all bedrooms has attached bathroom and toilet seat. nice yard in the back. so, we'd like to relax there. several gerontological scholars have noted that memory is an integral part of constructing identities (hoods 2011; jenkins 1996; woodspring 2016). indeed, many of ourrespondents described how their memories of embodied experiences in both cultural contexts shaped their later life identities. for instance, 64-year-old hiral, while talking about her dietary preferences, shared that her preference for “canadian” food over “indian” food was influenced by racial prejudices that she had faced in public and professional spaces during her younger days. hiral recounted how a racially, discriminatory public environment led her to feel pressured to learn english, acquire professional culinary skills, and take up work at a canadian restaurant. she said that the fear of smothering her clothes with the smell of garlic http://anthro-age.pitt.edu/ devi, hurd, & samanta | 97 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu and other spices with strong aroma(often used in indian cooking), which at times, drew harsh comments and stigmatization (goffman 1963) from non-indian canadians, compelled her to change the dietary habits of her family to incorporate more ‘canadian’ dishes. her sartorial choices were also influenced by the practicalities of everyday life and included mostly “western” trousers and blouses. though she enjoyed dressing up in colorful indian traditional attire, she reserved those outfits for special, traditional occasions and celebrations. finally, clothes formed an important aspect of an attempt to fit-in or belong in both canada and india.11 the professional versus the casual (or traditional) divide was sharper for the older women. for instance, preeti (56) had this to say: i love wearing sarees. . . but there is no occasion to wear sarees often here. plus, the weather . . . i wear pants and shirts, tops to work. you want to fit in right, you don’t want to stick out. i find it more comfortable to wear it at home. . . i wear punjabi suits and sarees when i go to india. similarly, sangeeta expressed a strong desire to fit in through appropriate dressing: occasionally i will dress up. but i am not like i have to look perfect. . . like you will see my daughter, who is in the journalism. for her, you know, she looks very often in the mirror and “how do i look, my hair and my. . .” no, i don't do that, but i do dress up. i wear my outfits for every occasion, whether it is christmas or halloween. . . for our indian occasions i wear nice sarees or anarkalis or whatever dress, whatever i want to wear, whatever people are wearing there. taken together, expressions of identity are situational and contingent upon the shifting notions of home. fitting-into canadian society was often achieved by a simultaneous (studied) masking of their ethnic identities. at the same time, demonstrating belonginess in their ethnic community was asserted through everyday practices and rituals such as donning traditional indian garments and making yearly trips to the country. discussion building on the theories of embodiment, we have examined how our respondents described and experienced their transition into old age. in particular, we have analyzed how the meanings they attributed to aging and oldness reflected cultural norms that associated later life with a loss of physical and social vitality. while the participants equated youthful bodies with physical functionality and social worth, they defined old age in terms of physical decline, increasing dependence, and diminished social roles. at the same time, similar to previous studies that have found that growing old entails contradictory emotional reactions to bodily changes and social roles (bennet et al. 2017; gilleard and higgs 2018; laz 2003; simpson 2016), many of the participants articulated conflicting feelings about their changing physical and social realities. on the one hand, the participants were accepting of the inevitability of age-related bodily changes and death. on the other hand, they also conveyed annoyance, if not discontent, at their perceived inability to mitigate those changes. like the older korean immigrants in united states in tae-ock kauh’s (1999) study, our participants too reported feeling both relief as well as a sense of rejection resulting from their altered familial and social roles. these paradoxes were embedded in a culturally contextualized and prescribed performance and construction of gender with associated norms and ideals concerning masculine and feminine bodies, comportment, and social roles. the women in our study interpreted their experience of growing old primarily in terms of bodily http://anthro-age.pitt.edu/ devi, hurd, & samanta | 98 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu changes. in contrast, the men tended to emphasize how aging was undermining their economic and social power. while both male and female participants expressed some reluctance to accept these physical and social changes, all the participants had reprioritized the importance of their physical attributes; functionality often trumped appearance in later life(bennett et al. 2017; jankowski et al. 2014, reboussin et al. 2000) body.12 an ambivalent perception of home was observed among the participants in our study. most participants, though not always consciously, referred to both canada and india (and often africa while talking about their childhood), as home. using marco antonsich’s (2010) concept of belonging as the description of “the feeling of attachment to a symbolic space of familiarity and ‘home.’ lena nare uses belonging to refer to “the sense of being a part of and ‘fitting in’ to a particular locale or place, which can refer to a neighbourhood or to a community, or to a wider national entity” (2017, 628). belonging not only is limited to feelings but also translates into ways of living and everyday practices such as food habits and sartorial choices (bennett 2015; nare 2017). although such duality or ambivalence in experiencing belongingness among diasporic younger adults has been well researched, not much has been explored among aging diasporas. what distinguishes the older diaspora in terms of their connection with their homeland is the increased opportunity and enticement for them to visit india post-retirement (especially during winters). these increased proximities to homeland contribute significantly to the reshaping of their later life identities. unsurprisingly, this push and pull of belonging and nostalgia was less likely to be incumbent on the age of the participants than the type of migration. irrespective of their age, the participants who had migrated directly from india demonstrated a stronger pull towards their homeland than the twice removed and the second-generation migrants. we found that most participants experienced a sense of duality in their everyday construction of self. we argue that the sense of selfhood (as seen in studies of bauman and raud 2015; coupland and gwyn 2003) is intricately related to the embodied experiences of aging among the participants. these embodied experiences, in turn, are contingent upon spaces (homes, culture) and temporality occupied simultaneously by the participants. to be sure, this duality in the embodied experience of aging, expressed by the participants in their ideas about the physical and social markers of age as well as with the fluid idea of home in later life, is reflected in their everyday beliefs and practices. for instance, as noted earlier, the ambivalence between accepting bodily markers of age and a will to resist aging is starkly evident in our study. coupled with (a reluctant) acceptance of reduced energy, agility, and flexibility as well as the ‘slowing down’ with advancing age, the participants also demonstrated a firm belief in an ability to delay aging or ‘becoming old’ (defined often in terms of functional limitations of being able to do everyday chores and activities) by remaining physically active and continuing to do their own work.13 such coexisting contradictions were also evident in the mixed emotions induced by the change in the roles and anticipated status in the family and the society at large. the relief perceived by transferring responsibilities to the younger members was also tainted with the accompanying loss of social worth (in the form of reduced respect and diminished participation in decision-making). these physiological and social changes in later life were accompanied by uncertainties and insecurities and required new coping mechanisms. a similar tension was evident in the participants’ appreciation for the canadian health care system, and, at the same time, the fear of the unavailability of social support for mobilizing health care facilities during a medical emergency. finally, coping with the apprehensions of growing old in a cultural context that places huge emphasis on individualism, the idea of aging well becomes automatically linked to a healthy body and (economic) independence. most of our participants, irrespective of their ages, expressed apprehension about their increasing dependency on adult children due to loss of physical or cognitive functionality. participants across all age groups, younger old (55 years-70 years), as well as the older old (above 70 years), http://anthro-age.pitt.edu/ devi, hurd, & samanta | 99 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu expressed equal concern regarding loss of physical/cognitive functionality and increased dependence with age. hence, it is not surprising that study participants noted the cultural importance of health management practices, even though they were not actively using such techniques. apart from the fear of dependence, loneliness in later life emerged as a major concern among those growing old in the diaspora. along with the physiologically limiting influences of age, the relatively smaller population of diasporic gujaratis in the study region and the limited social interaction with people from outside the gujarati community further increased the possibility of alienation and loneliness in later life. to combat loneliness and social isolation, the senior community associated with the gujarati society of british columbia often found ways to get together and celebrate festivals to ‘practice’ both age and identity. laz’s (2003) contention that age and embodiment are both mutually constituted is illustrative of our participants’ negotiations of the dualities of body and the experience and meanings of home. limitation certain caveats remain. due to time constraints associated with the duration of the fellowship, a majority of the participants could not be interviewed multiple times which, we believe could have helped us to offer deeper insights into our participants’ perceptions and experiences of identity, integration, and belonging. we were also unable to pay specific attention to the sociological differences in caste identities. while we are acutely aware of the heterogeneity in diets, lifestyles, everyday practices, and belief systems by caste affiliations, a careful investigation of those dimensions remained outside the scope of the current study. moreover, due to the restricted nature of the sample recruitment (relying on snowball method), all our study participants belonged to the middle class. this limited our ability to examine how age remains interlocked with other forms of social ordering such as social class. despite these limitations, by focusing on a diasporic community and bringing to the fore the cultural construction of aging bodies and aging self, this study expands the scope of aging research. in the process, we have complicated the notion of “home” among aging immigrants and have broadened the possibility of multi-sited gerontological inquiry around questions of body, embodiment, and everyday subjectivities. notes 1. in her study on older adults living in institutional facilities in bengal (india), cultural anthropologist sarah lamb, highlights that dependence in later life, especially in the form of receiving seva “respectful service and care, paradigmatically provided by juniors to elders” (lamb, 2013, 176), is seen as an appropriate normative expectation of the life course. 2. for example, see tannistha samanta 2018, for an examination of the sociological possibility of “third age” in india; jagriti gangopadhyay 2020, for understanding the emergence of new class of older adults who redefine and repurpose aging through sustained financial independence and social interactions. 3. critical gerontologist, naomi woodspring (2016), who has written extensively on baby boomers in the developed west, defines ‘embodiment’ as the “collapse of the mind/body split” and “a profound intertwining of the two” (80). scholars working on aging have conceptualized embodiment through a range of dimensions including activity, fitness, health, appearance, and illness (see for example hurd 1999; laz 2003). we find laz’s conceptualization particularly fruitful for our analysis; laz privileges the phenomenology of the body and argues how embodiment (just like age) is both accomplished and performed. drawing from connell’s (1995) powerful analysis of “body-reflexive practices,” laz shows how individuals often through routine or at times by collective and social work, “make” their bodies. seen this way, embodiment involves social relations and symbolism. 4. for more details on the gujarati migrants in canada, see chundawat 2015; jha 2010, etc. 5. based on the time and original place of migration, four types of migrants were identified: 1) the ‘twice removed’ or ‘twice migrated’ (jayaram 2008), comprising of the migrants from east african countries such as http://anthro-age.pitt.edu/ devi, hurd, & samanta | 100 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu fiji, kenya, uganda and tanzania, who came to canada as political refugees in the 1970s; 2) the first-generation migrants from india who migrated to canada for education, employment and/or marriage; 3) the later-life migrants or the ‘zero-generation’ migrants who followed their children who had migrated to canada; 4) the second-generation migrants who were born in canada. 6. mazzarella, william. 2011. the middle class. (http://anthropology. uchicago.edu/pdfs/mazz_middleclass.pdf, accessed june 16, 2019). 7. slyvia vatuk (1990), based on her long-term study of aging in america and india, analyzes how old age related physical, mental, or financial dependence on others is seen as a source of anxiety depending on larger cultural conditioning. vatuk points out that anxiety of dependence on others in america is rooted culturally in collating the loss of physical and economic dependence with the loss of self-respect and self-reliance. while intergenerational dependence and reciprocity are culturally sanctioned expectations in the indian context. dependence anxiety in the indian older adults’ springs from experiential and realistic concerns about their children failing to uphold their filial duties towards the aging parents. 8. vaisho devi is a popular hindu temple and pilgrimage centre located in the northern most state of jammu and kashmir in india. 9. language did not seem to be a factor in restricting social interaction for most of the participants. two of the participants, who were zero generation migrants, reported facing difficulty with the language for the first few years after they had moved to canada. however, they mentioned that they learnt to speak english within the first 2-3 years. only one of the female participants, a first-generation migrant, faced difficulty and had reservations about communicating in english. 90% of the participants could communicate in english, though they preferred to use a mix of hindi, gujarati, and english languages for the interview sessions. 10. see for example, lena panare 2017. 11. see twigg 2009, for a careful analysis of how clothes are inextricably tied to gender, identity, and embodiment in old age. 12. in her study of korean older women living in new zealand, chung (2018) linked the increasing salience of body functionality in later life to the lack of expectation of informal care (such as familial support) in a transnational context. 13. everyday work for the participants, often, referred to household chores such as kitchen duties for women and cleaning the house for men. most of the participants, irrespective of their gender, reported the regular task of picking up their grandchildren (if they lived in the same city) from school and taking care of them till they were collected by their parents later in the evening. references alcoff, linda. 1988. “cultural feminism versus post-structuralism: the identity crisis in feminist theory.” signs: journal of women in culture and society 13 (3): 405-436. andersen, ranberg, k, k christensen, b jeune, a skytthe, l vasegaard, and jw vaupel. 1999. age and ageing 28 (4): 373-377. antonsich, marco. 2010. 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psychology 17-37. turner, bryan s. 1995. medical power and social knowledge. sage. http://anthro-age.pitt.edu/ devi, hurd, & samanta | 104 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.304 http://anthro-age.pitt.edu twigg, julia. 2004. “the body, gender and age: feminist insights in social gerontology.” journal of aging studies 18 (1): 59-73. twigg, julia 2009. “clothing, identity and embodiment of age.” in aging and identity: a postmodern dialogue. edited by powell, jason, and tony gilbert. new york: nov science publishers. twigg, julia., and wendy martin. 2015. the routledge handbook of cultural gerontology. london: routledge. twigg, julia. 2018. “fashion, the media and age: how women’s magazines use fashion to negotiate age identities.” european journal of cultural studies: 21 (3): 334-348. vatuk, sylvia. 1990. “to be a burden on others.” divine passions: the social construction of emotions in india 64-91. wolf, naomi. 1991. the beauty myth. new york: anchor. wong, sabrina t., grace j. yoo, and anita l. stewart. 2006. “the changing meaning of family support among older chinese and korean immigrants.” journal of gerontology: social sciences 61b: s4–s9. woodspring, naomi. 2016. baby boomers: time and ageing bodies. bristol: policy press. http://anthro-age.pitt.edu/ book review review of fletcher, david-jack. age as disease: antiaging technologies, sites and practices. singapore: springer singapore. 2021. pp. vii, 349. price: $ 139.99 (hardcover and paperback); $109 (ebook). ashwin tripathi indian institute of technology gandhinagar ashwin.tripathi@iitgn.ac.in anthropology & aging, vol 43, no 2 (2022), pp. 108-110 issn 2374-2267 (online) doi 10.5195/aa.2022.431 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | tripathi | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.431 http://anthro-age.pitt.edu 108 book review review of fletcher, david-jack. age as disease: antiaging technologies, sites and practices. singapore: springer singapore. 2021. pp. vii, 349. price: $ 139.99 (hardcover and paperback); $109.00 (ebook). ashwin tripathi indian institute of technology gandhinagar ashwin.tripathi@iitgn.ac.in as the global population continues to age and the anti-aging markets increasingly focus on expanding longevity, the book age as disease brings to attention the complex interplay of biopolitics and neoliberalism in the global north. in this book, cultural studies scholar david-jack fletcher develops the concept “gerontological hygiene” to analyze the nexus in and around aging. the six chapters both contextualize and criticize the rapidly evolving neo-eugenic regimes that have been altering the contemporary processes of aging. the complex navigation of oneself in old-age is here explored through the lens of “somatechnics,” defined as a “symbiotic relationship between technology and the body” (22). this relationship is analyzed in the book, using the foucauldian concepts of biopolitics and governmentality. overall, this work aims to meaningfully analyze the ways in which older adults and new technologies intersect. building on this analysis, the author productively challenges the existing welfare policies for older adults. additionally, this book aims to re-imagine what the future holds for the human population in the post-human era. chapter 1 expands on the biomedical model of age(ing) which configures older bodies as “deficit…as a form of disease-state” (3). in the process, fletcher points towards the complete ignorance of social and environmental factors, particularly in physiological and psychological models of aging. this reductionism, he believes, is embedded within the nexus of biopolitical and governmental regimes that only focus on “successful” and “productive aging” (rowe and kahn 1997). this rhetoric about active, self-reliant individuals that strive to overcome the inevitability of frailty in aging by curing old age has become common in medical and scientific circles in the us, uk, and australia. to bring the social aspects of aging back into hegemonic ideologies of aging, the author proposes to follow the “life course approach” (popularly used among dannefer and kelly-moore 2009) that acknowledges how both “genetics and agency operate together to produce an individual’s life trajectory and opportunities for living well” (6). the author advances psychological and social scientific approaches to acknowledge the impact of social, economic, environmental and life course factors that are disregarded or neutralized in a contemporary neoliberal understanding of aging that prefigures all older adults to be essentially selfreliant and self-governing individuals. independent and active older adults then become part of the cultural category of the “third age” (successful aging) while older individuals who are in need of support, comprise the “fourth age” (failed aging). these categories are complemented by different neoeugenic, biopolitical and sovereign regimes. following foucault’s concept of governmentality, these cultural imaginaries are internalized as socio-cultural expectations and norms which are in turn further reproduced through everyday bodily and social practices. http://anthro-age.pitt.edu/ book review | tripathi | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.431 http://anthro-age.pitt.edu 109 the biopolitics of somatechnics, based on the theoretical foundations by michel foucault (1963), is further elaborated upon in chapter 2. fletcher draws from foucault’s work to analyze “how the imbrication of biopolitics and regimes of normativity discursively constructs aging as a disease needing to be cured” (38). biopolitics, as foucault argues, regulates the relationship between technologies and the body. simultaneously, these biopolitical regimes exercise power that might result into “disruptions, counter-actualizations, destabilizations and the creation of new selves, affinities, kinship relations and cultural possibilities” (22). fletcher here gives the example of trinfinity8, a rejuvenation technology that uses algorithmic codes to help the user attain a state of physical and emotional health, and new lifestyle changes like caloric restrictions or intermittent fasting, to demonstrate the contemporary fusion between new age spiritualism and technology. this introduces the readers to discursive underpinnings of the new technologies where the idea of anti-aging has become central to government policies and everyday governance. moreover, by providing a brief history of longevity and rejuvenation technics, the author shows how eugenics and biopolitics have always been intertwined. the resulting re-enforced hygiene regimes have always aimed at abolition of age(ing), as in case of nursing homes or old age homes which have been transformed as sites of medicalized quarantine and constant surveillance. chapter 3 discusses “gerontological hygiene” as an important principle in the perpetuation of a neoeugenic paradigm that disenfranchises older bodies and renders them as frail and diseased. the author explores this phenomenon through an archaeological approach, discussing the origins of gerontology as a discipline. furthermore, he uses the case-study of the regis nursing home franchise (https://www.regis.com.au/), the largest provider of aged care in australia, to exemplify how a series of economic, technological, and biomedical discourses target, codify, and regulate older adults. these homes, as stated, could be private or public residential facilities providing long-term care, producing older bodies as frail and dependent individuals who are in constant need of support. institutionalized care further marks the contemporary bifurcation in aging by differentiating retirement homes and vacation resorts, that are more characteristic of third age, from hospice facilities that are seen as endof-life care and reinforce the fourth age as a grim cultural imaginary. how this bifurcation in aging intersects with other social differentials like class, gender, and context(s) remains unaddressed in this book. chapter 4 questions the very category of ‘the human’ in the politics of aging. the author abides and builds upon the humanist philosophy of heidegger, arendt, and derrida and levinasian ethics to elaborate on which bodies are made more acceptable than others. in heidegger’s conception of the human, the human species is superior to animals because of their cognition and language. a similar hierarchy is installed for prisoners and older adults who are seen as individuals without autonomy in comparison to ‘full’ human beings. fletcher not only finds this unethical but also observes how this categorizes older adults as unproductive beings of our societies. chapter 5 questions the ethicality of medical research and scrutinizes both human and animal experimentation in relation to somatechnics. drawing from levinas’ notion of the “same” and the “other,” fletcher reminds that the latter continues to be irreducible through violent acts of exploitation. the author uses the examples of xenotransplantation – such as the blending of animal testicles within a human body (238)– and quack medicines to show how de-humanization takes place through denial of rights, voice and consent and leads to questioning of the very category of humans. similarly, fletcher argues, older adults are by default assumed to be incapable and their ‘unable’ bodies commodified through anti-aging technology and medicines. additionally, informal conglomerates like the geroscience network and therapeutic research which contribute towards anti-aging movement(s) are here critiqued for their dehumanizing effects. the last few sections of this chapter tap into posthuman http://anthro-age.pitt.edu/ https://www.regis.com.au/ book review | tripathi | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.431 http://anthro-age.pitt.edu 110 theory and remind that, as anti-aging technologies remain uncontested, they are likely to perpetuate the idea of humans to become an “ageless cyborg” (290) chapter 6 concludes with an overview of the major arguments and interconnections in the book and tries to answer the question of whether the evolution towards agelessness should continue or old age should be abolished altogether? according to fletcher, as much as this question is interesting, it is more essential to know the concrete effects of anti-aging somatechnics which impact policies of aging. at the same time, new technologies also bring possibilities for new corporeal forms and new subjectivities that are counterhegemonic, like the possibility of the creation of humankind as an “ageless cyborg” (290). to conclude, although this work belongs to the broader field of cultural studies; it quite often intersects with popular assumptions of cultural gerontology and offers invaluable insights into the socio-cultural dimensions of aging. in the process, the reader is provided with a range of contemporary cultural theories that have critically examined aging. the book is a difficult read in terms of the esoteric connections made across disciplines, theories, and scholars. as a reader, more cultural examples could have made the text more accessible. nonetheless, the book is well-researched and presented in a very detailed manner along with leaving readers working in the area of cultural studies, gerontology, demography and more generally in social science, with some pivotal questions to ponder on. references dannefer, dale and jessica a. kelley-moore. 2009. "theorizing the life course: new twists in the paths." handbook of theories of aging 2, 389-411. rowe, john w.and robert l. kahn. 1997. "successful aging." the gerontologist 37(4): 433-440. http://anthro-age.pitt.edu/ book review review of hafford-letchfield, trish, paul simpson, and paul reynolds, eds. sex and diversity in later life: critical perspectives. bristol: policy press. 2021. pp. 238. price: $83.96 (hardcopy); $39.15 (paperback). monika singh indraprastha institute of information technology, delhi monikasi@iiitd.ac.in anthropology & aging, vol 44, no 1 (2023), pp. 125-127 issn 2374-2267 (online) doi 10.5195/aa.2023.474 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:monikasi@iiitd.ac.in book review | singh | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.474 http://anthro-age.pitt.edu 125 book review review of hafford-letchfield, trish, paul simpson, and paul reynolds, eds. sex and diversity in later life: critical perspectives. bristol: policy press. 2021. pp. 238. price: $83.96 (hardcopy); $39.15 (paperback). monika singh indraprastha institute of information technology, delhi monikasi@iiitd.ac.in in sex and diversity in later life: critical perspectives, trish hafford-letchfield, paul simpson, and paul reynolds bring together a wide range of critical issues concerning stereotypes on sexuality and aging as they play out in diverse aspects of later life. the volume is the first issue of the book series sex and intimacy in later life and focuses on aging and sexuality in varied regions as well as different sociocultural contexts. it highlights critical issues concerning age, sex, and sexuality as they emerge in different social, cultural, economic, and geographical settings. contributing authors from europe, north america, and australia from diverse scholarly backgrounds provide important insights into prominent issues concerning diversity in later-life sexuality. as such, this volume also assembles different theoretical lenses on aging, including a feminist lens (chapter 7 explores the complexities of older lesbians’ lives in northwest england using a feminist methodology), a post-structuralist lens (chapter 8 provides a literature review to reflect on the repression and surveillance experienced by older bisexuals in later life using foucault’s ‘heterotopia’), an intersectional lens (chapter 2 explores and analyzes the experiences of us and african american women and the impact of prejudices and constraints on their sexuality) and other prominent theories. the authors use methods as varied as literature reviews, case studies, life histories, surveys, and interview methods to highlight the relationship between age, sex, and sexuality and bust the myths around later-life sexuality and intimacy. in chapter 1, the editors of this volume introduce the significant themes and concepts of the book to explore diversity in sex in later life for further discussion in subsequent chapters. the chapter aims to put sex back into sexuality by emphasizing the need for more empirical studies on older people’s desire, love, and intimacy. the authors also discuss the importance of setting an agenda for future policy making to validate sexual desires of older people. chapter 2 brings a critical perspective on older black minority ethnic (bme) women’s sexuality, sexual rights, and reveals how they are affected by different cultural and social stigmas. debra a. harley uses an intersectional lens and draws from different international studies to argue that sexual desires and sexuality of older black women is stigmatized and contested. they are subject to socio-cultural and religious myths and experience multiple oppressions of gender, race, class and ethnicity. this is also observable in the fact that discussions around older bme women’s sexual rights are mainly absent in debates on later-life sexuality. in chapter 3, karen rennie presents a systematic literature review on the importance of sex and intimacy in the life of older persons and considers both bio-psychological and social perspectives. the author focuses on the positive impacts of sexual and intimate acts of touch for older adults to stay or become emotionally connected when coping with illness and finds that the need for physical intimacy http://anthro-age.pitt.edu/ mailto:monikasi@iiitd.ac.in book review | singh | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.474 http://anthro-age.pitt.edu 126 and sexual contact does not diminish in later life. in chapter 4, trish hafford-letchfield draws on her already published research articles and elaborates on themes around heterosexual love and desire based on views of older heterosexual women from different ethnographic case studies, including women aging alone. the author highlights the importance of deconstructing heterosexual aging stereotypes that inhibit heterosexual older women’s sexual expression, and advocates for the resexualization of sexualities in later life by giving importance to women’s agency and their experiences (73). in chapter 5, “sex and ageing in older heterosexual men,” authors david m. lee and josephine tetley use a mixed-method approach to explore challenges faced by older heterosexual men in england in communication with medical practitioners concerning sexual health and well-being in later life. lee and tetley go beyond the medicalized perspective of sexual activity in later life to discuss physiological and psychological factors associated with the aging bodies of heterosexual men. findings based on qualitative and quantitative data reveal that health, relationships, and physical changes affect the sexual activity of heterosexual older men. they show that erection and orgasm difficulties were key sexual difficulty issues reported by these men men and that also ‘not sharing sexual preferences’ is a major issue affecting older heterosexual men’s romantic and sexual relationships. in chapter 6, peter robinson discusses how gay sexual identities are predominantly scripted as youth identities. drawing from the life stories of 11 older gay men from different regions of auckland, london, los angeles, melbourne, and new york, the author outlines the socio-cultural constraints posed to gay men as they age and how they embrace these challenges. findings of the study reveal that older gay men associate sexual attractiveness with youthfulness and tend to make sexual activity central to their life. chapter 7 critically analyzes sexual abuse between older lesbian couples based on survey data and interviews of lgbt+ community members in northwest england. in this chapter, megan todd laments the absence of discussion around older lesbians and sexual abuse and emphasizes the importance of this topic. she critiques the stereotypes of gender, sexuality, age, and sexual violence and argues that older lesbians also experience violence and sexual abuse. in chapter 8, “foucault’s ‘heterotopia’: bisexuality in later life,” christopher wells gives a systematic literature review to recognize complexities of bisexuality and sexual practices in later life, invoking the foucauldian idea of ‘heterotopia’ and examines the causes of socio-cultural and institutionalised inclusion and exclusion of older bisexual intimacies from older lesbian and gay communities. in chapter 9, laura scarrone bonhomme highlights the debates around the transition process in later life and labels it ‘second adolescence,’ which is described as a revival of teenage physical, social, and psychological battles (168). the author explores the trajectories of physical and psychological changes experienced by individuals transitioning after age 50 across different sociocultural constraints through narratives of the trans community members (165). throughout chapter 10, ela przybylo takes a different approach to late-life sexuality. she focuses on asexual identities and experiences of individuals criticizing the obsessive association of compulsory sexuality with ‘successful aging.’ chapter 11, titled “older people, sex and social class,” provides an analysis of experiences of sexuality and intimate relationships in later life across class hierarchies drawing on the concept of “social class” by pierre bourdieu (1984). here, paul simpson argues that social stratification produces differences in perceptions and experiences of intimacy and sexuality in later life, as availability and access to resources are unevenly distributed in society. to conclude, chapter 12 provides a comprehensive discussion by the editors on significant themes and issues reflected in the volume. overall, this volume offers a combination of theoretical and empirical work that makes for an insightful read and an essential contribution to the anthropology of aging, gerontology, gender studies, and other social scientific disciplines by offering new perspectives on sexual and intimate experiences in later life. http://anthro-age.pitt.edu/ book review | singh | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.474 http://anthro-age.pitt.edu 127 although the authors discuss different sociocultural contexts, the contributors fail to decentralize western conceptualizations of aging and sexuality and mainly focus on studies of the global north. as a result, they extend a tradition in cultural gerontology that has been critiqued by other scholars in the field (lamb 2015). including discussions around aging in the context of the global south would have added a comparative understanding of sexuality in later life. moreover, the editors do assert they do not provide a comprehensive overview of different gendered and sexual identities, but disability and related constraints of sexuality are notably lacking from the discussions. this book will capture the interest of academics studying older adults. for teaching and researching, it is a good starting point for social scientists with a particular interest in aging and gerontology. it is also likely to inspire new research agendas for healthcare policymakers and practitioners. references bourdieu, pierre. 1984. distinction: a social critique of the judgement of taste. cambridge: harvard university press. lamb, sarah. 2015. “beyond the view of the west: ageing and anthropology.” in routledge handbook of cultural gerontology, edited by julia twigg and wendy martin, 59-66. new york: routledge. http://anthro-age.pitt.edu/ microsoft word fall2020_interview_in pdf.docx this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. the serendipitous life and career of dr. jay sokolovsky caleb chrisley george mason university cchrisle@gmu.edu bobby timms george mason university rtimms@gmu.edu keywords: aging; age; anthropology; aage; gerontology; fieldwork anthropology & aging, vol 41, no 2 (2020), pp. 246-249 issn 2374-2267 (online) doi 10.5195/aa.2020.327 mailto:rtimms@gmu.edu chrisley and timms | 246 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.327 http://anthro-age.pitt.edu the serendipitous life and career of dr. jay sokolovsky caleb chrisley george mason university cchrisle@gmu.edu bobby timms george mason university rtimms@gmu.edu when looking at a successful career from the outside, it is easy to see it as a linear trajectory, with each decision fully intended from the outset. however, with a deeper exploration, some successful careers are actually amalgamations of serendipitous moments and chance. from the start of any career, it is important to say yes to opportunities that suit one’s interests and stay connected to professional organizations that, from the beginning, have created networks for like-minded professionals. dr. jay sokolovsky has spent a major portion of his career studying aging as a cross-cultural phenomenon. judging from his wide-ranging publications, it would appear from the outside that a clear path has marked his professional trajectory. yet, he insists that his journey in anthropology is based on serendipity. while initially a physics major, anthropology captured his attention during his sophomore year of college, in large part due to the fascinating cultural practices, such as yogi rituals, that he learned about. from that moment, dr. sokolovsky refocused his educational goals to align with his budding interest in anthropology. during the covid-19 pandemic, we met dr. sokolovsky via zoom to hear about his professional life. even through the barrier of a computer screen, it is clear that he is a warm and vibrant person, who sees the importance of anthropology and invests endlessly in his students. “i have been pushing for my students to go to graduate school because there are huge opportunities if you can figure out how anthropology can contribute to the world,” said dr. sokolovsky. upon completing his ph.d. at penn state university in 1974, dr. sokolovsky focused his research on globalization among indigenous communities in mexico. he eventually made the decision to move into academia but found that the climate was overloaded with competitive candidates. when he was not able to snag a teaching position, he ended up in new york city teaching as an adjunct at a few different schools. soon, his first serendipitous moment would come to fruition when his connection to a close friend and psychiatrist, dr. carl cohn, paved the way for dr. sokolovsky to become involved in what would later become his life’s work. dr. cohn was in new york city at the time, working with communities of individuals recently released from mental asylums. dr. sokolovsky joined dr. cohn and his team of cultural geographers, psychologists, and sociologists. the team ended up publishing an article on human organization, which according to dr. sokolovsky, ended up becoming the “first applied work on health issues and released mental patients coming into urban areas.” the realization that many of their research participants had spent decades in asylums, led dr. cohn to suggest a study on older adult populations. initially not convinced that he would have much to contribute on the topic of aging, due in part to his previous work centered around indigenous http://anthro-age.pitt.edu/ mailto:rtimms@gmu.edu chrisley and timms | 247 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.327 http://anthro-age.pitt.edu populations, dr. sokolovsky eventually conceded and began working alongside dr. cohn in this new study. they set out to begin their work by looking at older people in residential hotels in new york city. between 1974 and 1976, their team completed research that led to several publications, but it wouldn’t be until another serendipitous event that dr. sokolovsky would recognize his calling as a specialist in the field of aging. in 1976, the stars aligned when the opportunity to teach at the university of maryland, baltimore arose, alongside an increasing national interest in aging and gerontology. the natural institutes of health (nih) became more interested in developing new ways of understanding the issues revolving around aging and offered fellowships for researchers. previous research focused primarily on broad surveys, which didn’t help to aid in designing programs that were suitable for encompassing issues surrounding elder care, ranging from the environment to healthcare to treating cognitive decline (i.e., dementia). the summer before starting at umbc, the nih offered fellowships through the university of chicago to, “learn how to apply social science to the study of gerontology and aging.” there, dr. sokolovsky met researchers such as christine fry and kevin eckert, amongst others, who were also interested in researching anthropology and aging. up until that time, limited studies were done on this topic of research, although dr. sokolovsky notes that there were individuals such as barbara anderson and margaret clark (who he calls the godmother of the anthropology of aging), who pioneered this branch of the field. dr. sokolovsky found that these connections went beyond the scope of anthropology and traversed across multiple disciplines, all working together to develop the most sophisticated research on aging possible. with no professional organizations to address the topic of aging at the time, dr. sokolovsky and dr. christine fry, and others, created a network of research that became the framework for understanding gerontology. this network also became instrumental in restructuring the grant proposal process by placing social scientists and their specialties on grant proposal advisory boards. eventually, an entire organization was created called the “association for anthropology, gerontology,” (now called the association for anthropology, gerontology, and the life course). the shift in mindset from simply studying “old age” to studying the entire life course expanded anthropological research in ways that included researching how the concept of “old age” continues to change in our own society. even more interesting is that as dr. sokolovsky’s research continued through this wormhole, he found earlier anthropologists such as the famous margaret mead and gregory batesmon had also written on the subject of aging. dr. sokolovsky realized that up until this point, aging was always closely associated with death— instead of having its own identity in research categories. even though anthropological publications did exist that addressed aging, such as margaret clark and barbara anderson’s, “culture and aging: an anthropological study of older citizens,” anthropology had yet to really embrace this subject matter compared to other social sciences at the time. working alongside dr. cohn in new york city provided dr. sokolovsky the opportunity to demonstrate how anthropology can be used to make a difference in communities. dr. sokolovsky acknowledges in his first book on the subject of aging, that anthropology provided a landscape to look “outside the surface” beyond what other disciplines had to say about aging, in order to see “how things were really functioning in the deepest part of people's lives.” an anthropologist’s perspective is both unique and vital to helping physicians understand both the cultural aspects of medical systems and medical systems themselves. dr. sokolovsky played – and continues to play – a vital role in developing the field, although it was not the path he intentionally set out on. he says: “i literally got sucked into this void – i mean, it was a void that was missing in anthropology.” from 1978 to the late 1980s, dr. sokolovsky notes that ph.d. degrees http://anthro-age.pitt.edu/ chrisley and timms | 248 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.327 http://anthro-age.pitt.edu in the field of anthropology and aging “took off”; many students were finding grants and publishing work that ultimately developed into the field it is now. dr. sokolovsky understands the unique ways anthropology contributes to all other fields and its ability to enhance most disciplines. he explains: “anthropology can really make a difference – not only in people’s lives, but it can interface with other disciplines that think they are doing applied gerontology, whether it’s in social work, medicine, or psychiatry.” moreover, dr. sokolovsky mentions a study with social workers from the census bureau and a team of undergraduate anthropology students to study the homeless communities in the baltimore–washington area. the study revealed to the social workers and to dr. sokolovsky, that the anthropology students were more equipped to go into the homeless communities and hear the voices of their research participants without any preconceived notions or predetermined ideas of what their lives were like. as a result, the anthropology students provided the most powerful information used in the report to the census bureau. dr. sokolovsky notes that during the review process of his first book, a reviewer accused him of anthropological chauvinism — but he does not shy away from that accusation, [they] were right! . . . in much of the book, my point was that many of the issues that sociologists, psychologists, and physicians thought they were solving with the disciplines looking at aging, they were really looking at it from the outside – at the surface, and they weren't looking at how things were really functioning in the deepest part of people's lives. dr. sokolovsky says that the advice he often gives to young graduate students, who might be working in public health, in pharmacies, or in hospitals is, “don't become a physician; become a professional anthropologist who helps physicians understand medical systems and the cultural aspects of that,” he continues to say, “if that is being an anthropological chauvinist, i'm really proud of that.” this interview would not be complete without gaining dr. sokolovsky’s perspective on the current covid-19 pandemic. being an expert on the topic of aging, dr. sokolovsky addresses the ways anthropologists working alongside older adults in nursing homes were making the biggest contributions in understanding how our cultural systems intertwine with addressing this outbreak. he said, how cultural systems are working either to help people deal with the social aspects of this in terms of promoting a psychological, social, and medical environment where people can limit the spread of the virus and also come up with cultural mechanisms as a hopefully temporary substitute for the kinds of human interaction that can sustain people that are in compromised medical conditions. additionally, there may be positive cultural aspects of the pandemic that activate society to redesign some of the structures that organize it, such as redesigning less congested cities, rethinking how we deal with food and development of urban gardening, and most importantly on the topic of aging, such as redesigning older age living environments. we can already see changes in society as biomedicine and healthy lifestyles transform our ideas of getting older. dr. sokolovsky notes polymath philosopher, harry moody’s coinage of the term: “wellderly,” which aptly addresses the new mindset surrounding age. many anthropologists now conduct research on the topic of aging and challenge the notion of stigmatized senescence. http://anthro-age.pitt.edu/ chrisley and timms | 249 anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.327 http://anthro-age.pitt.edu dr. sokolovsky encourages students interested in the anthropology of aging to become members of aage, which will provide them professional connections, grant, and funding opportunities. additionally, he urges undergraduate students to start thinking about the ways anthropology can contribute that differs from the types of research already done on aging. “become an anthropological chauvinist, but not an obnoxious one,” he added. as an example of the contribution, anthropology has the capacity to make, he mentions his oldest friend, carl. “[carl] started a community clinic for assessing cognitive impairment and dementia in the heart of this relatively poor, multiethnic community [in brooklyn], and he started–he got funding to start a training program for physicians.” dr. sokolovsky has been engaged with the clinic for the past decade offering training in anthropology and aging lectures as well as going on rounds with physicians and sitting in on initial interviews with patients. he told us, “one of the things i've been able to do is to show how an anthropological approach to interviewing can get at materials that the standard clinical interview doesn't get to.” dr. jay sokolovsky is a trailblazer in the world of anthropology and aging, who embraced serendipitous opportunity to build a successful life and career. he has paved the way for many more anthropologists to follow in his steps studying the cultural complexities of aging. dr. sokolovsky has just recently retired from the university of south florida, st. petersburg, but there is no doubt his legacy and contributions will continue to inspire generations of anthropologists as the study of aging continues to develop along new paths. old age as we know it is changing, and thanks to dr. sokolovsky and his early team of social scientists, we have been offered the awareness that this is a critical and extremely relevant study for the social sciences. through his example, dr. sokolovsky shows us that, like his career, research is not always – and in fact, it rarely is – a linear path where all parts are known in advance. rather, it is about being open to opportunities when they present themselves and pondering how anthropology can uniquely contribute to the world we know. http://anthro-age.pitt.edu/ aging, care, and isolation in the time of covid-19 lenore manderson university of the witwatersrand lenore.manderson@wits.ac.za susan levine university of cape town susan.levine@uct.ac.za anthropology & aging, vol 41, no 2 (2020), pp. 132-140 issn 2374-2267 (online) doi 10.5195/aa.2020.314 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 132 aging, care, and isolation in the time of covid-19 lenore manderson university of the witwatersrand lenore.manderson@wits.ac.za susan levine university of cape town susan.levine@uct.ac.za introduction south africa’s harsh lockdown was an urgent response to the virulence and capriciousness of sarscov-2. when it was introduced on march 26 2020, it was presented as a precautionary measure lest hospitals be overwhelmed with people requiring emergency and intensive care; restrictions were imposed for the public good until transmission abated. at this time, there was little opportunity to reflect on how else this pandemic might be managed, what else might need to be addressed, and what it might mean to live with a continuing threat of infection and/or extended lockdown. as these eventualities transpire, we see now the importance of examining the circumstances in which people live with multiple chronic health conditions, many of whom are aged and were, before lockdown, already struggling with limited mobility and contracted social interaction. in this article, we focus on how the proxemics of the pandemic affect people with chronic conditions, including the impact of changed norms of engagement for self-care and chronic disease management for individuals and households. among older people, covid-19 can both directly and indirectly increase their isolation, load onto existing health problems, and add to the risks of depression and anxiety. while there is excess mortality among older people from covid-19, the concomitant accumulating social and physical effects of changes to everyday lives may equally contribute to untimely death. with the spread of coronavirus, there has been growing concern for the vulnerability of older people to serious diseases for both biological and social reasons. emerging data suggest that covid-19 deaths and other acute conditions are increasingly unrelated to the virus itself, but born out of its social consequences (delmas, bouisset, and lairez 2020; manderson and wahlberg 2020). there is concern regarding increasing suicides and (often interconnected) problems of gender-based violence and alcohol misuse (al-ali 2020; gratz et al. 2020; ramalho 2020; troutman-jordan and kazemi 2020). the aptly named ‘broken heart syndrome’– stress cardiomyopathy or takotsubo cardiomyopathy – is also reported to have increased since the start of the pandemic, with the primary risk factor being age, along with anxiety and/or depression (alharthy et al. 2020; giustino et al. 2020; jabri et al. 2020; sattar et al. 2020). well into the pandemic, we now need to consider its continuing direct and indirect effects on people’s lives. below, we consider how housing, mobility, everyday functional activities, household composition, and underlying health conditions are all impacted by covid-19. we draw on our ongoing work in medical http://anthro-age.pitt.edu/ manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 133 anthropology and public health in south africa to highlight the ways in which covid-19 amplifies the structural vulnerabilities of aging and frailty, of multiple physical and mental health debilities, and the capacity of others to provide care (harling et al. 2020; mkhwanazi and manderson 2020). these vulnerabilities are largely not unique to south africa. rather, south africa instantiates the manifold problems affecting older people in middle income countries, where epidemiological and demographic transitions have occurred in tandem with growing inequality. the introduction of state regulations in response to covid-19 in local settings aggravates these social and physical vulnerabilities and inequalities. in this article, we highlight the interconnected, knock-on and accumulated impacts of the pandemic and its management. households and/of care while the earliest cases of covid-19 reported in south africa in march 2020 were among tourists, the first intense wave of infections occurred in old age homes in the provinces of western cape and gauteng (maree and khanyile 2020). influenced by the disproportionate death rate among older people in europe and north america, these residential care homes and hospitals privileged both clinical care and containment of infection. as one measure, those managing these settings opted to isolate elders to prevent younger members from being with parents, grandparents, or great grandparents. the restrictions on contact with vulnerable elders may have slowed community transmission, but in clinical settings, they presaged high rates of infection, as hospital employees struggled to gain access to adequate supplies of personal protective equipment and to adhere appropriately to protection procedures and protocols. with social distancing, the affective and proxemic dimensions of care in hospitals and in aged care facilities also changed. overnight, nurses on the frontlines, attempting to provide care through reassuring touch as much as medical attention, were draped in new protective gowns, masks, and gloves. they were asked to adopt a medical, more distanced form of care, which has been both reassuring and alienating to patients, nursing staff and their respective family members. people in residential care have faced months without face-to-face communication with loved ones, relying more and more on social media to stay connected. however, a small minority of older privileged and mostly white people in south africa live in residential care. the greater challenge to health and wellbeing is for the black and colored majority living alone or with family members in community settings (see also maree and khanyile 2020). here, markers of vulnerability, limits to care and social isolation were already challenges to health before covid-19. we turn now to elaborate on these structural challenges in households as settings of care and how they are aggravated by covid-19. we then consider how embodied constraints can extend vulnerability, including declining physical health, mental illness and distress, opportunistic infection, and hunger in under-resourced households. households are neither homogenous nor stable; they vary significantly in size, capacity and relatedness of members, and while multigenerational households are common, this is not necessarily the case (mkhwanazi and manderson 2020). households of one or two people only, and of seven, eight or more people, sometimes related only distantly, are both common. household composition is often fluid, with temporary episodic changes occurring with seasonal labor and during holidays (spiegel et al. 1996). this fluidity undermines the structures and reliability of care, including that provided at home for chronic conditions. a recent study in gauteng province, the most populous province of the country including both johannesburg and pretoria, showed that 74% of older people live in households of two or more people. of these, 82% are reportedly head of household, and over half are the primary carers of dependent children (56%) and have at least one dependent child (65%) (de kadt et al. 2020; parker and http://anthro-age.pitt.edu/ manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 134 de kadt 2020). these figures also mean that 26% of older people live alone, many lacking regular everyday interactions and access to personal assistance as needed. in community settings, as these figures suggest, care is generally provided by older people to dependents, including grandchildren, great-grandchildren and other unemployed family members, as well as to other older frail members of households (see further below). one case illustrates how this transpires in the everyday. thembisa khwalo lost her job as a domestic worker in 2019, and now, at age 60, is without any future work prospects, pension, or savings (levine, fieldnotes). incapable of looking after herself or her children in cape town, she returned to her rural home in the eastern cape, a region in crisis from extreme drought, with health and educational infrastructures eviscerated through state corruption and the ongoing legacy of apartheid race policy (magubane 1979). neither of her children are working, and while her son was enrolled in college prior to the lockdown, there is no longer any family income from which to draw support. she suffers from chronic pain and limited mobility due to knee injury. health care systems at all levels are insufficient and unable to cope with the high incidence of illness, which includes hypertension, cancer, tb, hiv/aids, and now, additionally, covid-19. yet, when asked about the presence of covid-19 in her area, thembisa responded: “nobody is sick, only struggling with money and food.” covid-related unemployment and systemic race inequality, born out of racial capitalism, have already led to massive food scarcity (amadasun 2020; levine 2013; phogole 2010). early opinions on the impact of the pandemic in south africa suggested that poor people would die of hunger before they died of covid-19, and this is now increasingly likely for elderly people without any arable land to grow food. as eggan (2020) reported, “behind… specific lockdown-related developments a great specter looms: hunger.” thembisa’s garden has space enough for egg laying chickens and unlike in her densely populated township home in the city, she feels protected from covid-19 in the eastern cape due to the distance between houses in this rural setting. her house in cape town is sandwiched between informal shacks and semi-built houses with the close proximity between people difficult to avoid in a time of social distancing. but the political geography of greater space in her rural home also means that thembisa has no contact with her neighbors. in a country already devasted by the impact of hiv and tb, the resistance to social distancing that has occurred in the united states and parts of europe are nearly non-existent. the elderly are most at risk of infection, and their children and grandchildren, neighbors, and friends are staying away to protect them. the greater adherence to new public health protocols around social distancing has, however, simultaneously led to isolation and intensified feelings of loneliness among aging populations in both urban and rural contexts. the complexity of different affective and material dimensions of this differential proxemics requires the kind of ethnographic work currently prohibited along ethical and public health lines. in contrast with thembisa’s isolation from younger family members, a notable effect of the hiv pandemic was the redistribution of care because of “skip generations” (schatz and madhavan 2011; schatz, madhavan, and williams 2011; schatz and ogunmefun 2007). nothemba bhaxa’s daughter died of an aids-related illness in 2012 in zwelethemba township in the western cape (levine 2013). she left behind a daughter aged six, and twin boys aged two. nothemba, now in her seventies, is still the primary caretaker of all three grandchildren in this “skip generation” household. however, the roles of older women – especially in childcare and as household heads – predates hiv. the vital role of older women in caregiving is the result of male labor migration and apartheid era control over mobility and residence. it has continued as young parents seek employment as and where it is available. but while older women provide much of the care, the reverse is true. younger people do provide care to their elders, and when this is compromised for a range of reasons, this impacts their own sense of wellbeing, connectedness, and their ideas of a future without fear. http://anthro-age.pitt.edu/ https://www.dailymaverick.co.za/article/2020-04-17-the-biggest-lockdown-threat-hunger-hunger-everywhere/ manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 135 this seems to be slighty different in townships on the margins of cities. in informal settlements at least, strict adherence to lockdown regulations is often impossible, and life continues relatively unchanged even under the harshest lockdown rules, with the exception of increasing police enforcement of isolation (levine and manderson 2020). the other exception is of massive unemployment, so that men and women of working age are home to a greater extent. when families live together along intergenerational lines, for some there is more, not less support for those who need it. data are not yet available on recent changes in household size and composition, including as a result of temporary changes associated with covid-19 lockdown regulations. householders often depend on the older person’s grant (schatz et al. 2012; schatz et al. 2015). this dependency has likely increased with the contraction of the economy and unemployment, including domestic work, laboring, gardening, recycling, and other informal work. while some temporary members of households are entitled to state support due to unemployment associated with covid-19, the amount (c.us$20 per month) is insufficient to meet subsistence costs. further, notwithstanding our comments above, greater numbers of people in households do not necessarily result in improved personal care and assistance. as we illustrate below, instead, concerns about infection and the management of risk further influence the care provided for other health conditions, such as cardiometabolic diseases and hiv. these conditions amplify covid-19’s lethality. syndemics and recursivity public health measures, improved hygiene and sanitation, early diagnosis and surgical and medical interventions, have had a substantial effect on south africa’s demography and population aging. associated with this, in south africa and elsewhere in sub-saharan africa, there has been a significant increase in the absolute numbers and proportion of people living with cardiometabolic disease (obesity, heart disease and diabetes), cancers, arthritis and chronic obstructive pulmonary disease (chang et al. 2019a; 2019b). these conditions may be unstable because of pathological changes, difficulties with medication supplies and the challenges of comorbidities. in addition, around 5 million out of 7.7 million people living with hiv receive antiretroviral (arv) medication. like others, they concurrently live with various chronic conditions. these conditions and their management are all affected by social circumstances, and both social and biological factors, in multiple ways – biological with biological, social with social, biological with social – interact to complicate, compound and exacerbate illness (manderson and warren 2016; singer et al. 2017; singer 2009). the syndemic effects of sars-cov-2 and cardiometabolic conditions are still being identified (singer 2020). while relatively low death rates have been reported in populations with high rates of hiv, prompting speculation of the protective effects of arv medication, other chronic conditions are clearly implicated in poor outcomes for covid-19 (flaherty et al. 2020; mahumud, kamara, and renzaho 2020). covid-19, chronic conditions, and aging are linked in ways that stretch beyond clinical risk. complications from various chronic conditions, typically exacerbated with aging, impair independent living. people with impairments and others who become more frail as they age may require extensive personal assistance, including help with what the international classification of functioning (icf) identifies as “basic functional tasks”: the ability to eat, toilet, dress, and bathe/shower, get in and out of bed or chairs, and walk (warren and manderson 2013; world health organization 2001). if a person with such limitations lives with others, assistance with everyday activities may need not to be impeded under lockdown restrictions, but where bathing facilities and toilets are shared beyond the household, people must move in and around the community in ways that contradict distancing strategies.furthermore, loss of communication and/or sensory, cognitive, social and interactional skills http://anthro-age.pitt.edu/ manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 136 – as may occur with stroke and dementia – by default shrink people’s social worlds and everyday living skills. more complex tasks of domestic, household and community life – managing money, shopping, preparing meals, undertaking housework, using a telephone – regarded as instrumental activities of daily living (iadls) (barberger-gateau, dartigues, and letenneur 1993; harling et al. 2020) – are harder to address when household size and economic resources are constrained. further, while people who are frail and in poor health, aging and otherwise, depend on other householders for intimate care and other assistance with daily living, they also find relief from relative isolation through visits from other family members, neighbors, and, occasionally, community health workers. physical distancing has introduced new constraints to the giving and receiving of care, particularly when caregiver(s) and care recipients live separately. thus, the faltering rhythms of a predictable life, due to social constraints in response to the pandemic, are likely to reduce the provision of everyday care – and may well heighten confusion or add distress for people with cognitive decline. infrastructures of care covid-19 has resulted in growing pressure on households through socio-economic constraints and the reduced capacity to provide care. in this paragraph, we illustrate how care infrastructures are specifically eroded with covid-19, impacting negatively on the health of older peple with chronic conditions. henriette langstrup (2013) relates “care infrastructures” to a person’s capacity to self-care and receive care: an assemblage of people, spaces and material items that link the home with external structures of care. these infrastructures include people (health professionals, social workers, taxi and bus drivers, families, neighbors and friends) and technologies (telephones, medicines and other items, such as a blood glucose meter and associated materials for its use as well as boxes, cupboards and fridges for safe keeping) (langstrup 2013, 1018). in south africa, however, although population-wide cell phone ownership is high, people cannot always afford data, and topping up data requires time and mobility. furthermore, storage space is limited in small rural houses, cottages and peri-urban shacks where four, five or more people may live in one or two rooms and where people may keep drugs on the top of cupboards and wardrobes and in handbags to be out of reach of small children (manderson 2020). the simple tasks of “homework” stretch logistics and resources in community settings, as care needs change (manderson and wahlberg 2020; mattingly, grøn, and meinert 2011). poverty already adds complexity to undertaking these tasks. the covid-19 lockdown has further complicated this through declines in household income, changes of household composition and size, and limits to movement. any single factor can unsettle home infrastructure and disrupt the critical consistency of care. in poor households, people compete for care and resources. moreover, there is rarely simply one carerecipient and one caregiver; rather, people provide and receive care depending on need, capacity, resources, proximity and availability to others (manderson and block 2016; manderson, block, and mkhwanazi 2016; schatz et al. 2018; singer 2020). caregivers can also simultaneously be care-recipients; caregiving is often mutual and at any point, a person with the predominant role of caregiver may be incapacitated and in need of care themselves (nxumalo, goudge, and manderson 2016). in this syndemic context, couples are being reported to have died of covid-19 on the same day. one can only imagine the agony, of not having been able to provide care for their beloved one, and the distress of their closest family members, unable to attend to them in the hospital or find solace in their grief at a family burial due to funerary regulations. there are other cases of asymmetrical outcomes, where only one partner survives. in both instances, the household becomes a space of debility. under ordinary circumstances, a community health worker, an ngo activist, or a neighbor may step in if a primary caregiver is absent or without capacity to care. but with shifting proxemics and explicit emphasis on physical distance and likely social withdrawal, it is possible, without intentional programs, to overlook http://anthro-age.pitt.edu/ manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 137 the evolving care needs from conditions other than covid-19 when people lose the care which they had relied on. in south africa, governmental health support supplements home care through a model of integrated chronic care that is delivered through community clinics (limbani et al. 2019). chronic conditions require that patients adhere to medication at home and attend clinics for monitoring. this requires that they can walk to a clinic, or that transport is affordable and accessible. the older the person, the more likely she or he depends on at least one other person to assist with these tasks within the home and in relation to clinic visits. if the caregiver is a paid worker, then he or she needs to negotiate time and to ensure good enough care for a household member with care needs through facilitating a visit to the clinic. if the caregiver has children, cares for other older people or grandchildren, for instance – then someone else needs to care for them at the moments of clinic visits. for these and other reasons, people in rural areas and in townships have poor access to health facilities even under ordinary circumstances. covid-19 constraints only further limit access to medical care, and thus increase the social and physical vulnerabilities that derive from this lack. concluding remarks covid-19 has amplified tensions between formal clinical care, state care, and interand intra household care for the aged, who as a population are rendered more or less vulnerable along the deep systemic cleavages of class, race, and gender that impact generations. there is another ordinary story of aging, not unique to south africa, where elderly people fear that they will not again be able to hug their children, nor travel to them if they live overseas, and where deep depression is settling in. covid19 has exacerbated isolation and loneliness, again sadly revealing how inequality tailors living circumstances and political response. a father died at an old age home alone, not because he was sick but because he decided life was no longer worth living under covid-19. his wife was in a hospital, seriously ill after an extended period of suffering from alzheimer’s disease. he was unable to visit her, and their children and his other daughter lived at a distance. he was despondent. he could hear his children’s concern. he did not die an assisted death, nor did he die from covid-19, but his daughter believes that he died a "covid death" due to isolation and the lack of care that he might have been provided under other circumstances. other friends and colleagues have lost parents and other older relatives as a direct result of covid-19, and equally, they have been trapped by the demands of isolation from providing them with the personal care that might make all the difference to ways of dying, and from farewelling them (kaufman 2009; kaufman and morgan 2005). this has slightly changed in south africa, as interprovince travel has opened up, enabling some people to travel to be with elderly family members, particularly when dying of causes other than covid-19. but this assumes that travel is logistically and economically possible. we have, throughout this article, showed how covid-19 amplifies and exploits household fragility in different ways, producing social isolation in wealthier households and heightening dependency and vulnerability in poorer households (cox 2020). yet, as thembisa’s story indicates, even this is an uneven balance, and domestic violence, depression from isolation, and emerging fears of dying alone and being buried without a funeral, clearly cut across class, race, and geographical division. caregiving continues in environments of lack. the networks of care shrink in some cases, while blowing out in others. those whose incomes derive from providing others with personal care and domestic work are affected economically. most people who care for others at home in south africa – and worldwide – cannot afford masks and gloves, and necessarily breach guidelines to continue to provide intimate http://anthro-age.pitt.edu/ manderson and levine | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.314 http://anthro-age.pitt.edu 138 bodily care. similarly, those without household members to assist them face particular risk, not from covid-19 but from neglect. references al-ali, nadje. 2020. 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"international classification of functioning, disability and health: icf." geneva, switzerland: world health organization. http://anthro-age.pitt.edu/ the effects of social-withdrawal characteristics among older academics: an indonesian case study adityo pratikno ramadhan ramadhan.adityo@gmail.com centre for global sustainability studies, universiti sains malaysia suzyrman sibly suzyrman@usm.my centre for global sustainability studies, universiti sains malaysia abstract indonesia, the world’s fourth-most populous country, sees a significant increase in its aging population each year. this demographic shift is reflected in the country’s public higher-education sector, where the number of older academics has been growing substantially in recent years. however, older people’s social participation is often limited due to certain forms of withdrawal, such as shyness, avoidance, and unsociability. this research report aims to explore the impact that these social-withdrawal characteristics among older people may have on data collection and policy-formulation processes in public universities in indonesia. to gather data for this study, an online questionnaire was employed. the results of this study suggest that older people’s social-withdrawal characteristics can have two effects. first, older individuals are often reluctant to participate in research, particularly as online questionnaire respondents, which can result in a lower response rate. second, our study found that most older academic staff were unwilling to request or demand specific services or facilities from university administration, making decision-makers unaware of the needs of their older staff and aging issues in general. as a consequence, university administration may not consider instituting an aging policy at their institution, as they believe that older workers do not require special attention. this lack of awareness can have serious implications for the well-being of older academic staff and the overall effectiveness of university policies. keywords: older academics; aging policy; university policy; indonesia; social withdrawal; aging research anthropology & aging, vol 44, no 1 (2023), pp. 57-64 issn 2374-2267 (online) doi 10.5195/aa.2023.444 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. ramadhan and sibly | 57 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu the effects of social-withdrawal characteristics among older academics: an indonesian case study adityo pratikno ramadhan ramadhan.adityo@gmail.com centre for global sustainability studies, universiti sains malaysia suzyrman sibly suzyrman@usm.my centre for global sustainability studies, universiti sains malaysia introduction indonesia, the world’s fourth-most populous country, has experienced a significant increase in its aging population each year. as of 2019, there were 25 million older people aged 60 and over in the country, accounting for 9.6% of the total population (maylasari et al. 2019). the number of older people in indonesia continued to rise in 2020, with 26 million individuals comprising 9.92% of the population (sari et al. 2020). recent statistics show that the number of older indonesians has reached 29.3 million, making up 10.82% of the population (girsang et al. 2021). these statistics demonstrate a clear trend of population aging in indonesia, which has significant implications for public policy and social programs aimed at supporting the needs of older individuals. the public higher-education sector in indonesia is also affected by the country’s aging population, with a significant increase in the number of older academic members each year. based on government data, the percentage of older academic staff in public higher-education institutions was 27.16% in 2018 (ministry of research technology and higher education 2018). however, this percentage slightly decreased in 2019 to 27.13%, or 21,712 older academic staff of the total number of academic staff in indonesian public higher-education institutions, which was reported to be 80,023 (ministry of research technology and higher education 2019). maintaining health is one of the most pressing issues that older people experience, as emphasized by the who (world health organization 2015). a study by scholars on the theory of “active aging” (world health organization 2002), found that participation in various activities is a key factor in maintaining older people’s health and well-being; older adults who participated in social activities experienced an improvement in their quality of life during the aging process (paúl, ribeiro, and teixeira 2012). this finding has been supported by another scholar, who highlighted the benefits of social activities for the health of older people (boudiny 2013). older people’s participation is observed in different domains, such as work opportunities (boulton-lewis and buys 2014; walker and maltby 2012), social activities (rosso et al. 2013), and political engagement (powell et al. 2012). both scholars and officials at who emphasize the importance of participation in various activities. however, older individuals are often susceptible to certain forms of social withdrawal, such as shyness, avoidance, and unsociability (hill et al. 2021). these social-withdrawal characteristics among older people can have a significant impact on data collection for research and policy formulation in public universities. this can lead to lower response rates and an incomplete understanding of older adults’ needs and perspectives, as we highlight in this report. specifically, this study aims to investigate the effects of social withdrawal on data collection and the process of formulating policy concerning older adults at public universities. http://anthro-age.pitt.edu/ ramadhan and sibly | 58 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu older indonesian academic staff according to indonesian law 13/1998 on the welfare of older people, individuals in indonesia are considered “older people” when they reach the age of 60 (pemerintah republik indonesia 1998). however, most indonesians begin retiring from their official jobs before they turn 60. state business and private-sector workers begin retiring at age 55, while government workers start at age 58 (adioetomo and mujahid 2014). but certain occupations mandate retirement at age 60 or later, including academic staff in higher education who retire at the age of 65 or at 70, if they have been promoted to full professor (indonesia higher education database 2020). regardless of gender, older academic staff members have the same responsibilities and obligations as their younger colleagues. these duties include teaching courses, conducting research, and publishing academic work as well as contributing to community service, commonly known as tridharma in bahasa indonesia. every academic staff member is expected to fulfil the tridharma annually. university workplaces do not differentiate between older and younger academics, and they provide the same services to all staff members (ramadhan, sibly, and khelghat-doost 2022). in indonesia, the merit system for higher-education academic staff consists of five tiers. the first tier is junior lecturer, which is the entry-level for academic staff in higher education. the second and third tiers are lecturer and assistant professor, respectively. the fourth tier is associate professor, and the highest tier is full professor. academic staff members must accumulate academic points to move up from one tier to the next. these points are earned through three primary functions: teaching, research, and community outreach. academic staff members who are aged 60 and older have typically accrued significant experience and expertise through years of teaching, research, and community service at the university, making numerous contributions to the institution. many of them hold the rank of associate professor or full professor due to their senior academic status, and they are generally highly regarded by both their colleagues and the university administration. conceptual framework several academics have used various terms to describe social withdrawal among older people, though it is typically referred to as “social reductionism” (schroots 1996). sociologist lars tornstam (1997) introduced the concept of “social disengagement” as part of his theory of gerotranscendence, which involves a shift in perspective of older people on the emphasis and meaning of their social relationships. he suggests that this may lead to older people being more selective and less interested in certain social and personal relationships. older people often experience social withdrawal and may have various types of it (li and zhang 2015). the most common types are shyness, avoidance, and social isolation (hill et al. 2021). social isolation is typically defined as a lack of social contacts (kobayashi and steptoe 2018). older people may experience social isolation for various reasons, such as deteriorating health, losing their spouses or partners, living alone, and having fewer confidantes (victor and bowling 2012). other reasons are that cognitive and physical impairments may make people withdraw from social interactions (li and zhang 2015). moreover, older people tend to avoid using technology like the internet because of their cognitive and physical challenges, a behavior called “technology avoidance” (jokisch et al. 2020, 2). http://anthro-age.pitt.edu/ ramadhan and sibly | 59 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu internet technology can pose challenges for the current generation of older people, as noted by several scholars (hargittai, piper, and morris 2019; morrison, coventry, and briggs 2021; xie et al. 2020). there are three reasons why older people may disengage from online activities (morrison, coventry, and briggs 2021). first, older individuals may choose not to engage due to a perceived cost-benefit imbalance. second, they may not feel the need to engage since it is not their responsibility. finally, older individuals may be unable to engage due to a lack of technological proficiency, which can cause anxiety and a fear of making mistakes. online technology may limit older people’s participation in online questionnaire research (poli, kelfve, and motel-klingebiel 2019). however, a different perspective has been proposed, claiming that online surveys may be more efficient for older people in a country where internet access is widespread (kelfve et al. 2020). furthermore, kelfve and colleagues acknowledge that the online response rate for older respondents is lower and that a paper questionnaire should be provided as an option. moreover, education appears to be a significant factor related to internet skills among older adults (schehl, leukel, and sugumaran 2019). in particular, older people with higher levels of education tend to have better internet skills than those with lower levels of education (hargittai, piper, and morris 2019). methods this paper reports on a study conducted at two prestigious public universities in west java province, indonesia. this province has the highest population and the largest number of public universities in indonesia, as well as a high percentage of older academic staff at its public universities (ministry of research technology and higher education 2018). furthermore, west java province is indonesia’s most populous province and shares a border with jakarta province, the country’s capital. the public universities involved in the study are located in two different cities in west java province. this study was approved by the human research ethics committee of universiti sains malaysia with the code number: usm/jepem/20050257. the ethics committee and the principal investigator agreed to keep the identities of all participants, institutions, and older people involved in the study anonymous. the data collected and used in this paper are presented as letters and numbers to protect the confidentiality of any person or institution. this research involved two public universities, referred to as university 1 and university 2. university 1 has 1,527 academic staff, of which 18.2 % are aged 60 and over. university 2 has a larger academic workforce (1,740), with 17.7 % of the staff aged 60 and older. the quantitative sample consisted of 277 older academic staff from university 1 and 309 from university 2, a total of 586 older academic staff. in this study, a sequential exploratory mixed-methods approach was employed, which involved both qualitative and quantitative methods. the first phase of data collection involved conducting semistructured interviews with top university administrators, including the rector, vice rectors, and directors at both universities. the qualitative findings from this phase were published in an international journal (ramadhan, sibly, and khelghat-doost 2022). the second phase was quantitative and used a questionnaire to collect data from older academics at both universities in the study. the questionnaire was distributed online to the participants, and an online pilot test was conducted before sending the actual questionnaire to respondents. the data collection for the quantitative part of this study took place during july and august 2021 in indonesia, a period when the covid-19 pandemic was at its worst. consequently, all research activities that required physical presence in indonesia and other data collection were conducted through online platforms such as google forms and whatsapp applications. this study collected questionnaire data http://anthro-age.pitt.edu/ ramadhan and sibly | 60 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu for nearly two months. in the first two weeks, liaison officers from the participating universities distributed the questionnaires to their colleagues via whatsapp groups. however, this method did not reach many older academics, as there were fewer than 10 in the study sample. therefore, the deadline for the questionnaire was extended by one week and a different distribution method was used. due to the extremely low response rate of the first distribution, the liaison officers at universities 1 and 2 were instructed to send out the questionnaire again but in a different way. according to the liaison officer from university 1, he re-sent the link to the questionnaire along with a cover letter to older academic staff members. the liaison officer from university 2 delivered the cover letter and questionnaire link to all deputy deans of resource affairs at the university, and urged them to disseminate it to all older academic employees. these methods increased the number of responses to about 30. the researchers also extended the deadline twice and contacted friends, colleagues, and acquaintances who had connections with university 1 and university 2. they helped to distribute the questionnaire or provided the contact details of potential participants. through these efforts, the researchers recruited 41 participants for the study, which was a significant improvement from the initial response rate. findings and discussion this study has revealed two effects of social withdrawal among older academic staff. the first effect is their reluctance to participate in the research process. out of the 586 older academics targeted in this study, only 6.99% or 41 respondents completed the research questionnaire, despite repeated attempts to encourage more participation. the respondents’ academic levels were distributed as follows: full professors (41.5%), associate professors (43.9%), and assistant professors (14.6%). further details regarding the demographics of the respondents are presented in the table below. no. selected demographic characteristics of the respondents 1 age in years mean 64 standard deviation 2.60 2 sex men 20 (48.8%) women 21 (51.2%) 3 mean duration (in years) of work in university men 34.95 women 36 figure 1: respondent demographics one might assume that older academics’ low rate of participation in the questionnaire was due to their difficulty or confusion with using technology; however, this assumption is not supported by the evidence from this study. the older academics who agreed to take part in the pilot study did not encounter any problems or challenges when they completed the online questionnaire. this is consistent with the findings of other studies indicating that older adults who have higher levels of education tend to demonstrate better internet skills compared to those who have lower levels of education (hargittai, piper, and morris 2019; schehl, leukel, and sugumaran 2019). thus, the older academics’ low rate of participation in the questionnaire was unlikely to be caused by technological limitations, since most of them had high academic ranks of full professor or associate professor. this suggests that their low http://anthro-age.pitt.edu/ ramadhan and sibly | 61 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu response to the survey was likely due to their avoidance of technology, as other scholars have observed (jokisch et al. 2020), or disengagement from online activities because they did not have the motivation or feel the need to do so (morrison, coventry, and briggs 2021). this type of avoidance could be one form of social withdrawal (hill et al. 2021). moreover, it would be premature to infer that older academics’ reluctance to participate in the questionnaire was attributable to either the complexity of the questions or an excessive number of questions. the evidence gathered from the pilot study, which also enlisted older academic members as participants, suggests that neither of these factors represented significant obstacles to completing the online questionnaire. the second effect of social withdrawal among older academic staff is the lack of policies for aging. most of the older academics who participated in this study did not ask for any facilities or services from the university administration that could benefit them. specifically, 65.9% of respondents reported never requesting specific facilities for older personnel, and 63.4% reported never asking for special services for individuals over 60. the study also found that older female academic staff were the least likely to request such services or facilities. the older academics who did not ask for any facilities or services for older people came from various schools, such as school of language and literacy, school of education, social and humanities, school of social science, school of science and technology, and school of medical science. the older academics from the school of science and technology were the least likely to ask for facilities (33.33% never asked) or services (34.6% never asked) for older people. these findings highlight the importance of more research and policy development to support aging individuals in various academic settings. in general, universities may face serious consequences if they do not open a dialogue with older academics about their needs and issues related to aging. as some scholars have pointed out, decisionmakers may not be aware of the possible challenges that their older workforce is facing (earl, taylor, and cannizzo 2018). this may lead to a lack of aging policies or inadequate services and facilities to support older staff. moreover, older staff who are socially withdrawn or too shy to ask for support from university management may not get the fulfilment or support they need (hill et al. 2021). therefore, insufficient or nonexistent communication with older academics suggests that the university may not be ready to support its aging workforce, which can harm both the institution and its employees. even though the older academics in our study did not ask for their needs to be met by the university administration, we found that they had their own strategy to cope with their problems; specifically, they sought help from younger staff (ramadhan, sibly, and khelghat-doost 2022). furthermore, they explained that this situation was influenced by the local indonesian culture of caring for and supporting each other. other scholars have also argued that indonesian people tend to choose informal ways of coping with their problems (berenschot and van klinken 2018). conclusion this research report has highlighted the significant impact that social withdrawal among older adults can have on data collection for research and policy formulation. the social withdrawal or social disengagement mentioned in the gerotranscendence theory alters the perspectives and interpretations of older people regarding social and personal relationships. as we found, older academics may be more selective and less interested in certain social and personal relationships. http://anthro-age.pitt.edu/ ramadhan and sibly | 62 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu to ensure a comprehensive understanding of the needs and perspectives of older adults, survey research involving older adults should consider their social withdrawal characteristics. the findings of this study, particularly in the context of indonesian public universities, suggest that older adults’ social withdrawal may lead to a lower response rate, incomplete data collection, and a lack of formal and informal policies that support aging individuals. to address this issue, there is a need for more research involving older people from different socio-economic backgrounds and in other geographical contexts. however, based on this study, the universities that employ older people should start to recognize the need for an aging policy within the university institution that promotes inclusivity and accommodates the needs of all workers; this could have a significant impact on the prevention of social withdrawal, especially as employees get older. references adioetomo, sri moertiningsih, and ghazy mujahid. 2014. “indonesia on the threshold of population ageing.” in unfpa indonesia monograph series no. 1, edited by horst posselt. jakarta: united nations population fund berenschot, ward, and gerry van klinken. 2018. “informality and citizenship: the everyday state in indonesia.” citizenship studies 22 (2): 95–111. 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https://doi.org/10.1016/j.chb.2019.03.031 schroots, johannes j.f. 1996. “theoretical developments in the psychology of aging.” gerontologist 36 (6): 742–48. https://doi.org/10.1093/geront/36.6.742 tornstam, lars. 1997. “gerotranscendence: the contemplative dimension of aging.” journal of aging studies 11 (2): 143–54. https://doi.org/10.1016/s0890-4065(97)90018-9 victor, christina r., and ann bowling. 2012. “a longitudinal analysis of loneliness among older people in great britain.” journal of psychology: interdisciplinary and applied 146 (3): 313–31. https://doi.org/10.1080/00223980.2011.609572 walker, alan, and tony maltby. 2012. “active ageing: a strategic policy solution to demographic ageing in the european union.” international journal of social welfare 21 (suppl.1): 117–30. https://doi.org/10.1111/j.14682397.2012.00871.x world health organization. 2002. “active ageing: a policy framework.” who/nmh/nph/02.8. active ageing series. active ageing series. geneva. ——— 2015. world report on ageing and health. world health organization. geneva. xie, bo, neil charness, karen fingerman, jeffrey kaye, miyong t. kim, and anjum khurshid. 2020. “when http://anthro-age.pitt.edu/ https://doi.org/10.1016/j.socscimed.2015.02.007 https://doi.org/10.1002/hbe2.291 https://doi.org/10.1155/2012/382972 http://www.bphn.go.id/data/documents/98uu013.pdf https://doi.org/10.1186/s12889-019-7830-x https://doi.org/10.1016/j.giq.2012.01.003. https://doi.org/10.1177/0898264313482489 https://doi.org/10.1016/j.chb.2019.03.031 https://doi.org/10.1093/geront/36.6.742 https://doi.org/10.1016/s0890-4065(97)90018-9 https://doi.org/10.1080/00223980.2011.609572 https://doi.org/10.1111/j.1468-2397.2012.00871.x https://doi.org/10.1111/j.1468-2397.2012.00871.x ramadhan and sibly | 64 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.444 http://anthro-age.pitt.edu going digital becomes a necessity: ensuring older adults’ needs for information, services, and social inclusion during covid-19.” journal of aging and social policy 32 (4–5): 460–70. https://doi.org/10.1080/08959420.2020.1771237 http://anthro-age.pitt.edu/ https://doi.org/10.1080/08959420.2020.1771237 technologies of ascription: how does a dementia diagnosis acquire its symbolic power of exclusion in later life? sébastien libert paul higgs s.libert@ucl.ac.uk p.higgs@ucl.ac.uk division of psychiatry, university college london division of psychiatry, university college london abstract amidst the widespread stigma and exclusion attached to dementia in dominant narratives of successful ageing, this article addresses a gap in the scientific literature concerning our understanding of the medicalization of cognitive decline as a natural phenomenon. to this end, it explores how a dementia diagnosis acquires its symbolic power of exclusion in later life through an ethnography of cognitive rehabilitation therapy in two memory clinics in a southern european nation. it argues that this symbolic power of exclusion is locally produced through the meaning making practices of therapists and researchers administering regular cognitive training therapy and exercises to support autonomy. it shows how the different steps involved in rehabilitation play a role in dividing later life by defining and reifying a category of abnormal ageing during the cognitive assessment, and by applying a confrontational approach exposing decline. it shows how this approach generates the position of older adults who can be rehabilitated against those who cannot; the latter representing a “failed” ageing in the narrative of successful ageing. this article proposes the adoption of the concept of “technologies of ascription” to characterize this process of exclusion through reification and confrontation of “abnormal cognitive decline.” the paper argues that such practices are central to the local production of the symbolic power attached to a dementia diagnosis as well as its capacity to fragment later life. finally, it argues for the utility of this concept in offering new opportunities for anthropology to characterize exclusion in later life through medicalization. keywords: dementia; exclusion; ascription; successful ageing; failed ageing; technology anthropology & aging, vol 43, no 1 (2022), pp. 1-16 issn 2374-2267(online) doi 10.5195/aa.2022.355 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. libert & higgs | 1 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu technologies of ascription: how does a dementia diagnosis acquire its symbolic power of exclusion in later life? sébastien libert paul higgs s.libert@ucl.ac.uk p.higgs@ucl.ac.uk division of psychiatry, university college london division of psychiatry, university college london introduction as dominant public health narratives across the world present dementia as a “global priority” (world health organization and alzheimer”s disease international 2012), dementia further strengthens its status as a medical problem isolated from a so-called normal ageing (world health organization 2017, 2). scarcely challenged, despite its numerous incoherencies (lock 2013), the medical conception of dementia continues to expand and diversify. it is constantly adding new diagnostic labels including schema to categorize a predementia phase (e.g., mild cognitive impairment (mci), or prodromal dementia), as well as the identification of new risky causal behaviours occurring earlier in the life course (e.g., livingston et al. 2017). this is in addition to proposals for a more systematic screening of the older population for the condition (kitanaka 2020, 121). this expansion is also happening in the postdiagnostic phase attracting the attention of more and more clinical professionals and researchers, resulting in various attempts to develop pharmaceutical and psychosocial interventions (booth et al. 2018; clare and woods 2003; yates et al. 2019). overall, these transformations represent the reinforcement of an earlier trend that adelman (1995) called the “alzheimerization of ageing,” an extension of new regimes of health encouraging surveillance and screening for risk and preclinical signs of health conditions (armstrong 1995), further expanding the medicalization of human conditions into treatable disorders (conrad 2007; zola 1972). while some people still dispute a clear separation of dementia from the ordinary ageing process (cohen 1998, 70; lock 2013, 41), this expansion demonstrates a general trend to further medicalize cognitive decline (beard and neary 2013; lock 2013), maintaining the status of dementia as a threat to either prevent or cure (livingston et al. 2017; lock 2013; orrell and brayne 2015). much of this medicalization takes place in a general context marked by successful ageing as a dominant cultural narrative giving meaning to ageing today (andrews 2009). this successful ageing narrative essentially attempts to separate decline from a so-called “normal ageing” process (lamb 2017), impacting the meaning attributed to dementia (mcparland, kelly, and innes 2017). studies of the role of localized practices of medicalization of cognitive decline and their impact for an ageing population in this context have remained limited. looking at the consequences of medicalization in dementia within existing social science scholarship, researchers studied the impact of a diagnosis on emotions (aminzadeh et al. 2007) on the possibilities it offers to understand and manage one’s own decline (beard and fox 2008) or on the stigma experienced by older adults (milne 2010). they also looked at the consequences of a predementia diagnosis or mci (aminzadeh et al. 2007; beard and fox 2008; beard and neary 2013), the attribution of dementia risk (milne et al. 2018), or the impact of different clinical cultures on the diagnostic process (graham 2006). they explored the benefits of diagnosis in term of symptom management and access to therapy (aminzadeh et al. 2007), issues with self-esteem and social http://anthro-age.pitt.edu/ libert & higgs | 2 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu participation, accessing networks of support, and promoting an active citizenship with dementia (birt et al. 2017, 208). finally, they looked at issues with population-wide screening and the promotion of diagnosis in the absence of post-diagnostic support (fox et al. 2013). while considering localized processes to some extent, these studies do not consider the symbolism attached to the medicalization of cognitive decline within dominant cultural narratives of successful ageing. borrowing the words of anthropologist eriksen (2001), they do not locate these “small places” as constituting “large issues.” using ethnography, this article first aims at addressing these limitations in contextualization. meanwhile, cultural studies on ageing and health essentially proposed a macro-analysis of the medicalization of cognitive decline and its social significance, or ethnographies of people’s experience of cognitive decline in later life. these discussions considered the cultural origin of the boundary between normal ageing and (cognitive) pathology through narrative and historical analysis (ballenger 2006; pickard 2011). they also explored the current reconfiguration of health expectations under the dominance of cultures of active, “successful” ageing (williams, katz, and martin 2011) and their impact on how older adults give meaning to (cognitive) decline (kitanaka 2020; lamb 2017; 2014). while this corpus of research on the cultural aspects of health in later life helps to understand some of the impacts of the broader context of successful ageing on the symbolic value of diagnosis, or the experience of older adults in this context, they do not consider how localized processes of medicalization give a dementia diagnosis its capacity to substantially transform the identity of people in later life, or what forces give symbolic significance to a diagnosis within narratives of successful ageing. as we can see therefore, current research on the diagnosis of dementia either considers its effects in a decontextualised manner or explores the symbolic value of diagnosis in cultures of ageing while having limited concern for the local processes producing this symbolic power of exclusion. inevitably, these approaches miss the capacity of a dementia diagnosis to divide later life. to address this gap, this article will explore the following question: how does a diagnosis acquire its symbolic power of exclusion in later life? to answer this question, we present an ethnography of the daily practices of clinicians and researchers in two memory clinics implementing cognitive rehabilitation for people with dementia in a southern european country. this ethnography enables us to propose a detailed analysis of the local processes contributing to the symbolic power attached to a dementia diagnosis. the ethnography lasted for three months from october to december 2018 and was part of a broader 18-month multi-sited fieldwork exploring processes involved in the social exclusion of people with dementia across europe and the uk. this article results from a collaboration and joint analysis produced by sébastien libert and paul higgs (referred as “we” or third person in the text). both the ethnography and the fieldwork were conducted by sébastien libert (referred as “i” in the text and within the ethnographic vignettes). memory clinics are the most specialized facilities to provide a diagnosis of dementia in biomedicine and provide therapy for individuals diagnosed with the condition (jolley, benbow, and grizzell 2006). they represent pertinent locations to observe the processes contributing to the symbolic power of a dementia diagnosis and the manufacture of medicalized identities. the southern european region in which this ethnography took place has a small younger population caused by rural depopulation and economic difficulties. the exodus of working age people meant that this region had a disproportionate population of older people, making it one of the most important centres of ageing in europe. in this rural context, the memory clinics function as proximal forms of care supporting ageing communities. during the three months of research, i followed the activities of clinicians and researchers on cognitive rehabilitation interventions through participant observation, exploring the meaning that they produced about dementia, as well as their objective in the implementation of cognitive rehabilitation. i http://anthro-age.pitt.edu/ libert & higgs | 3 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu documented in detail the different steps leading to the separation of people with dementia from those with “normal” cognitive ageing in the diagnostic and rehabilitation process. i also considered how they conceived potential challenges associated with the implementation of the cognitive rehabilitation and how they understood the problems that they were trying to address. finally, i explored how the clinicians and researchers dealt with the progressive decline associated with dementia. the role and status of the individuals i encountered within the memory clinics varied. some were psychologists and neuropsychologists while also being phd and msc students. others were senior psychologists and neuropsychologists. some played a managerial role in the clinic, while others assisted in providing the therapies and research activities. as few of my informants spoke english in this region, i actively learned their language for a year and a half prior to the actual fieldwork, enabling me to participate in day-to-day interactions and research activities. being experienced to learning new languages, i could rapidly reach a level of competency necessary to understand the meaning conveyed in conversations. i also spent time discussing my observations with participants to ensure that i properly understood them. additionally, many discussions occurred in lay language because clinicians tried to avoid using technical language in their explanations to the patients. in this article, we will present the active role that researchers and clinicians play through discourse and practice in defining the problem of dementia in certain ways; in addition, the impact that it has on the identity and social position of people reaching memory clinics for symptoms of cognitive decline. we will explain how the symbolic manufacture of the meaning attached to a diagnosis in cognitive rehabilitation operates, indexing identity in later life as a result. we will review three different positions resulting from this indexation: active agers, people with dementia who can be rehabilitated, and those who cannot be rehabilitated. we will then present the cultural significance of these positions. finally, we will introduce the concept of technology of ascription to qualify the role of cognitive rehabilitation in the local production of the symbolic power attached to a dementia diagnosis. we will then present how the analytical lens of technologies of ascription can support studies of processes behind this symbolic power of diagnosis in other localities. this endeavour should support a better understanding of social exclusion in later life today. this research followed ethical guidelines from the american anthropological association (aaa) statement on ethics (n.d.). it received approval from university college london research ethics committee and an institutional research ethics committee in the southern european country where the research took place. informed consent was first recorded in writing. it was however continuously reassessed in dialogue with the participants so to accommodate their preferences in particular circumstances. participants were approached individually through the intermediary of a collaboration with a local mental health foundation. their agreement was kept confidential, and measures to maintain anonymity were established. the referral and first encounter defining the parameters of abnormal cognitive ageing where does the symbolic manufacture of medicalized identities start? to understand this, we need to look at the first contact that an older adult with cognitive concerns has with a memory clinic. it normally starts with a referral leading to a first encounter with the memory clinic. in this southern european country, a referral to a memory clinic is usually made by a physician, such as a general practitioner or a neurologist in a hospital. this referral leads to a first encounter with a neuropsychologist at the http://anthro-age.pitt.edu/ libert & higgs | 4 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu memory clinic. as i observed during fieldwork, and present in the following ethnographic vignette, this first encounter delineates important meaning-making processes around identity and announces more profound transformative processes for the older adult with cognitive concerns. 13th december 2018, inside the memory clinic: we sit together with the therapist and a couple who took a first appointment with the memory clinic to consider the possibility of a cognitive rehabilitation therapy. we are in a small room of the memory clinic, arranged like a restful living room. the couple comfortably sits on one side of the room while i am introduced by the therapist. the encounter starts and the neuropsychologist carefully explains the process involved in starting a cognitive rehabilitation programme with the memory clinic. she introduces herself to them and explains her role as a neuropsychologist in the centre, as well as what the centre does for whom in terms of therapy. she tries to reassure the person potentially receiving the therapy that there are many different causes capable of affecting memory. she also points out that there can be multiple causes behind memory problems. for instance, she describes traffic accidents or seizures. she also explains that memory problems can be diagnosed if the kind of memory issues encountered differs from the trajectory of “normal ageing.” she then presents the rehabilitation process and the voluntary nature of participation. this process starts with a cognitive assessment to understand the specificities of the memory problems encountered. the first encounter represents an important step initiating the process of rehabilitation and its capacity to shape the identity and social position of older adults with cognitive issues. through the intimate environment of the comfortable meeting room, the neuropsychologist progressively sets the scene for the life-changing processes that the potential patient will eventually experience in the memory clinic. indeed, this first encounter establishes the nature of the problem identified by the therapist and enables the medical professional to communicate a new system of meaning attached to a cognitively declining identity to the potential patient. hence, in this encounter, we notice how the neuropsychologist distinguishes the identity of someone experiencing a cognitive disorder substantial enough to be qualified as “abnormal” from a so-called “normal ageing.” through this exchange we perceive how the act of defining decline as abnormal inevitably announces the possibility that this adjective becomes attached to a person’s identity and prepares the potential patient for this transformation. this first encounter introduces to the potential patient the prospect of a first boundary-crossing exercise between normal ageing and pathology. this boundary-crossing will continue in the ensuing steps of the rehabilitation. the assessment reifying abnormal cognitive ageing the cognitive assessment represents a logical step ensuing from this referral and precedes the cognitive rehabilitation. baseline assessments are sporadic events as they generally happen once at the start of the care trajectory of the patient. during my period at the memory clinics, i observed two assessments with two different neuropsychologists. assessments i observed lasted for approximately an hour to an hour and a half. these assessments were based on “paper and pencil” exercises graded with standardized scales such as the wechsler adult intelligence scale and the mini-mental state examination which are common practice in memory clinics (tariq et al. 2006, 901). they can also be combined with brain scans or blood tests often earlier in the diagnostic process or in combination with it to rule out conditions that differ from dementia and assist diagnosis for instance (karas, scheltens, and barkhof 2008; national health service 2020; speechly, bridges-webb, and passmore 2008). assessments play an important role in shaping the identity of older adults as we will see in this vignette: 18th december 2018, consultation room: a therapist invites me to observe how she conducts a cognitive assessment. i meet her in the consultation room. the therapist introduces me to the patient as a researcher observing the therapist’s activities and asks if i can attend the assessment. i am then granted authorization by the http://anthro-age.pitt.edu/ libert & higgs | 5 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu patient to stay next to her to observe her work. the assessment will last for over an hour and a half, involving a series of standardized cognitive tests. she strictly controls the conditions of the assessment and carries a stopwatch with her to precisely keep track of time. she starts the assessment with the two usual questions part of the procedure of cognitive rehabilitation consultations, namely on temporal and spatial orientation. “what date is it?” and “where are we?” she asks the person being assessed. naively forgetting that these simple queries are part of the test, i try to help the person. while listening to the participant, the therapist interrupts me immediately with a fast and discreet gesture before i start intervening, concerned by the importance to maintain standardized conditions for the assessment. i stay quiet and the test goes on. i find the questions she asks to the patient challenging to answer, and i find myself unable to answer some of them. the atmosphere is tense, and the patient seems focused. the test is composed of various standardized scales of measurement based on questions displaying unique answers, either right or wrong. while the patient replies, the therapist does not provide any clues about the answer’s accuracy. only the time she spends scribbling on the paper with her pencil can eventually give a hint about this accuracy. the assessment ends and we spend time together with the therapist to discuss my observations. she shares her first thoughts on the dysfunctions the assessment probably indicated. she then explains to me how each singular test works while drawing a parallel between the objectives of these tests and a complex cartography of the brain, the functions associated with each of its areas, and how the tests aim to locate issues in them. in her explanation, a test result becomes the indicator of “neuro-localized” zones of cognitive success and failure, a numerical coordinate enabling to draw a map of the (dys)functional brain. the assessment i describe in this vignette is a key event and necessary step in the trajectory of care proposed by the memory clinic. it represents the crystallisation of previous assumptions made during the referral. it plays an important role in directing the future trajectory of care constituting the rehabilitation. this assessment presents a holistic picture based on a vast array of phenomena and their associated metrics defined by neuroscience disciplines. remarkably, the consequence of a test is the reification of the previously evanescent and eminently complicated phenomenon found in cognitive decline into a single label of dementia or alzheimer’s disease. this symbolic power of labels is central to social positioning in later life and marks the transition toward a new status for the older adult. rose and abi-rached aptly describe the symbolism of the encounter of a patient with what they call the neuro-disciplines (neuropsychology, neurology, neuroscience, etc.) within the novel means deployed by the neurosciences to assess the operation of the mind: when it comes to seeing the brain, seeking to discover within its fleshy volume the traces of the pathological or normal mental processes that the brain might embody, it involves the designation of those who have the authority to see: doctors, neurologists, researchers, psychopharmacologists, geneticists, and now, of course, the imagers. it also involves the subjectification of those who are spoken about—subjectification in the sense that living creatures become subjects of these visualizing technologies only as a consequence of certain technical interventions, and subjectification in another sense, in the case of humans, whose sense of themselves may well be transformed as a result of the images of their brains with which they are presented. (2013, 55) rose and abi-rached’s (2013, 55) explanation over the operation of the neurosciences and their impact on subjectivity suggests how the symbolic power of a diagnosis in dementia partly results from the authority of the neuroscientist and the particular images that they produce to legitimate it. the controlled environment of the cognitive assessment i describe in the vignette above presents similar parameters constituting the symbolic power of the encounter. the subjectivity of the patient in this encounter for instance becomes redefined through the constitution of a controlled environment http://anthro-age.pitt.edu/ libert & higgs | 6 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu composed of standardized metrics, acceptance of the medical gaze, standardization of the temporality of the encounter through the use of a stopwatch, and isolation of the consultation room from the outside world in the detached environment of the memory clinic. all these elements play an important role in crafting the social reality of this new identity, the reification of complex mechanisms and deficiencies in the brain into a coherent whole grading cognitive capacity. while this research essentially focused on the definitional practices and discourses of clinicians, other research (e.g., tolhurst 2015) suggests how clinical encounters in memory clinics can transform the patients’ “sense of themselves” alluded to by rose and abi-rached (2013, 55). the power of the images evoked by rose and abi-rached (2013, 55) is found here in the numerical coordinates of the (dys)functional brain emerging from the application of these standardized measures corresponding to particular zones of the brain. these numerical coordinates give a tangible materiality to the evasiveness of cognitive decline. overall, the assessment classifies individuals following a culturally informed definition of normality or abnormality in ageing. the assessment is an important reformulation of identity through medical tools—a sort of “rite of passage” and an initial triaging of individuals into different groups in later life. those who are not diagnosed as having dementia will be temporally assured as belonging to the most culturally desired position of normal ageing defined by third age cultures. for now, they will not be affected by the symbolic power of diagnosis on identity in later life. others whose cognitive ageing is now classified as abnormal will be prescribed cognitive rehabilitation, initiating a trajectory of care with variable consequences on identity. cognitive rehabilitation supporting people with dementia who can be rehabilitated this second position corresponds to the desired outcome for the memory clinic and to the success of the rehabilitation (the first position simply being the one of individuals whose diagnosis is negative for dementia). individuals in this position are valued according to the norms established by the neuropsychologists i met, who take great care of creating a supportive atmosphere when implementing the rehabilitation. the objectives of the memory clinics and the nature of rehabilitation are determinant to align the identity of people diagnosed along the norms defined by the active cognitive ageing narrative. this narrative according to libert, charlesworth, and higgs (2020) represents the current inclusion of brain health into active ageing. hence, the responsibility to stave off the impact of decline in ageing now includes the brain as a locus of prevention and risk management. in the following vignette i describe the nature of the rehabilitation itself to illustrate this correspondence: 12th december 2018, inside the memory clinic: i met with two clinicians to attend the cognitive rehabilitation session. the room is a casual classroom setting with two round tables and a series of computers on the side. i enter the room with the patients. we sit together at the table, two patients, the clinician, and me. the length of the consultation and the level of the challenges set for the patients are important, as i will discover during the next hour and a half that the session will last. the session for one of the patients starts with thirty minutes of cognitive exercises through the traditional “paper and pencil” rehabilitation—a contrast with the novel use of computers— followed by another thirty minutes of computer-based rehabilitation. the computer-based session requires the patient to sit in front of the computer and carefully answer the prompts and exercises that the cognitive rehabilitation software automatically generates. then the person comes back for thirty minutes of the same “paper and pencil” cognitive rehabilitation exercises. while sitting at the table, the clinician alternatively spends time with each patient, quickly shifting from one patient to the other in order to set up the exercises and monitor each of them. each “paper and pencil” exercise follows the same pattern: the clinician lays square-shaped cards down on the table with images of objects of different kind printed on them: a shirt, a bowl of soup, a train, keys and so forth. the patient then tries to remember this sequence of objects represented on the cardboard figures by creating http://anthro-age.pitt.edu/ libert & higgs | 7 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu a narrative based on these objects. here could be a typical example: i put my shirt on, drank some soup and left the house, closing the door with the key, and took the train. cards would then be put face down and the patient would attempt to recall the shirt, the soup, the house, the keys, and the train printed on the cards in a sequential order by visualizing the story in their head. some patients experience more difficulties than others in fulfilling these exercises as i observed during this consultation and on other occasions. indeed, the challenging nature of these exercises has the apparent capacity to expose different levels of deficits in patients. although patients can find the exercises challenging, they usually fulfil them successfully according to the standards of rehabilitation. the atmosphere of the consultation is supportive. i notice how therapists take great care to create an enjoyable environment where patients feel valued. when exercises appear too complicated for patients, therapists help patients to complete them, therefore supporting their sense of achievement and wellbeing. this vignette shows how cognitive rehabilitation implies an ethos of engagement, of “not giving up” in front of the challenges generated by dementia. in the cognitive rehabilitation, such an ethos is encouraged, and decline becomes a phenomenon that one should confront through self-discipline and self-management. sometimes, under the request of therapists, patients are expected to complete some homework in addition to taking part in the consultations. these are “pencil and paper” exercises to complete at home, ones that will be reviewed by the therapist at the start of the following session. significantly, this set of expectations regarding cognitive health in later life strongly echoes key aspects of the model of “successful” or active ageing developed by rowe and kahn (1997) which states that successful ageing is defined by three components: “low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life” (1997, 433). indeed, fostering autonomous living through the development of “alternative cognitive pathways” represents a central objective of rehabilitation echoing this definition. accordingly, a successful cognitive rehabilitation represents the maintenance of norms of capacity and independence in later life valued as part of active cognitive ageing. it therefore demonstrates the engagement of the individual to maintain an identity which remains connected to the one they had before the diagnosis. this engagement embodies the will to fight against the inevitability of decline valorised by successful ageing in later life. the demonstration of this will symbolizes remaining connections between the person with dementia and those who normally age according to the ideal of active cognitive ageing. for those individuals diagnosed with early-onset dementia, it also enables them to distance themselves from what gilleard and higgs (2010) call the “fourth age”—the most negative aspects of dementia which are often associated with the dreaded imaginary of a non-agentic later life. a successful rehabilitation is therefore a means to maintain parts of the individuals diagnosed with dementia away from the gravitational pull of a culturally devalued non-agentic life. active cognitive ageing and its periphery—people who cannot be rehabilitated however, this ethnographic vignette above also shows the complex relationship that such a form of therapy establishes with decline and altered capacities. this impression stemmed from the peculiar approach of rehabilitation practitioners relying on challenging exercises as a bedrock for therapy. these challenges that were meant to encourage the development of “alternative cognitive pathways” in people with dementia also render cognitive decline apparent. choosing the right answer, remembering a series of words sequentially, locating oneself temporally or spatially, etc. all these represent cognitive puzzles which are artificially created for the purpose of therapy. confronting decline becomes instrumental to supporting autonomous living through the maintenance of an idea of “optimal functioning.” therefore, the nature of this therapy inevitably results in situations where cognitive exercises become obstacles rather than enablers. they may either demonstrate the remaining capacities of the person and eventually support them, or they may lead to a situation where these obstacles become http://anthro-age.pitt.edu/ libert & higgs | 8 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu increasingly difficult to fulfil, giving a symbolic weight and a more tangible reality to the deficit fostering an encounter with the tangible reality of their own decline. the decision to proactively engage in a struggle against decline, to confront it through regimes of self-care and management, is a definitional characteristic of active cognitive ageing. when locating it in a more global cultural perspective, this confrontational approach represents a peculiar cultural conception of decline in ageing and the life-course (lamb 2017). indeed, lamb (2017) presents different ethnographic insights into various cultural spaces defining ageing around the world, showing that numerous other ways of perceiving and portraying decline exist beyond the western binary understanding of active ageing and its aversion for decline. the possibility of losing one’s agency remains a shadow persistently attached to the positive aspiration of cognitive rehabilitation. this double-edged nature of cognitive rehabilitation—of being both an obstacle and an enabler—represents an important challenge that cognitive rehabilitation therapists inevitably confront in their attempt to support people with dementia. while in the memory clinics, i interviewed a neuropsychologist who describes her perspective on rehabilitation and the issue of decline. this encounter specifies this important challenge of rehabilitation: i will first do an evaluation. i will do an evaluation which is more or less intensive. the objective is to determine which [capacity] is conserved and which one is altered. i don’t know whether the one which is altered we are going to get it back. because if the person lost her capacity to write, she will not get it back, like for someone who developed an aphasia [impairment of language affecting speech and writing]. she will not get it back. (…) but you will strive to maintain [the capacities] that you have kept. (…) and also, a struggle to work on the ones which are altered. if we speak of a cerebral damage, we are going to work on the ones which are altered. but for a neurodegenerative disease, we will try to work on [the altered capacities] but we know we are not going to recover. (…) because a degenerative disease, well, degenerates. so, the objective is, when you come to see me, i evaluate you. if we have here the conserved capacities, and there the altered ones, we will try to maintain the ones that remain for the time you are here (…) until you lose these capacities. [interview translated by the first author] in this vignette, we perceive how cognitive rehabilitation applied to dementia constitutes a struggle against its neurodegenerative nature, a complex balance between loss and stability. the role of the therapist is to localize these territories of alteration and stability and to specifically train the altered capacities—until they are lost. in this interview, the neuropsychologist makes an important distinction between stable and neurodegenerative conditions (such as dementia), evoking the complexity of treating progressive decline in this manner. this complexity in rehabilitation has only recently emerged as it became applied to dementia. indeed, the original purpose of cognitive rehabilitation was to treat brain injuries, it developed after the second world war to treat soldiers affected by cerebral damage on the european battlefields (prigatano 2005, 5). with the expansion of motorized transportation throughout the twentieth century, ensuing applications of rehabilitation involved the treatments of individuals affected by brain injuries resulting from car accidents. brain injuries are often relatively stable and do not lead to progressive decline. indeed, as another therapist pointed out during my fieldwork, individuals with such brain injuries are often able to benefit from rehabilitation for many years, therefore echoing the distinction with dementia made by the neuropsychologist i interviewed. this stability contrasts with the application of cognitive rehabilitation to a progressive condition. capacities sustained through hard work one month may be lost the next, and so can exercises completed by the patient in one month appear irrelevant or even frustrating in the next. as evoked in the interview above, the therapist needs to engage in a constant process of revaluation to reorient the therapy amidst this progressive loss of capacity. this caution is also raised by some supporters of cognitive rehabilitation in the scientific http://anthro-age.pitt.edu/ libert & higgs | 9 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu literature. prigatano (2005, 6), a neuropsychologist and prominent figure in the development of cognitive rehabilitation, recognizes this confrontational nature of cognitive rehabilitation with decline. prigatano (2005, 6) warns us that the level of difficulty of exercises should be progressively adapted and managed to avoid feelings of failure and frustration. while the subjective and psychological impact of this confrontation is considered by therapists who are particularly careful to ensure the wellbeing of patients throughout the rehabilitation, its social significance for identity in later life remains unexplored. the following quotes will help shed light on this matter. as a therapist told me, when a patient with dementia becomes too advanced to benefit from rehabilitation, when exercises become too difficult to adapt to the declining capacities of this patient, there needs to be a consultation with the family to decide whether to institutionalize the patient or not. the ultimate powerlessness of rehabilitation therefore signifies the rupture of a bond of the person with dementia with active cognitive ageing and her entry into a third position marked by a dreaded nonagentic state. this third position is distinct from the first most desired position of active ager and the second more culturally valued, although excluded, position of people with dementia who can be rehabilitated. in characterizing the operation of memory clinics, jolley and colleagues (2006) explain that “any clinics restrict their involvement to the assessment and treatment of patients early in their careers with dementia. longer term follow up falls to community mental health teams or primary care. if patients move into an independent sector nursing home, it is not unusual for them to be lost to follow up all together” (203). this explanation, together with the one of psychologists i encountered, alludes to the position of those existing in the cultural space beyond therapy, in the shadow of rehabilitation. hence, we argue that cognitive rehabilitation’s classificatory capacity reaches its peak as soon as it becomes unable to address neurodegeneration. cognitive rehabilitation in dementia, a strategy essentially directed toward the treatment of early-stage dementia, stands in this ambiguous space between its therapeutic objectives and the subsequent ascription of people on the path leading to the loss of agency encompassed by “unsuccessful ageing” (gilleard and higgs 2010). this is a feared cultural location that hazan (2011, 1129) also describes as “deep old age, which lies beyond the corrective power of therapy.” through the operation of its apparatus of detection, classification and monitoring, cognitive rehabilitation participates in the construction of this social space by implicitly filtering out the existence of those individuals beyond the reach of therapy. paradoxically, by elevating the status of those who can be rehabilitated, it inherently demarcates the social position of those who cannot, further reinforcing the symbolic power of exclusion of their diagnosis—a dementia beyond rehabilitation. technologies of ascription fracturing later life this ethnography of cognitive rehabilitation progressively unveils three significant positions in our treatment of cognitive ageing through the lens of the western “successful” or “active ageing” project (lamb 2017, xii) and its expansion in brain health through active cognitive ageing (libert, charlesworth, and higgs 2020). it presents how this practice inherently classifies people in three different social positions: the one of active agers without a label of dementia, the one of individuals diagnosed with dementia who can benefit from rehabilitation, the one of individuals diagnosed with dementia who cannot be rehabilitated. how do these three positions illustrate the capacity of rehabilitation to give its symbolic power to a dementia diagnosis in cultures of “successful ageing”? the first position is inhabited by “active agers,” those without a label of cognitive decline who often engage in prevention practices such as brain training (libert, charlesworth, and higgs 2020). although the life of these older adults representing an important segment of the population in later life is not http://anthro-age.pitt.edu/ libert & higgs | 10 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu directly described in this ethnography, it has been widely documented within ethnographic accounts and narrative analyses, often referring to this cultural field as “the third age” (baltes and smith 2003; lamb 2014; laslett 1989). the success of technologies such as brain training devices used to prevent dementia and other regimes of prevention, “brain health” and “cognitive fitness” in ageing populations characterize how the third age approaches cognitive ageing (libert, charlesworth, and higgs 2020). libert, charlesworth, and higgs (2020) explain how they are used as important instruments to maintain a social standing valued by cultures of the third age, as modes of distinction from individuals who embody the decline, abjection, and loss of agency symbolizing an “unsuccessful ageing.” this attitude toward decline in successful ageing often leads to the othering and exclusion of people with dementia (higgs and gilleard 2014; libert, charlesworth, and higgs 2020) whose existence echoes the widespread fear of “losing” oneself (degnen 2012, 9). this ethnography shows a complementarity between memory clinics and technologies of distinction in supporting the social position of the third age. the cognitive assessments and monitoring that they promote play an important role in “guarding the frontiers” of successful (or active) cognitive ageing. they closely monitor belonging to this ideal of later life by comforting some about their normalcy while relegating those whose cognitive ageing is perceived as abnormal outside of the third age paradigm. medical expertise, the establishment of strict procedures and controlled environments in memory clinics, as well as their legitimacy in healthcare play an important role in the reification and stabilization of this frontier between active ageing and dementia. this process of filtering is symbolically powerful in sustaining and affirming the triumph of third agers over cognitive decline. it celebrates their dedication to self-care and prevention in the field of later life. for those receiving a diagnosis of dementia, cognitive rehabilitation plays a different role from the one of distinction, yet intrinsically linked to it. the diagnosis marks a separation from active cognitive ageing and only initiates a more extensive process ascribing people with dementia in a trajectory of decline. what cognitive rehabilitation essentially does is to ascribe a medicalized identity upon people experiencing cognitive decline. previous studies showed that this label of dementia is intensely related to stigma (ballenger 2006; beard and fox 2008 ; fletcher 2021). ballenger (2006) argues that the biomedicalization of senility operating since the end of the second world war “has been at best ambiguous in lessening the stigma of old age” as it is central to the reinforcement of a boundary between normality and pathology (113). in this regard, fletcher (2021) points out that a diagnosis can reinforce “felt” stigma in the person diagnosed; “felt” stigma being the subjective anticipation of a hypothetical “enacted” stigma afflicted by others. although the patient can still choose disclosure or not, once being diagnosed there is often no turning back (unless a new medical authority counters the first one and indicates a misdiagnosis). current trends toward medicalization in the clinics show how this logic is likely to expand due to the routinization of large-scale screening and monitoring it enables. the steps that follow the classificatory event of the assessment continue this transformational process of identity in later life through the action of cognitive rehabilitation and its unvoluntary classification of people in later life into those who can and those who cannot be rehabilitated. this post-diagnostic process is however ambivalent. indeed, cognitive rehabilitation can be beneficial by potentially reducing the othering of those with a diagnosis of dementia. a successful rehabilitation raises their symbolic worth in the light of successful ageing when they can be rehabilitated. at a symbolic level, and leaving considerations of efficacy aside, the positive positional benefit of rehabilitation relates to its cultural desirability. it corresponds to a valued imaginary of individuals triumphing over their cognitive decline through active engagement and dedication to regimes of http://anthro-age.pitt.edu/ libert & higgs | 11 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu rehabilitation. this successful rehabilitation represents the primary objective of the neuropsychologists i encountered which is to mitigate the capacity of the diagnosis to create exclusion. however, this first benefit of reducing stigma through the cultural desirability of rehabilitation also foregrounds the tensions found in the position of those who cannot be rehabilitated. first because it essentially relies on diagnosis as a sine qua non entry point implying issues of stigma listed above. moreover, this strategy aspires to the expansion of this diagnostic process—for instance through digital population level screening (kitanaka 2020, 121) and forms of early diagnosis such as mci or prodromal dementia—therefore encouraging further labelling. labelling remains a challenge in a general context in which stigma against dementia is prevalent, and in which attempts to further medicalize dementia and separate it from previous categories of senility have proved limited in alleviating this stigma (ballenger 2008; 2006; kitanaka 2020). another issue beyond labelling is that rehabilitation confronts individuals diagnosed to the norms of capacity desired by active ageing. this confrontational approach to decline is illustrated through the challenging exercises imposed during the rehabilitation, which often need the reassurance from therapists that it is fine to fail and that participants should continue to try. this confrontational logic inevitable exposes their impairment as a result. the position of individuals who can be rehabilitated is therefore not without tensions. despite its therapeutic benefits, it reifies and exposes the existence of decline, therefore rendering it amenable to potential exclusion or “felt” stigma among patients (fletcher 2021). this exposition of decline through labelling and challenging exercises is an additional process leading cognitive rehabilitation to locally contribute to the symbolic power that society attaches to a diagnosis of dementia. finally, the more tacit, yet no less present, position of people with dementia who cannot be rehabilitated illustrates the ultimate process by which rehabilitation contributes to the symbolic power of a diagnosis. it exposes the existence of individuals whose decline is irreversible and separates them from the active ageing population. as i observed during this fieldwork, this third position is rarely discussed among key actors in the field of dementia, be it in memory clinics, influential institutions such as the who, or patient associations. its existence evokes fear and powerlessness in the face of irreversible decline. this narrative clashes with the hopeful discourse that these institutions wish to promote. however, this promotion of hopeful discourses is an important source of othering for people with dementia falling beyond the reach of therapy. rehabilitation, through its process of diagnosis ascribing label, and the filtering process it inherently operates by applying a selective therapy prioritizing early and moderate dementia therefore contributes to affirming and crystallizing the fear attached to individuals who cannot be rehabilitated. it further ascribes them in a culturally significant position symbolising a failed ageing. overall, when considering the relation of memory clinics with the broader context of successful ageing, we see how memory clinics play a specific social role in ascribing a pathological identity separated from ageing upon older adults experiencing cognitive decline. their definition of abnormality, standardized assessment reifying decline through metrics, and confrontational approach to decline locally produce the powerful symbolism attached to the dementia diagnosis and its capacity to separate individuals from a so-called normal ageing. we propose to conceptualize this peculiar symbolic role of cognitive rehabilitation in the dominant narrative of successful ageing as a technology of ascription. while the contribution of technologies of ascription to processes of social exclusion is difficult to perceive locally within the clinics, it becomes significant when the processes they deploy is relocated within dominant cultures of successful ageing. technologies of ascription help to understand how http://anthro-age.pitt.edu/ libert & higgs | 12 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu localized processes and day-to-day interactions—such as the ones taking place in rehabilitation within the memory clinics—are essential in generating the symbolic power of a dementia diagnosis to fracture later life. exclusion is not solely the by-product of large-scale dementia strategies and public health campaigns, but also results from the combined action of various sites and mundane practices materializing the aspirations of these discourses. other studies explore the social impact of diagnostic practices for other conditions (e.g., armstrong, michie, and marteau 1998; strong 1979). even though these practices can be transformative for identity, we argue that they do not possess the same symbolic intensity in evoking existential fear in later life as those found in cognitive assessment and rehabilitation. amidst the widespread expansion of medicalization in dementia, we propose that technologies of ascription are not limited to cognitive rehabilitation alone. technologies of ascription can help us analyse other pharmaceutical and psychosocial interventions and therapies playing a similar social role of separating decline from normality in later life and determine their capacity of exclusion. by pointing to the importance of studying technologies of ascription, we also wish to delineate a field of research which remains relatively understudied in anthropology. it could offer many promising avenues for future ethnography to study social exclusion in later life. importantly, what we point out is not an outright rejection of the medicalization of cognitive decline in later life. rather, in introducing the analytical concept of technologies of ascription, we call for the importance to more critically appraise the symbolic role that interventions can play in shaping identity and the benefits of medicalization for older adults. while medicalization can be beneficial for some— the ones whose decline remains “manageable” through rehabilitation—it also delineates a position associated with more exclusion for others. conclusion this ethnography starts from the observation that little empirical research has been conducted on the localized processes of medicalization of cognitive decline contributing to the symbolic power of exclusion of a dementia diagnosis. most psychosocial or gerontological research considered the diagnosis as an isolated entity requiring an intervention to facilitate its acceptance, underline its benefit, and promote it as an example of neurodiversity to prevent stigma and exclusion. research in this domain often involved either exploring experiences of people with dementia as if being detached from the dominant cultural narrative of “successful,” active cognitive ageing, or problematizing this narrative while paying little attention to documenting the localized processes reinforcing the symbolic power of a dementia diagnosis to divide later life. this ethnography observing the actions and meaningmaking practices of neuropsychologists and researchers implementing a cognitive rehabilitation therapy in two memory clinics in southern europe aimed at addressing this gap in the literature. in this study, we considered the various steps followed by individuals experiencing cognitive decline. we presented an account of how the referral and the assessment represent an important transformation of identity as separated from “normal ageing” enacted through the reification of cognitive decline into dementia through standardized tests and metrics. we then presented how the confrontational therapeutic approach to decline found in the cognitive rehabilitation implicitly divides people with dementia into those who can benefit from rehabilitation, thereby demonstrating a desired ethos of active cognitive ageing in dementia and separating them from those who cannot be rehabilitated. we explained how this implicit process of filtering in rehabilitation is constitutive of an excluded category of people whose identity increasingly represents a “failed” ageing marked by the loss of agency in therapy. based on this ethnography, we proposed the term of technologies of ascription to qualify this http://anthro-age.pitt.edu/ libert & higgs | 13 anthropology & aging vol 43 no 1 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.355 http://anthro-age.pitt.edu process defining and reifying abnormal cognitive ageing, and involuntarily filtering individuals experiencing cognitive decline. we explained that technologies of ascription exemplify how the symbolic power of exclusion of a diagnosis of dementia is locally produced, therefore materializing discourses of successful cognitive ageing. finally, we presented how technologies of ascription can be used as an analytical concept to explore how the symbolic power of division of a dementia diagnosis is locally produced in other therapeutic interventions for dementia. we explained how anthropology could play a key role in this exploration and improve our understanding of processes leading to social exclusion in later life. acknowledgements the research presented in this article was carried out as part of the marie curie initial training network (itn) action, h2020-msca-itn-2015, under grant agreement number 676265. we are grateful for the support of the health foundation involved in the care and therapy 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dementia (pride) intervention to enhance independence in dementia.” clinical interventions in aging 14: 1615–30. zola, irving. 1972. “medicine as an institution of social control.” the sociological review 20 (4): 487–504. https://doi.org/10.1111%2fj.1467-954x.1972.tb00220.x. http://anthro-age.pitt.edu/ profiles of ethiopian centenarians: a qualitative inquiry samson chane margaret e. adamek bahir dar university indiana university chanesamson@gmail.com madamek@iupui.edu abstract as global aging advances, the number of centenarians (people aged 100 and over) worldwide is greatly increasing. most of what is known about centenarians comes from the global north, and it is unclear which factors may contribute to the longevity of centenarians in impoverished, mostly rural areas of the global south that sometimes lack basic amenities. cultural differences in the profile, lifestyles, and needs of centenarians across africa have yet to be documented. using a case study design, this descriptive inquiry investigates the profiles of centenarians in ethiopia including religion, marriage, education, occupation, income, and living arrangement. data were generated through indepth interviews with nine centenarians (1 woman, 8 men) and were analyzed using descriptive narrative analysis. respondents were between age 100 and 108. all nine were adherents of orthodox christianity, had been married, and were great-grandparents. their adult lives were marked by both residential and marital stability. the ethiopian centenarians seemed to persevere through many losses and hardships with the help of strong community-based social networks. unlike studies of centenarians in the global north, most respondents were male and had strict religious upbringings. understanding the unique profiles of centenarians in the global south helps to inform research and practice with this growing population of the oldest-old. keywords: centenarians; ethiopia; qualitative inquiry; global south; oldest-old anthropology & aging, vol 42, no 2 (2021), pp. 126-136 issn 2374-2267 (online) doi 10.5195/aa.2021.336 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. chane & adamek | 126 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu profiles of ethiopian centenarians: a qualitative inquiry samson chane margaret e. adamek bahir dar university indiana university chanesamson@gmail.com madamek@iupui.edu introduction the number of centenarians (people aged 100 and over) is increasing globally. in 2000, there were an estimated 180,000 centenarians in the world (giraldo 2009), and by 2010 there were over 300,000 (serra et al. 2011). globally, the number of centenarians is expected to reach over 3 million by 2050 (sadana et al. 2013) and an incredible 25 million by the end of the 21st century (robine and cubaynes 2017). most of what is known about centenarians stems from studies conducted in the global north. thus, studies on centenarians tend to be western-centric. for example, existing studies often rely on birth certificates and public records to document ages. ferreira and kowal (2013) emphasize the inappropriateness of using western measurements to collect data in african settings. centenarians have unique health risks, needs, values, and life goals (pin and spini 2016) and yet, the factors contributing to longevity of centenarians in global south nations have not been delineated (giraldo 2009; serra et al. 2011). despite giraldo’s (2009) acknowledgement over a decade ago of the scarcity of research on centenarians in the global south, studies of centenarians in sub-saharan africa remain scant. thus, a full picture of the everyday lived experiences of older people in africa is lacking (aboderin 2005; ferreira and kowal 2013). existing gerontology studies in the african context are fragmented, lack comprehensiveness, and focus on certain thematic areas. a clearer understanding of african perspectives and concepts related to old age are necessary to explain the realities of the older population in africa. in relation to centenarians, research from different perspectives is needed to explain cultural differences in the factors contributing to longevity, the meaning of successful aging, and the socioeconomic and demographic features, health conditions, functionality, and behaviors of centenarians (afonso et al. 2018). documenting the profiles of centenarians can help to understand their geographical distribution, gender differences, occupational backgrounds, and lifestyles as well as how these conditions contribute to longevity, and importantly, can identify health and other care needs of the growing population of centenarians (giraldo 2009; serra et al. 2011). while it has been documented that improvements in living conditions including food, hygiene and medical services, education, and income contribute to increases in longevity (unfpa & help age international 2012), it is not clear what factors contribute to longevity of centenarians in impoverished rural areas of global south nations that lack basic amenities. in ethiopia, while just 5% of the population is age 65 and over, it is expected that the country will have 11.5 million older adults by 2050 (central statistical agency of ethiopia 2007). despite sub-saharan africa having the biggest gains in life expectancy (united nations 2019), gerontological studies in the region remain sparse (adamek et al. 2021). in the absence of systematic inquiries in ethiopia and other sub-saharan nations, we have little insight into the lives of scores of undocumented centenarians, including cultural differences in their profile, lifestyles, and needs. furthermore, in ethiopia, researchbased data documenting the profiles of centenarians is absent. empirical literature and statistical reports http://anthro-age.pitt.edu/ chane & adamek | 127 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu in ethiopia do not mention centenarians (federal democratic republic of ethiopia 2008; transitional government of ethiopia 1991). the age group of 100 and over is not listed as a separate category in government population reports. thus, there is not even a clear picture of the number of centenarians in ethiopia. to address the gap in the knowledge base regarding centenarians in sub-saharan africa in general, and in ethiopia specifically, we conducted qualitative research in order to introduce profiles of ethiopian centenarians and give voice to their experiences of aging. with the second largest population and the fastest-growing economy in africa (world bank 2021), ethiopia can reveal the overall patterns of aging that are likely to be evident in other sub-saharan nations. our study aimed to reveal insights about centenarians in sub-saharan africa with hopes that researchers may undertake further study to build a body of knowledge about this rarely researched minority cohort. documenting the profiles of centenarians can increase awareness of centenarians among stakeholders including researchers, practitioners, and policymakers. instead of relying on what is known about centenarians in the global north, the distinctive features of life as a centenarian in the african context needs to be detailed and thus valued. understanding the unique factors contributing to the longevity of centenarians in ethiopia may inform strategies to support the growing population of older adults in the global south and in africa in particular. methods we employed a qualitative case-study design to explore the profiles of centenarians living in the rural (five centenarians) and urban areas (four centenarians) of ethiopia. in the ethiopian context, areas inhabited by less than 2,000 people and where agriculture is the main source of livelihood are considered rural. we utilized case studies, since they are appropriate to study unique phenomena, issues, individuals or groups, in order to gain a more in-depth and holistic understanding of the centenarians (creswell 2018; yin 2003). purposive sampling, specifically the snowball technique, was used to recruit nine centenarians living in six woredas, a local administrative unit, in the amhara regional state. the inclusion criteria for study participants were being age 100 years or over and the willingness and ability to share their stories. data were collected through in-depth interviews using both structured and unstructured questions. all but one of the centenarians in this study were either bilingual or trilingual. all nine could speak amharic, the working language in ethiopia. altogether, centenarians used four domestic languages (amharic, tigrigna, awign, and geez) and three foreign languages (italian, english, and arabic). the first author who is a native speaker of amharic conducted face-to-face interviews in amharic with centenarians in their homes. the fieldwork was conducted intermittently between december 2015 and january 2019. on average, the interview sessions lasted 142 minutes. descriptive analysis was used to analyze the data and to create detailed descriptions of centenarians’ profiles; such analysis is fitting to reflect a clear picture of cases in their context (creswell 2018). ethical issues were considered throughout the research process including obtaining a letter of permission from the department of social work in the faculty of social sciences at bahir dar university to undertake the study; briefing centenarians and their families on the objectives of the study; obtaining oral informed consent from centenarians to take part in the interviews; and getting permission to use a voice recorder during the interviews. confidentiality of the data was ensured by using pseudonyms and concealing any identifying information. http://anthro-age.pitt.edu/ chane & adamek | 128 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu findings temporal contexts and determining age among the study participants, eight were men and one was a woman. all nine were born in rural areas of ethiopia. at the time of the interviews, participants ranged in age from 100 to 108. three centenarians provided the exact date, month, and year of their births; as we explain in more detail below, the others referred to certain events to specify their year of birth. the eldest centenarian was born on august 11, 1906, and the youngest centenarian was born in september 1918. these centenarians lived through periods of monarchical and military forms of government in ethiopia as well as through the more recent unitary and federal systems of government. many of our study participants stated that the practice of recording birthdays was rare in their rural communities. sometimes parents (usually fathers), family members, relatives, and priests or religious fathers1 who could read and write amharic recorded birthdays and baptismal dates. the centenarians frequently mentioned temporal contexts to communicate, clarify, and strengthen recollections. our participants mentioned major historical events that happened in ethiopia or in their localities as a reference to validate their ages, including the period of lij iyassu (r.1913-1916), the ascension of empress zewditu to the throne in 1916, and the great influenza epidemic of 1918, also known as the spanish flu and traditionally as ye hidar beshita (pankhurst 1989). the italian invasion of ethiopia in 1936, the return of emperor haile silassie i from exile, and the end of the italian occupation in may 1941 were also common events noted by centenarians to confirm their year of birth. one of the respondents, age 104, justified his age using contextual explanations. as he put it, “i was the eighth and the last child of my parents. i was matured and had two children during the italian invasion. i joined the resistance movement against the italians in 1936 and received wounds on my hip.” table 1: centenarians by gender, age, and religion n a m e o f c e n te n a ri a n (p se u d o n y m ) g e n d e r (s e lf -i d e n ti fi e d ) d a te o f in te rv ie w age religion y e a r o f b ir th a g e d u ri n g i n te rv ie w o rt h o d o x c h ri ri st ia n m o n k /n u n d u ra ti o n o f b e in g a m o n k o r n u n ( in y e a rs ) hiruy m dec 2015 1906 108 yes monk 18 kebede m dec 2017 1913 104 yes monk 1 belaynesh f dec 2018 1915 103 yes nun 20 abrham m jan 2019 1916 103 yes zelalem m nov 2018 1916 102 yes monk 25 bishaw m nov 2018 1917 101 yes monk 9 deribew m jul 2016 1917 100 yes michael m oct 2017 1917 100 yes monk 5 zekariyas m dec 2018 1918 100 yes http://anthro-age.pitt.edu/ chane & adamek | 129 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu according to the table, all nine centenarians followed orthodox christianity; six had become monks and a nun in their old age. becoming a monk or a nun in later life is part of the social and religious expectation among followers of ethiopian orthodox christianity. in this role, they are expected to pray daily for such blessings as peace and security in ethiopia and in the world, to cure diseases, and to enter paradise. they may perform community services such as helping the poor and giving condolences to the bereaved. marriage and family our study participants had established families and stable marital lives. two-thirds of the participants had married only once in their lifetime, with the longest lasting 78 years. most got married between the ages of 20 to 25. on average, most of the centenarians lived with their spouses for 54 years. three centenarians explained their late-in-life first marriages as a result of the need to lead a monastic life, inconvenient working conditions, and/or the need to earn a better income. respondents attributed their successful marriages to the qualities of love, faithfulness, tolerance, mutual respect, forgiveness, and commitment. some participants experienced divorce, widowhood, and remarriage. the number of spouses of the centenarians ranged from one to four, and three centenarians had living wives during the interview sessions. only two centenarians had not experienced widowhood while two centenarians had lost multiple wives. kebede (104) shared, “i married four wives in my life. all of them passed away. my fourth and last wife died in 2017 without giving birth to a child.” four of the centenarians remained widowers for 31 to 46 years after they had lost their first wives. being monks and preferring to live without a spouse, four of the centenarians never remarried after the deaths of their first wives; instead, they lived without a spouse for more than 30 years. the centenarians in this study had a total of 67 children, 37 of whom were still living. three centenarians had 10 to 15 children each. deribew (100) had his 15th child at age 91. he had a strong attachment to his youngest child and praised god for giving him offspring in his later life. he considered her to be “the gift of god.” these centenarians could extend the chain of successive generations with both grandchildren and great-grandchildren. they also mourned the loss of 30 children due to disease, murder, and accidents. abrham (103) had three sons and three daughters; all three sons passed away. as he described: i had three young sons, one of them was a university student; the others were serving as a soldier and a civil servant. my eldest son, a government employee, had four children. he was seriously sick and lost his life. the second son died on the battlefield, and the third one could not recover from his illness and lost his life. kebede (104) remembered the death of his children sadly, “i fathered 10 children. unfortunately, i lost seven sons to death; there are only three living daughters in the rural areas leading a destitute life in their old ages.” hiruy (108) and his wife had 11 children but only six were still living. he shared: my eldest daughter died from hiv/aids; she was a schoolteacher and had seven children. i lost my little kid at the age of four, and son who was a military officer with the rank of colonel. two of my young sons were members of the eprp (ethiopian people’s revolutionary party) and were imprisoned and assassinated in 1979 by government forces in debre markos prison along with 84 prisoners during the period of red-terror [in the late 1970s]. http://anthro-age.pitt.edu/ chane & adamek | 130 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu hiruy was shocked and saddened by the assassination of his sons. while the marriage and family lives of the ethiopian centenarians were marked by stability and long-term commitments, study participants also experienced considerable loss, including outliving some of their children as well as spouses. education concerning the educational background of these centenarians, four of the nine were illiterate. bishaw (101), deribew (100), and michael (100) attended the traditional education of the ethiopian orthodox church. hiruy (108) was also well-versed in traditional church education, attended school up to grade eight, and earned a teaching certificate after completing a three-year summer program in 1950. zekariyas (100) attended grade nine at the general wingate secondary school in addis ababa. in some cases, parents who attended the traditional church education themselves then sent their children, particularly boys, to church school. only four of the centenarians’ parents had attended church education and could read and write both amharic and geez—an ancient liturgical language used in the ethiopian orthodox church. deribew’s mother grew up in the court of empress taytu, wife of emperor menelik ii, and had the opportunity to learn reading and writing in amharic 115 or 120 years ago. the empress herself joined the traditional church education during her childhood and could read and write amharic and geez. she encouraged the program to teach daughters, sons, and relatives of the nobility as well as influential personalities in the palace. deribew’s mother was one of those children who was tutored in the palace. deribew explained the influence of his parents’ church education on their decision to send him and his sisters to church school. deribew’s grandfather also supported church education and made the necessary arrangements. as deribew explained: my paternal grandfather employed the geez teacher at home. my older sisters and i learned the amharic and geez languages, and could read and write in amharic and geez using the geez alphabet. we learned religious books including dawit (david), wudassie mariyam (praise of mary), teamre mariyam (the miracle of mary), and melke mariyam. i attended further traditional church education and was ordained as a deacon in debre tabor by abune abrham. then i continued providing religious services in the church for three and a half years. among the centenarians, hiruy had extensive experience in church education. he emphasized how a parent’s education could highly influence their children’s education. for example, through his father’s line, hiruy’s grandfather, great-grandfather, paternal older brothers, and uncle were distinguished in traditional church education and were influential in local religious and administrative matters, inspiring hiruy to proceed with his own educational career. hiruy spent three decades attending nine different church schools in various locations. he shared: my father and grandfather were well-educated in church schools, and they obtained the title of marigeta. they devoted their lives in teaching religious education and providing administrative services in the church holding different positions. my father was appointed as a marigeta in dejen, kosta teklehaymanot and wonqa. in the tradition of the ethiopian orthodox täwahédo church, marigeta refers to both a title and an office given to someone who has successfully completed different courses of the traditional church education. the marigeta has multiple roles as an administrator of the church or parish, teaching qene, zema, http://anthro-age.pitt.edu/ chane & adamek | 131 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu liturgical music, singing, and dancing (sokolinski 2007). occupation and source of income during their working years, each of the centenarians engaged in different occupations. these included being a farmer, teacher, priest, soldier, government employee, shoemaker, and automotive technician. six of them had farming experience as either their main or secondary occupation. farming was the permanent occupation for four centenarians until their retirement. kebede (104) claimed that he was one of the hardest working and productive farmers in his community until the age of 70. after that point, he occasionally sold grain to subsidize his household income. zelalem (102) was a successful farmer as indicated by the number of oxen, milk cows, sheep, and beehives he had, which supported the production of milk and dairy, honey, meat, and local drinks. he also hosted feasts for neighbors and relatives. belaynesh (103) was a farmer and a housewife. over time she had three husbands—two were farmers and one was an italian soldier. she regularly made charitable contributions to the church. she sold lemons for 15 years and generated about 100,000 ethiopian birr, which she gave to the church. belaynesh described her charitable activity as follows, “i feel strong spiritual satisfaction from presenting gifts to the church used to cover expenses for religious services. i have received recognition in the community.” hiruy (108) and michael (100) held two or more occupations simultaneously. hiruy was a schoolteacher, a farmer, and a priest, who actively participated in local church affairs. the combination of his traditional church education and modern education shaped his personality and perspective. he combined priesthood with farming and was employed by the ethiopian ministry of education as a primary-school teacher. hiruy taught amharic and geez for 24 years until his retirement in 1974. although he did not identify himself as a merchant, he also traded in grain, sheep, cows, and oxen to subsidize the family income. hiruy summarized his work experiences: i provided long years of church service from childhood to age 100. i was interested in doing different businesses. farming was my favorite occupation, and i liked running retail trade selling and buying farming products. if i were not a priest, i would have become a successful merchant. i taught amharic and geez in the primary school. abrham (103) had diverse occupational experiences as a young man, and later became a well-known shoemaker and business owner. he was born into a poor peasant family in the rural area near asmera. his father died when he was a child, so his widowed mother took the responsibility of raising him and his siblings as well as managing the family affairs. being poor and a widow, abrham’s mother faced many challenges. abrham assisted the family by doing household chores and looking after cattle. the family was desperate and suffered from a hard life due to a shortage of food. as a result, abrham fled to asmara and teseney—larger towns that were centers of manufacturing and agro-processing industries--in search of work. he remembered his childhood as a time of misery, sadness, and hopelessness. abrham worked a series of odd jobs in asmera, teseney, and gondar. for a decade, he was employed as a shoemaker in a private business. over time, abrham transformed himself economically, built up his confidence, and developed the skills to make leather products. he founded a private shoe-making enterprise, staffed with senior and junior shoemakers. he spent more than 50 years as a shoemaker and was popular, attracting many customers. abrham shared: http://anthro-age.pitt.edu/ chane & adamek | 132 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu my parents were very poor. i led a miserable life in my childhood. i fled to asmera and engaged in different occupations to earn income. in asmera, i was working with italians in an edible-oil factory and gained technical experience. i spent half of my life as a shoemaker. even now at the age of 103, i have the skills for shoemaking, but i have no capital and physical strength. currently, i have no occupation. i sit idly. i quit shoemaking for the last fifteen years. michael (100), effectively managed dual occupations. he was a farmer and an informal law-enforcement officer (locally in amharic “leba adagn” – which literally means ‘hunter of the thieves’ or “bounty hunter”). he was in charge of maintaining security by hunting criminals in his locality and taking them to court. michael served as leba adagn until his retirement at the age of 55. he continued cultivating his plots of land, employing a sharecropper in his later life. deribew (100), began his career as a deacon and served the church for three and a half years. during the italian invasion from 1936 to 1941, he joined the patriots’ resistance movement. in the post-liberation period, deribew took various positions in government offices at the woreda (a local administrative unit) as the secretary of senior officials and vice-administrator. after serving in the government for 29 years, he retired in 1974. in retirement, he joined the ethiopian patriots association and took positions as the coordinator, treasurer, and chairperson of the association. zekariyas (100) had a career related to automotive mechanics. he was employed by a highway company and government garages. there, he had many positions such as technician, field-chief mechanic, supervisor of junior mechanics, and manager. zekariyas worked for 60 years as a mechanic until his retirement at age 90. seven of the nine study participants had two or three sources of income that they generated themselves or derived from their adult children’s support, land rent, rental houses, and pension. other than kebede, whose children were very poor, financial support from their children was a primary source of income. belaynesh had no financial or material resources or assets as a source of income, so she depended on her daughter for financial support. however, a few of the centenarians supported their children and grandchildren. for example, hiruy, zelalem, and kebede shared their limited financial and material assets as well as land with their children and grandchildren. land rent was a second source of income for five of the centenarians (bishaw, hiruy, kebede, michael, & zelalem). they rented plots of farmland for brief periods of time, or they used the system of sharecropping. kebede relied on income from renting farmland, while abrham, deribew, and zekariyas earned income from rental housing. after serving in government offices for 20 to 30 years, three of the centenarians (deribew, hiruy, & michael) were beneficiaries of state pensions. place of residence and living arrangement all nine centenarians were born and raised in rural areas. five centenarians—bishaw, hiruy, kebede, michael, and zelalem—lived in their birthplaces with their extended families throughout their lives; they aged in place, never changing their place of residence. four participants--belaynesh, deribew, abrham and zekariyas--left their rural villages as teenagers or young adults, changing their residence twice or more from one town to another for work-related reasons. most of the centenarians lived with family members in households with an average of four family members in each. family households were composed of spouses, children, grandchildren, in-laws, great-grandchildren, and housemaids. none of the centenarians lived alone. http://anthro-age.pitt.edu/ chane & adamek | 133 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu discussion empirical studies from other nations indicate that the proportion of female centenarians is typically higher than the proportion of males (ribeiro et al. 2016; teixeiraa et al. 2017; us census bureau 2014). a population-based study in thirty-two european countries indicated that 86% of centenarians were female (teixeiraa et al. 2017) and in portugal, the national census revealed that 82% of centenarians were female (ribeiro et al. 2016). likewise in the us, the gender ratio of centenarians was found to be 5 to 1, with 100 female centenarians for every 20.7 male centenarians (us census bureau 2012). while the current study was based on a non-representative convenience sample of centenarians in ethiopia, it is remarkable that eight out of the nine centenarians we were able to locate were male. future studies may help to illuminate and explain whether this gender pattern exists in the larger aging population in ethiopia as well as in other patriarchal societies. in 19th and 20th century ethiopia, when illiteracy was widespread and there was no well-established institution responsible for registering births and deaths, legal birth certificates were not available. as an alternative, people resorted to referencing major events – battles, periods of famine, the enthroning and dethroning of emperors, and so on – in order to specify year of birth and fix their ages. relying solely on birth certificates to recruit study participants for gerontological research may exclude potential centenarians and other cohorts in the global south in general and less literate communities in particular. compared to studies in other nations, the centenarians in our study had less formal education. before reaching very advanced old age, four of the nine centenarians were illiterate farmers throughout their working lives. thus, previous reports of formal education contributing to longevity in global north populations (e.g., murtin et al. 2017) may not apply to centenarians in global south nations. it may be that being closely embedded in a supportive social network makes up for educational differences and other resource disadvantages of centenarians in the global south. the contributions of spouses, grandchildren, relatives, and neighbors in supporting centenarians should not be overlooked (pin and spini 2016). in developing countries such as ethiopia, family members, mainly adult children who themselves may be in their 70s or 80s, are responsible for providing care and support to older adults (adamek et al. 2020). most of the centenarians in this study were born and continued to live in rural villages throughout their lives. growing up in the rural ethiopian countryside, these centenarians had very close relationships with their neighbors, relatives, and the local community. they were deeply embedded in supportive social networks that shared socio-cultural values. collective life and togetherness are common cultural features in ethiopia where even unrelated people live together, share social events, and support one another in ways that promote livelihood resilience (weldegebriel and amphune 2017) these traditions have persisted with few changes, particularly in rural and semi-urban areas. typical family structures are extended and may include non-related individuals who are considered family. similarly, an ethnographic study in south africa found that non-kin caregivers of elders may be considered part of the family (bohman et al. 2009). in contrast, 85.7% of centenarians in the us (us census bureau 2012) and 72% in puerto rico (alemenas-velasco and ortiz-marin 2013) lived in urban areas. none of the ethiopian centenarians in our study lived alone in later life while the living arrangements for older adults in the global north is largely characterized by living alone, with a spouse (us census bureau 2012), or living in congregate settings such as institutional or residential care centers (holstege et al. 2018; pin and spini 2016). in the global south, older adults tend to live with multigenerational and extended family members (unfpa & help age international 2012; zimmer 2008). despite ethiopia being the third most populous nation in africa, with over 110 million residents, institutional care for http://anthro-age.pitt.edu/ chane & adamek | 134 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu older adults is rare with only ten facilities throughout the country (dr. messay kotecho, addis ababa university, 2020, personal communication). thus, nearly all elders, including centenarians, tend to live with family members. living in a multigenerational household seems to have an impact on longevity that is significant and deserves further examination. as people get older, especially centenarians, they are likely to experience the loss of spouses and children who are a source of care and support (kropf and pugh 1995; lymbery 2005). the nine centenarians in our study had more children on average than centenarians in other nations including puerto rico (almenas-velasco and ortiz-marin 2013) and the netherlands (holstege et al. 2018). nevertheless, six of the nine centenarians in this study outlived many of their children. conclusion more is known about centenarians in the global north than in the global south. population reports in african nations tend not to present centenarians in a separate age category. thus, the number of centenarians in global south nations remains largely unknown. this study confirms the existence of centenarians in ethiopia and provides insight into their profiles. although it may be considered a limitation of this study that centenarians did not have birth certificates, alternative approaches were used to validate their ages such as cross-checking birth years with contemporary events and other official written documents. understanding the unique profiles of centenarians in the global south helps to inform research and practice with this growing population of the oldest-old. in countries where life expectancy is low, particularly in the global south, much can be learned from the profiles and experiences of those whose lifespans stretch for a century or longer. further research is needed to compare and confirm the profiles of ethiopian centenarians with those in other nations around the world. inclusive longevity studies with diverse racial, ethnic, and sociocultural groups, geographical regions, and climate zones are needed to advance the scientific body of knowledge globally. a systematic census would help to provide an accurate accounting of the number of centenarians in ethiopia and other developing nations. in ethiopia and the rest of africa, centenarian issues have not been the focus of empirical research. longitudinal studies can be useful to overcome the limitations of this cross-sectional study and may help to inform scholars about the unique factors contributing to elders’ longevity in ethiopia. researchers from different disciplines and professions including social work, gerontology, sociology, demography, genetics, geriatric medicine and nursing, psychology, history, and anthropology are needed to promote a greater understanding of centenarians in the global south. epilogue by the end of the data collection period in january 2019, five of the centenarians were still living. three of them (kebede, michael and hiruy) lived for a year after their interviews. hiruy, the oldest of all the centenarians who participated in our study, lived for four years after the interview session; he died in november 2019 at the age of 113, reaching the status of super-centenarian. notes 1. a “religious father” is not a biological father, but a priest assigned to family members and was responsible for arranging the christening of a newborn, giving them a baptismal name, registering birth dates, teaching them about christianity, giving blessings during religious festivals and wedding ceremonies, praying, giving condolences to bereaved families, and reconciling conflicts among family members. http://anthro-age.pitt.edu/ chane & adamek | 135 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.336 http://anthro-age.pitt.edu references aboderin, i. may 2005. “understanding and responding to ageing, health, poverty and social change in subsaharan africa: a strategic framework and plan for research.” outcomes of the oxford conference on ‘research on ageing, health and poverty in 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in ethiopia. https://www.worldbank.org/en/country/ethiopia/overview#1. yin, robert k. 2003. case study research: design and methods. (3rd ed.) los angeles: sage. zimmer, zachary. 2008. “health and living arrangement transitions among china’s oldest-old.” research on aging 27 (5): 215-34. https://doi.org/10.1177%2f0164027505277848. http://anthro-age.pitt.edu/ https://doi.org/10.1186/s40677-017-0074-0 assisted reproductive technologies and the conceptualization of ageing in india anindita majumdar indian institute of technology anindita@la.iith.ac.in abstract through a mapping of field data collected from two parts of india: hisar in north india and hyderabad in south india, this paper looks at the ways in which reproductive decline and ageing have become part of the discourse on assisted reproduction in india. the importance of mapping reproductive decline in different clinics and regional spaces highlights certain shared and distinct conflicts. the thematic discussions of the research findings place the privileging of temporalities in an ambivalent relationship with chronological ageing and reproductive decline. the linkages between ageing and infertility/fertility are more marked in the infertility clinic wherein the diagnostic protocols and treatment towards achieving parenthood are evaluated through the prism of social and moral judgements. rural-urban differences, gendered expectations of familial roles and rules, and lived environments and lifestyles have a huge impact on the use and dissemination of assisted reproductive technologies in india. in this paper, social expectations surrounding fertility, children, and the family become part of the clinical discourse in the administration of assisted reproductive technologies; and carry important implications for ageing and age-related markers of status and role. keywords: temporality; biological clock; reproduction; masculinities; egg freezing; menopause anthropology & aging, vol 42, no 1 (2021), pp. 49-65 issn 2374-2267 (online) doi 10.5195/aa.2021.261 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 49 assisted reproductive technologies and the conceptualization of ageing in india anindita majumdar indian institute of technology anindita@la.iith.ac.in in this paper, i examine the role that assisted reproductive technologies (arts) such as in-vitro fertilization (henceforth arts/ivf) play in conceptualizing age and ageing in fertility treatments. assisted reproductive technologies facilitate conception through various methods of clinical intervention. there are primarily three methods that are used: (1) intrauterine insemination (iui) that involves the manual introduction of donated semen into the ovary through a syringe-like aperture; (2) in-vitro fertilization (ivf), the most popular method, that involves artificially fertilizing the egg and sperm in a laboratory before transferring the embryo directly into the uterus; and (3) intracytoplasmic sperm injection (icsi) which involves direct micromanipulation of the sperm and egg in the laboratory to assist the formation of an embryo, that is then transferred into the uterus. when utilizing these technologies, couples or individuals, who want children, seek out gamete “donations,” while “thirdparty” participants such as sperm donors, egg providers, and surrogates provide a form of “donation.” in this complex arrangement of gametes and medicine, the linkages between age and fertility may not be highly discussed or scrutinized. yet, previous research in this area documents the ways age comes to be trapped in the metaphor of “ticking clocks” in reproduction (friese, becker, and nachtigall 2006; friese, becker, and nachtigall 2008), especially in relation to motherhood and the choices that women make while seeking ivf. however, a larger conversation that documents the framing of reproductive decline within assisted reproduction as a cultural phenomenon involving demography and popular discourse on decline and birthing, seems to be missing. it is argued that the numbers of those infertile is certainly not distressing enough to pursue a more concerted policy engagement (jejeebhoy 1998), but representation and conversations around arts certainly suggest otherwise. globally, demographic discourse related to age and fertility is restricted to discussions on early marriage and chronicling the capacity to birth in a woman’s lifetime (bledsoe 2002). in india, this focus has been on high population indicated by rising or falling regional markers of total fertility rates (jeffery and jeffery 1997; nagaraj 2010; visaria 2010). reduced to statistical markers and “targets,” women have long been seen as pawns in a larger demographic game of population control (jeffery and jeffery 1997). despite changes to a policy perspective that engages with universalized markers, population control proves to be inadequate as a prism of analyzing how age/ageing are dynamic markers for infertility and childlessness. in my research, i suggest that the age-fertility linkage must be expanded to determine how arts are reframing conversations around ageing and reproduction. the discussion in this paper reflects upon the complexities of age and assisted reproduction by bringing together field data and narratives from ivf specialists and their patients. in the process, the representation of reproduction as being in inevitable decline, biologically, is contested through the meanings that clinicians put forth in their administration of fertility treatment. at the same time, this paper also engages with emerging findings about how the “treatment” of infertility becomes enmeshed http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 50 in other temporalities: marriage and sexual intimacy—both of which are important precursors to seeking ivf in india. methods and field sites the fieldwork for this research study was part of a multi-sited ethnography conducted in 2018. fieldwork took place in north india: in delhi and in hisar, haryana, and in south india in the city of hyderabad. in hyderabad, a metropolitan city, and the capital of the state of telangana, the fieldwork was primarily conducted in two clinics. one clinic catered exclusively to women, and the other provided reproductive health interventions for men. both clinics operated together and referred spouses to each other. i seek to discuss some points of difference and similarity between the two clinics and the spaces within which they operate and present differences within each region which cannot necessarily be standardized. ethical approval for this study was obtained from the institute ethics committee of the indian institute of hyderabad. the north indian town of hisar (pop. 301383 as per census of india 2011) is a predominantly agrarian culture. it’s the biggest town in the otherwise small state of haryana, which is 103 miles away from the indian capital city of delhi. haryana has been part of a national portrayal of overt masochism and gender inequality ever since news of skewed sex ratios with a depleting female population and rampant honor killings of women have been reported (chowdhry 1997; kaur 2008; john et al. 2009). the impact of the existing patriarchal culture continues to predominate emerging research on haryana (see mishra and kaur in this volume). in the city of hisar, within an area of 3983 kilometers per square, there were approximately four ivf clinics operating at the same time. my fieldwork was primarily based in the oldest ivf clinic, where the doctor was known for facilitating ivf births amongst women and men who were past their reproductive prime. dr. rajesh (pseudonym) was popularly known as the “rogue doctor” in the mainstream english language press for encouraging women in their 50s and 60s to have babies. amongst some of his successful cases were two women aged 66 and 70, who had carried a pregnancy and birthed triplets and a single baby, respectively. most of dr. rajesh’s clientele belonged to the landed gentry from rural haryana, but some also came from the neighboring states of punjab and belonged to peasantry with small landholdings. in hyderabad, which is a thriving multicultural metropolis with a long history of islamic rule, the data primarily comprised of hindu women at a multispecialty hospital that catered to women’s fertility health. along with other reproductive ailment care, and pregnancy and birthing interventions, the clinic had a very popular ivf wing. this clinic was one among many since hyderabad has a thriving fertility industry with numerous clinics and commercial surrogacy facilities (gupta and prasad 2019). a significant portion of the fieldwork was also conducted in a clinic catering to men where a mixture of african1 and indian men formed the clientele. however, this paper focuses only on data gathered from indian men and women, who frequented the clinics. the interviews were conducted primarily in english, with some respondents preferring to respond in telugu and/ or hindi. http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 51 sex no. of respondents average age average years of marriage average age of spouse hyderabad (2018) men* 13 31.07 3.8 24 women 29 30.4 5.7 34.7 hisar (2018) men 14 45.8 22.07# 41 women 17 40.7 21.5 44 table 1. age-marriage data amongst those frequenting ivf clinics in hyderabad and hisar (as per sex). *excludes data on 22 african men interviewed at the same clinic. #includes bigamous unions and the cumulative years of both marriages. the data discussed in table 1 is from five different clinics. the hyderabad data is drawn from two clinics, as identified earlier: a women’s fertility clinic and a men’s fertility clinic. the hisar data is from three clinics, although the majority of the data also includes figures from men and women married to each other, which is not replicated in the hyderabad data. the table primarily discusses the data on indian men and women, leaving out the complicated, but diverse data on african men visiting indian clinics for fertility treatment. i purposely seek to link age and fertility here with the linked data on spouse’s age and years of marriage. this is significant because the rhetoric surrounding fertility at all the clinics was centered on heteronormative ideals of conjugal family-making.2 as evident from table 1, the age of those frequenting ivf clinics in hyderabad is much younger than those seeking treatment in hisar. however, the hisar data does not reflect the number of times that men and women may have visited or sought treatment earlier, only noting their age at the time of the ethnographic fieldwork. the paper goes on to discuss some of these elements later, in relation to the thematic discussions. what is also significant is the relationship between the respondents’ ages and their marital years: as uniformly, there is a gap in the age between spouses, suggesting that husbands are older than wives in india—whether in the south or in the north (pande 2012; sarkar 2000). this combines cultural preferences and the legal age of marriage (for women 18, and for men 22). increasingly, however, in hyderabad, men seemed to visit the ivf clinic early into their marriage, as the data suggests. erectile dysfunction (3), infertility (2), low sperm count (2), not known or undisclosed (5), and low testosterone (1) were the main fertility issues amongst the indian men visiting the hyderabad fertility clinic. this rise in fertility treatment could also be due to the increasing awareness regarding fertility and reproductive problems that men face, along with a heightened awareness regarding male infertility due to exposure mass media reportage and emerging forms of urban conjugal intimacy (pathak 2020). the commensurate data for the men frequenting the clinics in hisar is unavailable due to the silence surrounding male infertility, which included the tacit approval of the ivf specialist, and the wives’ positioning of infertility as embedded within their bodies. similarly, a specialized diagnosis of women in hisar and their specific reproductive/fertility ailment was not articulated. this was primarily due to the age of the women frequenting the clinic, and their “obvious” positioning as post-menopausal. their medical history was marked by visits to local obstetricians and gynecologists, as well as faith healers http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 52 and mendicants—who were unable to diagnose the exact cause of infertility due to a paucity of available diagnostic technology in rural areas; but also due to the secrecy of the treatment and the pact of silence that couples entered into with their doctors. in hisar, my questions regarding specific ailments and associated treatments were met with stoic silence. among specific couples (both men and women) that i was interviewing, there was a refusal to discuss the kind of diagnosis that the clinician had suggested in identifying male or female factor infertility. the couples themselves did not know or did not wish to discuss their diagnosis (to protect each other from the social stigma of being labelled infertile)—they wanted a child, that’s all that mattered. in the later sections i discuss specific ailments that women in hyderabad suffered from, along with details of their treatment; where there was certainly greater clarity, knowledge, and understanding of reproductive ailments and treatment protocols. the rural-urban divide is very important here, as is the fact that most of the patients at the hisar clinics were school dropouts, and some of them had never received any formal education whatsoever. in hyderabad, all 29 women were graduates with some of them pursuing full-time occupations. all, except two women amongst those interviewed in hisar, were housewives. assisted reproduction in relation to reproductive decline the relationship between age and fertility goes beyond its conceptualization in demography and population studies—though that remains important in many ways as well. in anthropology, this relationship has marked conversations on the life cycle by seeking to understand the ways in which social roles and ageing are linked in different cultural settings. the most potent idea in relation to age and fertility has been that of the “biological clock.” its contemporary relevance has been spurred through mass media reportage and representations in popular culture. within anthropology and sociology, the concept of the ticking clock in relation to declining fertility has become a source of contemporary research. in carrie friese’ work (2015), the biological clock features both as a self-reflexive conversation and as a social representation. relatedly, the connections with older motherhood and the fear of declining reproduction has been explored especially in relation to infertility medicine (friese, becker, and nachtigall 2008). franklin (2002) speaks of the ticking clock as an essential aspect of the planning associated with family-making. planning and the family-making enterprise are intrinsically linked, especially in the use and proliferation of contraceptives (woodspring 2016). in essence, the oppositional, yet connected argument to the anxieties of declining reproduction through the “biological clock,” are replicated in the linked anxieties of the “ticking” population bomb. the cultural/natural distinction between the two timekeepers could not be starker, and yet connected. to offset the fears of increasing populations in the third world, the “population bomb” began to be used as an apt metaphor to fuel war-like investment into containing the multitudes of poor citizenry in the global south, especially in india and bangladesh (rao 2004). that both sets of time depend upon temporal imaginaries that are dependent upon controlling women’s reproductive bodies, is particularly telling. biology is represented as naturally declining, but also uncontrolled in nature—if left unchecked. yet, contraceptives do not only control undesirable fertility, but are, interestingly, also linked to the contingencies that life cycles are embodied with, which have very little to do with chronological time and the population bomb, and much more to do with the notion of experiential “tolls and tribulations” (bledsoe 2002). i find bledsoe’s (2002) conceptualization particularly stimulating when seen in relation to the ways in which age and ageing come undone in medical practice and diagnosis. consequently, the idea of http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 53 “denaturalizing ageing” is linked to the medicalization of nature (lock 2007). again, medicalization has been most predominant in the conversations around women’s reproductive bodies. lock speaks of the medicalization of menopause in the west that is primarily concerned with creating a dysfunctional body, headed towards inevitable decline, with the end of menstruation (lock 1994; martin 2001). in such a conceptualization, cultural manifestations of reproductive decline or reproductive bodies become universalized, which may not really be the case (lock 1994). in the case of india, fertility and reproduction have been important to the conceptualization of gender, marriage, and kinship (kumar 2006; patel 2006), but their relationship to technology has been fleetingly analyzed. in india, fertility is greatly prized, and childlessness carries a social stigma that can be debilitating. a large part of this stigma is linked to the idea of intergenerational care wherein children, especially sons (patel 2006), have the responsibility to care for their parents once they are old. in the hindu conceptualization of the life cycle, the householder must inevitably retire to old age and be cared for by their children. however, old age does not mean social decline, for the elderly hold positions of power and prestige in the hindu household (lamb 2000; madan 1989). elderly women, for instance, are often desexualized from their reproductive selves and may come to occupy influential positions within the community (lamb 2000). bledsoe (2002) finds this in the case of gambia, wherein elderly women, who have birthed children, are seen as having fulfilled an important social role and wear the badge of mothering and care work with great pride. in india and japan, menopause is the end of reproductive life but not social life (kaulagekar 2011; lock 1994). thus, reproductive decline is marked in a gendered way on the woman’s body across cultures, even though their manifestations may differ. such a conceptualization also influences the linkages with the biological clock, forcing us to think of the premature loss of fertility only by women. however, increasingly, men are also subjected to the critical gaze of declining fertility (wentzell 2013). this includes a conscious move away from anxieties regarding sexual performance and impotence, to concerns regarding infertility (inhorn 2003). emerging medical findings suggest that aging men pass on certain genetic defects to their children the later they father (malaspina et al. 2005). reproduction and its linkages with limited time is an important part of medical and anthropological engagements and comes to be framed through age and ageing. however, the conceptualization of temporal vicissitudes on reproduction seems to be limited to the process of circumventing infertility through ivf. the ageing and the aged in ivf alexandra crampton (2013) asks of her respondents, “who is old?” to ascertain their answers surrounding age and ageing. while i didn’t specifically ask such a question in the field, the notion of age came undone in specific ways in my ethnography. crampton (2013) notes that a dominant notion of old age consumes policy discourse, but the lived experience differs from such construction—often existing in opposition (lamb 2000). but in assisted reproduction, the boundaries between defining age and lived experiences constantly get blurred in clinical experience. the absence of the “statistical” continues to provoke ambiguous meanings around fertility and ageing, despite the overwhelming discourse on the “biological clock.” the ageing and the aged are part of a dynamic narrative within assisted reproduction that engages with lived experiences but also with the ways in which medicine and technology can reframe the social understandings of the body. http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 54 this is especially important since there are no age markers or limitations to get ivf administered. the indian council of medical research (icmr) which is responsible for the draft legislation on assisted reproductive technologies in india mentions that couples seeking arts should cumulatively be aged at 100. recently, the icmr has been more precise, defining the limit to 45 for women and 50 for men. however, many clinics seeking to circumvent these specifications might use the cumulative age bracket to make ivf accessible to those who are in their 20s or early 30s, older husbands, and/or younger wives. while explicitly looking at the identification of ageing bodies in terms of the reproductive lifespans of men and women, ivf specialists in india also visualize a time frame from most “fertile” to obvious failure. thus, the limits of reproductive fertility are contingent upon factors other than disease, such as the “tolls and tribulations” of one’s life span (bledsoe 2002). these tolls and tribulations are defined by factors such as late marriages and economic pursuits, often engaged with modern living and its trappings, or in other cases like bigamous marriages and long-term childlessness. the ageing and the aged are two sides of the same coin in assisted reproduction in india.3 couples that visit the ivf clinic in their mid-30s are deemed as already ageing. post-35 year-old women are aged. but is the post-60 woman who gets pregnant through ivf similar to the middle aged 35-year-old seeking arts? dr. rajesh, at the hisar clinic, continued to assert that the level of pathology amongst elderly pregnant women was the same as that found amongst middle-aged women during pregnancy. he states, “the pregnancy in an older woman mimics the same forms of maternal mortality as the middleaged woman. thus, the clinical outcomes for women in their 60s are similar to those in their 40s.” the aged woman as an “anomaly,” emerges from the potent identification of the “pathologized” middle-aged woman (lock 1993). in examining such a representation, lock engages with the biological clock through the lens of aging and middle age—as a spectrum that is constantly under scrutiny in western medicine and epidemiology. thus, the end of menstruation is for all practical purposes, the end of life, and to survive after that for a decade or more makes the aged woman an anomaly. the doctor in hisar similarly pathologizes the elderly woman seeking a child post-menopause. nonetheless, age is a marker, here, of forms of abnormality that the already aberrant may generate. in such a context, it is important to note that fertility diagnosis by clinicians create markers of normal, abnormal, aberrant, and monstrous(sity) within ivf practice. taking canguilhem (1989) as my starting point, the four categories overlap to eventually normalize how ageing in ivf practice emerges as a dynamic concept. i purposely use the values attached to the conceptualization of these concepts to briefly understand how medicine creates values around the idea of reproduction and bodies that can, may, or may not reproduce. here, age acts as the signifier for each value. however, age is not just a number but a process and a moment. in that sense, the categories of the normal, aberrant, and monstrous may constantly interchange, just as canguilhem conceptualizes them. overturning reproductive clocks the aged exhibit monstrosity in their identification as birthing parents. the monstrosity is marked in the horror of images that circulate of elderly women birthing emaciated, underweight babies. in newspaper reports on the birth of children through ivf amongst women who are aged, especially between the ages of 60 and 70, the mother and her children are symbolised through markers of debility—and decline: an indian woman who had a baby in her seventies has said that being a mother is harder than she thought it would be. . . . daljinder kaur said her health had deteriorated since she gave birth to her first child, last year . . . ‘since he’s been crawling, i am on my http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 55 hands and knees and its hard. my body can’t take it. it’s been harder than i thought. my blood pressure has suffered, and i get tired very easily now. i’ve seen several doctors, but they just give me medicines and a diet plan.’ (england 2017) in a recent reporting of a 73-year-old woman who gave birth to twin girls in a place close to hyderabad, the “horror” of the event was continuously channelized through the depiction of debility, especially in the expected fears of death related to elderly parenting. “the husband of a woman aged 73 who is thought to have become the world’s oldest mother after giving birth to twin girls [through ivf] . . . suffered a stroke just a day after his daughters were born” (ledwith 2019). the conversations surrounding elderly parenting through ivf often invoke the looming consequences of death for the newborn. therefore, concerns about the children’s future after the inevitable, and dangerously close, death of the parents leads to questions about the aberrant nature of their desire as well. in an article on facilitating birth amongst elderly couples, dr. narendra malhotra, head of indian society of assisted conception (isac) is quoted as saying: “we don’t endorse making mothers out of grandmothers . . . it’s too risky for the woman. their bodies are not designed to bear children after 50” (england 2017). here, the monstrous commingles with the aberrant in creating an unfriendly and dangerous representation of overturning biological clocks. but what does this overturning of biological clocks truly entail? is the medico-technological “overturning” problematic only socially? are the “monstrous” only socially marked this way? amongst those infertile couples who went on to have children through ivf at a later stage—that was deemed to be socially unacceptable—perceptions have changed. “when our babies came home from the hospital, everyone in the village turned up! the local political representative also came with his entourage. many said they had prayed for us to have a child,” says ahir poonia, 52, father of twins—when his wife at 50 gave birth to them through ivf. for ahir and his wife dharam, decades of “inauspiciousness” (abshagun) brought on by their infertility was miraculously and effectively overturned by technology. it did not turn back time but upended the social markings of age in terms of a social-chronological progression. overturning the biological clock carries social stigma—it is an act “against” nature. arts “assist” nature but do not necessarily challenge it. thus, an elderly parent is a “miracle” that cannot be replicated or should not be replicated. within the oft-quoted representation of ivf births as miraculous, the elderly parent is almost like a nightmare. there is also the question of repeated ivf use that incites reproductive decline before “it’s time.” arts are notorious for their flawed claims to high rate of pregnancies, in the constant positioning of ivf clinics through aggressive “success rates” (sarojini et al. 2011). after 20 years of marriage, nine miscarriages, and multiple cycles of both iuis and ivfs, dalip singh became a father to an infant son in hisar at the age of 51. dalip had given up: “i told my wife, it doesn’t matter. we will adopt, or take care of our nephews and nieces,” until his wife gave birth in their last ivf attempt at the age of 41. the fertility timeline is also induced and constructed by arts, as we will see next. mapping reproductive decline at the same time, the aberrant young couple who is unable to birth a child and goes to ivf clinics, is not turned away. they are often incorporated and pursued by ivf specialists in the hopes of a higher success rate that will promote their clinics. in hyderabad, dr. reddy notes, http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 56 i wish they [couples seeking fertility treatment] would come to me for treatment after a year and half of being married. instead, most couples come after five years of trying after getting married, which delays their chances of conception even further. this is particularly problematic if you are already in your 30s. i don’t expect them to come in the first year of their marriage, as that does not qualify as infertility, but after a year and a half would be ideal. their absorption into fertility treatment despite unexplained causes of infertility, such as issues with sexual compatibility, physical debility (such as a missing uterus, or a pin hole vagina), early menopause, or a life-threatening disease—nonetheless, do not invite retribution or horror. here, debility is not inevitable or in progress but in a state of unintended suspension: an aberration but not a monstrosity. their debility has social consequences that are not marked by death or immediate decline, thus requiring active intervention. dr. maithili notes regarding women in their 20s opting to freeze their eggs for use later, so, what they are doing is they come in their late 20s or early 30s and freeze them [eggs]. we have not had people coming back for it because it is only a recent norm isn’t it with google, that is past last year i am thinking.4 it’s such a strange thing for girls to come and freeze their oocytes, but because it was made possible by google, we have a lot of girls coming in for that. i am thinking they won’t come before a decade because they are in their early 20s and early 30s. and when we talk to them, most don’t even have their partners, they are not even seeing anybody. very smart girls who knew what they were doing in terms of their careers. so, i like that. dr. maithili is an exception amongst practicing ivf specialists and obstetricians who largely espouse the need to adhere to a time frame to not only produce through sexual reproduction, but also through ivf. in the data from the hyderabad women’s fertility clinic, 13 women (out of 29) were in the age group of 20-29 years. in haryana, only one female respondent (out of 17 women) belonged to the 20-29 age bracket. but dr. rajesh found an increasing number of young couples coming to his clinic, unlike his earlier clientele of elderly men and women. “they come in early nowadays because of familial pressure to have children soon after marriage.” in another clinic, close to dr. rajesh’s in hisar, the doctor was explicit in her avoidance of women above 45 seeking ivf, as it went against the medical guidelines, even though they received many cases from that particular age group. the 25-year-old woman who was in her first trimester after undergoing a successful iui at dr. rajesh’s clinic, had been married for four years and did not have a child, prompting her visit to the clinic. “we tried a lot of things for the past four years until tests at this clinic pointed to my husband’s low sperm count. i had to undergo lots of social censure even though i am educated, and a government schoolteacher and my husband is a farmer.” in hyderabad, the 20-year-olds battled polycystic ovarian syndrome/diagnosis (pcos/ pcod), husband’s low sperm count, and unexplained infertility. most came to the clinic within four years of marriage, with an average of two years of unprotected coitus and no pregnancy. some did conceive but had miscarriages or abortions. here, reproductive decline was not the reason for the visit, but reproductive health was mapped and marked through the rhetoric of impending decline. http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 57 ultimately, these 20-year-olds become “normalized” as they try to become pregnant through multiple failed iui and ivf treatments and enter their 30s. many of the 30-45-year-olds had already been through 5-10 years of treatment. at the hyderabad women’s fertility clinic, out of 29 women, 16 were between 30-45 years of age and had been through, on an average of two cycles of iui, with a few of them later transitioning to ivf. the preference for iui was linked to factors such as a younger age, the possibility of a pregnancy that closely mimicked the “natural” process, and the cheaper cost of the treatment. all those between 30-35 years were undergoing iui, while those above 35 were gently nudged towards ivf, especially in cases of a history of failed iuis, or due to their “advancing” age—implying increasing deterioration and decline. but it is the 35-45-year-olds who are the true “normals” of ivf treatment. childless women aged 30 and above are abnormal in case of delayed marriage and childbirth but normalized in the quest and recourse to ivf. ivf is an inevitable aspect of declining reproduction marked by the age range identified above. couples must prepare for entry into treatment, even if they have birthed a child through sexual intercourse (or “normally”), as they may come to suffer from secondary infertility.5 the mapping of infertility is predominantly concentrated on primary infertility or the inability to have a child after one year of unprotected coitus. secondary infertility does not engage public interest as the couple are seen to have “proven” their fertility by already having a surviving child. however, the stigma attached with secondary fertility is very real, especially for women who have daughters. a majority of those who came for secondary infertility in haryana and hyderabad were women in the age bracket of 35-45 years, and their normalization within ivf was part of the treatment protocol. in hyderabad, the son preference was not as acute as it was in haryana, largely due to the overwhelming culture of sex selective abortions and low female sex ratio in the north (john et al. 2009). proven fertility was easier to work with for ivf clinics, as opposed to primary infertility which was also associated with unexplained causes. thus, the “normal” was marked in particular ways in ivf discourse—which did not necessarily link age with reproductive decline but was nonetheless identified through it. age becomes a maneuverable category that may be used to “transfer” infertility to fertility and vice versa depending upon how the technology facilitates the birth of a baby. yet, it is marriage and sexual compatibility that brings forth the most important linkages between age and fertility within assisted conception. marriage and sex as markers of temporality in infertility treatment the repeated emphasis on marriage and marital ties becomes the central trope in using and administering infertility medicine in india. the column in table 1 that highlights the years of marriage is also important in identifying the role that sexual intimacy plays in the birth of children. thus, number of years being married, in the case of hyderabad couples, is less considering their age bracket. that of the hisar couples is longer. the ways in which age is constructed in arts comes to carry within it this paradox of marriage and the marital years that a couple share. marital longevity and childlessness become potent tools in the hands of ivf specialists in claiming eligibility for using the technology. as per the who and icmr guidelines, the inability to conceive after a year’s unprotected intercourse means that you are deemed infertile but eligible to use arts. in a pro-natal culture like india, marriages must reproduce children and kin soon, with many life cycle rituals embedded in childbirth, pregnancy, and motherhood (jeffery and jeffery 1996; patel 2006). http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 58 but within the conversation on how marital longevity impacts the imagination of arts-induced reproduction, divorce always operates as a silent and potent threat. the termination of companionship—arranged or through love, is especially threatening to reproductive temporalities as i discuss below. managing reproductive intimacies due to the public outcry against the hisar clinic for facilitating birthing amongst elderly women, especially the birth of triplets by a 66-year-old woman in 2010, dr. rajesh had to reinvent the way he presented his clinic. his focus was on facilitating the success of marriages that have remained steadfast despite the debilitating impact that childlessness can have. in most of the publicity material that the clinic exhibited, successful couples who had had children at the clinic were identified by the years of their marriage, rather than their respective ages. dr. rajesh wanted to “reward” women, who had been through years of social debility and abuse due to their childlessness, by giving them the “gift” of a child born through ivf. the idea of marital commitment in the heterosexual marriage is particularly marked on the woman. in rural haryana, as elsewhere across the world (inhorn and van balen 2002), infertility and childlessness are positioned on the woman as her “lack.” ideas regarding a man’s potency are never under scrutiny though they may be talked of in whispers, if after more than two marriages the man is unable to beget a child. bigamy is commonly practiced amongst men in haryana, especially amongst those who have been unable to have a child. in many cases, the wives facilitate the second marriage, in open contravention of the hindu marriage act 1955 which penalizes bigamy. while in my sample, only two men had two wives, i heard and read about multiple cases of bigamous unions undertaken due to infertility. here, the first wife would retain her position in the household as senior co-wife, with divorce being a non-option. divorce was not an option for many of the women faced with childlessness and co-wives. the economic and social stakes were too high, especially when marriages were arranged by families. divorce has been identified as antithetical to the “sacralized” bond of hindu marriage, however, its existence and recent predominance points towards various dynamics that may operate within the hindu social structure. caste endogamy remains the driving force in a majority of hindu marriage practices, and its violation is met with violent reprisals from kin, as chowdhry (1997) has documented in her research on honor killings in haryana. however, the circumvention of rules and customary laws, was found in the solemnization of what parry (2001) identifies as “secondary marriage” (following louis dumont’s classification). primary marriages are “pure unions” that follow caste and community norms, but the secondary union following the breakdown and dissolution of the first one involved self-choice and an affirmation of companionate marriages over arranged marriages. however, it is not necessary that the fluidity of the secondary union is applicable to both partners in a marital arrangement. that is, the marriage or union may be secondary-primary based on the position the individual occupies within the familial structure in terms of descent and gender.6 the documented bigamous unions in my ethnography in rural haryana were mostly primary unions for younger women marrying elderly already-married men, seeking to circumvent childlessness; all marriages, whether secondary or primary, were arranged by kin. besides the fertility of the second wife (again embedded in her youth), considerations of inheritance and spousal support were important in choosing the second wife. often, the wife would suggest a young woman from amongst her natal kin as a suitable co-wife.7 thus, sadhu, 60, who had married his wife, rajo’s younger sister, after 15 years of childlessness strengthened his ties with his affinal kin, while his first wife sought safety in her position by bringing in a relative as http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 59 a co-wife. eventually, his second wife, dhanno, who was in her 30s, was also unable to conceive naturally, leading them to dr. rajesh’s clinic. both wives underwent an embryo transfer, but it was rajo, at 55, who conceived surprisingly. she had a daughter but relinquished care to her co-wife and sister, dhanno. sadhu’s 90-year-old mother spoke to me about the decision to seek a second wife for him: we waited for rajo to get pregnant, but it was taking too long. sadhu is my only son, and we have all this land. he must have an heir. i told rajo (because sadhu was refusing to marry again), she could choose her co-wife. . . . a woman from her own family if that helped. and rajo would always be the first wife. now look, look at god’s will! rajo got pregnant before dhanno! their marital commitment was steadfast as sadhu successfully navigated his life with dhanno and rajo. in agrarian, rural societies in the north, with property and dowry as the prime movers of patriarchy, multiple marriages worked to keep land and kin close. yet, as per law, bigamy is outlawed. socially, the endorsement of a secondary marriage for those suffering from childlessness, while retaining the first wife—was seen as legitimate. but such a right was extended only to the man and not to the woman. despite the availability and use of fertility technologies and treatment, childlessness was identified in relation to the woman. and most importantly, the child belonged to the patrilineage—and to the father. his contribution was non-negotiable, especially if he was the eldest son, slated to inherit the family land or already managing them. dr. rajesh’s intention was ostensibly to prevent such second marriages so that fertility was not compromised. he sold ivf as a “feminist technology” that protected women’s rights within a marriage. “i support those marriages where the husband remains in love with his wife and does not remarry despite childlessness. there are many such men who remain committed after 30-40 years of marriage. they deserve ivf, and i am celebrating their love and support, and not their age.” the longer the marriage, the more suitable for ivf intervention. awkward intimacies on the other hand, in hyderabad,8 marriage and intimacy were under the scanner with many couples coming to the clinic within a year of their marriage. often these couples were in their early to midtwenties. here, the meaning of intimacy was marked by troubled associations with modernity and women’s choices. the desire to reproduce was “tainted” by the failure of marriage itself. in hyderabad city, couples did not seek intimacy but children. factors such as stressful work environments and schedules pushed many couples into the ivf clinic early into their marriage. all of the ivf specialists interviewed in hyderabad city reiterated the impact “lifestyle choices” have on fertility. excessive smoking, drinking, eating out, and hectic work schedules with associated stress contributed to difficulties in conceiving: many of the couples who come to me for treatment work in information technology. this means they have demanding corporate jobs and grueling schedules. if both husband and wife are working till late, when do they have sex? on weekends. they have quick, disconnected sex on holidays, which may not match with ovulation cycles and lead to zero chances of conception. (dr. reddy) others mentioned increasing promiscuity as another reason for the collapse of conception within marriage itself. http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 60 however, what is interesting to note is that in the hyderabad data, out of 29 women, a majority of them (20) were stay-at-home, while information technology professionals and other currently employed women were a minority. similarly, amongst the 13 indian men visiting the men’s clinic for fertility treatment, three of them were in information technology, and the majority (6) were in the service sector including teaching and public service. the association with particular professions was a trope that ivf specialists frequently used to explain failed treatment. but what emerged was a gendered notion of damaging lifestyle choices that impact sexual intimacy over a long period of time. thus, women pursuing demanding careers were at a risk of infertility, while men pursing supposedly “hedonistic” lifestyles were reneging on their role as responsible householders. here, the choice to pursue a particular lifestyle over traditional norms of marriage and the household, especially for women, was tied into the loss of conception—and the fulfilment of marriage. choice is an important trope when engaging with the question of marriage and divorce. just like rural haryana, amongst urban middle-class families in hyderabad city, the value given to marriage within the same caste and community is deeply gendered, with family-arranged unions being given precedence over love or choice marriages (saavala 2010). choice marriages (fruzzetti 2013) often involve the circumvention and rejection of parental authority as well as of community norms of endogamy (mody 2008), especially if they are primary unions. in saavala’s (2010) study, many of the couples who had chosen to go against their families to have inter-caste and interreligious marriages found love to be fleeting, which “disappears” soon after marriage. yet, in an interview with the clinic counsellor in hyderabad, love marriages seemed to work better in the support that the woman got from her spouse during the infertility treatment. this was especially potent in case of sexual intimacy: see, unconsummated marriages make up almost 30 percent of the cases that come to me in the infertility clinic. surprisingly, most of them are love marriages. i don’t know, but in my experience, i have seen that in an arranged marriage it is rare that husbands or wives will be understanding, or will say its ok take your time [to have sex]. because an arranged marriage is an agreement where the spouses know close to nothing about each other, and seek immediate parental intervention to solve any problem. in places like andhra and telangana, parents are more involved in the lives of children, so either the wife goes and complains to her parents or the husband goes and complains, and this is followed by both sides intervening. when it comes to love marriage during courtship, couples are comfortable and may try foreplay and stuff, but they still abstain till marriage. but after marriage, the lack of sexual intimacy continues. most of the times because they are comfortable and know that they love each other so much, they don’t want to force each other. but there is more to it than just love. familial abuse or past episodes impact women’s negotiation with sex and intimacy. in marriages arranged by families, this becomes exacerbated as couples know each other fleetingly before they marry. the familial pressure to birth soon after marriage along with the inability to do so puts pressure on them. arts are an easy resort to overcome the pressures of sexual intimacy and also avoid divorce. in interviews with young women frequenting ivf clinics in their 20s, many mentioned familial pressure as the main reason for visiting the clinic. here, spousal support is a very important part of navigating the treatment in the face of stigma and social approbation (becker 1994; franklin 2002). yet, divorce due to infertility is not unheard of. dr. maithili had become trapped in a potential lawsuit when the husband suddenly refused consent to transferring embryos fertilized from his sperm and his wife’s eggs into her uterus: http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 61 this man walks in, and i can see something has changed in him. he says he wants out from the entire ivf procedure and wants a divorce! suddenly! i don’t know what happened. earlier he used to be very timid, and his wife would openly berate him as being unmanly. i think when his tests showed that he had a good sperm count, he regained some sense of his manliness. arts continue to uphold heteronormativity as the ideal for marriage and fertility, while at the same time debunking its value through conflicting conversations on sexual compatibility and marital commitment. divorce is seen as a legitimate recourse in the case of childlessness, but not everywhere— often being replaced by bigamy. the temporal element of marriage compatibility comes to be positioned on their collective age, as much as on the desire for procreation. conclusion in this paper, i sought to discuss the ways in which age and ageing become important markers of seeking and administering assisted reproductive technologies to overcome infertility and childlessness. the two field sites belonging to different parts of india exhibit both points of cultural difference, and larger similarities. yet, age and ageing come across as dynamic symbols of the discourse surrounding the administration of a provocative technological intervention. the dynamism lies primarily in the ways in which temporalities come to represent the markings of age and fertility. in bledsoe’s conceptualization, “[t]emporalities . . . are not necessarily reducible to fixed points in history [unlike time] . . . [but] are a rich source for describing experience” (2002, 60). thus, marriage and sexual intimacy make their way into thinking about reproductive decline and become important markers of fertilities, or the lack thereof within clinical discourse. in the clinical practice and discourse of arts, the idea of decline is split; fertility and reproduction do not match and do not carry the same form of implications. here, one is not only talking about terminological or policy distinctions in conceptualizing the two ideas, but in how technology continues to create and problematize the idea of nature and biology. age is critical in manufacturing reproductive decline for women as they inch towards menopause, but their fertility and ability to birth is under threat early on itself. the medicalization of pregnancy and childbirth has explicitly created the female body as already compromised in its ability to birth due to the limited number of eggs a woman produces over her lifetime, with menopause being a form of “symbolic death” (lock 1993; martin 2001). within such an obvious split subject of eggs and wombs (further exacerbated by surrogacy), the reproductive timeline now embodies “already” declining, and “always already” declining in thinking about fertility and reproduction. but as i suggested earlier and do so through the discussion of arts clinical discourse, the ageing and aged are both stuck in their own chronologies. even though the consumption of arts continues to complicate it. and despite the emerging acknowledgement that infertility and reproductive decline are equally marked on men, the practice of arts continues to privilege patriarchal desires. acknowledgements this paper is based on research conducted in 2018, which was generously supported by grants from wellcome uk (for fieldwork in hisar) and indian council of social science research (for fieldwork in hyderabad). i would like to thank both the funding bodies for their support. the paper is a version of the annual lecture presented at the reproductive sociology group, department of sociology, university of cambridge in 2019. i would like to thank sarah franklin, noemie merleau-ponty, marcin http://anthro-age.pitt.edu/ majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 62 smietana and members of the reprosoc group, and the anonymous peer reviewers for their comments. i would also like to acknowledge the support i received from emily wentzell. notes 1. amongst my african respondents, all of them were on medical visas to seek reproductive interventions. 2. i did not encounter any gay or lesbian couples visiting the clinics, even though foreign gay men were a large section of my respondents during my previous research on transnational surrogacy. there are some reasons for this: as per the draft legislation, only heterosexual married couples can access arts (with some leeway for single men and women); homosexuality was recently decriminalized in india, the road to legalization and acceptance is still far away; and the clinics that are part of the ethnography were very invested in projecting socially acceptable practices. 3. here, i am following bledsoe in thinking of age as a non-temporal process of physical deterioration or senescence, as well as the ways in which chronological time becomes enmeshed in clinical discourse. 4. in 2017, google and facebook offered their female employees the “perk” to freeze their eggs to be able to pursue family planning according to their own ”timeline,” that “allowed” them to pursue their career choices. 5. the discussion on secondary fertility presents interesting findings from the data gathered from the two sites. in hyderabad, 3 out of 29 women had surviving children, and were aged 33-40 years of age. an overwhelming majority had no surviving children, though they may have suffered through miscarriages or stillbirths. in hisar, out of the 17 women interviewed, 6 had previous children, mainly daughters. again, the age range for seeking interventions for secondary infertility is between 35-42 years. in case of hisar, the data is also particularly provocative as it documents visits to the ivf clinic to circumvent secondary infertility, as much as to seek a son. 6. in research on cross-region bridal traffic in the state of haryana, where hisar is located, the practice of marrying the younger brothers to women belonging to different caste, religious and ethnic communities, has become popular since the decline in women in the area due to the practice of sexselective abortions. these are primary unions that buck the caste and community endogamy rule, primarily because younger male kin are not a priority in the familial inheritance hierarchy (mishra and kaur, this volume). 7. in an interesting linkage to the established practice of ‘karewa’ (chowdhry 2007), or the marriage of the elder brother’s widow to the younger brother, which was popular in rural haryana, in my ethnography, the wife would suggest her younger sister or other women from her natal kin in marriage. 8. hyderabad is known as a hub for information technology, with all international and national it companies operating out of the city. it is also known as “cyberabad.” references becker, gay. 1994. “metaphors in disrupted lives: infertility and cultural constructions of continuity.” medical anthropology quarterly 8 (4): 383-410. bledsoe, caroline h. 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september 6, 2019. https://www.dailymail.co.uk/news/article-7436963/husband-indianwoman-74-gave-birth-ivf-medical-miracle-stroke-day-after.html lock, margaret m. 1994. encounters with aging: mythologies of menopause in japan and north america. berkeley, ca: univ of california press. lock, margaret. 2007. “the final disruption? biopolitics of post-reproductive life.” in reproductive disruptions: gender, technology, and biopolitics in the new millennium. edited by marcia inhorn. berghahn books. madan, triloki nath. 1989. family and kinship: a study of the pandits of rural kashmir. new delhi: oxford university press, usa, 1989. malaspina, dolores, avi reichenberg, mark weiser, shmuel fennig, michael davidson, susan harlap, rachel wolitzky, jonathan rabinowitz, ezra susser, and haim y. knobler. 2005. “paternal age and intelligence: implications for age-related genomic changes in male germ cells.” psychiatric genetics 15 (2): 117-125. martin, emily. 2001. the woman in the body: a cultural analysis of reproduction. beacon press. mody, perveez. 2008. the intimate state: love-marriage and the law in delhi. new delhi: routledge. nagaraj, k. 2010. “fertility decline in the south indian states.” in the oxford handbook of population and development. edited by ak shiva kumar, pradeep panda, and rajani r. ved, 101-110. new delhi: oxford university press. pande, i. 2012. “coming of age: law, sex and childhood in late colonial india.” gender & history 24 (1): 205-230. parry, j. 2001. “ankalu’s errant wife: sex, marriage and industry in contemporary chattisgarh.” modern asian studies 35 (4): 783-820. patel, tulsi. 2006. fertility behaviour: population and society in a rajasthan village. new delhi: oup. pathak, gauri. 2020. “‘they think of a family only in their thirties’: gendered subfertility and emergent intimate modernities in india.” journal of the royal anthropological institute 25 (4): 778792. rao, m. 2004. from population control to reproductive health: malthusian arithmetic. new delhi sage publications pvt ltd. säävälä, minna. 2010. middle-class moralities: everyday struggle over belonging and prestige in india. new delhi: orient blackswan. sarkar, tanika. 2000. “a prehistory of rights: the age of consent debate in colonial bengal.” feminist studies 26 (3): 601-622. http://anthro-age.pitt.edu/ https://www.dailymail.co.uk/news/article-7436963/husband-indian-woman-74-gave-birth-ivf-medical-miracle-stroke-day-after.html https://www.dailymail.co.uk/news/article-7436963/husband-indian-woman-74-gave-birth-ivf-medical-miracle-stroke-day-after.html majumdar | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.261 http://anthro-age.pitt.edu 65 sarojini, n., v. marwah, and a. shenoi. 2011. “globalization of birth markets: a case study of assisted reproductive technologies in india.” globalization and health 7 (1): 27. van hollen, cecilia. 2003. birth on the threshold: childbirth and modernity in south india. berkeley: univ of california press. visaria, leela. 2010. “fertility transition: lessons from south india.” in the oxford handbook of population and development. edited by ak shiva kumar, pradeep panda, and rajani r. ved, 111118. new delhi: oxford university press. wentzell, emily a. 2013. maturing masculinities: aging, chronic illness, and viagra in mexico. durham, nc: duke university press. woodspring, naomi. 2016. baby boomers: time and ageing bodies. uk: policy press. http://anthro-age.pitt.edu/ recognizing caregiving fatigue in the pandemic: notes on aging, burden and social isolation in emilia-romagna, italy francesco diodati university of milano-bicocca f.diodati@campus.unimib.it abstract in italy, the covid-19 pandemic and its associated lockdowns have provoked potentially serious short and long-term consequences for older people with serious health conditions as well as their family caregivers. with the closure of adult day-care centres and the suspension of private homecare services, families have needed to rearrange care activities and many are concerned about the situation of their relatives in residential homes. this article examines interpretations of aging and caregiving fatigue during the first period of national lockdown in emilia-romagna, italy. the relation between old age, lockdown, and social isolation, with respect to global ideas and rhetoric, focuses on vulnerability, individual autonomy, and caregiving fatigue. i examine how the representation of the ‘burden’ of caregiving in late age shaped the media depictions, and i analyze it in relation to the meanings of fatigue attached to narrations from family caregivers and the members of a local alzheimer’s café. i also focus on the life story of one family caregiver to critique the idealized vision of family care that was reproduced during the pandemic. i argue that the recognition of aging and caregiving fatigue during the lockdown reflected pre-existing normative models and structural inequalities of family care rather than radically altering them. keywords: aging; caregiving; fatigue; pandemic; social isolation; italy anthropology & aging, vol 42, no 2 (2021), pp. 21-35 issn 2374-2267 (online) doi 10.5195/aa.2021.352 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. margaret clark award (2020) winner | diodati | 21 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu recognizing caregiving fatigue in the pandemic: notes on aging, burden and social isolation in emilia-romagna, italy francesco diodati university of milano-bicocca f.diodati@campus.unimib.it introduction at the end of february 2020, the alzheimer’s café in a small provincial town in the italian region of emilia-romagna closed along with the local senior day-care centre that hosted it. on 20 march, over a week after the national lockdown, i phoned mariagrazia1 to follow up on my intention to investigate how the pandemic was radically altering the everyday lives of the people i had met during my fieldwork. i first met mariagrazia and her 80-year-old mother, donata, at the alzheimer’s café, which i had been frequenting since 2019. donata had been living next door in the same condominium as mariagrazia and her husband since mariagrazia asked her to move there in 2011, when it seemed to her that her mother was no longer able to live alone in her house in another city. mariagrazia brought donata to the local alzheimer’s café after donata’s geriatrician had told her that her mother “was cognitively ok” but needed to be in the company of and socialize with other people to alleviate the depression and loneliness that comes in old age. with her sense of irony and humour, mariagrazia confessed to me immediately that nothing had changed in her relationship with her mum: she still had a hard time relating to her. “it seems to me we have nothing in common, so we still can’t stand each other.” she continued: you know, my mother is in better shape than the other people [at the alzheimer’s café]; she has just a little bit of depression and her legs are not as good as they were in the past, but she doesn't have dementia and can still take care of herself alone… despite this, she always complains about everything: for every little ache and pain, the medicines—she takes almost a quarter of the pills that the others have to take—people in the streets—“she gave me a bad look.” she believes i’m a bad person who treats her badly and doesn’t understand her, even if she doesn’t say that directly—she is sneaky. yesterday, a man was singing on the balcony—you know, all this kind of things like singing and playing music on the balconies that makes you happier—but she said he sucked, everything sucks, always. and then we had an argument about that. [phone conversation; 8 april 2020]2 mariagrazia is a 50-year-young grandmother; she was missing her grandson and was worried for her daughter and her husband because he worked as a sound technician for public events, which were all suspended until an unknown date. almost a week after that conversation, i phoned tommaso, a middle-aged man who had been attending a self-help group for family caregivers because he had cared for both his parents, who were affected by dementia. he continued to attend the group even though his father had died in may 2019 and, in the same month, his mother was admitted to a residential-care facility in the same city where the alzheimer’s café was held. the day the local nursing home started to forbid family visits, he had just http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 22 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu arrived there because, as he said, “i could smell that the situation would change soon,” but the staff did not let him in. at that time, he was living with his mother-in-law and his ex-wife. fd: you are a lucky man. tommaso: oh yes (laughing). they were renovating the house but now it is all interrupted due to coronavirus, so they came here with me and i’m living the same odyssey again. my mother-in law is one of those who’s always saying, “i would like to die” – and my ex-wife has no patience with her, so it is up to me, and in the evening i’m exhausted. the [caregiver support] group has been interrupted, and no, i don’t know anything about the others. i’ve tried to phone my mom because yesterday was her birthday, and i’m a bit sad we didn’t celebrate together as usual, even if last year she didn’t recognize me. i don’t hear anything about how she is now; they (at the nursing home) only call you if something bad happens. i hope the virus doesn’t spread here as i heard happened in piacenza [40 km away] because it would be like an atomic bomb! [phone conversation; 15 april 2020] based on ongoing ethnographic fieldwork in emilia-romagna, italy, this article aims to inquire about the social recognition of the deleterious changes in old age. in particular, i examine the way this notion articulates family life and responsibility for care in the household (cohen 1995, 316-319), which shaped the first phase of the pandemic response in italy. in this article, the covid-19 pandemic and its associated lockdown are considered with respect to global ideas and rhetoric about aging, vulnerability, individual autonomy, and caregiving (lamb 2017, xi-xv). in this article, i move on from these previous works and analyses to examine the representations of aging and caregiving fatigue that have emerged during the initial period of national lockdown from march to april 2020. rather than insisting on the idea that a pandemic radically alters social relationships and global social structures,3 i focus on how social norms and structural inequalities were reproduced via the isolation politics in italy. first, i examine public constructions of the ‘burden’ of old age during the pandemic that have emerged in social networks and newspaper articles, particularly the media’s and healthcare professionals’ depictions of older people as vulnerable and posing a risk to themselves and others. this also concerns discourses and experiences about residential-care facilities, where viral contagion reached a critical point. lastly, i explore the life story of one family caregiver: this life story is presented in order to grasp ideas about and normative models of sociality, family life, and responsibility for care in the household. ethnography of aging and caregiving during the pandemic at the end of february 2020, i was in the most intensive phase of my fieldwork during the second year of my ph.d. in social and cultural anthropology at the university of milano-bicocca. for a year, i moved around support groups, home care training courses, and public conventions on caregiving in the province of bologna. i was interested in studying the relationship between population aging and the normative model of ‘the family caregiver’ that has recently emerged globally in social services, healthcare services, and activists’ debates (leibing 2017; sadler and mckevitt 2013). emilia-romagna is one of the wealthiest regions of northern italy and, in the national imaginary, is seen as the rich and happy ‘sweden of italy’ due to its progressive welfare and healthcare services (pavolini 2015, 125). for the last 30 years, italy has had a mixed model of welfare, fragmented into regions and municipalities, which has relied mainly on private home-care services. these workers are mostly recruited from the migrant population to attend directly to the needs of older people (ascoli and pavolini 2010; bifulco et al. 2007; pavolini and ranci 2008). recently, thanks to the advocacy actions of newly created italian caregivers’ associations, public attention has also focused on the emotional exhaustion and social http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 23 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu isolation that workers experience while providing intensive assistance to people affected by neurological diseases. in the last 10 years, there has been a proliferation of respite care programs for family caregivers in the northern regions; this includes adult day-care centres and community services such as peer-to-peer caregiver support groups and alzheimer’s cafés run by local social services and social agencies (pavolini and ranci 2008; pavolini and spina 2015). when the italian prime minister declared a national lockdown on 9 march, i had just left my fieldwork site. all the activities i was attending—alzheimer’s and parkinson’s cafés, caregiver support groups, home care training courses—were just suspended by a regional decree until an unknown date. since then, like many other colleagues, i have tried to document in writing the changes and transformations that happened during my fieldwork and my own living environment at the same time i was experiencing them. i have also been part of the ongoing project “corona diaries” launched at the end of march 2020 by curare, the journal of the association for anthropology and medicine. here, the aim is to collect ethnographic diaries about the pandemic that include “descriptions of situations, descriptions of one’s own behaviour and the behaviour of others, notes of conversations, reflections, fragments of thoughts”4 from researchers’ own environments. with this aim, i started collecting phone interviews, whatsapp messages, email exchanges, newspapers, and journal articles weekly for every three to four days in a city 40 km away from my own research area. in many cases, caring for a family member or working as a domestic care worker does not leave very much free time to spend with a stranger/researcher. with some of these caregivers, in-depth telephone interviews about their life stories were the first interviews i was ever able to conduct with them. in some cases, particularly with people who had frequented the suspended alzheimer’s café, phone interviews became a ritualized practice during pre-arranged moments—for example, when the older person was sleeping in the afternoon or was with the domestic care worker in the morning. these moments offered the chance to share what they were experiencing, just as they used to do every friday at the café. our conversations often turned to how covid-19 seemed to affect their daily life. the caregivers acknowledged that the lockdown was provoking potentially serious short and long-term consequences for older people. in my fieldwork, i spoke with: caregivers of elderly people affected by neurological diseases who were experiencing great difficulty in doing physical exercises either inside or outside the house due to the interruption of rehabilitation therapies; family members who needed to rearrange care activities after the closure of adult day-care centres, and who were struggling with the decision of whether or not to suspend private home-care services; and those who were concerned about the situation of their relatives in residential homes, where the viral contagion often appeared to be devastating. that issue appeared side by side with many long-standing popular and media depictions of the irresponsible behaviour of old people who did not care about their health, and who were stealing scarce and precious economic resources from the community. similar representations of the “burden” of older people on the community in the covid-19 pandemic can also be found in medical anthropologist rebecca irons’ discussions about intergenerational conflict and discourses about “the boomer remover” and the “greedy old” society in britain,5 as well as in the blaming and accusation of the “selfish” japanese elders who stood outside drugstores to take the first few masks available in the country.6 many studies document how the covid-19 pandemic has been the source of a revival in ageist feelings around the world (previtali et al. 2020; reynolds 2020; verbruggen et al. 2020), and they emphasize how family caregivers’ stress has been exacerbated along with the health conditions of those receiving care (kent et al. 2020; cohen et al. 2021; giulia et al. 2020; russel et al. 2020). http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 24 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu covid-19, senility and family care in the media initially, politicians from both the government and opposition parties, national celebrities, and some popular scientists assured everyone via the italian media and on social networks that it seemed like the virus was dangerous only to frail people, such as the very old and people with a serious chronic illness (dubois 2020; marrone 2020). the media campaign “stay home and stay safe” was targeted mainly at older people, encouraging them to limit their social life while urging family members and other citizens to look after these most vulnerable members of the community (fabretto 2020). this included committing to buying essential goods for them, such as groceries and medicines, so they could stay at home while paying particular attention to wearing masks and keeping a safe distance away from them. in an article titled “the difficulties of sick people and caregivers during isolation” [le difficoltà di malati e caregiver durante l’isolamento] (di todaro 2020), one of the most popular italian newspapers la stampa reported on an interview with the director of a neurogenetics center in the south of italy. this neurologist discussed the dramatic situation of patients affected by dementia who were being forced to stay home: i am concerned about alzheimer’s patients for whom not being able to go out for the usual walk can mean an increase in anxiety and therefore a worsening of their health. in addition, the closure of health and social care places, such as medical clinics, alzheimer’s cafés and day-care centers, means that the care of patients seriously affects their families who, without those few hours of relaxation, cannot recover the physical and emotional energy to support these patients. there is a risk of increasing behavioural disorders, not only in the patient but also in the family member themself. the neurologist also stressed the importance of providing support for family caregivers of people with dementia; particularly, in relieving their feelings of fatigue and exhaustion: a vicious circle must be avoided by helping caregivers [...]. it is a disease that affects the whole family and impacts the lives of all family members. in these quarantine days, patients forced to stay at home can become more agitated, aggressive, and therefore more demanding. newspapers discussed the idea that the pandemic would be a disaster for older people, and therefore for a large part of the population in one of the oldest countries in the world; for example, on 5 april the economic newspaper il sole 24ore published an article on covid-19 death rates titled “the italy of our boomers’ grandparents will be wiped out by the coronavirus” [quell’italia dei nostril nonni e del boom economic sarà spazzata via dal coronavirus] (bricco 2020). a local newspaper in emilia-romagna, bologna today, also reported an interview with a psychologist working in a residential facility; the aim was to expose the “consequences of coronavirus on older people and caregivers” (bertossi 2020). talking about how she worked through phone conversations, the psychologist underlined the fact that older people were among the most vulnerable during the period of forced isolation because they also lacked the ability to understand and react to the situation: listening to the stories of my patients, i noticed that almost everyone talked about the way they were concerned for the health of their dear older grandparents or parents. in emergency situations, everyone activates their own resources and ways of dealing with stress; however, there are more vulnerable sections of the population, such as people of a certain age. in this pandemic, it was immediately clear that older people were the http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 25 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu most at risk of getting sick, but it is important to remember also, in addition to physical health, the pandemic can have a strong psychological impact on older people, or can exacerbate psychological disorders or pre-existing psychiatric conditions. at the end of the interview, the psychologist also offered some advice to caregivers, such as trying to maintain a normal routine of day and night, making video calls with relatives and friends, and asking health professionals for help. she explained the recommended attitude to adopt with older people: “it is important to try to explain this situation to them, trying to maintain a compassionate attitude while using simple language and repeat if it has not been understood.” that is because: a concern often reported to me was the low perception of risk by older people, with consequent difficulty in communicating to them the correct behaviours to follow to limit the risk of infection. because? they often have less access to sources or less understanding of such a complex phenomenon due, for example, to low education. … in contrast with these representations of older people as vulnerable subjects who lack the ability or education to react to and cope with the changes brought on by the pandemic, lisa, the psychologist at the alzheimer’s café i had been attending, published some reflections about her work experience in a residential-care facility. released in a local online newspaper at the beginning of may 2020, she aimed to give positive thoughts about older people7: the fact of having identified a majority of positive effects compared to the negative refutes one of the most widespread stereotypes about seniors – that of a lesser ability to cope with change. this is a scientific fact. our ability to cope with events and adapt to new conditions can improve over the years, and it is as if we become increasingly resilient, contrary to what we imagined. [older people] have a psychological force and creativity that we often do not consider. lisa emphasized what she had been repeating during the café encounters: in her view, old age is not necessarily a time of anxiety and giving up; rather, old age can also be a life stage of resilience and positive transformations. in contrast to what the other psychologist believed about vulnerable older people being unable to understand and adapt to the new pandemic conditions of living, lisa said that among her patients: there is a greater awareness of everyone’s individual role, responsibility for collective well-being; for example, also in compliance with the rules for hygiene and protection that this pandemic has imposed on us. older people in the building are not obliged to wear masks, but someone asked us to wear them after hearing the news on tv. one of the positive aspects i have found is that this quarantine is being seen as an opportunity to reflect and dedicate oneself to things worth living for. during april and may 2020, lisa posted photos and videos on social networks that portrayed smiling older people in wheelchairs at the residential-care facility, holding signboards translated into the local dialect with institutional pandemic slogans about the safety measures everyone should adopt to protect oneself and others: “wash your hands,” “wear masks,” “keep a safe distance”—but also positive messages as “everything is going to be all right.” immediately after the national lockdown in march, she created a whatsapp group for the family members at the alzheimer’s café, which she utilized as a surrogate for the physical café, inviting participants to share “oddities and curiosities that our dear ones http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 26 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu with alzheimer’s are doing during this quarantine period.” as she told us when she shared that interview in the whatsapp group, she aimed to speak against an excessive dramatization of the events—particularly in the case of residential-care facilities—which seemed to leave no space for positive attitudes and psychological wellbeing. one evening at the beginning of april, on her way back from work, lisa wrote a short post on facebook in which she said she felt inspired by the way her patients were reacting to the pandemic—with little self-pity and a huge sense of irony—something that gave her the strength and capacity to endure in these hard times. in the interview, she also spoke about the use of social media as something effective in maintaining ties and the relationships between patients and relatives. to her, those results refuted stereotypes about older people not being able to use modern digital technologies: even this stereotype one must abandon: the idea that older people are generally resistant to and almost reject the technological medium, while i can personally guarantee that, apart from the initial amazement of seeing loved ones on video, they have a great capacity for adaptation. two ladies equipped with smartphones have even independently enhanced their use of technology through video calls and social networks. in general, we do not tend to attribute this attitude to an older person and yet they can use social media and smartphones . . . therefore, older people are more connected and happier. following the same line of thought, the social agency in charge of the residential-care facility had spread photos on social networks documenting the video-call conversations between residents and their relatives. this social agency is one of those that allowed the residents to make video-calls with their relatives to maintain some form of personal and direct communication during the isolation period when physical family visits were forbidden in care facilities across the country. by posting photos that portrayed people maintaining affectionate relationships and emotions through technology, the social agency’s managers were directly and indirectly declaring the agency’s commitment to high-quality care standards. i decided to phone lisa in april, one month before her interview was released on the online local newspaper—the same interview was also reported briefly in one short item of the local news, where many of the café’s participants learned about it—to obtain some information about how residential-care facilities were experiencing and managing the pandemic. i realized that many residential-care facilities—but not all—were trying to organize virtual, ‘alternative’ possibilities to the physical interactions between residents and their relatives. at that time, news about the contagion in residential homes was beginning to spread more consistently; among my informants, this produced tragic and apocalyptic visions about the future of the oldest members of the community. lisa had already written a message in our whatsapp group two weeks earlier, in which she answered questions about how she was dealing with the situation, and confessing to being very worried about working in a residential home: . . .where contagion seems to be only a matter of time. my moods flow between feeling calm, focused, and determined to feeling confused, nervous, and afraid. in the last few days, i’ve also realized i have rigid muscles in my neck and my jaw is clamped shut, clear signs of the tensions and stress i’ve been experiencing. it’s also true that working offers me the chance to have some social contact with my patients and my colleagues; otherwise, i would be alone at home. i will take advantage of next weekend to rest. i hold you all in my heart <3. [message on whatsapp group; 21 march 2020] http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 27 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu one week before the closure of the alzheimer’s café at the end of february 2020, lisa had lashed out on facebook about her anger when dealing with family members who were unaware of the protective measures to adopt with their relatives in the residential-care facility where she worked. in the end, the managers of the facility succeeded in taking preventive measures, such as using sick leave for the health workers who showed suspected early symptoms; at the time, there was only one suspected, yet not confirmed, coronavirus case. for this reason, the residential home attracted media attention, at least locally. in the italian context, population aging and welfare restructuring emerged alongside institutional discourses about the dependency ratio of the “oldest old” in the population (greenberg and muehlebach 2007). in the first discourse of the first psychologist, older people were represented as vulnerable and passive subjects during the pandemic, while it was assumed that family members needed to care for them. in this sense, the recognition of “senility” links vulnerability in late age to normative notions of family responsibilities to care for older people through the medical and institutional environment (cohen 1995, 316-319). however, in the view of lisa, old age is neither a passive life stage nor an age of dependency: she pointed to the way people in later life can make a positive contribution to society and community, even in the midst of a pandemic. she stressed how older people can develop a different perspective on their life stage and remain open to self-change, which is generally assumed to be related to young people and adults. in both her public interview and in the photos with seniors smiling and holding institutional slogans about the safety measures to adopt, older people are no longer a vulnerable group who, through no fault of their own, constitute a burden for their family and the society at large; rather, these people emerge as responsible citizens who are able to adapt to new transformations, and are thus to care for themselves and others. furthermore, lisa underlined how residential homes can develop forms of sociality that are not opposed to the notion of “home” care widely used to talk about forms of care that emerge in the domestic environment (visser 2019). news about the contagion in care facilities increased the stigma and mistrust of these care settings around the world (allen and ayalon 2020). this is especially true for italy, where institutional discourses have often promoted home care with the help of private home care workers as the option preferable to a residential-care facility because it tends to keep older people in their “warm” family environment (degiuli 2010). in the next section, i show how in my fieldwork the contagion in residential-care facilities worsened the social blaming of patients’ relatives accused to do not care about their older loved ones. residential-care facilities and the moral blaming of patients’ relatives while in the public interview she emphasized that older people can also adapt to new changes, lisa privately confessed to me, referring to video-calls between institutionalized patients and relatives: these are ambivalent tools; sometimes, they only increase anxiety and fear, and people with a serious cognitive deficit also can’t use video calling appropriately, and they are of interest only to relatives, not to patients. i realized also that my mediation is fundamental because i saw that people, whom i know had not previously accepted it and had felt guilty for having their loved one in a residential facility, are now very worried: “why does he look so pale? oh my god, he is sick, is dying!” and i try to bring everyone back to reality. [phone conversation; 12 april 2020] social-media platform have fostered communication and affective interaction between older patients and family members who were forced to stay away, confirming the fact that digital technologies can effectively function as a path between older and younger generations (danely 2015; kaplan et al. 2015). http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 28 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu at the same time, the last fragment shows how those technologies can have ambivalent effects, creating more family pressures and social expectations that are often difficult to satisfy (nedelcu and wiss 2016, 216; peletz 2000). furthermore, while lisa publicly advocated for a more positive view of old age against the social representation of the vulnerable and burdensome older people, she also acknowledged that elders with the most serious health condition could be left out of the global discourse about “active aging” (lamb 2017; rickli 2020). returning to my conversation with tommaso—a middle-aged man who had been attending a self-help group for family caregivers because he had cared for both his parents, who were affected by dementia— i phoned him a week later: tommaso: but they didn’t they say anything to you? the virus has got into my mother’s care facility. fd: oh, i’m sorry! tommaso: i told you that if the virus got in it would be like putting a bomb at the station . . . i don’t know much because i haven’t visited her for a month. i went on tuesday after the first decree because i already understood the climate, but they didn’t let me in—yes, very cordial and kind, but they didn’t let me in. i heard about the virus from the manager, who called me; he told me there are three housekeepers at home on sick leave as a precaution, but i don’t know if all three have the virus. the director says he is struggling to have everyone who works there get a swab, but they can’t do it—it’s only for those who have symptoms . . . then an asymptomatic person will infect 50 people. [phone conversation; 22 april 2020] uncertainty and fuzziness about the future perpetuated the idea that the infection in residential care facilities would be a death sentence for many vulnerable older people. as i mentioned early, the flows of data and information about infections in residential-care facilities and the terrifying hypothesis that this contagion was intentionally driven by political administrations seemed to anticipate an apocalyptic future for the oldest members of the community. some scholars interpreted it as a sign of a shameful society that is unable to take care of the oldest members of the community who live in conditions of abandonment and social isolation.8 the covid-19 pandemic and its associated lockdown policies increased the perception of residential-care facilities as “cold” forms of care as opposed to the “warm” care provided by relatives, and as a sign of social death and family abandonment (thelen 2015, 210). however, the discourses on warm family care reproduced an idealized vision of family relationships that was sometimes contested by my interlocutors. this was especially true for situations where the covid-19 pandemic forced family members to rearrange the care provided to an older family member in an unwanted way. in an online meeting of the caregiver support group, tommaso lashed out about the fatigue of living with his mother-in-law—she and her daughter (his ex-wife) had come to stay with him because the lockdown had interrupted the renovating work in their home: a member of the group: you’re so nice! you take care of both of them. tommaso: ehm [laughing]. she is one of those who always complains about everything. my ex-wife has got no patience with her, so it’s all up to me. she calls me all the time, but i’ve seen that she is able to do things alone when she has no one to rely on, so now i come only when i’m really needed. she is one of those aged people who always complains. before this situation, we had applied to the adult-day care center for some relief but now everything has been stopped. [transcript from one online meeting of the caregiver support group; 29 april 2020] http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 29 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu in italy, where the institutionalization of older adults has always been viewed as a betrayal of traditional family values (degiuli 2010), the information about covid-19 in residential-care facilities worsened the social blaming of family members with older loved ones living in these homes; e.g., the psychologist lisa’s words about the sense of guilt felt by her patients’ relatives. in this sense, i consider the phone conversation that i had in early april 2020 with elsa (age 74), a woman who attended the café. elsa was the sole caregiver for her husband, who was affected by dementia; she had also cared for her father at home until he died in march. but rather than describe the way she experienced the loss of her father in the pandemic, i want to briefly consider how this woman, who had decided a year ago to take care of her father at home instead of finding a residential-care facility, spoke about such facilities. we were discussing the situation regarding viral contagion in the residential-care facilities in the same town as the alzheimer’s café; she told me that patients’ relatives had been told that infected patients would be sent to a residential-care facility where an old friend of hers lived; one who she used to visit before the lockdown: i’ve told her, “you know, i have a small room in my house; please come whenever you want.” and that is because her daughter doesn’t care about her. if she were my father, i would have brought him back home immediately. you see, francesco, she is one of the ‘modern women’ and it is true that not everyone is like me: she doesn’t want her around, she doesn’t want to wash dishes and do the housework for her, and i suspect that even her boyfriend doesn’t want her. she does not care.” [phone conversation; 15 april 2020] it seems that the covid-19 pandemic exacerbated pre-existing social norms on senility and kin responsibility for care rather than radically altering them. these norms concerned the idea that older people were vulnerable and passive subjects during the pandemic, assuming that the relatives— especially the woman of the households—were primarily responsible for their health and wellbeing. the social construction of old age has not been shaped by the covid-19 pandemic and lockdown itself: rather, it seems that interpretations of old age related to the socio-cultural context have shaped how the pandemic has been represented and conceived. in the following section, i examine the interpretation of senility and family responsibility for care, as expressed through local idioms of fatigue and exhaustion in caring for a family member (danely 2017). these emerged from the life story of a family caregiver who i interviewed in these early months of the pandemic. family life and fatigue: adriana’s story in april, i was concerned about adriana, a retired schoolteacher who lives in the countryside with her husband, viviano (age 55) who was diagnosed with early-onset alzheimer’s in 2016. her son works in a nearby factory, and adriana cares for her mother (age 90) who has lived with them since she became a widow and had both legs surgically amputated. i met viviano and adriana at the café, but we did not speak much before the lockdown. however, she kindly accepted my request to interview her during the lockdown months; we made a sort of weekly appointment that was very close to the café times. i phoned adriana several times from the beginning of lockdown, usually in the morning, after she was done with care activities and when the home care-workers were taking care of viviano and her mother, which left her some free time. adriana had been one of the more active participants at the café, and she often took the floor to talk about something that had happened recently: an event, a new problem, or new anxieties and worries. but, like many others, she seemed to struggle a lot to speak about her present situation, the relationship with her husband and her mother, and the way her husband behaved at http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 30 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu home. nevertheless, she appeared to be endowed with patience and the capacity to endure. at the café, she used to smile a lot and reflect on her sorrows with a huge sense of self-irony and humour. two years after the diagnosis of viviano’s early-onset dementia, it had taken several months for adriana to be able to speak with other people about her husband’s situation. little by little, thanks also to her gynecologist who begged her to look for help “because these sorrows are too heavy to be carried by a single person,” and to her psychologist who said, “mrs., you don’t need a psychologist: instead, you need to find other people who are living the same experiences,” she started to look for a support group which have been recently multiplying in italy. she initially refused the idea of bringing her husband to an alzheimer’s café, partly because her family doctor believed that viviano was still young and that an “old” environment such as the café would not be a positive thing. but when his symptoms became worse, she finally decided to come to the café, where we met in november 2019. similar to my other research informants, i often asked myself if my interviews would cause adriana suffering; if our discussions might touch on intimate and sensitive aspects of her past and present that could harm her—something she would be unwilling to speak or hear about. some others had refused to speak with me because they believed that the present was too heavy to be mentioned or thought about. but adriana often confessed to me that she appreciated our phone conversations; she felt they were good for her because the café had been closed. she had lost a place that she couldn’t do elsewhere; a place where she could speak about her situation and being listened to. viviano had been a skilled mechanic who used to say that he needed to use his brain for his work, not only his hands. two years after the diagnosis of dementia, his condition worsened, and adriana had to leave her job as a teacher to care for him. although he has seven brothers and sisters, they didn’t really care for him after the illness started—something that adriana regretted but that she also made sense of through a disenchanted view of family relationships, saying with a bitter smile: “he was very much there for his sisters and brothers when they were in need. i can say that they haven’t returned this attention, but i know that it often goes like that; this is how things go.” after the illness started, all of her husband’s friends almost entirely disappeared, including his former colleagues: they always ask me or my son how viviano is doing. i always respond: “why don’t you come round? even for a short visit—spend some time with him, he would appreciate it.” but they never come. they say that they can’t stand seeing him like that; they suffer too much. i understand that it’s hard, but i also understand that he feels lonely because of that. [phone conversation; 9 april 2020] her son has never accepted his father’s illness and refused to speak about it. adriana confessed to me that she always wondered whether maybe the illness would have been less aggressive if her son—who shared viviano’s passion for motorcycles—had spent more time with his father; for example, taking him to motorbike races. for this reason, she cannot rely on him much, “because he has no patience; he is very rude with him when he forgets something, and then he [viviano] suffers a lot.” she also told me that the son used to say to both his grandmother and his father, “when mom can’t stand any more, i’ll put both of you away! [in a nursing home].” adriana and viviano didn’t have a very “active” social life, which was similar to many older members of the alzheimer’s café, who often mentioned how friends and relatives usually disappear after the illness starts. the café allowed members to remake social and family ties . many members also used to meet outside the café’ scheduled meetings, going out for dinner all together with the psychologist lisa and her husband. for this reason, many of them referred to the café as a “new family.” http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 31 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu in the conversation we had, adriana and i talked a lot about the pandemic. she believed that she was luckier than people living in the city (she lived in the countryside) because she was able to go into the garden with viviano and take a walk in the small woods nearby, as they had usually done. viviano spent the lockdown months working in the small garden outside. adriana often talked about the image of her husband crying with his hands on his face because he failed to dress himself in the morning, or because he realized he could not recognize the home repairs he was once able to do: there are good days and less good days. for example, a few days ago it was viviano's birthday. before lunch i had told him to make fruit salad with my mother. while he was cutting an apple, my mother said to him: “why didn’t you peel it?” he got angry, threw the apple on the table, and went to the bedroom. i found him on the bed crying with his hands on his face. in these cases, he closes in on himself more than usual. [phone conversation; 9 april 2020] on one of the “good days,” adriana told me with enthusiasm and happiness that viviano smiled when he saw lisa—the psychologist at the café—speaking on television, and she got the impression that her husband’s personhood was still there in some way. on these days, she struggled with the decision of whether or not to suspend the home care worker, being caught in the middle of the care needed by her husband and the care needed by her mum while getting no help from her son: i’ve been wondering for a long time if i was right to get the home care worker [assistente famigliare] to help me out. i also talked about it with the family doctor, because my neighbors who have vulnerable relatives have suspended all contacts because they are afraid, and i too am afraid. [phone conversation; 16 april] for example, adriana’s neighbor, whose husband has only one lung, suspended the family assistant who came every day. adriana told me: “and then i asked myself, ‘but can i do it alone with my husband and mother?’ and so, in the end, i put the weights on the scale and decided.” just before the pandemic, she had made another important decision for her and viviano: through the social service, she contacted an adult-day care center, which people attend from the morning to the afternoon every day or certain days per week. there, they engage in socialization activities, memory exercises, and psychosocial therapy, and family members receive some respite moments. adriana tried to justify that decision on a dual basis. first of all, she believed that she needed to take some time for herself and engage in other activities because she had to give up work prematurely to care for viviano. second, it was because she thought her husband needed to adapt to other caregivers in case something bad happened to her. she was happy that her husband seemed to have accepted the decision: “he didn’t jump for joy, but he didn’t say anything bad either.” but then the lockdown came, and the adult daycare center was shut down just when she had begun the process to activate the service for her husband. one afternoon at the end of april, for the first time, it was she who phoned me: it is not that we used to go out a lot, but we used to do little things such as going for a car ride. at one time, his crises were rare but now, i see that they are frequent and he looks absent most of the day. this morning was very hard: he tried to dress himself alone; he realized he was not able to do it anymore, and then began to cry with his head in his hands. now he is with the assistente famigliare [home care worker]: she was very good; she handled the situation by getting him to do some work in the garden. maybe http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 32 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu i will go for a car ride again. i want to speak with lisa—to ask her if it is a good idea, and if she has some advice because i miss the discussions at the café. thanks for your calls; it really helps me to talk about my situation with other people. do you think i can call lisa? i don’t want to look for another psychologist because i would have to start again telling our story from the beginning, and it’s a real struggle [laughing nervously]. [phone conversation; 24 april 2020] i phoned her a week after that conversation to hear how she was handling the situation. i found her, surprisingly, more relaxed. she told me that she had cried over the weekend but then found in herself the strength to go on and endure. i noticed from her tone of voice that she was smiling bitterly when she admitted that: “also, because what should i do? i don’t see any other alternatives; i have to go on and endure, and try to have hope and see the positive side.” adriana’s tales of fatigue and daily struggles during the pandemic were not so different from how they were before it, and like many other interlocutors, she believed that covid-19 didn’t radically affect her social life. even though her son, who worked in a car-parts factory, was forced to stay at home during the pandemic, it had not changed the situation—adriana still had to assume all the responsibility for care, including making important life-decisions alone, such as whether or not to suspend the home-care worker because she was unable to care for both her husband and her mother. conclusion what happened to old age and caregiving during the first period of covid-19 pandemic? has the covid-19 pandemic radically altered the way we understand fundamental notions of aging, care and family relations? in this article, i have presented representations of aging and caregiving fatigue that emerged during the pandemic in italy between february and may 2020. considering pandemic, lockdown, and social isolation with respect to pre-existing global ideas and normative models about senility, individual autonomy, and caregiving (lamb 2017, xi-xv; cohen 1995), i have examined a representation of the “burden” of old age that shaped the italian media’s portrait of the vulnerable older people and their exhausted caregivers; i then juxtaposed this representation with the narratives of daily struggles from family caregivers and the members of a local alzheimer’s café, including the psychologist. the viral contagion in residential-care facilities increased the stigma and mistrust of these institutions as places of family abandonment and social isolation in contrast with the “warm” domestic environment (thelen 2015, 210; visser 2019). information about infections increases anxiety not only among residents of these facilities, as some scholar noticed (schroyer 2021), but also among their relatives, popularly accused to betray traditional family values to care for older people at home. finally, i have also presented the life story of a family caregiver during the pandemic in order to critique the idealized vision of family care that went alongside the promotion of home-care in italy—a vision containing structural and gender inequalities that have been reproduced under the pandemic (degiuli 2010). in adriana’s story, social isolation came long before the pandemic, which had not changed the way the responsibility for care was arranged in her family and household: it was she and the home-care worker who performed all of the care activities. this is not to say that the covid-19 pandemic has not been a radical event with serious long-term consequences. the suspension of public and private home-care services, as well as semi-residential services such as adult day-care centers, increased social inequalities and posed serious threats to older people and their family in italy and elsewhere (kent et al. 2020; manderson and levine 2020). and yet, before the covid-19 pandemic in italy, like many places in the so-called euro-american area, the http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 33 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu general assumption had been that modern medical technologies have succeeded in defeating the infectious diseases of the past, and have given us the opportunity to live a long life. the issue has thus become finding ways to face the ironic consequences of having achieved longevity—namely, chronic illnesses and mental disabilities, and the threats that they pose to family and community life (cohen 1995, 316-319; sivaramakrishnan 2018). the consequences of covid-19 were related to pre-existing structural holes in the care system, making even more visible all of the care labour that is needed not only to make long life possible but also to improve the quality of live in several illnesses such as dementia. sustaining this care labour includes the necessity to fight against the taboo, social isolation, and blaming that surround who live with the diseases and their family networks. in this sense, the pandemic and the lockdown reflected pre-existing cultural interpretations and normative models about old age and kin responsibility for care rather than radically altering them. the social construction of old age has not been shaped by the pandemic and lockdown itself: rather, it seems that interpretations of old age and caregiving related to the socio-cultural context have shaped how care for older people has been represented and managed during the pandemic. notes 1. all the names have been changed. 2. all the interviews and newspaper articles have been translated from italian by the author. 3. latour, bruno. 2020 “is this a dress rehearsal?”. 2020 pandemic, critical inquiry blog. march 26. accessed june 12, 2020. https://critinq.wordpress.com/2020/03/26/is-this-a-dress-rehearsal/. 4. curare editorial team. 2020 “curare corona diaries project. call for diaries in the strict sense of the term”. witnessing corona, boasblog. march 23. accessed june 10, 2020. https://boasblogs.org/witnessingcorona/curarecorona-diaries-project/. 5. irons, rebecca. 2020. “grasping for unity in a divided britain: ageism, brexit-era politics and the covid-19 ‘boomer remover’. consciously quarantined: a covid-19 response from the social sciences, ucl medical anthropology blog. march 24. accessed june 9, 2020. https://medanthucl.com/2020/03/24/grasping-for-unityin-a-divided-britain-ageism-brexit-era-politics-the-covid-19-boomer-remover/. 6. danely, jason. 2020. “those who come early: reflections on the social standing of senior citizens in the time of covid-19 pandemic in japan”. the age of covid-19, somatosphere blog. may 31. accessed june 13, 2020. http://somatosphere.net/2020/those-who-come-early.html/. 7. i omitted the source to protect the anonymity of my informants. 8. douglas, cristina. 2020. “lives and deaths with dementia during covid-19: our shameful (but hopeful transformative) post-pandemic legacy.” co-existing with covid-19: moving into the post-pandemic world with the social sciences, ucl medical anthropology blog. june 12. accessed june 20, 2020. https://medanthucl.com/2020/06/12/lives-and-deaths-with-dementia-during-covid-19-our-shameful-buthopefully-transformative-post-pandemiclegacy/?fbclid=iwar0qbcgw_rsnhyysrzx_jxuywzhpyjxvxmf67jbgn6wfxjzfnqmvmexycoi. references ascoli, ugo, and emmanuele pavolini. 2010. “le due italie del welfare locale: le conseguenze di decentramento e regionalizzazione in assenza di regia nazionale.” il mulino 2: 99-109. allen, laura d., and liat ayalon. 2021. “ ‘it’s pure panic’: the portrayal of residential care in american newspapers during covid-19.” the gerontologist 61 (1): 86–97. bertossi, erika. 2020. “covid-19 e anziani. la psicologa spiega a chi si prende cura di loro come gestire la quarantena,” bolognatoday. may 2. accessed june 12. http://www.bolognatoday.it/cronaca/coronavirusanziani-conseguenze-caregiver-regole.html. http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 34 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu bifulco, lavina with massimo bricocoli and raffaele monteleone. 2008. “activation and local welfare in italy: trends and issues.” social policy and administration 42 (2): 143-159. doi: 10.1111/j.1467-9515.2007.00600.x. bricco, paolo. 2020. “quell’italia dei nonni e del boom demografico sarà spazzata via dal coronavirus.” il sole 24ore. april 5. accessed june 15. https://24plus.ilsole24ore.com/art/inchiestaanziani_briccoadxkwjh?fbclid=iwar2fk2oxomcjlmykfoo7ifr6l9wpoeermsxxdooirpko8-vkcklkk3cfu7y. cohen, lawrence. 1995. “toward an anthropology of senility: anger, weakness and alzheimer’s in banaras, india.” medical anthropology quarterly 9 (3): 314-334. cohen, steven a., with zachary j. kunicki, megan m. drohan, and mary l. greaney. 2021. “exploring changes in caregiver burden and caregiving intensity due to covid-19.” gerontology and geriatric medicine, january 2021. danely, jason. 2015. “of technoscapes and elderscapes. editor’s commentary on the special issue ‘aging the technoscape.’” anthropology and aging 36 (2): 110-111. doi:10.5195/aa.2015.121. danely, jason. 2017. “caregiver narratives of fatigue and endurance in japan and england.” subjectivities 10: 411426. doi: 10.1057/s41286-017-0037-7. degiuli, francesca. 2010. “the burden of long-term care: how italian family care-givers become employers.” ageing and society 30: 755-777. doi :10.1017/s0144686x10000073. di todaro, fabio. 2020. “ coronavirus: le difficoltà di malati e caregivers durante l’isolamento.” la stampa. april 29. accessed june 20, 2020. https://www.lastampa.it/salute/2020/04/29/news/coronavirus-le-difficolta-deimalati-e-dei-caregiver-durante-l-isolamento-1.38745276. dubois, s. maria. 2020. “coronavirus, lo psicologo: come parlare ad anziani e bambini.” il corriere della sera. february 26. accessed october 10, 2020. https://corrieredelveneto.corriere.it/veneto/cronaca/20_febbraio_26/coronavirus-psicologo-come-parlaread-anziani-bambini-d8257dc6-586f-11ea-8ac8-f5da3705b70d.shtml fabretto, madina. 2020. “coronavirus: perché è più pericoloso per gli anziani e cosa è meglio fare.” la difesa. march 16. accessed october 10, 2020. https://www.difesapopolo.it/media/openmagazine/il-giornaledella-settimana/articoli-in-arrivo/coronavirus-perche-e-piu-pericoloso-per-gli-anziani-e-cosa-emeglio-fare. gulia, abhity, seema mishra, and sushma bhatnagar. 2020. “multiple caregiving role with the novel challenge of covid-19 pandemic: a crisis situation.” indian journal of palliative care 26 (1): 163–65. greenberg, jessica, and andrea muehelebach. 2007. “the old world and its new economy: notes on the “third age” in western europe.” in generations and globalization: youth, age, and family in the new world economy. edited by jennifer cole and debora durham, 190-215. bloomington: indiana university press. kaplan, matthew, mariano sanchez, and leah bradley. 2015. “conceptual frameworks and practical applications to connect generations in the technoscape.” anthropology and aging 36 (2): 182-204. doi: 10.5195/ aa.2015.99. kent, erin e., katherine a. ornstein, and nicholas j. dionne-odom. 2020. “the family caregiving crisis meets an actual pandemic.” journal of pain and symptom management 60 (1): 66–69. lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. new brunswick: rutgers university press. leibing, annette. 2017. “successful selves? heroic tales of alzheimer’s disease and personhood in brasil.” in successful aging as a contemporary obsession: global perspectives. edited by sarah lamb, 203-218. new brunswick: rutgers university press. marrone, cristiana. 2020. “cosa sappiamo sulle morti legate al coronavirus in italia.” il corriere della sera. february 24. accessed october 10, 2021. https://www.corriere.it/salute/malattie_infettive/20_febbraio_24/coronavirus-vittime-sono-davveromorte-covid-19-7b733736-56e8-11ea-b89d-a5ca249e9e1e.shtml http://anthro-age.pitt.edu/ margaret clark award (2020) winner | diodati | 35 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.352 http://anthro-age.pitt.edu manderson, lenore, and susan levine. 2020. “aging, care, and isolation in the time of covid-19.” anthropology & aging 41 (2): 132–40. nedelcu, mihaela, and malika wyss. 2016. “‘doing family’ through ict-mediated ordinary co-presence: transnational communication practices of romanian migrants in switzerland.” global network 16 (2): 202-218. pavolini, emanuele, and costanzo ranci. 2008. “restructuring the welfare state: reforms in long-term care in western european countries.” journal of european social policy 18(3): 246–259. pavolini, emanuele. 2015. “welfare all’emiliana (la famiglia e i servizi)”. il mulino 1: 125-130. pavolini, emmanuele and elena spina. 2015. “users’ involvement in the italian nhs: the role of associations snd self-help groups.” journal of health organization and management 29 (5): 570-581, doi: 10.1108/jhom-052014-0089. peletz, michael. 2000. “ambivalence in kinship the 1940s.” in relative values: reconfiguring kinship studies. edited by sarah franklin and susan mckinnon, 413–44. durham (usa): duke university press. previtali, federica, with laura d. allen, and maria varlamova. 2020. “not only virus spread: the diffusion of ageism during the outbreak of covid-19.” journal of aging & social policy 32 (4–5): 506–14. rickly, francesca. 2020. “old, disabled, successful? transfigurations of aging with disabilities in switzerland.” medicine anthropology theory 7 (1): 117–135. doi: 10.17157/mat.7.1.630. reynolds, laurinda. 2020. “the covid-19 pandemic exposes limited understanding of ageism.” journal of aging & social policy 32 (4–5): 499–505. sadler, euan, and christopher mckevitt. 2013. “‘expert caregivers’: an emergent normative model of the caregiver.” social theory & health 11 (1): 40-58. doi:10.1057/sth.2012.17. schroyer, david. 2021. “media effects on individual worldview and wellness for long-term care residents amid the covid-19 virus.” the gerontologist 61 (1): 8–12. sivaramakrishnan, kavita. 2018. as the world ages. rethinking a demographic crisis. cambridge (usa): harvard university press. thelen, tatjana. 2015. “care as social organization. creating, maintaining and dissolving significant relations.” anthropological theory 15 (4): 497-515. verbruggen, christine, brittney m. howell, and simmons kaylee. 2020. “how we talk about aging during a global pandemic matters: on ageist othering and aging ‘others’ talking back.” anthropology & aging 41 (2): 230–45. visser, renske. 2019. “going beyond the dwelling: challenging the meaning of home at the end of life.” anthropology and aging 48 (1): 5-10. doi: 10.5195/aa.2019.215. http://anthro-age.pitt.edu/ book review review of aubrecht, katie, christine kelly, and carla rice, eds. the aging-disability nexus. vancouver: ubc press. 2020. pp. 296. price: $70.85 (hardcover); $25.95 (paperback and ebook). yvonne wallace university of toronto yvonne.wallace@mail.utoronto.ca anthropology & aging, vol 42, no 2 (2021), pp. 169-171 issn 2374-2267 (online) doi 10.5195/aa.2021.367 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:yvonne.wallace@mail.utoronto.ca book review | wallace | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.367 http://anthro-age.pitt.edu 169 book review review of aubrecht, katie, christine kelly and carla rice, eds. the aging-disability nexus. vancouver: ubc press. 2020. pp. 296. price: $70.85 (hardcover). $25.95 (paperback and ebook). yvonne wallace university of toronto yvonne.wallace@mail.utoronto.ca diverse forms of physical and cognitive impairment are often considered a natural part of the aging process, yet at the same time, notions of 'good’ old age—or successful aging—are considered only for those who succeed in avoiding impairment and falling into ‘old age’ (gibbons 2016; minkler and fadem 2002). the relationship between aging, illness, and impairment is indeed complex (solimeo 2008), making the recent publication of the aging-disability nexus, edited by katie aubrecht, christine kelly, and carla rice, a welcome contribution to the distinct yet related fields of aging and disability studies. this book shows the theoretical, social, and political significance of examining both common ground and difference between age and disability. this analytical endeavour helps counter ageist and ableist assumptions about people aging into disability as well as about people with disabilities who age. as the editors suggest, “creative and generative possibilities emerge when aging is situated in a disability politics and when interpretations of disability take account of the weaving of material, social, and cultural relations in and through which the meanings of bodies as young or old are made and unmade” (5). part 1, “conceptualizing the nexus,” presents a number of overlaps and intersections of aging and disability. the variety of topics that the four chapters in part 1 engage illustrate that the nexus is not singular but that both phenomena are intertwined in multiple ways. dementia has been identified as a particularly productive space to interrogate the fraught relationship between disability and aging: dementia is considered a disease of old age, but simultaneously as “an experience that is not a normal part of aging” (silva, cascio, and racine 2020, 31) that can also befall people under 65, who are given the culturally specific diagnosis ‘early onset dementia.’ as important as is this distinction, it is equally important to pay attention to the compounding effects of ageism and ableism on older people with dementia. lucy burke (chapter 2) critically examines the stigma of 'uselessness' for the old and disabled against the backdrop of a culture that idealizes productivity and efficiency. she provides a literary critique of two dystopian novels, the mandibles: a family, 2029-2047 by lionel shriver and the unit by ninni holmqvist, highlighting dementia as “one of the most culturally powerful signifiers of unproductive or wasted life” (45). the section ends on a positive note, however: monique lanoix (chapter 4) shows that the embodied experience of age and disability draws both parallels and possibilities. through the creative expression of people with parkinson’s disease, normative ideas that one's agency is only enacted through bodily and cognitive control are challenged, leading to the destabilization of both ageist and ableist assumptions of normality. http://anthro-age.pitt.edu/ mailto:yvonne.wallace@mail.utoronto.ca book review | wallace | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.367 http://anthro-age.pitt.edu 170 part 2, “the politics of care,” focuses on the structures and policies of institutionalized care and the possibilities and limitations within them. margaret oldfield and nancy hansen (chapter 8) present the experiences of two women—susan who aged with cognitive impairment and helen who, through a dementia diagnosis, aged into cognitive impairment. this critical distinction—between aging with and into disability—is made throughout the book, with this chapter tracing, through poignant accounts, how conditions of care and possibilities of agency are influenced by their diverse circumstances. for example, while power was exerted over their lives in similar ways, susan was, for a time, permitted to live in a group setting, while helen was moved directly into a nursing home after her diagnosis. this difference, the authors note, illustrates one of the consequences of dementia being considered a ‘disease of old age’ rather than a cognitive disability. in part 3, “timescapes and landscapes,” contributors move outside of healthcare settings to explore the intersection of age and disability in various places and temporalities. from may chazan’s (chapter 13) reflection on the impact of hiv/aids, age, and disability on the roles of older women caregivers in south africa to nathan kerrigan’s (chapter 14) exploration of social exclusion in the english countryside, the disparate settings of these final chapters reveal how pervasive and universal the intersections of age and disability are, if only we learn to recognize them. the final chapter is a dialogue between disability scholar alison kafer and age studies scholar ruth bartlett. their exchange is anything but a conclusion, however, and instead invites continued dialogue beyond this collection. notably, they remind us that talking about a single aging-disability nexus is far too limiting. they ask instead, “does it not make more sense to talk about nexuses?” (253). their exchange invites readers to think about how the categories of ‘age’ and ‘disability’ shift in different contexts, times, and in relation to other frameworks and concepts. for example, they ask how the nexus might change if we consider julie livingston’s (2005) concept of debility or how it would be conceived by gender studies scholars. i could not help but think what conversations this collection might have included had it been published in the post-pandemic world. a significant takeaway from this edited volume is that the generally held expectation that old age brings with it physical and mental impairment has led to the depoliticization of the bodily and social realities experienced by older adults in this process. this book would be enjoyed by anyone focusing on topics that address aging and disability in any capacity. the writing is not overly academic, and the chapters both inform and inspire, making chapters an excellent addition to teaching resources on topics of age, disability, dementia and health policy. scholars of the canadian context will find it particularly relevant, however. for example, christine kelly argues (chapter 6) that while disability activism has resulted in deinstitutionalization of people with disabilities in favour of other forms of community-based care in canada, this has not been the case for older adults. instead, elder care is almost entirely institutionalized in canada, and overwhelmingly privatized (armstrong & armstrong 2020), the consequences of which have been tragically revealed during the covid-19 pandemic where the majority of deaths have been long-term care residents (cihi 2021). paying attention to the nexus, however, illuminates yet another layer: 85% of people who live in long-term care homes in canada have some kind of cognitive impairment, with the majority having dementia (banerjee & estabrooks 2021). the disability-aging nexus offers both theoretical and practical tools to address inequities that have surfaced—and to reveal those still systemically buried—in order to create a more just later life for individuals who age with and into disability. references armstrong, pat, and hugh armstrong, eds. 2020. the privatization of care: the case of nursing homes. new york: routledge. http://anthro-age.pitt.edu/ book review | wallace | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.367 http://anthro-age.pitt.edu 171 banerjee, sube, and carole estabrooks. 2021. “long-term care outbreaks, deaths, reveal how badly we undervalue seniors and people with dementia.” cbc news opinion, february 2. accessed september 9, 2021 from https://www.cbc.ca/news/opinion/opinion-dementia-long-term-care-homes-1.5871981 canadian institute for health information. 2021. the impact of covid-19 on long-term care in canada: focus on the first 6 months. ottawa, on: cihi. gibbons, hailee m. 2016. “compulsory youthfulness: intersections of ableism and ageism in ‘successful aging’ discourses.” review of disability studies 12 (2-3): 70-88. livingston, julie. 2005. debility and the moral imagination in botswana. bloomington: indiana university press. minkler, meredith, and pamela fadem. 2002. “successful aging: a disability perspective.” journal of disability policy studies 12 (4): 229-235. silva, olivia, ariel m. cascio, and eric racine. 2020. “person-oriented research ethics and dementia: the lack of consensus.” anthropology & aging 41 (1): 31-51. solimeo, samantha. 2009. with shaking hands: aging with parkinson’s disease in america’s heartland. london: rutgers university press. http://anthro-age.pitt.edu/ https://www.cbc.ca/news/opinion/opinion-dementia-long-term-care-homes-1.5871981 anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 71-73 issn 2374-2267 (online) doi 10.5195/aa.2014.38 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review jurkowski, elaine t. implementing culture change in long-term care: benchmarks and strategies for management and practice. new york: springer publishing company. 2013 isbn: 9780826109088. 298 pp. price $55.00 (paper) renée rose shield, phd health services, policy & practice (clinical), brown university http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.38 http://anthro-age.pitt.edu book review jurkowski, elaine t. implementing culture change in long-term care: benchmarks and strategies for management and practice. new york: springer publishing company. 2013 isbn: 9780826109088. 298 pp. price $55.00 (paper) renée rose shield, phd this volume is written by professor and graduate program director at southern illinois university carbondale’s school of social work, elaine jurkowski, msw, phd. more than a ‘howto guide,’ implementing culture change in long-term care: benchmarks and strategies for management and practice reflects the author’s extensive and practical experience in promoting culture change practices emblematic of nursing home reform. particularly informed by the culture change initiatives within the pioneer network umbrella (and with a foreword by a recognized culture change champion and founder of the eden alternative, bill thomas), the book is organized as a useful handbook to assist administrators, care staff and other stakeholders in long-term care. the chapters progress logically with suggestions of how to implement practices and policies within culture change domains to reduce the institutional feel of these facilities and create a more person-centered, humane and homelike experience for the frail, older adults housed in them. the culture change movement has great face validity but has just the beginning of a sturdy evidence base to support its feel-good intentions. nonetheless, numerous culture change practices are being incorporated in increasing numbers of nursing homes to challenge the typical look and feel of institutional hospital-like routines, practices and décor. such changes include expanded resident choices for dining, bathing and activities, and environmental improvements such as the elimination of overhead paging systems and nurses’ stations and more comfortable living areas, to name a few such commonly implemented practices. the book’s organization reflects its purpose to provide benchmarks and strategies to further institutional reform. in a succinct, clear and easy to follow writing style, jurkowski in part i describes the context of the system of american long term care and includes historical and demographic information to situate nursing home populations and how nursing homes have developed over the decades. various “paradigms” of care that have guided how institutional care is financed, organized and carried out in this country are described against which the culture change paradigm is held up as significantly different and positive; in culture change model, individuals and their preferences are honored and not delegitimized. jurkowski summarizes the origins and principles embedded in the culture change movement. she clarifies the purpose and content of the artifacts of culture change tool (acct) developed by the centers for medicare and medicaid (cms) and used as a summary of benchmarks to identify and measure culture change implementation in long term care settings. in part ii, jurkowski describes strategies and benchmarks of culture change practices in detail, itemizing the different domains that are typically targeted: care practices, environmental improvements, family/community practices, leadership practices, workplace practices and outcome practices. part ii is replete with examples and strategies that have been used in facilities to demonstrate practical ways to implement useful improvements. numerous photographs graphically depict these suggestions. for example, in a shield| book review anthropology & aging vol 35, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2014.38 http://anthro-age.pitt.edu 72 section describing how meal time can be enhanced to be more person-centered and less institutional, photos of dining layouts are included for table or buffet arrangements; and in a chapter about environmental practices, photos of alternative bathrooms, bedrooms, reworked nurses’ stations, showers and bathrooms, and outside areas with raised gardens help the reader understand the attraction of these improvements. in part iii, jurkowski lays out strategies and resources for implementing change broadly. using strategies from other reform movements, including disability rights, she discusses how assessments can be made to track and sustain progress as well as to itemize ways to engage a variety of stakeholders in the process of planning and implementing changes effectively. each chapter ends with a useful summary paragraph. the discussion/reflection questions following each summary are nicely conceived and can help trigger productive conversations among involved stakeholders about long-term care and how it is delivered. also useful is chapter 15 which itemizes and deconstructs “interpretive guidelines” from cms that govern regulations for long-term care. the appendices feature culture change organizational resources, websites, and a glossary of terms. while this volume is a useful handbook to help implement culture change practices in us long-term care, anthropologists will find certain considerations lacking. in particular, as is typically done, the word “culture” has been used without discussion of what culture means. jurkowsky certainly cannot shoulder the blame for using this term without definition or exploration since this omission is common in reform movements. still, i find myself wishing that while “culture” (or its lack) is often blamed or credited for problems or successes generally, some thoughtful exploration of what defines or is meant by culture would be a nice and informative accompaniment. the same goes for the unscrutinized use of the word “community.” in my opinion the book would also be greatly enhanced if there were mention of erving goffman’s masterful description of the “total institution” (goffman 1961) or thomas kuhn’s influential idea that “paradigms” are not so easily overthrown and largely determine how scientists and the rest of us think about any given subject (kuhn 1962). the ideas of these seminal thinkers undergird the premises and the challenges involved in the attempted overthrow of institutional regimes that still rule nursing home care. another gap is that the ambitious efforts that the us department of veterans affairs has made to restructure their nursing home equivalent, community living centers, have gone unremarked in these pages. i did not find the tips and strategies that were promised for anticipating barriers in existing policies and from regulators, nor do i see strategies for positive collaboration with them that were supposed to end the book. in this regard, some payment policy reforms, such as pay-for-performance, may help institute the adoption of beneficial practices and environmental changes. i’ve often wondered why physicians are usually left out of proposed reforms for improving nursing homes. even if it’s difficult to involve physicians in collaboration with other disciplines in these settings, i’d appreciate ideas about how to overcome barriers in recruiting them and thoughtful exploration about how their involvement would aid the practices and processes in nursing homes and the culture change movement. finally, anthropologists and others may wish that the book were enlightened with illustrations of nursing home care in the us and how other societies house and care for their frail citizens. illuminating examples can be found that would enrich and fruitfully enlarge the ideas suggested here. for example, savishinsky’s wonderful examination of how the inclusion of pets in a facility triggers domestic talk among staff and residents would have improved the section on shield| book review anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.38 http://anthro-age.pitt.edu 73 “facility pets” (1991). resident, staff and family discontent as well as suggestions for improvement are vividly described in books such as gubrium’s living and dying at murray manor (1975), diamond’s making gray gold (1992), foner’s the caregiving dilemma (1994), shield’s uneasy endings (1988), kayser-jones’ old, alone and neglected (1981), gass’s nobody’s home (2004), as well as other and more recent works. though this volume is more how-to than ethnography, the cultural critique embedded in the radical notion of culture change might be thought to require the inclusion of anthropological perspectives and the wealth of argument and example they offer. i wish it had. references cited diamond, t. 1992. making gray gold: narratives of nursing home care. university of chicago press. foner, n. 1994. the caregiving dilemma: work in an american nursing home. university of california press. gass, te. 2004. nobody’s home: candid reflections of a nursing home aide. cornell university press. goffman e. 1961. asylums: essays on the social situation of mental patients and other inmates. doubleday. gubrium, j.f. 1975. living and dying at murray manor. st. martin’s press. kayser-jones, j. 1981. old, alone, and neglected: care of the aged in scotland and the university states. university of california press. kuhn, t. s. 1962. the structure of scientific revolutions. the university of chicago press. savishinsky, j. 1991.the ends of time: life and work in a nursing home. bergin and garvey. shield, r. 1988. uneasy endings: daily life in an american nursing home. cornell university press. book review book review anthropology & aging quarterly 2014: 34 (4) 246 introduction nelson [rodriguez, the playwright] said to me, ‘tatiana, only assholes age. everyone else becomes wiser.’ this is very true. if you are super happy, have an active life, and a wrinkle bothers you, why not do something about it? that’s different than having plástica out of bitterness. aging is not cool. -tatiana, brazilian plastic surgery patient such a breezy acceptance of “plástica” has become common in brazil as the country experiences a boom in cosmetic surgery. tatiana’s comment that “aging is not cool” also points to new ideals of aging that have been popularized in industrialized societies since the 1980s. surgery-for-life: aging, sexual fitness and self-management in brazil the terms “successful aging,” “new age,” and “third age” reflect an optimistic view of aging as a process that can be managed to maintain not just physical health but also mental wellbeing, social engagement, and sexual fitness. this vision of aging has been described as an inspiring ideal that enables the elderly to counteract social isolation -but also as an ideology that masks structural changes in the life course in late capitalism, not all of which are positive. in this article i draw on ethnographic fieldwork on plastic surgery to explore tensions in ideals and norms of aging in brazil.  i situate this analysis theoretically in relation to a debate in gerontology about the “de-chronologization” of the life abstract this article draws on ethnographic fieldwork on plastic surgery to explore tensions in aging norms and ideals for women in brazil. i situate my analysis in relation to debates about a “de-chronologized life course.” some scholars argue that the life course in late capitalism has become less standardized. in this account, chronological age diminishes in importance as consumers are defined by life style choices available to all ages and the period of youth extends into middle age and beyond. in brazil consumers embrace plastic surgery as a means to “manage” aging, mental wellbeing, and reproductive and sexual health. this promise of a flexible and optimized aging trajectory seems to echo the notion of a de-chronologized life course. i argue, however, that medical discourse and patients’ accounts show ambivalence about aging and conflicts in the ideal of medically-managed sexual fitness for women. drawing on analysis of changes in family structure and women’s health regimes, i argue that passage through the life course, rather than becoming more flexible, is in some ways becoming more rigidly defined by biological processes. keywords: aging, plastic surgery, de-chronologized life course, sexual fitness, self-management, alexander edmonds professor of social and medical anthropology university of edinburgh aging, sex and well-being in brazil anthropology & aging quarterly 2014: 34 (4) 247 alexander edmonds surgery for life  a rich literature in symbolic anthropology has explored how initiations, marriage ceremonies, funerals and other rites of passage “move” individuals and groups through life stages in ways that culturallly meaningful. in brazil and other industrialized countries there are of course many such rites and ceremonies, often with christian roots but distinctly secular expression: such as the 15th birthday party, weddings, baby showers, and increasingly since it was legalized in 1976, divorce. the experience of passage through the life cycle, however, i argue is becoming mediated by medical practices that are used to manage women’s reproductive and sexual health. i analyze how plastic surgery contributes to a biologized experience of aging that radically reduces the social persona to a sexual, reproductive and aging body defined in physiological terms.  this article explores the dialectic between the erasure of biological aging and its inscription on the body. i discuss how plástica addresses an “aging subject” made responsible for managing psychological health and well being through aesthetic and therapeutic techniques. but while this medical practice seems to promise an extension of youth into middle age and beyond, it also makes the “problem of aging” start early in life as younger patients plan “preventive surgeries.” while it inspires affects like hope and happiness, aging continues to provoke anxiety and disgust. plastic surgery is not just a means of selfmanagement, but a way to manage sexual relationships as family structures change. some women see themselves as competing in a market where youth is sexual capital that continually loses value. in this medical and social context passage through the life course, rather than becoming more flexible, is in some ways becoming more rigidly defined by biological processes. plástica, rejuvenation and the “mask of aging” brazil is the world’s second biggest cosmetic surgery market (after the us). mainstream news media, telenovelas, blogs, and entertainment magazines widely endorse plástica and present it as a routine consumer service. in the private sector cosmetic surgery became more available to a growing middle class after the stabilization of inflation in the 1990s. remarkably, plástica has also come within reach of patients from across the socioeconomic spectrum. credit course. scholars have argued that passage through the life course in late or post-fordist capitalism has become less standardized (debert 2011, macmillan 2005, moody 1993). the thesis of a “de-chronologized life course” builds on research analyzing historical changes in the life course in western societies (brückner and mayer 2005, kohli 2007, held 1986). in the transition from a pre-modern to modern period the life course became more standardized, or in the expression of kohli and meyer (1986), there was a “chronologization of life.” this was a multidimensional transformation in the structures and experiences of aging. mass education and an industrial labor market divided the life course into distinct phases: student, worker, pensioner. identity became less defined by family position than by rights and duties specified by the state.  the modern life course, some argue, has now been superseded by a “postmodern life course” in “which chronological age loses its relevance” (featherstone and hepworth 1991, debert 2011, 6). periods of work, leisure and education become intertwined as workers adjust to a dynamic labor market. the consumer is defined more by lifestyle choices available to all ages than by an ageddefined role in the productive order. sexual norms have become less linked to age with the rise of serial monogamy and divorced men and women who date in middle and old age (bruckner and mayer 2005). youth extends into middle age, middle age blurs into old age.  in this article i analyze the thesis of a “postmodern,” de-chronologized life course in light of the experiences of brazilian plastic surgery patients. consumers from a broad socioeconomic spectrum embrace plástica as a means to manage psychological and women’s health. some patients view it as a way to correct aesthetic damage attributed to childbirth, breastfeeding and menopause. other women say it enables them to “look as young as they feel,” manage sexual relationships, and maintain a youthful lifestyle throughout their lives. plastic surgery’s promise of a flexible and optimized aging trajectory seems to reflect the notion of a de-chronologized life course. one problem with the term “postmodern life course,” however, is that it mirrors the ideal of successful aging that is promoted by the anti-aging industry. while plástica generally has a “sex positive” discourse, a closer look at medical practices shows major tensions in new aging and sexual norms. anthropology & aging quarterly 2014: 34 (4) 248 alexander edmonds surgery for life as rhinoplasty or some kinds of breast surgery). but even breast surgery -both enlargement and reduction procedures -often aims to project the breast and counter perceived effects of aging. the goals of aesthetic improvement and rejuvenation are also intertwined since women’s beauty norms strongly stress youthfulness.  surgeons and patients view the rejuvenating effects of plástica as a powerful means of improving psychological well being. a key term in medical discourse and patients’ testimonials is auto-estima (“self-esteem”). regardless of whether patients said they had “good” or “bad” autoestima, they saw plástica as a legimate means to boost it. one woman i met in a public hospital said simply: “it’s psychological. i think that for any woman who does plástica these days, it’s more psychological than anything.” while patients gave different reasons for “low selfesteem,” many said they felt their outer appearance did not match their sense of self. glaucia was as comfortable discussing plastic surgery as lacananian psychoanalysis. in her early 50s, she has two adult children and a namorado (boyfriend). she described the effects of her multiple operations: “the moment you see that you’re young again is really good, because in reality the spirit of a person does not age. what ages is the shell (caraça), nê? if you have a young spirit and have those aging problems, it’s terrible. i’m young, i’m a girl (garota).”  similarly, lídia, a middle-aged facelift patient, said: every time that i got up and looked at myself in the mirror i had this desire [for surgery] because i said, “it’s not possible. ah, to wake up with this face, i don’t want to wake up anymore, no.” [laughs] because when i put on make-up everything’s more . . . but it’s the moment when you wake up, nê?  for lídia a facelift did not reflect a desire to “be someone else,” but to “look like herself.”  in freud’s (2003) account, recognizing oneself in what at first seems to be a strange image in a mirror or photograph elicits an “uncanny” feeling. this uncanny double recalls lídia’s experience of not recognizing herself in the mirror, as if the aged face confronting her was both familiar and monstrously unfamiliar. for some patients their “naturally” aged appearance can seem more foreign to them than an “artificially” enhanced one. one critique of plastic surgery is that it distorts identity or causes selfalienation. but for many patients aging itself is a form of self-alienation, which plástica can correct. plans allow patients to make small monthly payments and some are marketed to “maids and secretaries” (the latter are often paid a very low, subsistence wage). some hospitals in the ailing public health system also offer free cosmetic operations.1 while the sus (public health care system) did not directly authorize comsetic surgeries (except for a few procedures), chief surgeons in some hospitals were able to successfully argue that residents-in-surgery need training in cosmetic techniques. some doctors also maintain that both reconstructive and cosmetic surgeries are a powerful means of psychological healing and thus should be offered to what they call the povão, the “common people.” surgeons from latin america, europe and elsewhere come to train in these residency programs where long lines of patients provide opportunities for intensive practice.2  i undertook ethnographic fieldwork in plastic surgery clinics, interviewed surgeons and patients from a range of socioeconomic backgrounds, and researched sites that play a central role in the production and consumption of beauty, such as television studios and advertising agencies. this research was conducted primarily in rio de janeiro intermittently for approximately two years. i have given a fuller ethnographic account of this fieldwork and the lives of patients and surgeons (see edmonds 2009, 2010). here i explore what plastic surgery reveals about changing aging and sexual norms in brazil.  many operations are seen to “work” on the aging body. surgeons present facelifts and eyelid surgery as “rejuvenation” – even if a few doctors are critical of this promise. one senior surgeon became so exasperated by patients with “unrealistic demands” that he complained: “if i operate on a woman who is old and ugly, she is going to continue old and ugly, but with her skin stretched. ‘how many years am i going to rejuvenate, doctor?’ they ask me. and i say, ‘i’m not going to operate on your heart, operate on your liver, i’m not going to operate on anything, i’m going to stretch the skin of your face!’” operations performed on the body are also seen to counter aging effects. abdominoplasty, breast and buttocks lifts, liposuction, and genital surgeries “correct” changes blamed on childbirth, breast feeding or menopause, and thus “reverse the clock” – a frequent metaphor used to describe plástica’s effects. a few surgeries are motivated primarily by dissatisfaction with the size or shape of a body part, and are thus not directly linked to aging (such anthropology & aging quarterly 2014: 34 (4) 249 alexander edmonds surgery for life focus on aesthetics. the psychological subject of anti-aging medicine brazil’s rise to “empire of the scalpel,” as a news magazine boasted, coincided with larger changes in social constructions of aging in brazil beginning in the 1980s. imported from abroad, the terms “third age” (terceira idade) and later “successful aging” refer to the ideal of a sociable, healthy, productive lifestyle for the elderly (leibing 2005, debert 2011). more generally, a youthful lifestyle is being defined as a norm for an expanding portion of the population. “successful” aging can refer not just to the avoidance of disease and infirmity but rather the active pursuit of health through a variety of therapeutic techniques.  as we’ve seen, plastic surgery is one such technique used to remedy low self-esteem and a disjuncture between appearance and the self. however, the psychological problems patients report can also be linked to a psychological subjectivity that has emerged as aging norms have changed in brazil. once a “young country,” over the past fifty years brazil experienced a rapid demographic transition. the percentage of elderly doubled as brazil’s fertility declined in the 1960s and 1970s and life spans were extended (leibing 2005, 17). while the population aged, the elderly were also made socially visible as a population in new ways. for example, pension funds began conducting market research that contributed to the notion of a “gray market” with political and consumer muscle (debert 2011).  annette leibing (2005) argues that beginning in the late 1970s aging has been removed from a christian moral framework that emphasized a simple, ascetic life as the key to longevity. seniors instead were constituted as a “national problem” as social workers and psychologists provided new interventions. new models of aging stress, though, that the elderly should not become wards of the state, but rather remain active in order to avoid biological decline and depression (leibing 2005). new aging ideals have sparked a social movement and reflect new social and politial aspirations of the elderly. however, the promise of liberation from (internalized) ageism is potentially undermined by new forms of self-monitoring.  for some women aging not only creates a gap between an ageless self and an aged body, but also pushes them into a new social role that they reject. tatiana said that already in her 50s she was being called “minha senhora,” a more formal form of address: there are men with white hair, for example, with the biggest charm, but women . . . they already become “minha senhora.” this is crazy. women they develop earlier. this is something genetic . . . women become sort of matronly, they get fatter, here [in brazil]. at 13 years old they’re already menstruating, with a woman’s body . . . because women are the generators of life, they have a hormonal factor, a different physical formation.  while she acknowledges a social double standard for men and women, her account of women’s aging stresses biological differences (genetics, menstruation, reproduction, hormones), which in turn require more medical management.  medical discourse sometimes stresses that historical changes have made aging a more problematic domain of psychosocial life. dr. barretto argues that medical progress expanded the life span from 35 years a century ago to between 80 and 90 today, which in turn has caused a “disequilibrium” between the mind and body. plástica can correct this historically “new” problem: “it’s more than normal to try to make the physical organism fit our interior youth, which is becoming more and more prolonged” (plástica & beleza, may/june 1999, 203). plástica is often presented as a new technology that enables women to negotiate the specific challenges presented by contemporary life.  this medical discourse recalls the representation of experiences of aging in “postmodern” societies made by some scholars. featherstone and hepworth (1991) describe a “mask of aging,” a kind of self-alienation where the inwardly young consumer ceases to identify with an outwardly aged appearance. similarly, katz and marshall (2003) discuss how new aging ideals address a “timeless” consumer who is trapped in an aging body (katz and marshall 2003). plastic surgery could be said to reflect aspirations for a more “plastic” sense of identity not defined or limited by processes of biological aging. in the next sections i explore tensions in this psychotherapeutic project. i first discuss the social forces that address an “aging subject” made responsible for maintaining a state of pyschological, reproductive and sexual health with a anthropology & aging quarterly 2014: 34 (4) 250 alexander edmonds surgery for life “ruins” of psychoanalysis, and is often combined with, or else replaces, the older talking cure. in public hospitals the psychotherapeutic rationale for plastic surgery was also prevalent. sonia, who was waiting on line to have abdominal plástica, said, “i think my “i” is going to really improve, because the important thing is your interior. if your head is good, you’re going to look at yourself and feel good.” she also, though, added another reason: “we [a gente] want to be beautiful for the husband, nê?” like many women in public hospitals she often used the pronoun “a gente” (we) in place of the “eu” (i) more commonly used by middle class women. other patients were not fully conversant with the psychological idiom of plástica, or else doubted or mocked it. janaina had worked as a “mulata” (in her account a job description not a color term) in a samba show. when i asked her why she wanted liposuction, she said, “look, i’m going to do this surgery not because i’m bad in the head, but because i’m bad in the body . . . i looked at myself in the mirror and i saw that i was a pig [porcaria]. it doesn’t do to look at myself and say, ‘hum, i’m sexy [gostosa]’ if my eyes fight with my thoughts.” other women simply said that plástica was a “woman’s thing” or “women’s vanity.” some patients, like dona firmina, an illiterate woman in her 50s, showed up to consultations with a picture of an artista (celebrity). such patients could discomfit surgeons who worried that patients “did not have the culture to understand that plastic surgery is a medical procedure.”  thus, while psychological rationales for having cosmetic surgery were widespread, patients also had many other concerns that entered into their decision-making. some worried about getting fired because they were “old” or feared losing a partner. others were motivated by modest aspirations to break into the service economy and escape their mother’s fate of “working for a family” (a euphemism for employment as a maid). some psychologists employed by surgeons to screen candidates (to turn away those suspected of being too emotionally disturbed to be satisfied with results) were concerned that women were replacing psychotherapy with plastic surgery. yet plastic surgeons simply said that their techniques were more “effective” than the talking cure. and as one psychologist acknowledged, many working class patients – for whom talk therapy is not an option – simply “prefer surgery” (edmonds 2010).  positive aging, of course, presumes an opposite: negative aging. avoiding this fate – and the mental health problems that come in its wake – requires self-management. leibing points out that messages about “positive aging” involve “techniques of the self” and a “psychologization” of daily life (leibing 2011, 25). she argues that the notion of “selfesteem” (auto-estima) figures as a key term in pastoral programs aimed at seniors. keeping sociable as well as thinking positively are recommended as a means to age well. conversely, psychological problems are said to “accelerate aging” (leibing 2011, 24). plástica discourse reverses this formula: beauty work that slows aging becomes a means of avoiding psychological problems. the psychotherapeutic benefits of surgery are available throughout the life course, as a “miss third age” beauty contest made clear. the rationale of this event was to “augment the self-esteem” of the elderly. the 1996 winner was “judged by her plastic surgery, elegance, and empathy with the audience” (among the prizes was additional plastic surgery) (leibing 2005).  the rising popularity of plástica thus reflects the growth of a psychotherapeutic worldview and “psy-” institutions (cruikshank 1996, rose 1996). the notion of self-esteem can be seen as a “therapeutic technology” in that it morally authorizes the healing of healthy patients. elizabeth haiken (1997) points out that in the u.s. plastic surgeons in the early 20th century scorned “beauty” doctors in a bid to legitimate the specialty. the eventual acceptance of cosmetic surgery depended not just on improved surgical technique but also on psychological notions such as the “inferiority complex,” and later self-esteem. from a technical term used in psychological research (ward 1996) the term self-esteem entered into a range of everyday uses: self-help manuals, black social movements, mobilization around third age, and beauty industries (edmonds 2009). in brazil, for example, in the 1990s new magazines oriented towards “black” beauty practices and celebrities began to speak of “rescuing the self-esteem of the black brazilian” (filho dias 2006, 4; fry 2002).  in brazil the term auto-estima, like “third age” and “successful aging,” was originally imported. its foreign status does not mean it was inauthentic, but differences in class, education and religiosity have shaped the dissemination of a psychotherapeutic ethos (duarte 1986). among the middle class and elite plástica is thriving in the anthropology & aging quarterly 2014: 34 (4) 251 alexander edmonds surgery for life  plástica is often given to teens as a birthday present, especially the festa de quinze anos. while a variety of operations aim to make patients look younger, ironically women are rarely considered “too young” to have plástica. carlos garcia, ex-president of the brazilian society of plastic surgery, argued that at the age of 16 the body is already “formed” and “nothing prevents adolescents from seeking a new appearance. it’s in the physiology text books” (“reino das formas perfeitas,” época, 6/19/00). another surgeon said that liposuctions “should only be performed four years after the first menstruation.”  the ideal of successful aging holds out the promise of extending a youthful lifestyle into middle age and beyond. yet, plastic surgery also pushes the “need” to manage the aging body into early adulthood. surgeons say that younger patients are “better patients.” younger skin means a smaller chance of complications and better aesthetic results. at a plastic surgery conerence in rio de janeiro, a surgeon told me that “the wrinkles of the future are not going to be the wrinkles of the present, that is, very deep wrinkles . . . plastic surgery is becoming more preventive.” the rise in “preventive surgery” and higher numbers of adolescents and women in their 20s having surgery have likely contributed to a drop in the average age of the patient. in 1980, the average age of the cosmetic surgery patient was 55 years. ten years later it had dropped to 40 and by 2000 it was only 35 (“os exageros da plástica,” veja, 3/6/02). there are also few upper age limits for plastic surgery. imagining a skeptical reader asking why an eighty year old would elect to have plástica, one surgeon asserted “to simply feel better, younger, a little over sixty perhaps.” rather than being presented as an “artificial” prolongation of youth, plástica is often seen as a “natural” means – provided it’s done well – to age in a modern world.  both facial and bodily surgeries are also linked to menopause. márcia had been waiting ten months to have a second facelift. she discussed her motivation to have the operation: “when i began menopause three years ago, everything fell, fell really fast. women age more quickly . . . menopause, hormones, breast feeding, giving birth, everything deforms the stomach, your body . . . and domestic life too is wear and tear, stress. and also men demand more of us.” while márcia mentions gendered social roles, she stresses that plástica is a means of  coached by surgeons, psychologists, or other patients, surgery candidates come to replace “bad” motives – such as the desire to look like an artista or secure a marriage – with “good” ones, such as “boosting self-esteem.” interactions in the clinic thus are didactic in that they train patients to describe “defects” in clinical terms. but they also teach a psychotherapeutic rationale for surgery and “open up” the body as a terrain of self-management. plastic surgery is thus not only a socially validated means to heal the suffering psyche, it also reflects a notion of appearance as a psychic domain requiring therapeutic management. yet while plástica promises to liberate the timeless consumer from what glaucia called the “shell” of the body, it can also reinforce awareness of aging as inexorable biological decline as it becomes embedded in the female life course. surgery-for-life: plástica and the female life course one of the most significant and problematic aspects of cosmetic surgery is that it is often a lifetime therapy for women. it was rare to encounter a patient who had had only one operation or was not already at the time of her first surgery planning additional ones. around 70 percent of patients are women, but plástica is also highly gendered in that surgeries are often timed to female lifecycle events.  a former president of the brazilian society of plastic surgery sketched out a “typical timetable” of surgeries that begins in adolescence: age 15 to 20: breast reduction surgery age 20 to 25: liposuction, even before marriage age 25 to 35: breast-lifting and liposuction, to correct the sags and bulges that can come with child-bearing age 35 to 43: she waits a while and goes back to the academia (gym) for exercise age 43 to 50: facial surgery, taking the opportunity to have some ‘freshening’ done on the body (“war on fat: rio cultists: good looks at the beach,” los angeles times, 8/15/87).  however, patients often discussed their operations not only in relation to a “need” defined by chronological age but in relation to significant age-related milestones: “becoming a woman” (in brazil often celebrated at the 15th birthday party); childbirth and breast feeding; decisions to end reproductive life (often by tubal ligation); divorce; and menopause. anthropology & aging quarterly 2014: 34 (4) 252 alexander edmonds surgery for life wanted to combine the birth, which like the others would be a caesarean, with a tubal ligation and a correction of abdominal “flaccidity.” as with many other women, cecilia timed her surgeries to the end of her reproductive life (due to tubal ligation) in part because of a concern that becoming pregnant again would “ruin” the effects of surgery. after her gynecologist told her, however, that he couldn’t “fix her belly” during the birth since he was already “tying the tubes,” she decided to postpone the plástica. a few years later she had combined liposuction and abdominal surgery to “repair” the caesareans and reduce “localized fat” she had gained during her pregnancies.  cecilia was not considered “vain” by family or friends and in any event, vaidade (vanity) has a neutral or even positive connotation of “self-care” in brazilian portuguese. rather, her medical history reflects a more widespread, sometimes routine use of plastic surgery to manage reproduction and aging. ob-gyns refer patients to plastic surgeons after giving birth, reinforcing the idea that cosmetic operations are a “normal” aspect of women’s health. vaginal birth is said to cause sexual and aesthetic damage that can be avoided with caesarean sections, which comprise more than 70 percent of births in some private hospitals (rebelo et al. 2010, carranza 1994).3 plástica is also used to correct iatrogenic damage from c-section, but also to “compensate” for medical suffering since it is “good for the self.” women who are unable to acquire a c-section are often given episiotomy,4 an incision made in the perineal muscle during delivery, and later followed by the ponto de marido, the extra “husband’s stitch,” which aims to correct “vaginal trauma” (diniz and chacham 2004).5 other women giving birth in public hospitals who are “denied” c-sections are offered cosmetic vaginal plástica as a “proxy” c-section, emilia sanabria (2011) found. links between ob-gyn, plastic surgery -and sometimes endocrinology too -have helped to routinize an aesthetic approach to managing reproduction and aging within a highly interventionist medical culture (edmonds 2010, 2013a).  clinical practices themselves contribute to “producing” the age-related defect and a consciousness of aging as biological decline. the surgeon measures defects with surgical instruments or discusses them in technical language with the patient, which can lend them an compensating “damage” blamed on women’s “quicker” aging.  but the most important lifecycle events mentioned in relation to plástica are pregnancy, childbirth and breastfeeding. breast surgery, abdominal surgery, and liposuction are said to correct flaccid skin or localized fat or else “lift” areas of the body described as acabado (finished), caído (fallen) or murcha (shriveled). this language reflects a clinical gaze – sometimes taken on by patients – that fragments the body. while the field of “aesthetic medicine” presents aging as a holistic biosocial process, clinical practices instead localize aging in body parts, some of which become pathologically or prematurely “aged.” plastic surgery, however, is often used not just once to correct a “defect,” but is integrated into a larger management regime for reproductive and sexual life.  now in her mid-40s, cecilia lives a comfortable life in a condo in the south zone of the city. she grew up, though, in one of the poorest rio suburbs, raised by a mother who gave birth to her at age 15, never learned to read, and converted from catholicism to an evangelical church. cecilia studied psychology in university and has tastes she considers “moderna,” which run from a love of french cinema to a simple and “relaxed” (in her mother’s words) sense of fashion. on her living room book shelf stand the entire collected works of freud, translated into portuguese. she is now separated from her husband, a self-made man with whom she had three children. talking about her multiple surgeries she often mentioned her reproductive and marital life.  while her mother blamed her for the end of her marriage -“you let yourself go” (se largou) – cecilia simply said, “we had grown apart.” it was at this time, when she was in her late thirties, that she decided to have abdominal surgery and liposuction on her thighs and abdomen (followed by an additional liposuction operation some years later). she explained how the operations were designed in part to “correct” the effects of her three caesarean births: i did it on my belly, which had a very flaccid part due to the cesáreas. . . . and the doctor made a cut a little bigger than the caesarean scars, and took out that piece of meat that was really flaccid, without life, and then he sewed it up, and did the liposuction.  she explained that when she was pregnant with her third child, she began to think about having surgery. she anthropology & aging quarterly 2014: 34 (4) 253 alexander edmonds surgery for life menopausal playboys: sexual rights and duties in middle age new models of aging have, of course, not simply replaced older ones. positive images of the elderly are often presented with an underlying irony, leibing (2011, 22) points out. for example, activity is represented as a sign of successful ageing, but activity among the elderly is often seen as “empty bustling.” contradictions in new ideals of aging are particularly salient in the area of sexual health and sexual “fitness.”  the ideal of successful aging validates to some extent sexual activity among middle aged and older women as “healthy.” for example, the ministry of health announced that “86 percent of brazilians are sexually active between 41 and 55, a higher proportion than the 66 percent among youth from 16 to 25 (“sexo depois dos 40,” veja, 24/5/2000). an article in época claimed that over the last 30 years women have “succeeded in transforming their bodies into sources of pleasure” (“sem medo dos 40,” época, 9/27/99). celebrities too have played a role in defining a more “liberated” sexual norm for middle-aged women (goldenberg 2002, 19).  the new media interest in what one magazine article termed “sex after 40,” however, coincided with heavy promotion of medical or quasi-medical sex and beauty treatments. for example, a veja news article on the “arsenal of middle age” touted the benefits of a range of therapies for “him and her”: from viagra and antidepressants to aphrodisiacs that “combat frigidity” to cosmetic surgeries. such techniques enable the middle aged to have a “much more active sexual life” than their parents did. plástica is sometimes explicitly presented as erotic enhancement for middle-aged women. for example, actress ângela vieira – who like many celebrities has publicly discussed her surgeries -appeared nude in a magazine and was dubbed a “menopausal playboy” (“sem medo dos 40,” época, 9/27/99).6  flávia, a working class woman in her 20s, is one admirer of such images. she said that she “loved” to read magazines like playboy because she “loves to see the body,” i.e. the nude bodies of female models. plástica is sometimes positioned in this visual culture as way to achieve sexual fulfillment. flávia’s mother, bete, said men “flirted” more and that they had more tesão (desire) objective existence. in public hospitals discussion of defects is often a pedagogical exercise performed for a room filled with residents. a senior surgeon will (gently) pinch the nose, pull the skin on the forehead, pick up and drop the breast to test for skin elasticity. surgeons also use digital photography to measure the size of asymmetries or defects. in private clinics too surgeons frankly describe defects. lídia spoke of one consultation: “i went with my sister. i said to the doctor i’m thinking of a lift. he said, ‘you have to do it, you have to do it now.’ he took me into another room and with a pincer, showed me all i had to do. he said ‘our lady, you’re finished [acabada].’ the clinical description of defects though is often “softened” by gallant praise. when lídia said she had told him she was afraid of having a “stretched face,” he replied, “no, you’re a beautiful girl [moça], it will be good.”  i found it difficult to understand the effects of plástica on its ostensible therapeutic object: self-esteem. some patients used superlatives, describing how they felt “marvelous,” “super-happy,” “super-woman.” others spoke in a more restrained manner of a boost to self-esteem. but many patients came back for repeat surgeries, to correct complications, for retoques (touch-ups), or simply because their aesthetic expectations were not met. those who were satisfied often had additional surgeries later, either to counter new effects of aging or because they had perceived new defects. ironically, their interactions in the clinic could also create a heightened awareness of flaws. some surgeons said correcting one defect can accentuate another one, for example, a breast reduction can make the belly appear to protrude too much. in other cases the expert simply points out an asymmetry the patient had never perceived, but quickly learns to “see.”  patients and surgeons view plástica as a powerful means to overcome limits imposed by aging. yet the “operable body” is embedded in the female life course as patients time surgeries to biosocial events. thus, while plastic surgery reflects a view of the body as “plastic” – malleable, manageable, improvable – it can heighten awareness of aging as a biological trajectory. in the next sections i explore this tension further by analyzing the use of medical therapies to maintain or enhance sexual wellbeing throughout the life course. anthropology & aging quarterly 2014: 34 (4) 254 alexander edmonds surgery for life approach to sexual fitness is also apparent in the marketing of cosmetic genital surgeries. medical discourse claims that these operations enhance women’s sexual pleasure (by correcting “vaginal widening” following normal birth) (cirurgia plástica íntima, 2006). this reasoning, in ways similar to discourses surrounding c-sections, promotes a view of childbirth as a process that puts women at sexual and aesthetic risk. marketing discourse also claims that “aesthetic aspects” of the genitals are “increasingly important for self-esteem.”7 sexual fitness is thus a complex ideal and norm. it aims not only to boost self-esteem and libido, but also entails a norm of medically-managed, “aesthetically pleasing genitalia” (mccallum 2005, 226). some patriarchal sexual norms -such as the ideal of premarital virginity -are in decline. on the other hand, these sexual norms resurface in an “aestheticized” form in revirginization genital surgery or in a management regime that views reproduction as a sexual and aesthetic threat.  to some extent anti-aging medicine seems to take seriously the sexual concerns of middle aged and elderly women, reflecting a shift from an older medical assumption that sexual decline was an inevitable and natural part of the life course (marshall 2009). in brazil it also, however, often normalizes beautification as a health aim throughout life course. teenagers have access to the same techniques of self-optimization as adults. women in their 20s, 30s, and 40s are “already” ageing and need preventive medicine. and all adults are potentially “falsely aged,” requiring therapy to look as young as they feel. the liberatory promise of anti-aging medicine thus coexists with a new “positive” morality that makes sexual fulfillment a right, but which also entails a duty to medically maintain attractiveness to preserve family relationships, self-esteem, and even health itself. “mom is a snapshot of me in the future”: aging in the family i have discussed tensions between the promise of a liberation from an aging body and a biologized experience of passage through the life course. i explore this point further by examining how women see themselves as being linked to female kin through a genetic inheritance that creates shared medical “needs.” plástica is often represented as a personal choice undertaken by the patient in private consultation with a physician. but during after she had several plastic surgery operations. these assertions of sexual agency, however, contrast with the disgust, contempt or even fear expressed by male peers, husbands, partners, and sons of female patients. one tv viewer said he felt repulsed when he noticed the contrast between a 40-year old face and an “old, wrinkled hand.” another man was outraged by a patient who said she had decided not to breast feed in order not to “ruin” her breasts. even positive depictions of sexuality in “older” women (where older is a category that encompasses ever younger women) often have an ironic tone. the term menopausal playboy is partly humorous, as is the separada malhada, a separated woman with toned muscles.  katz and marshall (2003) analyze how sexual fitness has become a “pivotal sex/age body-problematic” in the new ideal of successful aging. they argue that a more standardized life course has given way to a “postmodern life course” in which “timeless consumers” become responsible for transcending sexual decline. men have recourse to viagra and testosterone therapy while women have access to various hormonal therapies, and perhaps eventually, an arousal pharmaceutical. they conclude that “the discourses of positive aging have created the sexy ageless consumer as a personally and socially responsible citizen” (katz and marshall 2003, 12).  this ideal of the “sexy, ageless consumer,” however, involves very different therapeutic techniques for men and women. sexual fitness for men is often focused on “performance” and erectile function through diet, exercise and drugs; sexy means in this context, “feeling like having sex.” sexual fitness for women – perhaps especially in brazil – has a remarkable focus on beauty; sexy means here “sexually desirable.” as in other western countries, women’s magazines in brazil are filled with tips on erotic techniques. however, sexual fitness is often “aestheticized” in that it focuses on the technical management of attractiveness throughout the life course.  some patients see plástica as a means to explicitly enhance erotic allure. many operations that make relatively minor changes promise to project the breasts or “contour” the waist, hips and buttocks to create a more “gostosa” (sexy) figure. one female surgeon was distressed to see more clients in their 20s who “were already beautiful” and wanted to become “more perfect.” an aestheticized anthropology & aging quarterly 2014: 34 (4) 255 alexander edmonds surgery for life  this mother and daughter pair stress the importance of “support” (força or apoio) they receive from each other.8 having plastic surgery can be seen as a kind of rite of womanhood, especially when it is linked to a key life event. other kinds of beauty work, such as wearing make-up or dressing up, can be seen as form of passing on the “arts” of femininity across generations and perhaps a form of bonding between kin. but plastic surgery also targets a notion of “beauty” that is defined biologically - in terms of anatomy, reproductive processes, hormones, and secondary sexual traits (edmonds 2013b). the mother “maps” the future because she provides the example of how to successfully manage aging, but also because, flávia said, their bodies age in similar ways.  patients spoke too of inheriting from kin combinations of ethnic traits that require surgical correction. for example, some women who identified as branca (white) or morena (“brown” or “brunette”) said they inherited the shape of their nose from an indian or black grandparent or great-grandparent. they sought rhinoplasty to narrow their nose and make it more in “harmony” with their face. their comments point to the “plasticity” of brazilian constructions of race and color, as well as color hierarchies that value white, or relatively white, brancina, facial features (edmonds 2010: part ii, goldstein 2003). they also show how generations are linked through genetic inheritance that creates particular medical “needs.”9  plástica also mediates the kin relation by making generational gaps less apparent, or even invisible. flávia and bete mentioned being mistaken for siblings. flávia hoped that when her five-year old was grown up, strangers too would assume they were sisters: “because my body will be so well-treated, so conserved, like my mom’s is now.” while the age gap separates mother and daughter into different family roles, aging also in a sense links them in a biological process that requires management.  patients spoke of plástica in terms that echoed the postmodern life course, and seemed to support the thesis of a “de-chronologized life course.” but one problem with this thesis – which some argue is a more general problem plaguing postmodern theories – is that it mirrors new ideologies about the social phenomena it depicts. successful aging is promoted by plastic surgeons. yet patients, not surprisingly, also had more ambivalent attitudes towards the psychosocial effects of aging and the fieldwork i was struck that plastic surgery was often a family matter. surgeons acknowledge that the most effective means of marketing is boca a boca, word of mouth, which is often from kin to kin. mothers, grandmothers, aunts, sisters, daughters and cousins recommended surgeons to each other or accompanied each other during multiple visits to the hospital.  i met flávia and her mother, bete, at a private clinic. both women live in a working class neighborhood in the zona norte. now in her mid-20s flávia was having a breast lift and liposuction to “correct problems” she attributes to childbirth. she said she could never afford the clinic’s prices, but got a heavy discount through a personal connection. she spoke of the influence her mother had on her when she was a small child: my mother here already had four plásticas, and so since i was really little i lived with plástica in the family, nê? because she did her nose, she did her eyes, she did the same breast surgery and lipo i am doing now. and i was with my mom through all these procedures.  mothers can provide “inspiration” to have surgery, but they can also “map out” the daughter’s future aging. she said: “i usually say to men, look at your mother-in-law to see what you’re buying, taking home. mom is a snapshot of me in the future.”  like many unmarried women, flávia lived with her mother. both women were separated from the fathers of their children and in flávia’s words were “in the market” (of dating): in the past, a 40 year-old woman felt old and ugly. and she was traded for a younger one. but not these days. a 40 year-old is in the market competing with a 20 yearold because of the technology of plastic surgery. she can stretch [her skin], do a lift, put in silicone, do a lipo, and become as good as a 20 year old.  this description echoes the collapse of generational differences analyzed by gerontologists. plástica “allows” women of different ages to enjoy sexual freedom, making chronological age less relevant. figueira argues (1996) that in consumer capitalism family members become less identified with age-defined roles. for flávia, rather than being defined relationally through different rights and duties, mother and daughter become “equal” sexual beings, though situated in different moments of the aging process. this equality between the 40 year-old and 20 yearold though also puts them in a competitive relationship in a market, a point i return to below. anthropology & aging quarterly 2014: 34 (4) 256 alexander edmonds surgery for life with the duty to maintain disposicão and diminish periods of sexual unavailability to partners. what appears to be a technique for sexual self-optimization can also be a means for managing sexual relationships.  tensions between reproductive and sexual rights (and duties) also surfaced in conversations with plastic surgery patients. tatiana saw plástica as a way to “have it both ways,” enabling her to enjoy breast feeding (without worrying about “damage”) while boosting libido. maria josé said that after becoming a mother, the “role of woman becomes secondary” – a problem again that can be solved with plastic surgery (her comment was taken from an interview in ribeiro and aboudib 1997). in these accounts plástica is a kind of modern technology that allows women to overcome the “split” between motherhood and sexuality, which sandra bartky (1990) argues characterizes patriarchal society. the highly interventionist approach to women’s health in brazil can also reinforce this split as it normalizes a view of reproduction and aging as biological processes threatening sexual and “asthetic” integrity.10 conclusion this article has approached plastic surgery as a window on tensions in aging and sexual norms. i began with a discussion of the thesis that the life course has been dechronologized in contemporary societies. to some extent plastic surgery patients live in social circumstances that support this thesis. women are postponing motherhood in brazil (as in other industrialized societies). across the socioeconomic spectrum they are less defined by domestic and reproductive work as brazil’s economy grows and gender norms shift (to give just one example, while the vast majority of older surgeons were male, young residents in surgery are about half female). in consumer culture youth is an ever-expanding category -a lifestyle more than a stage in the life course. and medical discourse portrays aging as a process that can be limited or transcended with the right psychological, health, and beauty work.  i have argued, however, that in some important respects the life course remains “chronological” as plastic surgery and other therapies are medically authorized as management techniques that accompany a woman through the life stages of adolescence, birth, breast feeding and menopause. patients embrace plástica as a means to bridge the gap between a youthful interior and aged exterior; yet possibility of managing them medically. flávia saw bete’s surgeries as an “inspiration,” yet her mother’s aging is also a sign of her own inevitable decline. she said in front of bete: “aging is horrible. i try not to even think of how i’ll be at 50.” mothers not only map the daughter’s aging body, but also possible futures of relationships. divorce and separation rates have been rising since divorce was legalized in 1976 in brazil. the number of men aged 40 to 59 marrying women in their 20s doubled from 1978 to 1996 (veja, 24/5/2000). plástica was also practiced by women in happy marriages, where it could provoke “jealousy” in the husband. but in intimate conversations women often expressed anxieties about current relationships or hinted at hopes that surgery would rekindle a marriage.  lídia said she had “done one plástica with each husband, this is now my third.” while flávia seemed reassured that plástica can make a 20 year-old woman as “good as” as a 20 year-old, valéria -who was divorced -joked about men who “trade one woman of 40 for two of 20.” luisamar spoke more despairingly about the breakdown of relationships: “in the past man didn’t separate. he had his lover, or lovers, but the family was sacred. this is changing . . . everyone separating. i think it’s absurd, a man living 40, 50 years with a woman, and then leaving her. it’s a kind of cruelty. 40 years of marriage, and they marry a 20 yearold.” other women viewed plástica as a “compensation” for the loss of love or inability to have more children due to the end of a relationship. the self-work in plástica is thus not just a “private” therapeutic technique for calibrating mind and body, but also transpires in a world of uncertain familial and sexual relationships.  plástica is not the only medical therapy used to manage sexual and “aesthetic” anxieties. in her ethnographic work in bahia, emilia sanabria (2010, 2011, 2012) found widespread experimental uses of sex hormones. compounding pharmacies offer hand-crafted implants that combine a variety of hormones, including testosterone. these are used for off-label indications: menstrual suppression, coping with work difficulties, and regulating mood, libido and sexual disposition, disposicão. dubbed “beauty chips” by the media, implants are also said to have “aesthetic” effects, such as diminishing cellulite, improving skin elasticity, and avoiding weight gain. these therapies are presented as a means to greater “freedom.” however, sanabria argues, this promise is subtly blurred anthropology & aging quarterly 2014: 34 (4) 257 alexander edmonds surgery for life “elective” c-sections, compared to vaginal birth, protect sexual health or result in a speedier return to sexual activity (barrett et al. 2005). 4. demand for c-sections, as well as for plastic surgery, is partly fueled by class dynamics since both these therapies are considered in some contexts as “modern” medical goods that have been normalized in healthcare for middle class women (béhague et al. 2002, edmonds 2010). 5. medical studies dispute that the routine use of episiotomy has any health or sexual benefits (belizán and carroli 1998). 6. the news article held up the actress, a 47 year-old divorced mother, as an example of a generation of middle aged women who “give a new meaning to the phrase coroa enxuta” (literally “a crown in good shape,” that is, a well-preserved, middle aged person). 7. herbenick and reece (2010) claim to have developed a new psychological research tool, the “genital self-image scale.” 8. similarly, another working class patient, sonia, brought her teenage daughter, taís, with her to the hospital. sonia was waiting for abdominal surgery and at first i thought her daughter was there to give her moral support. discussing her decision to have the operation, she said that her husband “supports” her just as she supports her daughter’s decision. “it’s her 15th birthday present, the nose. she doesn’t want a party, she wants to make a “book” [in english, a fashion modeling portfolio] with a nose that makes her feel good.” 9. surgeons too reinforce a “racialized” aesthetics of aging. they argue that ‘pure whites’ have skin that ages more rapidly, while women with some african descent have a tendency to gain weight more easily. 10. tensions between maternal and sexual roles have historical roots in modernity, perhaps especially in latin societies that have been described as having a “madonna/whore complex” (yalom 1997). but this “complex” takes a specific form in brazilian medicine. when an ob-gyn says to a woman after she has her first child, “you don’t have to look like that,” sexual fitness is reinforced as an aesthetic norm attainable through proper management. references barrett, geraldine, janet peacock, christina r. victor, and isaac manyonda 2005 cesarean section and postnatal sexual health. birth. 32(4):306–311. bartky, sandra 1990 femininity and domination: studies in the phenomenology of oppression. new york: routledge. also compete in markets of sexual relationships where youth is a form of capital. medical discourse valorizes “sex after 40” and women’s sexual pleasure; yet practices focus on a notion of sexual fitness that emphasizes the technical control of “aesthetic damage.” the timeless consumer can transcend some limits of the standardized life course, yet also have a heightened awareness of biological aging. some patients praise plástica as a way to manage conflicts between maternal and sexual roles; yet these conflicts also contribute to the pursuit of health practices which have health risks.  the goal of successful aging is thus often shadowed by the prospect of a failed rejuvenation. self-tinkering reinforced by medical authority has the potential to make patients even more conscious of aging as biological and aesthetic decline. it’s true that some patients experience therapeutic effects from both cosmetic and reconstructive surgery. medical treatments (e.g. cancer surgeries, gynecological surgeries, psychotropic drugs) often cause sexual and aesthetic damage, thus it is arguably more legitimate to correct such damage. however, the medical and psychological management of aging comes with considerable risks. perhaps the greatest is that plástica often becomes “surgery-for-life”: a therapeutic process that is entangled with life course events and necessary for healthy aging, healthy reproduction, and healthy sex. acknowledgements research was supported with grants from the social research council, princeton university, and a woodrow wilson postdoctoral fellowship. notes 1. one major plastic surgery center is located in santa casa de misericordia hospital, which is run with a mix of charity funds and state subsidies. unlike fully public hospitals where all medical services are free, it offers free reconstructive surgery, but charges a small fee to cosmetic surgery patients to cover costs of medical materials and anesthesia (surgeons receive no payment). both santa casa and public hospitals attend mostly working class patients. 2. price competition between surgeons in a crowded market – combined with an international reputation for quality – also attracts medical tourists (edmonds 2011). 3. a meta-study concludes that there is no evidence that anthropology & aging quarterly 2014: 34 (4) 258 alexander edmonds surgery for life -2009 learning to love yourself: esthetics, health and therapeutics in brazilian plastic surgery. ethnos 74(4):465489. featherstone, mike and m hepworth 1991 the mask of aging and the postmodern life course. in the body, social process and cultural theory m. featherstone, m. hepworth and b.s. turner, eds. pp. 371-389. london: sage. freud, sigmund 2003 the uncanny. london: penguin classics. fry, peter 2002 “estética e política: relações entre ‘raça,’ publicidade e produção da beleza no brasil.” in nu & vestido: dez antropólogos revelam a cultura do corpo carioca, edited by mirian goldenberg. rio de janeiro: editora record. garcia, julio 2007 hormone administration in an aesthetic surgery practice: one surgeon’s experience. aesthetic surgery journal 27:212214. goldenberg, mirian 2002 “laços de família”: novas conjugalidades na novela das oito. web manuscript, accessed june 24, 2013. http:// miriangoldenberg.com.br/images/stories/pdf/lacosdefamilia.pdf goldstein, donna 2003 laughter out of place: race, class, violence, and sexuality in a rio shantytown. berkeley: university of california press. haiken, elizabeth 1997 venus envy: a history of cosmetic surgery. baltimore: johns hopkins university press. held, thomas 1986 instituionalization and deinstitutionalization of the life course. human development 29(3):157-162. herbenick, debra and michael reece 2010 development and validation of the female genital selfimage scale. the journal of sexual medicine. volume 7, issue 5, pages 1822–1830. katz, stanley and barbara marshall 2003 new sex for old: lifestyle, consumerism, and the ethics of aging well. journal of aging studies 17(1): 3–16. kohli, martin 2007 the institutionalization of the life course: looking back to look ahead. research in human development 4(3-4): 253271. béhague, d. et al. 2002 consumer demand for caesarean sections in brazil: informed decision making, patient choice, or social inequality? bmj 324 (7343):942-5. belizán, j. m., and g. carroli 1998 routine episiotomy should be abandoned. bmj 317 (7169):1389. brückner, hannay and karl ulrich mayer 2005 de-standardization of the life course: what might it mean? and if it means anything, whether it actually took place? in the structure of the life course: standardized? individualized? differentiated? advances in life course research, volume 9. pp. 27-53. amsterdam: elsevier. carranza, maria 1994 saúde reprodutiva da mulher brasileira. in mulher brasileira é assim, m. muñoz-vargas and s. heleieth, eds. rio de janeiro: rosa dos tempos. cirurgia íntima feminina 2006 webpages, www.vitalita.med.br, visited january 20, 2006. cruikshank, barbara 1996 “revolutions from within: self-government and selfesteem.” in foucault and political reason, eds. andrew barry, thomas osborne, and nikolas rose. london: university college london press debert, guita grin 2011 the dissolution of adult life and youth as a value. horiz. antropol. [online]. 2010, vol.5, no.se porto alegre. diniz, simone and alessandra chacham 2004 “the cut above” and “the cut below”: the abuse of caesareans and episiotomy in são paulo, brazil. reproductive health matters 12(23):100-110. duarte, luiz fernando 1986 da vida nervosa (nas classes trabalhadoras urbanas). rio de janeiro: jorge zahar editor/cnpq. edmonds, alexander. -2013a can medicine be aesthetic? disentangling beauty and health in elective surgeries. medical anthropology quarterly 27(2) (accepted). -2013b the biological subject of aesthetic medicine. feminist theory 14(1): 65-82. -2011 ‘almost invisible scars’: medical tourism to brazil. signs 36 (2):297-302. -2010 pretty modern: beauty, sex and plastic surgery in brazil. durham: duke university press. http://miriangoldenberg.com.br/images/stories/pdf/lacosdefamilia.pdf http://miriangoldenberg.com.br/images/stories/pdf/lacosdefamilia.pdf www.vitalita.med.br anthropology & aging quarterly 2014: 34 (4) 259 alexander edmonds surgery for life sbme 2011 sociedade brasileira de medicina estética. webpages visited may 20, 2011. www.sbme.org.br/portal ward, steven 1996 filling the world with self-esteem: a social history of truth-making. canadian journal of sociology 21(1). yalom, marilyn 1997 a history of the breast. new york: ballantine book kohli, martin and meyer, j. w. 1986 social structure and social construction of life stages. human development 29:145-149. leibing, annette 2005 the old lady from ipanema: changing notions of old age in brazil. journal of aging studies 19: 15–31. macmillan, ross 2005 the structure of the life course: standardized? individualized? differentiated? advances in life course research, volume 9. amsterdam: elsevier. marshall, barbara 2009 rejuvenation’s return: anti-aging and remasculinization in biomedical discourse on the ‘aging male.’ medicine studies 1(3): 249-265. mccallum, cecilia 2005 explaining caesarean section in salvador da bahia, brazil. sociology of health & illness. 27(2):215-242. moody, harry 1993 overview: what is critical gerontology and why is it important? in voices and visions of aging: toward a critical gerontology. r. cole et al., eds. pp. xv-xvi. new york: springer. rebelo, fernanda, et al. 2010 high cesarean prevalence in a national population-based study in brazil: the role of private practice. acta obstetricia et gynecologica scandinavica 2010, 89(7):903-908. rabinow, paul and rose nikolas 2006 biopower today. biosocieties 1:195–217. rose, nikolas 2007 the politics of life itself. princeton: princeton university press. 1996 inventing our selves, cambridge university press. sanabria, emilia 2010 from subto super-citizenship: sex hormones and the body politic in brazil. ethnos 75(4): 377-401. sanabria, emilia 2011 the body inside out. social analysis: the international journal of social and cultural practice 55(1): 94-112. sanabria, emilia 2012 le genre de la substance: pratiques hormonales et reconfigurations pharmaceutiques des identités sexuelles au brésil. clio histoire, femmes et societies 37. book review review of kavedžija, iza. making meaningful lives: tales from an aging japan. philadelphia: university of pennsylvania press. 2019. pp 208. price: $45 (hardcover); $24.50 (paperback and ebook). theresa southam teaching and learning centre, selkirk college tsoutham@email.fielding.edu anthropology & aging, vol 43, no 2 (2022), pp. 116-118 issn 2374-2267 (online) doi 10.5195/aa.2022.434 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | southam | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.434 http://anthro-age.pitt.edu 116 book review review of kavedžija, iza. making meaningful lives: tales from an aging japan. philadelphia: university of pennsylvania press. 2019. pp 208. price: $45 (hardcover); $24.50 (paperback and ebook). theresa southam teaching and learning centre, selkirk college tsoutham@email.fielding.edu “must an anthropology of the elderly be about aging?” with this provocation, anthropologist iza kavedžija opens making meaningful lives, a book in which she pursues prevailing issues in contemporary ‘aging’ japan based on fieldwork in community salons for older adults. her focus is on how ‘care’ is here maintained during a rapid demographic change and more specifically to “the moments when—against the odds or despite the challenges that face them—people manage to hold things in balance, and care works” (172). making meaningful lives explores moral compasses over a large spectrum, from individuals at her ethnographic field sites—community salons—to civil society in japan. the salons kavedžija attends as her field sites are rooms, in storefront locations with tables and chairs, where older adults can pass the time and have a cup of tea. she pays particular attention to how the changing roles of the government, particularly in programs like these salons as well as home support for older adults, ripple down as everyday care. in making meaningful lives, care relates to an attitude expressed in japanese as ikigai. kavedžija says of ikigai, what and who one cares for is “closely related to purpose in life [and] sometimes considered the basis of ikigai”(3). the kind of care kavedžija documents resonates with what is articulated in an ethic of care: a moral theory developed in the mid-eighties (gilligan 1993; noddings 1988). an ethic of care places emphasis on relationships, social networks, and other human interdependencies. kavedžija’s research participants struggle to maintain the wellness of both care-receivers and caregivers. for example, newer generations in japan can interpret ikigai as personal happiness, having perhaps seen their parents weight familial or work responsibilities at the expense of their own happiness. this sole focus on personal happiness might result in a loss of purpose in life, an outcome that is captured in the last of the five phases of the ethic of care as developed by joan tronto (2013). the first four may seem familiar: caring for, caring about, caregiving, and care receiving. however, the last, caring with, emphasizes the reciprocal nature of caring, where the carer must also receive some benefit. the ethnography making meaningful lives examines how traditional interpretations of ikigai which include a “sense of contribution to the larger social whole”(2) can be maintained by not only caring for others but receiving, in turn, a life with purpose. the chapters of making meaningful lives analyze interviews with the salon’s members and organizers in relation to seven main themes: aging communities, mutual help, living well together, life stories, intimacy and interdependence, life as a path, and the good life. the first two chapters introduce readers to the field sites kavedžija attended to in 2009—shimoichi in old downtown osaka and awara in fukui http://anthro-age.pitt.edu/ book review | southam | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.434 http://anthro-age.pitt.edu 117 prefecture, japan—and to some key concepts in japanese cultures such as ikigai—the social value of a person’s life—and living “a good life,” a theme that emerged from her research. in chapter 1, “subjects of care,” we learn that in the salons, care is done “through giving gifts, offering measured statements that are polite yet friendly, dropping in on each other, giving information and recommendations, taking up volunteering, and helping out”(7). these acts of caring, kavedžija finds, are “intimately related to the idea of purpose in life, as these entwinements with others so often lie at the very heart of one’s sense of a meaningful existence” (8). throughout the book, photos of the communities in which the salons are situated give a sense of the differences in the degree of urbanity that surround the two salons. in chapter 2, “aging communities,” the author argues that salons create communities of care in a civil society that is struggling with demographic change. kavedžija outlines how the government of japan socialized care of older adults in response to the “perceived weakening and the limited capacities of families to care for the elderly” (26). the government introduced long-term care insurance (ltci) in april 2000. ltci is government funding for people over the age of 65 who need support to avoid full institutionalization or total reliance on family. the government funding is dispensed through both public and private providers. the salons are part of the distribution of this insurance as their staff organizes and pays home care providers. chapter 3, “mutual help,” explains how kavedžija’s field sites benefited from the ltci while maintaining volunteer programs. in doing so the organizations weighed the benefits of volunteering where rich social relations can be developed against the potentially excessive demands that result from thick social networks. both volunteers and users are charged a membership fee with the assumption that someone who at first gives volunteer support might in turn become a recipient. for example, a young mother might help an older adult and later receive some babysitting support. this mutual aid is organized with a voucher system. kavedžija argues that such a formalized exchange of services could help to restore the balance between social interdependence and autonomy. this seems unlike community care that is less organized. still, in larger urban centres, more formalized solutions to care, like those kavedžija describes in japan, may indeed be a solution to the systematic unravelling of social networks that can be a casualty of neoliberal agendas. in chapter 4, “living well together,” the balance between autonomy and dependence is further explored through the “personal but not intimate” (65) relationships that kavedžija witnesses. there is an interesting discussion about how much tatemae persona—external and rule-bound—and how much honne persona—expression of one’s true self—occurs in the salons as well as how both personae can be cultivated throughout the lifecourse. kavedžija explains that even when salon goers seem “all right” they might have difficulties of which their fellow salon goers are unaware. outbursts from salon goers, although rare, are interpreted as possible expressions of one’s honne persona. another communication form discussed is ‘talking practice,’ an integral part of coming together for tea in the salon. in the salons, dialogue on topics such as food, local geographies, politics, self-development, appearance, aging and health, death, family, and leisure can be okeiko. okeiko indicates a kind of self-development that happens if the salon goers are self-reflective and making meaning of their lives through these exchanges. in chapter 5, “a life in a story,” model stories endemic to japan, such as the ‘salary man’ and the ‘housewife’ are set against the life stories of some of kavedžija’s research participants. like arthur w. frank (2010), kavedžija believes that our expectations are moderated by our life stories which “can only exist in relation to the others available in one’s culture or which circulate in society” (85). the meaning of our lives, kavedžija posits, depends heavily on whether we adopt or resist model stories. among her participants are older adults who followed and those who resisted model life stories. both can be impactful in harmful and beneficial ways. the research participant kawasaki-san resisted the model story of staying with one’s career throughout the lifespan by leaving teaching. kavedžija narrates: http://anthro-age.pitt.edu/ book review | southam | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.434 http://anthro-age.pitt.edu 118 kawasaki-san felt that his work in school was utterly ordinary and unchallenging, and he felt he couldn’t bear to think that he would spend the rest of his time in such a way. he is a human being who needs stimuli: “that is my ikigai.” it seems that kawasaki-san sees himself as a person who likes a challenge and dislikes routine, who replaced the security of this mild employment with the challenging and often dangerous environment of his insurance company work. (97) chapter 6, “intimacy and independence,” adds further evidence to recent findings about the importance of intragenerational communication. whereas in the past most of the emphasis has been placed on the importance of intergenerational relations for older adults, she finds that her participants are building up networks within their friend groups, especially where family ties have weakened, and that these relationships can be as beneficial as those with family. a salon goer who did not appear as expected one day was sought out by other salon goers before her family thought to investigate. her fellow salon goers found she was ill and helped with groceries and friendship. in the seventh and final chapter kavedžija summarizes her findings. she reflects on whether her participants are rational actors in their selfdevelopment or if the choices that lead to the ‘good life’ are more a case of judicial opportunism. in the end, kavedžija responds to her own opening provocation: making meaningful lives is not necessarily about aging, but about living well throughout the lifespan. in this book we learn about lives finding meaning and lives losing meaning. it is an intermixing of rich life stories, observations of the salons, and artful critiques of life story approaches and narrative identity. the participants’ voices are directly quoted and remade as narratives by the author. making meaningful lives will cause readers to reflect on how a society and country might respond to demographic changes with care. similar increases in the percentage of the aging population are occurring worldwide and culturally specific caring responses are needed urgently. there are a few stunning gems in the text like “gratitude is not irrelevant” (159) which powerfully link to everyday care practices. kavedžija herself says that “care in its multiple incarnations within efforts to live well offers a different perspective, one deeply embedded in everyday life” (172). although participant voices are japanese, an international public will benefit from the universality of the findings of the book such as the importance of mutual aid and care. if anything, the importance of these topics has been heightened during the pandemic. references frank, arthur w. 2010. letting stories breathe: a socio-narratology: university of chicago press. gilligan, carol. 1993. in a different voice: psychological theory and women’s development. cambridge, ma: harvard university press. noddings, nel. 1988. "an ethic of caring and its implications for instructional arrangements." american journal of education 96(2): 215-230. doi: 10.1086/443894. tronto, joan c. 2013. caring democracy: markets, equality, and justice. new york: nyu press. http://anthro-age.pitt.edu/ fiestas, saints and spirituality: collective rituals as community eldercare in andalusia chloë place c.a.s.place@sussex.ac.uk university of sussex abstract in this paper, i explore how spirituality and collective rituals influence eldercare in a small town in andalusia, spain. i describe how older people’s interactions with the town’s virgin mary statues generate personhood, situating the virgin saints as spiritually protective kinship care-givers. as ubiquitous religious symbols, the saints can be recognised by some people with dementia, providing reassuring familiarity. older people nearing end-of-life seem to draw comfort from these saints, who become mediators between everyday and spiritual worlds. during fiestas, the statues are carried as part of celebratory processions, stimulating intergenerational solidarity and spiritual protection, and strengthening residents’ sense of belonging, which can be especially valuable to older people at risk of isolation. in care institutions, activities encourage older people to participate in fiestas, reaffirming their community membership. for people with dementia, the multisensorial nature of fiestas can be therapeutic by inciting embodied long-term memories, whilst their seasonality can be reorientating. this paper brings insights from the anthropology of religion into dialogue with the anthropology of ageing by arguing that religious rituals have the capacity to generate a spiritually and collectively therapeutic role in eldercare; this then reveals the need to approach eldercare as ‘communitycentred.’ it further demonstrates the capability of ethnography to reveal the diverse ways that collective cultural practices can influence eldercare. keywords: eldercare; dementia; collective ritual; spirituality; community-centred care anthropology & aging, vol 43, no 2 (2022), pp. 1-23 issn 2374-2267(online) doi 10.5195/aa.2022.384 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:c.a.s.place@sussex.ac.uk margaret clark award (2021) winner | place | 1 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu fiestas, saints and spirituality: collective rituals as community eldercare in andalusia chloë place c.a.s.place@sussex.ac.uk university of sussex introduction spain boasts one of the highest life expectancies in europe but also rising dementia rates (oecd 2021). european countries are increasingly turning to long-term care institutions to look after people with dementia (verbeek et al. 2015). despite this trend, the majority of people with dementia diagnoses in spain live at home with family (ruiz-adame and jiménez 2017). eldercare in spain, even of those with neurodegenerative diseases like dementia, has traditionally been considered a family responsibility, reflecting mediterranean kinship values and, until recently, there has been a reluctance to use formal care services (lillo-crespo and riquelme 2018). andalusia, an autonomous community with a history of socioeconomic marginalisation from spain’s central state (cazorla sánchez 2010; pratt 2003), is well-known for its strong family values and closeknit kinship networks, which provide core care provision to dependent older adults (ruiz-adame and jiménez 2017; tobío and cordón 2013). i thus approached andalusia as a critical site to explore global debates around elderand dementia care experience. straddled across the craggy slopes of a mountain range in andalusia lies pueblo, the small town where i spent 14 months conducting ethnographic fieldwork for my ph.d. research during 2018-2019. i use pueblo, translating into english as “town/village,” as a pseudonym to protect residents’ anonymity. during fieldwork, i regularly participated as a volunteer at pueblo’s day centre and care home, and assisted local families caring for older relatives at home to gather rich ethnographic data around eldercare. i use the word abuelos, translating into english as “grandparents,” to signify older people, as this was the local term used to refer to older people. pueblo’s inhabitants were split into an upper neighbourhood, protruding across the top of a sharp mountain slope, and the lower, more affluent neighbourhood, which held the town’s main commercial centre, and was nestled at the bottom of the gradient. each neighbourhood had its own chapel, in which resided a distinctive statue representation of a virgin mary saint. the lower neighbourhood had la virgen del pilar (the virgin of the pilar), and the upper neighbourhood housed la virgen de la humildad (the virgin of humility).1 early on in fieldwork, i noticed the frequency with which abuelos, at both care institutions, would discuss the statues in everyday conversation. one adjustment i struggled with initially was talking earnestly with abuelos about these statues. although i now describe myself as agnostic, my awkwardness in these conversations may have stemmed from my fervently atheist upbringing. i found it difficult talking with abuelos about these statues, which they seemed to hold in such profound reverence. what surprised me was how abuelos spoke about the statues as real people. one conversation at pueblo’s care home went as follows: http://anthro-age.pitt.edu/ mailto:c.a.s.place@sussex.ac.uk margaret clark award (2021) winner | place | 2 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu “chloe! did you see the procession last night?” isabel asked me excitedly. “yes, i watched the whole thing. i was…impressed!” i replied, unsure of how to better describe my feelings about it. “wasn’t the virgin so beautiful?” “oh, she was incredible!” esperanza chimed in. “absolutely stunning! i couldn’t take my eyes off her.” “yes, she moved with such grace! so elegant!” carmen added, nodding enthusiastically. abuelos used the pronouns ‘she’ and ‘her’ to describe the statues. as time passed, and i observed the multitude of ways people spoke about and interacted with these statues, i realised that, to many people, particularly older generations, these were more than statues. through devotional interactions – like speaking with, touching and kissing the statues – the statues generated interdependent personhood. the personhood of catholic statues has been explored by anthropologists investigating religion (see mitchell 2010; whitehead 2018). in this paper, i bring this work into an anthropology of ageing by analysing how the statues’ personhood provided abuelos with spiritual protection. these deeply venerated local virgin mary saint statues are celebrated with annual fiestas (celebrations). during fiestas, people assemble at the particular statues’ resident chapel, recite prayers and sing devotional songs. pueblo is decorated with colourful bunting and banners praising the distinctive virgin saint being celebrated. celebrations include huge processions where the statues are placed on ornamental floats and paraded through the streets to the cheers of “¡viva la virgen!” (“long live the virgin!”), “¡guapa!” (“pretty!”), and jubilant music from the town band (see photograph 1). residents attend a feria (fair) from midday until the early hours of morning, with funfair rides for children and booths containing stages equipped with dancefloors, where flamenco performances take place (see photograph 2). this ethnography explores the dynamic ways that spirituality and collective celebration can serve as meaningful forms of community eldercare. i begin by discussing how personhood is generated in pueblo’s virgin mary statues through people’s interactions, bringing the statues to life. many abuelos drew profound comfort from their devotional interactions, which seemed to create reciprocal relationships with the saints, making them become spiritual protectors who mediate between everyday and spiritual worlds. next, i explore how these saints are celebrated through annual fiestas. i employ anthropologist cheryl mattingly’s (2010, 2014) conceptualisation of ‘moral laboratories’ of care, explaining how care-givers navigate complex ethical choices to generate hope, combined with mette nordahl svendsen et al.’s (2018) concept of ‘magical moments,’ whereby people with dementia connect with their surroundings. these theorisations help me analyse how care-givers in pueblo deliberately incorporated fiesta rituals into eldercare to reap therapeutic benefits. i then use the durkheimian [1912] (2007) concept of ‘collective effervescence’ to explore how pueblo’s fiestas strengthened abuelos’ sense of belonging to the town. the seasonal, repetitive nature of fiestas orientated abuelos with dementia to the present, whilst linking them to their community’s shared past. my analysis brings insights previously explored by anthropologists investigating religion into dialogue http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 3 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu with anthropologists investigating ageing by arguing that community religious rituals have the capacity to generate a spiritually and collectively therapeutic role in eldercare. this demonstrates the importance of approaching elder and dementia care as not only ‘person-centred’ but also as ‘community-centred.’ photograph 1: residents carry a virgin mary statue in a fiesta procession (n.b. faces blurred to protect anonymity). photograph taken by author. may, 2019. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 4 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu photograph 2: residents celebrate at the feria during fiestas. photograph taken by author. august, 2019. the personhood of statues as fieldwork progressed, i began to learn how pueblo’s residents, particularly older generations, attached profound meaning to the virgin statues. to many, they were more than statues; they were real embodiments of the virgin saints. through engaging in devotional interactions with the statues—i.e., by speaking with them, saying prayers to them, touching and kissing them—the statues were attributed with personhood. i gradually became more confident talking about the statues, referring to them using feminine pronouns, and even interacting with them directly. in the weeks leading to the fiesta for la virgen de la humildad, excitement filled the air in pueblo, particularly in the upper neighbourhood where i lived, which held the resident chapel of this statue. colourful bunting and banners were strung up and fluttered across the streets, proclaiming “¡viva la virgen de la humildad!” (“long live the virgin of humility!”). on the first day of the fiesta, a ceremony was held in the chapel. people had been talking to me enthusiastically about this upcoming event. i had been instructed to wear my best, and i spent significant time getting ready to meet this important member of pueblo’s community. the town band were playing in front of the chapel, and there was a lively atmosphere as people queued outside. i ran into mercedes, an 84-year-old woman who attended the day centre: “have you got in mind something you’d like to ask her?” mercedes enquired. “urrm… no, not really. i don’t really know what to tell her,” i muttered sheepishly. “you can say anything you like! she’s very understanding. tell her what you’re worried about, and she’ll help you…don’t worry!” mercedes reassured me, seeing the bemused expression on my face. “she’s kind! there’s no need to feel nervous!...it’s a real honour to be so close to her. this is the only time of the year we can do this.” http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 5 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu inside the chapel, as i drew closer to the front of the queue, i looked up at the statue. i was surprised by her smallness. people stood several metres back, giving the person at the front a more private, intimate moment with the virgin. when it was their turn to approach her, people would bow, sign the cross, and speak to the virgin in quiet whispers. after a few minutes of intimate exchanges, they would go right up to the statue and kiss her hand, then wipe it with a tissue. to my dismay, i realised i did not have a tissue on me! i frantically asked the people in front of me, but i was unable to get hold of one before my turn. when my moment came, i asked the virgin (in spanish) to look out for me during fieldwork, kissed her hand and apologised for not having a tissue, then awkwardly used my cardigan sleeve to wipe her hand clean. i walked away, feeling silly but also relieved and optimistic. the personhood of these saints seemed to be generated through people’s social, embodied interactions with the statues that represented them. through devotional interactions, the statues came to exist as real embodiments of the saints. previous anthropological work has found personhood to be co-created through devotees’ interactions with catholic statues. jon mitchell observed during his ethnographic work in malta how people’s interactions towards catholic statues meant they were perceived as “persons rather than things” (mitchell 2015, 25). in amy whitehead’s (2013) ethnography of practices towards a virgin mary shrine in andalusia, devotees referred to the shrine’s statue using feminine pronouns, and these interactions seemed to generate relational personhood. similarly, pueblo’s virgin mary statues thus came into being. even my interactions as an agnostic outsider led me to treat the statues as more than just statues. for many of pueblo’s residents, the saints were important parts of their lives; living beings with whom they shared meaningful relationships. virgin saints as kinship care-givers not only did interactions with the statues generate personhood, but the interdependent relationships people also maintained with the virgin saints seemed to fulfill a caring, kinship role. abuelos’ bedrooms in pueblo’s care home were covered in objects celebrating the saints: magazine cuttings; handmade decorations; ornaments and trinkets (see photographs 3-5). this contradicts assumptions of care homes as impersonal, showing how abuelos personalised and spiritualised such environments. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 6 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu residents regularly spoke to these objects to communicate with the saints. isabel, an 87-year-old resident, explained her night-time ritual with her miniature replica of pueblo’s la virgin del pilar statue: i’m lucky. i’m never lonely because i have my pilar here beside me [gestures towards statue on bedside table]. i tell her everything. i tell her about my day, and she always photograph 3: a care home bedroom decorated with photos of the virgin mary. photograph taken by author. september, 2019. photograph 4: a homemade decoration of the virgin mary on the wall in a care home bedroom. photograph taken by author. september, 2019. photograph 5: stickers of virgin mary statues on the wall of a care home bedroom. photograph taken by author. september, 2019. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 7 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu listens to me. before i sleep, i kiss her and wish her goodnight. then she watches over me as i sleep…i was having lots of problems sleeping, especially when i first moved here, i couldn’t get used to the change. and because of antonia [her ex-roommate who has advanced dementia]. she was not well in the head. she was always getting up in the night and shouting, and sometimes she would even shake me awake. it was terrible. but i spoke to my pilar about it, and she handled it. eventually antonia was moved to another room. i’m so thankful for that because, since she’s gone, i’ve been sleeping much better…if i ever wake in the night, i look over at [pilar] and seeing her there helps me get back to sleep. in this example, isabel understood the transfer of her roommate to another bedroom as the virgin’s doing; she had shared a problem with the virgin, who had resolved it. tanya luhrmann’s (2012) ethnography, exploring evangelical christian worship in the us, highlighted how, through prayer, worshippers shared the personal minutiae of their daily lives to develop intimate, personal relationships with god. this resonates with isabel’s experience of praying to the virgin, as through the sharing of her everyday thoughts, worries and wishes, she generated an intimate, interdependent, reciprocal relationship with the saint. the virgin mary, as mother of god, is considered the quintessential mother of catholic theology. linda hall’s (2004) book, investigating virgin mary devotion in spain and the americas throughout history, described how the virgin is regarded as a feminine vision of peace and unconditional love. people in pueblo seemed to identify with this maternal, perpetually caring attribute. moreover, whitehead’s work, exploring devotional practices towards an andalusian virgin mary shrine, explained the shrine as adopting a ‘kinship role’ by protecting devotees (whitehead 2018, 225). in pueblo, the warmth and care that the virgin offered seemed to provide maternal protection. for abuelos, the kinship they experienced with the saints appeared especially meaningful because, as elder family members, they had lost parental kin. a maternal relationship, achieved through interactions with representations of the virgins, proved especially comforting as it seemed to restore kinships lost in life. isabel recalled how her devotion to the virgin had helped her manage grieving for her mother. she described how she now considers that she has “two mothers watching over me”, referring to her biological mother who had passed away, and the virgin saint. the saints thus provide not only interdependent care, whereby devotional interactions are reciprocally repaid through comfort and protection, but also a maternal relationship. the virgins’ capacity to nurture appeared especially important for people with dementia. for those in earlier stages who were aware of diagnosis, this protection could be a source of profound comfort. this was seen in my conversation with 82-year-old mari carmen, who had been diagnosed with alzheimer’s disease a year earlier: i know my memory is bad, and i know it will only get worse as time goes on. but i try not to worry. i try not to worry because i know even if i cannot remember, pilar [the virgin saint] is watching over me, and if i do not remember, she will remember for me. mari carmen trusted that if her cognitive capabilities failed, they would be filled in by the virgin. her words suggest that she understands her memories, which form part of her personhood, as interdependent with the virgin. by compensating for the memory deficiency that could make mari carmen vulnerable, the virgin looked after her the way a mother cares for a child. social interactions of devotion towards the saints can thus become a profound source of interdependent kin-like spiritual care. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 8 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu as representations of deeply ubiquitous religious symbols, the virgin statues were still recognised by some abuelos with advanced dementia who were experiencing greater memory loss. for example, 89year-old rosita, who regularly attended the day centre, had been diagnosed with vascular dementia 15 years earlier. by the time i met rosita, she was displaying advanced dementia symptoms: she was wandering, appeared disorientated, could not recognise people she knew and seemed to hallucinate. when i tried engaging rosita in conversation, she would sometimes respond by smiling or talking. although what she said often seemed incoherent, there were moments of lucidity. rosita also had an increasing tendency to get agitated, and she would sometimes shout or even hit others. one technique staff discovered was walking her to a large, framed photo of la virgen del pilar statue that hung on the lounge wall. staff would gesture to rosita to look at the image. rosita would look up at the virgin and, on processing the image, she would often snap out of her agitation, sign the cross with her hand and mutter a prayer. sometimes this technique worked brilliantly; other times it did not, and rosita continued to exhibit aggression. one staff member, who described herself as nonreligious, suggested it was because the virgin mary was such a recognisable image that it was relatable even to people with advanced dementia who might struggle to recognise other things. virgin-saint representations also aided abuelos with dementia through the repetitive, multisensorial nature of devotional rituals. ana was care-giver to her mother, 92-year-old paquita, who was bedbound with advanced vascular dementia. ana described generating hope from moments when her mother became more lucid. she explained how, during the fiesta’s opening ceremony, she would put the local radio station on in the bedroom paquita occupied, and they would listen to devotional songs made to la virgen de la humildad. as i mentioned earlier, this virgin statue resides in the upper neighbourhood, where paquita had lived her entire life. ana described how, during the ceremony’s broadcast, paquita would sit up and her features became more alert. she would smile and move her lips to these songs she had memorised since childhood. ana understood this as her mother connecting with the saint to whom she had been devoted throughout her lifetime. ana deliberately decorated paquita’s bedroom with photos of the virgin to help her maintain this connection. such practices were ana’s attempts to manufacture the conditions that triggered seemingly more lucid, connected moments in her mother. through their ethnography of a danish dementia-care unit, svendsen et al. described how carers deliberately attempted to stimulate moments when “the person with dementia responded, albeit slightly, with a nod, a movement, or a verbal sound, expressing some kind of comfort or fulfilment in life,” describing these as “magical moments” (svendsen et al. 2018, 28). i use this theorisation in combination with mattingly’s (2010, 2014) concept of ‘moral laboratories’ of care. mattingly’s research with families of children with serious chronic medical conditions explored how, when making complex decisions regarding care, care-givers become experimenters in creating conditions that generate hope. similarly, i argue that care-givers to people with dementia strive to create ‘moral laboratories’ of care that result in those for whom they care experiencing ‘magical moments.’ in ana’s case, she experimented using multisensory sources—religious images, prayers, and hymns—to create the necessary experimental conditions for paquita to experience a ‘magical moment’ whereby she spiritually connected with the saint. the repetitive, structured nature of rituals, such as prayer, also appeared to ground people with dementia into the present. many abuelos in pueblo said prayers, explaining these as an important part of their devotion. they said prayers to themselves or to religious trinkets, images, or icons before going to sleep or when in moments of distress. mari carmen, who was in the early stages of alzheimer’s disease, recalled how worried she had been when she first started experiencing memory loss. she described http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 9 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu finding comfort in saying a prayer to la virgen del pilar each night. performing this nightly prayer seemed to provide consistency, rhythm and routine that calmed her. ritualised devotional practices towards the virgin saints could be especially comforting for people approaching end-of-life. although people of varying ages engaged in devotional practices towards the saints, it was more pronounced in older generations. this may have been partly because this generation grew up during a time when religious worship was more active across spanish society. however, it could also be due to life stage, as these were people approaching death and perhaps seeking spiritual mentorship. mari carmen described her comfort that the saint was there at this point in her life, “before i go to sleep, i say a prayer to pilar [the virgin saint], i ask her that if tonight is the night that i am ready [for death]. but i ask that she guides me and be by my side through my journey.” in his ethnographic work in malta, mitchell (2010) explained how catholic saints are not entirely supernatural entities from mythology, as they can be verified as actual historical figures with lives that can be empirically confirmed. saints are thus part human, which may enhance the relatability of the saints’ statues to their worshippers. as hall analysed, the virgin mary is “not god but the mother of god. she is fully human” (hall 2004, 7), which may make her more relatable. this relatability may be further enhanced by the localised versions of the virgin statues that exist in pueblo, which seem to position these saints as ideal candidates to act as divine mediators, guiding people from life to death. fiestas as social solidarity the first annual procession with a virgin statue was met with a particular atmosphere of excitement and expectation as it occurred straight after the fiesta de las cruces (festival of the crosses), another of the many fiestas that decorated pueblo’s calendar, which involved people adorning large crucifixes with flowers. pueblo was thus already in the full-swing of fiesta by the time la virgen de la humildad left her chapel to parade the streets for the procession in her honour. below, i describe my experience witnessing the start of this procession: as i headed through the streets towards the chapel, i could hear the thumping of drums and hooting of the brass band drawing closer. children holding brightly coloured balloons ran past excitedly, heading towards the crowd. i joined the excited hubbub gathered in the plaza outside the chapel. men dressed in traditional-style suits with wide-brimmed hats stood alongside women in colourful polka-dot flamenco dresses, chatting excitedly, whilst chewing on sunflower seeds, scattering the ground with their discarded shells. the uniformed town band were playing outside the chapel and the atmosphere was jubilant. my neighbour, closer to the front of the crowd, caught my attention and waved me over. “you’re here just in time.” she pulled me into the crowd, smiling, “she’s about to come out!” minutes later, the chapel doors were flung open, and the procession streamed out. people dressed as priests—some carrying large crucifixes or candles, others waving pots on chains filled with strong-scented frankincense— marched alongside an array of costumed people: women in ornate dresses with veils, children dressed as shepherds with tea towels over their heads, all marching in line. moments later, the crowd let out a huge cheer and the unmistakable, towering figure of la virgen de la humildad emerged from the church doorway, wearing a huge golden ringed headpiece and a lavish, gold-embellished dress with a long trail flowing behind her. she stood on an ornately decorated float, supported over great wooden beams resting on the shoulders of men in white shirts, marching in unison. the band upped the volume and blasted out a celebratory tune, whilst members of the crowd shouted “¡viva la virgen de la humildad!” “¡guapa!” and “¡morenita!”2 to rapturous applause. spectators standing on balconies overlooking the plaza threw colourful http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 10 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu petals that spun and floated over the crowd. people were smiling, clapping, cheering, and shouting at the virgin statue, stretching out their arms to get closer to her. the excitement of the fiestas was not only spiritual, but a collective, social experience that seemed to produce community solidarity. many younger residents described themselves as nonreligious, with some even using the term ‘anti-religious’ because of catholicism’s role during franco’s dictatorship. at that time, andalusia had suffered oppressive laws and mass slaughter under franco’s regime. his dictatorship was supported by the catholic church and resulted in over one in ten andalusians being killed (pratt 2003, 48). younger generations frequently explained their turn away from catholicism as related to this dark period of national history. yet, even many of pueblo’s most fervently ‘anti-religious’ residents still described enjoying the fiestas as they understood them as a celebration of their community. émile durkheim famously investigated collective worship rituals and analysed these religious practices as capturing something beyond the individual, i.e., rituals can be collective, social processes through which people connect as a group. he emphasised how group religious rituals are fundamental in establishing ‘collective life’ (durkheim [1912] 2007, 276). with inspiration from durkheim, i argue that residents’ participation in pueblo’s fiestas linked them to the spiritual and everyday worlds of their social community. for abuelos needing care, this solidarity across generations seemed to offer profound comfort. durkheim described collective participation in religious ritual as generating “a sort of electricity,” which he called “collective effervescence” (durkheim [1912] 2007, 247). i extend this analysis into eldercare, arguing that this experience is particularly meaningful to older people who, due to physical and/or cognitive decline, may be experiencing social isolation. as i observed, through their participation in fiesta rituals, abuelos seemed to enter into a state of collective effervescence. as anthropologist janelle taylor warned in her reflections on caring for her mother with dementia, “it is only as members of communities that any of us can hope to transcend forgetfulness and death” (taylor 2008, 333). the collective act of engaging in the fiesta ritual thus seemed to become a therapeutic way for abuelos in pueblo, many of whom were at risk of social isolation, to connect with a social solidarity in their wider community. fiestas as ‘community-centred care’ a great deal of care research has emphasised the need to approach elderand dementia care as ‘personcentred.’ the social psychologist, tom kitwood, revolutionised approaches to dementia care with his (1997) work advocating for ‘person-centred care.’ this approach critiqued biomedical conceptualisations of dementia as dehumanising. rather, ‘person-centred care’ advocates for people’s unique sense of personhood, thus restoring the individual behind the diagnosis. kitwood’s work helped rehumanise dementia care, and person-centred care has been widely adopted into healthcare professionals’ practices worldwide. however, when viewed anthropologically, ‘person-centred care’ can become problematic as a contextual product that stipulates specific cultural meanings around a highly individualised understanding of personhood, particularly when emphasising the value of independence. anthropologist annette leibing (2017) critiqued how researchers investigating dementia care highlighted enduring personhood, reifying nostalgic imaginings of people pre-dementia. such emphasis on a static, individual self seems to parallel the ‘successful aging’ movement in the us and elsewhere, which has been critiqued by, among others, anthropologist sarah lamb (2014). as lamb described, individuals are expected to work hard to stay healthy by engaging in disciplined exercise, healthy eating and lifestyles, to maintain independence in older age and avoid dependence on others. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 11 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu further evidence of this approach can be found in ethnologist amy clotworthy’s (2020) work exploring health policies for older people in denmark. clotworthy describes how health policies frame older people as a high risk to the state due to their potential for declining health, and thus manages them as a burden. some politicians and health professionals attempt to counter-balance this by promoting an overtly positive narrative around healthy ageing to encourage older people to engage in self-help interventions to preserve their health. this paradigm pushes an unrealistic promotion of a highly individualised, static form of personhood that seeks an unattainable eternal independence in older age. this seems to deny the inevitability of ageing, decline and the need to depend on others for care. investigating the therapeutic effects of abuelos’ collective participation in religious rituals suggests that elderand dementia care need not only be approached through a ‘person-centred’ framework that assumes an individualised understanding of personhood that values independence. instead, personhood can be understood as relational, recognising that older dependent people, despite lacking independence, remain people who are deeply affected by their social relationships. such an approach reflects the theoretical work of political scientist joan tronto. in exploring what she called an “ethics of care,” tronto (1994) claims that, as human beings, we need to both give and receive care. she explains how “care helps us to rethink humans as interdependent beings” (tronto 1994, 21). in recognising this interdependency, and taking a more relational form of personhood, it becomes necessary to approach elder and dementia care as not only person-centred and attuned to individual differences, but also as deeply affected by collective social processes and interactions that occur within specific cultural contexts. this approach also builds on theoretical work investigating relational autonomy. in their work about medical ethics, carlos gómez-vírseda, yves de maeseneer and chris gastmans (2020) explored relational autonomy in end-of-life care. they advocated against paternalistic and deindividualising approaches to autonomy, and instead promoted recognition of the complex ways that human autonomy is shaped by social relations and the cultural contexts humans are embedded within. similarly, i propose a need to shift understandings of elder and dementia care from person-centred approaches towards understandings that recognise care as profoundly ‘community-centred.’ durkheim explained how a totem object “is the centre of all regards…the permanent element of social life” (durkheim [1912] 2007, 278-9). the virgin mary in pueblo appeared to become a totem-like mediator, generating social cohesion across generations, and between natural and supernatural worlds. anthropologist and historian william christian’s (1972) ethnography of a devout region of northern spain explored people’s experiences of religiosity and devotional practices. specifically, christian investigated the function of catholic shrines and saints, and explained the virgin mary as a ‘totem object’ who becomes a community’s link between real and spiritual, and to ancestors who celebrated her before and future generations who will celebrate her after. during fiestas in pueblo, the virgin mary statue is carried on an ornate float and marched through the town as part of a huge procession. her float is swung from side-to-side which makes her move and appear to come to life. spectators call, shout, and hold their arms out towards her. this celebration of people’s devotion stimulates collective effervescence, which generates shared protection and care across the community that is especially felt by abuelos; this suggests the value of ‘community-centred’ care. during processions, the virgin’s personhood comes into closer proximity to people’s everyday reality, enabling deeper emotional engagement with the virgin and an enhanced sense of her spiritual protection. the statue, resting on a float, in being swung by those who carry her, appears active and animated, which emphasises her vitality and personhood. as mitchell described of the maltese festa, the processions that animate the saint paul statue make him “an agent,” enabling people to experience http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 12 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu closer social engagement (mitchell 2004, 68). as i observed, pueblo’s residents positioned themselves close to the procession and held out their arms towards the statue to experience this proximity. the processions carrying the virgin mary statues also made special stops at pueblo’s day centre and care home. the saint’s physical proximity to the town’s care institutions gives abuelos an enhanced spiritual protection and again demonstrates how eldercare in this town is profoundly community-centred. the virgin mary statue, carried as part of these processions, is thus brought into an intimacy of moving within the everyday world of her people’s community. fiestas as a sense of belonging as i observed, feelings of solidarity experienced during fiestas seemed to link with a sense of belonging to pueblo’s community. pueblo is naturally distinguished by the mountain it occupies and its virgin statues are associated with its landscape, forming part of its municipal identity. in his ethnography, christian described how spanish saints occupying shrines can possess their own “territory of grace,” which was “an area over which its benevolent power seems especially manifest” (christian 1972, 44). ritual practices during pueblo’s fiestas appeared to link the saints to pueblo as their ‘territory of grace’. for example, in the chapels housing the statues are objects that connect to pueblo’s unique local identity. there are vases filled with dried branches from pueblo’s olive groves and, during the fiestas, small glasses of pueblo’s locally-produced alcoholic drink are placed by the statues. photographs used in pueblo’s annual calendar display its landscape alongside images of the virgin statues, suggesting the saints watch over pueblo as their ‘territory of grace’ (see photograph 6). for abuelos, i observed how they seem to feel local spiritual protection from the virgin saints more keenly and intimately when approaching the end of their lives. as i described earlier, bedroom walls in the care home are covered in images of these saints and pueblo’s landscape. the ‘territory of grace’ and spiritual protection offered by the saints, which is experienced through devotion towards the statues, appears to generate a sense of community belonging that could protect them from some of the health and social challenges they may face as they move into older age. photograph 6: poster of virgin mary statue in front of pueblo’s landscape, on the bedroom wall of a care home. photograph taken by author. september, 2019. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 13 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu for abuelos who attended pueblo’s day centre or lived in its care home, a sense of belonging was especially important as it could reduce the social displacement they may have felt through their new lives in the care institutions. medical anthropologist erica borgstrom (2017) examined social death, particularly in relation to illness and dying. social death, she explained, describes “the ways in which someone is treated as if they were dead or non-existent” (borgstrom 2017, 5). such treatment can have significant consequences for the care a person receives. taylor (2008), who cared for her mother with dementia, highlighted how once someone with dementia moves into a care institution, they often experience a social death whereby friends and even close relatives effectively abandon them. in contrast, the fiestas in pueblo seemed to reaffirm a social sense of belonging to the community despite this move into the care institution. care institutions harnessed the fiestas’ capacity to generate belonging by engaging abuelos in activities that were integral to the fiestas – this may have prevented feelings of social abandonment for which these elderly residents were at risk. in the weeks leading up to the fiesta de las cruces, abuelos attending the day centre made craft flowers to decorate a large crucifix that was displayed outside. whilst i was there, we painted pinecones collected from pueblo’s forests. in previous years, they used dried pasta, plastic spoons and egg boxes (see photographs 7-12). during the fiesta, a party was held at the day centre, and the decorated crucifix was displayed alongside other local markers of identity. for example, walls were decorated with specific trinkets and items, such as flamenco fans and instruments that were used to make the locally-produced alcoholic drink (see photograph 13). abuelos recounted with pride how they had previously won pueblo’s competition for the most beautifully decorated crucifix. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 14 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu photograph 7: craft flowers made from pasta. photograph taken by author. april, 2019. photograph 8: craft flowers made from plastic spoons. photograph taken by author. april, 2019. photograph 9: craft flowers made from egg boxes. photograph taken by author. april, 2019. photograph 10: craft flowers from pine cones laid out for painting at the day centre. photograph taken by author. february, 2019. photograph 11: craft flowers made from pine cones in 2019. photograph taken by author. april, 2019. photograph 12: staff member preparing day centre’s cross for fiesta de las cruces. photograph taken by author. april, 2019. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 15 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu during the fiesta of la virgen del pilar, the care home was invited to its own intimate visitation with the statue. staff accompanied residents to this visitation, where they could kiss the statue and speak with her directly. this enabled an intimacy with the saint that seemed to strengthen the protection abuelos felt from her, as well as their sense of belonging to the community. during these fiestas, a procession paraded down the street where the care home was located and paused in front to sing devotional songs. as i observed, residents who were mobile enough sat outside the building awaiting the procession’s arrival, whilst others clustered around windows to watch. the street in front of the day centre was too narrow for the procession to enter, so it paused at the top of the street; the float carrying the statue was turned to look towards the day centre and give her blessing. mitchell (2010) noted how, as statues are paraded around the streets during the maltese processions, the power of saints seemed to flow directly from the statues, spreading powerful spiritual protection throughout the community. as i observed, the stops the procession made to acknowledge the care home and day centre highlight how the saint’s healing powers are considered particularly important to the lives of abuelos. through their integral participation in pueblo’s fiestas, abuelos who may experience displacement from their new lives in care institutions are thus reaffirmed as important community-members. thus, their sense of belonging may be reinforced through these collective rituals. a sense of belonging is not localised to just pueblo but also further to the town’s neighbourhoods. la virgen de la humildad rests in the upper neighbourhood chapel, and la virgen del pilar in the lower neighbourhood chapel. as i observed, several houses in both neighbourhoods had icons of their distinct neighbourhood virgin saint set into their walls (see photograph 14). my neighbours in the upper neighbourhood emphasised that, although they celebrated la virgen del pilar because they were from the upper part of town, they were most devoted to la virgen de la humildad. “because she’s our neighbor,” my neighbour explained. “it is she who we know will watch over us up here.” as i mentioned, the upper neighbourhood was less affluent than the lower neighbourhood, and there was some animosity amongst my neighbours towards the lower neighbourhood. they recounted how the council had privileged the restoration of the lower neighbourhood’s plaza as it generated more money from tourism, and they felt that the upper neighbourhood was neglected. it appeared then that people photograph 13: the day centre’s decorated cross on display with local artifacts during fiesta de las cruces. photograph taken by author. may, 2019. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 16 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu felt a closer alliance, devotion, and sense of belonging to their neighbourhood statues because these objects were closely tied to their home and everyday life. photograph 14: icon of virgin saint set into a house in pueblo. photograph taken by author. may, 2019. one example of this sense of neighbourhood alliance was 86-year-old louisa, who had moved from her life-long home in the upper neighbourhood into pueblo’s care home in the lower neighbourhood. her bedroom walls in the care home were covered in photos of the upper neighbourhood’s la virgen de la humildad. she had cut-outs from local magazines and photos tucked behind the fall-alarm on the wall above her bed (see photograph 15). she showed me around her bedroom enthusiastically: “and here is la virgen de la humilidad from last year’s processions. beautiful!” she said, beaming, pointing out one of the magazine cut-outs stuck on the wall. “you see, i am from the upper neighbourhood,” she said to me, lowering her tone of voice, “and i know my dear virgin, my morenita, felt betrayed that i had come down here.” a look of remorse came over her, “but what could i do? i couldn’t keep living there. i couldn’t manage that big house alone anymore, and all that shopping up the hill from the supermarket. it was too much… but i felt terrible at first. of course, i love pilar [la virgen del pilar], but it’s not the same.” the guilt that louisa expressed about moving from the upper to the lower neighbourhood—and her displays of loyalty towards the upper neighbourhood’s virgin saint—suggest how the saints may contribute to feelings of localised neighbourhood identity and belonging. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 17 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu photograph 15: photos of virgin mary statue tucked behind a fall-alarm in louisa’s bedroom in the care home. photograph taken by author. september, 2019. older people living in the care home, many of whom had never previously left home or only done so after marriage, seemed to feel a strong identity with their neighbourhood. when a resident died, the upper or lower chapel’s bells would chime depending on which neighbourhood they were from, and many abuelos could distinguish between these chimes. during my fieldwork, a man who had been living in the care home passed away, and the chapel in the upper neighbourhood chimed for him. despite having spent his last years in the care home in the lower neighbourhood, his identity was inherently connected to the upper neighbourhood where he had lived most of his life. the virgin statues thus appeared to generate a sense of belonging to pueblo and the specific neighbourhood people were from. for many abuelos, the sense of closeness to community could have been restricted by their physical inability to access pueblo’s streets and public spaces. however, local media networks compensated for this. despite only having 10,000 inhabitants, like other andalusian towns, pueblo has its own radio and television networks, which show unedited live coverage of pueblo’s fiestas. when i visited abuelos at their homes, i noticed how commonly these local channels were played. i became friends with diego, the camera operator for the local tv station. chatting with him over a beer one night, he stressed the importance of the local channels to abuelos: “i remember one year i was in the upper plaza filming the feria and an abuelita [little old lady] came up and kissed me and said, ‘thank you so much for recording the feria, because i had a hip operation last year and i couldn’t leave my house, but seeing it all on tv made me feel like i was there.’ it made me so happy,” diego recounted, looking wistful. diego also explained how, as a media network for a small municipality, it is possible to adapt content and broadcast times to fit with viewers’ needs, most of whom are older people: we can be very flexible. say, if an abuelo rings me up to ask what time we’re showing a procession, i’ll say, ‘what time would you like us to show it?’ and she might say, ‘well, 3pm would be great’ so i’ll say, ‘no problem!’ and we’ll run it then. these older generations are our main audience. despite the town’s relatively small population, having its own media networks gives it scope for http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 18 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu flexibility, which facilitates greater accessibility. by broadcasting live coverage of the fiestas and being flexible to local people’s needs, abuelos who can no longer attend the fiestas in-person are able to tune in to the sense of belonging of their community. fiestas as inciting embodied memories investigating the role fiestas play for abuelos with dementia, i noticed how fiestas appeared to influence memories. the fiestas and all they include—the ceremonies, processions, lights, incense, decorations, singing, dancing, and costumes—seem to invoke a deeply multisensorial experience. michael bull and jon mitchell’s (2015) work investigated the potential of combining cognitive/neuroanthropology with performance studies and the anthropology of the senses in order to reach new understandings of religious transmission. rather than focusing on mental representations in religious transmission, they advocated for the need to investigate people’s embodied experience of ritual, approaching the body as “the sensing body” (bull and mitchell 2015, 4). this is helpful in analysing pueblo’s fiestas in relation to the bodily, sensorial experiences of those participating. as i observed, such ritual practices affected those abuelos who, due to cognitive impairment or dementia, were not able to communicate through conventional verbal modes. i found that the multisensorial experience of fiestas may generate longlasting, deeply imprinted memories, which could remain accessible to people with memory problems. the annual repetition of these fiestas since childhood also meant that people described certain sensorial triggers, such as the smell of frankincense (a strongly-scented incense that was burnt from ornamental holders during the processions) as triggering nostalgic memories of past fiestas. processions play on the multisensory body; the music, the strong smell of frankincense, and the striking image of the virgin statue make the procession a persuasive and sensorially stimulating event that may imprint long-lasting memories. i describe this in more detail through my observations of tano, a 91-year-old man with dementia who lived near me in pueblo: as i left my house and walked down the street this morning, i’d seen the usual sight of tano wandering up to his garage, situated at the end of our street. i’d seen him often marching up to his garage, opening the door, entering for a few moments, then leaving and locking the garage door behind him. he then tended to wander back down the street but stop and turn back halfway down. he would then return to the garage and check it was locked; sometimes, he would open it again and check inside, before closing and locking the door. he would start heading back down the street, then turn around and repeat the whole process. his wife would get frustrated with him when he said he was going to the garage. “you’ve already checked it twice this morning” she’d say, but she could not stop him heading out multiple times throughout the day, sometimes for hours at a time… it was tano’s repetitive ritualised behaviour that i witnessed again on the day of the procession. but this time, his behaviour was fitting to his surroundings. the procession was due to pass through our street, so i’d decided to watch it from my house. crowds were gathered, running up the street awaiting the processions’ arrival. it began its march down from the top of the street…at the lower end of the street, i saw tano turning up the street, garage keys in hand. i knew where he was likely to be heading. but on seeing the crowds, he stopped in his tracks. as the procession marched down the street, i saw him stand to the side amongst the crowd. as the procession drew closer, he doffed his hat and shouted, “viva la virgen!” he then clapped along with the music, remaining amongst the crowd. the multisensory, embodied experience of the ritual appeared to cause tano to enter into what svendsen et al. called a “magical moment” through which he momentarily became embedded within the surrounding procession to connect with others around him (svendsen et al. 2018, 28). experiencing early-stage dementia, tano struggled to form newer short-term memories but could recall long-term http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 19 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu memories—in this example, he stopped to participate in the ritual of the procession. this suggests that tano was experiencing a deeply embodied long-term memory that had formed through his bodily participation in these rituals annually throughout his lifetime. the repetitive multisensorial nature of pueblo’s fiesta rituals may thus be therapeutic for abuelos with dementia as these rituals can trigger the recall of long-term meaningful memories that enable abuelos to understand and join in with the collective celebration. on another occasion, as i stood outside the care home with the residents to observe the arrival of one of the saint statues, i similarly observed one of these ‘magical moments’ in auxi, an abuela in her mid-90s with advanced dementia. auxi was usually not able to verbally communicate and would generally seem unaware of her surroundings. if people tried to interact with her, she was often unresponsive. yet, when she stood with the crowd outside the care home to watch the procession, she joined in the applause as the statue arrived. malcolm goldsmith, a rector and sociological writer interested in the influence of spirituality on dementia care, investigated how people with dementia responded to religious ritual. he explained how people with dementia participating in religious rituals often engage effectively, as they “just know what they have to do” (goldsmith 2002, 145). as i observed, the collective ritual appeared to trigger a deeply embodied memory in auxi, inciting a ‘magical moment’ whereby she connected to this shared celebratory moment with those around her. during pueblo’s fiestas, memory also seems to connect people to their shared historical and spiritual past. this can be particularly meaningful for abuelos, who are approaching the end of their lives, as it can provide a reminder of participating in these rituals with their relatives who have since passed away. for example, people described to me how processions triggered nostalgic memories of watching them with family years ago. this forms a connection to the spiritual world of their ancestors alongside the religious saints. processions also celebrated a shared catholic history. during pueblo’s semana santa (holy week/easter) processions, catholic stories are re-enacted. abuelos spoke with genuine sorrow about the procession recreating the betrayal of christ, and with jubilation about the procession performing his resurrection. this can play a reminiscence role for abuelos to generate a sense of belonging in a shared religious history. mitchell, describing catholic maltese processions, explained how through the annual reenactment of past events, a “concertina-ing of time” is created by “bringing events and persons from the distant historical past back into the present” so that spiritual entities are felt as a “continuous presence” (mitchell 2009, 61). as i observed, this ‘concertina-ing’ of time occurred through pueblo’s fiestas, which were repeated annually in line with specific seasons. this could help orientate people with dementia to the present, whilst providing a reminiscence of the past. it could have an especially powerful effect on abuelos at the end-of-life by highlighting the temporal and connected nature of time, nostalgically connecting them to past relatives, the community’s shared history, and the spiritual world for which, as believers, they awaited. for many abuelos with dementia, however, the fiestas had become inaccessible or even disorientating. claudia looked after her 88-year-old mother, adela, who had alzheimer’s disease. claudia described how her mother had lost interest in the processions and disengaged from prayers to the virgin statue, which she had performed avidly throughout her lifetime. claudia recalled taking adela to a visitation with the statue but described how adela had shown disinterest towards the statue. claudia believed this was evidence that adela had declined and changed—so much that she was no longer the person claudia had known her to be before the onset of alzheimer’s disease. the fiestas had thus assumed a sad tone for claudia, as memories of previously enjoying the fiestas with her mother now gave her a profound sense of loss. http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 20 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu i also witnessed in one abuelo that the fiestas could be disorientating. josé was an 85-year-old retired shepherd and olive farmer in the early stages of alzheimer’s disease, who i had met at pueblo’s day centre. i would often pass him in the large plaza in the upper neighbourhood as he was sitting on the benches chatting to other men or playing pentanca (boules), a gentle sport that involves rolling small balls along the ground and is often played by older people in pueblo. josé had recounted to me many times how he had keenly participated in the fiestas throughout his lifetime. however, one afternoon during a fiesta, the feria (fair) was occupying the plaza where josé would normally socialise, causing it to overflow with a hectic mix of people, stalls and loud music. i ran into josé, who was looking completely lost and barely seemed to recognise me, saying he had forgotten how to get home. i was able to get him to a neighbour who accompanied him home. it seemed that the chaotic change of everyday circumstances caused by the fiestas had disrupted josé’s usual routine of socialising with friends in the plaza, which then caused him to become disorientated. this shows how the fiestas’ disruption to everyday life also had the capacity to disorientate people with dementia, who may rely on routines to compensate for memory deficits. although i only observed such effects occurring in josé during my fieldwork, some people with dementia can become easily disorientated; thus, it seems likely that others could also experience the fiestas as disorientating; this requires further investigation. but josé’s reaction indicates how the meanings attached to these fiestas are deeply dependent on each individual’s unique contextual experience. although i generally noticed abuelos reacting positively to pueblo’s fiestas and have focused on their therapeutic capabilities, fiestas could also be experienced as inaccessible or disorientating, and it is therefore important to recognise that such therapeutic effects are not universally experienced. conclusion with a point of departure in my ethnography from rural spain, in this article, i have delved into the spiritual and collective realms of eldercare. by exploring older people’s interactions with an andalusian town’s virgin mary saint statues and residents’ participation in collective fiesta rituals, i have revealed that such social-cultural practices form a meaningful part of community eldercare. i explored older people’s interactions with the statues, describing how the statues possess personhood and provide spiritual protection. some people with dementia continue to recognise the statues; thus, as powerful, ubiquitous religious symbols, they can provide stability despite the confusion that dementia can bring. spiritual protection from the saints may be especially important to older people approaching end-oflife and preparing for their own transition to the spiritual world. with inspiration from durkheim, i analysed how pueblo’s rituals generate “collective effervescence” that incites social cohesion and intergenerational solidarity. i also explored how the virgin saints act as mediators across generations, and between everyday and spiritual worlds. such an interpretation of these collective rituals leads me to advocate for a shift towards understandings of elderand dementia care as deeply ‘community-centred.’ as i have described, the fiestas form a uniquely local celebration, drawing on municipal symbols of identity to generate belonging. this is particularly important to abuelos in care institutions, who may be experiencing feelings of displacement. during the fiestas, the multisensorial collective action may also trigger “magical moments” (svendsen et al. 2018, 28) in some people with dementia. specifically, people with dementia who still can access long-term memories may, through multisensorial elements of the rituals, enter a therapeutic spiritual state whereby they connect with those around them in the here and now. meanwhile, the seasonal, repetitive nature of fiesta rituals may bring a shared spiritual history into the present. this is particularly important for older people who have lost loved ones and are reminded of the connectedness of past to http://anthro-age.pitt.edu/ margaret clark award (2021) winner | place | 21 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu present and spiritual to everyday. however, i also highlighted how, whilst the fiestas can be comforting to some people with dementia, they can be distressing to others. the meaning of certain rituals is thus subjective across individual contexts. by investigating how meaning is generated around an andalusian town’s saint statues and fiestas, i have illuminated how community religious rituals have the capacity to generate a spiritually and collectively therapeutic role in eldercare. this brings scholarship from the anthropology of religion into dialogue with the anthropology of ageing to demonstrate the importance of approaching eldercare as not just ‘person-centred’ but also as profoundly ‘community-centred.’ the benefits of this shift in approach are being recognised by anthropologists investigating dementia and eldercare as well as by healthcare practitioners working with older people and people with dementia; these professionals are seeking ways to incorporate community rituals into care practices. exploring the benefits of participation in collective rituals for older people is especially relevant now, as people worldwide continue to negotiate new forms of physically-distant care during the covid-19 pandemic. this was poignantly demonstrated in pueblo’s response to an outbreak of the virus at its care home in april 2020, which resulted in multiple hospitalisations and deaths. pueblo’s local council arranged for la virgen del pilar statue to be carried to the care home in a special socially-distanced ceremony in order to emphasise the virgin saint’s presence and spiritual protection over the care home during this difficult period. in times of crisis, engagement in such familiar, locally-specific rituals may generate solidarity, both spiritually by the saint and socially by the wider community. this reinforces the importance of investigating how collective rituals can influence eldercare, and supports a shift towards care that is fundamentally ‘community-centred.’ in this article, i have also demonstrated how ethnography can provide a critical tool for exploring how localised cultural practices can be harnessed to create communities where older people and people with dementia feel valued and able to participate in civic life. more broadly, this suggests the benefits of taking an ethnographic approach to investigating ageing, dementia, and care that moves beyond healthcare sites to reveal the diverse ways that collective cultural practices can form an essential part of eldercare. acknowledgements this research was funded over a period of four years, from 2018-2022, by the economic and social research council, uk. notes 1. saint names used are pseudonyms to protect anonymity. 2. morenita translates into english as ‘little tanned woman’ and is an affectionate nickname for the virgin that expresses an adoration of her tanned skin. references borgstrom, erica. 2017. “social death.” qjm: an international journal of medicine 110 (1): 5-7. https://doi.org/10.1093/qimed/hcw183. bull, michael, and jon mitchell. 2015. “introduction.” in ritual, performance and the senses. edited by michael bull, michael and jon mitchell, 1-10. london: bloomsbury. http://anthro-age.pitt.edu/ https://doi.org/10.1093/qimed/hcw183 margaret clark award (2021) winner | place | 22 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu cazorla sánchez, antonio. 2010. fear and progress: ordinary lives in franco’s spain 1939-1975. oxford: wileyblackwell. christian, william. 1972. person and god in a spanish valley. princeton: princeton university press. clotworthy, amy. 2020. empowering the elderly? how ‘health to self-help’ health interventions shape ageing and elderly in denmark. new york: columbia university press. durkheim, émile. [1912] 2007. the elementary forms of the religious life. new york: dover publications. goldsmith, malcolm. 2002. “when words are no longer necessary: the gift of ritual.” journal of religious gerontology 12 (3-4): 139-140. https://doi.org/10.1300/j078v12n03_11. gómez-vírseda, carlos, yves de maeseneer, and chris gastmans. 2020. “relational autonomy in end-of-life care ethics: a contextualized approach to real-life complexities.” bmc medical ethics 20 (1): 1-14. https://doi.org/10.1186/s12910-020-00495-1. hall, linda. 2004. mother, mary and warrior: the virgin in spain and the americas. austin: university of texas press. kitwood, tom. 1997. dementia reconsidered: the person comes first. buckingham: open university press. lamb, sarah. 2014. “permanent personhood or meaningful decline? toward a critical anthropology of successful aging.” journal of aging studies 29 (1): 41-52. https://doi.org/10.1016/j.jaging.2013.12.006. leibing, annette. 2017. “successful selves? heroic tales of alzheimer’s disease and personhood in brazil.” in successful aging as a contemporary obsession: global perspectives. edited by sarah lamb 203-217. new brunswick: rutgers university press. lillo crespo, manuel, and jorge riquelme. 2018. “from home care to care home: a phenomenological case study approach to examining the transition of older people to long-term care in spain.” journal of research in nursing 23(2-3): 161-177. https://doi.org/10.1177/1744987118755550. luhrmann, tanya. 2012. when god talks back: understanding the american evangelical relationship with god. new york: alfred a. knopf. mattingly, cheryl. 2010. the paradox of hope: journeys through a clinical borderland. berkeley: university of california press. mattingly, cheryl. 2014. moral laboratories: family peril and the struggle for a good life. oakland: university of california press. mitchell, jon. 2004. “ritual structure and ritual agency. ‘rebounding violence’ and maltese festa.” social anthropology 12 (10): 57-7. https://doi.org/10.1017/s0964028204000059. mitchell, jon. 2009. “ritual transformation and the existential grounds of selfhood.” journal of ritual studies 23 (2): 53-66. mitchell, jon. 2010. “performing statues.” in religion and material culture: the matter of belief. edited by david morgan, 262-277. london: routledge. mitchell, jon. 2015. “ontology, mimesis, and divine intervention: understanding catholic visionaries.” in ritual, performance and the senses. edited by michael bull and jon mitchell, 11-30. london: bloomsbury. oecd/european observatory on health systems and policies. 2021. state of health in the eu: spain country health profile 2021. available at: https://health.ec.europa.eu/system/files/2021-12/2021_chp_es_english.pdf. accessed: 12 10 2022. pratt, jeff. 2003. class, nation and identity: the anthropology of political movements. london: pluto press. ruiz-adame reina, manuel, and juan de dios jiménez aguilera. 2017. “factors associated with living situation among alzheimer’s caregivers in the south of spain that affect the election of external support services.” dementia 18 (5): 1695-1709. https://doi.org/10.1177/147130121772354. http://anthro-age.pitt.edu/ https://doi.org/10.1300/j078v12n03_11 https://doi.org/10.1177/1744987118755550 https://health.ec.europa.eu/system/files/2021-12/2021_chp_es_english.pdf https://doi.org/10.1177/1471301217723543 margaret clark award (2021) winner | place | 23 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.384 http://anthro-age.pitt.edu svendsen, mette, iben gjødsbøl, laura navne, and mie seest dam. 2018. “a life worth living: temporality, care and personhood in the danish welfare state: a life worth living.” american ethnologist 45 (1): 20-33. https://doi.org/10.1111/amet.12596. taylor, janette. 2008. “on recognition, caring, and dementia.” medical anthropology quarterly 22 (4): 313-335. https://doi.org/10.1111/j.1548-1387.2008.00036.x. tobío, constanza, and juan antonio 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http://dx.doi.org/10.1111/amet.12596 https://doi.org/10.1111/j.1548-1387.2008.00036.x https://doi.org/10.1080/03906701.2013.771051 https://doi.org/10.1111/jan.12663 https://doi.org/10.1353/mrw.2018.0018 modest swimwear, religiosity and aging: apparel and physical activity for women throughout the life course allison m. kabel akabel@towson.edu towson university college of health professions abstract swim-related activity is one of the most recommended forms of physical activity for older adults, increasing the importance of access to swimming and water sports throughout the life course. this study examined eight online forums addressing topics related to religious-based modesty and moral judgements about different types of swimwear, such as the bikini or the burqini. online discussion forums dedicated to modest dress for women with religious or faith-based modesty preferences are often called “modesty blogs.” these blogs have grown in popularity and influence on social media, and one of the most controversial topics discussed is the notion of a woman’s choice in swimwear as a moral indicator. this article analyzes the ways in which these blogs serve as informal sites of knowledge production and sites of religious interpretation. these forums reveal insights about physical activity and the sense of belonging regarding modesty within a moralized domain. the review of these modesty blogs resulted in examples of (1) modest swimwear as empowering for religious women throughout the life course, (2) conflicting modesty narratives, and (3) modesty as a way to avoid shame and uphold middle-class values. apparel-related barriers to physical activity, including swimwear and water sport, have the potential to negatively impact the health and wellbeing of religious women and their families throughout the life course. keywords: swimwear; modesty; aging; religion; morality; social media anthropology & aging, vol 43, no 1 (2022), pp. 35-48 issn 2374-2267(online) doi 10.5195/aa.2022.359 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. kabel | 35 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu modest swimwear, religiosity and aging: apparel and physical activity for women throughout the life course allison m. kabel akabel@towson.edu towson university college of health professions introduction swimming is a form of exercise, a leisure activity, a competitive aquatic sport and, in some circumstances, a lifesaving survival skill. swimming is frequently suggested as an ideal form of exercise for older adults; however, older adults rarely achieve the recommended amount of physical activity per week (elsawy and higgins 2010). the clothing and apparel items people who self-identify as women wear while engaging in swimming or swim-related activity (also known as swimwear, swimsuits, bathing suits, or swim costumes) have been the subject of controversy regardless of the amount of skin exposed or the religious affiliations associated with them. modest swimwear blogs, online modesty discussion forums, and photo-sharing websites focused on swimwear options for women with religious-based modesty preferences represent a growing network of communities where ideas are shared and debated; these comprise the network of “online modesty discourse” (lewis 2015). one might be tempted to dismiss or overlook the significance of online forums, especially those focused on fashion, clothing, and apparel; however, online forums are capable of functioning as sites of knowledge production, influencing the opinions and health-related behaviors of both their participants and readers (kuchinskaya and parker 2018). modesty blogging is a form of “female-led religious interpretation, and knowledge transmission” (lewis 2013). current online forums addressing modesty and swimwear range from interpreting a woman’s choice in swimwear as part of an individual’s modesty journey, a factor in social or religious acceptance, or an indicator of one’s moral status. these forums lead those who study life-course issues surrounding health, culture, and identity to question the decision-making processes that constitute moral, modest, or acceptable active wear, specifically swimwear, and how these processes are negotiated. in this article, i present my analysis of these modesty forums after describing the historical background and the challenges religious women face when engaging in swimming or water sports and outlining my methodology. in the analysis of my findings, i focus on whether modesty requirements serve as barriers or facilitators to achieving adequate amounts of physical activity for women throughout the life course and highlight opportunities for religious women to have greater access to swimming and water sports. moral status and swimwear selection historically, swimwear has inspired debates about female morality at the individual and societal levels. morality is the way people ‘ought to act’ under given circumstances according to a presumed “objective moral charter,” defining all that is right and good (shweder and menon 2014, 362). the styles of swimwear serving as the ‘bookends’ of controversy are the bikini for exposing too much skin and the burqini (also known as burkini) for too much coverage. bikinis have been criticized as immodest and morally corrupting to society (balogun 2019; booth 2001; heffernan 2018). bikinis are a two-piece style of swimwear resembling a set of bra and panties that expose the navel and were introduced in france http://anthro-age.pitt.edu/ kabel | 36 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu during the late 1940s (charleston 2004). bikinis were initially controversial but grew in acceptance in the united states during the post-world war ii economic boom, particularly as more people were exposed to european fashion trends through travel and because private backyard swimming pools became more affordable (hunt-hurst and scarborough 2013). the burqini was created by a lebanese designer living in australia at the request of a lifeguard association that needed swimwear for muslim female lifeguards (akou 2013; serhan 2016). this fullcoverage swimsuit is associated with muslim women and consists of swim leggings, a long-sleeved, high-neck top, and a swim hijab [a head covering worn by some muslim women]. the burqini was controversial in many settings when it made its debut, and burqinis have received criticism for being culturally ‘corrupting’ in western countries such as in europe, north america, australia, and new zealand (akou 2013; jung 2016). burqinis were not controversial for being too revealing, but rather because they, along with veils or hijabs, were perceived as symbols of religious affiliation in public spaces (nielson 2020; sommier 2017). wearing the hijab or other concealing clothing has been harshly criticized in the west as a form of invisibility. however, in muslim-minority countries, it has had the opposite effect—specifically, it promotes a type of hyper-visibility often used to represent foreign otherness or behavior “somehow alien or different” (tarlo 2010, 9-10). the ultra-modest burqini was not well-received in some western countries and even resulted in attacks and harassment of women wearing them on french beaches. some attackers attempted to label those wearing a burqini as islamist extremists, and a burqini ban was subsequently issued on several beaches in france (jung 2016; serhan 2016; sommier 2017). the ban was eventually overturned, but the damage was done in terms of harming the already tenuous sense of belonging felt by many french muslims, both immigrants and native french citizens (nielson 2020). the backlash was also swift for france, as much of the western world condemned the burqini ban and attributed it as evidence of the weakening of french liberalism: “the theme of french decline was also conveyed through the parallel made between france today and conservatives from the past, for instance those who first opposed the bikini” (sommier 2017). some public beaches and swimming pools in the united states attempted to ban burqinis for being unhygienic (abdelaziz 2019). these obstacles politicize the attempts that muslim women make to engage in water sports and may also complicate family outings, as mothers, grandmothers, or other female family members are prevented from accompanying young children into the water. conflict between the underlying values people claim to embrace and the ethical practices in which they engage is referred to in the literature as a “moral breakdown,” according to social theorist and anthropologist jarrett zigon (2008). a prime example of this is consumer demand for corporate social responsibility in clothing manufacturing and environmental stewardship versus the demand for inexpensive, disposable apparel that follows the latest trends (pandit et al. 2021). this opposition seems to surround and influence modern consumer decision-making, including those seeking modest apparel. in the western world, there is a moral imperative to be health-seeking (white et al. 1995). however, the lack of access to modest swimwear or modest athletic apparel complicates the pursuit of health for modest women. this imperative can be especially taxing on older women due to covert ageism, as visible signs of aging are interpreted as a personal failure and may thereby incentivize covering up regardless of religious background. according to cultural gerontologist julia twigg, “failure to look fit, toned and slim…becomes a new sign of moral laxity, evidence of failure to exert proper discipline over the body” (2013, 42). beyond the moral breakdown, a growing number of anthropological studies dedicated to the concept of moral development have been conducted in recent years (e.g., cassaniti and hickman 2014; csordas 2013; mattingly and throop 2018). scholars such as anthropologist nancy eberhardt (2014) argue that the concepts of personhood and agency are essential to making sense of the moral decision-making in diverse cultural contexts. this moral complexity is crucial for illuminating http://anthro-age.pitt.edu/ kabel | 37 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu the issues navigated by women with religious-based modesty preferences as they participate in physical activity, especially swimming or water sports due to the apparel required for these activities. swimming as exercise, relaxation, and self-care technological advancements have changed the ways in which people engage with swimming and other water sports. for example, the development of elastic yarn in the 1930s led to the creation of stretch fabrics and body-contoured swimsuits (edwards 2020). more recently, sun-proof fabric and protective aquatic clothing for surfers, called rash-guards, have been developed. these have been adopted by the modest-swimwear community and incorporated into designs for people looking for more coverage, protection from ultraviolet sunlight, or chafing for various water sports (gambichler et al. 2001; gies 1994). the ability to swim serves as a kind of gateway to many types of water sports and leisure activities, including boating, fishing, kayaking, canoeing, surfing, paddle boarding and water aerobics, among others. all these activities require some level of confidence or familiarity with conducting oneself in the water in order to be performed safely. swimming is frequently recommended as a form of exercise, especially for older adults due to the minimal amount of weight-bearing required (alkatan et al. 2016; nualnim et al. 2012; tanaka 2009), which can alleviate stress on the joints. the importance of swimming and water sports to older adults highlights the need to eliminate barriers that could prevent or complicate attempts by women with religious-based modesty preferences from fully engaging in water sports as a form of physical activity or self-care. beaches and poolside public spaces can be sites of unwelcome scrutiny for women in western societies generally, subjecting them to corporeal surveillance, societal pressure to cover their bodies as they age, or to select and wear apparel items that offer increasingly more coverage; this may result in a type of “cultural exile” and marginalization from the youthful feminine ideal (twigg 2013, 41-43). several communities in places such as australia, denmark, sweden, norway, and brooklyn, new york, have attempted to provide accommodations at public pools by offering women-only swim hours to accommodate muslim and orthodox jewish women who are more comfortable swimming while shielded from the male gaze (christian science monitor 2016; lenneis et. al. 2021; marinescu et al. 2013; pardy 2011; rosenberg 2016) these accommodations have generated mixed results. for example, in denmark, some muslim women reported that participating in women-only swim sessions offered them opportunities for self-care and a safe space where they could exercise and relax out of view from men and not feel judged by non-muslims (lenneis et al. 2021). however, gender-segregated swimming hours have also resulted in a debate over whether the practice was empowering or regressive for women in sweden while, in brooklyn, it resulted in a lawsuit for a civil-rights violation based on religious intrusion into public spaces (christian science monitor 2016; rosenberg 2016). such conflicts illustrate the need for a deeper understanding among members of the swim and water sports community regarding the reasons that religious women select modest swimwear. this study examined online discussion forums about modest active apparel as sites of moral consensus-building and information-sharing regarding water-related physical activity for women with religious-based modesty preferences. these forums inspire contemplation of numerous issues related to women’s opportunities and abilities to engage in the social, physical, and health-seeking behaviors that require donning a swimsuit throughout the life course. methods and analysis this study analyzed online forums addressing topics related to religious-based modesty and moral judgements about different types of swimwear. all data were collected on publicly available socialmedia platforms that feature health and fitness forums and discussion threads for women interested in http://anthro-age.pitt.edu/ kabel | 38 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu maintaining certain standards of modesty. these forums, referred to as ‘modesty blogs,’ were examined over the course of six months, i.e., from january to june 2021. during this time, i reviewed eight forums, including blogs and vlogs [video web logs], both with and without public commentary and discussion. the goal was to explore the content and questions posted, the responses received, as well as the images and opinions publicly expressed on the topic of modesty and swimwear on social-media platforms. no participants were recruited or interviewed for this study as their online comments were available to the public. the authors, creators, or hosts of certain online forums are identified, however, since they have specifically created content to be viewed by the public. the real names and social-media handles of respondents to the blogs and forums are not included to safeguard their privacy as much as possible. in addition, i have combined or aggregated multiple quotes from the same commenter in order to protect the privacy of the individual (bond et al. 2013). the institutional review board status for this project is exempt according to the author’s home institution. eligibility for the forums included the following criteria: open access to the public; no interaction by me, the researcher, with the participants in the forum; no membership requirement; no purchase of featured items required; and no confidentiality clause. discussion forums had to feature posts or photographs dedicated to beachwear, summer active wear, bathing suits, or swimsuits, and the observance of religious modesty standards. blog or forum posts and discussion threads that met these criteria were captured as a form of purposeful sampling. posts were reviewed and categorized following a qualitative, thematic approach. analysis was conducted on the captured posts with a modified grounded theory technique, constructing categories to represent the concepts as they were identified (charmaz 2014). the goal of the analysis was to examine the relationship between modesty-protecting athletic apparel, specifically swimwear, and health-seeking behavior among women from religious backgrounds, and then, to create a set of codes or descriptive terms and a code dictionary, which linked the terms with a working definition. i refined this coding dictionary over repeated readings of the forum transcripts until it could be applied across all the samples collected. i then used the refined codes to interpret the behavior, thoughts, and opinions expressed on the modesty-blog forums. the coding analysis revealed several apparel-related barriers to swimming and water sports for women with religious-based modesty requirements and preferences. after reviewing the eight modesty swim blogs/vlogs forums, i determined that there are many interpretations of and conflicting narratives that constitute ‘modest’ swimwear among women with religious-based modesty preferences. there are also a wide range of rationales or motivations for blogging about and showcasing modest swimwear and lifestyles. posts were primarily based on the religious perspectives of muslim, orthodox jewish, and evangelical christian women, and the majority of the creators of these forums were involved in the design, manufacture, or modeling of modest apparel. others were social-media influencers of modest lifestyles, who typically receive free merchandise for featuring the items on their platforms. one such example is leena asad, who uses her with love, leena platform to represent modest dress from a muslim-american perspective (2019). leena shares with viewers on youtube and instagram where to purchase items and how to style them to meet religious modesty requirements. the assumption is that the viewer is already interested in modest fashions, and she does not attempt to ‘convert’ viewers to a modest lifestyle. leena evaluates apparel items based on appearance, function, and practicality. in the forums i analyzed, the rationales for posting about modest swimwear were all presented within a religious context but ranged from female empowerment and personal dignity to recognizing and avoiding negative consequences associated with immodest behavior and appearance. in the following sections, i focus on the most prominent themes and include excerpts from the blogs or vlogs. the first category to be explored here focuses on content that portrays modest swimwear as empowering and dignifying for women. http://anthro-age.pitt.edu/ kabel | 39 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu revealing dignity: modesty as a form of empowerment a digital printing company called spoonflower allows designers to create and print their own fabrics and sell their designs on its website, promoting sustainability and positive environmental change for the textile industry (spoonflower 2021). the website hosts a blog meant to inspire consumers interested in creating their own apparel, crafts, and artwork. at the time of my study, the spoonflower blog featured a british muslim woman with her own social-media presence in the crafting community. she goes by the name rumana and is a medical doctor who also hosts her own blog, the little pomegranate, on sewing and crafting. her modest swim dress and swim turban were well-received on the spoonflower site. she started off by sharing why designing and sewing her own modest swimwear was important to her: there are so many reasons why someone might want more coverage from their swimsuit— religious reasons (like me), personal comfort (some people just prefer to cover up more) or even sun protection for sensitive skin. there’s been a rise of ready-to-wear versions, from the standard (and in my opinion awfully named) ‘burqini’ made up of trousers and a long top, loose one-piece wet-suit style ones, to more fashionable three-piece affairs with detachable wrap-around skirts. while there are some great companies out there, a lot of what’s available is decidedly frumpy and dull. i wanted something lush and tropical, something that screams ‘holiday!’ (spoonflower 2019) rumana acknowledged resisting religious discrimination and harassment in the united kingdom and europe as her motivation for this particular creation: i know everyone says this, but being able to sew my own swimwear has been a real gamechanger. as a muslim, hijab-wearing woman, i’ve often felt self-conscious and stared at on the beach—even more so in parts of europe where there is backlash against ‘burqini’-style swimsuits (some cities are even banning them). i’ve tried to not let things like that stop me— i’ve gone swimming in oceans, snorkeling amongst coral reefs and even had kite-surfing lessons in my old swimsuits, but i’m always aware of myself and how i look. but this swimsuit really has changed that. with its unashamedly bright and bold print it has given me the confidence to step out onto the sand with my head held a little bit higher, because everyone deserves to feel fabulous in their swimwear, right? [italics original] (spoonflower 2019) the bright palm print on the swimsuit mentioned in rumana’s post presents an open rejection to selfconsciousness, anxiety, religious, or political stigma. featured on a fabric and crafting forum, most of the comments posted by the public had to do with asking for details on the pattern or the fabric used or offering praise for the swimsuit. based on these comments from the forum’s readers, the post did not seem to generate controversy, and some of the comments referenced their status as a fan of rumana’s personal blog. regine monavar omid tessone hosts the aqua modesta blog, and she designs modest swimwear targeted toward orthodox jewish women in the united states (blog aquamodesta 2019). tessone’s modesty narrative reveals that both her own adherence to modest dress and her decision to design modest active wear were intertwined with the growth of her religious and spiritual identity: designing was something i absolutely loved doing and now that i was growing more observant i needed something modest to wear while swimming. i realized dressing half naked was no longer a solution but a problem for me. by studying the torah and performing mitzvot, i now http://anthro-age.pitt.edu/ kabel | 40 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu had the knowledge that was required to make that change. the desire was there and therefore the solution would surely come my way. i saw myself swimming in the ocean in this swim dress night after night in my dreams. that was the beginning of the idea of aqua modesta modest swimwear. the planning, the research, the follow up was all with super divine intervention. (blog aquamodesta 2019) based on information posted on the blog, tessone developed her passion for modest dress as an adult and it evolved along with her deepening religious beliefs. these experiences inspired her career in designing modest swimwear and exercise apparel. this aqua modesta excerpt, along with the spoonflower excerpts above, showcase examples of how women are using social media to share their experiences of feeling empowered to engage in swimming, express religious beliefs, and use design skills and training to assist other women in their modesty journeys. both women created opportunities to share their designs and beliefs with wider online audiences, contributing to the network of women interested in modest dress. blessed is she is an online christian community and blog based in the united states that refers to itself as a sisterhood. the site features approximately 40 content contributors who discuss issues based on their own lived experiences as women of faith. while not devoted exclusively to swimwear, the blog features a particular post about modesty, modest dress, and swimwear that dignifies or honors the bodies of women who have experienced pregnancy, childbirth, trauma, illness, and loss. the author featured in this blog post shared a deeply personal narrative about what modest swim apparel means to her and how she has been challenged to uphold her commitment to modest dress: modesty is a virtue that i have struggled with for the majority of my life. i still struggle with it! i’ve always loved fashion, and our [american] culture is not one that encourages the beauty of modesty. i have allowed myself to get lured into purchasing and wearing immodest clothing. i have also worn certain pieces of clothing out of vanity. modesty, like most of the [biblical] virtues, doesn’t come easily for me and is something that i must constantly strive for. through prayer and a desire for true, authentic beauty, my love and desire for modesty has grown. there is such freedom and joy found within modesty! over the past few years, through nursing school, wedding planning, pregnancy, postpartum, and a recent diagnosis of polycystic ovarian syndrome, my body has changed quite a bit. i want a swimsuit that i feel comfortable and confident in, and one that upholds my dignity as a woman through its modest and beautiful features. i want to wear a suit that pays tribute to all that my body has gone through. not one that puts my body on display or draws attention to certain parts that our culture says are the most attractive. (blessed is she 2019) the narrative post above provides insight into the motivations of some christian women to adopt a lifestyle and apparel that goes against the mainstream culture, which typically promotes an unattainable standard of beauty. the author described her personal struggles with remaining committed to modest clothing, concluding that—ultimately—the rewards of doing so outnumber the challenges because modest clothing, including swimwear, dignifies her body and all that it has endured. for her, a sense of empowerment came from making wardrobe choices, specifically swimwear, that concealed more of her body. in her case, bodily concealment was not enacted out of shame but rather out of self-respect. having access to modest swimwear for purchase was essential for her, as she did not sew her own clothing or own a design studio as in the previous examples. however, conflicting narratives can complicate the overall goal of supporting religious women in swimming and water sports. http://anthro-age.pitt.edu/ kabel | 41 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu modest swimsuit designer jessica rey provides a clear example of the conflicting narratives within the modesty movement. rey’s video post about the evolution of the swimsuit and her critique of the motivations behind the creation of the bikini went viral in the united states. her video, originally posted on q media, ideas for the common good (the evolution of the swimsuit 2013), has been reposted in several other christian modest swimsuit and lifestyle blogs that encourage women and girls to adopt modest dress. the take-away line from rey’s video is: “modesty is not about covering our bodies because they are bad. modesty is not about hiding ourselves. modesty is about revealing our dignity.” the video generated hundreds of responses, but much of the controversy surrounded references to neuroscience research claiming that images of immodestly dressed females alter male brains in ways that are harmful and objectifying to women: brain scans revealed that when men are shown pictures of scantily clad women, the region of the brain associated with tools, such as screwdrivers and hammers, lit up. some men showed zero brain activity in the medial pre-frontal cortex, which is the part of the brain that lights up when one ponders another person’s thoughts, feelings and intentions. researchers found this shocking because they almost never see this part of the brain shut down in this way. a princeton professor said, ‘it’s as if they are reacting to these women as if they are not fully human.’ (the evolution of the swimsuit 2013) the comments posted were divided between readers who celebrated this discussion as evidence of female apparel choice being responsible for objectification and those who disapproved of making women shoulder the consequences of a male behavioral shortcoming. an examination of the neuroscience studies mentioned in the blog post is beyond the scope of this paper. however, it is worth noting that women have historically faced objectification regardless of wardrobe (bartky 2015; moradi and huang 2008). in general, rey is critical of the bikini, and she promotes the message that modest swimwear is about the dignity of women and girls. for those who have already decided to accept the challenge of finding modest swimwear, the blog hosted by cleo madison provides photos, descriptions, and sourcing information for modest swim options, showcasing a wide variety of interpretations for what is considered modest (cleo madison 2020). featured swimsuits include two-piece designs with more coverage than a typical bikini, traditional maillot one-piece suits, swim leggings with rash-guard shirts, and full-coverage burqinis complete with a swim hijab. the blog’s overall message of modesty as dignity and empowerment is complicated by the following observation about swim leggings: “these are leggings you wear while swimming! you’ll see surfers wearing them, but they’re not alone. some women, like aimee, wear them when they feel terrible and miserable about themselves after having a baby. instead, swim leggings helped her enjoy playing in the water” (cleo madison 2020). this citation refers to a fitness blogger who goes by the name aimee; she posted enthusiastically about swim leggings when she first discovered them. however, the overall tone of the post takes an unexpected turn with the statement about swim leggings working well for women who “feel terrible and miserable about themselves” (cleo madison 2020). this is perhaps a mild critique of the swimapparel industry for making women feel this way, or perhaps it was meant as a comedic take on the fitness blogger’s rejection of traditional swimsuits. whatever the case, the overall positive messaging is lost when a blog suggests that post-baby bodies need to be dressed ‘more’ modestly than others because they do not fit the societal standard of beauty. this conflict in messaging is promoted by modest swim http://anthro-age.pitt.edu/ kabel | 42 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu blogs that focus on the perceived negative consequences of ‘immodest living,’ which i discuss in the next section. concealing for the sake of sin, shame, and social class homeschooling teen is a blog geared toward a specific audience of adolescent and young-adult christians located in the us (2009). the overall tone of the modesty-related posts appears persuasive in nature, not disguising the fact that the creators are trying to convince women and girls to dress modestly, including with swimwear. as with some other sites mentioned earlier, the fear of corrupting boys’ thoughts is deployed to encourage modest dress at the pool or beach: the bible says that ‘women should adorn themselves in respectable apparel, with modesty and self-control’ (1 tim. 2:9 esv). would you go out in public wearing only your underwear? i know i’d sure feel embarrassed and self-conscious! and yet people wear swimsuits that cover less [than] their underwear does! it makes no sense why it’s okay to wear revealing garments at a pool or the beach when they would not be considered appropriate in other places. most modern bathing suits also pose a problem for guys when they see you in them. jesus said that anyone who looks at a woman to lust after her has committed adultery already in his heart (matt. 5:28). young christian men shouldn’t have to walk around with their eyes pointed down at the ground just to stay pure in their thoughts. so modest swim apparel is not only appreciated by girls who wish to honor god with their bodies, but also by guys who wish to honor god with their minds. (homeschooling teen 2009) these passages communicate a vastly different message than the sites mentioned before concerning the dignity of modesty. in the above excerpt, covering the body is a way for girls to honor god, yet the need for girls to honor god with their minds was not mentioned. one final plea was made for girls and young women: “girls, if you can’t find a modest swimsuit, then don’t swim. avoid the beach or wear shorts and short sleeves. purity is really that important” (homeschooling teen 2009). this interpretation of religious morality serves as a reminder of the crucial role that access to modest swim apparel plays for women and girls in some christian communities in the us. access to modest swimwear can potentially turn a barrier into a facilitator when it comes to engaging in water sports and other forms of water-based social participation. the following blog excerpts from the great swimwear debate (emily wilson 2015) addressed social class and the perceived decline of middle-class women safeguarding standards of appropriate appearance and conduct: if wearing a small bikini was not seen as comparable to underwear in the eyes of some people before...this new swing of bikini fashion has confirmed it. these suits you see here are underwear you wear outside. and to the point of class...wearing your underwear outside is not classy. it is not classy to show your booty to everyone you pass by on the beach or at the pool— 18 year old and 80 year old men alike. it is not and never will be classy to put a picture of your backside on your instagram in a bikini. wearing a swimsuit that covers a few square inches and reveals nearly your entire body to the general public says sadly and loudly. . . ‘i am an object to be looked at. here is nearly every inch of me for all the world to see.’ on the surface, this poster seems to embrace the modesty-as-dignity message discussed above, yet the focus of social class—and behaving in a way that is ‘classy,’ presumably conforming to middle-to-upper class norms—directs the reader toward a narrower scope of acceptable standards. this poster suggests http://anthro-age.pitt.edu/ kabel | 43 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu that middle-class standards should be upheld by avoiding the behaviors described, such as exposing too much skin, for example, and excluding or disassociating with those who refuse to do so. the message of concealing or covering the body to avoid objectification is consistent throughout several of the christian forums based in the united states; however, the responsibility for objectification varies considerably, as i discuss in the final example about the “decline of decency” from a blog called girl defined (2015): the bikini has single-handedly destroyed the moral compass of the average woman today. the bikini has warped almost every woman’s view on modesty and decency. when a woman is told that it’s completely normal and appropriate to uncover 90% of her body, she is being taught that nakedness is totally normal. and here’s the biggest problem of all. the bikini has lowered the “modesty” bar so severely that very little is now considered inappropriate. the bikini has initiated a moral domino effect that will eventually lead to mainstream cultural nudity. sadly, the bikini is a clear sign that america is moving away from god’s word. the bikini has totally destroyed our view of modesty. we’re now one step behind europe. in this example, the poster yields a substantial amount of power to the bikini by claiming that this particular style of swimwear has undermined mainstream secular standards of morality. as the post continues, the poster connects the argument to religious morality by explaining how communities of faith are in peril due to the corrupting power of “a few measly pieces of triangular fabric” (girl defined 2015). in the following blog comment, the responsibility extends beyond passivity, such as being looked upon by others lustfully: so here’s another obvious question. should you, as a christian girl, wear the bikini? well, it all depends on your worldview. if you’re a practicing christian, your worldview and beliefs should be built on biblical principles. your moral compass should align with god’s word. you should have a solid understanding of god’s purpose for giving you clothes in the first place and you should act on that understanding. your clothing should reflect your desire to honor god with your body. your clothes should reflect the purity and holiness of your savior. your clothing should display humility rather than pride. your clothes should reveal your need for a savior. (girl defined 2015) according to this poster, the responsibility of women of faith is to actively pursue purity when it comes to clothing, including swimwear. the overall tone of the blogs in this section emphasizes the negative consequences of not concealing the body, which include being viewed by others as ‘low-class,’ failing to uphold social class norms, corrupting the thoughts of boys and men, failing to honor god with one’s body, losing ‘purity,’ and having no moral compass. these blogs did not have much to offer women who already practice modest dress, and instead, were focused on converting readers to adopt modest dress. finally, in the next section, i discuss my interpretation of these findings and provide some concluding perspectives. discussion and conclusion my analysis of eight modesty forums has identified aspects of the cultural and religious significance of modest swimwear—both as a means of female empowerment and personal dignity and as a means to avoid negative spiritual and societal consequences while engaging in swim-related physical activity. however, the conflicting narratives within these modesty forums threaten to confuse the overall mission of promoting swim-related fitness for modestly dressed women—and may ultimately serve as http://anthro-age.pitt.edu/ kabel | 44 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu a way of policing women’s bodies. the motivations behind these forums fell into two main categories: those that offered support and inspiration to women who have already adopted a modest-dress lifestyle [supportive modesty forums] and those that sought to convert women and especially girls to a modestdress lifestyle [conversion modesty forums]. in these contexts, modesty forums can facilitate access to swimming and water sports by helping women strategize what to wear in the water and navigate potential apparel-related issues, such as maintaining the necessary coverage while in view of others. forums such as rumana’s the little pomegranate and spoonflower, with love, leena, aqua modesta, cleo madison, and blessed is she are all examples of supportive sites that provide helpful advice and ‘tips’ on meeting certain life challenges while honoring the requirements of religious-based modesty. however, the swimwear-related narratives from the evolution of swimwear video, the homeschool teen, girl defined, and the great swimwear debate are examples of attempts to convert women to these points of view and to build a stronger modesty movement. examples of this second category all came from evangelical christian forums, which may be a reflection of the relatively small sample size in this study, or a reflection of the historical moment that the christian modesty movement is currently experiencing in the united states. when compared to muslim and orthodox jewish traditions, guidelines for modest dress among christian women have not been as clearly established, so it is possible that forums advocating for this lifestyle are more plentiful than those that support women who already dress modestly for religious reasons. on the surface, it appears that both of these approaches—the supportive and the conversion-themed forums—work towards achieving the same goal. still, the conflicting narratives threaten to create confusion and distract from the overall mission of raising awareness about modest swimwear and safeguarding opportunities for women who want to wear a swimsuit without violating certain standards of modesty. conflicting narratives within the modesty movement—including the clash between those who embrace athletic modest dress as empowering for women and girls versus athletic modesty as a dutiful way to prevent the corruption of men and boys—may ultimately undermine the helpful and meaningful contributions of these forums. while few of these forums address aging directly, they exist within a larger context of culturally established norms around the negative portrayal of aging women and women who are not physically fit (twigg 2010; white et al. 1995). attempts to engage in swimming or water sports are risky for many women regardless of age, due to the everpresent and paradoxical surveillance of female bodies and the threat that they will be sanctioned for being immodest or inadequately disciplined, i.e., failing to exert proper discipline over the body as exemplified by a toned physique. women’s swimwear has become what anthropologists julia cassaniti and jacob hickman call a “moralized domain,” or an aspect of the social world where behaviors are given different moral weight (2014). navigating these moral concerns should be deployed in a way that is careful not to discourage women who prioritize modesty from engaging in swim-related activity, especially older women who may already experience swimming pools and beaches as areas of bodily surveillance. objections to modest swimwear have also been viewed as a ‘proxy’ for anti-immigration rhetoric and threaten the sense of belonging for muslim women (nielson 2020). muslim women living in western countries participate in all aspects of society, including sports, and there is no religious prohibition against engaging in physical activity as long as modesty requirements are met (tarlo 2010). access to modest swimwear facilitates two aspects of the moral quest: modesty required by one’s faith community and health-seeking behavior that may be called for by society-at-large (white et al 1995). it is worth noting that context is crucial for understanding these opinions and the moral-decision-making involved, especially the need to “untangle” societal norms from the work of social media agents of influence (eberhardt 2014). http://anthro-age.pitt.edu/ kabel | 45 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.359 http://anthro-age.pitt.edu since swimming is so highly prioritized as an activity in which people can engage throughout the life course, there should be a greater level of awareness at swimming facilities and water parks, etc. regarding modest-apparel requirements and other considerations for religious-based modesty. these considerations might include women-only swim hours and easing restrictions for head coverings in the water, such as swim turbans and swim hijabs. if young women with religious-based modesty preferences are discouraged or prevented from engaging in swim-related physical activity, it becomes difficult to imagine that they will engage in these activities as they age. this type of discouragement, and not the modesty requirement itself, thereby becomes the barrier to physical activity that has the potential to deny religious women a lifetime of engagement in water sports. as a consequence, this barrier may negatively impact women’s sense of belonging, health, and wellbeing. this study provides a unique overview of some of the attitudes and opinions of women regarding their religious-based modesty preferences and how some women may navigate issues surrounding how to dress for swimming and water sports throughout the life course. these findings may be useful to researchers interested in further exploring the role of modest apparel in physical activity among members of this population. the limitations of this study are associated with the chosen methodology and small sample size. specific limitations include the lack of recruited participants, observed phenomena, and interviews or questionnaire data, as all data were collected from open social-media forums. language was an additional limitation, as only forums written in english were reviewed. the ‘closed’ or restricted social-media forums that are available only to community members, subscribers, or followers of the blogger/influencer were not accessed for this study; they may have contained alternative interpretations or deeper insights into the issues presented here. the sample of eight online forums was not exhaustive but did enable an initial exploration of modest-swimwear blogs and an introduction to the shared culture and growing network of online modesty blogs. further research involving participatory, first-hand data is necessary to delve deeper into the barriers and facilitators for women with religious-based modesty preferences as they seek opportunities to engage in water sports and swim-related physical activity throughout the life course and especially in older age. references abdelaziz, rowaida. 2020. “when swimming as a muslim woman becomes a political act.” huffpost, 45:11 400ad. https://www.huffpost.com/entry/muslim-women-are-fighting-to-swim-inamerica_n_5d5594d1e4b056fafd08aa70. akou, heather marie. 2013. “a brief history of the burqini.” dress 39 (1): 25–35. https://doi.org/10.1179/0361211213z.0000000009. alkatan, mohammed, jeffrey r. baker, daniel r. machin, wonil park, amanda s. akkari, evan p. pasha, and hirofumi tanaka. 2016. “improved function and 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https://thelittlepomegranate.co.uk/ https://www.youtube.com/watch?v=4sgx7fkzxuy https://doi.org/10.1080/07053436.1995.10715495 anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 61-63 issn 2374-2267 (online) doi 10.5195/aa.2014.42 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review sugar, judith, rieksa, robert, holstege, henry, & farber, michael. introduction to aging: a positive, interdisciplinary approach. springer publishing company. 2014. 978-0-8261-0880-7. 317 pp., $75.00 (paperback) denise c. lewis, phd department of human development and family science, university of georgia http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.42 http://anthro-age.pitt.edu book review sugar, judith, rieksa, robert, holstege, henry, & farber, michael. introduction to aging: a positive, interdisciplinary approach. springer publishing company. 2014. 978-0-8261-0880-7. 317 pp., $75.00 (paperback) denise c. lewis, phd the purpose of this book is to provide an accessible textbook with a positive view of aging by focusing on wellness and health promotion. it is arranged in six parts that cover growing older in the 21st century, the realities of growing older, diverse living conditions of older people, support systems, risk and public policy issues. undergraduates and master’s level graduates are the intended audience for this textbook. each section ends with a brief discussion of practice-based information. there are many things to like about the textbook. the first is that it is highly accessible and includes a multidisciplinary framework. undergraduates would likely appreciate the brevity of each segment and the very clear chapter objectives. each chapter is arranged in manageable segments with clear headings. the textbook has a refreshing focus on normal aging processes and adaptations. the positive approach in this textbook goes a long way toward explaining many issues elders, their family members and caregivers, and society currently face in the united states. each chapter begins with a list of learning objectives that give readers an overview of the chapter and provide a “road map” that cues the reader to the important concepts to be covered. the text begins by delivering the foundational vocabulary for meaningful discussions of age and aging. it also acknowledges broad cohort differences between young-old, aged, and oldest-old segments of the population. the authors also situate the information with a strong historical context as they describe the evolution of aging and perceptions of older people from colonial times and the industrial age. next the authors focus on normal biological changes associated with aging, a refreshing change from the focus on diseases of aging that dominate some texts. they continue their positive approach in a discussion of health enhancement and maintenance— including a significant section on nutrition, activity, and other forms of health promotion. the inclusion of a chapter devoted to mental health with topics ranging from alzheimer’s disease to creativity and art acknowledges the devastation of dementia but also offers encouraging news of ways older people can continue their engagement in society. this biologically focused section also offers a realistic description of sexuality and aging and relays information on factors that inhibit and enhance sexuality in later life. overall, the entire book follows the pattern of approaching sensitive topics with a straightforward and positive manner. the sections on practical application include thought provoking questions that would be useful in a classroom discussion. the textbook is very strong in providing the historical context of aging. there are also several things lacking in this textbook. the strength it has from the inclusion of historical contexts of aging is also its greatest weakness. the textbook is almost devoid of current theoretical perspectives. two chapters include a discussion of theories used by lewis | book review anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.42 http://anthro-age.pitt.edu 63 gerontologists. the first discussion is in chapter 2 in the form of an overview of “historical social theories of aging,” a view that is apparent when reviewing the dates of the citations in this section (1961-1998) but there is no inclusion of more widely used social theories (i.e., life course, feminist, political economy of aging, or cumulative advantage and disadvantage). chapter 3 includes only a very brief discussion of a few biological theories of aging with no mention of programmed theories (i.e., longevity, endocrine, or immunological) or error theories (i.e., cross-linkage, wear and tear, or free radicals). there is little attention given to the heterogeneity of the aging population beyond gender and comparisons of black, hispanic, and white populations. there is no discussion on the role of immigration on the aging population and no discussion of global issues of aging. the section on widowhood (a few paragraphs in chapter 7) is far too brief and does not consider cultural or gender differences in experiences of losing a spouse or partner. the extensive focus on history and lack of depth makes this book inappropriate for master’s level graduate students. the absence of current theories makes this less useful in upper level undergraduate courses where current theories are applied. there would be a great need to supplement the text with more comprehensive readings should this text be used in upper level undergraduate or in graduate classes. this text would be most useful for a lower level undergraduate class as an introduction to aging. it provides clear and accessible information that could spark interests in studies of aging. moreover, its positive approach is nearly devoid of the inherent ageism of other texts that focus almost exclusively on diseases and disabilities associated with older bodies. book review book review on vulnerability, resilience, and age: older americans reflect on the pandemic sarah lamb brandeis university lamb@brandeis.edu anthropology & aging, vol 41, no 2 (2020), pp. 177-186 issn 2374-2267 (online) doi 10.5195/aa.2020.317 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 177 on vulnerability, resilience, and age: older americans reflect on the pandemic sarah lamb brandeis university lamb@brandeis.edu introduction ever since covid-19 burst into public consciousness, we have known that older adults are more vulnerable to the disease. each morning, we wake to fresh news of the toll the novel coronavirus pandemic is exerting upon ‘vulnerable older people’ – from the likelihood of developing a more severe form of covid-19, to the risks of isolation and mental health problems as older people give up social contacts in order to stay safe. we come across essays like the new york times opinion piece by professor of medicine louise aronson (2020), telling us not only about the menace of death, but also about another “rapidly growing phenomenon among older americans as a result of the covid-19 pandemic: lives stripped of human contact, meaningful activity, purpose, and hope.” we are also confronted with disturbing pandemic narratives of old people as expendable in a time of crisis. we cringed when a uk journalist suggested that covid-19 might even “prove mildly beneficial” to the uk economy, by killing off, or “disproportionately culling,” dependent elderly retirees (roberts 2020). at the same time, we witnessed a surge of public proclamations of the value and belovedness of vulnerable older people in need of civic care, and we could not ignore the call for intergenerational solidarity: if not to protect oneself, we should each be wearing masks and practicing social distancing to safeguard vulnerable others, namely the cherished elderly among us. so, the college youth who was criticized for partying nonchalantly over spring break on the beaches of florida (“if i get corona, i get corona”) later performed over instagram and cnn a dramatized public apology, pronouncing that he has in his life “elderly people who i adore more than anything in the world” (ortiz 2020). in all this shifting and divergent public dialogue about aging and covid-19, a very uniform image of the older person has emerged, as suffering and vulnerable. a gerontological society of america editorial, “aging in times of the covid-19 pandemic,” aptly identifies this homogenization: “what we are seeing in public discourse is an increasing portrayal of those over the age of 70 as being all alike with regard to being helpless, frail, and unable to contribute to society” (ayalon et al. 2020, 1). paired with such images of vulnerability is a highly disease-centered view of aging, with old age relentlessly presented vis a vis covid-19 as a risk factor akin to a comorbidity – that is, a disease or medical condition simultaneously present with another disease in a patient – so that aging or old age itself becomes one of a pair of risky diseases. yet, anthropologists know that (older) people lead highly diverse lives that are situated by bodily-health conditions, class, race, gender, cultural backgrounds, life experiences, and personal aspirations. it hence http://anthro-age.pitt.edu/ https://www.nytimes.com/2020/06/08/opinion/coronavirus-elderly-suicide.html lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 178 did not come as a surprise to me that in my early pandemic research with a group of 25 older americans (from march through september, 2020), i found that not all older people are languishing in the era of covid-19. it is significant that among this group of 25 participants – whose ages range from 69 to 93 – all are economically secure (although one lives in state-subsidized housing, and several were raised poor), and each has access to a computer and the internet. in terms of health, some in this group are highly fit, while others contend with conditions like diabetes, chronic cancer, and difficulty walking. none are in the “fourth age” of “deep” old age characterized by acute frailty, loss of agency, and dependence (gilleard and higgs 2010, 2011; twigg 2006, 50-51). this is not to say, though, that anthropologists should not also work hard to conduct fine-grained pandemic research with frail older people, rather than leaving their voices during this crisis muted and out of reach (verbruggen, howell, and simmons, this issue). at the same time, i did not find to be unusual my study population of relatively fit older persons able to engage in socially-distanced research conversations through the use of virtual technologies. we all know countless older people in private and public life – including leaders like dr. anthony fauci and both the 2020 us presidential candidates – who are enjoying vigorous thirdage lives and are adept at using virtual technologies. in this preliminary piece, i wish to share and explore my older interlocutors’ diverse and often upbeat stories of resilience, sociality, and innovation. my aim is help recast the overgeneralized narrative of the ‘vulnerable older person,’ which risks being reified through the prevailing pandemic discourses on aging. pandemic stories as the pandemic took hold, my university’s institutional review board announced that “effective immediately and until further notice, the irb has determined that all face-to-face interactions with human subject participants must cease.”1 so, i quickly transitioned to online and phone research, turning my attention to older interlocutors’ experiences of the pandemic. as i had been conducting ethnographic fieldwork already with older americans, focusing on their engagement with healthysuccessful-aging discourse (lamb 2014, 2018), it made the most sense for me to draw mainly from the same group of participants for the new pandemic-focused project. in the virtual interview conversations, i was sometimes accompanied by undergraduate student research assistants, and many older interlocutors expressed their pleasure in engaging with the students, especially as other crossgenerational interactions were curtailed.2 my 25 interlocutors live mostly in massachusetts (also new york and california) and are of a range of race-ethnicities, including mostly white, one asian american, and four black participants, with religious identities that vary from jewish to christian to buddhist to “spiritual but not religious” to atheist. most are living in independent houses or apartments, both with and without a spouse, while three live in retirement communities, and one had moved into a multigenerational home with two daughters and a grandson. a few striking themes stand out from the many rich interviews and conversations held by zoom, facetime, whatsapp, email, and phone. one is a common feeling among the interviewees that the pandemic is less hard on older people than on many younger folk. many also indexed a resilience that comes with age. i was also struck by my older interlocutors’ inventive ability to pivot routines, as they persisted in maintaining vibrant social connections and a sense of some control over their own health, even amidst the pandemic and quarantine. finally, i noticed new and rather positive ways people identified with being ‘old,’ an identity previously shunned. i turn now to explore these themes in my interlocutors’ pandemic stories and reflections. http://anthro-age.pitt.edu/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 179 life (less) disrupted everyone i spoke with felt shocked by the pandemic and quarantine during the early days, and many described periods of feeling overwhelmed and deeply saddened by the magnitude of what the society and world was going through, facing so much disruption and loss. but when i asked, “is the pandemic harder on the older or younger generations?” i was struck that most replied that it’s harder on younger people. sure, in terms of physical health, older people are at higher risk of developing serious complications from the disease. but because they had already retired and fashioned the large contours of their lives (marriages, careers, education…), many imagined that, compared to the young, the quarantine is less disruptive to their daily routines, incomes, and aspirations. doug, age 71, remarked: i’d say unquestionably the quarantine is harder for the younger people. because a lot of the older people are kind of, i won’t say isolated, but they already have a home routine. … it’s almost easier for them to do the distancing. and even though everybody’s social at every age, i find that the older people have it a little easier, because they don’t have to worry about stopping school; they don’t worry about going out on dates. you know, my son’s 33 – he’s still dating, and i said, ‘well, how’s it going?’ and he said, ‘well, i haven't been able to go out.’ when i asked how her days were going, susan, age 78, remarked, “basically fine! we’re fine. i really think it’s easier for the older people.” ken, 75, remarked, “we feel lucky that we’re [retired and] not working – we didn’t lose our jobs like a lot of younger people did, so nothing changes with the income stream.” ruth, age 87, told a few students and me on a zoom chat: “it’s harder for younger people! i’m 80-something years old. i’ve had a good life. you should have a chance.” expressing a minority perspective, cynthia disagreed with others in my study that the pandemic is even harder for younger than older generations, because missing one or two years of regular life will only be a fraction of remaining time for a 25-year-old. she and her husband had just turned 70. “say we have ten more years to live,” she mused. “if we spend two of them locked down, that’s 20 percent of our remaining lifespan.” yet many conversations expressed a deep concern for younger people, who – although much less likely to endure severe medical complications from covid-19 – are uniquely vulnerable to the potential of having their social lives upended, careers derailed, and finances shattered (mull 2020). public representations of intergenerational solidarity have focused on the need for younger people to protect the older, vulnerable ones, while leaving largely invisible older people’s expressions of care for younger generations. elders in my multi-generational fieldwork conversations, however, frequently articulated expressions of care, understanding, and solidarity flowing from older to younger generations. resilience that comes with aging many of my older interlocutors also described a vital resilience that comes with increased age and life experience, giving them a resourcefulness to brave the pandemic. other commentaries in gerontology and geriatrics have also stressed the importance of resilience – the capacity to cope with difficult situations – in many older people’s responses to the pandemic (chen 2020; colenda et al. 2020).3 doug in my study commented: i think the tension is much worse for younger people because, you know, it’s unprecedented for everybody; but when you haven't had any [difficult life challenges before] – i mean, the older people, we've coped with, you know, not pandemics, but crises before. http://anthro-age.pitt.edu/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 180 shirley, age 69, had survived two cancers with enduring health impacts, a divorce, and the death of her younger brother. she related, “people tell me now, during the pandemic, ‘don’t do this! don’t do that! it’s not safe!’ i want to tell them, ‘life is not safe!’” directing her comments especially to the two young students on our zoom chat, she observed as we were weathering the pandemic’s early days: older people tend to be a lot more flexible and creative. i think the more experiences you have, the more ways—the more ways you have to look at life. … as one ages, you have great experiences, good experiences, horrible experiences, and everything. so, you learn to kind of surrender and do what you have to do to make the best of it. … i know that at my age, part of life is just to feel joy … – to be as happy as you can given the circumstances, and sometimes they [the circumstances] suck! lulu, age 81, remarked: “every year that goes by, i feel stronger. … i guess i’m resourceful enough now [during the pandemic] not to feel upset by missing all the things i would ordinarily wish to do.” dianne, age 77, articulated a similar advantage of being older during the pandemic: we’ve learned to have more patience. when we were younger, like you girls [addressing the students on our zoom chat], we didn’t have the patience that we have now. some people may not, but i think most people, from all the things you go through in life, you learn patience. harry, age 73, told of how this pandemic brings to mind his vietnam war experiences, where he first developed resiliency. to the students on our group zoom chat, he recalled: i was dealing with something really scary when i was your age, 19 years old in vietnam, and there was no guarantee i was going to come back. … i wasn't the fastest. i wasn't the strongest. i was scared! you know, i was a kid from the southside of chicago and suddenly at 19, i’m confronting this craziness and confronting my mortality. so, now you may be confronting your mortality. … but what you learn from this experience … can help prepare you for your future. pointing to his six other older friends on the group chat, he said, “we all, you know, we’ve overcome a lot. … i guess the message about aging is that resiliency is really important.” ruth, age 87, told of growing up poor as a black girl in the segregated south; her parents were live-in domestic servants for a white family, and her schooling in the 1930s took place in a one-room schoolhouse for black children, hand built by local black farmers. since that time, while forging a meaningful career as an educator, ruth had persisted through other life challenges, including the deaths of beloved family members, her own breast cancer and, most recently, her son being hospitalized for six weeks on a ventilator from covid-19. through several zoom conversations, she exuded a sense of resilience and optimism, some of which she attributed to her being “an 87-year-old person” who had learned from so many life experiences. about the pandemic, ruth remarked, “we need to look for the good in this opportunity. it didn’t just happen for nothing.” some of the lessons this crisis could teach us, she thought, were learning to become more attentive to the needs of others, doing with a little less and sharing, and taking time for reflection, to stop and think. she told us that each day, she tries to find and notice some “beautiful things of the pandemic,” such as how her grandson set up two gardens in the backyard, and what a joy it is to see how all the green beans, cucumbers, and tomatoes are coming along. we glean in such narratives a sense of the multiple ways that past life experiences can shape older adults’ current experiences of the pandemic. their narratives suggest that the transformative life http://anthro-age.pitt.edu/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 181 experiences many older people have accrued over long lives gives them a resilience, insight, and emotional protection that helps them traverse this challenging time. vibrant socialities and distant proximities most of my interlocutors also report being able to pivot their routines to maintain vibrant social connections, even while carefully observing all the social-distancing rules. aside from standard phone calls, many have quickly adopted virtual platforms like zoom, facetime, houseparty, and bridge base online as avenues for social interaction. when he logged on to our zoom meeting, walt at 93 had just come in from his daily walk outside with his wife and sister-in-law, six feet apart. in mid-march, he had also quickly adapted to holding over zoom the music appreciation class he teaches through his synagogue, while signing up for the synagogue’s many other virtual classes and services. ken and june, ages 75 and 74, described the quarantine as feeling almost party-like at first, as friends were getting together for socially-distanced walks outside, learning to use zoom, and participating in virtual seders. “zoom has become even more popular than toilet paper!” ken laughed. a few weeks into the massachusetts lockdown, lloyd, age 71, commented, “the last 72 hours, people i haven’t been in touch with for years – those who are still alive – are all checking in. … so, i absolutely have more contacts now with some people than before!” he held up his calendar for me to see over zoom; in each white square, he had entered one or more people he planned to contact by phone, email, or video conferencing. “on a day where there’s a vacancy, i insert a reason to call a person – and now i have a full week!” he copied me on a cheerful message he emailed to a group of old friends: two days ago, jerry and i had the wonderful pleasure of zooming with a long-lost friend of 49 years. how wonderful we all concluded that was. the world is a mess, but zoom has transformed our existence in it. recommendation: reach out and ‘zoom’ someone. to socialize, dianne, age 77, has shared virtually every pandemic meal by speaker phone with a close friend who, like her, is widowed and living alone. she looks forward to carrying her breakfast, lunch, and dinner out to her balcony, propping up the phone, and enjoying her meals and conversation with a dear friend. when i asked gayle, 84, how she was doing with the pandemic, she replied, “i’m fine! i have a deck. i can have one or two people over for lunch seven days a week.” she had always enjoyed cooking, and now even more so. she and her friends are all sure to sit six feet apart. “if it’s cold, we either drink more wine or bundle up!” gayle laughed. senior residential communities are getting an especially bad rap in media and public discourse, and of course many nursing homes have experienced tragic, shocking losses of residents to covid-19. here, too, however, we encounter an overgeneralized narrative of nursing home horrors. my few interlocutors living in three different retirement communities in massachusetts and california each describe feeling very safe in their homes, which to date (as of september 2020) had experienced almost no covid-19 cases. while missing their institutions’ in-person group activities, each interlocutor had adapted to socially distant connections. elizabeth, a white woman in her late seventies, participates in zoom meetings throughout the day and evening, including as a member of her residence’s diversity and hospitality committees. then, when the black lives matter movement resurged across the nation in response to the police killing of george floyd, elizabeth’s local church began a zoom anti-racism group which she joined, reading and virtually discussing books like ibram kendi’s how to be an antiracist and robin diangelo’s white fragility. carol described how her retirement community began to organize a mobile bar to come to residents’ doors for pandemic friday happy hours, as she and her http://anthro-age.pitt.edu/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 182 hallway neighbors would choose their cocktails and pull their chairs into their open doorways, conversing with each other at a distance. “it almost feels like normal again!” she exclaimed with a smile. we can see that the prevailing narrative about older people languishing in isolation during pandemic times is, for many, simply untrue. at the same time, it would be equally overgeneralizing to suggest that all my interlocutors found social distancing easy and joyful. the most common regret expressed was missing physical time together with grandchildren. marjorie further declared, “i’d dump the alone time in a second! the thought of living an isolated life like this, just electronically connected, is unbearable.” on being (“yes, i am”) old finally, i have been struck by new ways my interlocutors are claiming the identity of being ‘old,’ as an unexpectedly motivating identity. anyone familiar with us cultures of aging will know that americans have long eschewed identifying as old, an identity widely perceived as negative, pejorative, ageist, and something “other” than one’s “ageless” self (gillick 2006; kaufman 1985; lamb 2018). this is a phenomenon i had been critically scrutinizing in my us research for some years (lamb 2014, 2018). suddenly, when the pandemic struck, i began noticing the very same interlocutors who had resisted calling themselves old, now claiming the identity: “you know, i’m old! i’m in a high-risk group.” “i’m old! i qualify for the senior grocery-store hours—i’m going to use them!” “i’m old! i have to be very careful!” “now, friends just as old as you, are calling to tell you, ‘now, don’t go out!’” one certainly could consider such acts of embracing an ‘old’ identity to be evidence of internalizing the kinds of ageist ideologies that have flourished during the pandemic, such as that all people over a certain age (say, 65 or 70) are ‘on the way out’ and doomed to die (gullette 2020). yet in my interlocutors’ old-embracing dialogue, to my surprise, i began to see the new claim to the identity of ‘old’ as being often not defeatist or self-deprecatory, but rather in some ways affirmative and motivating. for some, donning the identity of ‘old’ served to heighten their motivation to take agency over their own health – practicing self-care and hygiene, “following all the rules,” eating well, and exercising more. marjorie, age 77, had never been able to get herself to exercise, but now, during the pandemic, she made a point to walk each day. walt at 93 described walking and exercising as “almost an addiction,” especially during the pandemic, saying with a smile, “if i miss a day, i’m almost afraid!” lloyd described his meticulous safety practices, including scrubbing down everything to enter the home, and (after seeing “covid-19 is present” signs in his building’s lobby) keeping as far as possible from the crack under his apartment’s front door. “i’m trying to keep going! now i have a threat at my door, if you know what i mean! but i’m trying to keep going.” doug, age 71, and his wife had both been infected by the virus during the early days when new york city, their home, was at the pandemic’s us epicenter. “and you know, when you’re old and you realize that you’re in the cohort that is [at higher risk], it’s tough. and so, you know, it was a sobering thing.” but now that they have both recovered, doug remarked: i’m maniacal about trying to get my 30 to 45 minutes of a workout in every other day. … my point on this is that you got to be, you got to remain active, you got to keep moving. that’s critical … you know, i want to live forever or die trying! that’s my mantra. http://anthro-age.pitt.edu/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 183 some also described how a new awareness of their own aging and mortality during the pandemic inspired a heightened sense of making the most of life and understanding or even embracing the existential limits of the human condition. in a group zoom conversation with me, five students, and seven longtime friends in their seventies, jack shared: “i used to think i was invincible and invulnerable. like nothing could hurt me. and now i’m using hand sanitizer when i open the door! i’m afraid of this virus!” he urged the students on our chat to not take their health for granted. “i didn’t really realize before that health really is evanescent. it’s fragile. … so, my message is that this event has awoken me to my vulnerability. i think this should be a lesson to all people.” bill concurred, adding, “it’s good not to lose sight of that objective truth.” harry observed, “whenever you’re confronted with death, like we are right now, and you overcome that, then you have resiliency. and the more you learn from that, the better quality of your life.” doug, the one who had survived the virus, mused: i think this illness just potentiated our ability to battle it out every day. … in terms of my sense of mortality, i think, man, i’m surprised i got to this age to begin with! so, you know, i look at every day like it’s a gift. you know, live every day like you’re gonna die tomorrow, because one day you’re going to be right! doug feels that his newfound awareness of mortality serves to heighten, rather than curtail, his positive drive to make the most out of life. in a different conversation, george, age 85, reflected: i’m gonna tell you right now what it’s like in the coronavirus crisis. i’m old, and old people are supposed to be especially vulnerable. … but, you know, i feel lucky to be as old as i am. i will feel lucky to be older still if that works out. … you know, i’m alive. i’ve been alive for a long, long time. i look forward to whatever i look forward to, but i know it will end. . . . i had this very kind of weird email exchange the other day with somebody who said, because we’re going to die, life has no meaning. and i said, ‘no, just the opposite! because we’re going to die, we have 60 or 80 or 100 years to give it meaning.’ we humans have that right – it’s part of what agency is. it’s that i create the meaning of my life. on the eve of the pandemic rosh hashanah of 2020, lloyd – who is african american and christian – sent to a group of mixed-ethnic old college friends an email greeting: “ya’ll are getting’ old!! we’ve been doing this for a l-o-n-g time now! and, no matter our conditions, how blessed we are to still be able to celebrate another year’s passing in whoever’s tradition. happy rosh hashanah and peace, lloyd.” humor about being old during the pandemic has also cropped up a lot in my pandemic conversations, possibly for reasons suggested by tom mctague in his atlantic essay, “yes, make coronavirus jokes”: “humor helps us take back control and connect – two things we have lost in our fight against the pandemic” (mctague 2020). lloyd joked about his grocery shopping experiences while utilizing the pandemic senior citizen hours: “they only give us an hour to walk around, and half of us can’t walk!” while i was chatting with nick, a text message came in from his niece. he texted back, reading aloud to me and laughing: “they say old people are more in danger from the virus, so it’s a good thing i’m only 91! ha ha.” here, we see examples of older adults claiming value and agency with, rather than merely against, vulnerability (verbruggen, howell, and simmons, this issue). http://anthro-age.pitt.edu/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 184 concluding thoughts we are witnessing such profound human suffering amidst the covid-19 pandemic that it may seem strange or unbefitting to bring to light some older americans’ pandemic narratives of optimism, humor, and resilience. anthropologists are well positioned to strive to expose the suffering of vulnerable populations facing covid-19, illuminating the myriad intertwined biological and social complexities of the virus in a world riddled with intensified social, economic, and health inequalities (ennismcmillan and hedges 2020; higgins, martin and vesperi 2020; sadruddin and inhorn 2020). as part of understanding pandemic suffering, we absolutely need to recognize the global toll the covid-19 pandemic is exerting upon vulnerable older people, and to pay attention to the diverse origins of this vulnerability. however, the dominant narrative of the ‘vulnerable older person’ in the time of covid-19 is misleading and even damaging in its uniformity. older people in the pandemic are not only vulnerable, isolated, and dying. many are also experiencing resilience, vibrant social connections, agency, and pleasure. if discourse on aging in the time of covid-19 focuses only on vulnerability, we risk perpetuating implicit ageist assumptions, which are already so rampant in our society in ways often hard for north americans to recognize (applewhite 2016; gullette 2017, 2020; lamb 2018). in the prevailing pandemic public discourse of aging, we are bombarded with overgeneralized images of all older people as ‘those who are about to die,’ vulnerable, frail, unable to employ new virtual technologies, and not innovative in times of dramatic change. by seeking out older americans’ own voices and perspectives – concentrating for this project on those who were able to communicate virtually, with privileged access to the internet and technology – we see some alternatives to the prevailing stereotypes. the abundant conversations and narratives shared by my interlocutors shed light on more complex and nuanced pandemic aging experiences, providing an antidote to the homogenization and anonymization of a large and diverse group. these fieldwork conversations have helped me see how an anthropology of aging in pandemic times needs to regard both the harsh realities of the immense suffering of many older people, and the diverse ways the positive human experiences of optimism, resilience, hope, empathy, strength, and creativity can come to matter across the life course. acknowledgements an earlier version of this article was published on july 9, 2020 in the “age of covid-19” blog series of the association for anthropology, gerontology, and the life course. i am tremendously grateful to my research participants, who generously shared their insights and experiences, and to my brandeis undergraduate-student research assistants, ji chen, izzy hochman, gabriela mendoza, claire ogden, tirtza schramm, and lin xinbei, who participated in some of the virtual interviews and data analysis, and several of whom served as co-authors of the original blog essay. i am grateful also for the productive suggestions offered by christine verbruggen. the article was made possible in part by a grant from carnegie corporation of new york. the statements made and views expressed are the responsibility of the author. notes 1. this announcement was made by the brandeis university irb on march 19, 2020, and remained posted on its website as of this writing: https://www.brandeis.edu/ora/compliance/irb/. accessed september 23, 2020. 2. from march through june 2020, brandeis undergraduate research assistants ji chen, izzy hochman, gabriela mendoza, claire ogden, tirtza schramm, and lin xinbei participated in many of the zoom interviews and http://anthro-age.pitt.edu/ https://anthropologyandgerontology.com/aage-news/the-age-of-covid-19/ https://www.brandeis.edu/ora/compliance/irb/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 185 helped with interview transcribing and data analysis. 3. see also macleod et al. 2016 for a review of gerontological literature on resilience among older adults. references applewhite, ashton. 2016. this chair rocks: a manifesto against ageism. new york: celadon. aronson, louise. 2020. “for older people, despair, as well as covid-19, is costing lives.” new york times. accessed september 22, 2020. https://www.nytimes.com/2020/06/08/opinion/coronavirus-elderlysuicide.html. ayalon, liat, alison chasteen, manfred diehl, becca r. levy, shevaun d. neupert, klaus rothermund, clemens tesch-römer, and hans-werner wahl. 2020. “aging in times of the covid-19 pandemic: avoiding ageism and fostering intergenerational solidarity.” the journals of gerontology: 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(april 16, 2020). https://doi.org/10.1093/geronb/gbaa051. chen, liang-kung. 2020. “older adults and covid-19 pandemic: resilience matters.” archives of gerontology and geriatrics (july-august 89): 104124. https://doi.org/10.1016/j.archger.2020.104124. colenda, christopher c., charles f. reynolds, william b. applegate, philip d. sloane, sheryl zimmerman, anne b. newman, suzanne meeks, and joseph g. ouslander. 2020. “covid-19 pandemic and ageism: a call for humanitarian care.” journal of the american geriatrics society. july 14, 2020. https://doi.org/10.1111/jgs.16663. ennis-mcmillan, michael c., and kristen hedges. 2020. “pandemic perspectives: responding to covid-19.” open anthropology 8(1). https://www.americananthro.org/stayinformed/oaarticledetail.aspx?itemnumber=25631. gilleard, chris and paul higgs. 2010. “aging without agency: theorizing the fourth age.” aging & mental health 14(2): 121-128. gilleard, chris and paul higgs. 2011. “ageing abjection and embodiment in the fourth 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old: agency, self-care, and life-course aspirations in the united states.” medical anthropology quarterly 33(2): 263-281. macleod, stephanie, shirley musich, kevin hawkins, kathleen alsgaard, and ellen r. wicker. 2016. “the impact of resilience among older adults.” geriatric nursing 37(4): 266-272. https://doi.org/10.1016/j.gerinurse.2016.02.014 mctague, tom. 2020. “yes, make coronavirus jokes.” the atlantic. april 3, 2020. https://www.theatlantic.com/international/archive/2020/04/humor-laughter-coronaviruscovid19/609184/. http://anthro-age.pitt.edu/ https://www.nytimes.com/2020/06/08/opinion/coronavirus-elderly-suicide.html https://www.nytimes.com/2020/06/08/opinion/coronavirus-elderly-suicide.html https://doi.org/10.1093/geronb/gbaa051 https://dx.doi.org/10.1016%2fj.archger.2020.104124 https://doi.org/10.1111/jgs.16663 https://www.americananthro.org/stayinformed/oaarticledetail.aspx?itemnumber=25631 https://www.tikkun.org/avoiding-bias-and-tragedy-in-triage https://doi.org/10.1080/19428200.2020.1760627 https://doi.org/10.1016/j.gerinurse.2016.02.014 https://www.theatlantic.com/international/archive/2020/04/humor-laughter-coronavirus-covid19/609184/ https://www.theatlantic.com/international/archive/2020/04/humor-laughter-coronavirus-covid19/609184/ lamb | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.317 http://anthro-age.pitt.edu 186 mull, amanda. 2020. “generation c has nowhere to turn.” the atlantic. accessed april 13, 2020. https://www.theatlantic.com/health/archive/2020/04/how-coronavirus-will-change-young-peopleslives/609862/. ortiz, aimee. 2020. “man who said, ‘if i get corona, i get corona,’ apologizes.” new york times, march 24. accessed september 22, 2020. https://www.nytimes.com/2020/03/24/us/coronavirus-brady-sluder-springbreak.html. roberts, joe. 2020. “telegraph journalist says coronavirus ‘cull’ of elderly could benefit economy.” metro, march 11. accessed september 22, 2020. https://metro.co.uk/2020/03/11/telegraph-journalist-says-coronaviruscull-elderly-benefit-economy-12383907/. sadruddin, aalyia feroz ali, and marcia inhorn. 2020. “aging, vulnerability and questions of care in the time of covid-19.” anthropology now 12: 17-23. twigg, julia. 2006. the body in health and social care. new york: palgrave macmillan. http://anthro-age.pitt.edu/ https://www.theatlantic.com/health/archive/2020/04/how-coronavirus-will-change-young-peoples-lives/609862/ https://www.theatlantic.com/health/archive/2020/04/how-coronavirus-will-change-young-peoples-lives/609862/ https://www.nytimes.com/2020/03/24/us/coronavirus-brady-sluder-spring-break.html https://www.nytimes.com/2020/03/24/us/coronavirus-brady-sluder-spring-break.html https://metro.co.uk/2020/03/11/telegraph-journalist-says-coronavirus-cull-elderly-benefit-economy-12383907/ https://metro.co.uk/2020/03/11/telegraph-journalist-says-coronavirus-cull-elderly-benefit-economy-12383907/ debate which self is ‘ageless’? jason danely oxford brookes university jdanely@brookes.ac.uk anthropology & aging, vol 44, no 1 (2023), pp. 111-114 issn 2374-2267 (online) doi 10.5195/aa.2023.477 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:jdanely@brookes.ac.uk debate | danely | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.477 http://anthro-age.pitt.edu 111 debate which self is ‘ageless’? jason danely oxford brookes university jdanely@brookes.ac.uk “the self is the agent of a life: the ambiguously self-aware progenitor of the most deeply grounded and all-encompassing existential project a person can be involved in – being you, making the life you have.” (steven parish 2008,4) “old age isn’t a state of mind. it’s an existential situation.” (ursula k. leguin 2017, 13) the first time i was called out during fieldwork for referring to ‘seniors’ is vividly etched into my memory. it happened during a discussion at an ‘elder welfare center’ (rōjin fukushi senta), a municipally managed community building hosting various clubs and classes open to anyone over the age of sixty, located in kyoto. having just arrived in japan for fieldwork, i was excited to have already secured an introduction. as i sat at the table with the center’s director and three regular attendees, i confidently launched into my pitch to hold a special event so that i could introduce myself and start a discussion about general topics related to aging in japan with the men and women who used the center. this was going to be my fieldwork debut, and i was sure that everyone there would enthusiastically assent. i was doing my best to impress, using polite, formal japanese, as i stumbled through the explanation of how interested i was in the perspectives of seniors, when i was suddenly interrupted sharply by one of the regulars, a tall man with a well-groomed moustache and bolo string necktie. “seniors?! who are these ‘seniors’ you’re talking about? there are no ‘seniors’ here!” the mood had suddenly tensed, and my impulse to laugh was caught in my throat. i smiled, frozen in shock and embarrassment, desperately trying to assess what had just happened: was this comment meant to be a joke? surely, they identified as ‘seniors’ if they are spending their days at an elder welfare center? the center director jumped in to ease the tension, explaining that my fumble was simply due to the fact that i was a non-native speaker. i apologized to everyone and managed to continue, carefully avoiding any words like ‘senior’ that might connote ‘old age.’ still, the incident left me a little confused. how was i to learn anything about growing older in japan if older people didn’t identify as old? how could i determine the focus of my research if ‘old age’ did not constitute an identity or even a meaningful stage of the life course? what did the man mean by ‘there are no seniors here’? fortunately, the meeting ended amicably and i was invited to come back to the center. i made these visits a regular part of my weekly schedule, sneaking into the different activity groups to learn traditional dancing or watch classic movies. as i got to know the attendees, i soon began to get a sense of why the term ‘senior’ (kōreisha) might have sparked such a strong response. to me, it had seemed like the most neutral term for the category of ‘older person,’ and was used frequently in newspapers http://anthro-age.pitt.edu/ debate | danely | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.477 http://anthro-age.pitt.edu 112 and scholarly articles alike. alternate japanese words used to identify someone as older carried too much baggage. the word used in the name of the center, ‘elder’(rōjin), for example, retained a kind of old-fashioned overtone of the wise and ‘honorable elder,’ while at the same time, it suggested frailty, dependence, and senility. it was rarely used in everyday conversations in a positive way. the term ‘senior,’ by contrast, tended to be reserved for use in more professional, administrative, or clinical contexts. it simply meant a category of people over the age of 65. although more technical, its association with institutions related to social dependence and burden (forced retirement, pensions, discount bus passes, etc.) was something that the users of the center were all taking great pains to avoid. as john traphagan (2006) pointed out in his research on being a ‘good rōjin’ in japan, involvement in social activities and clubs at places like the center is strongly tied to moral imperatives to preserve independence and avoid becoming burdensome on others in later life. whether the activity was mainly physical (ballroom dancing), cognitive (crafts), or social (karaoke), there were frequent comments among participants about things like relatively minor lapses in memory, as well as more serious illness and impairment. all of this talk flowed eventually towards the concern that if they did not do more, they would soon reach a point where they would have to get help from children or professional care ‘helpers.’ would these men and women at the elder welfare center think of themselves as ageless? or to be more precise, would they agree with sharon kaufman (1993) when she states, “old people do not perceive meaning in aging itself so much as they perceive meaning in being themselves in old age” (1993, 14)? many, no doubt, would, though not without some hesitance. they certainly didn’t want to take on a label of ‘senior’ along with the meanings those supposedly neutral terms obtained as they circulated through institutions, bureaucracies, and public discourses. while the intellectual contributions of sharon kaufman's oeuvre are beyond debate, and her carefully stated empirical findings regarding selfperception among older adults in the late seventies us west coast are compelling, generalizing the conclusions of the ageless self requires critical consideration of the ways subjectivities are politically and historically situated. one of the dangers of theorizing too broadly on the basis of kaufman's findings is that it risks downplaying the role of the social and political context in which ageless selves are produced, lending itself to neoliberal notions of selfhood. most people at the center were born just a few years prior to the post-war baby boom generation (1947'49). their retirements coincided with a rapid rise in neoliberal policy rhetoric around prevention, responsibility, and independence, with all the moral and ideological force that entailed (moore 2017). with the establishment of a new long-term care insurance system in the early 2000’s, a new vocabulary re-inscribed the boundaries of old age, with ‘customers’ of care services on one side, and old ‘patients’ on the other. old age was not only pathologized, but it was transformed into an incurable lifestyle disease, that people at the center wanted to avoid it all costs. japanese popular media is more direct in voicing the terror of becoming a ‘senior.’ lonely deaths (kodokushi) (danely 2019), care murders (kaigo satsujin) (saito 2017), and other viscerally shocking images saturate media representations of a national population aging as a crisis of “no future” (allison 2013, 23). the reluctance among older people to adopt negatively weighted categories of ‘old age’ and to actively resist them by adopting narratives aligned with “successful” or “active aging” (whether in the us or japan or elsewhere) (lamb 2017), reveals how an ‘aged self’ falls outside of the structure of values of modern society and its future—it becomes “unspeakable” (cohen 1998, 184). historically contingent discourses constrain the possibilities for personal experiences of aging to be felt and appraised as meaningful. however, older japanese adults are also not entirely oblivious to these discourses and may strive to find other ways of recovering a sense of meaning in old age. one such experience of the current cohort of older adults in japan is caring for older parents, without the benefits http://anthro-age.pitt.edu/ debate | danely | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.477 http://anthro-age.pitt.edu 113 of extended family support, often over long periods of time marked by chronic debility. unlike the older sample of san franciscans kaufman spoke to (born decades earlier), caring for older parents in advanced old age had a major impact on the japanese baby boomers’ own sense of longevity, and their hopes that their own children would not experience the same hardships of providing unpaid care. projects of healthy aging at places like the center are not only aimed at buffering the effects of agerelated physical and mental decline, but they are also a way of restoring a hopeful future for one’s own children. as markus and kitayama (1991, 245-246) explain, in japan, “relations with others in specific contexts are defining features of the self.” that is, the japanese self is not only construed in relation to others, but includes others within its boundaries (markus and kitayama 1991, 245). the self that is ageless lacks this capacity. it is only by virtue of age that a japanese person can be part of generational relationships rather than outside of them, and such self-construal brings an alternate meaning to healthy aging based in kinship rather than the separate and independent self. as anthropologists who have worked with other structurally marginalized groups have demonstrated, selves overflow the power of cultural and biopolitical narratives (stevenson 2014). they show that selves – ageless or aged – are not things that are determined or contained by discourses. part of the power of kaufman’s ethnography, and a reason why it is still important, is precisely the way it revealed the weakness of historical events and institutional structures to determine the shared and meaningful identities for people across the life course. outside of the center, older japanese people i spoke with cultivated aging selves through exploring the new relationships, rituals, and play afforded by an aging self (danely 2014, 2017; see also kavedzija 2019; moore 2014). they mourned parents and spouses, embarked on pilgrimages, took up new hobbies, and moved houses. through it all, what lasted and became part of their enduring values was the ways the self rose up to meet the world, and was changed in the process. steven parish (2008) describes this process of becoming as one of “possible selves,” of people as they move through life and encounter “existential possibilities: what they might become; what they have to become as they enter life or clash with existence; as well as what they desire to be or not to be” (2008, x). instead of consolidating and defending an essential, unchanging self-identity across the life course, a perspective of possible selves considers the ways selves might be reorganized or made anew by mobilizing feelings, imagination, and relationships. aging, as the process of inhabiting change over time, then, is the work of developing and shedding what parish calls, “the sensitive membranes of feeling and attitude that join us to the world” (2008, 6), to find possibility, even freedom, not in the abstraction of age, but in its lived capacities. this urges us to question, can a self that finds no meaning in old age meet itself in the conditions of later life? outside of the elder welfare center i kept walking alongside my interlocutors. they talked about the changes in the facades of the buildings we passed and the shifting timing of flower blooms marking the start of new seasons. maturity made these changes not only more accessible, but more deeply rooted in their self-reflection. they opened up about their past, the choices they might have made, their regrets. they turned these reflections over, back and forth like a hot potato that was only comfortable if kept in motion in your palms. why did these pasts at times still sting, while at other moments my interlocutors seemed to discard them easily as unimportant? others talked about the future, not in terms of personal fitness or professional achievements, but as a project to extend the capacity of the self within the potentialities of the world by placing it in a lasting legacy carried on by others. one older man, for example, devoted his time to the preservation of a local festival, which depended on the transmission of customs to younger generations, but which was at risk of disappearing because new families in the neighborhood were smaller and had less personal http://anthro-age.pitt.edu/ debate | danely | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.477 http://anthro-age.pitt.edu 114 connection to the area (danely 2014, 96-101). for this man, the festival was a project of hope, not for the ageless self, but for the continuation of a meaningful older self, whose legacy would continue to enliven the world long after individual identities had faded from memory. in these projects, we might see possible selves, deeply engaged with pasts and futures, relationships, bodies, spirits. as one older woman put it to me, they were the very “heart of aging” (danely 2014, 185), the sublime beauty of change, transience and yielding. possible selves offer a way to examine older age as a potential source of meaning in later life, not necessarily as a social role that one occupies, but as an "existential situation" as ursula k. leguin (2017, 13) puts it, without reliance on the normative categories based on chronological age, stages, or prescriptive social roles like those that clashed with kaufman's informants' sense of self. in attending to the capacities of possible selves that arise or are denied in later life, we break free from both conventional notions of age and self, and open to their multiple fluctuating configurations. references allison, anne. 2013. precarious japan. durham, nc: duke university press. cohen, lawrence. 1998. no aging in india: alzheimer’s, the bad family, and other modern things. berkeley: university of california press. danely, jason. 2014. aging and loss: mourning and maturity in contemporary japan. new brunswick, n.j.: rutgers university press. _______. 2017. “foolish vitality’ in successful aging as a contemporary obsession: global perspectives, edited by sarah lamb, jessica robbins-ruszkowski, and anna corwin, 154-167. new brunswick: rutgers university press. kaufman, sharon. 1986. the ageless self. madison: university of wisconsin press. kavedžija, iza. 2019. making meaningful lives: tales from an aging japan. philadelphia: university of pennsylvania press. markus, hazel r., and shinobu kitayama. 1991. “culture and the self: implications for cognition, emotion, and motivation.” psychological review 98 (2): 224-253. lamb, sarah, jessica robbins-ruszkowski and anna corwin, eds. 2017. successful aging as a contemporary obsession: global perspectives. new brunswick: rutgers university press. leguin, ursula k. 2017. “the diminished thing” in no time to spare: thinking about what matters. boston: mariner books. moore, katrina. 2017. “a spirit of adventure in retirement: japanese baby boomers and the ethos of interdependence.” anthropology & aging 38 (2): 10-28. moore, katrina l. 2014. the joy of noh: embodied learning and discipline in urban japan. albany: state university of new york press. parish, steven 2008. suffering and subjectivity: possible selves. new york: palgrave macmillan. saito, mao. 2017. “current issues regarding family, caregiving and gender equality in japan: male caregivers and the interplay between caregiving and masculinities.” japan labor review 14 (1): 92-111. traphagan, john. 2006. “being a good rōjin: senility, power and self-actualization in japan” in thinking about dementia, edited by annette leibing and lawrence cohen. new brunswick, nj: rutgers university press. http://anthro-age.pitt.edu/ book review review of armengol, josep m., ed. aging masculinities in contemporary u.s. fiction. london: palgrave macmillan cham. 2021. pp. xii, 192. price: $104.35 (hardcover); $73 (paperback); open access (ebook). arthur ivan bravo new york city department of education arthur.ivan.bravo@gmail.com anthropology & aging, vol 43, no 2 (2022), pp. 111-113 issn 2374-2267 (online) doi 10.5195/aa.2022.432 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | bravo | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.432 http://anthro-age.pitt.edu 111 book review review of armengol, josep m., ed. aging masculinities in contemporary u.s. fiction. london: palgrave macmillan cham. 2021. pp. xii, 192. price: $104.35 (hardcover); $73.04 (paperback); open access (ebook). arthur ivan bravo new york city department of education arthur.ivan.bravo@gmail.com despite the fact that the population of aging men is growing, particularly in the western world, there is a dearth of scholarship on how aging affects masculinity. in response, professor of american literature and gender studies josep m. armengol, has edited a volume titled aging masculinities in contemporary u.s. fiction, to rectify said deficit by considering the subject as it has been depicted in recent american narrative media. the volume mines into thematic material from mostly contemporary american fiction literature, but also discusses some non-fiction, and even television series. contributions examine a wide range of issues, such as the problem of defining masculinity across local to global scales, the dynamic between sexuality and aging, the feminine association with aging, the aging male body as a site for exploring tensions in power and privilege, how modern capitalist society devalues older adults, and the psychological and emotional work involved in aging, just to name a few. the sources employed range in publication from 1960 to 2016, however the settings in which they take place reach from the immediate post-war era far into the imagined future. as armengol explicates in his introduction to the volume, remedying the dearth of scholarship on aging masculinities entails more than merely considering the discrepancy between this ever-growing demographic and the relative lack of scholarly attention directed at it. aging masculinities urges us to look at the subject population as a decidedly heterogeneous one on the way to unearthing just how exactly its identities are fashioned. towards those ends, armengol has organized the volume’s contributions according to overarching areas of concern in popular representations of aging masculinities: “gendering age,” “men’s aging in popular fiction,” “older men in autobiography and memoir,” “aging beyond whiteness,” and “queering age.” in the first part, “gendering age,” the superiority and power historically associated with masculinity is pitted against the emasculation that aging bequeaths upon the masculine condition in the contemporary world. in this regard, the volume’s first chapter by juan gonzález-etxeberria, is an analysis of john updike’s epic yet familiar narrative of the life of middle-class everyman harry “rabbit” angstrom. rabbit’s life story spans the prosperous, post-war peacetime era of 20th century america, in retrospect, as is well known, a time perhaps now ripe for thinking about through the prism of how aging disturbs the very identity of masculinity, including its expectations. this is, considering how visibly the subject population rabbit is a part of, has itself aged in the public and academic eye, all the while the very concept of masculinity has itself weathered unprecedented tension in the modern era. the concerns in gonzález-etxeberria’s analysis are wide-ranging and http://anthro-age.pitt.edu/ book review | bravo | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.432 http://anthro-age.pitt.edu 112 expansive. they make reference to a multitude of overarching themes in the study of aging masculinity, many of which will reappear throughout the volume. notably, he cites from arthur schlesinger’s timely 1958 article, “the crisis of american masculinity,” “today men are more and more conscious of maleness not as a fact but as a problem,” foreshadowing much of what follows in the volume (20). but still other themes are explored, through the thoughts and actions of rabbit, as they occur in the narrative. they range from the feelings of general uselessness, and pointlessness in life, that rabbit feels in his semi-retirement, to the physical, psychological, and emotional consequences of getting older that spur him to take a more passive and un-masculine role in his household, allowing his wife to take a larger role in household decision-making, to fretting over his own virility, possibly playing a role in a tryst with his own daughter-in-law. likewise, in chapter 3, teresa requena-pelegrí posits the aging male body itself as a site where a seemingly taken for granted privilege suddenly becomes vulnerable to contention. thus she aims to explore “the inherent tension in the aging male body that results from the different experiences of privilege and discrimination and the ways in which…possibilities for constructing non-normative identities arise…” (48). she further explicates that the “analysis of male privilege and aging offers a nuanced representation of masculinities in old age as a site of intersecting identity positions” (58). she finds two such examples in the characters of larry cook and jack kennison, in jane smiley’s novel a thousand acres and in elizabeth strout’s novel olive kitteridge, respectively. while larry clings to a privilege that has allowed him to unjustly and harmfully wield power over his own daughters, even after his retirement and bodily deterioration, jack arrives at a kind of acceptance to the thought of yielding the power that privilege confers, which may or may not allow him to partake of a valued intimacy with his lover. the second part of the volume focuses on the representation of aging masculinity specifically in popular fiction. in chapter 4, m. isabel santaulària-capdevila echoes gonzález-etxeberria’s findings relating the desperation, even resignation, in the face of the inevitable process of aging, when looking at how famed horror author stephen king has portrayed the aging male in some of his most wellknown novels such as it, dreamcatcher, and doctor sleep. in king’s narratives, santaulària-capdevila finds a near-unbearable abundance of pain, the angst bitterly earned from a loss of innocence as inevitable as aging and death. this recalls simone de beauvoir’s observation from the coming of age, that “old age exposes the failure of our entire civilization,” touching upon the risks of power and purpose that come with the modern, capitalist way of life (31). nevertheless, she argues king’s narratives present alternatives wherein patriarchy is thematically contested even as his aging male protagonists cope with their respective conundrums at least partly by discovery of decidedly feminine values such as “love, memory, childhood, and friendship” (75). meanwhile, in chapter 5, ángel mateos-aparicio martín-albo finds in the fictional lives of the male protagonists of the science-fiction television franchise star trek, namely james t. kirk and jean-luc picard, both the problematic trappings of an american heritage built on colonization and imperialism as well as the creative freedom inherent to the genre to consider alternatives to existing conceptions of aging. in “older men in autobiography and memoir” (part 3) the relevant writings of two prominent jewish-american authors, philip roth and paul auster, are considered. in her contribution, “selfrepresentation ‘between two’” esther zaplana employs psycholinguist luce irigaray’s concepts of the “sexuate” identity or subject, the related need for a culture “between two” or “being in two,” and considerations of an “other,” towards realizing some sort of “self-representation” (102-103). she uses these in order to articulate roth’s own relationship with his dying father as narrated, and to potentially realize “an ethics of care in a relationship with older and elderly individuals which involves respecting the differences arising from old age” (106). http://anthro-age.pitt.edu/ book review | bravo | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.432 http://anthro-age.pitt.edu 113 the volume’s final two parts, “aging beyond whiteness,” and “queering age,” discuss thinking about aging for non-white and queer or non-heteronormative males, respectively. regarding the former, mar gallego appraises african-american author toni morrison’s novels the bluest eye and love, firstly to identify the author’s “attempts to defy denigratory stereotypical designation[s] of black men,” and secondly to do the same towards articulating her visions for new or alternative relationships reflecting her ethics as a “feminist and anti-racist” (125). tellingly, the formula of said ethics and values, informing such relationships, echoes those of other contributions in the volume, such as the idea of achieving self-realization by nurturing relationships with others, as proposed by irigaray (chapter 6, 97). in much the same spirit, though specifically responding to a post-9/11 and globalized era, marta bosch-vilarrubias selects five notable novels from the late 90s into the noughties written by arab women about aging arab men. as mentioned, the volume’s final part, “queering age,” explores aging as depicted in fiction but specifically for queer or non-heteronormative males. apart from this, it also summarizes and complements findings and alternatives arrived at in the prior contributions. in “sex and text: queering older men’s sexuality in contemporary u.s. fiction,” volume editor josep m. armengol mines the subjects of aging queer or gay men in literature with the intent to deconstruct the traditionally held, narratively dominant, stereotypical assumptions atrributed to them. perhaps fittingly, the volume’s final contribution, “on long-lasting humanimal friendships: gayness, aging, and disease in lily and the octopus” by ignacio ramos-gay and claudia alonso-recarte, provides a thought-provoking coda of sorts to one of the many thematic undercurrents informing the volume throughout, that of relationships, and by extension, care given and received. the authors add to this theme by invoking the work of poststructuralists gilles deleuze and felix guattari, through the concept of “becoming-animal” (174-175). this concept denotes a tendential attempt by an individual to defy the existential gulf that emerges between them and someone else that they care about, but are aware may pass on. to be sure, the field of study devoted to aging masculinity, as depicted in any contemporary fiction, is vast, and the aims of aging masculinities in contemporary u.s. fiction are nothing if not ambitious, yet also an admirable effort. potent analyses are directed toward a careful selection of the output and major works of prominent american authors of various backgrounds, yielding a useful diversity of interpretations of how aging masculinity has been portrayed in fiction. due to the fact that the overwhelming proliferation of fiction in media sees no end, and that portrayals of aging masculinity will almost certainly be present in any such production, this volume will likewise serve as a welcome introduction into an area of research and discourse that will hopefully grow with the contributions of future scholars. those working in the disciplines of anthropology, sociology, comparative literature, and media studies, to name a few, but specifically with a reflexive focus on the contemporary western, industrialized world, as well as anyone interested in contemporary american fiction and its literary criticism, will find much to start their work off from here. http://anthro-age.pitt.edu/ 33 (2).indd anthropology & aging quarterly 2012: 33 (2) 64 book reviews imagined families, lived families: culture and kinship in contemporary japan. akiko hashimoto and john w. traphagan, eds. albany: suny press, 2008. pp. 178 isbn978-07914-7578-2 (paperback) the editors of imagined families, lived familes, akiko hashimoto and john w. traphagan, have both published several important books on aging in japan, most notably, the gift of generations: japanese and american perspectives on aging and the social contract (hashimoto, 1996), and taming oblivion: aging bodies and the fear of senility in japan (traphagan, 2000). so although this volume brings together work on the family and generations in a broad sense, it never strays far from the importance of the “low fertility, aging society” trend that has characterized much of the work on social demographic change in japan and increasingly, the rest of asia (see takenaka, this issue). while the book’s cover illustration features four anime-style charicatures of wayward japanese youth gazing somewhat menacingly at the reader against a modern high-rise cityscape, two silloutes of elderly figures hang ghostly at the periphery, visible, yet obscured, a poignant image of the “family” as it is figured in a changed society. in their introduction, the editors write, “our primary interest is in understanding ‘the family’ as a dynamic and continually changing social unit that does not simply exist, but is imagined or conceptualized and reconceptualized in the minds of individual people and in public discourse” (p. 10). the chapters follow this aim, exploring the myriad forms of relationality between youths, adults and elders that have emerged in post-war japan, not only as they circulate as represtations in cultural ‘texts’ (comics, anime, films), but also in lived experiences and national rhetorics of intergenerational (dis)connection. the book is divided into two sections: “imagined families” (hashimoto, napier, mcdonald) and “lived families” (steinhoff, tamanoi, long). rather than summing up the contribution of each chapter in detail, i will try to look at each section as a whole, since there is significant cohesion and conversation going on between them (certainly one of the strengths of this volume). the three chapters that compose the section on “imagined families” all agree that popular media representations of the family in some ways parallel or reflect the experiences of consumers, and in other ways work to shape or open a space to rethink those experiences. like the serialized family comics that hashimoto describes, japanese people see themselves in these representations, but are allowed to enjoy the punchline that plays on the everyday worries and failures to smoothly negotiate complicated family relationships and personal desires. this is ‘the family as comedy’ in the aristotelian sense of revealing the ridiculous in the mundane efforts to establish a sense of normalcy and harmony. napier’s chapter on japanese anime, which begins by detailing a scene on robotic eldercare from kitakubo hiroyuki’s 1991 animated film roujin z, ventures into somewhat less quotidian comedies, to explore a broader range of fantasy and imaginations of the family. napier’s discussion of anime clearly displays a mastery of the genre, its many layered stories, its psychological implications, its social commentary. like mcdonald’s chapter that follows, napier also takes time to develop a few key filmmakers and their work to draw out themes of ‘reconfiguration’ introduced by hashimoto. mcdonald, (who passed away shortly before the book was published and to whom the book is dedicated) focuses more on the care of elders with memory loss, introducing a new perspective on this topic by looking at the work of two female filmmakers. while the chapter is titled ‘the agony of eldercare,’ it could be equally called the ‘redemption’ of eldercare, as the films and the filmmakers themselves find ways to turn pain and conflict into moving moments of raw humanity so often left out of the social science literature on care but immediately recognizable to caregivers in both family and institutional settings. taken together, the chapters in “imagined families” repeat a few key themes of modern japanese culture and kinship. most obvious is the importance of changing gender roles, and especially the role of women in the family. secondly, and closely related to the first, is the push-pull of conservativism and innovation. all of these chapters underline the desire to reconstitute “the family” in some sense, drawing on an always partial sense of traditional values and cultural models of kinship. however, this conservativism is constantly producing the grounds for change, as actors (the fictional characters, the artists and directors that create them, and the public that consumes them) weigh personal desires, dreams, traumatic dislocations, identities, affiliations and moments both painful and hopeful. the second half, “lived families” is just as strong and diverse as the first. steinhoff’s chapter is thrillingly original and illuminating, braiding together different cases of “family crisis” occuring over and between generations. as she follows the trajectories of lifecourses punctuated by crisis, steinhoff pulls together an analysis that is as anthropology & aging quarterly 2012: 33 (2) 65 much political as it is psychological, and where connections and disconnections between family members are a profoundly shaped by both. tamanoi similarly looks accross japanese history and political discouse to examine changing concepts and interpretations of ethnic identity, immigration and otherness that threaten nationbased tropes of the family. long (see this issue) has, arguably, the strongest contribution to the book, providing detailed ethnographic accounts of older adults and their families and caregivers to illustrate the reconfigurations and responses to changes in contemporary japan. while the other five chapters do provide some anecdotes from fieldwork based research, they are much more focused on evaluating and critiquing discursive realms that do not reach the everyday voices of individuals. long’s chapter goes far in filling this gap for the more traditionally minded anthropologist. long’s focus on ethnography gives clear examples of ways caregivers are sometimes “borrowed” from “non-normative categories of kin,” as well as the tension generated within kin networks as the burdens of caregiving are shared and negotiated among family (p. 140). in this way, long chapter shows most clearly the importance of the old anthropological category of kinship, even as it underlines how the conceptual content of the family and the desires and affects of individuals that produce families exceeds this category. all of the other authors in the volume express this same sentiment in different ways, as relationships are reconfigured within and against kinship idioms, new imaginative spaces emerge that bring forth important revaluations of vitality itself. imagined families is not a merely an update on the state of the family in japan (there are many books and edited volumes that might be more suited to this), nor is it interested in looking at the aging population as something that can be understood distinct from its historical and generational contexts. rather, it approaches these topics with a keen critical perspective that never disappears into the sometimes obscure language of cultural theory. by taking kinship as a central concept, the authors stay rooted in the pains and pleasures of relatedness in its various forms. not only is this slim volume accessible and interesting, but it also succeeds in balancing the discussion between artisitc creations and social and political discourse, engaging with a variety of mediums and perspectives, all of which have a place at the table. as such, imagined families serves as a model for other books on aging, generations, and the life course in anthropology and should be a welcome addition to courses that examine these themes. jason danely department of anthropology rhode island college glimpses into my own black box: an exercise in self-deconstruction. by george w. stocking, jr. madison: university of wisconsin press, 2010. pp. 232. isbn 978-0-299-24984-7. paperback. “the ice-cold flame of the passion for seeking the truth for truth’s sake must be kept burning, and can be kept alive only if we continue to seek the truth for truth’s sake” —franz boas1 autobiographies are not straightforward. for one thing, their truths, whether reflective or testimonial, are partial and personal. stocking’s recent book is not a simple autobiography; in fact it is a different kind of species altogether. although stocking flippantly dismisses this book as a kind of self-indulgent ‘biographical’ monograph (p.7), it is much more. in fact, stocking subtitles glimpses into my own black box as ‘an exercise in self-deconstruction’, and he is both the writer and its weighty reader. so the question then arises, is this simply a narrative exercise whereby anthropology’s preeminent intellectual historian in his efforts to stave off boredom and the encroachment of death upon his shrinking island, attempts to make sense of his past in the specious present? or is this exercise an act of deconstruction, where stocking becomes the historian and evaluator of his life, and in doing so opens up an interstitial space between his own autopoiesis and the personality of history itself. book reviews anthropology & aging quarterly 2012: 33 (2) 66 potential readers (perhaps as onlookers) will have to make up their own minds, but this reviewer sees stocking’s latest book, the 12th and final volume in the history of anthropology series, as an earnest self-reflective composition. of course there are many ways to read stocking’s account. on the one hand, there is the perspective of someone who is grappling with aging and posterity. on the other, this book can be viewed as a self-critique of an historian of anthropology whose life, taken in full as a human story, is an unfolding fieldwork open to further revelations. even though there are plenty of biographical vignettes (stocking calls them revelatory juicy bits p. 74), these ‘events’ cannot be read or historicized as construed texts. stocking shows through his analysis that biographical vignettes and recollections empower, but also reveal the imperfections of memory. the issue with historical consciousness is that events are subject, if we are ‘truthful’, to multiple contextualizations. in writing about the genre of autobiography, alison donnell likens autobiography and for our purposes here, self-writing, as, “[…] a restless and unmade bed; a site on which discursive, intellectual and political practices can be remade […] a place for fun, desire and deep worry to be expressed”.2 glimpses into my own black box is stocking’s attempt to remain restless, and to rethink how the development of ideas he was so much a part of (and helped to shape) resonated inside and outside of the academy. in this way, stocking stays faithful to the craft of intersecting anthropology and history for the sake of an uneasy and enlightened rapprochement. aaq readers will want to read his book, but be warned, this is not an exercise for the light-hearted. younger readers will be forced to make an imaginary leap into the world of old age, and to grapple with the ethics and complexity of recollection, especially when other people’s lives and representations are at stake. older readers might temper their engagement with a dose of empathy, but they will be forced to confront their own potential legacies, and the challenge (if they take it upon themselves) to question and unsettle their unfolding histories that can never cohere psychoanalytically into a meaningful and straightforward narrative. glimpses is divided into three sections. earlier drafts of the first two sections were already being worked on before 1999. the first section, which is the longest, is entitled “autobiographical recollections” and “[…] is a selective narrative account of the life events that shaped [stocking’s] work as an historian”(p.7). we come to learn about stocking’s family and upbringing. furthermore, we are given a first-person account of someone who dedicated a portion of his early adult life (seven years) to the american working-class cause. stocking’s experience with the unions and his work in various industrial activities, however, could no longer sustain the narrative and promise of radical change. like many of the old left, stocking was disillusioned by the khrushchev revelations, and he eventually returned to his “liberal academic patrimony”(p.68). in addition to understanding how stocking’s upbringing and working years as a communist sympathizer helped to shape his ideas about social groups, race and history, the reader also gets a strong sense about how his relationship with his parents was formative and complicated. his parent’s ideals, and the zeitgeist they were more or less tangential to, functioned as a touchstone. in one of the book’s most moving passages, we get a sense of where stocking’s resilience comes from. like a rewritten ingmar bergman movie, stocking’s visit to his mother’s deathbed reveals the following: “[…] i leaned close to her face, i thought i heard her say that she wanted to end the suffering, but when she heard me suggest this, she responded in a perfectly clear voice: ‘are you crazy?’—which i took as an affirmation of life, rather than a deathbed conversion” (p.58). stocking also writes about his mother’s influence in the following way: “i remember my mother’s kulturkampf of the 1930s in positive terms as a lasting enrichment of my own life—although in some respects a superficial and somewhat uneven one”(p.55). “historiographical reflections” follows up this section with a “[…] retrospective analytic interpretation of major methodological and substantive themes in the work shaped by that life”(p.7). the point here is how an historian of anthropology interprets the ideas and texts of anthropologists in an ineluctable light; one that eschews book reviews anthropology & aging quarterly 2012: 33 (2) 67 book reviews the inertia of facts and causal authority, but draws enlightenment from an arduous bottom-up reading and contextualizing of multiple motives, factors and relativist positions. in this section, stocking describes his move back to academia and how working as a laborer inspired his bottom-up approach to history as a kind of inductive interpretation. there is much in this section that shows how stocking grappled with various tensions, one of them being the “[…] struggle between yearnings for a platonic ideal of categorical ordering and the deeply rooted countervailing forces […] of its disarray)”(p. 146). for stocking, the challenge to an historical understanding of an anthropologist’s thinking is that their texts may not fully evoke underlying intentions and even relevant thinking processes. we are told that given the unconscious nature of thought and reflection, and the evidential gaps in source materials, the historian of anthropology “[…] must write around or across in a cautiously qualified but responsibly suggestive way”(p. 150). by revisiting his methodological take on conceptualization and “honest groping”(p. 146), stocking treats us to an exploration of why and how historiographical orientations get taken up. “octogenarian afterthoughts: ‘fragments shored against my ruin’” is the shortest section in the book and will most likely interest readers who want a glimpse into how an intellectual comes to grips with personal loss, change, and optimism. this section was written more recently and reveals stocking’s personal experience with loss and decay from a phenomenological point of view. anxiety, hypochondria, depression, and a certain unbearable lightness of being come to haunt this section, making it the most personal and fragmentary of the three. in the end, stocking ends the book with a short epilogue in which he comes full circle. instead of closing the black box, we are left with stocking’s worries about outwitting zeno’s race, and the finality of an abyss after life. glimpses is a book that showcases stocking’s contribution to the history of anthropology, by revealing that what has influenced him (and what he has influenced), is neither structural nor overdetermined. in the end, this piece of work will endure, because what is being personalized here is history. in other words, how do our own histories run alongside and interpenetrate the history of the world and ideas. this review has now runs its course, and we are faced with the beginning epigraph. boas maintained an idealistic notion of science, and even though he was committed to a universalistic conception of rational knowledge, understanding the cultural and historical conditions of social life and social scientific knowledge was at the center of that flame. it wasn’t so much what science could do for us technologically that was important to boas, but rather by investigating the givenness of social structure, we could bring ourselves closer to a moment of conscious freedom. in a similar way, stocking’s book represents an attempt to render such a project emotionally and historically liberating, at least for one individual. after reading this book for a second time, i was left wondering what other black boxes are out there that require a disciplined and ice-cold stare?3 philip kao university of st andrews notes 1 f. boas, race and democratic society (new york: j. j. augustin, 1945), 1. 2 a. allison, “when writing the other is being true to the self: jamaica kincaid’s the autobiography of my mother” in women’s lives into print: the theory, practice and writing of feminist auto/biography. ed. pauline polkey (london: macmillan, 1999), 124. 3 i would like to thank professor ira bashkow for comments on an earlier draft. all shortcomings in this piece are entirely my own. if you are interested in writing a book, film, journal or exhibit review for anthropology & aging quarterly, please contact the book reviews editor, sherylyn briller, s.briller@ wayne.edu. include your name, areas of expertise, current occupation (research, professor, graduate student, e.g.) and any titles you would be interested in reviewing from the last three years. aaq does not accept unsolicited reviews. book review review of batzke, ina, lea spinoza garrido, and linda m. hess, eds. life writing in the posthuman anthropocene. cham, switzerland: palgrave macmillan. 2022. pp. 268. price: $139 (hardcover); $109 (ebook). joão pedro martinez pinheiro pontifical catholic university of rio grande do sul 1joaopedromp@gmail.com anthropology & aging, vol 44, no 1 (2023), pp. 118-120 issn 2374-2267 (online) doi 10.5195/aa.2023.475 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | pinheiro | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.475 http://anthro-age.pitt.edu 118 book review review of review of batzke, ina, lea spinoza garrido, and linda m. hess, eds. life writing in the posthuman anthropocene. cham, switzerland: palgrave macmillan. 2022. pp. 268. price: $139 (hardcover); $109 (ebook). joão pedro martinez pinheiro pontifical catholic university of rio grande do sul 1joaopedromp@gmail.com life writing in the posthuman anthropocene illustrates the relevance of posthumanist accounts of the life course in the present-day context of ecological crisis. past collaborators ina batzke and linda m. hess (batzke et al. 2018) are here joined by lea espinoza garrido in presenting an analytically-sophisticated and politically-poignant, yet often entertaining, collection of seven essays and one interview. in addition to their introduction, these texts show how well the editors’ shared interests in auto/biography, queerness, gender, popular culture, and migration studies synergize with the environmental humanities, a novel dimension in their respective bibliographies. the eight contributions are equally distributed across two sections—“responsible relationality” and “relational responsibility”—that highlight two general approaches to the following posthumanist concern: how could life writing, the literary epitome of humanism, support more responsible/decentralized human-environmental relations, given that for centuries humanist philosophy helped justify the anthropocentric attitudes that caused the ecological crisis? katja sarkowsky frames this concern as a paradox in the opening essay, “relationality, autobiographical voice, and the posthuman paradox: decentering the human in leslie marmon silko’s life writing.” her case study of silko’s memoirs, letters, essays, and photobooks uncovers a type of autobiographical storytelling that allows human and nonhuman elements to interface without breaching each other’s ontological boundaries, for example without anthropomorphizing the “other-than-human” (25). to attempt such a breach would only result in an unproductive paradox. instead, the author argues, this renowned native-american writer scrutinizes both her material and discursive dependency upon human-nonhuman relations and her own privileged/human-centric position within said relations. sarkowsky’s comparative methodology shines particularly bright when she traces the effects of place upon the memoirist’s narrative voice across and within her works: hence there is silko, the host at the “storied spaces” (40) of her ancestral land in new mexico, retelling tales from the past, but also silko, the explorer of her new estate in arizona, creating stories in the present. the second contribution to this volume is christina caupert’s “the big picture: life as sympoietic becomings in rachel rosenthal’s performance art.” like sarkowsky’s essay, this one takes the reader on an analytical tour de force through decades-worth of work by a profound female artist. the frenchborn daughter of jewish russians who fled the 1917 revolution, rosenthal was, for caupert, a precocious posthumanist ecofeminist. caupert reconstructs the philosophical progression of rosenthal’s one-woman shows from their earlier, feminist iterations (which critiqued individualist, stable, pre-given identities) to their latter-day, posthumanist ones (which often featured untrained http://anthro-age.pitt.edu/ book review | pinheiro | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.475 http://anthro-age.pitt.edu 119 animals and dystopian sci-fi elements). although illustrations would have been helpful here (supposing that they even exist), caupert’s vivid descriptions of these “collective sensory, affective, and intellectual journeys” (57) nonetheless convey how topics like interspecies companionship, war, gender norms, and technocratic capitalism collided on rosenthal’s stage as she openly processed autobiographical (mis)adventures. in “edges and extremes in ecobiography: amy liptrot’s the outrun” jessica white extols works that, like liptrot’s, critically update the historically anthropocentric and imperialistic nature writing genre. echoing a prime posthumanist concern, she asks whether nature is a mere “backdrop [...] to the human world” (115), or are they co-constitutive? for white, liptrot’s ultimately human struggles with alcoholism and homesickness are nonetheless environmentally contingent. they manifested when she moved to the big city in an attempt to flee the cold, rural isolation of the scottish archipelago of her youth and the stress caused by her father’s bipolar disorder. furthermore, liptrot overcomes her addiction only after reconnecting with her home by farming, ocean swimming, and protecting its endangered bird species. however, as compelling as texts like the outrun and interpretations like white’s are, “the relationships between a human and their ecosystem” (100) that are presented here often do not exceed the level of metaphor and analogy. for example, when liptrot’s and her father’s emotional swings are characterized by herself and white as analogous to the archipelago’s extreme weather, this is a nice allegory, but not an instance of more-than-human entanglement. even the titular outrun, “the rough grazing land on the furthest reaches of a property [...] where domestic and wild animals co-exist” (103), eventually becomes a metaphor for liptrot’s anxious, though adventurous, personality. when the environment, then, is a mere mirror to one’s soul, is this so different from old nature writing? finishing the first section, we encounter what is arguably the volume’s most creative piece. “the sentience of sea squirts” is a first-person account whereby poet clare brant combines her ocean diving anecdotes with kaleidoscopic philosophical musings. inspired by “those questions of scale” that accompany “anthropocene-minded criticism” (124), brant introduces us to the tiny lives of sea hares, marine snails, and sea squirts. “their lowliness on our scale of recognition makes them easy to overlook. we can’t see the processes by which they filter, feed, repair, reproduce, so we think they do nothing” (129)—and treat them as pests, food, or pharmacopoeia. her point is that posthumanist life writers should responsibly relate not only to those macroscopic and dry parts of the earth wherein humans roam, but also to the small and underwater worlds that necessitate attention and care just as much. scientific biographers, for example, could achieve this by exposing the “human constructedness” (135) of biological discourse, as illustrated in brant’s brief genealogy of sea squirt taxonomy. the second part of the book is opened by renata lucena dalmaso, for whom “relational responsibility,” this section’s title, entails a move away from seeing human-nonhuman relations as merely spatial. like brant, dalmaso invites us to go beyond anthropocentric scales—in this case, of time. her essay “humanity, life writing, and deep time: postcolonial contributions” illustrates postcolonial life writing’s power to articulate posthumanist temporalities. the span of celestial and geological formations, deep time is a cornerstone concept in her reading of two books: one by the renowned indian writer amitav ghosh, and another by brazilian philosopher and indigenous militant ailton krenak. for dalmaso, these authors’ depictions of their ancestral connection to rivers, forests, and mountains transcend personal, familial, and ethnic narratives. more specifically, they circumvent anthropocentrism by spotlighting nonhuman narrators, like tree rings, sedimentation layers, and the weather. human agency, a tenet of humanist storytelling, is thereby reframed as but one of the many vectors in a story being told for much longer than anyone’s lifetime. http://anthro-age.pitt.edu/ book review | pinheiro | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.475 http://anthro-age.pitt.edu 120 the second essay in this section continues the literary criticism format followed by the majority of the contributions. “helen macdonald’s h is for hawk and critical posthumanism” by monir gholamzadeh bazarbash is a reminder of the physical, psychological, and social challenges to ethical interspecies relationships. bazarbash extracts many practical insights from macdonald’s experience of training mabel, a goshawk. evoking “this sense of close connection and radical difference at the same time” (190), her process of understanding (rather than suppressing) mabel’s wants, needs, and habits involved hunting with and sleeping in the same quarters as mabel but also coping with her random nightly attacks. insofar as it is a radical stance against humanist hierarchies of bodies, groups, and species, posthumanism can be uncomfortable to implement sometimes, as suggested by bazarbash’s reading of macdonald’s self-reported display of relational responsibility towards mabel. in “writing life on mars: posthuman imaginaries of extraterrestrial colonization and the nasa mars rover missions,” jens temmen shows that space colonization politics is not only an extension of european colonialism but it also sidesteps the climate crisis public debate. powerful states and their ultrawealthy contractors, enamored by the promise of an entire planet’s worth of unmined, unfarmed, and undeveloped land on mars, have weaponized humanity’s fear of extinction, temmen argues, by framing the idea of an off-world mass resettlement as a viable solution to environmental collapse. he proceeds to carefully demonstrate how this neoliberal project of privatizing mars fuels the mediatic processes of animorphization of nasa robots and heroification of billionaire ‘astronauts,’ an analysis which makes this a compelling piece of cultural criticism. the book closes with “(life) narrative in the posthuman anthropocene: erin james in conversation with birgit spengler,” a truly effervescent interview of ecocritical, narratological, and feminist proportions. one gets pleasantly lost in the interlocutors’ perspectives on, for example, forest fire science communication and econarratology as an anti-imperialism of the mind. moreover, james invites scholars to investigate how the environment, broadly conceptualized, is made absent in humanist narratives. jane austen’s mansfield park is her example here: “the whole plot is made possible by sir thomas bertram’s plantation in antigua”, “the whole thing is financed by a system of enslavement [...] that largely goes unnarrated” (239-240). life writing in the posthuman anthropocene is a down-to-earth (quite literally) posthumanist account that substitutes speculative futurism for a much-needed socioecological sensitivity. students of the aging process would be inspired by the ways in which their object is put into perspective—temporally, philosophically, culturally, and bio-ecologically—by all of the authors discussed above, except perhaps for brant and temmen (although the latter does touch upon nonhuman death rituals). the book would also benefit anyone interested in the intersection between environmental and biographical studies; in the search for ‘actually-occurring’ posthumanism; or in the analytical import of theories by figures like donna haraway, rosi braidotti, and karen barad. indeed, although this is not a theoretical book (i.e., one will not find the clarification of basic terms like post-, anti-, trans-, and nonhumanism in it), all of the essays stand as rigorous examples of theory application. references batzke, ina, eric c. erbacher, linda m. hess, and corinna lenhardt, eds. 2018. exploring the fantastic: genre, ideology, and popular culture. bielefeld: transcript. http://anthro-age.pitt.edu/ book review review of miller, daniel, laila abed rabho, patrick awondo, maya de vries, marilia duque, pauline garvey, laura haapiokirk, charlotte hawkins, alfonso otaegui, shireen walton, and xinyuan wang. the global smartphone: beyond a youth technology. london: ucl press. 2021. pp. 320. price: $27 (paperback); $50 (hardcover); open access (pdf). paro mishra indraprastha institute of information technology, delhi paro.mishra@iiitd.ac.in anthropology & aging, vol 43, no 2 (2022), pp. 126-129 issn 2374-2267 (online) doi 10.5195/aa.2022.438 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. https://press.uchicago.edu/ucp/books/author/m/d/au5504193.html https://press.uchicago.edu/ucp/books/author/m/d/au5504193.html https://press.uchicago.edu/ucp/books/author/a/l/au127902742.html https://press.uchicago.edu/ucp/books/author/a/p/au127902744.html https://press.uchicago.edu/ucp/books/author/d/m/au127902746.html https://press.uchicago.edu/ucp/books/author/d/m/au185843795.html https://press.uchicago.edu/ucp/books/author/g/p/au127902465.html https://press.uchicago.edu/ucp/books/author/h/l/au185843797.html https://press.uchicago.edu/ucp/books/author/h/l/au185843797.html https://press.uchicago.edu/ucp/books/author/h/c/au185843799.html https://press.uchicago.edu/ucp/books/author/o/a/au185843801.html https://press.uchicago.edu/ucp/books/author/w/s/au127902484.html https://press.uchicago.edu/ucp/books/author/w/x/au35506922.html mailto:paro.mishra@iiitd.ac.in book review | mishra | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.438 http://anthro-age.pitt.edu 126 book review review of miller, daniel, laila abed rabho, patrick awondo, maya de vries, marilia duque, pauline garvey, laura haapiokirk, charlotte hawkins, alfonso otaegui, shireen walton, and xinyuan wang. the global smartphone: beyond a youth technology. london: ucl press. 2021. pp. 320. price: $27(paperback); $50 (hardcover); open access (pdf). paro mishra indraprastha institute of information technology, delhi paro.mishra@iiitd.ac.in the multi-author work the global smartphone is one of the first comparative ethnographic projects to examine smartphone adoption and usage amongst older persons. the merit of this work lies in its shift in focus away from the conventional young, often referred to as digital nomads, to older populations and their engagement with the smartphone. eleven anthropologists focusing on research sites across brazil, ireland, al-quds, uganda, japan, italy, chile, china, trinidad and cameroon unravel what smartphones mean for older people and what its consequences are for the everyday lives of older persons. adopting the perspective of “smart from below” (5) the authors depart from an understanding of smartphones as smart, intelligent devices that can adapt to their user through autonomous learning, but rather argue that it is the users who, with their ingenuity and craftsmanship, transform the smartphone into “an extraordinarily intimate and personal tool” (5), thereby, privileging people over devices. the book is organized into nine chapters with the first and the last offering an introductory overview and theoretical reflections respectively. the remaining chapters draw on themes linked to smartphone usage among older persons that emerged from the ethnographic fieldwork conducted by the eleven anthropologists involved in this study. chapter 2 unpacks “what people say about smartphones” by mapping the varied discourses that smartphones generate in various ethnographic sites. the authors remind that these discourses are operating across scales, from the macro level (e.g., in the media, state policies, market) to the everyday micro level (amongst smartphone users) and as such shape people’s ambivalent and contradictory understandings of smartphones as both harmful and useful. thus, older persons in uganda convey resentment against this material device by expressing discontent with younger generation’s disregard for conventional wisdom. similarly, in italy, older persons perceive youngsters as becoming ‘slaves’ to the ‘device.’ for chinese users, on the other hand, smartphones encourage good citizenship practices and support the state’s path to digital modernity. chapter 3 examines smartphones as material objects. it shows how smartphones’ tangibility may be appropriated by users to convey class, status, gender and fashion. for example, phone screen wallpapers, phone cases, and covers are carefully chosen to convey personal aesthetics and communicate a sense of self as playful, flamboyant, or serious. on the other hand—and particularly relevant when considering an aging population—the materiality of a device can also introduce http://anthro-age.pitt.edu/ https://press.uchicago.edu/ucp/books/author/m/d/au5504193.html https://press.uchicago.edu/ucp/books/author/m/d/au5504193.html https://press.uchicago.edu/ucp/books/author/a/l/au127902742.html https://press.uchicago.edu/ucp/books/author/a/p/au127902744.html https://press.uchicago.edu/ucp/books/author/d/m/au127902746.html https://press.uchicago.edu/ucp/books/author/d/m/au185843795.html https://press.uchicago.edu/ucp/books/author/g/p/au127902465.html https://press.uchicago.edu/ucp/books/author/h/l/au185843797.html https://press.uchicago.edu/ucp/books/author/h/l/au185843797.html https://press.uchicago.edu/ucp/books/author/h/c/au185843799.html https://press.uchicago.edu/ucp/books/author/o/a/au185843801.html https://press.uchicago.edu/ucp/books/author/w/s/au127902484.html https://press.uchicago.edu/ucp/books/author/w/x/au35506922.html mailto:paro.mishra@iiitd.ac.in book review | mishra | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.438 http://anthro-age.pitt.edu 127 challenges in terms of accessibility. chapter 4 shifts the focus away from the exteriority of the device to the many mobile applications (popularly called apps) that it has. using the concept of “scalable solutionism,” (86) the authors argue that people using smartphones are not oriented to apps but to tasks, and often creatively combine apps to get tasks accomplished. this is evidenced strongly in the use of smartphones for health. in this case, smartphone usage is not just restricted to the use of apps but also involves sending mobile money, voice calling solely for health purposes and constant checking-in on those who need care. these behaviours are not just evidence of ‘smart from below’ but equally challenge the idea that dotcom technologies fuel individualism and weaken social ties; here we see how care at a distance is facilitated by the multiple ways smartphones are deployed. building on james everett katz and mark akhus’ (2002) idea of “perpetual contact,” (104) chapter 5 argues that smartphones facilitate “perpetual opportunism” (103). the authors contend that because the smartphone is always within reach, it creates possibilities of being constantly opportunistic. this is reflected in opportunistic photography, (over)consumption of news, information, and entertainment and in the expanded sociability through travel facilitated by transport and travel-related apps like uber, google maps, baidu, tripadvisor etc. the authors note that this opportunism is also experienced differently by smartphone users across various field sites. for example, while middle class people in ireland routinely use a configuration of apps to plan regular uk travel and feel secure using gps as it reduces their chances of becoming lost in unfamiliar terrains, older people in santiago are reluctant to use gps out of fear of their location being tracked but do use apps to reduce waiting time for bus arrival. additionally, perpetual opportunism also brings new vulnerabilities and anxieties, caused by ‘being available’ constantly for others who are just a device away. chapter 6, “crafting,” refers to the “way in which people align their smartphone with individual, social and community life” (135). crafting here does not convey a sense of unhindered agency but is always grounded in context, usage and cultural values as different case studies and anecdotal evidence establish. for example, the predominance of ‘family groups’ on the line app amongst japanese users reflects the importance of the patriarchal family within japanese domesticity and society. similarly, in dar al-hawa, the majority of muslims use an app that reminds them five times per day to pray on time. chapter 7 explores the relationship between smartphone usage and age. it shows how older adults initially struggle to use the smartphone, due to the complex interface and younger generations’ impatience with teaching older persons to use the device. however, the authors argue, as older adults learn to use their smartphone, it not only provides them with new capabilities, but also makes them ‘feel younger’ through association with a youthful technology. this chapter for me reinforces the ideas of ‘successful aging’ and ‘smart aging’ which have dominated both the popular, academic and policy discourses in the last few decades (lamb 2017; sun et al. 2016). however, adoption of smartphones is not without challenges associated with old age particularly associated with frailty and dexterity. the ethnographic evidence presented in this chapter makes visible older adults’ constant contestation around the debilitating decline that aging is associated with, and the eagerness to ‘manage’ that decline and make it meaningful, through immediate connection with the contemporary world, facilitated by their engagement with smartphones. chapter 8 engages with the use of social media apps like line, wechat and whatsapp to show how they augment people’s ability to connect with families and communities. most notable in this chapter is the conclusion that these platforms have consequences for people’s ability to exhibit and extend care to others through audio-visual materials such as voice notes, emojis, memes, stickers and web-cam calling. these, the authors argue, are perceived as making care at a distance “warmer” (185) for their respondents. these findings differ from those in mirca madinou’s (2012) study of transnational mothering, where the respondents argued that caring at a distance via technologies is ‘cold’ in http://anthro-age.pitt.edu/ book review | mishra | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.438 http://anthro-age.pitt.edu 128 comparison to the ‘warmth’ of physically proximate care. given these differences, it may be interesting to probe under what conditions care that is digitally mediated comes to be constituted as ‘cold’ or ‘warm.’ is the everydayness of routine care different from extraordinary contingencies of life; whether (or not) these have a bearing on the meanings proximate in-person care or non-proximate distant care via technologies gets imbued with? the final chapter summarizes key arguments in the book. for example, with the concept of “transportal home,” the authors make a case for viewing smartphones not simply as devices but as homes through which people who are living in times of increased mobility and instability, can ‘feel at home.’ in this concluding chapter the authors also argue that the smartphone has moved “beyond anthropomorphism” because even as this technology, unlike the robots, “does not look one iota like a human being” (228) it complements human capacities such as cognitive functions—e.g., by complementing or substituting the human memory—and through its ability to drastically change our mundane practices. finally, the smartphone, as argued in the book, is a “relational smartphone” as it is not just a means of communication but also constitutes relationships, groups, and networks. this relational smartphone comes with its own set of ambivalences, as it is both a technology of care as well as of surveillance. while the global smartphone discusses a wide range of issues on the intersection of the usage of smartphones and older persons, it would have been nice to read a bit about how older adults’ familiarity with other technologies, such as computers, relates to their adoption of smartphones. as the group of older persons that served as informants for this study was highly diverse across age, region, and class location, understanding their sense of familiarity with other technologies in relation to these broader categories would have helped ground the findings further. in the end i only have praise for the global smartphone that for me is an apt representation of what a multi-author work looks like. the term “multi-author work” has been applied previously by alpa shah and colleagues (2018) to refer to their book ground down by growth to recognise research that is collectively prepared and executed in multiple sites and eventually brought out as a single book with all researchers listed as authors. there is, however a fundamental difference with the global smartphone in the way the authors collaborated in the analytical labour of composing the book’s content. ground down by growth is still organised pretty much like an edited volume, with an overarching introduction (and conclusion) by alpa shah and jens lerch, followed by individual chapters from five other contributing authors who worked as researchers in different field sites. the global smartphone is in that sense a much better example of how multi-author work needs to be executed: it is not composed of chapters by individual authors but is the result of a truly collaborative exercise of organizing material around focal themes as they reflect, overlap and sometimes diverge across sites while being constantly attentive to cultural differences. the team of authors in the global smartphone did not become contributors of specific chapters based on their ethnographic sites but essentially contributed to all chapters and to the book as whole, as was the case in the publication of daniel miller and his team’s other project on how the world changed social media (2016). laced with ethnographic vignettes, images and screenshots of devices, and infographics of smartphone usage across sites and written in a highly accessible language devoid of heavy academic jargon, the global smartphone makes for an interesting read. this book offers a much needed contribution to the literature on smartphone adoption amongst older populations. it will be of interest to scholars working in the field of aging and gerontology, elder care, social change, media and communication. being published open access will ensure its reach to a wider audience. http://anthro-age.pitt.edu/ book review | mishra | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.438 http://anthro-age.pitt.edu 129 references katz, james everett and mark a. aakhus, eds. 2002. perpetual contact: mobile communication, private talk, public performance. cambridge, new york: cambridge university press. https://doi. org/10.1017/cbo9780511489471. lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. new brunswick, nj: rutgers university press. madianou, mirca. 2012. “migration and the accentuated ambivalence of motherhood: the role of icts in filipino transnational families.” global networks 12(3): 277–295. miller, daniel, elisabetta costa, nell haynes, tom mcdonald, razvan nicolescu, jolynna sinanan, juliano spyer, shriram venkatraman, and xinyuan wang. 2016. how the world changed social media. london: ucl press. shah, alpa, jens lerche, richard axelby, dalel benbabaali, brendan donegan, jayaseelan raj, and vikramaditya thakur. 2018. ground down by growth. tribe, caste, class and inequality in twenty-first-century india. london: pluto press. sun, yao, margaret l. mclaughlin, and michael j. cody. 2016. “using the smartphone to support successful aging: technology acceptance with selective optimization and compensation among older adults.” in human aspects of it for the aged population. design for aging, edited by jia zhou and gavriel salvendy, 490-500. cham: springer. http://anthro-age.pitt.edu/ 33 (1).indd anthropology & aging quarterly 2012: 33 (1) 4 president’s message lori l. jervis, ph.d. department of anthropology and center for applied social research university of oklahoma greetings, aagers! aage met twice this fall as usual, at the american anthropological association meeting in montreal, quebec on november 19th, as well as at the gerontological society of america meeting in boston on november 20th, 2011. it is interesting serving an organization whose membership is divided (or torn?) between these two national organizations, whose annual meetings nearly always occur at the same time. if only we could be in two places at once! samantha solimeo, a long-time aage member, was voted president-elect of the aage. she will assume the presidency in fall 2012. congrats, samantha! our website continues to serve us well. thanks to robert schrauf for keeping it going! jason danely has made a number of improvements that have improved the website’s aesthetic appeal. speaking of technology, did you know that aage has an anthropology and gerontology facebook page? examples of recent postings: an article on the economic wellbeing among older americans, a video on lgbt elders, and a posting on the aaa aging and the life course interest group. this is another way for us to communicate with each other and share mutually beneficial information. please join in, if you haven’t done so already. to keep doing what we are doing—and to do more for our members— takes funds. getting those expired memberships renewed is a high priority for aage. if your membership has expired (or if this applies to someone you know), please renew. it only takes a few minutes at https://aage.clubexpress.com/content.aspx?page_id=0&club_id=497336. while you are at it, please update your profile in the membership directory. as for the future, we are thinking ahead to the next annual aage conference. if you think you might be interested in hosting the next annual aage conference or would like more information, please contact me at lori.jervis@ou.edu. until next time! from the editor jason danely, ph.d. department of anthropology rhode island college the continued rise of interest in anthropological perspectives on aging and the life course presents incredible opportunities for the future of aaq. as editor, i realize both the potentential and the challenge of staying at the center of new research and scholarly activities, which, like other fields, is increasingly global, digital and interdisciplinary. in consdieration of these factors, i have planted a few seeds of change for this year’s aaq that i invite all of us to watch over as they spring up. these include: • new designs and accessibility options, including greater fluidity with the aage website • diversification of submission categories to include new media, pedagogy, interviews and dialogues • expansion of the editorial board to accomodate more and diverse submissions • more issues dedicated to special topics in aging and anthropology • public, searchable online access to selected content through our website • increased graphics content, especially photographs of aage members these changes will be gradually phased in over the next two years. in the meantime, aaq will continue to bring members regular content, such as commentaries and reviews; field, research and conference reports; and carefully reviewed articles from both junior and senior scholars around the world. the current issue contains some great examples of this, with a detailed report on aging in native american communites and two timely book reviews. i will also be introducing new members of the aaq editorial board beginning with this issue, and encourage everyone to continue submitting content for them to look at. looking forward to an exciting 2012 at aaq! 33 (2).indd anthropology & aging quarterly 2012: 33 (2) 38 although japan may have lost the economic might and awe of the 1980s, there is one area in which it still has a lead: population ageing. today, japan is ageing faster than any other nation, with the world’s highest proportion of adults over 65 (23%), followed by italy and germany (20.4%), and one of the lowest ratios of children under 15 (13%). its population is declining on a scale unprecedented in the developed world (at least in peacetime) and may further shrink by 32% to 86 million by 2060 from the current 128 million (national institute of population and social security research 2012; nihon keizai shinbum october 27, 2011). by 2060, the ratio of over-65s is expected to reach 40% (national institute of population and social security research 2012). in 2001, the united nations warned that to sustain the size of the working-age population at the 1995 level of 87.2 million, japan would need 33.5 million immigrants from 1995 through 2050 (un 2001). by this estimate, the immigrants and their descendants would comprise 17.7 per cent of the country’s total population by 2050 (un 2001). this poses a dilemma, particularly for japan. japan regards itself as an ethnically and culturally homogeneous country and has accepted only a limited number of foreigners in the past decades. even though the volume of migration has recently grown, the proportion of foreigners, presently at 1.5%, or just over 2 million (ministry of justice 2012), is very small in comparison with that in other industrial countries--8.2% in germany, 7.1% in the u.k. and 7.1% in italy (2009 statistics on the proportion of foreign, not foreign-born, population, quoted in oecd 2011). the official statistic of japan’s foreign population even includes 400,000 multi-generational korean residents who typically are not considered foreign elsewhere; even though they were born and raised in japan, they nonetheless remain foreign due to japan’s jus-sanguinis (blood-based), rather than jus-soli (based on place of birth), citizenship policy. how does japan deal with this demographic dilemma? is immigration a viable solution to population ageing in japan? how will population ageing shape the future of immigration policies, and how will immigration dynamics, in turn, affect demographic projections? as a forerunner in population ageing, and one of the most “reluctant” countries of immigration, japan and the choices it makes are likely to offer lessons for the rest of the ageing world in tackling similar demographic challenges. immigration debate in the context of population ageing in the context of accelerating ageing and continuous population decline, immigration has recently re-surfaced in public discussions (repeta and roberts 2010). keidanren, japan’s powerful business association, has actively advocated for accepting more skilled foreign workers; through publications, such as “policy suggestions for accepting global talent” (2010),” “how to deal with the economy and society faced with population decline” (2008), and “toward a vibrant and attractive japan” (2003),2 it has argued that in the context of population ageing and decline, it is critical to attract foreign talent to revitalize japan’s economy and society. so, too have other organizations and think tanks, including the japan economic research institute (2008), council on population education and akashi research group (2010), and the japan immigration policy institute (sakanaka 2012, 2011, 2010). faced with pressing demographic concerns, the japanese government has also recognized the need to accept more skilled foreign workers. in 2008, it created the council on accepting highly qualified foreigners in the prime minister’s office, and the publication, “on the new growth strategy: blueprint for revitalizing japan,” issued by the cabinet (2010), explicitly states that accepting foreign talent is key to the country’s economic growth and revitalization. these views, though far from unanimous, c o m m e n t a r y / p o l i c y r e v i e w demographic challenges for the 21st century: population ageing and the immigration “problem” in japan1 ayumi takenaka bryn mawr college tohoku university anthropology & aging quarterly 2012: 33 (2) 39 ayumi takenaka demographic challenges for the 21st century have led to a series of policy decisions to encourage foreign inflows, including tourists, at least to some extent. while maintaining to accept only skilled migrants in line with the existing policy, the japanese government affirmed its stance to entice, and retain, more skilled migrants, along with foreign students and tourists, who would contribute to japanese society and economy. according to the ministry of justice (2010), a ministry in charge of immigration policy, “amid the serious decline in the population…, (w) e will proactively accept foreign nationals who possess specialized knowledge, technology or skills … in order to create new vitality of the japanese economy and society … and to strengthen its international competitiveness” (p. 21). the plan, it states, aims to create “a vibrant, prosperous society,” “a safe and secure society” and “a harmonious society coexisting with foreign nationals” (p. 2). foreign inflows should be encouraged, therefore, not strictly for demographic reasons (i.e., to make up for the country’s ageing and declining population), according to the government, but only in the framework of social and economic development—to revitalize the rapidly ageing society and its economic vitality (ministry of justice 2010). to entice more “favorable” migrants and encourage them to stay in the country, japanese immigration policy has become more selective, facilitating the entry of the skilled, while restricting that of others. part of the scheme is a skill-based “points-system,” to be introduced later this year. similar to one adopted in many other developed countries, the points-system will allocate points to “preferred” individuals with an advanced degree, more work experience and higher income, particularly in the fields of business management, science and technology, and academic research; a degree from a japanese educational institution adds 5 “bonus” points and japanese language proficiency, 10 more points, out of a total of 100 points (ministry of justice 2011). once they have entered, those “highly-qualified” migrants will be able to obtain permanent residency more easily than before (after 5 years of residence, instead of 10 years). financially dependent parents and household employees will be allowed to come along, while spouses will be permitted to work for the first time (ministry of justice 2011). the expanding skilled migration scheme also includes a foreign care worker program. introduced in 1998 under the economic partnership agreement (epa) with indonesia and the philippines, the program aims to provide opportunities for indonesian and filipino workers with specialized knowledge in eldercare and nursing, fields afflicted by perpetual labor shortages in an aging japan. the program is not meant to fill labor shortages; it is fundamentally a “trainee” program that attempts to promote bilateral economic cooperation and integration with these countries (ministry of health, labor and welfare 2011). under this program, 793 indonesians and 438 filipinos have entered japan on 3 to 4-year contracts. at the end of their contracts, trainees must pass japan’s notoriously difficult national nursing examination to stay in the country. between 2009 and 2011, only 19 (out of 817 exam takers) passed the exam. the rest returned to their countries upon termination of their contracts (ministry of health, labor and welfare 2011). the dismal result, largely attributed to linguistic barriers, invited nation-wide criticisms (yomiuri shinbun january 29, 2012) and resulted in revising the exam, making it easier for foreign test takers by using fewer technical terminologies and chinese characters. subsequently, the number of successful foreign exam takers “jumped up” to 47, or 11.3% out of 415 exam takers, in the most recent test, according to asahi shinbun, a major daily, reported on march 27, 2012. to encourage more skilled migration in eldercare and nursing, the government is currently negotiating a similar treaty with vietnam, india, and thailand. at the same time, various programs have been implemented in an attempt to increase the number of foreign students. the “300,000 foreign student plan,” for instance, intends to increase the number from the current 138,000 (in 2011) to 300,000 by 2020. other programs, such as “the asia gateway initiative” (prime minister’s office), “global 30” (ministry of education, science, and culture), and “career development program for (asian) foreign students in japan” (ministry of economy, trade, and industry), aim to lure foreign students (and scholars) and retain them upon graduation by recruiting students abroad, providing financial support and career opportunities, and increasing the number of englishmedium courses. similarly, the government plans to increase the number of foreign visitors to 25 million by 2020 under the “basic plan for the promotion of tourism” (2007). to this aim, the japan tourism agency was established in 2008 within the ministry of land, infrastructure, transport, and tourism, with a broad objective of “building a country good to live in, good to visit” and “achieving a true tourism nation” (japan tourism agency 2012). all these measures were officially implemented as part of national growth strategies under the grand scheme of the “new growth strategy (basic policy)” (2009). thus, bringing in more foreigners, once again, is not meant to serve as “replacement migration” (un 2001) to make up for the country’s ageing and declining population. even though the current public discussion on immigration, fueled in the context of accelerating population ageing and decline, is inexorably linked to demographic anthropology & aging quarterly 2012: 33 (2) 40 ayumi takenaka demographic challenges for the 21st century problems, immigration is treated only as a means to revitalize its ageing society and increase the country’s economic competitiveness in an increasingly globalized world. actual outcomes the outcomes of these measures, however, are quite different from their intentions. highly skilled migrants, at least the kinds of migrants the government intends to attract, are not coming to japan in significant numbers. in fact, the number of newly admitted skilled migrants declined from over 120,000 in 2005 to less than 60,000 in 2009 (ministry of justice 2011). moreover, a good portion of these “skilled” migrants are so-called “entertainers,” many of whom work in bars as hostesses. nor are many skilled migrants staying in japan very long. in particular, the highly talented with extraordinary abilities and globally compatible skills are less likely to stay and tend to see japan as a stepping-stone to move on elsewhere, according to interviews i conducted with foreign migrants and students in japan between 2008 and 2010.3 a korean student, who studied physics at a prestigious japanese university with a fully-funded japanese government scholarship, told me during an interview that he intended to pursue his ph.d. in the u.s. “i want to challenge myself at a higher level,” he said in fluent english, mixing up with some japanese words; “if i stay here for so long and get too used to the japanese way of doing science, i feel i won’t be able to compete globally.” he regarded the japanese academic environment rather parochial and not quite globalized. whether he actually leaves for the u.s. after completing his master’s course is unclear. this tendency was clearly observed among foreign students interviewed, particularly in science and engineering (see also murakami 2009). similarly, tourists are not coming in large numbers, either. currently, japan is ranked 30th among major countries in attracting foreign tourists (6.2 million in 2011) (japan national tourism organization 2012). as for foreign students, the overall number coming has steadily increased each year, reaching a “record high” of 141,000 in 2010 (in 2011, it dropped to 138,000, according to jasso 2012). yet, so, too, has the number leaving japan. in 2010, about 40% left japan upon completing their studies (jasso 2012). moreover, over one fifth of all foreign students were non-degree seeking students, such as exchange students and short-term language learners. in addition, more than half (or 51%) of foreign students are undergraduates, rather than graduate students (27%) and enroll in the humanities and social sciences (over 80%) instead of science and engineering (19%) (jasso 2011). doctoral students are less likely to stay in japan (48%) than masters (63%) and undergraduate students (70%) (jasso 2011). and those enrolled in english-medium “global courses” (particularly in science and engineering) tend to leave, using the education and resources they acquired in japan as a stepping-stone to move on to other countries, such as the u.s. (according to interviews i conducted). ironically, japan appears to lose many ambitious and talented students by offering english-medium courses in an attempt to globalize itself. all in all, japan has not been quite successful in attracting, and retaining, the kinds of foreigners it intends to attract (tsukazaki 2008). foreigners who come and stay in japan in large numbers are not “highly qualified individuals” as targeted by the government, but rather low-skilled workers who enter through familial and ethnic ties. in 2009, only 17% of foreign workers engaged in professional and skilled jobs (ministry of health, labor, and welfare 2010). whether this trend will be overturned by the new points-system and other “proactive” policies trumpeted by the government is yet to be seen. lessons for other countries? in the midst of growing public discussion over immigration fueled by population ageing and decline, japan has nevertheless succeeded in increasing temporary and cyclical migration. that is, the volume of entry has grown through “revolving-door” migration. foreign nurses and caregivers began to come, but the majority go home after a couple of years. foreign students, particularly those with advanced degrees in science and engineering, are also not likely to stay for long. this may reflect the intent of some policy makers, as one put it during an interview: “japan should accept immigration only on a temporary and rotating basis to keep the nation culturally homogeneous and socially stable. … in the end, japanese people are concerned about crime and disorder associated with growing inflows of foreigners.” as another policy maker interviewed implied, skilled migrants may be encouraged, perhaps because they are unlikely to come or stay in japan for long. the series of policies being implemented, thus, may be merely rhetorical. regardless of its intent, japan is clearly faced with a number of contradictions. if the government truly intends to achieve their stated goals, there is a significant gap between intentions and actual outcomes. as indicated earlier, not so many skilled migrants are coming or staying, as intended by the government. at the same time, unskilled migration, which the government tries to regulate, has grown more. this contradictory outcome fuels public anxiety that there ought to be stricter control anthropology & aging quarterly 2012: 33 (2) 41 ayumi takenaka demographic challenges for the 21st century over immigration, particularly for unskilled foreign workers. and this, in turn, reinforces the image outside the country that japan is a closed society, unwelcoming foreigners. the international media often portray japan battling its demographic crisis by refusing to let in immigrants; the country is also viewed as doomed in the face of demographic crisis – or to be revived by boosting new industries. in a washington post article, “demographic crisis, robotic cure? rejecting immigration, japan turns to technology as workforce shrinks,” harden (2008) discuses how japan embraces robots for its demographic crisis. the new york times reports, “despite need japan keeps high wall for foreign labor” (tabuchi 2011), and japan may indeed “pick robots over immigrants” (bbc may 17, 2011). this widespread image may have contributed to keeping the immigration volume low by discouraging highly skilled migrants to come and stay in the country. and this, in part, resulted in pressing the government to adopt a more open immigration policy (at least in appearance), according to an interview conducted with a policy expert. in reality, japan maintains a fairly open policy toward skilled migrants (admitting skilled foreign workers without setting numerical quotas, unlike the u.s., for instance); the result, however, is that despite this, many of them, once again, are not coming or staying for long. if, on the other hand, the government truly prefers to avoid immigration, it still faces a contradiction between what they say and what they want. in this scenario, the policy has served them well; it has helped to limit the overall stock of immigration, while maintaining an “open” immigration policy on the surface. by adopting an “open” immigration policy, moreover, japan can counter the image oft portrayed in the foreign media that it is a closed country. in fact, the japanese mainstream media tend to focus on the “growth” of foreign-resident population, describing hopes, problems, and challenges associated with growing “multiculturalism” within the country. between 2009 and 2010, asahi shinbun ran a series of articles about growing chinese migrants in japan, and in an article, “opening up the country (semarareru aratana kaikoku)” (january 9, 2010), it reported how the society has grown multicultural. yomiuri shinbun, another daily, published a report, “becoming international through multicultural exchange” (tabunka koryu de kokusaijin ni) (may 8, 2008) by focusing on a school with a growing number of foreign students, and nihon keizai shinbun, a business daily, recently quoted an expert in calling for greater awareness and acceptance of cultural differences (“toward a multicultural society” (kizukou tabunka kyosei shakai), february 18, 2012). the tendency to focus on “multiculturalism,” reflected also in the growing volume of scholarly work (e.g., kondo 2011; satake 2011) and government initiatives on the subject (e.g., ministry of international affairs and communications 2006; ministry of foreign affairs and international organization for migration 2012), further reinforces the contradiction described earlier by concealing the reality – the reality that immigrants, in fact, are not coming or staying in significant numbers. whether japan truly intends to accept more (skilled) foreign migrants or not, the country does have a limited volume of foreign migration, mostly temporary, cyclical, and unskilled. it is remarkable that japan has managed to maintain a low level of immigration amid continuous calls for (skilled) immigration and rapidly ageing population. it is equally remarkable that the country has dealt with its ageing crisis and sustained itself socially and economically, thus far, with only limited immigration. the way japan has handled the demographic challenge may not offer lessons for other countries on how to incorporate immigrants to cope with population ageing. it may also not provide an answer as to how immigration may help alleviate population ageing. it may nevertheless offer a lesson on how to manage, and regulate, immigration amid rapid populating ageing or how to cope with population ageing without resorting to large-scale immigration. japan has dealt with its demographic problems by increasing “revolving door” migration. whether this helps, or will help, reinvigorate an aging japan remains to be seen. equally uncertain is how long japan can continue to sustain itself, both demographically and economically, unless the country opened up, genuinely, toward more immigrants —not simply in terms of the sheer number it allows to let in, but in welcoming them as part of their society. notes 1 this paper is based on the author’s presentation delivered at the 16th international metropolis conference in november, 2011 in ponta delgada, azores, portugal. i am grateful to the audience at the conference and robert dujarric for helpful comments. 2all my translations. whenever official translation is not available, i provide my own throughout this paper.acknowledgement: 3 during the period, i conducted interviews with over 50 foreign residents of various nationalities in the tokyo area and a dozen policy makers and public commentators. i also interviewed 45 foreign students (with kumiko tsuchida) enrolled in a japanese university. anthropology & aging quarterly 2012: 33 (2) 42 ayumi takenaka demographic challenges for the 21st century references cited bbc 2011 “japan may pick robots over immigrants” (may 17, 2011 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anthropological gerontology maria g. cattell it’s snowing as i write this. but i know that under the snow, snowdrops and aconites are a-bloom. and if you’ve been hiding your latest publications under some bushel, please let me know about them–things i’ve missed, book chapters, articles in specialized journals, whatever: mgcattell@aol.com. abbreviations: ai=ageing inter-national; a&s=ageing & society; eja=european j.aging; geront.=the gerontologist; jah=j.aging & health; jaha=j.aging, humanities & the arts; jccg=j. cross-cultural gerontology; jg=j. gerontology (p=psychological; s=social); jpa=j.population aging; qhr=qualitative health research. *name in boldface indicates aage member. about a former member, by himself: *von mering, otto 2008 anthropology on the margin: changing an academic career into a professional calling. in the tao of anthropology, ed. a.j. kelso. pp. 201-225. gainesville: university press of florida. (i have fond memories of otto, who died in december 2010.) aging behuniak, s.m. 2011 the living dead? the construction of people with alzheimer’s disease as zombies. a&s 31(1):7092. cohen, p. 2012 in our prime: the invention of middle age. ny: scribner. fingerman, k.l., c.a. berg, j. smith, t. antonucci, eds. 2011 handbook of lifespan development. ny: springer. friedman, h.s. & l.r. martin 2011 the longevity project: surprising discoveries for health and long life from the landmark eight-decade study. ny: hudson street press. friedman, m. 2011 the big shift: navigating the new stage beyond midlife. ny: public affairs. fry, p.s. & c.l.m. keyes, eds. 2010 new frontiers in resilient aging: life strengths and well-being in late life. ny: cambridge up. gullette, m.m. 2011 agewise: fighting the new ageism in america. u chicago press. kirkwood, t. 2010 why can’t we live forever? scientific american 303(3):42. liechty, t. & c.m. yarnal 2010 older women’s body image: a lifecourse perspective. a&s 30(7):1197-1218. margolies, l. 2010 the anthropologist as caregiving daughter: lessons from the world of the frail elderly. jaha 4(2):119-132. mcfadden, s.h. & j.t. mcfadden 2011 aging together: dementia, friendship, and flourishing communities. baltimore: johns hopkins up. piachaud, d., j. macnicol, j. lewis 2009 just ageing? fairness, equality and the life course: a think piece on intergenerational equality. london: centre for the analysis of social exclusion. portacolone, e. 2011 the myth of independence for older americans living alone in the bay area of san francisco: a critical reflection. a&s 31(5):803-828. powell, d.h. 2011 the aging intellect. ny: brunnerroutledge. sanjek, r. 2010 sustaining a social movement: gray panther ideal and tactics. jah 4(2):133-144. scheibe, s. & l.l. carstensen 2010 emotional aging: recent findings and future trends. jg/ps 65b(2):135-144. settersten, r.a. jr. & j.l. angel, eds. 2011 handbook of congratulations to *caitrin lynch for her new book due out in 2012 retirement on the line: age, work, and value in an american factory. from lr press/cornell university press! anthropology & aging quarterly 2012: 33 (1) 6 new publications in anthropological gerontology sociology of aging. ny: springer. biogerontology biogerontology 12(1): special issue on “biogerontological research in europe.” caregiving guberman, n., j-p. lavoie, i. olazabal 2011 baby-boomers and the ‘denaturalisation’ of caregiving in quebec. a&s 31(7):1141-1158. joo, j.h., m. witthink, b. dahlberg 2011 chared conceptualizations and divergent experiences of counseling among africa american and white older adults. qhr 21(8):1065-1074. shura, r., r.a. siders, d. dannefer 2011 culture change in long-term care: participatory action research and the role of the resident. geront. 51(2):212-225. talley, r.c., k. chwalisz, k.c. buckwalter, eds. 2011 rural caregiving in the united states. ny: springer. comparative perspectives: cross-cultural & crossnational albuquerque, p.c. 2011 grandparents in multigenerational households: the case of portugal. eja 8(3):189-198. buse, c.e. 2010 e-scaping the ageing body? 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approach the social needs of older adults through the lens of ‘community,’ both as a concept and as a lived experience. our attention to communities of peers and arenas for everyday interaction is discussed in the context of the dominant policy discourse of ‘ageing in place.’ in this discourse, ‘place’ is predominantly interpreted as physical infrastructure, with little formal recognition of the importance of the arenas of social everyday interaction for older adults outside the home/family. our exploration draws on the empirical study of three organisations in toronto, canada and bergen, norway that, in various ways, represent places for everyday interaction. we discuss how belonging is understood from the perspective of different older groups and how it is facilitated by organisations and services, through the creation of shared, informal social spaces. even though there is considerable difference in size, aesthetics, target population and geographical impact field, all three organisations offered their patrons a space for informal social interaction in which they were allowed to claim the space as their own. our analysis indicates a pronounced need for a diversity of arenas for older adults to interact socially. furthermore, we portray how these spaces for everyday interaction are created often in addition to, or even in divergence from, the official mission of these organisations, in a form of co-optation by patrons. keywords: community; older adults; ageing in place; space anthropology & aging, vol 43, no 2 (2022), pp. 40-57 issn 2374-2267(online) doi 10.5195/aa.2022.391 mailto:gudmund.agotnes@hvl.no mailto:sara.charlesworth@rmit.edu.au mailto:martha.macdonald@smu.ca ågotnes, charlesworth, & macdonald | 40 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu ageing in space: remaking community for older adults gudmond ågotnes sara charlesworth gudmund.agotnes@hvl.no sara.charlesworth@rmit.edu.au western norway university of applied sciences rmit university, melbourne, australia bergen, norway martha macdonald martha.macdonald@smu.ca saint mary’s university, halifax, canada introduction social isolation and loneliness among older adults have been portrayed as a pressing and indeed increasing societal challenge, in both popular policy and academic outlets (freedman and nicolle 2020; grenade and boldy 2008). nevertheless, research on social isolation among older adults remains both scarce and varied (van regenmortel et al. 2016). older adults are also portrayed as particularly connected to their neighbourhoods or local environments, in part because many have lived there for a long time, in part because they, in a rapidly changing world, ‘connect’ with the local (buffet et al. 2012, 15-16; gardener 2011, 264). yet, and particularly in urban areas with more potential for providing social spaces for dealing with issues of inclusion, belonging and social identities (gamba and cattacin 2021), older adults report low involvement in social networks (blekesaune and haugen 2018). this is perhaps an indicator of the lack of social arenas for meaningful social interaction particularly designated for an older age group, many of whom are ageing at home, alone (blanchard 2013, 6). the ongoing covid-19 pandemic has also drawn our attention to the lack of social interaction experienced by older people; a societal challenge also preand post-pandemic. relatedly, welfare states have been critiqued for overemphasizing medical needs over social needs of the older population (ågotnes and jacobsen 2017; eggebø, munkejord, and schönfelder 2020), contributing to a silencing of the importance of meeting social needs of older adults. in this paper, we explore the need for social interaction by older adults by investigating how local and everyday communities are produced by different community service organisations and experienced by their patrons. we approach the social needs of older adults through the lens of ‘community,’ both as a concept and as a lived experience, including the dimensions of space and place, and a sense of belonging this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ mailto:gudmund.agotnes@hvl.no mailto:sara.charlesworth@rmit.edu.au mailto:martha.macdonald@smu.ca ågotnes, charlesworth, & macdonald | 41 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu or fellowship. our exploration draws on the empirical study of three organisations in two cities that, in various ways, represent places for the everyday interaction of groups of older adults. we discuss how belonging is understood from the perspective of different older groups and how it is facilitated by organisations and services through the creation of shared, informal social spaces. drawing on rapid, team-based ethnography studies in two cities, toronto, canada and bergen, norway, and an analysis of observational data and interviews with staff and patrons of three organisations catering to the social needs of older adults in diverse ways, we ask three overarching questions. first, what do the organisations provide (and, by implication, seen not to be provided elsewhere, including in the local welfare system)? second, how are the boundaries of these organisations maintained (who has access, who does not, who is considered the ‘right patron,’ who is seen as a ‘space invader’)? third and consequently: how are informal communities of older adults constructed, facilitated and perceived? our attention to what can be construed as communities of peers and arenas for everyday interaction is discussed in the context of the dominant policy discourse of ageing in place (aip). we argue that within this discourse, ‘place’ is predominantly interpreted as physical infrastructure, resting on a notion of the private home as ideal. in many official aip policy discourses ‘place’ is understood as a physical container with distinct boundaries. aip polices also often have an inherent normative dimension. they assume that if needed, older adults should receive service provision in their home. the relevance and need for community in a broad sense, and a community of peers in particular, is absent in such policy discourses. perhaps as a reaction to this policy silence, a need to move from ‘ageing in place’ to ‘ageing in community’ has been voiced (blanchard 2013), in which, for instance, older adults can gather in community dwellings. the need to address social issues of older adults has also been made in research scholarship, for instance, through a framework of ‘community gerontology’ (greenfield et al. 2018) or through calls for an explicit focus on “places of aging research” moving away from the large body of research on ageing in place (gardner 2011, 263). our analysis, similarly, highlights a pronounced need for a diversity of arenas for older adults to meet and interact socially and portrays how these spaces for everyday interaction are created often in addition to, or even in divergence from the original or official mission of the social service organisations, in a form of co-optation by patrons. ageing in place & community our paper draws on literature on aip policy and, given the growing concern with social isolation among older adults, on alternative perspectives on ‘community,’ ‘place,’ and ‘space.’ ageing in place across the global north, aip policies have developed in response to the burgeoning pressures of ageing populations and, in particular, the financial cost of providing long term care (pani-harreman et al. 2021; starr and szebehely 2017). societal expectations are also changing and maintaining independence well into old age is an assumed goal of older people today. the steady increase in the acceptance and implementation of aip is seen as “aging at home rather than in a home” (mcdermott et al. 2009, 246). the policy goal of supporting people in their own homes—the idea of ‘ageing in place’—is extended to focus on those supports but is very much about keeping someone in their homes as long as possible, thus alleviating pressure on services and being cost efficient. however, research also supports older adults’ preferences for staying at home as long as possible (buffet et al. 2003, 16). while there are diverse understandings of what constitutes ‘place’ in aip policies, the role of housing and the home remains central (martens 2018). http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 42 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu in many countries, aip policies have seen some decentralisation of government responsibilities at the local level and the development of programmes to help frail older adults remain in their own homes (pavolini and ranci 2008). in norway, which will serve as an example here, the conceptualization of aip by norwegian health care authorities as a goal for older adults has led to the implementation of policy initiatives for the older population (ministry of health and care services 2015a, 2015b). the balance of formal long-term care services for older adults has shifted, with an increase in home help services and assisted living facilities and a relative decrease in traditional institutional care, or nursing homes (otnes 2015), following patterns seen elsewhere in europe (spasova et al. 2018). the model of institutional care has also shifted towards an ideal of ‘homelike,’ for instance by having smaller units and single rooms with adjoining bathrooms (ågotnes 2017; otnes 2015). the downscaling of institutional care towards less extensive and more cost-efficient care at home rests on a cost containment policy logic—that the current system of significant public and institutional service provision is not sustainable (blix and hamran 2017). furthermore, a shift away from the state towards the individualization of responsibility of the service recipient and their family has accompanied these developments (christensen and fluge 2016), in parallel with general changes in the distribution of responsibility, or welfare-mix, between various sectors. the volunteer sector role is seen as contributing in line with these shifting responsibilities, specifically to address social isolation and loneliness among older adults (ministry of health and care services 2019, 43-46). ageing in what place? in the literature, there are diverse understandings of ageing in place which extend to attachment to place which brings social connection, security and familiarity (pani-harreman et al. 2021). yet, there is scant analysis of the role of social networks within the aip policy literature (pani-harreman et al. 2021, 2054). further, as dalmer (2019) points out, the policy narratives of aip are surprisingly unexamined. in many instances policies focus mainly on self-reliance and independence. such policies frame aip as a process that can and should be responsibly managed by older adults—as a matter of choice. however, they produce only one option for people, which is to age in place in their own homes (dalmer 2019). further, critiques of aip policies point to their normative force and the absence of the voices of older people in their construction. for example, a study in the netherlands found very different understandings of aip by professionals and older adults (van hees et al. 2017). for the professionals, aip was much more about requiring objective features of neighbourhoods such as access to amenities, mobility and meeting places that enable older adults to stay living independently. in contrast, the older adults associated aip more with their own lived experiences and attachments to “specific, intangible and memory-laden public places” (van hees et al. 2017, 11). other studies have highlighted the ways in which aip policies ignore multiple systems of power and oppression that operate to exclude certain cohorts of older adults (sixsmith et al. 2019) as well as the “emotional geographies” of ageing in place, particularly pertinent to migrant older communities (warnes and williams 2006). a study on older lgbt people also points to the importance of the normative social and policy context, highlighting how their experiences with aip varied depending on the extent to which the contexts (places and spaces) in which they are ageing were able to accommodate lgbt lifestyles (hoekstra-pijpers 2020). the dominant aip policy discourse is related to a discourse on ‘the age-friendly city’ (afc), addressing issues of city planning, transportation, accessibility, and inclusion in a broader sense (who 2015). however, like aip policy discourses, many afc policies presuppose a normative older population (gamme and rafoss 2020). while liveability indicators such as income and access to social housing may be recognized, much more rarely recognized are diverse characteristics of the older population such as gender, class, ethnicity or first nations status. both afc and aip policies pay, as such, scant regard to http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 43 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu the intersectional location of older people (sixsmith et al. 2019, 646-648) across different axes of advantage and disadvantage. while the importance of social networks is recognized in some aip and afc policies, they are generally conceived of in static terms, as “a strategy that focuses on providing for physiological and safety needs, but one that too often fails to provide opportunities for the other basic human needs of love and belonging, self-esteem, and self-actualization” (blanchard 2013, 10). there is little recognition that social networks are dynamic and change over time and thus that there will not be just one static experience of place for an individual older person (vos et al. 2020). consequently, there is a general absence of any formal recognition of the importance of the arenas of social everyday interaction for an ageing population, outside what can be considered as close-knit networks (in the private home and the family). ‘place’ in aging in place is therefore not understood as “an integral and meaningful part of peoples’ social lives that is constructed by past experiences and desired futures” (van hees et al. 2017, 12). as such, aip discourses overemphasize older adults attachement to ‘home’ as opposed to that of ‘people’ (hillcoat-nallétamby and ogg 2014). feminist geography represent a contrasting or perhaps nuancing perspective to this, by conceptualizing ‘spaces’ as distinct from ‘places.’ pruitt (2008a), for example, uses the term ‘space’ as an abstract concept that refers both to physical surroundings (physical space) and to the impact that particular spatial configurations have on many aspects of life, from social relationships to social spaces. ‘space’ is further conceptualised as the product of interrelations as constructed through interactions from the global to the tiny and, because it draws on multiplicity and heterogeneity, is always under construction (massey 2005, 31-32). ‘place,’ meanwhile, is conceptualized as a concretization of ‘space’, containing identifiable characteristics making, on an emic level, a given place at a given time distinguishable from others (pruitt 2008b, 341). conceptualizing community by analysing meaning-making and belonging among older adults, we suggest that also ‘community’ can serve as a relevant analytical lens in supplementing existing aip literature. community is, however, both complex and contested as empirical phenomena and as an analytical term. according to dominelli (1995, 133-134), for instance, ‘community’ is notoriously difficult to define, leading to 98 different interpretations, alluding to a variety of themes and attributed concepts from the more or less hyperlocal to the nation-state (svensson and nielsen 2020, 39), and, we can add, the global and digital. ‘community’ thus relates to both place and space, where ‘place,’ according to cresswell (2015, 12-14) inspired by agnew, contains both locale, location, and sense of the place. however, ‘community’ does not only relate to ‘place’ as a geographical entity. turunen (2009, 49-50) for example, writing in the context of community work, suggests a threefold operationalization of ‘community’: a) a geographical area (a district, a village, a part of a city, a neighbourhood), b) a social system for interaction (an association, an organisation, the workplace, a network), and c) a symbolic unit of belonging (shared values, traditions, interest). significantly, the three categories can and often do overlap, for instance for minority groups living in the same geographical area. regardless of this division, ‘community’ is characterized by having both a sense of belonging and of interaction, both of affinity and of practice. community is therefore more than merely the sharing of characteristics within groups of similar people; an aim or a purpose is also present. furthermore, ‘community’ can be operationalized based on membership: ascribed and acquired. communities based on acquired membership can also be described as ‘imagined communities,’ that is, communities in which members strive to be members, and must make an effort to be able to do so (larsen, sewpaul, http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 44 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu and hole 2014, 4). such communities have, therefore, a stronger bond, compared to communities where membership is automatic. furthermore, ‘community’ is conceptualized as non-static: communities are interpreted and negotiated and change character, for better and worse (ledwith and springett 2014, 49). literature on community thus describes the changing nature of communities in connection to globalization and migration, for instance, in which peoples’ affinity in and between groups have a more sporadic and porous nature. while not completely novel—luckmann (1970, 581) described ‘modern man’ as part-timers in multiple belongings some time ago—the idea of belonging to multiple, changing communities does speak to changing patterns in mobility of both people and ideas, supported, for instance by massey’s (1994, 2005) notion of “a global sense of place.” savage et al. (2005) proposed the term “elective belonging,” in which one’s affinity to a place is based on choice. yet, it is further argued, communities are not completely imagined, even in a globalized world: they exist and matter, while relating to something more than strict geographical locales. communities are lived and experienced. soja’s (1999) conceptualization of “thirdspace”—as the intersection between the specific/material places and the perceived/imagined space—captures these lived experiences of agents. for older adults, this can take the form for instance of neighbourhood networks (gardner 2011), simultaneously informal and bounded by ‘place.’ methodology the paper is based on ethnographic fieldwork in two cities, highlighting three service organisations. it is part of a larger project investigating age friendly cities. field research is being undertaken in a number of cities and this paper draws on fieldwork conducted in toronto, canada and bergen, norway in 2018 and 2019. the methodology used is team-based rapid ethnography (baines and cunningham 2013). this methodology, which ensures multiple perspectives from multiple researchers over a relatively short, but intense, period of time. this method has a number of advantages in negotiating policy and cultural issues in cross-national studies and in deepening understandings of a specific context through multiple analyses of the same events (millen 2000). in particular, involving both insider and outsider researchers in all aspects of data collection and analysis—where typically insider researchers know the case study site and the national content within which it is located and outsiders are less familiar with both, provides shared opportunities for reflection and critique (see also rubin and rubin 2005). in our case this allows practical and theoretical links to be made between the everyday life of community organisations and the city context in which they operate (see szebehely 2007). building on extensive background research on each city, including its policies, organisations and services related to the needs of the elderly, a team of 10-20 insider and outsider researchers spent a week in each city doing observations and interviews. these involved meetings with key policy stakeholders as well as conducting fieldwork in teams in selected organisations. when conducting our team ethnography, ‘locals’ and ‘natives’ were paired in both cities, and collaborated in discussions on-site and in later analyses. ‘locals’ also assisted practically, for instance with translations during interviews and conversations. while all participants in the canadian fieldwork were proficient in english, language barriers occurred more frequently in the norwegian fieldwork. here, a norwegian speaking partner served as an on-site (and later textual) translator for informants who spoke limited or no english. our site visits centred both on geographic neighbourhoods within each city with particular characteristics (income, cultural mix) and demographic communities, such as migrants or the homeless. http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 45 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu the data on the selected organisations included fieldnotes of each researcher based on observation, interviews with program participants, staff and volunteers, and background material collected by the team. during the week of the site visits the team met at least twice to share their insights. fieldnotes and interview recordings and transcriptions were later made available for the team to use in their analyses. for the purposes of this paper, in line with the overall project, we targeted organisations focusing either exclusively or indirectly on older adults, while offering some form of either organized or ad hoc social activities. these organisations had a low threshold for admittance, while also, as we shall see, targeting various (sub-)populations. two of the selected organisations are in bergen and one in toronto. toronto, the largest city in canada, is ethnically and racially diverse, with a large immigrant population. geographic neighbourhoods tend to differ in both cultural mix and income. bergen is a relatively small city, with a more ethnically homogeneous population. while the policy context differs, the range of organisations serving various populations is quite similar, thus providing a comparative foundation. they include multi-service organisations offering a range of programming to older adults in a geographic neighbourhood and programs targeting a particular demographic, such as migrants, immigrants, or lgbt. these are typically run by not-for-profit organisations with some public funding. in addition, there are what we term one-off initiatives that contribute to the quality of life of particular groups of older adults, whether it be cultural programs or community gathering places. all three selected organisations, given pseudonyms beneath, offered their patrons a space for informal social interaction in which they were allowed to claim the space as their own. our intention with our three different cases was not to analyse the interplay between context and practice. while the significant contextual differences among the case studies could serve as an important rationale for their selection, our three different cases were chosen for the purposes of illuminating aspects of the lives of older adults that transcend organizational and policy contexts. relatedly, our goal was to explore commonalities despite contextual differences rather than compare organizations in different countries. we chose a large multi-service organisation in toronto, referred to as the the centre. like many such organisations it offers a range of programmes for an older population (55 plus), including drop-in activities, lifelong learning programs, recreation and fitness programs, health clinics, referrals to other services, and a cafeteria. founded to serve the needs of the local older jewish population, it is located in a geographic neighbourhood with a concentration of largely russian jewish immigrants. the second organisation, referred to as the coffee house, is targeted to those considered to be socially disadvantaged in the city centre of bergen, with a particular emphasis on a) those suffering from longterm substance use and b) illegal work migrants. it runs a coffee house that serves as a positive space to hang out and make connections and an entry to other services. the organisation provides counselling, referrals and advocacy on behalf of its clientele. while not specifically targeted to older adults, many of the patrons who visit the coffee house fall into this category. the final organisation is a unique program in an older suburban neighbourhood of bergen, referred to as the second-hand store. as the name suggests, the organisation runs a second-hand store targeting a neighbourhood considered relatively impoverished. its particular focus is a) providing inexpensive clothes and homeware for poorer families, many with a migrant background and b) providing a place to meet for older adults, many of whom volunteer at the store. in addition to offering an affordable shopping space, snacks and coffee are provided in one section of the shop. http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 46 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu creating spaces for community here we present four key aspects of how the organisations we studied provide spaces for community among different groups of older people and how those cohorts adopted and adapted this provision: a) the exterior of the place and how the place relates to the space beyond, b), the interior of the place, c) inclusion and exclusion at the place, and d) content of the space. location, location, location: a place within a space? the experience and utilization of the organisations as physical places is connected to their interior, their aesthetics and atmosphere, as we will return to, but also to how the places relate to the spaces outside its boundaries. the second-hand store in bergen is located by a main road in a what is considered the local centre of that part of the larger city, a fair distance outside the city centre. it is located near a shopping centre, a nursing home with attached assisted housing, a church and the newly build city light rail. this local part of the city (‘bydel’ in norwegian) is considered relatively poor with an overrepresentation of social housing tenants, migrant populations as well as poorer seniors who have resided in the area for a long time. the second-hand store was portrayed by both staff and patrons as a place belonging to this extended neighbourhood, as opposed to the larger city, serving, primarily, a small geographical area. other people belonging to different parts of the city are welcome to shop, of course, while contributing to the revenue of the store, ultimately benefitting the extended neighbourhood. this role of the store in the larger geographical community was not an official policy but was communicated by both volunteers and patrons when describing the vital function of the store in the surrounding area. three female patrons of the second-hand store, one also serving as a volunteer, speak about this relationship between the store and their community, having different experiences and histories. one of the patrons talks positively of the old days in the community, perhaps alluding to how younger generations finds connections and meaning in the wider community and/or how the wider community have changed over time. regardless of interpretation, the second-hand store is presented as filling a function not covered elsewhere: so, i have lived here, in this part of the city, for sixty years. we really like it here, we thrive here. it’s both rural and central at the same time, so you get everything. and then i am a part of this store. i’m also a volunteer and have my own shifts. i meet a lot of great people, former neighbors, former colleagues. i have lived here for 10 years. i’m from [name of neighborhood], where i lived. i was very well received [here at the second-hand store], a very nice place. we have sort of a club for those over sixty, well not a club with membership, but still… you don’t sign a form, but are sort of asked to join. i was a bit sceptical at first, but i am very glad now, now it’s just great. i have also lived here for sixty years, well next year, i will have lived here for sixty years. then we were very young. i had a child of two and a half years and was expecting a second child. everything around us was un-finished, we had to walk over make-shift boards or bridges to get around, and i remember the postman struggling to find his way. but it was nice because there were so many young families. in our hallway, there were 18 children, but at night time all was quiet. it was idyllic, green lawns and playgrounds… we lived in a three-room apartment but when the children grew older, we moved to a four bedroom apartment close by, well where she lives. and i have lived there since. but now i will move to a serviced apartment. but yes, i really http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 47 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu like it here. and two of the children moved up here, when they were married. (focus group interview, the second-hand store) the coffee house in bergen is located on an average street (combined commercial and residential) in the city centre and appears to blend into its surroundings: the building is similar to the surrounding ones, while the coffee house itself blends into the building, having the appearance of a regular coffee house, with large windows near the seating arrangements making the space between the interior and the city outside very small. having a more targeted demographic, as described above, the coffee house caters to a larger downtown geographical area, rather than focusing on a particular neighbourhood or area of the city. public transportation makes access possible, as well as being within walking distance for many, being located in a relatively small and compressed city centre. the coffee house belonged to all geographical areas, in other words, while not belonging to all social groups, as we will see later. the centre located in toronto differed considerably from the two other cases, both in location and access. it is located by a busy road, like the second-hand store, just beside one of the main streets, being easily accessible by car. in this geographical area, several social housing estates are located, in which many patrons live. the centre is also located in a far larger city than the bergen cases, making its connection to its specific part of the city important. the centre was, in other words, thought of as belonging to one particular geographical part of the city, while also catering to a particular population. as one patron explained, a sense of belonging, as communicated through involvement at the centre, related to both geographical and ethnic belonging: i feel like there’s a real shared sense of community in a lot of the folks, who’ve grown up along the bathurst street corridor, or even there are some folks who all grew up in ottawa together, because i guess the jewish community is quite small in ottawa and so they all knew each other. and so even though they’ve moved from ottawa and they haven’t seen each other in 50 years, they’re like oh, do you know this person? yeah, i know that person or that’s so and so’s niece. and then they have this kind of instant connections, so that’s kind of this really powerful thing where everybody knows somebody or knows somebody’s somebody, you know?. (interview, staff member, the centre) the centre served both a geographical area and an ethnic population, while apparently having some flexibility about the eligibility of patrons belonging to the ethnic population but residing outside the geographical area. in summary, in all three cases, the organisation as location is not separate from the outside world, but, relates to it in different ways and is shaped by it, connected to who has physical access, creating possibilities and limitations for nascent or more established communities of older adults. the organisations also differed concerning whether their patrons were considered as belonging to a geographical area or if membership was based on other characteristics. these differences have implications for who is seen to belong to the organisations, as we will return to, making access much more than a question of transportation and physical movement. finally, the organisations are located in ever-changing geographical spaces, which mould the physical surroundings for older adults who have lived ‘in place’ for many years, if not their whole lives, seeing their neighbourhood or city change around them. before returning to issues of belonging and ownership to the places, we dwell on the more internal aspects of them, connected to atmosphere and aesthetics. http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 48 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu locale: aesthetics and ambience of the place while being connected to the world outside their walls, the organisations also represented physical places in a more confined sense, being locales with distinct physical boundaries and an interior content. within these walls, the organisations created a physical ambience, more or less welcoming, more or less specifically adapted to communities of older adults they saw as their main clientele. however, we observed considerable variation in how the organisations interpreted what a community of older adults entails. most of the interior of the second-hand store was set aside for the display of the many items for sale. these were arranged in rows of large shelves, somewhat eclectically ordered throughout a large area, giving it the appearance of a warehouse. the rows were, as for other similar stores, divided into various subsections: goods for children, kitchen utensils, art and so on. the display differed, meanwhile, from similar stores in that they did not have a separate section for furniture. rather, furniture for sale was arranged in several seating arrangements placed throughout the store. these seating arrangements also functioned as places where patrons could sit, relax and chat, thus blurring the boundaries between a traditional store and a social arena. the boundary of the store part of the second-hand store is, meanwhile, clearly demarcated by the checkout till. just outside the checkout till, but still inside the actual building, is an area set aside with a couple of large tables not for sale. here, volunteers make coffee and waffles and serve cookies for patrons, providing a place where visitors can stop and have snack. this part was particularly elaborately arranged, with tablecloths and nice furniture. it was old fashioned and cosy, in a form of place mimicking what an older cohort might be assumed to prefer. a counter with waffles and coffee was placed just beside the large table, available for the staff and volunteers who serve the patrons there. this part of the second-hand store offered a welcoming scene, particularly adapted to the older groups of adults who used this section frequently. the aesthetics of the seating arrangements and the atmosphere contributed to providing a place to meet as opposed to shop, as one patron explained: “we feel that we are nicely welcomed and this place to come where you don't have to buy things” (interview, patron, the second-hand store). this old-fashioned aesthetic was, meanwhile, not apparent at the coffee house. when entering one arrives directly into the coffee area, similar to most other modern coffee houses. it has been newly renovated based on plans by a famous architect, with a carefully thought-through style throughout, largely relying on solid oak furniture. the renovation included both the café and the open plan kitchen adjacent to the café, with fancy new appliances and white tiles on the walls which changed the area from a “home kitchen on steroids to a professional kitchen,” as one of the staff members explained. in the café, which used to be painted white and was described as “institutional-looking,” now one wall had bench seating its full length with shelving that held plants and board games. the three longer rectangular tables along the bench side had lowered lighting, the rest of the lighting was pot lights and the remaining 12 tables were smaller and square, with a lit candle on each. there was also a counter at the window with a couple of higher stools (and a guitar perched on top), offering variation in both seating options and general aesthetics, further downplaying the sense of being institutional-like. the furniture was high end, fashionable and comfortable. a staff member explained that the design of the interior and atmosphere was a deliberate attempt to provide people with a more luxurious daily life, for example to sit on expensive furniture in a café and talk with others. as such, the design and aesthetics provided a break from everyday life for the patrons, http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 49 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu a sense of having or being part of something nice—visible to the world outside through the large glass windows leading out to a busy street outside. the centre provided yet another approach to design and aesthetics, or perhaps a lack of a deliberate approach. the building is a single storey brick building appearing somewhat worn down. the interior, meanwhile, is similarly bland and relatively sterile, brown bricks dominating. when entering the building one immediately enters the cafeteria, similarly to the coffee house. apart from this commonality, the difference is striking. here, one is reminded of a hospital cafeteria—sterile and standard—and the entire area is relatively cold, being close to the entrance and apparently having no heating. several tables with six to eight chairs each are placed next to a booth selling warm (kosher) meals. the seating arrangement was also standardized, not offering options or variation for the patrons. food could be purchased at a reasonable price from a kiosk at the far end of the seating area. while this arrangement was identical to the coffee house, several differences were noticeable: there was less variation in the food for sale, no aroma of food (no adjacent kitchen), and there was far less traffic between the sitting area and the food. some patrons also brought their own food to the centre. going past the open space, one enters a hallway leading to various small and large rooms, most of which offers a wide range of programming and activities. there was a constant stream of people going back and forth this hallway, all passing, and most stopping, at the open space. this open space, having the function of a transit zone, appeared as the liveliest and most vibrant part of the centre. the three organisations represent three vastly different examples of aesthetics, both in their interiors and use of space, providing different physical contexts for facilitating social interactions between older groups. these different adaptations, deliberate or not, have consequences also for how a sense of fellowship or community was communicated by the organisations, and interpreted by older patrons. at the second-hand store the physical surrounding was deliberately created with which many older cohorts of adults might identify. at the coffee house, a similarly deliberate approach to aesthetics contributed to the creation of a space of relative luxury, offering the patrons something different from everyday life. at the centre, the place was not as aesthetically pleasing as the two other cases, yet a space was provided for many patrons to meet or interact, offering a large degree of social flexibility and variation. these approaches, as well as the boundaries between the place and the outside as previously discussed, is again connected to the boundaries of inclusion at the place: who is considered the ‘right’ patron. inclusion at the place: a sense of community? at all organisations, albeit in different ways, the idea of who belonged was negotiated by both the organisations and the patrons. designating ‘the right patron’ was, in other words, significant for the organisations perhaps in a process of carving out a service niche, while equally so for the patrons, allowing them to designate whether they belonged. at the second-hand store, visitors were diverse in both age (in contrast to the centre and to the coffee house) and ethnicity (in contrast to the centre), as illustrated in this fieldnote: in the shop space, there was a constant stream of visitors, some dropping stuff off, some buying, some coming for coffee and waffles, the latter of which led to a truly lovely smell of baking throughout the place. the visitors ranged from babies to people i’d guess in their 90s. there were lots of mothers with babies in carriages, and we were told there are many single mothers in the http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 50 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu area as well as many newcomers to norway. many of the visitors had visible disabilities. (fieldnote, the second-hand store) for the older adults attending the store, such a diversity was portrayed as a positive, as an alternative to arenas solely focusing on a (white/christian) ageing population: we'll see, of course, people – so many different people coming here. that's very interesting because very often you go to places where there's just elderly, just white people, just christian people, whatever. so it is segregated. and here you see it's such a wide variety. different cultures, different background, different ages, different problems. also, people looking for nice things and [who] have lots of money. (interview, volunteer, the second-hand store) as such, the second-hand store provided an arena of diversity and variation for patrons, attuned to the neighbourhood the shop was serving, but perhaps not constituting a community of peers. but, within this diversity, various roles were assigned: both volunteers and older patrons distinguished between the ‘visitors’ (older adults – mostly female and white) and ‘shoppers’ (poor – migrant). these groups were assigned different areas in the store, one to the store part, one to the coffee area. this distinction was facilitated by the allocation of space within the organisation, allowing for patrons not buying goods and creating a unique place for them. at the coffee house, patrons were categorized, by the organisation and themselves, into two major groups: the old guard and migrant workers. the first group comprised ethnic norwegians of both sexes, most of whom were older adults and considered socially disadvantaged. for this group, this disadvantage was associated with both substance use and poverty, often but not necessarily in combination. the second group, migrant workers, comprised of (predominantly) men and women of romani origin, on average, younger than their norwegian counterparts, and categorized as poor but not dealing with substance use. the organisation also catered to a third group, migrant workers from other european countries, but this group was declining, and somewhat surprisingly, identified more with the norwegian than the romani group. the two groups were easily distinguishable in looks, in age and how they sat and clustered together. the two groups represented, in other words, clearly distinctive social identities, sharing, albeit different, social stigmas. the centre, meanwhile, catered to a specific ethnic grouping, in contrast to both the coffee house and the second-hand store: the jewish community. the centre also had a more specific profile towards an older aged cohort, while not having strict rules for admittance. the inclusivity of the centre is as highlighted in the account of an older man who had been looking for a place to take a yoga class with his wife and found a social milieu in which they both felt comfortable: i always saw that building and it seems a bit strange to me, um, i mean, i just told myself it’s not for me, it’s not for us, it looks so jewish, so, and then um, i saw the website, and um, i think um, i read that it was for everybody, so i called and the lady told us—told me that it was for everybody….we have been doing the yoga here for maybe, i don’t know, a year and a half now. and also, there are the opera lectures that we appreciate so we come too, and also we meet some people that we’re going to get—say we make friends, but um, at least we talk to other people— we socialize. (interview, patron, the centre) yet, as for the coffee house, most patrons identified as belonging to one of two groups: canadian/english speaking jews or russian speaking jews. most russian speaking jews spoke limited or no english, making this group particularly tight knit. the english-speaking jews seemed to be comprised of a larger http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 51 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu variety of nationalities, mainly born in canada (many of whom spoke about rediscovering their jewish identity in old age), and those born in other countries, israel in particular. for the russian speaking patrons, commuting between their own group and the larger community was a constant endeavour, as illustrated by the following fieldnote also speaking to the vibrant open space at the coffee house: at the end of the common area a group of men, all speaking russian, are playing chess. they converse constantly with each other, between each other and also across the two tables. within a ten-minute time period, between four and eight people at these two tables, while two games are going on. one of them suddenly breaks away from the group and goes over to the volunteer desk. he chats with the two women there. one of them is a young lady and he talks about what kind of language they speak, in english. he has a thick fur coat and a matching fur hat. the phone of one of the other russian chess players rings in a very loud, traditional russian guitar melody. he abruptly leaves the table, talking loudly, almost as if leaving his opponent alone to play at the chess table. another man approaches the remaining player and sits down beside him, discussing it seems like the position on the table. the man in the fur coat has meanwhile discussed another game at another table but has had enough of this and returns to the volunteer desk again, this time addressing the other volunteer, the oldest of the two in russian this time. (fieldnote, the centre) as seen in this example, within what is considered a relatively homogenous community, a sub-group or ‘a community within a community’ is identified. perhaps because belonging to a minority within the larger community, a social identity of russian jewish is emphasized. in summary, at all organisations group identities are negotiated and nuanced into categories. consequently, various (sub)groups deemed more or less ideal by both organisations and patrons were identified, producing communities of perceived peers among older adults. context between our cases differs in respect of the boundaries of communities, and of whom, at any time, is considered to be a peer. yet a core need remains: the need to meet and socialize with peers. dynamics of the place: a place of what? even though there is considerable difference in size, aesthetics, target population and geographical impact field, all three organisations, in different ways, offered their patrons more than their official programming and services might suggest. looking at this from another perspective, the patrons also utilized the organisations for more than their stated purpose. the centre, as previously described, represents perhaps the best example of such a dynamic, in which social life among older adults was pursued despite not providing a particularly welcoming atmosphere. most patrons did not seem to mind the bleak physicality of the place, or experienced that other positives were more important. a similar social atmosphere or an ambience was observed, particularly at the centre and the coffee house, despite the considerable differences in physical atmosphere. as seen in this researcher fieldnote, the social atmosphere is described as vibrant, dynamic, and loud: it appears as lively, vibrant, and at the time as hectic. it’s not hectic and lively in the sense of a sort of constant stream of members going to and from, but rather of different people, individuals or small groups doing different things at different times and in different places, people there all the time, a form of openness, to do as you please. and there appears to be sort of an acceptance of this being a centre for the members, where they can belong and even influence, although they http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 52 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu perhaps cannot control it. they seem, in other words, at ease, comfortable, not at home but still having a sense of belonging. (fieldnote, the centre) in one of our interviews, a patron described what the centre means to her: it is a beautiful – this is a home away from home, if i may say that. it is beautiful. they have a very big variety. i didn’t think that this place was like this until i came, and i see by myself and i experienced the programs that they have here…. i feel like i belong. like i feel like i have a place to come. i feel like i have to get dressed and i have to come to [the centre]. (interview, patron, the centre) in an interesting reflection about the isolation facing many older adults, this patron also recalled how busy she had been in her working life so that when she retired, she really didn’t have many friends. and because working and raising my children in my life, i don’t have too many friends. i have some friends, but they were working; they had their own lives. so, in a way i was ... i will say i was isolated then because all my live it was just my children and my job, work, at home, and the kids. (interview, patron, the centre) even at the second-hand store, though not primarily intended as a social arena, people, especially older adults, came together to meet in informal ways: but there are many regulars, many regulars. and i think that fulfils one of our aims to be a meeting place in the community. and not only pushing money and pushing things but being an open place for people. i think there was—it's a hole that we have filled, hopefully. i think it's – we see it at people coming again and yeah. (interview, volunteer, the second-hand store) as such, the organisations offer something more than their official mission and fill a void for their respective (and different) target populations, seemingly filling a need for interaction, sociability and even friendship: i imagine so because i think people are drawn here because it’s very comfortable and i think most people are looking to connect with other people because it’s kind of that type of environment. i mean people can sit by themselves if they choose to, but it also seems to be an environment that enhances friendships and people getting to know each other and kind of reaching out to each other. (interview, staff member, the centre) in summary, different groups of seniors congregated at the three organisations, in various ways and for various purposes. some met acquaintances, whom they may or may not have previously met at the organisations, some met to make acquaintances, or just to be in a social space. some gathered based on prearranged appointments, some met by chance. a common denominator, despite these differences, was that groups of mainly older adults met to socialize among others they considered peers and, one would assume, to meet an unfulfilled need for social interaction. another commonality is that the patrons had time to spend at the organisations—most spent considerable time there. perhaps most significantly, the organisations, being very differently structured and having different target groups, all offered their patrons more than the official articulation of their function would suggest, that is: a space for informal social interaction in which they were allowed to claim the space as their own. conclusion http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 53 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu the function of the three organisations analysed in this paper—being social support and counselling, to offer a variety of leisure and cultural activities, or provide affordable goods to relatively deprived parts of a city—were interesting and relevant for the patrons, but not the primary reason for seeking out the organisations. the official function, from the perspective of the patrons, provided a gateway into something else, fulfilling different needs. through social interaction among those considered peers, patrons of the organisations experienced something missing in their everyday lives: reciprocal relations and a sense of community among peers, often in the form of sporadic and unorganized interactions. thus, our analysis of the case studies provides some material evidence of the ways in which informal and spontaneous interaction can be “very important in constituting one’s belonging in a place, alongside the ongoing networks one might develop with people one comes to know personally” (fincher 2021, 13). the ways the different places were used can be read as a form of co-option by the patrons: they utilized the places for what they saw as their primary needs, transforming the stated and narrower function of the places by doing so. at the second-hand store, for instance, this had profound effects on the store, transforming it into something very different than its original mission, while at the coffee house and the centre this co-option took the form of informal spaces being sought out, as opposed to the food and programs that were the official reasons for being there. from the perspective of the organisations, meanwhile, what constituted their main function differed when it came to how formal and informal social interactions were approached. this difference was highlighted by approaches to aesthetics. in the second-hand store and the coffee house, the interior appeared to be deliberately designed to contrast with other spaces familiar to the patrons, thus allowing for a familiar surrounding indicating to their patrons what the places were all about. the second-hand store contrasts with other similar stores, while the coffee house is contrasted to other, less high-end possibilities for the patrons. moreover, the organisations differed in whether providing social arenas was the very function of the endeavour. providing or facilitating more or less informal social interaction, was not the primary purpose of the centre or the second-hand store, as we have seen. at the coffee house, however, facilitating the informal meeting of patrons (having volunteers and staff play a more peripheral role) was explicitly used as a way to ‘reach their target group’, who were considered to be not only marginalized but also sceptical of official support systems. here, the social arena was a mechanism to build rapport and confidence in the organisation, and thus a means of offering what the organization viewed as more substantial social services. as such, informal social interaction at the coffee house was a gateway in a different sense than that of the patrons: a gateway increasing the legitimacy of the organisation. at the other organisations, somewhat contrarily, facilitating informal social interactions appeared to be less intentional, and, from the perspective of the organisations, a side-effect of the formal program. regardless of perspective, the three organisations offered spaces for social interaction and community building. the patrons, in all organisations, carved out a space within the various places suited for their individual needs, that were, in essence, a search for connection or a community. these communities were both overlapping regarding affinity (geographical belonging, age cohort, interests) and, to some degree, imagined: membership was not automatic, but had to be negotiated and actively sought out on an ongoing basis. from ageing in place to ageing in space our material speaks of a simultaneous profound and unfulfilled need for informal social interaction. in doing so, different understandings of belonging, social environments to that of aip policies can be http://anthro-age.pitt.edu/ ågotnes, charlesworth, & macdonald | 54 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.391 http://anthro-age.pitt.edu traced. the patrons in the included organisations expressed and demonstrated needs for interaction, flexibility and variation when creating spaces to meet others, underlining mobility as significant in people’s construction of place. for our patrons: “places thus cannot be seen as containers, bounded, fixed and inward-looking. rather they are porous and reshaped by affairs of the world and the globe as much as by affairs internal to their dwellers” (fincher 2020, 11-12). in this framing, engaging in social spaces becomes more than formalized and lasting networks, and includes the informal. this can be seen through chance encounters in which the very space one is engaged in is negotiated (see also gardner 2011) and where spaces for community, as massey (2005, 32) puts it, are always under construction. perhaps most notably, our qualitative material speaks of how older adults interact with their environments, and how they have agency in their everyday lived experiences in ‘thirdspaces,’ influencing as well as being influenced by their surroundings (buffel et al. 2012, 19-20). the communities sought out, negotiated and constructed in our study are not fixed, material entities, although they are formed in a physical place. they contain meaning because of the interaction of the people contained in spaces created. as such, our findings re-affirm the position of community as offering negotiations of identity and belonging as dependent on a “complex aggregation of different elements” (gamba and cattacin 2021, 3). our older communities are not static, reducible to a specific locale, they also have a transformative element: they contain different meaning depending on one’s position—or place of departure—and in time. in conclusion, our analysis shows older adults searching for belonging and fellowship, not through the familiar or the stable (‘place as home’) but through the dynamic and vibrant (‘place as space’). this, we argue, contrasts with the static portrayal of older adults in dominant aip policies. in these policies, which we argue is a form of ageist misrepresentation, the older adult is supposed to ‘age in place,’ in familiar and safe soundings, representing a view of older adults as both homogenous and reduced to certain familiar characteristics. acknowledgements the research on which this paper draws was funded by the canadian social sciences & humanities research council 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understanding the situated meaning of intangible places for ageing-in-place.” health & place 48: 11-19. https://doi.org/10.1016/j.healthplace.2017.08.007. van regenmortel, sofie, liesbeth de donder, sarah dury, an-sofie smetcoren, nic de witte, and dominique verté. 2016. “social exclusion in later life: a systematic review of the literature.” population ageing 9: 315–344. https://doi.org/10.1007/s12062-016-9145-3. vos, willeke. h., leonieke c. van boekel, meriam m. janssen, roger t. a. j. leenders, and katrien g. luijkx. 2020. “exploring the impact of social network change: experiences of older adults ageing in place.” health & social care in the community 28 (1): 116-126. https://doi.org/10.1111/hsc.12846. warnes, anthony m., and allan williams. 2006. “older migrants in europe: a new focus for migration studies.” journal of ethnic and migration studies 32 (8): 1257–1281. doi:10.1080/13691830600927617. world health organization [who]. 2015. measuring the age-friendliness of cities: a guide to using core indicators. retrieved october 26, 2021, from https://extranet.who.int/agefriendlyworld/measuring-the-agefriendliness-of-cities-a-guide-to-using-core-indicators/. http://anthro-age.pitt.edu/ https://doi.org/10.1332/239788217x14866307026424 https://doi.org/10.1007/s12062-016-9145-3 https://doi.org/10.1111/hsc.12846 anthropology & aging quarterly 2010: 31 (3-4) 43 letter from the editor kimberly marie jones department of sociology and anthropology elon university welcome to the 2010 conference edition of anthropology and aging quarterly. the association for anthropology and gerontology (aage) has lots in store for us at the american anthropological association (aaa) and gerontological society of america (gsa) meetings this year, which happen to be overlapping in new orleans (november 17-23). the key aage events to attend are friday at 12:15, the (aaa) aging and the life course interest group meeting and book event, the aage dinner friday night at 7:30p.m., and the aage business meeting (gsa) on saturday at 11:30. our table at the aaa is a great place to check out books and past issues of this journal, get tee-shirts, and chat with aage members and authors of aage-sponsored books. i hope to see you at the booth or at one of these events. a full listing of anthropology and aging related aaa and gsa presentations and events are included in this issue. abstracts for featured presentations are also included. in our listing of events, posters, panels and sessions at both conferences, you may note that there are an exceptionally large number of presentations this year at the aaa on aging, gerontology, and life course issues. this has added to the executive board’s excitement regarding the upcoming meetings. while all the members of the aage executive board are consistently supportive, insightful, and hard-working, jay sokolovsky is a model of long-term commitment and passion for us all. this issue also features a guide to key resources developed by jay and the aaa aging and the life course interest group. this guide includes important new texts as well as a listing of pedagogic and theoretical standards. jay is also serving as the editor of a book series on the life course, culture and aging: global transformation that will serve to support publishing other relevant works in our field. it is equally rewarding to find new members early in their careers who demonstrate passion and a desire to serve the discipline. a doctoral student from the university of st. andrews in scotland has been infusing the journal and association with new energy and excitement these days. philip y. kao, our new student editor, is developing a section of the journal dedicated to student projects. in this issue, he begins the series with reflections on caregiving and how this articulates with the doctoral research he is currently conducting. it is a pleasure to be working with him! look out for more student work in 2011, and encourage your students and colleagues to consider submitting their work. it is also a pleasure to introduce the new elected secretary of aage, dr. eric miller. thank you for taking on this service to our organization and welcome aboard! as usual, this issue also celebrates scholarship in anthropology and aging through our regular columns: new publications, edited by maria cattell, and member news, edited by margaret (peggy) perkinson. be sure to renew your aage membership (just $18 for students and $28 for professionals) for 2011, which includes access to all past issues of aaq. weaving flexible aging-friendly communities across generations while living with covid-19 nanami suzuki national museum of ethnology / sokendai guas suzunana@minpaku.ac.jp anthropology & aging, vol 41, no 2 (2020), pp. 155-166 issn 2374-2267 (online) doi 10.5195/aa.2020.311 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 155 weaving flexible aging-friendly communities across generations while living with covid-19 nanami suzuki national museum of ethnology / sokendai guas suzunana@minpaku.ac.jp introduction in this article, i consider the possibility of developing flexible aging (age)-friendly communities that allow people to reorganize their lives under changing circumstances, such as the current pandemic in japan. i would like to think about aging-friendly communities, in terms of the well-being of older people being deeply connected to the well-being of all generations, and in terms of the possibility of fostering communication that responds to the multilayered and expansive nature of older adults’ interactions. in the midst of rapidly aging societies, the term is used to describe the environments that are woven by the efforts of various people to concretely respond to the question of how we age well, taking into account that aging is a highly diverse and relational experience. as research and movements that recognize the importance of older adults as community members have developed around the world, various terms have been used depending on the characteristics of the intended community, such as elder-friendly communities, communities for all ages, livable communities, and life-span communities (stafford 2009). scharlach and lehning use “the term aging-friendly rather than age-friendly or elder-friendly in recognition of the dynamic, transactional nature of the aging process as it unfolds in an ever-changing environmental context” (scharlach and lehning 2016, vii). an “aging-friendly" community is one where older citizens can continue to engage in life-long interests and activities, enjoy opportunities to develop new interests and sources of fulfillment, and receive the necessary support and enjoy those accommodations that help them meet their basic needs (scharlach 2012, 28). age-friendly community researchers have actively examined and worked toward creating environments that can be enjoyed equally by every older adult. research on age-friendly communities has highlighted the importance of diverse sectors working well together to realize this goal. movements toward age-friendly cities, or communities, have become vibrant, especially over the last decade (e.g., buffel and phillipson 2019; greenfield et al. 2015; moulaert and garon 2016; phillipson 2011; stafford 2019). the importance of multigenerational co-existence – viewing the well-being of older adults as deeply intertwined with those of other generations – has become clearer (suzuki 2019b). in addition to the indicators presented by the who for the “global age-friendly cities” project and to a certification program, also by the who (world health organization 2007), the center for home care policy and research in the us has developed the first comprehensive model through a community planning and development project. the advantage initiative presents four indicators of age-friendly communities: addressing basic needs, optimizing physical and mental health and well-being, http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 156 promoting social and civic engagement, and maximizing independence for frail and disabled people (oberlink and davis 2019). certainly, a good environment is not created all at once following neatly a pre-ordained model, but is something that people weave together on a daily basis, including nature and landscape design, and considering the history and culture of the region. one of the most vital elements of this process, is human interaction. what i encountered during ethnographic research in people’s practices of caring for older adults, was that they always tried to facilitate face-to-face interactions and time spent together using the five senses. however, many of those efforts have become very difficult to conduct amid the crisis of coronavirus infection. a crisis in aging-friendly communities? amid the spread of the coronavirus infection (covid-19), and with the state of emergency declared by the government in april 2020, the local governments in japan requested citizens to refrain from crossprefectural travel, from organizing events or doing business, from engaging in ‘non-essential’ activities, and so on. in other words: ‘stay at home.’ in conjunction with the distribution of masks and money to all citizens, as well as assistance to needy traders, the state of emergency was lifted in late may, and economic activity was resumed while avoiding three conditions that facilitate the transmission of infectious diseases (closed spaces, crowds, and close contact). in addition to these, ‘social distancing’ was implemented, which implied for example not talking loudly, even not with family members at dinner. by the end of july, the number of infected people began to increase again and a second wave occurred, while as of the end of november, a third wave has been suggested. as we come to realize that the end of this pandemic is difficult to predict, there is a growing interest to rethink and propose lifestyle changes, in order to live better ‘with corona.’ will we lose the joy of working side-by-side under behavioral restrictions? at first, i was baffled by the situation we were forced to live in, of being behaviorally restricted by the risk of being infected. this is partly because i have for long been interested in the communication of older adults with others and their environments, and in their roles in creating a community for all ages with their wisdom and experience (suzuki 2012, 88). for example, since 2004, i have continuousely looked closely for attempts to promote new industries that draw on the experiences of older adults to make a small, depopulated town in japan a sustainable place to live. this project was made possible by the collaboration of the younger generations from in and outside of the town. the project was highly successful, making people further develop other activities and interactions, and it led to all generations finding a new and enjoyable place to live in this town. i have written papers and articles about people's experiences and disseminated them for use elsewhere, as well as held a symposium including a talk of a leader of the third-sector that had the coordinating role of townspeople, people from outside, enterprises and public institutions in town. in interviewing the older women who played a key role in the project, i was impressed by the fact that they voiced that, for the first time, they felt they had become a "visible" presence in the community. this feeling was linked to being recognized as someone who could impart knowledge and experience to the people around them, to getting the necessary support from the younger generation, and to their interactions with the young people in terms of caring for each other and of actually being by their side (suzuki 2012; suzuki 2013a; suzuki 2019a). a multi-generational community is like a living organism, never standing still, but in a process of continuous motion. that is why it is necessary for people across generations to continue to devise ways to make the place they are in more livable, to create opportunities for the future together with people from diverse cultural backgrounds and to interact with each other and foster new ways of thinking and http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 157 living. but since these practices are supported by the ingenuity of active communication in communities and regions, i feel the strong need today to think about aging-friendly communities and multigenerational wellbeing, bearing in mind situations where face-to-face encounters may continue to be limited. this reflection is not limited to older adults ‘aging-in-place.’ as i will discuss in this article, especially in hospitals and residential communities for older adults, direct contact and communication are limited as well. while my research has focused on older adults living in continuing care retirement communities (ccrcs) where communication has remained relatively lively, i also explore how to support various interactions to enhance the lives of people with vulnerable conditions who stay in institutions under the restrictions of not being able to see the people whom they are close with.. face-to-face interactions at stake i have been conducting research on aging-friendly communities in rural municipalities over the past years. most recently, i have focused on akita city in the tohoku region, which is one of the cities in japan participating in the who cities project as of 2019 (suzuki 2019b, 213). older adults who want to continue living in their own homes without moving to a senior-care facility, can rely on various support services developed under the long-term care insurance system. these include help with activities of daily living such as eating and bathing, as well as recreation and exercise, provided either at a facility called ‘day services,’ or by a healthcare worker at home. the integrated activities provided by day service, include transportation, dining, taking baths with the support of the staff, singing songs, playing games, etc., all year round. day service is also a familiar space for local residents, and in the wake of the great east japan earthquake, a day service in natori city, miyagi prefecture, voluntarily served as a temporary shelter (suzuki 2019b, 121-147). figure 1: older adults and staff enjoying exercises and games at a day service (akita, japan, march 2016. photo courtesy of author) http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 158 numerous residential facilities for older adults, including nursing homes, have not been allowing visitors – not even family members – into the facilities for several months in order to prevent transmission of the coronavirus. at the request of the ministry of health, labour and welfare, no inpatient visits were allowed at the hospital either. also residents of ccrcs have suffered from the restrictions. ccrcs have become increasingly common in japan, and allow older adults to age in place through various phases of their life. older adults who have moved in with the expectation of living in a community where they could socialize with new friends, have now been prohibited from performing various social activities, such as dancing, singing, playing go, shogi, and mahjong, watching movies, and participating in seasonal events, in order to avoid the spread of infection. many activities that were previously conducted face-to-face, with the aim of maintaining and improving well-being, are now difficult to continue due to the coronavirus crisis. modest challenges to interacting and living together within constraints in despite of these restrictions to sociality, sensorial contact and freedom, there has been a wide range of intergenerational initiatives to guarantee the continuity of meaningful interactions, indicating the potential ‘flexibility’ of aging-friendly communities. alternative facetime as the coronavirus made its disturbing entrance into everyday life, one of the problems that came to the fore was the lack of access to people in older adult facilities and hospitals. this caused a boundary between the inside and outside of the facilities and prevented the elderly and inpatients from meeting their families and loved ones. in order to improve this situation of social isolation, numerous facilities, such as nursing homes, invested in the organization of non-virtual, face-to-face interactions without sharing the same space. older adult residents and their family members, who are not used to online communication, could meet face-to-face through a glass window, and talk to each other using special phones provided by the facility. this somewhat analog method, is used in numerous facilities to satisfy older adults’ sense of security, especially those with cognitive impairments, who may not understand why they have suddenly stopped seeing their families, thus sustaining aging-friendly communities in times of social constraint. there are, however, limitations to this method. it is, for example, not suitable for older adults who are too weak to move. in addition, hospitalized patients, even if they are not infected with coronavirus, must stay in the hospital alone, without the comfort of family and visitors, as the hospitals do not permit visitors. another example of provisions where a continuity of sociality and care were sought during the pandemic, are facilities for older adults and rehabilitation hospitals, that are commonly built in suburban areas. in the past there has often been a concern regarding the social isolation of older adults and patients here. these pandemic times, however, have altered the parameters of what can account for a safe and healthy environment. we now see a growing interest in staying in the suburbs because there is sufficient social distance. residents and patients can still breathe fresh air and walk in the sunshine, while facing the same direction, instead of communicating face-to-face with the supportive facility staff to prevent contagion. through this, they get to enjoy the beauty of the surrounding environment and perform physical activities without any problems, with little or no hindrance of the state of emergency. moreover, such observations can be a good starting point for everyone to not only recognize the importance for suburban living and for building a community where people avoid the ‘triad’ of enclosed, dense and intimate spaces, but also to reconsider which spaces are good and comfortable to live and to work. this can help people improve their well-being, during and after public health crises. it also highlights the alternative ways people can still communicate with each other without the use of technology (or without having to be tech-savvy). http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 159 non-discrimination, appreciation and solidarity in a one-and-a-half meter society discrimination and exclusion against health-care workers, who are, together with their families, making the most sacrifices, has been especially detrimental these past months. whereas parents with other professions are able to work from home and take care of their children who are also staying home due to school closures, parents who are health-care workers may have to work in dangerous health-care settings and leave their children at home alone. in a survey for health-care workers, 60% of them reported that they had experienced discrimination or exclusion. despite this, there are also positive examples that show how the efforts of health-care workers are praised, such as the gesture by elementary school children in kobe city. in an area that was reconstructed following the great hanshin-awaji earthquake, elementary school children posted a sign intended for the hospital staff who treated numerous patients reading, “itsumo arigatō gozaimasu. mina de ōen shiteimasu! [thank you for everything. we're all rooting for you!]” on the windows located opposite the main hospital. a response to those words “ōen arigatō, ganbarimasu! [thank you for your support, we’ll do our best!]” was then posted on the walls of the hospital. this area, with a nearby kindergarten, hospital, ccrc and prefectural art museum, is normally filled with liveliness brought by people from different generations, but it has become less crowded and much more quiet since the coronavirus outbreak. however, the words of gratitude from children reminded people of the sense of security, solidarity, and the stance against discrimination. figure 2 figure 3 figures 2 and 3: words of gratitude and support from elementary school pupils for the staff of the hospital across the street, with a reponse at the front door of the hospital across the street (kobe, japan may, 2020 photo courtesy of author). this was not the only sign of solidarity that bridged physical distance. with the call for self-restraint following the state of emergency declaration in may, many parts of japan started using neon signs to inform people of the situation of local areas. in the case of osaka prefecture tourist attractions, such as the tsutenkaku tower, osaka castle, the tower of the sun in expo park, and the nearby ferris wheel (see figure 4), all have switched on their nighttime lighting certifications to red (alert), yellow (caution), and green (safe), depending on the level of danger being posed. this was a collaborative effort between the private and public sectors. the sites where neon signs were illuminated were all symbolic buildings reflecting the history of the area. they conveyed a deep sense of belonging to the people who practiced self-restraint, such as staying home, and made them realize that they were not alone in their efforts. people continue to look at the lit neon lights while obtaining more general and impersonal information from the television and radio. http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 160 figure 4: the light of the ferris wheel near the expo park in northern osaka informed the residents of the status of the coronavirus outbreak through the color of the neon signs: red, yellow, and green (osaka, japan may 2020; photo courtesy of author) perspectives on thriving and living together even more compelling activities were organized to convey a message of hope and togetherness to people and to send good thoughts while living together in a densely populated place where coronavirus transmission is a pertinent concern. all summer festivals and fireworks displays in japan have been cancelled due to the risk of spreading coronavirus infection. yet, the “cheer up! hanabi [fireworks to cheer everyone on]” project was held in early june, but this without revealing the place beforehand in order to avoid a mass gathering. fireworks were displayed at various locations throughout the country in cooperation, with 163 fireworks companies nationwide, to pray for the eradication of epidemics and to revitalize the people. companies have experienced income loss due to the cancellation of regular annual fireworks events, but they did not want to waste the fireworks. moreover, they titled the event “yoake [dawn]” in order to express the message that there is no night that does not dawn to see sunlight again. many people were not able to see the fireworks display due to lack of information about the location of the event, but the organizers believed “it's okay if you can't see it, as long as it warms your heart” (kansai television 2020). the pyrotechnicians also wished to give a seasonal message, especially for children who did not have had an april school entrance ceremony. although some of the schools that were asked to close were offering online classes, new students that had to transition from elementary school to college, were in a particularly anxious state as they started new stages in their lives. the story of the fireworks was also a story for them, and aimed at giving them a sense of security, a feeling of hope and a sense of joy in life. however powerful, fireworks alone are not sufficient to save the economy. to meet a particularly urgent need, the staff at a yakiniku, or a japanese dish of grilled meat, often meaning korean barbecue, restaurant in osaka purchased a 3d printer to produce face shields and offer them to medical sites for free. they said they worked hard to produce these face shields because they felt that their lives would be at stake if they could not reopen their restaurant and get back to work as soon as possible. http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 161 the restaurant was in tsuruhashi, an area known for its delicious yakiniku, a cuisine developed by people of korean descent who lived there. on a previous visit to this area with a korean friend who lives there, i was impressed by the number of gathering places created for older adults to chat and eat, and my friend told me that this was common, not only in urban areas but also in the rural areas of south korea (sawano 2018). the efforts of the restaurant staff to help themselves and those in need were also a way of sharing the local story of how people have lived together and can thus also be seen as a particular way of supporting aging-in-place. these modest efforts are not only about what ‘we’ can do, as a collective, here and now, but also point to the concrete actions people can take to prepare for a viable future built on the resilience and flexibility of social relations. the actions people have taken to achieve the clear objective of ‘not losing any lives’ during the pandemic, provide a base from which people of all ages can receive the care they need in ever-changing circumstances. rethinking aging-friendly communities through intergenerational and multifaceted interactions this last section describes how people keep searching for ways to live well with the viral threat as they experience the second and third wave of coronavirus transmission and the state of lull that follows. our perception of the continuing coronacrisis provides us with opportunities, as a diverse group of people, to think about how to act in a balanced manner so as to prevent loss of lives in the midst of this crisis on the one hand, while retaining a life with time for work, leisure, and relaxation, on the other hand. in october, tokyo, which has had the highest number of coronavirus infections in japan thusfar, also began applying the “go to travel” program, which provides public support for travel to increase the number of travelers. large-scale events are also being held, while guaranteeing physical distance between participants and limiting their social interactions. foreigners are now able to enter japan if they meet certain conditions such as working or studying. these activities have been conducted within the well-known restrictions such as the wearing of masks, temperature testing, hand disinfection, social distance, and ventilation upon entry in many facilities as a measure against infectious diseases. also, activities and interactions with older adults living in their homes have resumed, such as welcoming support staff and going out to day services, while adhering to the security measures. at a ccrc in kobe, where relatively healthy older people live, infection-control acrylic partitions were installed so that they now can enjoy games and conversation. family members can now enter the elderly's room and visit them for up to two hours. while restrictions continue to make up everyday life, people keep repatterning the lines of the social tissue across generations. an exception to the return to more flexible social contact, may be hospitals and nursing homes. in general, it is still prohibited for family members or acquaintances to visit the sick in the wards, or elderly in nursing homes. according to my experience at a hospital in the kanto region in early october this year, only in cases where recovery is very unlikely and the patient has little time left, health care workers allow family members to visit patients at the hospital or let patients go home for a short period of time, to ensure that patients and family members can have face-to-face contact. however, as i observed the nurses and physical therapists who attended to and cared for each patient in this hospital one by one, it occurred to me that people in pain and difficult conditions were enjoying a diversity of care relations and interactions outside of kinship networks, that could all support them in this process in distinct ways. i was again reminded of the fact that people’s lives can be enriched not only through their interactions with their families and close friends, but also through a wider range of relationships. this perspective of valuable non-kin interactions has also been suggested within gerontological research. the concept of “geriatric transcendence,” (or, “gerotranscendence,” as it was cued by swedish http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 162 social gerontologist lars tornstam) presents three psychological changes that occur with aging: aspects of social relations, aspects of the self, and aspects of cosmic consciousness (how we perceive the world) (gondō 2016, 49-50). a change in cosmic consciousness means that the barriers of time and space disappear in our thoughts, and our consciousness is free to move back and forth to the past and future. while seen as an impairment by many (e.g., in the case of dementia), as a result of this alteration in consciousness, the sense of being connected to the wider world expands, which is counterintuitive to the common conception of the process of aging into frailty as increasingly inhabiting a shrinking and even empty world. if we can recognize these kinds of relationships in our lives across ages, we will be able to trace the memories of people we have met including people who are not of this world, and expand our interactions to feel the breath of various living beings with our five senses. in this regard, i remember the active engagement of staff members in facilities for older adults and hospitals that i have visited, to make cosmic and supra-local dimensions part of sociality and everyday life. at a hospital in shiga (japan), there were monks working as staff members who would talk with patients about the wider world. i also recall us nursing homes, where residents participated as part of hospice teams and visited each other (suzuki 2013b), expanding their mundane worlds. the constant presence of these people in the facility can now ensure that patients and elderly residents have a companion to talk to, even when outside visits are blocked. similarly, in a multi-generational facility of assisted living and a nursing home for the elderly that integrated a children's learning center in switzerland, people could discuss and meditate on the relationship between the universe and human beings, while professional staff members were always on hand to support them. related to this, i was once struck by initiatives in the field of dementia care, that revealed how savoring life’s memories and time spent connecting with non-human life is important for both those being cared for and those who care for them (see figure 5). in fact, there was even a place intentionally and concretely prepared to help both the elderly and the nurses and other support staff as well as family members spend a quiet time after cooking and eating together, sharing memories of past meals and allowing them to fully appreciate and enjoy the moment (suzuki 2019b, 113-115). figure 5: a place for quiet rest and meditation by the window of the day care attached to the senior citizens' residence (walklingen, switzerland june 2015, courtesy of the author) http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 163 also, some practices that have been carried out in residential facilities for older adults which aim to be open to multigenerational interaction, can be continued even under the current coronavirus threat. in order to ensure that senior housing facilities do not become a closed environment to the younger generation and the surrounding community, some have attempted to build kindergartens on the premises of the facilities and make them accessible to the younger generation. at the kindergarten, elderly people living in the facility also volunteered, putting to work their experience as teachers. in addition, the elderly home's wide, wheelchair-accessible corridor has been provided for young people to use as a place to display the results of their studies and work. for example, a display of people of all ages, from 0 to 100 years old, with pictures and descriptions of them, made by university students in the neighborhood, was part of the exhibit. these exhibits allowed people to reflect on the lives of different generations while living in the home for the elderly. the exhibition itself, if created in a carefully controlled environment, does not require contact between visitors from the outside and the elderly inside, and can thus be continued in the midst of the pandemic. figure 6: exhibit in a large hallway of a facility for the elderly (lititz, usa, november 2014 courtesy of the author) conclusion: continuing to weave aging-friendly communities throughout the different sections, particular attention was paid to how we can make the time and space to share what we feel is important; a foundational value of the ideas and practices of aging-friendly communities, even in the midst of our limited lives. researchers and practitioners in the domain of aging-friendly communities, have over the last months expressed their concern that the diverse areas that underpin people’s wellbeing, especially when these entail social interaction, risk being curtailed by protective measures taken to contain the covid-19 pandemic. however, as i discussed in this article, actions initiated or continued during this public health crisis, remind us of the breadth and flexibility of human wellbeing, as it is rooted in various vital connections from the past to the future. all practices that meet the need of realizing a sense of belonging and proximity, can be devised and practiced under the flag of aging-friendly communities. http://anthro-age.pitt.edu/ suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 164 under the present conditions of limited interaction, social problems such as poverty, social inequality and discrimination have become more acute. yet, people, even at a distance, take interest, share awareness of the problems, and devise ways to improve them. but since this situation is perennial, we need to keep a close eye on the plight of the younger generation in particular. it is imperative to think in terms of sustainable practices that ensure physical and mental wellbeing and promote underlying livelihoods that can only be fully obtained face-to-face. it is necessary to continue exploring the ingenuity that all generations have, so that those who seek to learn and work can enjoy diverse ways of doing so. the narratives of people who continue to be limited in their interactions with those close to them, such as in hospitals and senior citizen facilities, make explicit the diversity and multi-layered nature of human interactions. moreover, older adults and patients, who are unable to be ‘active,’ find joy in reminiscing about important things in their lives, such as people, plants, animals, and things from the past. these findings, together with previous improvements of living conditions for older adults in nursing homes and senior living facilities, should help us to persistently devise ways to make any facility an integrated community of aging in the broadest sense. an environment that expands the diversity of roles and characteristics of residents and staff, has a variety of topics for conversation, and takes into account the rhythms of human stillness and movement, is a stage conducive to the rich interaction between people, objects, and images of all those involved in a facility or community – an aging friendly community as a living being in transition. these multiple faces of the effects of the coronavirus crisis have made it clear once more, that agingfriendly communities can be flexibly woven together by continuing to devise ways to enrich multiple generations, and not just the well-being of the older generations. the practice of looking at the wholeness of humans, learning from and acknowledging diversity, and reconciling the conflicts that arise from it, is a central life challenge that those interested in aging-friendly communities can pursue as both research and work. references kansai television. “tokushü: zenkoku issei “surprise hanabi” no butaiura” [special feature: behind the scenes “surprise fireworks” all over the country] https://www.ktv.jp/news/feature/20200603.html (october 14, 2020) (the project is also described in english. https://www.cheeruphanabi.com/pg2792762.html). buffel, tine and chris phillipson. 2019. “creating age-friendly communities in urban environments: research issues and policy recommendations.” in the global age-friendly community movement: a critical appraisal. edited by philip b. stafford, 15-30. new york: berghahn books. gondō, yasuyuki. 2016. “hyakujusha kara manabu kenkō chōju toha” [healthy longevity learned from centenarians] in chōkōrei shakai wo ikiru [living in a super-aged society]. edited by hisao nagata, 36-52. tokyo: seishinshobō. greenfield, emily, mia oberlink, andrew e. scharlach, margaret b. neal, and philip b. stafford. 2015. “agefriendly community initiatives: conceptual issues and key questions.” gerontologist 55(2): 191-198. moulaert, thibauld and suzanne garon, eds. 2016. age-friendly cities and communities in international comparison: political lessons, scientific avenues, and democratic issues. new york: springer. oberlink, mia r. and barbara s. davis. 2019. “assessing the aging-friendliness of two new york city neighborhoods.” in the global age-friendly community movement: a critical appraisal. edited by philip b. stafford, 127-135. new york: berghahn books. http://anthro-age.pitt.edu/ https://www.cheeruphanabi.com/pg2792762.html suzuki | anthropology & aging vol 41 no 2 (2020) issn 2374-2267 (online) doi 10.5195/aa.2020.311 http://anthro-age.pitt.edu 165 phillipson, chris. 2011. “developing age-friendly communities: new approaches to growing old in urban environment.” in handbook of sociology of aging. edited by richard e. settersten and jacqueline l. angel, 279-293. new york: springer. sawano, michiko. 2018. “kyōshoku ga umidasareru ba: kankoku nōson “keirōdo” no jirei kara” [age-friendly communities in korea: focusing on the cases of communal dining at “gyeong-ro-dang”] in chōkōrei shakai no eiji furendorī comyuniti [aging-friendly communities in super aged societies]. edited by nanami suzuki, 67-86. osaka: national museum of ethnology. scharlach, andrew. 2012. “creating aging-friendly communities in the united states.” ageing international 37: 2538. scharlach, andrew e. and amanda j. lehning, 2016. creating aging-friendly communities. new york: oxford university press. stafford, philip b. 2009. “aging in the hood: creating and sustaining elder-friendly environments.” in the cultural context of aging: worldwide perspectives. third edition. edited by jay sokolovsky, 441-452. westport, connecticut, london: praeger. stafford, philip b., ed. 2019. the global age-friendly community movement: a critical appraisal. new york: berghahn. suzuki, nanami. 2012. “creating a community of resilience: new meanings of technologies for greater wellbeing in a depopulated town.” anthropology and aging 33(3): 87-96. suzuki, nanami. 2013a. “carrying out care: an exploration of time and space in cooperative life design.” in the anthropology of aging and well-being: searching for the space and time to cultivate life together. edited by nanami suzuki. senri ethnological studies 80: 1-19. osaka: national museum of ethnology. http://doi.org/10.15021/00002488. ----. 2013b. “a reflection on time and space for crossing over in life: weaving a story that reverberates in the world and outer space.” in the anthropology of aging and well-being: searching for the space and time to cultivate life together. edited by nanami suzuki. senri ethnological studies 80: 143-160. osaka: national museum of ethnology. http://doi.org/10.15021/00002497. suzuki, nanami. 2019a. “creating an age-friendly community in a depopulated town in japan: a search for resilient ways to cherish new commons as local cultural resources.” in the global age-friendly community movement: a critical appraisal. edited by philip b. stafford, 229-246. new york: berghahn. ----. 2019b. eijingu furendorī communiti: chōkōrei shakai ni okeru jinsei saishushō no sugoshikata [aging-friendly communities: wellbeings in the last chapter of life in super aged societies]. tokyo: shinyosha. world health organization (who). 2007. global age-friendly cities: a guide. accessed november 15, 2020. https://www.who.int/ageing/publications/global_age_friendly_cities_guide_english.pdf http://anthro-age.pitt.edu/ http://doi.org/10.15021/00002488 http://doi.org/10.15021/00002497 https://www.who.int/ageing/publications/global_age_friendly_cities_guide_english.pdf book review review of gatta, mary. waiting on retirement: aging and economic insecurity in low-wage work. stanford ca: stanford university press. 2019. pp. 184. price: $85 (hardcover); $23.85 (paperback). neri de kramer university of delaware dekramer@udel.edu anthropology & aging, vol 42, no 2 (2021), pp. 172-174 issn 2374-2267 (online) doi 10.5195/aa.2021.368 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | de kramer | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.368 http://anthro-age.pitt.edu 172 book review review of gatta, mary. waiting on retirement: aging and economic insecurity in low-wage work. stanford ca: stanford university press. 2019. pp. 184. price: $85 (hardcover); $23.85 (paperback). neri de kramer university of delaware dekramer@udel.edu once a waitress in college herself, sociologist and labor advocate mary gatta has spent her career researching low-wage work, workforce policies, inequalities and discrimination, and how low-wage workers get by on minimum and subminimum wages. her most recent volume, waiting on retirement: aging and economic insecurity in low-wage work is a culmination of this work, offering a qualitative account of the economic insecurity experienced by low-wage restaurant workers as they age and addressing the question: “what happens after work?” (121). the answer to this question is an alarming call to action. while the focus in the book is on the cooks, servers, bartenders, and other restaurant employees who sat down with gatta to tell of their often heart wrenching struggles to make ends meet, in her prologue, gatta explains why their experiences are representative of a much broader slice of the american workforce and why the united states as a whole is facing a retirement crisis. restaurant work is a classic example of increasingly common low wage work that does not provide the income or benefits that provide a secure retirement. wages are too low to allow for saving and paying into social security; work shifts tend to be unpredictable, making it hard to plan and save; health care and retirement benefits are lacking, and the industry is characterized by unsafe as well as discriminatory workplace practices and lack of worker protections. gatta explains that these conditions also apply to middle-income workers for whom neoliberal policies have depressed wages, eroded public supports such as housing, health insurance and transportation, ended defined benefit plans, and increased the cost of drugs. this underscores how the american retirement crisis is not limited to the poor and foreshadows what is in store for many of us. the book is concise at 119 pages, consisting of a prologue, five chapters and a methodological appendix. its core data come from 31 in-depth interviews with current and former restaurant workers, supplemented by focus group data gatta collected for comparative purposes and enriched by gatta’s lifelong career researching and advocating for low wage workers in various sectors. it provides a comprehensive background and history of the widespread precarity experienced by large swaths of aging and elderly americans today. the topic of elder poverty was recently propelled to the forefront of the general public’s mind after the release of oscar-winning film nomadland, adapted from jessica bruder’s book by the same name. this means gatta’s book will be of interest not only to academics, graduate students, and policy workers but also to lay people recently alerted to this problem. the book’s clear language, engaging first-hand accounts, and lack of jargon make it an accessible read for this broad audience as well. http://anthro-age.pitt.edu/ book review | de kramer | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.368 http://anthro-age.pitt.edu 173 chapter 1, “the new normal,” can be read as a general introduction to the origins of certain forms of precarity in the us; it offers statistics on the composition of the low wage workforce and describes historical trends in the us labor market and retirement system. it tells the story of the erosion of the new deal social contract, how neoliberalism shifted economic risk to the individual and changed dependency into a negative state. the subsequent three chapters chronicle the financial challenges of three generations of restaurant workers as they age, told in their own words and contextualized with a treasure trove of historic, economic, and policy facts. chapter 2, “the fast money trap,” describes the strategies a set of current restaurant workers, gen x’ers in their 30s and 40s, are deploying to help mitigate their current and looming future economic insecurity. because the restaurant industry is rife with age and sex discrimination, job insecurity significantly increases for restaurant workers of around this age, women in particular. one strategy involves the creation of local social safety nets based on a sharing economy and bartering system in which aging workers can share services, expertise, and resources to better weather their economic insecurity. other workers are trying to find security in the gig economy, which offers just as little worker compensation, access to health care, paid sick days, or avenues for retirement as restaurant work. others try to secure better jobs or start a business. many of them adjust their expectations of what they once thought a retirement might look like, an emotional process marianne cooper calls “downscaling” (27). chapter 3, “aging in low-wage work,” moves further into ‘old age’ and describes the daily experiences of lifelong restaurant workers reaching retirement age. even though these older workers have worked continuously for decades, they are not in a financial position to stop working. for most, their ‘retirement’ plan thus consists of working longer and working indefinitely, which is complicated by their physical limits and common experience of chronic pain, as well as age and sex discrimination. their predicament is perhaps best illustrated by the following text message gatta received from one of her interviewees: “hi mary! i’ve polled some restaurant friends about their retirement plans and the consensus seems to be—hope i die before i get old. crazy, no?” (69). chapter 4, “retiring in a coffin,” underscores the reality that no long-time restaurant worker voluntarily retires from restaurant work and outlines the stressful experiences of restaurant workers forced into retirement due to health problems, restaurant closings, or other circumstances. public assistance programs are critical for these workers and often insufficient, as the story of a person dying while waiting for medicare benefits painfully makes clear. one informant found her 76-year old father a job rolling silverware in the restaurant where she worked. he needed the money to pay his medicare supplement and worked there till he died at 82 years old. chapter 5, “crisis or come together,” concludes the book by outlining progressive policy proposals for a new social contract that could restore retirement security for america’s workers. it reimagines the three central tenets on which security in retirement depends: good jobs, a guaranteed retirement system based on state support as well as less volatile savings vehicles, and affordable health care so that workers do not need to tap into retirement savings to cover medical costs. the proposals are utterly sensible yet apparently not politically viable as “[t]hese ideas have been and continue to be floated and rejected” (119). the question which emerges then is, how do we build the capacity to turn these proposals into policy? one place to start might be to tap into the resentment of those most precariously situated, such as the aging restaurant workers featured in this book. if there is anybody viscerally aware of the fact that the american dream ideology of working hard and playing by the rules has failed to deliver on its promise, http://anthro-age.pitt.edu/ book review | de kramer | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.368 http://anthro-age.pitt.edu 174 it is this hardworking lot. however, of gatta’s informants, only about a handful have turned to social activism to fight for better jobs and stronger public policies. the rest are pouring their energy into individualized responses to economic stress or commoning practices like bartering and shared housing arrangements, which are more collectivist but still not political in nature. after reading this extremely informative and important book i am left wondering about the difference between the workers embracing political action and those turning inward. what moved the former group into activism and how can we politicize the rest? social scientists have an important role explaining the lives of society’s most vulnerable. can we put our understanding to use by locating and supporting those pockets of resistance with the most transformative potential? these questions are urgent. gatta cites economist teresa ghilarducci who “grimly predicts that by 2050 the usa will have 25 million poor elderly americans” (2). on top of this, social security, the primary source of income for the majority of retired americans, is projected to exhaust its reserves in 2037. after that, annual taxes are expected to cover only 76 percent of its benefit obligations (goss 2010). as the baby boomers reach old age in an already weak retirement system with dwindling social security support, the number of elderly americans financially struggling in old age will only increase in the absence of a comprehensive collective policy response. references bruder, jessica. 2017. nomadland: surviving america in the twenty-first century. norton, w. w. & company, inc. goss, stephen. 2010. “the future financial status of the social security program.” social security bulletin 70 (3) https://www.ssa.gov/policy/docs/ssb/v70n3/v70n3p111.html. http://anthro-age.pitt.edu/ https://www.ssa.gov/policy/docs/ssb/v70n3/v70n3p111.html anthropology & aging quarterly 2014: 34 (4) 238 introduction is old age a developmental phase of degenitalization of the body when the two ideal bodily forms, two ideal morphologies-the male and the female – should be dismissed? this question, inspired by the work of judith butler (1990, 2004), has guided my reading of the interplay of gender, aging and sexuality in texts produced by brazilian gerontologists. these brazilian gerontologists and sexologists argue that decreases in sexual activity in old age are, in fact, replaced by a unique and intense sexual pleasure, based not so much on genitals, but rather on a more holistic bodily experience. the aim of this article is to show how women in senior citizen clubs and men in retiree associations react to the discourses of these specialists. aging, gender and sexuality in brazilian society guita grin debert, phd full professor, department of anthropology institute of philosophy and human sciences,universidade estadual de campinas  prescriptions by gerontologists and geriatricians for ‘successful’ aging in brazil tend to eroticize old age, simultaneously reproducing a gender-based sexuality (foucault 1990). one of the ideas they specifically promote is the degenitalization of male sexuality. that is, these experts insist on the importance for older men to explore new areas of their bodies to increase sexual pleasure, similar to the more diffuse notion of female sexuality. in the case of older women, sexual activity is often linked to the questioning of a restrictive moral code interconnected with male domination (bourdieu 2001), which supposedly forms the basis of their sexual learning. older women are stimulated by these professionals to delink the practice of sex from their partner’s desires, and instead to focus on abstract drawing on the interplay between gender, aging, and sexuality, the aim of this article is twofold: (1) to show how brazilian gerontologists treat gender differences and sexual activity in old age; (2) to analyze the ways discourses regarding the aging body and sexuality are perceived and evaluated by older women and men . i argue that attempts of gerontologists’ to eroticize old age have to contend with the widespread notion that the desire for sex is inevitably lost with age. thus, in the retiree associations that were studied, men had a tendency to assume they are not ‘old’ because their erectile function was still in good condition, and divorced or widowed women, in senior citizen associations, tend to regard themselves as happy due to having freed themselves from the sexual obligations imposed by marriage. in both cases, the dominant belief that there is a loss of sexual desire in old age was reproduced. keywords: sexuality, gender, aging, brazilian gerontology, sexology aging, sex and well-being in brazil anthropology & aging quarterly 2014: 34 (4) 239 guita grin debert aging, gender and sex in brazilian society their own. this suggests that old age also brings with it the possible freedom from concerns over children, as well as from judgments of society. thus, aging can create a space for women to actively engage in their sexual interests, openly assuming their interest in sex.  the pervasive dogma that guided studies in gerontology starting at the beginning of the 20th century considered aging to be a homogeneous experience, as the problems faced by the elderly were so similar, and prominent in the public sphere; consequently, differences of ethnicity, class, gender and religion were minimized. some analysts assumed that the later stages of life would be characterized by androgyny. gender roles would become less sharply defined: older men would begin to show increasingly more affective, nurturing tendencies, while older women became more independent and assertive than their younger counterparts (gutmann 1987). some researchers report that the traditional domestic division of labor into female and male tasks tends to diminish with age (sinnott 1977; arber and ginn 1995); this convergence of gender roles is explained, by some researchers, as a product of hormonal changes (gutmann 1987). social roles, values and attitudes considered typically masculine or feminine tend to mix in old age. or, aging involves a masculinization of women and feminization of men, so that gender differences would dissolve in the “unisex normality of old age” (mcgee and wells 1982; marshall and katz 2006).  a central part of my argument is that the efforts of gerontologists to eroticize old age contend with a double reaction: 1) sexual function promotion campaigns, particularly marketing by the pharmaceutical industry which have been widely disseminated through the brazilian media in the last decade and which directly link sexuality to the erectile function; 2) the common brazilian assumption that the decline in desire, loss of physical attractiveness and the virtual erasure of sexual identity are among the leading marks of old age. this view leads to a widespread disgust and fear of bodily degradation, along with the well-known positive evaluation of youth in brazilian society. interestingly, both of these tendencies reinforce each other, as the marketing campaigns coincide with these much older conceptions that characterize brazilian culture along the axis of race, gender, and social class.  methodologically, i juxtapose content analysis of texts produced by gerontologists with an ethnographic account that was undertaken in senior citizen clubs or third age programs which are primarily enrolling a female audience, and in retiree associations which are attended mostly by males.1 i show how the elderly participating in these various contexts react to the brazilian gerontological assumption that in old age the decrease in sexual activity is compensated by sexual pleasure of an amplified intensity. this article thus seeks to demonstrate the difficulties faced by gerontologists in promoting a gratifying sense of sexuality in old age, while operating within a complex culture that is dominated by a cult of youthfulness and corporal beauty in which old age is inextricably linked to a loss of libido. the third age programs and the retiree associations in brazil third age programs2 can be understood as leading a fight for cultural change in the sense that they struggle against prejudices and stereotypes and celebrate the elderly and the aging process. within this context, older adulthood is considered a privileged moment in life and one where one’s personal fulfillment, satisfaction and pleasure are in full swing and are experienced in a more mature and fruitful way.  participation in programs for the third age is quite insignificant when we take into account the brazilian population of elderly women as a whole, just as male participation in the associations is modest when compared to the total number of retired people in the country. in 2013, brazil had 201,032,714 inhabitants. the population over sixty was 24.85 million (12.6% of the total), the great majority of whom live in urban areas (20.94 million). of these, 13.45 million are women (the brazilian institute of geography and statisticsibge 2013). however, the proliferation of general ideas from these third age programs cannot be underestimated, and they continue to reach a wider population through dissemination in the media.  the women i interviewed showed enthusiasm about the recent changes in the experience of aging in brazilian society. they stress that, unlike their mothers anthropology & aging quarterly 2014: 34 (4) 240 guita grin debert aging, gender and sex in brazilian society and grandmothers, they no longer have to wear black or stay at home waiting for the children and grandchildren to visit. they believe they are enjoying unprecedented liberty when compared to the elderly of the past, and furthermore, that they have more freedom than younger women. their participation in third age programs is an expression of this and an opportunity for these women to engage in motivational activities, expand their group of friends and their repertoire of skills, and explore new identities and lifestyles.  when asked what they understood by the expression “third age,” the women enrolled in the university of the third age in campinas, são paulo state replied: i find the third age to be an innovation, the best thing possible for the elderly, because it leaves us in total freedom. you know, it’s a great pleasure. i felt that, despite my age, i could still be someone, still a soldier in battle. for me, the third age is a beginning, there must be some better things there for me that i don’t know and need to know. life is an experience that is renewed every day.  dona lázara, a 62-year-old seamstress who participated in a recreational group for the third age engaging in dance, singing, and yoga, can be considered an embodiment of the way these new images of aging are promoted. she made the following comment: my big transformation began when my daughter gave me an unexpected gift: she signed me up for a workshop on dance and corporal expression. i was 49 years old and had never worn shorts. in the first classes, i felt ridiculous, old, and awkward. i continued and my mind opened – it opened to the world. i lost weight and began to feel alive.  these feelings were very common among participants in third age programs.3 they clearly show that well-being, as defined by these women, is not dependent on references to an active sexual life. the women had difficulty in explaining the lack of male participation in the program. the men themselves, who comprised a small part of these third age programs, were the ones more concerned with pointing out the role of women and in explaining the lack of male participation. as some of the men said: men are more proud. they don’t want to give in to those who know more. it seems that the world is now turning to the side of women. we have to give way to those who have it by right. women are getting much more involved in everything. after women’s liberation, things have changed and i think it’s better. i don’t know whether men are more inhibited, or they think that they’re better. (they are) machos who think they know it all, but they don’t know what they’re missing.  in the retiree associations,4 men were less optimistic about social change. they claimed that young people no longer respected the elderly, which consequently undermined their status. they challenged stereotypes related to aging by criticizing governments, politicians and the media, demonstrating their mental agility and lucidity. many were critical of the third age programs, denigrated by some as the “playground of the old,” which diverted retirees and pensioners from their real interests and their true consciousness. these men considered the exploration of new identities and the intense experience of leisure activities offered by third age programs as a form of infantilization of citizens, a kind of denial of masculinity. these views help to explain the lack of men in these programs. as a colleague of mine studying masculinity noted: “men suppress their emotions so they can play the role expected of them in our society: provider, protector, and creator.” to the elderly in third age programs this masculine ethos is denied, and instead, they are encouraged to view old age as a time to rethink life, remake projects, and develop new relationships.  women are excited about the changes associated with aging experiences and men are vividly concerned to protect and improve retiree’s rights. however, they both react to gerontologists’ attempts to eroticize old age, as shown below. sexology and gerontology sexology is the scientific study of sexual interests, behavior, and function. as a clinical discipline, its therapeutic strategy includes the use of medicines and other interventions, such as educational techniques of behavior modeling, and use of the body in order to promote a better functioning sex life. for the elderly the goal, in most cases, is to “maximize” or “optimize” their sexual activity. anthropology & aging quarterly 2014: 34 (4) 241 guita grin debert aging, gender and sex in brazilian society  the new generation of brazilian gerontologists are eager to emphasize the advantages brought by the aging process. inspired by international gerontology (katz and marshall 2003), this new generation opposes the more traditional brazilian gerontology that characterized old age as a state of physical decline and loss of social roles. when addressing aging and sexuality this generation enthusiastically adheres to the assumptions and empirical tradition of sexology, and further, they promote active sexuality (narrowly defined in terms of heterosexual intercourse) as a signal indicator of positive and successful aging (brigeiro 2000).  additionally, a statement on the nature of sexuality in old age commonly accompanies this generation’s new commitment to reconceptualizing old age. despite the decrease in its frequency, which is acknowledged empirically, these gerontologists emphasize that sexuality can be expressed in a myriad of ways other than sexual intercourse. a book, published by the university of the third age at the catholic university of campinas, written by sá (1991: 20), concisely summarizes this new vision of the advantages of old age: passions and lust are replaced by more refined pleasures. the sexual issue is resized in the sense of love, warmth, sharing, touch of intimacy between people.  gerontologists challenge assumptions of older people as asexual beings by proposing a reversal in the conventional depictions of female versus male sexuality in old age, or by uncoupling genitalia from sexuality. old age seems to give rise to a new phase in the course of one’s sex life; this assumption can be verified not only in the discursive reiteration of the prolongation of sexuality, but also in the description of the sexual problems faced by men and women in old age – as well as in the specific technologies produced as part of the solution. the advice regarding therapy and sex education, for example, suggests a shift of sexuality from the genital area to diverse “erogenous zones” of the body. this amplification is of such an order that there is no part of the elderly person’s body that is not a potential source of pleasure. consequently, there is a transcendence of the very notion of ‘zone’ from that of the specialists’ understanding, to one where there are no limits or demarcations. this shift is very well illustrated by the words of psychoanalyst sueli souza dos santos, whose book about sexuality and love in old age has inspired a reflection amongst professors and coordinators of third age programs. recovery of an elderly person’s right to a sex life implies being able to think of love in its forms of libidinal transformation, that is, other forms of love, including tenderness, physical contact that eroticize the body, such as looks, touch, the voice, rediscovering the human being’s first forms of love. (…) with aging, when the organic functions suffer loss of sexual performance, the libido(...) returns on its investment in other areas of the body, marked in the first experiences, returning to the pleasure found in other erogenous forms, such as touch, looks, the delicateness of all the sensibility. (...) it is the prejudices that make one think that the so-called andropause in men and the menopause in women are responsible for sexual difficulties. hormone loss modifies the mechanism and frequency of erection, and also alters vaginal lubrication, thus hindering coitus. this seems to decree that penetration is the only pleasureproducing source and that the absence or difficulties in these functions incapacitate the elderly person as a sexual being (...), what interferes in his/her sex life is of a psychological and social order (santos 2003:22-30).  in the literature analyzed, this amplification of the erogenous or pleasure zones often appears through the accounts given by the elderly themselves. however, it is above all the specialists who advise or prescribe a new sexuality. in words loaded with humor, the social psychologist, josé carlos ferrigno – who for more than a decade, coordinated the programs conducted for the third age in sesc (serviço social do comércio) in são paulo – observes that degenitilization seems to be especially associated with men. [elderly men and women] they report a different experience with their own bodies, the partner’s body, and in the relationship itself. no longer is there preeminence of the ‘big bang’ of the orgasm, no longer principally among men, erotic sensations concentrated only in the genitals, but rather full eroticization of the entire epidermis, sex throughout the entire body and permeating the whole spirit. sex without haste. no longer is it the ‘hamburger with chips’ greedily devoured during youth, but rather a dish carefully prepared and delicately savored. (ferrigno 1988: 16).  women are generally encouraged by gerontologists to assume their interest in sex; in the process, all associations that limit their experimentation are disrupted – be it subordination to the will of the male partner, or concerns regarding children or other family members and society anthropology & aging quarterly 2014: 34 (4) 242 guita grin debert aging, gender and sex in brazilian society in general. for men, ferrigno proposes that they discover different parts of their bodies to experiment with sexually, thus making their corporal sexuality more diffuse, an aspect normally attributed to women.  this insistence by gerontologists and sexologists that sexuality among the elderly encompass far more than genital-based pleasure as it includes multiple “erogenous zones” of the body is contradicted by the messages put forth by powerful actors in the marketplace, such as the pharmaceutical industry, which persists in overstating the importance of genital based pleasure, subsequently reducing male sexuality to erectile function. in this way, the drug viagra, which has been popularized worldwide, transforms impotence into the medical condition of “erectile dysfunction”, thereby challenging the social and psychological factors related to aging (brigeiro and maksud 2009; bozon 2004).  one of the difficulties in the study of sexuality, as shown by luiz fernando dias duarte (2004), is the tension between, on the one hand, “an incitement to talk about sex” (foucault 1990), and on the other, a movement that renounces this talk or even reflection on the theme, given the correlation between sexuality, intimacy and privacy. this tension leads to a separation between two levels of experience: a sensorial pleasure of sex (termed sensual) and a sentimental affective pleasure (corresponding in our culture to the ideology of love). it is appropriate to establish a correlation between the sensual and the male, and between the affective and the female. this correlation tends to be redesigned and inverted when one thinks of sexuality and old age. psychoanalyst otto f. kernberg, professor of psychiatry at weill cornell medical college, draws upon his clinical experience to demonstrate the inversion of supposedly male and female sexual traits that occurs in old age: in the light of the observations of love relations of older couples, i suggest that this development continues into old age, with surprising role reversal. men falling in love and establishing a passionate love relationship at late stages of their lives frequently have the exhilarating experience that their intense love for a woman transcends their erotic desire in new ways, so that love becomes the bridge to sexual intimacy. in their fusion with the woman they desire, they experience a sense of total security and certainty about their love and an overwhelming gratification at having found the love object of their lives. love, it would seem, becomes a means for the achievement of erotic desire, replicating, we might say, the early maturational characteristics of younger women. women who fall in love in later stages of their lives, on the contrary, experience a freedom of sexual desire that becomes the bridge to love for the men they have found. one male patient in his sixties said jokingly to his new girlfriend: “i fear, at times, that you are only treating me as a sexual object and that my feelings and personality are of no relevance to you (kernberg 2001: 183-184).  kernberg was president of the international psychoanalytical association from 1997 to 2001. he was in brazil on numerous occasions and is widely respected among brazilian psychoanalysts. however, his enthusiasm with the potentialities of sexual life in old age does not seem to have reached the representations that most elderly men and women have about sexuality. the obligation of having sex a survey carried out by datafolha, one of the most important brazilian survey agencies, in november 2008, interviewed 1,238 respondents aged 60 or over in different brazilian cities. seventy eight percent of the male respondents declared having a normal sex life, and one quarter said they had sex once a week. twenty four percent of the female respondents aged 60 or over declared they were still having sex.  the claim made by gerontologists that sex life does not cease with old age was manifested in the views of the married women, but this was contradicted in the views of the unmarried women in the third age program i researched. among the elderly, topics of sex generated jokes and much laughter. expressions like: “heaven forbid! get a boyfriend now at 65!” caused enthusiastic agreement among them. among married women, sex and love were indissolubly linked; personal statements by the women reflected notions of the advantages of sexuality in old age, as it is espoused by program conferences and lectures given by the coordinators of the group. in the words of a married woman whom i interviewed after a conference on aging and sexuality at the catholic university of campinas in 2011: “i find it much better now without all the overexcitement-less quantity and more quality”; “true love between two persons at our age is much more beautiful, it’s fantastic...” and “at anthropology & aging quarterly 2014: 34 (4) 243 guita grin debert aging, gender and sex in brazilian society this stage, there are no worries, it’s much better, more tranquil”. these considerations – which are quite in line with the gerontological discourse – were rejected by most unmarried, separated or widowed women whom i interviewed in the same third age program. these women mocked the supposed advantages of sexuality in old age which were affirmed by both the coordinators and the married participants in the program.  unmarried women didn’t miss an opportunity to show how husbands imposed work on their wives, citing duties such as, “providing meals,” “dealing with the laundry,”and being “always willing and in a good mood”. in their view, sex was just one more marital obligation from which widowed and divorced women are relieved. in this sense, they vehemently expressed how male dominance has had a specific configuration on their lives, including their sexuality. it should be noted that being free from marital obligations did not lead to a negligence of their physical appearance. on the contrary, the women interviewed show great concern for their physical appearance, but these beauty concerns were not necessarily linked to sexual activity or sexual seduction: i want to be beautiful, but we know that our bodies are no longer the same. so, what to do about it?”, asked one of the women after the conference regarding old age and sexuality; lowering her hands in front of her breasts as if she wanted to show that these parts of the body inevitably droop, she continued, “men are only interested in older women when they need someone to do their housework.  the senior men in the associations of retirees seemed to wholeheartedly agree with the discourse of pharmaceutical marketers: they valued sexual expertise and their performance was strongly determined by expectations for intercourse, depending on their erectile capacity. they all reported an interest in maintaining an active sex life, but did not seem overly influenced by the gerontological discourse that sexuality is broader than genital-based pleasure. most of them stated that their sex lives were currently limited to the marital context.  arthur, who at the time of the interview was 72 years old and who had been the director of a retiree association, made the following statement, very common among those interviewed: it is not the same as when i was 30. the liveliness and the rhythm are not the same (…) but i am always up for it, i never lost interest. i have been married for 40 years now. that initial enthusiasm softens a bit, there is a tiredness that is natural, but the love never ends (…). we need sex to live (…) it does us a lot of good.  it is difficult for a female researcher to talk about sex with older men. they prefer to talk about national and international politics and make criticisms of those retirees who have a hard time supporting their families and maintaining decent living standards. it is mainly through jokes, never told in the presence of a woman, that these men express the importance of sexuality in their lives. these jokes, which discuss the erectile difficulties of elderly men, were told under one’s breath, and were heard by my male research assistant . : after 30 years of marriage, a couple was having sexual difficulties. they decide to consult with a specialist, who says: “many couples like you have solved their issues with a prosthetic penis.” the husband asks: “really? and how much does it cost?” “i charge 30,000 reals for a small size prosthesis, 40,000 for a mid-size, and 50,000 for a large-size new penis.” the husband turns to his wife: “what do you think, honey?” the wife thinks for a minute, then says: “well, if i’m going to spend 50,000, i’d prefer to redecorate my kitchen.” another joke similarly makes fun of the assumed inactive sexual life of the elderly: two elderly men are speaking: -“do you prefer sex or christmas?” “sex, of course! christmas happens every year, i get bored of it.  through playful performances, jokes, and funny stories, men express the importance of sexuality in their lives, which is divergent from the notion of a reconceptualized sex life proposed by gerontologists. for men in this study, the importance of sexuality is linked to traditional values of masculinity and to a resistance towards old age, which is assumed to be a phase of life with diminished lucidity, less self-control and the loss of a rewarding sexual life. in short, they validated the negative stereotyping of the elderly in brazil. most of the women i interviewed, on the anthropology & aging quarterly 2014: 34 (4) 244 guita grin debert aging, gender and sex in brazilian society other hand, assumed that a rewarding aging experience was independent of a gratifying sex life. for them, the aging body cannot be seen as an object of sexual desire, and they consider that only elderly women who have lost their lucidity can imagine having an active sex life. thus, the elderly respondents in my research did not reproduce the arguments put forth by gerontologists and sexologists pertaining to the broader, more corporal nature of human sexuality. on the contrary, they articulated a proliferation of divisions, thus creating greater differences among themselves.  this article discussed how transnational discourses take on specific articulations in local contexts and how specific groups react to these discourses. in brazil, a country where the cult of beauty, youth and sexuality is seen as one of its most prominent cultural characteristics, sexual function has become central to contemporary gerontological conceptions of well-being, the good life and happiness in old age. our interest in the subjective accounts of older adults pointed to ways in which old age can be negated by older men, alleging that their erectile function is in good form, or that old age can be conceived by some women as one of the best moments in their lives because they have been exempted from the obligations of sex. notes 1. research funded by the fundação de amparo a pesquisa do estado de são paulo (fapesp) and by the conselho nacional do desenvolvimento científico e tecnológico (cnpq). 2. about the emergence of the category “third age” see laslett (1987); on new images of old age see featherstone and hepworth (1989) and featherstone (1992). 3. on womens’ positive view of third age see the comparative study by cachioni (2003) on third-age universities in different regions of the country; debert (1999) on third age programs in são paulo; and cabral (2002) on third age programs in paraíba state; motta (1998) study on a group of lower class elderly in porto alegre, rio grande do sul state; and motta’s (2001) study on forms of sociability among the elderly in bahia state. studies on the subject can be found in the volume edited by barros (1998) and by goldenberg (2002). 4. it is possible to identify four types of retired peoples’ associations: (1) associations connected to state companies that have their own welfare funds, offering their workers supplementary retirement benefits and a series of other advantages; (2) labor union associations that bring together the retired of the professional category they represent; (3) eclectic associations that gather people of different professional categories; (4) associations born of political interests. these are ineffective and short-lived associations, generally organized at election time through candidates’ initiatives or campaigners seeking votes. on the different types of associations of retirees, see simões (1996). references arber, sara and ginn, jay 1995 connecting gender and ageing: a sociological approach. buckingham: open university press. barros, myrian l. 1998 velhice ou terceira idade? rio de janeiro: editora fgv. bourdieu, pierre 2001 masculine domination. stanford: stanford university press. bozon, michel 2004 sociologia da sexualidade. rio de janeiro: editora da fundação getúlio vargas. brigeiro, mauro 2000 rir ou chorar? envelhecimento, sexualidade e sociabilidade. rio de janeiro: universidade do estado do rio de janeiro. 2002 envelhecimento bem-sucedido e sexualidade: relativizando uma problemática. in interfaces gênero, sexualidade e saúde reprodutiva. regina. m. barbosa et alli, eds. pp.171-199. campinas: editora da unicamp. brigeiro, mauro and maksud, ivia 2009 aparição do viagra na cena pública brasileira: discursos sobre corpo e sexualidade na mídia. estudos feministas 17(1):71-88. butler, judith 1990 gender troubles: feminism and the subversion of identity. new york: routledge. 2004 undoing gender. new york: routledge. cabral, benedita e. s. l. 2002 recriar laços: estudo sobre idosos e grupos de convivência nas classes populares paraibanas. campinas: ifch, unicamp. cachioni, meire 2003 quem educa os idosos? um estudo sobre professores de universidades da terceira idade. são paulo, ed. alínea. anthropology & aging quarterly 2014: 34 (4) 245 guita grin debert aging, gender and sex in brazilian society debert, guita g. 1999 a reinvenção da velhice. são paulo: editora da universidade de são paulo. duarte, luis f. d. 2004 a sexualidade nas ciências sociais: leitura crítica das convenções. in sexualidade e saberes: convenções e fronteiras. adriana g. piscetelli, maria f. gregori and sergio carrara, eds. pp. 39-80. rio de janeiro: garamond. featherstone, mike and hepworth, mike 1989 aging and old age reflections on the post-modern lifecourse. in becoming and being old: sociological approach to later life. bill bytheway, teresa keil, and patricia allatt eds. pp 152-154. london: sage publications. featherstone, mike 1992 the body in consumer culture. in the body social process and cultural theory. mike featherstone, mike hepworth and brian s. turner eds. pp 170-196. london: sage publications. ferrigno, josé carlos 1988 a sexualidade dos mais velhos. intercâmbio, rio de janeiro, v.31, n.1, p. 5-16. foucault, michel 1990 the history of sexuality. new york: vintage books. goldenberg, mirian 2002 a civilização das formas; o corpo como valor. in nu e vestido: dez antropólogos revelam a cultura do corpo carioca. mirian goldenberg ed. pp 19-40. rio de janeiro: editora record. gutmann, david 1987 reclaimed powers: toward a new psychology of men and women in later life. new york: basic books. ibge (instituto brasileiro de geografia e estatística) 2013 http://www.ibge.gov.br/home/presidencia/noticias/imprensa/ ppts/00000014425608112013563329137649.pdf kernberg, otto f. 2001 love relations in later years. in within time & beyond time – a festschrift for pearl king riccardo steines and jennifer johns eds. pp 177-92. london: karnak books. katz, stephen and marshall, barbara 2003 new sex for old: lifestyle, consumerism, and the ethics of aging well. journal of aging studies, 17 (1):3-16 laslett, peter 1987 the emergence of the third age. aging and society, 7 (2):133-160. marshall, barbara and katz, stephen 2006 from androgyny to androgens: re-sexing the aging body. in age matters: realigning feminist thinking. toni calasanti and kathleen slevin, eds. 75-98. new york: routledge. mcgee, jeanne and kathleen wells 1982 gender typing and androgyny in later life: new directions for theory and research. human development 25:116-139. motta, alda b. 2001 novas formas de sociabilidade de idosos: o caso de salvador. análise & dados, 10 (4):129-137. motta, flávia m. 1998 velha é a vovozinha: identidade feminina na velhice. florianópolis: edunisc. sá, martins j. l. 1991 a universidade da terceira idade na puccamp proposta e ação inicial. campinas: pontifícia universidade católica de campinas. simões, julio a. 1996 o movimento de aposentados e pensionistas e a solidariedade pública entre as gerações. análise & dados 6 (1):149-151. sinnott, jan d. 1977 sex-role inconstancy, biology and successful aging: a dialectical model. the gerontologist 17:459-463. santos, sueli s. 2003 sexualidade e amor na velhice. porto alegre, sulina http://www.ibge.gov.br/home/presidencia/noticias/imprensa/ppts/00000014425608112013563329137649.pdf http://www.ibge.gov.br/home/presidencia/noticias/imprensa/ppts/00000014425608112013563329137649.pdf book review review of sun, ken chih-yan. time and migration: how long-term taiwanese migrants negotiate later life. ithaca: cornell university press. 2021. pp. 264. price: $49.95 (hardcover); $32.99 (ebook). jeanne l. shea university of vermont jeanne.shea@uvm.edu anthropology & aging, vol 43, no 2 (2022), pp. 119-121 issn 2374-2267 (online) doi 10.5195/aa.2022.436 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | shea | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.436 http://anthro-age.pitt.edu 119 book review review of sun, ken chih-yan. time and migration: how long-term taiwanese migrants negotiate later life. ithaca: cornell university press. 2021. pp. 264. price: $49.95 (hardcover); $32.99 (e-book). jeanne l. shea university of vermont jeanne.shea@uvm.edu ken chih-yan sun’s book time and migration: how long-term taiwanese migrants negotiate later life masterfully combines meticulous field research, rich ethnographic content, and astute analysis. as an anthropologist of aging and a scholar of chinese culture and societies, i was delighted to review this book. while most of my research on chinese populations has been conducted in mainland china and canada, i am writing this review from taiwan where i am on sabbatical researching taiwan’s supports for older adults. based on longitudinal ethnographic research, time and migration explores the ways in which transnational migration affects experiences of aging and how aging and the passage of time affect experiences of migration among immigrants from taiwan to the us. examining the interaction between space, place, and time, sun’s book documents how long-term taiwanese immigrants to the us view and negotiate their evolving needs and the changing opportunities and constraints that emerge in their receiving and sending countries as they grow older. the research for this book involved eight years of longitudinal fieldwork with older adult taiwanese immigrants conducted between 2009 and 2017 in both the us and taiwan. this book’s data was drawn from 115 interviews, many years of participant observation, and numerous return visits to participants over time. allowing for an analysis from differing perspectives, the sample included not only taiwanese immigrants who were still in the us, but also taiwanese immigrants to the us who had subsequently returned to taiwan. at his us sites, the author interviewed 58 taiwanese immigrants between the ages of 60 and 88 living in boston and new york. in taiwan he interviewed 57 returnees, ranging from 62 to 80 years old, most of whom lived in taipei or kaohsiung, but a few of whom lived in rural areas. in time and migration, sun offers a much-needed corrective to the research literatures on migration and on transnational aging, both of which have tended to present mostly snapshots in time. focusing on the concept of the “temporalities of migration” (10), the author examines longitudinal change across the lifecourse in the lives of taiwanese migrants, charting how such change relates both to the accumulated experiences of being an immigrant and to the evolving social contexts of the sending and receiving societies. this book’s content conveys how aging immigrants rethink their sense of social belonging and come to new understandings of their natal and host societies and what they each have to offer at this time in their lives. sun also shows how taiwanese immigrants negotiate their changing needs and desires and reassess and refashion their roles and relationships with various family members and communities. this complex analysis gives sustained attention to the resilience and agency of aging http://anthro-age.pitt.edu/ book review | shea | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.436 http://anthro-age.pitt.edu 120 immigrants in contrast to some public health studies which have overwhelmingly stressed the vulnerability of these populations. each of the book’s six chapters addresses a different dimension of the nexus of aging and migration in the context of time and space. the chapters flow from a focus on experiences of immigration over time, to changing experiences of aging and family relationships, to strategies for support and negotiating rights to social care. more specifically, chapter 1 examines taiwan transnational migrants’ experiences of emigrating to the us and changing perceptions of both societies and their membership in each. sun describes an “economy of belonging mediated via temporalities of migration” (21) in which initial idealized visions of the american dream gave way to a more tempered understanding of both opportunities for and barriers to social mobility. views of the homeland also evolved over time as economic conditions in taiwan improved and the home country became a viable place to retire but with the difficulty of cultural readjustment. the next three chapters focus on family roles and relationships. chapter 2 investigates how ideals of aging, family and intergenerational reciprocity were reconfigured over time for older migrants. calling this “reconfigured reciprocity” (48), sun shows how despite having been raised with traditional ideas of filial piety, taiwanese immigrants were unlikely to expect instrumental care from their children. the author argues that this was due not only to the influence of american individualism, but also to how many of the older immigrants did not take care of their own elderly parents because of the physical distance. chapter 3 looks at how spousal relationships changed over time for taiwanese elders who migrated. leaving behind their homeland communities and subsequent americanization led them to rethink patriarchal gender norms, becoming more egalitarian in later life. in addition, sun recounts how aging itself tended to “promote gender flexibility” (99). especially in the face of needing to rely on each other in times of illness or of emerging disabilities and of the prospect of having to operate independently in the event of future widowhood, taiwanese older adults found themselves adjusting their gendered roles. chapter 4 examines older taiwanese migrants’ experiences of grandparenthood. the chapter looks at how this life transition was affected by their immigration circumstances and by their relationships with their children – relationships which were, in turn, reshaped by grandparenting. sun describes three styles of “doing grandparenthood” (107) among his various informants, including active grandparenting in place among those who stayed in the us, grandparenting from afar among return migrants in taiwan, and minimal grandparenting among some members of both groups. for each style, the author details the factors contributing to its emergence and how migrants thought about and negotiated their grandparenting roles and positioned themselves in relation to cultural heritage transmission. the chapter also relays how gender inflected migrants’ sense of their new rights and responsibilities, with grandmothers more likely both to provide hands-on care than grandfathers and to encounter intergenerational childrearing conflicts, especially with daughters-in-law. chapter 5 details different strategies for organizing cross-border networks and navigating social supports and belonging for migrants who stayed in the us versus those who returned to taiwan, describing these phenomena both in their home and host societies. sun argues that “the interplay between time and migratory experience profoundly affected the networks that these older adults maintained and the relationships that they sought to establish” (160). he describes the process as “knowing their place” for those who stayed in the us and “relearning their place” for those who returned to taiwan (137). in both cases, co-ethnic ties strengthened with age, and social networks among co-ethnics were influenced by taiwan politics and by class distinctions, with birds of a feather flocking together. those who returned to taiwan often struggled with re-acculturation and gravitated toward old friends, relatives, and other returnees. http://anthro-age.pitt.edu/ book review | shea | anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.436 http://anthro-age.pitt.edu 121 chapter 6 unravels migrants’ perceived rights to “social care” from the us and taiwan governments. those who stayed in the us were more likely to feel that they deserved public benefits in contrast to other shorter-term immigrants who they saw as less deserving. in contrast, those migrants returning to taiwan after long sojourns in the us encountered critiques about their worthiness to entitlements in taiwan, and many made compensatory efforts to demonstrate how their contributions to the homeland, despite their long absence. taiwan’s national health insurance was a large draw for returning there, especially for migrants with lower incomes or more extensive health issues. time and migration offers a myriad of rich ethnographic accounts of aging taiwan migrants’ views and lives embedded in a nuanced understanding of the historical and contemporary sociocultural contexts of the us and taiwan. the book is written in clear, beautiful prose with the theoretical discussions just as accessible as the poignant ethnographic stories of migrants’ experiences. in addition, sun weaves in reflexive content on his fieldwork experiences and on his experiences of being raised in taiwan by chinese grandparents who had migrated from mainland china. for limitations, experiences of taiwanese immigrants to us locations other than boston and new york or of returnees to taiwan cities other than taipei and kaohsiung are not included in the analysis. the taiwan sample did include a few returnees in rural locales there, but the us sample did not. in addition, readers must keep in mind that sun’s research ended in 2017 and that there will have been changes in the experiences of taiwanese immigrants. for example, the covid-19 pandemic limited travel between taiwan and the us for older adults and their family members and elevated health risks and everyday inconveniences in the lives of seniors in both places. in the continuing saga of the pandemic, the covid calculus of comparative case and death rates and the looming possibility of future border closures will be a key element in the considerations as to where taiwanese immigrants will opt to spend their final years and how those years will play out. overall, this is an excellent book that will appeal to scholars and students interested in aging, the lifecourse, kinship, caregiving, migration, transnational care, intergenerational relationships, longitudinal change over time, globalization, and east asian studies. it brings together the concerns of a small but growing number of studies that examine aging in transnational context and of a larger set of studies that focus on how older adults continue to evolve and change with the times. i highly recommend time and migration for researchers and for university courses. http://anthro-age.pitt.edu/ book review review of leibing, annette and silke schicktanz, eds. preventing dementia? critical perspectives on a new paradigm of preparing for old age. new york and oxford: berghahn books. 2021. pp. 260. price: $145 (hardcover); open access (ebook). noa vana tel-aviv university noavana@gmail.com anthropology & aging, vol 43, no 1 (2022), pp. 66-69 issn 2374-2267 (online) doi 10.5195/aa.2022.387 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | vana | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.387 http://anthro-age.pitt.edu 66 book review review of leibing, annette and silke schicktanz, eds. preventing dementia? critical perspectives on a new paradigm of preparing for old age. new york and oxford: berghahn books. 2021. pp. 260. price: $145 (hardcover); open access (ebook). noa vana tel-aviv university noavana@gmail.com a few years back, one of my family members, a virile and relatively young individual, was diagnosed with early-onset dementia. unfortunately, the disease has progressed significantly in recent years. preventing ‘it’ would have been a blessing. what does ‘it’ even mean? how would prevention have even been possible? who or what is responsible for preventing ‘it’? and when and where have we missed the “window to act” (30)? these are but a few of the queries that annette leibing and silke schicktanz’s edited volume preventing dementia?: critical perspectives on a new paradigm of preparing for old age made me reflect upon, and i am grateful for the opportunity to review this fascinating anthology. the scientific narrative of dementia has seen some profound changes, shifting its focus from finding a cure and ameliorating care to, currently, prevention. the professionalization of prevention means a major change of perspective after decades of rather unspecific therapies such as “brain training” for older adults in the form of crossword puzzles and sudoku. the authors propose an interdisciplinary and cross-cultural reading of what they coin as the “new dementia”: “an understanding of dementia prevention with an epistemic focus on risk factors, risk prediction, prevention claims, and a close brainbody-interaction” (3). this makes for an intriguing edited volume that will interest, first of all, social scientists studying health issues but also policymakers, health experts, social workers, nongovernmental organizations caring for people with dementia, and the media. in addition, people with dementia and their family members and caregivers will find this interesting. the authors themselves come from a great variety of disciplines such as medical anthropology, critical bioethics, sociology, science and technology studies, gerontology, psychology, nursing, history of science, history of medicine, and neurology. preventing dementia is the 7th volume in the series “life course, culture and aging: global transformations” published by berghahn books. the volume is divided into three sections. the first section centers on the recent turn towards prevention and provides specific case studies of the ways prevention is discursively and socially constructed. the second part discusses prediction and early detection, specifically with regards to the contested diagnostic category of mild cognitive impairment (mci). the third section focuses on the socio-political investment in the concept of ‘prevention’ itself. in the following, i would like to offer an anthropologically oriented reading of this rich anthology. http://anthro-age.pitt.edu/ book review | vana | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.387 http://anthro-age.pitt.edu 67 in the first chapter, historian lara keuck traces the “larger changes” (9) in the history of dementia research since alois alzheimer’s first publication of his famous first case on auguste deter in 1907. claiming that dementia is a “working title” (21) and a “placeholder label” (33), keuck shows how the definition of dementia shifts over time between competing research frameworks while, at the same time, remaining relatively stable in its obscurity. she argues that although the big questions of defining dementia and alzheimer’s disease (ad) have not been answered, those affected by this label are nevertheless constantly called upon to act—to take a drug, undergo a test, eat healthily—according to whichever research framework is prevailing at the time. the hereby ‘patients’ are then expected to do so within a specific time frame, and with the preventive turn especially, preferably before clinical symptoms occur. in the second chapter, annette leibing follows “mini epistemic” shifts (9) in recent dementia studies and sets the themes that are further debated in the volume. based on ethnographic data gathered in a geriatric outpatient clinic in brazil, leibing depicts both the dangers and the opportunities emanating from the epistemic shift towards the “vascularization of alzheimer’s disease” (40). she recognizes that the preventive logic can indeed lead to blame and exclusion but also furthers the conscientization of health as an assemblage deeply embedded in societies and their structural inequalities. leibing finds that economically disadvantaged brazilians are easily held individually responsible for their health while social contexts (e.g., poor health care system, expensive medications, and few healthy dietary choices) receive secondary accountability. yet, leibing shows that what is at stake in the preventive turn today, was already encapsulated in the diagnostic category of ‘vascular dementia.’ vascular dementia (vad), which is typically linked to the nine risk factors (e.g., hypertension, obesity, etc.), has always been considered more preventable as it anchors the aging brain in the aging body (56). thus, it frames the disease as part of a continuum of aging through the life course rather than a symptom of pathological aging. in acknowledging this parallel, leibing also considers the potential advantages of the preventive turn: if dementia is demystified as a result and “efforts are taken to enhance living conditions, there might be a real chance” (57) for a better old age, she argues. mark schweda and larissa pfaller (chapter 9) revisit this theme of personal accountability. they maintain that expert discourses in an era of neoliberal governmentality encourage self-caring subjects to take preventive actions, thus reducing social phenomena to the aggregate of individual actions (198). similarly, tiago moreira (chapter 6) follows the evolution of mci (mild cognitive impairment) through what he here calls “classificatory drifts.” he understands people who experience cognitive decline as “consumers” of diagnostic information, which situates them in a liminal space between normal and pathological aging. as a result, they find themselves “grappling with continued medical surveillance and the mundane complexities of managing their own condition” (148). the theme of social responsibility is addressed in three chapters. in the canadian context, stephen katz, kevin r. peters, and peri j. ballantyne (chapter 7) focus on the concrete products and practices through which the ambiguities surrounding mci are socially negotiated and rendered meaningful in the interactions between older individuals, their family members and caregivers, and “the market” (i.e., the commercialization of “memory products,” food, games, and exercises). in chapter 10, thomas foth admonishes the neoliberal arguments that promote cutbacks in the canadian federal medicare system and highlights the significance of the lifestyle paradigm in governing the health of people through prevention. matthias leanza (chapter 4), however, provides “an alternative perspective to the critique of neoliberalism” (93). inspired by niklas luhmann and bruno latour who consider risks as preventable social phenomena (luhmann 2005) that require a long and tedious “chain of translations” (latour 1999), leanza writes about the “improbability of dementia prevention” (94). he describes http://anthro-age.pitt.edu/ book review | vana | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.387 http://anthro-age.pitt.edu 68 prevention as a “fragile” idea, projected into the future and in need of being situated in local assemblages of health care. in her chapter, co-editor of this volume silke schicktanz (chapter 3) poses the intriguing question, “if dementia prevention is the answer, what was the question?” (65). based on fieldwork experience in germany, she finds that german professional and popular dementia discourse targets individuals in their forties and fifties and prompts them to be physically active and maintain a healthy lifestyle to prevent dementia. these discursive trends, she contends, reconstruct ad as a non-age-correlated disease. inspired by leibing, she argues that longstanding disease models are changing by conceptualizing the brain-as-body. this holistic approach to dementia prevention is also central to alessandro blasimme’s analysis of scientific geriatric literature (chapter 5). he contends that the “new geriatric logic” pushes for the conceptual inclusion of frailty in a broader multidimensional understanding of dementia (114). in other words, as individuals are encouraged to cope with agerelated pathologies through various preventive measures (e.g., cognitive training, physical activity, and nutrition), a continuum between normal and pathological aging is restored. in a similar vein, kirsten bell’s study (chapter 8) of the us commission’s discourse on chronic illness highlights lifestyle changes as a form of holistic prevention. in fact, bell argues that the most astonishing part of the preventive turn in dementia discourse and research is not its possible effectiveness in relation to dementia prevention— the lancet report (livingston et al. 2017) that prompted the publication of this edited volume claims that one-third of dementia cases might be preventable if nine risk factors were better managed—but rather, the fact that the whole discussion around prevention started so late when compared to other health conditions. this intriguing volume concludes with peter j. whitehouse and daniel r. george’s short and provocative piece stating that, in our era, the correlation between the mind and the body, as well as the individual responsibility and the structural factors that affect preventive efforts, must be considered as a whole in order for us to be able to ask “larger questions about what kind of societies we want to have” (248). i believe that the medical race to outrun dementia is a blessed effort for those affected by it, including me and my close family. however, as this anthology outlines, it is paramount to remember that the “new dementia” focuses too much on individual responsibilities without fully accounting for the structural factors that would make such preventive behavior possible for all citizens in the first place. precision medicine (i.e., a medical model that proposes to tailor healthcare, medical treatment and products to individuals or a subgroup of patients) that now governs the medical discourse (au 2021) further aggravates this problem. on a final note, the hero of a.b. yehoshua’s novel the tunnel (2020) employs his diagnosis as ‘dementia patient’ to legitimize actions and perspectives that he would not have dared to act upon and voice out otherwise. yehoshua utilizes the ‘demented’ hero’s voice to criticize the israeli occupation and calls the israelis to act differently. i wonder, if we wish for dementia to be extinguished through prevention, who will play this essential social role? references au, larry. 2021. “recent scientific/intellectual movements in biomedicine.” social science & medicine 278: 1-12. latour, bruno. 1999. pandora’s hope: essays on the reality of science studies. cambridge, ma: harvard university press. http://anthro-age.pitt.edu/ book review | vana | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.387 http://anthro-age.pitt.edu 69 livingston, gill, sommerlad, andrew, orgeta, vasiliki, costafreda, sergi g., huntley, jonathan, ames, david, ballard, clive, banerjee, sube, burns, alistair, and cohen-mansfield, jiska. 2017. "dementia prevention, intervention, and care." the lancet 390 (10113): 2673–2734. luhmann, niklas. 2005. risk: a sociological theory. new brunswick, nj: transaction publishers. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2012: 33 (1) 10 introduction wayne warry anthropology mcmaster university in june 2009 lori l. jervis organized a meeting on ‘aging and the indigenous peoples of america’ in norman, oklahoma that was sponsored by the association of anthropology and gerontology. the idea of organizing a session for the 2010 american anthropological association meetings in new orleans arose at this meeting. subsequently lori l. jervis and i organized a session titled ‘culture, health and aging in native north american communities.’ this article summarizes the papers and presentations given at that session. as noted in the aaa session abstract, despite the often-stated value of elders as cultural resources and spiritual leaders, little is known about the actual contemporary social and health statuses of native north american elders. the anthropological and health science literature on older native people is sparse; by some accounts less than 2 percent of all studies focus on seniors. in the united states and canada the percentage of older native peoples are projected to double in the next decade. despite these projected increases, the number of anthropologists studying aging in native populations has remained small. this aaa session brought together anthropologists from canada and the united states who are engaged in research with native/aboriginal elders in order to examine how anthropological approaches may further our understanding of this small, but growing component of the native population— one which has traditionally been influential beyond their numbers with respect to their roles as culture bearers and socializers of future generations. what follows are short summaries of these presentations and papers, following the order of presenters at the session. conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities anthropology & aging quarterly 2012: 33 (1) 11 conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities marie’s story of aging well: toward new perspectives on the experience of aging for aboriginal* seniors in canada sylvia abonyi, university of saskatchewan and marie favel, ile a la crosse, saskatchewan, canada this paper, co-authored by a university researcher (sylvia) and an aboriginal community elder (marie), considers the construction of a framework of healthy aging for aboriginal peoples in canada. there has been limited work in this area, and a clear need for it identified as the cohort of aging aboriginal people in canada grows. our contribution begins with marie’s story of aging well as a launch point from which we plan to collect more stories like hers. our goal is to build a framework of aging well within which to locate issues like dementia, cancer, and other challenges of aging that are emerging for aboriginal peoples. many of these challenges are not unique to aboriginal populations, but their magnitude and manner of expression and the colonial context in which they have unfolded is different from other populations in canada, demanding that we build our understanding anchored in these realities. research by collings (2001) with the inuit, and by edge and mccallum with métis (2006) noted that the most important determinants of successful aging for their participant groups are ideological (rather than material), noting the importance of history, culture, and language, as well as their successful transmission to new generations, for understanding the health, healing, and wellness needs of these populations. as marie’s story reveals, these ideological themes, coupled with their transmission to younger generations, are key elements of her life as well. marie: a brief biography: marie was born in 1939 and has lived most of her life in and around the métis community of ile a la crosse in saskatchewan, canada. she married her husband jimmy in 1958 and over the next 58 years she raised 8 children, became a teacher, a religious educator, a community health worker, and an advocate for the inclusion of aboriginal influence in the education and governance of their people. throughout this time she attended post-secondary training, worked with her husband to help him overcome an alcohol addiction, and together they reconnected with their aboriginal heritage. she does not see herself as a strong person, but points to people around her, such as jimmy, as her source of strength. together they are dealing with health challenges that come with aging and at the same time continue to make tremendous contributions to the well being of their community and the métis nation in saskatchewan. as she looks back on her life, marie observes: “…i see that i have moved through the medicine wheel; that my pursuit of more education and experience has taken me through all four quadrants as a teacher (mental & emotional), as a religious educator and sweat leader (spiritual), and in community health education (physical). and having searched the wheel i found the last piece in health education. and this is where i feel i can make the most contribution to the health and healing of my community. so today i am still involved in many things that are about sharing my life experiences, about helping our youth stay in school, about helping our young people parent well and drawing on the old ways, and about dealing with the hurt that is still there in the high suicide rates among our youth. ” frameworks for understanding aging experiences for older aboriginal people: as marie and i talk about her story we see there are some important elements of her aging well experience that need to be reflected in frameworks that we might develop to explore other stories of aging for aboriginal people. central is the significance of her ongoing contributions to community life. it is clear that she is valued in this role as she can scarcely keep up with the invitations to present in classrooms, workshops, and conferences. consistent with collings (2001) research among the inuit for successful aging, marie is dedicated to the transmission of her accumulated knowledge and wisdom to younger generations. her capacity to engage in this way has its roots earlier in her life, when she was able to pursue her passion for further education, to advocate for the inclusion of aboriginal voices where there were none, and importantly, to connect with cultural traditions that were denied to her earlier in life. these latter two factors are directly linked to the colonial context of aboriginal populations in canada. these linkages to culture and agency are also important aspects for inclusion in any framework that would shape our understanding of aging experiences –good and bad, for these populations. marie’s story, and other research, provides evidence that the role and value of older aboriginal peoples has remained strong in aboriginal communities, and has been growing, since they are valued as an continued on page 20 anthropology & aging quarterly 2012: 33 (1) 12 conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities mistreatment and the meaning of respect for native elders lori l. jervis, anthropology and center for applied social research, university of oklahoma, william sconzert-hall, anthropology, university of oklahoma and the shielding american indian elders project team* respect—particularly respect for elders—is frequently said to be a central value in many american indian communities. assertions of its continued cultural salience are often accompanied by the lament that this important value is in decline. based on findings from a community based participatory research study of native elder mistreatment, we examined respect as it appeared in the discourse of what constituted good and poor treatment by family members (as broadly defined) among 100 elders from 2 data collection sites, 50 from a tribal elder center on a northern plains reservation and 50 from protestant indian churches in an urban area in the southcentral region of the us. the interview consisted of both a survey meant to assess the usefulness of several measures of elder abuse, neglect, and financial exploitation in this population, as well as a series of open-ended questions that allowed elders to expound on the treatment of elders in their communities. nearly ¾ of the sample were female (72%), 46% age 70 or older, 52% married, and 26% spoke their tribal language moderately to very well. the scholarly and academic literature on conceptualizations of respect of elders is scarce among all u.s. ethnic groups, and is especially thin for american indians. dillon sees respect as “a particular mode of apprehending something, which is the basis of the attitude, conduct, and valuing, while “to ignore, neglect, or disregard something, or to dismiss it lightly, thoughtlessly, or carelessly is to not respect it” (dillon, 1992:108). although frequent assertions are made in native communities about the importance of respect for elders, the constituent elements of the respect concept are seldom explicated. it is clear, however, that elderhood without respect is not truly elderhood. in weibel-orlando’s (weibel-orlando, 1989:152) distinction between elders and elderlies, she notes that an american indian elder is recognized by his/her community for “….one’s embodiment of certain exemplary and ethnically valued traits (e.g., sagacity, high moral standards, responsibleness).” an elderly, on the other hand, is dependent, impaired, and nonproductive—a social problem rather than a respected member of the community. findings in this study, no questions were specifically asked about respect. participants were asked what it meant to be treated well by family members, however. here, almost ½ of the participants equated respect with good treatment of elders. a thematic analysis of respect revealed that it had a number of dimensions, with behavior (e.g., the provision of various kinds of assistance) and status (e.g., exhibiting courtesy, demonstrating admiration, asking for and heeding advice, and honoring) the most prominent. disrespect, on the other hand, was often seen as synonymous with mistreatment (e.g., financial exploitation or verbal abuse). some participants presented the disrespect leveled at today’s elders as unthinkable in comparison to the traditional tribal norms with which they were raised. these changes were often attributed to assimilation and culture loss, sometimes to alcohol. in summary, several themes emerged in this study: the continued centrality of respect as a tribal ideal, the decline of respect as a reality, and the equating of disrespect with mistreatment. the ideational aspects of elder respect are crucial to understand its prominence in indian county. if attitudes about respect toward elders have indeed so dramatically shifted in such a relatively short period of time, presumably this reflects a decline in their social worth. where once, in the absence of a written tradition, elders would have been highly valued as the transmitters of tribal culture and history (weibel-orlando, 1989), they now must compete with popular culture and a number of pressures that push people toward a “modern” future where elders’ contributions to the community are not nearly so obvious. unpacking the complexities around respect is essential to understanding how elders are treated in tribal contexts, and will be an important aspect of our continuing analysis. * the shielding american indian elders project team includes david baldridge, janette beals, connie bremner, dedra buchwald, john compton, alexandra fickenscher, william foote, julie holden, yvonne m. jackson, lisa james, chebon kernell, anne libby, crystal loudhawk-hedgepeth, spero m. manson, traci mcclellan-sorell, lisa nerenberg, emily matt salois, bessie smith, charlene smith, and gloria tallbull. continued on page 20 anthropology & aging quarterly 2012: 33 (1) 13 conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities forgetting and forgotten: dementia in aboriginal seniors kristen jacklin, human sciences, northern ontario school of medicine and wayne warry, anthropology, mcmaster university our research concerns alzheimer’s disease and related dementias (adrd) in aboriginal communities in ontario, canada. the title “forgetting and forgotten” is meant to convey that like mainstream society aboriginal communities are also experiencing high rates of adrd as their senior population increases. however because of historically low rates of adrd in these communities their specific needs as aboriginal people are overlooked by mainstream service providers as well as by the government funding agencies that provide services on reserve. our research aims to bring light to this new health issue through community-based anthropological investigations into the experience of adrd in diverse aboriginal communities in ontario. the preliminary results highlighted here focus primarily on the cultural influences on the experiences of adrd in this population at two of our research sites: (1) the haudensaune six nations reserve in southern ontario and (2) the seven rural ojibwa, odawa, and pottawatomi first nations of manitoulin island in northeastern ontario. our methodology is community-based and participatory and is qualitative. at each site semi-structured depth interviews were conducted by the authors and community based researchers with: seniors (≥55); persons with dementia (pwd); family caregivers for pwd; health care providers for pwd; and key informant interviews with physicians, traditional knowledge keepers and healers, and specialists (manitoulin island n=20; six nations n=16). focus groups with personal support workers were also carried out in each location. the preliminary results presented concern the similarities and diversity in the experience, knowledge and traditions of aboriginal people with adrd at these two culturally distinct sites. preliminary results differences in access to health care resources are evident between the sites. at six nations we see a high degree of medical system involvement in public education, diagnosis and care for people with symptoms of dementia. on manitoulin island where medical services are more restricted and focused on primary health care we see much less involvement from physicians and specialists and very few reports of official diagnoses or screening. other than those who are in nursing homes, at both sites we have found very few people on prescription medications for dementia. the analysis of the interview data has revealed that these two different cultural traditions display many similarities in the way people describe understandings of adrd and cognitive health. at both sites respondents spoke about how their culture helps them cope and care for those with dementia. for example, cultural beliefs around the role of family was a positive influence on the experience of adrd; the value of humour is important in coping with adrd in the family and community; and aboriginal language use was highlighted as an important part of caring. further similarities between the sites are noted in relation to understandings of prevention and overall cognitive health. seniors at both sites noted that listening to indian music or language tapes, speaking the language, storytelling, taking indigenous medicine for ailments, and participating in ceremony are good for keeping your mind healthy. participants at both sites also reported that they did not have knowledge of ceremonies specific for dementia but that traditional remedies that thinned the blood could be used for people with dementia. taking an explanatory model approach (kleinman 1981), we are finding that there are some similarities in the way people think about and experience adrd at the two sites. at both locations the majority of participants agreed that adrds are new diseases in various senses: for example, new in magnitude and new in the way people are now being identified and labeled (i.e., diagnosed). participants at both sites also suggested that despite the increase in cases, adrd was not a major health concern in their community because (1) the majority of people face complex health concerns and dementia is very low on their health priority list and that of their physicians; and (2) because the symptoms and behaviours associated with adrd were consistent with cultural understandings of what is expected as one ages and becomes closer to the eastern doorway on the medicine wheel. further to this, some commented that the behaviours associated with late stage adrd (what we call hallucinations) set people apart as “special” as they are closer to the creator. the very idea that “we” would label visions as hallucinations was outright offensive to some participants. when ideas of causation were explored participants cite causes which can be classified as (1) physiological -genetics, aging, brain chemistry, vascular disease, medication side effects and parkinson’s disease; (2) psychosocial - unresolved continued on page 21 anthropology & aging quarterly 2012: 33 (1) 14 conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities understanding aging: culture, cognitive health and contemporary aboriginal people’s experience with dementia jessica pace, ph.d. candidate, anthropology, mcmaster university introduction past research about aging and health has focused on “the elderly” as a homogenous group, resulting in an underrepresentation of the unique concerns of marginalized and minority seniors. this bias can be overcome if researchers attempt to understand the perceived expectations for successful aging of specific groups. doing so can lead to a better understanding of the impacts of pressures, such as illness, on the aging process and can create opportunities for culturally-relevant health promotion. my phd research attempts to understand expectations for successful aging among aboriginal peoples on manitoulin island, ontario with the goal of gaining perspective into the way that individuals, families and communities in this context react to and cope with the pressures associated with age-related memory loss and cognitive decline (i.e. alzheimer’s disease and related dementias [adrd]). using qualitative, ethnographic methods (see jacklin and warry, this issue), this community-based research attempts to understand 1) how culture shapes the experience of being and becoming old in contemporary aboriginal communities on manitoulin island? and; 2) how perceptions of aging and the elderly impact the knowledge, attitudes, beliefs and behaviours about adrd in this context? successful aging and expectations for growing old successful aging theory has been critiqued for the use of biomedically-determined criteria for success in aging and terminology that connotes failure for those who do not achieve these criteria. however, recent research indicates that a successful aging paradigm can be productive when the criteria used to define success in old age are drawn from people in a specific context or community and the focus for success in aging is directed away from physical and cognitive capacity and towards values, attitudes and behaviours. the relevance of this approach for research with aboriginal peoples has been demonstrated in recent research which shows that for aboriginal peoples success in aging is characterized more by a positive attitude, ability to manage declining health, community engagement and spirituality than by good physical health. these findings are compatible with my phd research. alzheimer’s, dementia and successful aging in manitoulin island first nations in manitoulin island aboriginal communities aging is expected to be a time of teaching and respect, when family and community assist seniors when they need help with day to day tasks and activities. for traditionally-oriented individuals, the process of growing older is shaped by beliefs related to the medicine wheel and the seven grandfather teachings, which emphasize balance, respect, teaching, acceptance and maintaining a purpose in life by staying engaged in social, physical, spiritual, intellectual and emotional realms. aboriginal seniors have expressed that these teachings help them to accept the changes that occur as they grow older. prior research suggests that aboriginal people are generally respectful and accepting of seniors with dementia, believe dementia is a natural part of life’s cycle and that the patient may be moving closer to the creator. aboriginal people with dementia are thought to be less stigmatized than their mainstream counterparts, but embarrassment and denial about the condition emerge as symptoms worsen. although aboriginal people on manitoulin island are aware that alzheimer’s disease (ad) exists and that it causes memory loss, there is little clinical knowledge of what causes ad or that there are other conditions that can cause similar symptoms. however, experiential knowledge of the symptoms of cognitive decline in old age has resulted in local explanatory models that accurately describe symptoms of adrd. these symptoms include memory loss, a tendency to return to previous life stages, lack of recognition of family members, wandering, suspiciousness and a loss of awareness of time and place. beliefs about the causes of memory loss are varied, and include food, environmental contaminants, stress and emotional trauma, imbalance in the medicine wheel, substance abuse and prescription medications. aboriginal people’s beliefs about dementia and cultural tendency for acceptance and respect act as both enablers and barriers to the care of persons with dementia. although acceptance can be beneficial, attempts to normalize the symptoms may cause people to put off seeking help until the person with dementia’s condition has deteriorated beyond the point where the family is able to cope and provide adequate care. continued on page 22 anthropology & aging quarterly 2012: 33 (1) 15 conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities perspectives on brain autopsy, diabetic amputation, and end-of-life issues among elderly american indian people neil henderson, health promotion sciences, university of oklahoma health sciences center, l. carson henderson, health promotion sciences, university of oklahoma health sciences center, ryan blanton, anthropology, university of oklahoma and steven gomez, anthropology, university of oklahoma the american indian (ai) population is rapidly aging and, consequently, at increased risk for dementing diseases like alzheimer’s disease and other dementias (ad/rd). while the exact epidemiology of ad/rd among ai people is unknown, current research shows that ad/rd is certainly present among north american indigenous people. the net result is that more cases of ad/rd will increase among ai’s due to more people living into the ages of greatest risk. moreover, there is an association between ad/rd and diabetes which remains at epidemic proportions among ai’s. ad/rd are fatal diseases and/or contribute to mortality. unfortunately, very little is known about contemporary ai beliefs and practices regarding end-of-life (eol) phenomena in general. even less is known about eol in relationship to death caused by dementia. this gap is important because 1) caregiving and coping are stressful and benefit from appropriate information and counseling, and 2) neuroscience efforts to ameliorate ad/rd require post-mortem brain tissue for pathophysiologic process examination and definitive diagnosis. however, a common cultural principle demands that bodies be buried intact which, in turn, reduces post-mortem opportunities for ai-specific research. cultural context of post-mortem body alteration among many ai’s there is a belief that the body should be physically whole at burial. “physically whole” means without loss of body parts from amputations, other surgical interventions, or retention of body parts at autopsy. the overarching reason for this belief is that in the after-life, the person will need all body parts in order to be as functional as they were in life. the implied concept is that in some way, the death of the person who has had preor post-mortem body part loss will be hampered in their ability to travel the spiritual path to the after-life. stated more emically, the concept is that all body parts are required for full spiritual coherence, peace, and function in the after-life. clearly, the value placed on body intactness at burial is a significant one of long-standing history. surgical resection of diseased body parts, particularly for life-saving purposes, is commonly accepted by ai people. surgical amputations of limbs and digits to prevent general sepsis beyond the local dead tissue are also unfortunately common. for many people, these surgical procedures evoke a conflict of belief and practice even if they are not always voiced. however, because autopsy, of course, does not save the autopsied person’s life, it still is subject to the intact body value referred to above. methodology the research design is from the interpretivist paradigm using grounded theory. the theoretical wellsprings include david mechanic’s health belief model, help-seeking behavior and arthur kleinman’s explanatory model of disease. data was collected by a one-time, 45-minute, semi-structured interview with ad/rd caregivers in five federally recognized oklahoma ai nations (n=77). there was an assessment of the degree of cultural identification (dci) using a 20 item questionnaire. findings there is a range of willingness to have post-mortem brain autopsies. the range is a function of age and degree of tribal cultural identification. for example, the post-mortem intact body preservation value is strong among those with age above 60 and high dci loading. however, for those younger and with low dci loading, the value is weak. there is also a “conditional belief-flexibility” in which post-mortem brain autopsy is potentially acceptable if, there would be a small amount of brain tissue removed, there were a way to non-intrusively extract brain tissue (e.g., nose, mouth, eye orbit, ear canal), the brain tissue was examined and returned for burial, or medical progress was an outcome. this “conditional beliefflexibility” position may represent a conceptual adaptation between contemporary sociocultural conditions abutting older more non-western cultural systems. such an interpretation may also help explain that post-mortem brain autopsy was often reconceptualized as similar to the more generally familiar “organ donation” concept which is commonly noted on driver’s licenses. continued on page 21 anthropology & aging quarterly 2012: 33 (1) 16 conference report: 2009 meeting of the american anthropological association session on culture, health and aging in native north american communities discussion robert c. harman, professor emeritus, cal state, long beach and wayne warry, mcmaster university. we conclude by noting some general comments on the papers and presentations. as most of the papers are coauthored, for simplicity’s sake we refer to the papers by the first author or presenter’s name. the papers submitted are based on recent, qualitative and in some cases ongoing research among aboriginal/native american peoples of canada and the united states. all the papers differ somewhat in methods and interpretive orientations. jervis’s and abonyi’s papers most explicitly address the cultural ideal of the preeminence of elder’s status or role within aboriginal cultures; but several of the papers speak to the changing perceptions and roles of elders, and of course, cite idealized conceptions of health and appropriate behavior that cannot or are sometimes not met by others. abonyi and jervis’s papers concern more general aspects of aging and qualities of health and care. in contrast jacklin, pace and henderson’s papers address aspects of dementia or end of life health within the cultural and social context of aboriginal health and illness. each of the four papers has somewhat different objectives and data. abonyi’s paper is a biographical account of maria’s life that reflects on traditional ways and changes affecting the lives of older aboriginal peoples. the research highlights beliefs about healthy aging which are linked to notions of community, community involvement and engagement. that is, the analysis suggests that health is produced not simply by individual action, but through socially constructed behaviors and interactions. jervis analyzes respect as an american aboriginal concept, specifically as it applies to the social and cultural status of elders. her analysis shows the linguistic complexity of the concept “respect,” as it pertains to elders. jervis’s paper also addresses changes in aboriginal society and culture. professor harman notes at one point jervis found that some, perhaps most, aboriginal families want to enjoy the presence of older relatives and provide them with care. harman says he believes that “implicit conventional understandings and generous care giving, smack of what westerners call unconditional love.” jacklin’s analysis in two cultural and geographic areas of ontario emphasizes attitudes toward alzheimer’s disease from both traditional aboriginal and western perspectives. she develops explanatory models of diagnosis and treatment that contrast traditional aboriginal and biomedical understandings. her analysis makes the important point that language and ceremonial participation with the requisite knowledge of traditional teachings and values are integral to good health. that implies healthy living, cognitive health, and developing meaningful systems of care. pace is primarily concerned with cognitive aspects of aboriginal health and aging and with cultural constructions of healthy aging. henderson’s research focuses on beliefs and behaviors around end of life and medical interventions that necessitate bodily interventions or transformations of the “whole“ body and thus clash with traditional beliefs. the common threads that seem to run through these research projects are that of changing or contested values and beliefs which come with what henderson calls degrees of cultural identification and which other authors refer to as traditional or cultural orientation. the flip side of such analytic focus is the extent to which biomedicine, and the values represented by the dominant medical system, have been accepted by individuals and communities. the papers quite naturally analyze the nature of changing systems of care, emerging values around health and aging, and the diversity of behaviors that arise from the interaction of western and indigenous values and health beliefs. the tension between cultural identification and biomedical values or power are manifested in many ways throughout the papers, for example, in how abonyi refers to aboriginal peoples relying less than other segments of the population on formal care continued on page 20 anthropology & aging quarterly 2012: 33 (1) 20 important part of the cultural renewal process taking place for many years now among aboriginal people in canada. the importance of retaining aging seniors in communities and supporting their aging well in place requires us to consider, for example, the nature and value of communityand kin-based informal care systems in aboriginal contexts. this one example highlights that there are substantive and meaningful differences in the aging experiences of aboriginal and non-aboriginal seniors. it is timely that we now turn in canada to the inclusion of aboriginal ideas about aging in frameworks applied to aboriginal contexts. in collecting more stories about aging well, we will ask, “what does aging well mean to you?” the answers to this question may allow us to be better positioned collectively to navigate the interface between western and other contexts in the design of effective policies, programs, and support for the growing cohort of aging aboriginal seniors in canada. * the term aboriginal refers to the descendants of the original inhabitants of canada, as defined by the constitution act 1982; indians, inuit and métis. references collings , p. (2001). “if you got everything, it’s good enough”: perspectives on successful aging in a canadian inuit community. journal of cross-cultural gerontology 16(2):127 –155. edge , l. , & mccallum , t. ( 2006 ). métis identity: sharing traditional knowledge and healing practices at métis elders’ gatherings. pimatisiwin: a journal of aboriginal and indigenous community health 4(2):83 –115. abonyi, continued from page 11 jervis and warry continued from page 12 acknowledgements we wish to express our appreciation to our research participants and collaborating tribes and host organizers references dillon, r. s. (1992). respect and care: toward moral integration. canadian journal of philosophy, 22(1), 105-132. weibel-orlando, j. (1989). elders and elderlies: well-being in indian old age. american indian culture and research journal, 13(3 & 4), 149-170. harman and warry continued from page 16 and more on the informal sector, especially within their large tended family networks and in jacklin’s observations about negative perceptions of nursing homes and a preference for family care giving for elders with memory loss. whether these ideological tensions are framed in terms of older notions of resistance, cultural resiliency or more contemporary notions of post colonialism or hybridity anthropologists are confronted with the analytic challenge of teasing out the nature of contemporary aboriginal health beliefs and behaviors that are the product of culture change and the contestation of beliefs that ultimately shape peoples pursuit of health, their desire for appropriate care, and their experience of illness and disease. collectively these papers exemplify anthropologists’ desire to ensure the best of biomedicine, while identifying the hazards potentially dangerous aspects of mainstream medical care in the aboriginal cultural context. the papers advocate on behalf of safe and effective care for aged aboriginal peoples. agencies that provide health care for aboriginal communities must become better informed about the cultural orientations of those aboriginal individuals and communities they serve. more collaboration by mainstream health care personnel with anthropologists will help to ensure that aboriginal beliefs and values are honored by western practitioners. identifying the hazards potentially dangerous aspects of mainstream medical care in the aboriginal cultural context. the papers advocate on behalf of safe and effective care for aged aboriginal peoples. agencies that provide health care for aboriginal communities must become better informed about the cultural orientations of those aboriginal individuals and communities they serve. more collaboration by mainstream health care personnel with anthropologists will help to ensure that aboriginal beliefs and values are honored by western practitioners. anthropology & aging quarterly 2012: 33 (1) 21 henderson, henderson and gomez, continued from p.15 grief and historical trauma, stress, alcohol and drug abuse; and (3) indigenous - disruptions in the relationship to the land and traditional life ways and bear-walking (we understand bear-walking to refer to a form of ‘bad medicine’ that is directed towards an individual). we have found the relative proportion of people placing importance on physiological explanations of causation to be much greater at six nations suggesting that in a relatively short period of time a medicalized explanatory model of causation has emerged for participants at six nations. this is likely related to the availability and accessibility of western health care services. in contrast, the communities on manitoulin island appear to still be in a period of explanatory model negotiation. the tendency has been for respondents to look at the onset of dementia as a natural part of aging or to engage in a discourse of social dis-ease; for example, failure and suspicion of the medical systems especially in relation to prescription medications, indigenous beliefs about balance, historical trauma, and bear walking. very few people recognized this as a genetic disease, vascular disease or a brain disease. we feel comfortable in saying that at this time adrd has not been medicalized for the first nations on manitoulin island. conclusion in the case of new illnesses explanatory models and specifically those around causation serve to highlight cultural dis-ease as it is related to the struggle between biomedical and traditional approaches to aging and health and much broader socio-political struggles to protect indigenous epistemologies under the pressures of colonial and post-colonial states. the process of medicalization we see in relation to dementia provides us with an opportunity to examine the relationship between the colonial system of biomedicine and modern indigenous communities; and, the struggle to negotiate models of understanding that incorporate traditional values and understandings with biomedical explanations. this site-specific depth of understanding will allow for knowledge translation activities that are sensitive to the specific needs and beliefs of these diverse communities. while the sites differ in their level of adoption of biomedical ideas of causation of dementia we see at both locations a model emerging that places value and emphasis on traditional values, cultural attributes, and traditional methods of prevention and healings in the prevention and care of individuals with memory loss and confusion. this represents a strong assertion of the place of indigenous health in an increasingly medicalized domain. acknowledgements we express our gratitude to our research partners six nations health centre, noojmowin teg health centre, mnaamodzawin health centre, and nahndahweh-tecigehgamig wikwemikong health centre; the participating first nations: six nations, wikwemikong unceded indian reserve, zhiibaahaasing, sheshegwaning, m’chigeeng, aundeckomni-kaning, whitefish river, and sheguiandah; research assistants karen pitawanakwat, jessica pace, trisha macdonald and lisa boesch; and research coordinator agnes kanasawe. our research is funded by the alzheimer’s society canada and the ontario mental health foundation. jacklin and warry, continued from page 13 in summary, a post-mortem intact body preservation value exists as a strongly positive relationship among those with high age and dci loading whereas it is an inverse relationship among those with low age and dci loading. essentially, those older, more “traditional” people were more likely to reject brain autopsy and those less traditional and younger were more likely to accept it. those with the conditional belief-flexibility” position that made brain autopsy potentially acceptable was characterized by two positions: 1) if changes to the medical protocol could be made that honored the value, then it could be more acceptable, and 2) if there is general social benefit, then it could be more acceptable. to the extent that ai’s may have some unique characteristics due to the indigenous origins compared to the majority population, participation in medical research could generate significant insights that could assist with the development of better understandings and treatments for all people. consequently, there is a significant need to better understand eol sociocultural phenomena so that at least a chance for negotiation of ai models and biomedical models can be tried. acknowledgements funding for this study was provided by the centers for disease control and the alzheimer’s association. anthropology & aging quarterly 2012: 33 (1) 22 this can lead to increased caregiver burden and can also raise the level of stress faced by the person experiencing symptoms. further, poor understanding of the condition, what causes it, and how to manage symptoms may increase the risk for shame and stigma. knowledge about how to support a person with dementia, and available medical interventions are low. culturally-appropriate educational materials and increased health promotion would be of value to the seniors and families in these communities. in particular, education about when, where and how to get help for dementia is needed. it is inherently difficult for people with dementia to meet the criteria for successful aging. fear about their condition or stigma related to mental health often cause people to withdrawal from social activities, and the symptoms of dementia can make it difficult for individuals to participate in activities and interests in the way they were able to before the onset of the condition. if people with dementia withdrawal and isolate themselves, or are isolated by family members out of embarrassment or shame, the problem becomes invisible to the community, and potentially to healthcare providers. this can be a barrier to both care provision and awareness. however, cultural perceptions of aging and what it means to age successfully can be used to positively impact the lives of people experiencing dementia. the value of maintaining a purpose in life and an active engagement with the intellectual, spiritual, emotional and physical realms is particularly relevant in the context of promoting personhood and the continued integration of persons with dementia in community activities. if we can determine what ‘purpose’ elders in contemporary aboriginal communities want to have we can better assist people with dementia to achieve value in their lives in a way that has meaning to them thus, allowing for the promotion of better quality of life. with adequate support from family, friends and health care providers many elements of successful aging can be approached, if not achieved, for people with dementia. however, in today’s changing world, the challenge is to continue to keep families engaged in the care and support of seniors with dementia, which can be difficult when adult children work or move away from the reserve. conclusion aboriginal peoples on manitoulin island hold values that are generally supportive of seniors and that promote healthy and active aging, even in the face of complex health concerns. however, the care needs of seniors with dementia are complex and demanding and the lack of access to information, services and culturally-appropriate supports put a great deal of pressure on individuals with adrd as well as family caregivers. in a discourse about acceptance and respect there is denial and a lack of knowledge about the realities of the needs of people and families coping with dementia. this lack of awareness of dementia can lead to inherently disrespectful actions which can compromise the dignity and safety of elders with dementia. it is necessary to better promote culturally safe knowledge, education and training related to this condition for seniors, families and care providers and to work with the cultural values of purpose, acceptance and respect to promote better health and quality of life for aboriginal people dealing with dementia. acknowledgments: sincere thanks to all of the individuals and organizations on manitoulin island who lent their time and expertise to this research project. special thanks to mnaamodzawin health services, noojmowin-teg health services and the wikwemikong health centre. i would also like to express thanks to my research assistant, karen pitawanakwat, for her hard work and dedication, and to the principle investigators of the project, dr. wayne warry and dr. kristen jacklin. this research was supported by the school of graduate studies at mcmaster university, the indigenous health research development program, ontario mental health foundation and the alzheimer’s society of canada. pace continued from page 14 pages from aaq33(1) march 2013-10-17 pages from aaq33(1) march 2013-20-22 anthropology & aging quarterly 2012: 33 (3) 97 feature aging & anthropology in east asia the problem of japan’s aging society japan has faced with a falling birth rate and a growing aging population for several decades, especially in rural depopulated areas. people aged 65 and above accounted for 23.1% of the total population of japan in 2010. this is already the highest ratio in the world, and the ministry of health, labor and welfare estimates that it will reach 30% in 20 years. in that social context, the ministry of health, labor and welfare issued its annual report, which indicated that life after retirement was “the second active life” and suggested that it was an important toward developing one’s own ikigai. the japanese word ikigai means “that which most makes one’s life worth living” can be translated into the english expression of “the sense the sense of social commitment and well-being among elderly japanese women: focusing on the reinterpretation and exhibition of bridal noren yoko taniguchi, ph.d. senshu university, japan of well-being” (mathews 2010: 167). the report implied that development of one’s own ikigai could be realized by increasing one’s social connectedness through active commitment to neighborhood activities (ministry of health, labour and welfare 2003). on the other hand, a white paper on japan’s aging society issued in 2009 showed that the number of elderly who expressed uneasiness due to living alone was increasing. in 2009, 22.5% of the elderly lived alone. if households comprised only of an older couple are added, the percentage goes up to 52.9% of the whole. the high ratio itself is not the problem. the problem is, again, the high ratio of elders who express uneasiness due to living alone: abstract this article explores the ways in which elderly japanese women’s sense of well-being relates to their sense of “social responsibility” and “deep involvement with society.” it is based on fieldwork conducted in nanao city (ishikawa prefecture) in 2010-2011. the local government of nanao recently emphasized the development of a community welfare network and tourism resources in order to deal with depopulation and an aging community, and to reinvigorate the local economy. i describe various activities in the social and political context of nanao, meant to revitalize the local community. one of these activities is performed by women in their sixties, who retreated from their roles as housewives and/or shop proprietors. these women’s activity reinterprets the given values of bridal noren (door curtain), a local object known for its beautiful sensuousness. when the women recently initiated activities to display bridal noren as objects of art, they become one of the main tourist attractions in the city. this paper concludes by demonstrating that elderly women expressed subjective well-being through involvement in their social world via social activities. keywords: well-being, social commitment, folk art, reinterpretation, exhibition special international submission on aging and materiality in japan anthropology & aging quarterly 2012: 33 (3) 98 yoko taniguchi social commitment and well-being among elderly japanese women 63% in 2009 (cabinet office, government of japan 2009: 18-19). moreover, over 30% of the elderly who expressed uneasiness remarked that they felt uneasiness when they thought that they had no close family or friends to be able to rely upon in their neighborhood (cabinet office, government of japan 2009: 18-19). these results indicate that creating or rebuilding close relationships with others in late life may have significant value for older japanese adults’ sense of well-being.1 inter-relationship between well-being and social connectedness quite a few reports and studies concern the interrelationship between one’s sense of well-being and social connectedness. in the 2001 report of oecd (the organisation for economic co-operation and development) stressed that an economic aspect of wellbeing is only a part of human well-being and defined “human well-being” as a broader concept: “(it) is more than the sum of individual levels of well-being” (oecd 2001: 11-12), while the 1976 oecd report stated that “social well-being” was the aggregate of well-being of individuals that were affected by their relations with other human being and the physical environment (oecd 1976: 11-12). the important point to note about the 2001 report is that it stressed not only economic factors but also the complementarity between well-being and human and social capital that affects human well-being, employing american sociologist james coleman’s work on social capital in the 1980s (coleman 1988, oecd 2001:13). putnam’s assertion that “social connectedness is one of the most powerful determinants of human’s wellbeing” (putnam 2000: 332) was also quoted in the report. in his work, putnam explained the way in which social isolation is profoundly linked to personal unhappiness and illness (putnam 2000: 332). various reports since the late 1980s have supported the strong relationship between personal well-being and social connectedness from the sociological and psychiatric viewpoints (klinenberg 2010; 2012, kiley 1989). many sociological studies of japan have discussed the inter-relationship between social connectedness and well-being, social isolation and selfneglect that often causes death (nhk “unrelated society project” press 2010, tachibanaki 2011, ishida 201, inaba 2011). these studies showed that a sense of well-being, especially among japanese elders, was affected by whether they had close social relationships with others.2 in this article i use mathews and carolina izquierdo’s definition of “well-being”, which offers an anthropological concept involving a sense and experience that differs among individuals with different sociocultural contexts and a sense and experience that are common among humans (mathews and izquierdo 2010: 1-22)(2). purpose and contents in this article i will present one of the japanese elderly women’s activities that increases social connectedness through community based activities to reinterpret and exhibit folk objects called hanayome noren3 (“bridal door curtain”—i will call it bridal noren) in nanao city of japan’s hokuriku region. noren is a door curtain and is often hung at store entrances, however, bridal noren is a special luxury door curtain which is used only for wedding rituals. the women i will focus on are in their sixties and have retreated from their roles as housewives, caregivers of children and elderly parents, and co-managers of a family business. these roles were handed over to their daughters-in-laws. these older women express a sense of ikigai when participating in activities related to the broader social world. in their household roles, their social world was primarily in the domestic sphere, but now they are mediating between the domestic and public spheres by displaying and telling stories about the bridal noren in exhibitions. first, i will examine the social and cultural background of the city in which i conducted my research. second, i will focus on the activity of exhibiting the bridal noren. finally, i conclude by reconsidering the meaning of the concept of “productivity” in late life. research methods and background method and material the main research method that i employed was participant observation, interview and an analysis of a brochure that was published by an executive committee of exhibitions. i conducted informal, “non-directed” interviews with two of the five women who took leadership in the activity of bridal noren exhibition. . i asked a few questions to trigger off the story but the interviewee guided the course and the flow of the interviews. research area: nanao as a researcher, i have been conducting fieldwork in a rural depopulated area for the last four years. magnitude 9 earthquake, known as niigata chuetsu earthquake, struck this area in 2004, and i have been, researching the way in which the elderly expressed a sense of uneasiness and well-being in the recovery process from disaster.4 for making a comparative study on this topic, i started fieldwork in nanao city, which was struck by a magnitude 6.9 earthquake in 2007, known as the noto peninsula earthquake. fifty houses collapsed and 6,745 were damaged by the earthquake in which 127 people were injured but no one was killed.5 after the earthquake, the municipal government began to emphasize the idea that the most efficient measures for preventing a disaster are to anthropology & aging quarterly 2012: 33 (3) 99 yoko taniguchi social commitment and well-being among elderly japanese women strengthen existing relationships and organization among neighbors and for people to reform close-knit relationships in the local community. the local government recognizes senior citizens who live alone or with only a spouse as “vulnerable people in emergency”, and thus it works hard to strengthen local community ties and the services provided to them. promotion of welfare and well-being, especially of elderly, receives much attention today in nanao. geographically, nanao faces the sea of japan (or the east sea), situated at the entrance to the noto region of ishikawa prefecture. it has a population of 57,714, as of 2011, but faces depopulation and a rapidly aging population. thirty percent of the population is aged 65 or above (nanao city 2009), however, nanao is still the largest city in the noto region. culturally, nanao is influenced by kaga where is now a capital of ishikawa and has a nickname of “a little kyoto”, the ancient japanese capital city kyoto, which was once the political and cultural center of japan. for instance, the traditional techniques used to dye bridal noren were named after kaga and it was originally imported from kyoto. nanao consists of 15 rural districts, and its economy depends on agriculture and fishing. tourism recently became one of the city’s key industries. a popular annual festival, held from may 2–5, called seihaku-sai attracts 15,000 tourists every year. the exhibition of bridal noren is one of the events at the festival. the bridal noren exhibition is launched by the bride and groom parade down the 400-meters-long old ipponsugi shopping street, while fifty or more norens are hung from the front doors of the shops on both sides of the street. along the street leading to the ancient temple are four old-style storefront residences. they received the cultural asset specification in 2004 and sell local products to tourists, such as marine products, handmade japanese candles, and soy sauce. there are 37 shops in this street which has become one of the popular tourist attractions for those who are interested in the history and products of nanao. why bridal noren? background of my research at the beginning of my research in 2010, i conducted participant observation in an activity of the communitybased elderly group for the purpose of “prevention of long-term care” (kaigo yobou). that activity was based on a yearly grant from the local government. the group has been continuing the activity twice a week for 8 years since the frame of the grant was established. there are no other groups like this in this city. five to ten members over 65 come together to have a chat, sing and play small games. the group activity is not limited to recreation. they voluntarily visit the hospital and some welfare facilities to entertain by singing, playing games or dancing a few times a year. their social commitment was unique and i became interested in understanding these older adults’ feelings of well-being. some members were just looking at other people talking or playing games from a distance, but they said “it is fun to come here.” the other member said, “it is fun to be involved with the local friends and to visit facilities.” from these comments, i became more convinced that the opportunities to meet people and work together would affect a sense of well-being for the elderly. then one day during my fieldwork, i met a lively elderly woman who was delightedly working on an exhibition activity of bridal noren. i was very impressed with her story about her experience of social commitment and fulfillment and she became my first interviewee about bridal noren. what is bridal noren? the origin of the bridal noren dates back to the premodern period around the nineteenth century, and they had been used widely up to the beginning of the twentieth century. a bridal noren is made using techniques called kaga yuzen, a dyeing process, commonly used for highquality silk kimonos. although, in general, the noren curtain is made of stout cotton dyed with a simple indigo dye, a bridal noren is made of silk (sometimes cotton and linen) and is designed with auspicious, colorful, handpainted patterns such as court carriages, mandarin ducks, and flowers. the noren is a gift from the bride’s family to the groom’s family. it can be understood as a kind of dowry. the custom of using bridal noren as dowry was introduced by the upper warrior caste to the general public during the late pre-modern period, around 19th century and was a symbol of an alliance between the families. the bride’s mother, who passed it on to her daughter, arranged the patterns and colors of noren. when wedding rituals were customarily held in the groom’s house, at least until the 1950s or 1960s, wedding rituals were held as follows. first, the bride and groom would stand in front of the entrance of the groom’s house and drink a small cup of water mixed from their respective natal houses. second, they would step into the groom’s house, where the noren hung from the lintel at the entrance to the room near the family’s buddhist altar. the room was the area where the groom’s family’s ancestors were worshiped. the bride would pass under the noren, enter the room, sit straight, put her hands together in front of the altar, and say, “please recognize me as a new family member” (korekara yorosiku onegaishimasu). it was a rite of passage anthropology & aging quarterly 2012: 33 (3) 100 yoko taniguchi social commitment and well-being among elderly japanese women for the bride to transfer her family membership to her spouse’s family. in addition to the noren, the bride also brought a lacquered multi-tiered food box filled with fresh japanese sweets for the neighbors. the box was wrapped in a colorful wrapping cloth (furoshiki), which is also made using the kaga yuzen dyeing process. although the location and style of weddings have varied in association with the change of lifestyles and values after the world war ii, noren still play a significant role in the wedding ceremony. now, the wedding ceremony venue has shifted from the groom’s family home to a wedding hall, and weddings with christian-style rituals have gained popularity. the rite of passage using noren is still performed in wedding ceremonies with christian rituals in the wedding halls. the patterns and colors for the noren are listed in a catalog provided by kimono shops; thus, a new custom for the bridal noren has emerged, in which brides and their mothers can choose patterns and colors together. the exhibition of bridal noren and expressions of the sense of well-being reinterpretation of the values of bridal noren after a wedding, a bridal noren becomes the property of the bride’s and the family she married into and will not be reused as dowry. however, since it was of no practical use, it was usually put away in a storeroom drawer and was seldom released from there. the exhibition of bridal noren l started when four old-style houses in nanao were registered as important cultural properties in 2004. women in their early sixties, who co-managed stores along with merchants of ipponsugi street, realized the significance of their own noren stored in their drawers and came up with the idea of renewing the face of the street and establishing a historical town. one day a woman asked her friends whether they still kept their noren in a drawer. they looked for her noren in their drawers and found not only their own noren but also their mothers-in-law’s. since most of the norens were kept without moth damage for years, the artistry of the noren was evident.. they consulted with their husbands, who were shopkeepers, about the plan of exhibition of norens and with a neighborhood association as well. in this way, the executive committee for exhibition was organized including five women of ipponsugi as main members. then the exhibition of norens started in 2004 using rooms of the building registered as cultural properties to entertain tourists visiting on the days of seihaku festival. exhibition as mentioned above, exhibitions are held using spaces in the old-style houses during the festival. the women who plan and host the galleries also play the role of guides. they tell the audience about the stories embedded in norens. the story of noren always comes with its owner’s life history and family story. here is an example of the narrative given by a woman in early 60s: this is a noren of the woman born in 1919. she married a successor of the store of ipponsugi during the second world war when she was 18 years old. in spite of a shortage of food and clothes, her mother saved money to make a beautiful noren for her daughter’s wedding. three sets of a chest of drawers filled with kimonos were also given to the daughter. please look at the patterns of a pair of family crests and a pair of court carriages painted on the noren. they are all hand painted and made using the kaga yuzen dyeing technique. the bride’s mother decided all of the patterns of the noren and its arrangement. so, for her daughter, the noren has become a significant object that reminds her of her mother’s love in her life after marriage. noren seemed indispensable for weddings, even during the war. it is bride’s pride and more importantly, it is her natal and conjugal family’s pride. noren is sometimes considered to serve as an amulet to prevent women from misfortune and bring good luck to them after used for wedding, while it is confined to the storeroom drawer (kitani 2008: 22). by telling the story behind their norens, the women look back at their lives as daughters, new brides, and mothers. one of the women said that most of the audiences are women in the same age as them or younger; they are sometimes mothers and daughters and seem to display empathy listening to her story about her noren’s history and the bond that had formed between mother and daughter. it is apparent that she feels a sense of joy when telling the story of her noren and sharing its beauty with people. she said that the activity made her feel “ikigai in the second life.” she told me that she had pursued and felt a sense of ikigai by discovering a new artistic value for bridal noren and telling her story at the exhibitions. the exhibition has since expanded outside the city. the women took their norens with them to tokyo and osaka for exhibitions, hoping to reach a wider range of people. in osaka, they rented an old-style house for a show, and the exhibition went well. it takes approximately five hours by express train to get to the exhibition from nanao. i interviewed an older woman, one of the storytellers of noren, who had just returned from an exhibition in osaka. she expressed her excitement: anthropology & aging quarterly 2012: 33 (3) 101 yoko taniguchi social commitment and well-being among elderly japanese women it was the very first experience for me to communicate with people outside my hometown as deeply as this. thanks to my bridal noren, i was able to meet many people and pass on stories about affection between mothers and daughters that are embedded in the curtain’s beauty. i want to continue this activity as long as possible because this is indeed my ikigai. where does her ikigai come from? how is it different from what she had before she retreated from her household role? what does her ikigai mean to her? i asked her these questions. she answered that she felt a sense of ikigai while fulfilling her household role of caring for her children and elderly parents and managing the family business with her husband. “that is my past ikigai,” she said. although the role of housewife was allocated to her automatically when she married, she got a feeling of satisfaction by fulfilling that role. she continued, “now my son is married, and his wife, my daughter-in-law, has taken over the housewife role, and she is doing very well in it. i have retreated now, but i found my new ikigai during the last stage of my life. my new ikigai is to tell as many people as possible about noren.” the noren has become an object that facilitates communication between the local community and the outside world. with noren as an art object, she seemed to have discovered the broader social world in which she can actively participate. conclusion the elderly women of ipponsugi revaluated the sensuous beauty of bridal noren, reinterpreting it as art object and also discovering their exhibition activity as a place to realize ikigai in their later lives after retreating from earlier household roles. they worked together not only for their own sake but also for the common good of the local community, connecting different generations of the community. sociologist glenn loury6 suggested that such social relationships can be understood as “local public goods.” he used the concept to explain one aspect of social capital that indicated “public education, (…) peer influences that shape the development of personal character, contacts that generate information about the world of work, and friendship networks that evolve among persons situated in the same or closely related communities” (loury 1988: 273). social relationships in local as “local public goods” are intangible but reliable sources that increase opportunities of social commitment. the elderly women also used “local public goods” to extend their social relationships to outside the community. later-life retirement may give one the image of “a phase of regression” or “withdrawal from an active phase” but it is neither. it means nothing other than entering a new phase of the life cycle. in american gerontology, the concept of being “productive” was reconsidered as a concept that included the wide range of activities in which elderly people engage in of their own accord. the concept overarches any activity, whether paid or unpaid, such as housework, childcare, volunteer work, assistance to family and friends, as well as capacity building and self-care (butler, r.n. & gleason, h.p. eds., 1985; howell, n. m., j. hinterlong, & m.w. sherraden 2001). aging is not a negative transition at all, but is a positive and active phase that recreates individuals and their way of living. robert c. atchley argues against previous sociological works, referring to retirement as a “roleless role.” he states that socialization during retirement involves establishing prerequisites at least as much as developing specific knowledge and skills (atchley 2000: 124). one of the specific prerequisites for retirement is to develop leisure skills and ties with organizations in the community (ibid.: 119). doris francis discusses how retirement after 35 years of work is perceived as an opportunity to reassess and renew commitments, explore untapped avenues of creativity, and reconstitute the self (francis 2000: 183). reconsidering the meaning of the concept of “productivity” provides us with an idea for reexamining an inter-relationship between a sense of social commitment and well-being. defining ikigai for oneself is important not only for the elderly after retirement but also for people at any stage of life. acknowledgements this article is based on my presentation “pursing the well-being of elderly women: creating a new meaning for hanayome noren,” comments, and discussions conducted at the session 10 : “recontexualization of technologies and materials pursuing the well-beings in changing aging societies in japan and korea” on august 2, 2011 at chonbuk national university (jeonju), of the 2011 seaa conference organized by korean society of cultural anthropology and american society for east asian anthropology to publicize the results of the project ‘anthropology of caring and education for life’ (2011-2013), a core research project of minpaku (nme: national museum of ethnology) in the domain of ‘anthropological studies of inclusion and autonomy in the human world.’ notes 1 japanese pedagogist hiroaki terasaki contends that “wellbeing” has gained currency as the translation for the japanese word fukushi, which was often used as the translation for the english word “welfare.” referring to michael foucault, he explains that the term “welfare” came to take on a restricted and superficial meaning owing to the overwhelming torrent of the concept of “police” that arose in the seventeenth and eighteenth centuries (terasaki 2010: 22-23). he summarizes foucault’s work, which described policing as a national institution that extended beyond the sphere of civic order, which deals with crime and criminals, to the comprehensive oversight and management of such spheres of life as poverty, anthropology & aging quarterly 2012: 33 (3) 102 yoko taniguchi social commitment and well-being among elderly japanese women hospitals, hygiene, the nursing of children, and schools (ibid.). therefore, the areas subject to policing were the marginal areas underpinning modern society. the concept was referred to as “biopower” by foucault who contended that capitalist states exerted control over people’s birth, morbidity and longevity (foucault 1976: 139-140). foucault defined biopower: “the set of mechanisms through which the basic biological features of the human species became the object of a political strategy, of a general strategy of power, or, (in other words) how, starting from the 18th century, modern western societies took on board the fundamental biological fact that human beings are a species” (foucault 2007: 1) and “an explosion of numerous and diverse techniques for achieving the subjugations of bodies and the control of populations” (foucault 1976: 140). the capitalist states promote people’s better life. this better life is so called welfare. under “welfare,” the old, the sick, children, and other marginalized groups are to be protected and controlled. on the other hand, terasaki stresses that “well-being” is a subjective sense of feeling good, such as when eating, and the resultant visceral sensation in human’s bodies of feeling comfortable, and it must be said to be meaningful life for all living human beings regardless of sociocultural differences (terasaki 2010: 22-23). 2 from an anthropological point of view, mathews and izquierdo regarded it important to consider an inter-relationship between human commonality and sociocultural differences of sense of well-being. they define that “well-being is an optimal state for an individual, community, society, and the world as a whole. it is conceived of, expressed, and experienced in different ways by different individuals and within the cultural contexts of different societies: different societies may have distinctly different culturally shaped visions of well-being. nonetheless, well-being bears a degree of commonality due to our common humanity and interrelatedness over space and time” (mathews and izquierdo 2010: 5). 3 there is an official website on hanayome noren. the url is as follows: http://ipponsugi.sakura.ne.jp/noren/ 4 in the background of the growing interest in revaluation of social connectedness in japan, it is pointed out that there were disasters that frequently struck japan in the last decade. 5 the earthquake killed one person in another city. 6 he primarily discussed concerning the inequality of social capital and how it affected young people of the same community to form social cluster (loury 1988: 273). references atchley, robert c. 2000 retirement as a social role. in aging and everyday life. jaber f. gubtium and james a. holstein eds. pp. 115-124. blackwell publishers. butler, r.n. & gleason, h.p. eds. 1985 productive aging: enhancing vitality in later life. springer. cabinet office, government of japan, 2009 white paper on aging society 2009. coleman, james s. 1988 social capital in the creation of human capital. in the american journal of sociology, vol. 94, supplement: organizations and institutions: sociological and economic approaches to the analysis of social structure, pp. s95-s120. the university of chicago press. foucault, michel 1979 the history of sexuality vol.1. translated from the french by robert hurley. allen lane. 2009 security, territory, population: lectures at the collège de france, 1977-1978. edited by michel senellart, general editors: françois ewald and alessandro fontana, english series editor: arnold i. davidson, translated by graham burchell, palgrave macmillan. francis, doris 2000 the significance of work friends in late life. in aging and everyday life. jaber f. gubtium and james a. holstein eds. pp.175-192. blackwell publishers. hanayome noren exhibition executive committee press 2008 nanao ipponsugi-dori hanayome noren. bunka shuppankyoku. quaterly ginka. ministry of health, labour and welfare 2003 annual report on health, labour and welfare 2002-2003. howell, n. m., j. hinterlong, & m.w. sherraden, 2001 productive aging: concepts and challenges. johns hopkins university press. inaba yoji 2011 introduction to social capital: from isolation to bonds. chuko-shinsho. ishida mitsunori 2011 sociology of isolation: a prescription for unrelated society. keiso shobo. kiley, dan 1989 living together, feeling alone. prentice hall press. kitani makoto 2008 it is beautiful though it is of no practical use in nanao ipponsugi-dori hanayome noren. pp. 20-22. bunka shuppankyoku. quaterly ginka. klinenberg, eric 2010 heat wave: a social autopsy of disaster in chicago. chicago: university of chicago press. 2012 going solo. penguin press. loury, glenn 1989 why should we care about group inequality?. in social philosophy and policy 5(1): 249-271. mathews, gordon 2010 finding and keeping a purpose in life: well-being and ikigai in japan and elsewhere. in pursuits of happiness: http://ipponsugi.sakura.ne.jp/noren anthropology & aging quarterly 2012: 33 (3) 103 yoko taniguchi social commitment and well-being among elderly japanese women well-being in anthropological perspective. pp. 167-188. berghahn books. mathews, gordon & carolina izquierdo 2010 preface. in pursuits of happiness: well-being in anthropological perspective (paperback edition). pp. 1-22. berghahn books. ministry of international affairs and communications 2010/9/19 statistical topics no.48. statistics of the elderly in japan. http://www.stat.go.jp/data/topics/pdf/topics48. pdf, accessed june 10, 2012 nanao city 2009 long-term care insurance plan/ senior citizens welfare plan of nanao city. nhk “unrelated society project” press 2010 unrelated society. bungei shunju oecd 1976 measuring social well-being: a progress report on the development of social indicators. 2001 the well-being of nations: the role of human and social capital. putnam, robert d. 2000 bowling alone: the collapse and revival of american community. simon & schuster. suzuki, nanami 2010 preface. in a study of well-being and life design of elderly people. suzuki nanami, fujiwara kuniko and iwasa mitsuhiro ed. pp. i-vii. ochanomizu shobō. taniguchi, yoko 2011 various means for the pursuit of well-being by japanese elderly women. in international symposium living in a community of resilience: a comparative study on the search for well-being in multicultural aging societies, session ii, creating a place for everybody in the pursuit of the well-being of the elderly, national museum of ethnology, seminar room 4. tachibanaki toshiaki 2011 the real nature of unrelated society: how did social relationship collapse?. php institute. terasaki, hiroaki 2010 nourishing life: an attempt to vitalize the concept of wellbeing. in a study of well-being and life design of elderly people.suzuki nanami, fujiwara kuniko and iwasa mitsuhiro eds. ochanomizu shobo. http://www.stat.go.jp/data/topics/pdf/topics48.pdf http://www.stat.go.jp/data/topics/pdf/topics48.pdf anthropology & aging quarterly 2012: 33 (3) 73 in the previous issue of aaq, we highlighted scholarly work on east asia, one of the most rapidly aging regions in the world and home to a diverse array of cultures. unfortunately, many of the articles that i had hoped to include were still being prepared, including what i felt was an very exciting group of articles from scholars in japan, organized around the theme of aging and materiality. when aaq recieved a unique submission looking at intergenerational communication in mongolia and america, i decided to extend the special issue on aging in east asia to part ii. the result is the current issue, featuring articles that together highlight the importance of the anthropological lens for understanding macro-level social transformations as well as more intimate processes of managing age-related life transitions. choi, giles and hajek’s examination of intergenerational perceptions of communication not only makes an important contribution to social science studies of mongolia in general, but stands out for its use of statistical methods, which provide compelling data linking cultural attitudes and communicative strategies. these quantitative measures allow the authors to present cross-cultural comparisons with an american sample, further setting their findings into relief. using the cpam model of the intergenerational encounter, the authors elaborate on the changing values and relationships in contemporary mongolia that no doubt resonates with the situations in other asian countries where communication between the young, middle-aged and old has profound implications for social integration, care, and continuity. while aaq has not published many quantitative studies, choi, giles and hajek’s work is a strong example of the utility of these methods for helping us to question the salience of cultural norms across cohorts and their influence on behaviors. the following three articles (suzuki, taniguchi, and fujiwara) were adapted from papers originally delivered at the society for east asian anthropology conference “material asia: objects, technologies and rethinking success” in august, 2011. it was a pleasure to have aaq submissions from this exceptional group of japanese scholars, and i sincerely appreciate the earnest efforts made to develop their work for our journal. each article in this group not only show how various objects, materials, and technologies affect older adults’ self-identity, sense of meaning, and agency, but they also illustrate the ways in which materials extend persons into the social and natural world, creating new possibilities for intergenerational relationships, configurations of labor, and political authority. older adults not only remain productive members of their communities, but they are energetic innovators, self-promoters, and keen business-people. suzuki’s ethnographic work on decorative leaf industry in the town of kamikatsu and taniguchi’s study of decorative traditional textiles both show how older adults’ have been able to leverage practical knowledge, experience, and labor in ways that have expanded their skills, created opportunities for new forms of intergenerational communication, and brought about changes not only in wealth, but also in local infrastructure and the social capital of the community. fujiwara goes even further in deconstructing the border between persons and materiality, drawing on older aduts’ beliefs and practices focused on statues of jizō. fujiwara suggests that worshippers’ dependence on jizō, materialized in the practice of vows and the circulation of the statue’s many heads, produces a new understanding of “successful aging,” in which authenticity is not tied to a singular notion of an integral identity, but rather, it is ambiguous, transient, and distributed across bodies and locations. not only have these articles covered a broad range of material engagements, but they have also provided some wonderful photographs to accompany them. to be sure, we have not seen the last of aging in east asia in aaq, as many regions and topic still remain unaddressed in these last two issues. i continue to look forward to more fine submissions for future issues of aaq, including commentaries, photo essays, reviews, and research reports. my sincere thanks to all of the contributors, reviewers, and aage for making this issue possible. jason danely editor from the editor jason danely, ph.d. department of anthropology rhode island college jdanely@ric.edu mailto:jdanely@ric.edu 29(2).indd anthropology & aging quarterly 2008: 29 (2) 44 research report aging, relatedness, and social abandonment in highland peru jessaca b. leinaweaver, ph.d. assistant professor of anthropology brown university jessaca_leinaweaver@brown.edu i recently conducted a month of preliminary ethnographic research on aging in highland peru. during june and july of 2007, i was in the mid-sized andean city of ayacucho (population approximately 125,000). this research report describes the methods and some of the preliminary findings of this project. i come to the anthropology of aging from a broader interest in kinship. in previous research in this region, i investigated “child circulation,” or children’s movements between caregivers, and addressed the specific social, economic, and political meanings of these movements (leinaweaver 2007 and in press). i also considered the role of orphanages. i was interested in the circumstances under which children do not live with their families. in andean contexts, families are extended and kinship solidarity is widely acclaimed, yet there are orphanages for children just as there are long-term care facilities for the aging, and, in both cases, the presence of abandoned children or elderly in those institutions is explained locally by a sense of family breakdown or crisis. thus, i anticipated many similarities between the childhood research and the aging study. i was also interested in this topic because, when studying the circulation of children, i found that occasionally children were asked to move in with and provide company to older relatives or aging community members. in one particularly poignant case, this connected closely to migration: an older widow’s grown children had migrated to europe, and she was accompanied first by her grandson, who stayed behind when his parents migrated, and later – when he rejoined his parents – by another young woman (leinaweaver n.d. and in press). thus, i had already found migration to be a key practice within which care for children and care for the aging might intersect, and i was curious about how increasing transnational migration might affect both elders and children in this population. over the last decade, the numbers of peruvians leaving to seek socioeconomic improvements abroad have increased dramatically, in response to peru’s position within the global political economy (berg and paerregaard 2005). if adult migrants cannot bring their children with them immediately upon leaving peru, then child circulation allows them to meet their parenting responsibilities by ensuring their children are cared for in their absence. however, transnational migrants also rely on child circulation in order to meet important social responsibilities as grown children of aging parents, because they have brought into the household a related child who will accompany and care for the elder. this is as yet a completely understudied phenomenon; the lack of emphasis on aging has obscured the ways in which care is given and received on multiple levels. in order to better understand the intergenerational affects of transnational migration, during this stage of research i focused on philanthropic and governmental approaches to peru’s aging population, using three linked approaches. first, i conducted a few formal interviews and several hours of participant-observation in a local, urban institution designed to assist the aging population. this institution is the asilo de ancianos (or “elderly asylum”) padre saturnino, a home that houses up to 115 elderly and which is run by a congregation of nuns, the hermanitas de los ancianos desamparados or “sisterhood of the unsupported elderly.” this congregation was founded in spain in the 19th century, and they run similar institutions throughout spain and the americas. there are twelve of these homes throughout peru, and the nuns at the ayacucho home (which was founded in the 1960s) explained to me that their efforts are financed entirely through donations (pairs of nuns go out and collect money from community members once a month). secondly, i also spoke with informants of various ages, also living in the city, who shared their understandings of what the home was for and of how aging should work in their particular cultural context. finally, i conducted interviews with individuals representing institutions that are interested in aging (such as the government’s office of senior citizens, or direccíon de personas adultas mayores). ayacucho is a unique setting because of the recent internal war (see, for example, kirk 2005). from 1980 to the mid-1990s, the shining path insurgency and peruvian military and police fought a war that resulted in almost 70,000 deaths and disappearances. a disproportionate number of these were from ayacucho, the desperately poor agricultural region where the war began. i was told that many of the ancianos in the asilo have seen terrible things, like their children being killed, and many had psychological or mental difficulties as a result. since ayacucho is also poor in terms of anthropology & aging quarterly 2008: 29 (2) 45 research report psychiatric or gerontological specialists, the ancianos do not always get the care that they most need, but the nuns do the best with what they have. trained as nurses, they are able to take care of the ill, who reside in a separate infirmary. the institution is designed around two large open patio gardens. the residents are segregated by sex, one patio for the men and one for the women. residents’ dormitory-style rooms, a bathroom, workrooms, and a dining room surround each patio. at least one of the sisters has a green thumb, and the patios are beautiful gardens with doves, peacocks, and even a toucan providing splashes of color. according to inocencio,1 one of the ancianos with whom i spoke, the residents wake at 5:30, attend mass in the asilo’s chapel at 6, eat breakfast at 7:30, sit in the sun until lunch at 11:15, say the rosary at 2:45, sit out again until dinner at 4:45, then go to bed. this routine is embellished with visiting days on thursdays and sundays. i’d been invited to visit daily during the hour or two between lunch and dinner, and during those times i generally found the patios full of twenty or twentyfive residents, for the most part sitting quietly and still in plastic chairs. the chairs and the occasional walker have metal legs, and the patio floors are gleaming polished cement, so, the screeching of a chair being slowly pushed across the patio often drowned out conversations. the experience of being in the home is a challenging one. francisco, a resident who did double duty as the asilo’s doorman, explained to me that the elderly become resigned, or come to accept this life, rather than getting accustomed to it. and, in fact, from my interlocutors who lived in the city, i heard more than one story of an elderly family member who briefly entered the asilo and then left, preferring to be alone in their towns. one of the main difficulties seems to be the sudden shift from a perceived independence to a forced dependence. i asked ernestina if she liked living in the asilo, and she said no, then launched into a story that at first seemed to me to be unrelated. she told me she was from huancavelica (a province adjacent to ayacucho, similarly poor and agricultural), and in huancavelica there are potatoes, barley, wheat, sheep… and her list went on. she showed me with words and hand signals how she would spin wool while tending the sheep, how she would plant seeds and later harvest the produce, and she described to me how delicious fava beans are when mixed with just a few peas and tossed into a soup at the last minute. it’s not like that here in the asilo, she concluded – this is a house, there are no fields.2 catrien notermans has also drawn attention to the larger importance of fields for aging women in cameroon: “they do not willingly abandon their fields as both food and the sharing of it are vital elements in maintaining and creating social relationships, which are crucial for having the feeling of ‘being alive’” (2004:10). i took ernestina’s invocation of her fields to stand for all the activities and tastes and experiences she no longer participated in. as i prepare to expand and continue this research in years to come, my preliminary analysis of this data has revealed a deep and textured understanding of the meaning of what joao biehl has called “social abandonment” (2005). as one of the nuns at the asilo, madre felicitas, informed me, the elderly that they care for are generally “abandoned.” either their families bring them to the asilo saying that they can no longer tend to the aging family member, or the aging person shows up asking to be cared for. the reasons for abandonment are not surprising, and they are similar to the reasons i collected for child abandonment in previous research. these include poverty (the family may be too poor to feed and clothe every family member; indeed, madre fortunata told me that in 1992 when then-president fujimori’s “paquetazo” or sudden sharp increase in all prices occurred, the sisterhood’s homes instantly swelled to the brim with abandoned elderly), the related issue of the demands of work (an elderly person can’t be left home alone, or the absence of jobs in ayacucho require that the caretaker migrate to lima or the jungle), and personal or social transformations (a growing intolerance for the challenges of caring for an aging person). poverty is perhaps the most powerful trigger of social abandonment, and in peru, poverty tends to align with indigeneity. a quick glance at the women’s patio confirms this (as marisol de la cadena has noted, “women are more indian” [1996], so markers of indigenous identity will likely be more visible on women’s persons): all but one of the ancianas wore heavy pollera skirts that mark their indigeneity. a second important theme is the relationship between the ancianos, their caregivers, and their kin. francisco, the recently arrived anciano who attended the telephone and the main door in the nuns’ absence, drew my attention to this relationship as he told me the story of asunción, who brimmed with resentment and anger. her niece had brought her to the asilo saying that asunción couldn’t take care of herself, and because the niece worked, she wasn’t able to keep asunción with her. asunción often raged at francisco, telling him that she hated him when he wouldn’t let her out of the asilo. francisco said tentatively that he thought perhaps the madres are almost complicit with the niece in this case – that perhaps they should intervene, telling the niece that her duty is to tend to asunción, rather than agreeably carrying out the niece’s instructions. anthropology & aging quarterly 2008: 29 (2) 46 having heard this about asunción, i was eager to meet her and hear her side of these events, but, when i first started to approach her, one of the other ancianas told me not to, because being left here by her niece had made asunción go crazy. as one of the nuns told me, asunción “is here against her will.” asunción informed me that her niece comes to take her out on sundays, but, she mourned, only to this little park right on the corner. she asked if i knew her neighborhood, named specific streets, reeled off her address. she asked the sister on duty to tell her niece to take her home, and the nun gently humored her. later asunción told me that she had escaped and one of the asilo’s workers had come to collect her in a car: she felt that they wouldn’t let her leave. at dinner that evening, one of the nuns swept in and retrieved a plastic container full of medicine from the pantry, removing a bottle of anxiety suppressants and telling me that asunción can’t sleep without them. asunción’s grown niece did come on one visiting day, and i caught up with her as she took asunción to the corner to catch a taxi to the other side of town. i asked her about asunción and she said that asunción had lived with them, but she and her husband can’t tend to her now because they work during the day and can’t leave asunción alone. asunción had accompanied her sister until she died, and, in the niece’s view, this affected asunción so much that she became mentally ill and the asilo was the only option. on one of the last days i visited, one of the nuns gave asunción a crochet hook and some wool, and it seemed to work wonders; the next day she was still doing it, and her tears had dried. yet the nun’s small act of kindness, dozens of which i witnessed during my short research trip, cannot obscure the complexity of asunción’s story, which highlights the tensions and ambivalences that inhere in the social relations between resident, family members, and caregivers, as well as the sometimes sharp divergences in their understandings of aging, social responsibility, and appropriate responses to political economic pressures. as my research advances, i am particularly interested in exploring how intergenerational caregiving practices have been transformed by globalization, transnationalism, and increasing rates of out-migration. the findings from this fieldwork in ayacucho’s asilo – the specter of social abandonment and the importance of relationships – remind me that the role of the state and private philanthropic organizations is central, even if only as a foil against which migrants make their caregiving decisions. references berg, ulla d., and karsten paerregaard (eds.) 2005 el quinto suyo: transnacionalidad y formaciones diaspóricas en la migración peruana. lima: instituto de estudios peruanos. biehl, joão guilherme 2005 vita: life in a zone of social abandonment. berkeley: university of california press. de la cadena, marisol 1996 ‘women are more indian’: ethnicity and gender in a community near cuzco. in ethnicity, markets, and migration in the andes: at the crossroads of history and anthropology. b. larson, o. harris, and e. tandeter, eds. pp. 329348. durham: duke university press. kirk, robin 1995 chaqwa. in the peru reader: history, culture, politics. o. starn, c. i. degregori and r. kirk, eds. pp. 354-367. durham: duke university press. leinaweaver, jessaca 2007 on moving children: the social implications of andean child circulation. american ethnologist 1(34):163-180. in press the circulation of children: adoption, kinship, and morality in andean peru. durham: duke university press. n.d. outsourcing care: how peruvian emigrants meet transnational family obligations. latin american perspectives, special issue on peruvian emigration, edited by karsten pærregaard, ayumi takenaka, and ulla berg. notermans, catrien 2004 sharing home, food, and bed: paths of grandmotherhood in east cameroon. africa 74(1):6-27. jessaca b. leinaweaver (ph.d. michigan, 2005) is an assistant professor of anthropology at brown university. between 2000 and 2006, she conducted research on children, gender, and adoption in peru with support from fulbright iie, the wenner-gren foundation, the national science foundation, a jacob k. javits fellowship, and the universities of michigan and manitoba. her 2007 research on aging and transnationalism was supported by the university of manitoba’s centre on aging and a university research grant. she is grateful to kim jones and to two anonymous reviewers for anthropology & aging quarterly for their comments on this report. (endnotes) 1 in order to protect the confidentiality of the people with whom i worked, all interlocutors’ names are pseudonyms. 2 while the asilo is centrally located in downtown ayacucho, it does have research report continued on page 46 anthropology & aging quarterly 2010: 31 (3-4) 47 new publications in anthropological gerontology new publications in anthropological gerontology maria g. cattell i’m looking forward to seeing many of you in new orleans. come by the aage table, say hi—and renew your membership, see and bid on members’ books, buy a tee, sign up to help out (more info elsewhere in this aaq). as always, do let me know about your publications, things i’ve missed, book chapters, articles in specialized journals, whatever: mgcattell@aol.com. abbreviations: ai=ageing international; eja=european j.aging; geront.=the gerontologist; jah=j.aging & health; jaha=j.aging, humanities & the arts; jccg=j.cross-cultural gerontology; jg:ps=j. gero:psychological sciences; jg:ss=j.gero:social sciences; jpa= j.population aging; qhr= qualitative health research; roa=research on aging; sir=social indicators research. *name in boldface indicates aage member. book reviews—of members’ books / by members review of *jay sokolovsky, ed., the cultural context of aging, 3d ed. (praeger, 2009) by *lori l. jervis in jccg 24(3) 2009:319-320. review of *samantha solimeo with shaking hands: aging with parkinson’s in america’s heartland (rutgers up, 2008) by k. dassel in geront. 49(5) 2009:720-723. abuse & neglect gutman, g.m. & c. spencer 2010 age, ageism and abuse: moving from awareness to action. boston: elsevier. aging brennan, m., s.e. karpiak, r.a. shippy, m.h. cantor, eds. 2009 older adults with hiv: an in-depth examination of an emerging population. hauppauge ny: nova science publishers. burns, v. 2010 socially isolated older adults: not so ‘at risk’ after all [canada]. pluralages 1(2):12-13. fahy, g.m., ed. 2010 the future of aging: pathways to human life extension. ny: springer. miller, t.w., ed. 2010 handbook of stressful transitions across the life span. ny: springer. weiner, j. 2010 long for this world: the strange science of immortality. ny: harpercollins. aspects of caregiving ball, m.m., m.m. perkins, c. hollingsworth, c.l. kemp, eds. 2010 frontline workers in assisted living. baltimore: johns hopkins up. beckett, j.o., ed. 2009 lifting our voices: the journeys into family caregiving of professional social workers. ny: columbia up. lavoie, j-p., *annette leibing et al. 2010 a balancing act: serving elderly people with severe mental illness [canada]. pluralages 1(2):14-15. phillips, l.r. & p.g. reed 2010 end-of-life caregivers’ perspectives on their roles: generative caregiving. geront. 50(2):204-214. shabahangi, n.r. & b. szymkiewicz 2008 deeper into the soul: beyond dementia and alzheimer’s: toward forgetfulness care. san francisco: elders academy press. *shenk, dena 2009 moral agency of direct care workers and the people for whom they care. jaha 3(4):285-299. shulman, a.k. 2008 to love what is: a marriage transformed. ny: farrar, strauss & giroux. shulman, n., m.a. silverman, a.g. golden 2009 the real truth about aging: a survival guide for older adults and caregivers. amherts ny: prometheus. anthropology & aging quarterly 2010: 31 (3-4) 48 new publications in anthropological gerontology cognitive aging basting, a.d. 2009 forget memory: creating better lives for people with dementia. baltimore: johns hopkins up. bosworth, h.b. & c. herzog, eds. 2009 aging and cognition: research methodologies and empirical advances. washington dc: american psychological assocation. damianakis, t. et al. 2010 the psychosocial impacts of multimedia biographies on persons with cognitive impairments. geront. 50(1):23-35. hoblitzelle, o.a. 2008 the majesty of your loving: a couple’s journey through alzheimer’s. cambridge ma: green mountain books. innes, a. 2009 dementia studies: a social science perspective. thousand oaks ca: sage. snyder, l. 2009 speaking our minds: what it’s like to have alzheimer’s, rev. ed. baltimore: health professionals press. voris, e., n. shabahangi, p. fox 2009 conversations with ed: waiting for forgetfulness: why are we so afraid of alzheimer’s? san francisco: elders academy press. comparative perspectives: cross-cultural & crossnational ai 35(2) 2010, special issue on “dementia care and chinese culture” [china & u.s.], ed. h. chen & s.e. levkoff. amit, k. & h. litwin 2010 the subjective wellbeing of immigrants aged 50 and older in israel. sir 98(1):89-104. andrews, g.j. & t. muzumdar 2010 rethinking the applied: public gerontology, global responsibility. jag 29(2):143-154. cann, p. & m. dean, eds. 2009 unequal ageing: the untold story of exclusion in old age. bristol uk: policy press. carmel, s., ed. 2009 aging in israel: research, policy and practice. new brunswick nj: transaction. cheng, s-t. et al. 2009 social network types and subjective well-being in chinese older adults. jg:ss 64b(6):713-722. gwodz, w. & a. sousa-poza 2010 ageing, health and life satisfaction of the oldest old: an analysis from germany. sir 97(3):397-417. hashizume, y. 2010 releasing from the oppression: caregiving for the elderly parents of japanese working women. qhr 20(6):830-844. hossen, a. & a. westhues 2010 a socially excluded space: restrictions on access to health care for older women in rural bangladesh. qhr 20(9):1192-1201. hungwe, c. 2010 evaluating older persons’ perceptions on their quality of life in an old people’s institution: a zimbabwean case study. jag 29(3):333351. hyde, a., j. nee, e. howlett, j. drennan 2010 menopause narratives: the interplay of women’s embodied experiences with biomedical discourse [ireland]. qhr 20(6): 805-815. jang, s-n. et al 2009 employment status and depressive symptoms in koreans: results from a baseline survey of the korean longitudinal study of aging. jg:ss 64b(5):677-683. lee, j. & j.p. smith 2010 work, retirement, and depression [korea]. jpa 2(1/2):57-71. lee, j-j. 2009 differences between older chinese men and women from hong kong in the impact of urinary incontinence on their lives. jccg 24(3):307317. lien, s-c., y.b. zhand, m.l. hummert 2009 older adults in prime-time television dramas in taiwan: prevalence, 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65b(4):461-469. peacock, j.p., j.a. o’quin, l. pannell 2009 a method for improving intergenerational encounters: the case of mama bettie. jaha 3(4):266-284. webster, j.d., e.t. bohlmeijer, g.j. westerhof 2010 mapping the future of reminiscence: a conceptual guide for research and practice. jag 32(4):527-564. retirement ekerdt, d.j. 2010 frontiers of research on work and retirement. jg:ss 65b(1):69-80. rural arcury, t.a. et al. 2009 complementary therapy use and health self-management among rural older adults. jg:ss 64b(5):635-643. theory alley, d.e., n.m. putney, m. rice, v.l. bengtson 2010 the increasing use of theory in social gerontology: 1990-2004. jg:ss 65b(5):583-590. diehl, m. & h-w. wahl 2010 awareness of agerelated change: examination of a (mostly) unexplored concept. jg:ss 65b(3): 340-350. hendricks, j., r. applebaum, s. kunkel 2010 a world apart? bridging the gap between theory and applied social gerontology. geront. 50(3):284-293. knight, b.g. & p. sayegah 2010 cultural values and caregiving: the updated sociocultural stress and coping model. jg:ps 65b(1):5-13. widows & widowers van den hoonard, d.k. 2010 by himself: the older man’s experience of widowhood. toronto: u toronto p. anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 59-60 issn 2374-2267 (online) doi 10.5195/aa.2014.43 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review wentzell, emily a. maturing masculinities: aging, chronic illness, and viagra in mexico. durham, nc: duke university press. 2013. isbn 978-0-8223-5491-8 (cloth), isbn 978-0-8223-5506-9 (paper) 224 pp. price $84.95 (hardback), $23.95 (paperback) sarah lamb, phd department of anthropology, brandeis university http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.43 http://anthro-age.pitt.edu book review wentzell, emily a. maturing masculinities: aging, chronic illness, and viagra in mexico. durham, nc: duke university press. 2013. isbn 978-0-8223-5491-8 (cloth), isbn 978-0-8223-5506-9 (paper) 224 pp. price $84.95 (hardback), $23.95 (paperback) sarah lamb, phd maturing masculinities explores the ways men in mexico faced with aging, chronic illness, and decreased erectile function incorporate these experiences into their conceptions of themselves as men. the proliferation of medical technologies for enhancing penile erection has spurred a worldwide medicalization of impotence, offering men new ways to understand changes in their sexual function over time. viagra has found in mexico the developing world’s largest market for the drug (p. 7), and the ubiquity of public discussion about erectile dysfunction or ed, along with the high level of debate within mexico about who mexican men are and should be, made researching male sexuality in mexico a compelling project. strikingly, anthropologist emily wentzell found that the majority of men in her study rejected ed treatment for their own decreasing erectile function. rather than taking drugs to prolong youthful sex lives, male patients—together with their physicians and wives—tended to frame decreasing erectile function as a signal that they should make the shift to an appropriately mature style of masculinity. this eye-opening ethnography is based on an analysis of engrossing and intimate interviews with more than 250 patients in a urology clinic of a government-run regional hospital in the city of cuernavaca. one might wonder how a female anthropologist could manage to talk openly with men about their erections, but several factors came together to facilitate the research. the crowded conditions of the government clinic meant that physicians found little time to discuss anything other than the most pressing medical issues with their patients. urologists tended to ask any man they suspected of experiencing erectile difficulty if he wanted to participate in a study on sexuality. to wentzell’s initial surprise, most did. patients who had long waits for short visits said they appreciated the chance to talk in more depth about their problems and concerns. wentzell’s position as a white, american woman also seemed to help establish the trust (confianza) participants felt. they appreciated that she was a woman, noting that they did not feel they had to compete with her to seem manly; and being american helped, too, as stereotypes about gringas’ comfort with sexuality made the participants feel, some reported, that they could discuss sex without shocking or offending her. the result is a rich, vivid ethnography centered on the intimate narratives of men as they incorporate age-related changes into their gendered selfhoods. rather than casting masculinities as static or uniform, wentzell proposes a model of “composite” masculinities to show how men weave together a range of elements from their life worlds—including cultural ideals of machismo, new biomedical ways of understanding, and physical and social changes—into their evolving ways of being men. most men in the study once regarded an active (hetero)sexuality—the ability to have sex with (often multiple) women—as central to their successful masculinity. however, helped by their wives’ responses—many of whom were reportedly no longer interested in sex and relieved that lack of erectile function lamb| book review anthropology & aging vol 1, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.43 http://anthro-age.pitt.edu 60 might put an end to their husbands’ philandering—older men worked to regard decreasing erectile function as a timely prompt encouraging a masculinity more appropriate to their mature age. this mature masculinity emphasizes not sexual virility but familial togetherness, settling down in the household, and accepting the “natural” bodily changes of age. yet not all narratives were the same. the nuanced ethnography presents as well the painful struggles of some men who deeply missed being able to have sex, felt stingingly embarrassed by what they perceived as the loss of their manhood, and worried that their wives would look elsewhere if they could no longer “provide” for them sexually. wentzell in turn uses the “composite” approach to analyze erectile dysfunction treatment in medical context. few men or doctors attributed their ed to biology alone (even those 11 percent of men in the study using medical ed treatment) but rather were likely to understand erectile difficulty holistically, drawing on composite understandings of health and sexuality that incorporated biomedical, humoral, and emotion-based perspectives. one question that arose for this reader concerns wentzell’s foregrounding of the notion of “penetrative” sex in her analyses. as wentzell conveys: “in mexican and many other cultures, both having a penis and using it to penetrate others are important ways of asserting manhood” (pp. 3-4). yet when wentzell reports that certain interviewees were disappointed no longer to be able to have “penetrative sex,” one wonders whether the men themselves intended to focus on penetration alone in their narratives, or whether they felt more broadly that they were being compelled to give up “sex” altogether? much of the data suggests the latter. in this sense, in some places, the author’s foregrounding of the notion of sexual penetration seems perhaps to be unduly narrowing. overall, though, this is a fantastic, highly successful, and illuminating ethnography. it is one of the best studies on mexico or anywhere on masculinity and aging. the accessible, smart book will be welcomed by students, scholars and the public alike interested in cross-cultural understandings of aging, gender, masculinities, health, medical anthropology, ethnographic fieldwork and writing, and mexico. book review book review designing products for older people’s social and emotional needs: a case study p.j. white pj.white@setu.ie designcore, humanities, south east technological university, carlow, ireland abstract the products that we use in our living environment greatly assist us in maintaining health and independence as we age. much research has been conducted on the physical ergonomic needs in product design for older people, overlooking an understanding of the ‘softer’ functionality that domestic products offer. through an ethnographic case study of older peoples' cooking and heating product needs (n=40), this paper presents 1) a theoretical framework which supports the need for designers to consider social and emotional connections when designing domestic products for older people and 2) practical implications and requirements for future designers to consider when designing these products. in this paper, i encourage designers to consider the reflective and visceral connections domestic products hold and how products can both inhibit and increase social inclusion. keywords: product design; older people; domestic products, emotional design; social design; design ethnography; aging anthropology & aging, vol 43, no 2 (2022), pp. 24-39 issn 2374-2267(online) doi 10.5195/aa.2022.364 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. white | 24 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu designing products for older people’s social and emotional needs: a case study p.j. white pj.white@setu.ie designcore, humanities, south east technological university, carlow, ireland introduction the environment in which we age is central to living an independent, productive, meaningful, and healthy life (davern et al. 2020). the products and, more precisely, domestic products that we use to achieve tasks in our living environment e.g., cooking/kitchen tasks, can assist us in maintaining these circumstances (soar, yu, and al-hakim 2020). much research has been conducted on the physical ergonomic needs in product design for older people, overlooking the ‘softer’ functionality that domestic products offer. the emerging field of socio-gerontechnology has highlighted that social and emotional needs should be understood in future technology and the design of products, services, and environments for older people (bischof and jarke 2021; marston, shore, and white 2020; marston and van hoof 2019; white et al. 2020). acknowledged is that products that are designed to improve social well-being are more likely to improve health and well-being and quality of life (schulz et al. 2014). omnipresent in our daily lives, domestic products embody important emotional connections and can assist us with social aspects of our lives as we age (white 2012, 2018). cooking and heating products are an example of domestic products that possess emotive qualities far beyond their primary functionality. holding many latent emotive connections, their presence in the home provides spaces of comfort and social interaction, offering a sense of home and familiarity, and greatly enhancing emotional well-being (white 2012). this paper presents a theoretical framework that supports the need for designers to consider social and emotional well-being when designing future domestic products. it also presents practical implications and requirements for future domestic designs for older people. the case study this paper draws from ethnographic fieldwork conducted over 12 months within the homes of 40 older adult participants (aged 65-93) across various socio-economic groups in ireland. fieldwork was conducted by the author within the domestic environment, seeking to understand how older people used domestic products, specifically cooking and heating products. the research sought to broadly identify issues (ergonomic and otherwise) older people encountered with these products, the results of which would be used for consideration in future design and redesign. this form of user enquiry is encouraged by researchers in occupational therapy, brenda vrkljan et al. (2019), who state that by proactively involving users early in the design process, potential barriers can be identified and addressed early. regarding the products researched in this study, cooking and heating products come in many formats, shapes, and sizes within the domestic environment of irish homes. these can range from microwaves, stoves, hobs, and cookers to fireplaces, central heating appliances and space heaters. all were considered and observed during this study. http://anthro-age.pitt.edu/ white | 25 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu participant sample strategy since older adults are not a homogeneous cohort, a diversity of participants was required in the study to gain a representative sample. in deciding on a participant sample strategy, i chose to sample older people living in ireland but not necessarily of irish nationality. due to the nature of the research (insight into heating and cooking products), further sample framing was necessary. this included dividing the study equally by gender and distributing the interview sample over a period of time. this was of interest especially in gauging the use of heating products throughout different seasons. to accommodate this, the research was conducted over the span of 12 months, from january to december. access was gained by contacting gatekeepers of older person communities and through full participant consent (white 2013a). prior to fieldwork, two aspects of the sample were undecided 1) should the sample include varying socio-economic classes? 2) should the sample be divided equally over an urban and rural geographical spread? these decisions were made in the field as interviewing progressed, to obtain a balanced study. prior to fieldwork, however, i decided that different forms of domestic settings would be investigated, e.g., houses, (terraced, bungalow etc.), apartments, care-home settings, and retirement homes. deciding on a diverse range of settings enables the viewing of comparative and contrasting product usability. to start the process, purposive sampling was used to identify and select representative informationrich cases (palinkas et al. 2015; patton 2002). however, it was also important that purposive sampling did not limit the study in any way. the framing selection needed to be sufficiently broad to facilitate the development of emerging theories, allowing for appropriate movement between participants as the study progressed. therefore, it was determined that further construction of the sample would be decided and shaped by developing theories within the field. for this, i planned to construct approximately six interviews purposefully and decide on future participants afterwards. methods of sample construction were utilised both before and during the research, allowing the freedom to explore and enquire as my fieldwork progressed. the 40 participants consisted of 15 males, 15 females, and 5 male/female married and cohabitating couples (all self-identified). each participant was over the age of 65 years, had a variety of health conditions, and belonged to different socio-economic groups. both older adult (+65) n=26 (17 female and 9 male) and older-old adults (+85) n=14 (three female and 11 male) cohorts were included in the study, all with varying levels of independence. participants were from a geographical spread of eight counties in ireland, both rural (consisting of three female, six male individuals, and one female/male married couple) and urban settings (consisting of 12 female, 9 male individuals, and 4 female/male married or cohabitating couples). these participants lived in a variety of housing types, ranging from private and government housing to apartments and assisted living environments. nine participants had moved or downsized (to assisted living or gated communities) within the previous 10 years. the ethnographic data-collection methods were informal conversational interviews, participant and artefact observation, and participatory techniques (white 2012, 2013b, 2018; white and devitt 2011). rather than as a structured protocol for fieldwork, the three data-collection methods were introduced when i decided they were appropriate and necessary. each interview lasted between one and four hours. to immerse myself fully and to get the most value from each site visit, the objective to was to remain in the field for as long a duration as possible. data from ethnographic fieldwork was collected via audio recordings and digital photography. this data was analysed post-fieldwork through a grounded theory approach. data was iteratively coded in various stages; first, through manual open coding to reduce and clean the data, then selective coding to identify themes in the data (white and devitt 2021). http://anthro-age.pitt.edu/ white | 26 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu to ensure rigour and validity in the analysis, peer-debrief sessions were conducted (creswell and creswell 2018). each session included a facilitator (the researcher) and one participant (interpreter/reviewer). short memos were documented by both facilitator and participant on a single post-it note and placed beside the coded themes (see image 1 below). image 1. an example of ‘in progress’ images from the peer-debrief sessions. courtesy: author following the analysis, themes and insights were accumulated for consideration in the future redesign of domestic products for older people. the main themes included usability, ergonomics, cost and safety of use, and social and emotional well-being derived from products. the theme of ‘health benefits’ was discovered amongst all of the above. in this article, i focus on the findings of the social and emotional well-being themes. http://anthro-age.pitt.edu/ white | 27 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu emotional well-being i drew upon design researcher don norman’s (2004) levels of emotional state in product characteristics to classify my observations of emotional well-being in the field. these are cited as visceral, reflective, and behavioural connections. from a purely emotive stance, the visceral and reflective levels were continually apparent. therefore, this paper focuses on these two levels. rather than isolated entities, visceral and reflective levels were intrinsically linked. the ‘behavioural level’ was also ubiquitously present but was seen more in product functionality. in the sections below, i outline how these levels emerged during the research. according to designer andreas komninos (2020), norman’s visceral emotive level concerns itself with appearances and refers to the perceptible qualities of the object and how they make the user/observer feel. in product design, norman (2004) claims that visceral level or “wired in” emotive responses relate mainly to the aesthetic values of products. however, in my research, i found that visceral level responses from product aesthetics also appeared to heighten the illusion of functionality, e.g., physical comfort. this was strongest in heating products, with visual aesthetics enhancing the sense of warmth and increasing the physical comfort level in homes. many older people preferred the ‘open fire aesthetic’, having a traditional open fireside visual light or ‘a glow’ emanating in a room providing a sense of heightened comfort. even when heat emission was not active by heating products, this aesthetic provided older people with the comfort to relax and offered them a sense of familiarity and companionship. an ‘open fire aesthetic’ also encourages older people to engage in more activities such as hobbies within environments, providing an active and ‘lively’ focal point in the home. the fireplace provides companionship within the home by offering older people a comforting unimposing presence; both when they are on their own or in the company of guests. in this regard, one participant noted: “i generally don’t use the electric fire, but i do like turning on the glow effect; it makes the room feel comfortable and warm.” in terms of visceral emotive levels, the importance of humanistic qualities in cooking and heating products was noted in the fieldwork. while co-existing with products in the home over many years, some people may describe cooking and heating products anthropomorphically and assign them with attributes of human behaviour. anthropomorphism is a large part of visceral emotive connections, particularly in heating products. some of the older people referred to them by personal ‘nicknames’ and described them with humanistic metaphors such as “waking up the house” and “…it’s the heart of the home.” both cooking and heating products may also represent visceral emotional experiences for older people through family stories, shared occurrences, and significant moments from the past. the products heighten these experiences by being a sensory trigger for smells, sights, and sounds (i.e., traditional cooking, baking, and open fires). these are all positive familiar touch points of ritual domesticity. reflective emotive connections norman (2004) suggests that people have reflective emotive connections with products in many ways such as through personal satisfaction in use and how products can evoke memories and meaning in the user. in this definition, ‘meaning’ within products deals with self-image and how the product ‘reflects back’ on the user. reflective emotive connections from the products that older people use are complex and intertwined with visceral level connections through product aesthetics. there are two main forms of reflective connections in cooking and heating products. from an aesthetic viewpoint, products are used as cues to remember the past and look toward the future. from a functionality viewpoint, products are used as reminiscent and personalisation focal points in the home. http://anthro-age.pitt.edu/ white | 28 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu in the older people’s homes i visited, traditional and contemporary product aesthetic styles coexisted. my informants explained that they did not want to feel stigmatised by ‘old-style products,’ and they openly embraced modern and contemporary product aesthetics within the home. however, a clear ambiguity or tension exists between their desire for traditional aesthetics, reflecting nostalgic tones and those they grew up with, and contemporary aesthetics, reflecting convenience and modernity. this ambiguity existed as a desire to have cues both to the past and future within material objects displayed in the home. in my observations of their domestic artefacts, modern technology with contemporary styling (e.g., laptops, tablets, and smartphones) showed visual outward statements of intent, possibilities for the future, self-sufficiency, and independence. contrasted with these were traditionally styled products (some with redundant functionality). many of the older people used these specifically and explicitly as cues for nostalgia, sentimentality, and memories of positive life experiences. the phenomenon of reflective emotive connections and aesthetics is seen further in product functionality. as a secondary function, cooking and heating products are some of the main visual focal points in the home. fireplaces, stoves, cookers, and microwaves (see image 2) provide affordance for displaying material possessions. image 2. a participant uses their microwave as a display focal point for memories and mementos. courtesy: author these products act as congregation points for important and sentimental material goods such as photographs, awards, mementos, religious artefacts, and many others. within this functionality, there were strong connections between older adults and emotive, nostalgic, and narrative values in the displayed material items. a typical example of this is shown in image 3. in this instance, a participant’s fireplace has been made redundant of its heating functionality; however, it is now used for its emotive qualities, displaying the older adult’s important personal possessions. the participant explained: “my fireplace is blocked up, but i like to keep all my stuff there.” http://anthro-age.pitt.edu/ white | 29 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu image 3. an unused fireplace becomes a “reminiscent focal point” for one research participant’s important material possessions. courtesy: author this gathering of important items for display assumes a highly emotive function for some older adults, suggesting that these are “reminiscent focal points” (white and devitt 2011) in the home. developing these emotive functions in products further is of topical interest. recent research on dementia indicates that the positive effects of reminiscence and remembered experiences may improve the quality of life, cognition, and communication of older people (woods et al. 2018). this is particularly positive for but is not restricted to, older people living with dementia. in future design development, human-computer interaction researchers amanda lazar, hilaire thompson, and george demiris, demonstrate the benefits of developing information and communications technology-supported reminiscence therapy for older people (2014). reminiscence therapy can involve a range of activities to create positive memory triggers, from music interventions and memory-box activities to life storybooks (macleod et al. 2020). as i found, the display of material items on and in the proximity of cooking and heating products provides further affordance for personalisation. designing future products with elements of personalisation could promote positive mental health in older adults through acts of reminiscence and may also add to their comfort and familiarity within the domestic environment. in my research, acts of personalisation were seen as distinctly important during transitional periods in later life. the concept of personalisation provides an older person with a more familiar and comfortable environment in times of radical transition. moving home in later life is a major event on multiple levels. this event is particularly emotionally distressing if a spouse has recently passed away or if one is moving out of a home that contains lifelong memories. as in many cases with moving in later life, one is often downsizing to a smaller dwelling. therefore, only essential items generally accompany this change of life. the fundamental products older adults have in this transition, and the ability to personalise these may be essential to their emotional well-being. http://anthro-age.pitt.edu/ white | 30 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu social well-being social inclusion is a basic need for all humans. built environments and living spaces have a bearing on loneliness and social inclusion (lyu and forsyth 2021). from my research, domestic products play a wide and complex role in older people’s sense of social inclusion. i observed in the field that an older adult’s ability or inability to use these products seemed to affect their levels of inclusion. both positive and negative social experiences are derived from the inability to use products and poorly designed usability features. this leads to sometimes more, and at times, less social interaction. in terms of more social interaction, i observed that heating products, for example, provided focal points for social activity, assuming ideal natural gathering points for social interaction, (image 4) places where memories, stories, and events can be contained, recalled, and shared. image 4. a fireplace with seating close by, a gathering point for social interaction. courtesy: author the emotional well-being connections discussed previously have a direct correlation with social connections involved in cooking and heating products. this correlation may stem from social interactions involving these products, their users, and others. heat and heating of the home influence social interaction (basham, shaw, and barton 2007), my research showed that heating products create both social and emotional hotspots in the domestic environment. the previously discussed reflective emotive act of reminiscence seems to create an important individual/personal experience and shared/social experience. when older people are on their own, reminiscence may be a positive, reflective, and comforting experience for the individual. when shared with others, it often evolves into a rich social experience through sharing conversations, stories, and memories. this sharing, in many cases that i observed, becomes part of a daily and weekly routine that further increases social integration. participants in this study viewed domestic-product usability as a balance between independence and social interaction, and new products created should allow for this balance. specific examples were seen both in cooking and heating products and, most notably, the usability of controls in these products. http://anthro-age.pitt.edu/ white | 31 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu strong social bonds may be created by using peripheral control products such as thermostats and temperature switches. in one respect, the use of controls (e.g., thermostats) is necessary for independence in the home. however, family, friend, or carer interaction and involvement in the operation of these provide both social contact and peace of mind for everyone involved. these controls also provide a sense of security and safety for users, families, and carers. in some situations, an older person’s inability to operate these controls is their only opportunity for social contact; typically, through the intervention and assistance of a family member. one example of this was when a participant was discussing their thermostat: “i don’t understand how to use it, so i just leave it on” but mentioned they welcomed the social interaction when a family member came to visit to help them operate the thermostat, setting it up for the week ahead. from my research, dining and eating with family and friends provide one of the most effective means of social inclusion for older people. many older people rely on this as a daily or weekly source of interaction. whether it is visiting friends, neighbours or family, having daily meals in a communal space, or being visited in their own home, dining in company provides an essential routine and strengthens the sense of self and independence. thus, an inability to cook or provide meals can have negative effects on health (plastow, atwal, and gilhooly 2015). from my research, this is seen to not only lead to nutritional issues but also associates itself with older people being socially excluded. image 5, for example, illustrates the unused dining space of a female research participant who, after a series of falls, had sustained injuries to her wrists and could not cook to her desired standards anymore. prior to this, her main social outlet was to entertain friends at dinner parties with her talent for cooking. she has had fewer visitors to her home since her falls and her inability to cook and stated: “i miss hosting my dinner parties; after my falls, i can’t cook well.” image 5. this image shows an example of unused dining space. a research participant feels socially isolated following several falls at home. her dinner parties were her only social outlet, and these have ceased due to her inability to cook. courtesy: author http://anthro-age.pitt.edu/ white | 32 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu the act of cooking is more than the provision of personal daily nutrition. cooking is an outward gesture of ability, a statement of independence and self-sufficiency, all of which enhances social involvement and sense of purpose (fitzsimmons and buettner 2003). my research found that for older irish men and women, the ability to cook for themselves is a strong source of pride, and a statement of self-confidence and independence. pride is enhanced when offered a platform to demonstrate ability rather than disability to their peers, friends, and family. my research indicates that cooking products should and can be designed to enhance a demonstration of ability rather than disability in the older person. the research from this case study suggests that the social role of these products becomes more complex when associated with emotional, health, financial, and mobility themes. these products, whether heating sources or cooking appliances are essential domestic social touchpoints, fostering positive social inclusion in older people. financial costs financial costs of energy and the usage of daily household energy was an omnipresent topic throughout this study, and this is even before the current energy crisis in europe. this occurred across all of the participants, whether they were financially comfortable or struggling daily with financial issues. in ireland, there are many energy price discounts available for older people together with manageable payment plans; however, many of the research participants noted that these still fall short of relieving a pervading and underlying fear of energy costs and usage. cooking and heating products and appliances are central to this fear of increased energy usage in the home. older adults in the study also suggested that cost factors may have a direct effect on their sense of social inclusion, which i discuss below. this is further heightened when linked with mobility issues, which diminishes pride and, more importantly, can be damaging to both physical and mental health. due to ireland’s generally mild and cool climate with inclement weather year-round, high energy costs remained constant for older people in my study. as irish people get older, they are also more likely to live alone, which may affect their ability to maintain and manage their accommodation (orr et al. 2016). throughout the research, cooking and heating products were essential in making the domestic environment more comfortable and healthier for older adults to live in for extended periods. one of these comforts was ‘thermal comfort’ provided by heating products, with the appropriate level of this critical in the home. the combat poverty agency (2008) claims that this is essential in supporting health and human activity in the home with the appropriate temperature being between 16 and 21 degrees celsius. in the field, i noted that when internal temperatures were reduced and thermal comfort was neglected, it was extremely problematic for both older adults’ health and social inclusion. the main catalyst for reductions in thermal comfort was the issue of high energy costs. this reflected findings by researchers kathy walsh and brian harvey indicating that fuel and heat costs are the greatest financial point of pressure for older irish people (2011). i continually observed instances of research participants dipping in and out of suspected ‘fuel poverty.’ fuel poverty, although complicated to measure, is cited as involving a mix of energy efficiency, household incomes, and fuel costs (grey et al. 2017a; mcavoy 2007). traditionally, the issue of fuel poverty is prevalent across all age groups; however, older people, due to factors discussed previously, are often the most susceptible to its hardships (walsh and harvey 2011). it was noted in my research that as a result of fuel poverty, a proportion of participants live in a smaller area of their dwelling, usually in the corner of a ground floor room centred in proximity to a localised heat source such as a radiator. in many cases, the remaining house is left unused, prone to disrepair due to lack of use, and open to health hazards through dampness and deterioration over time. this phenomenon in living environments has been described as “spatial shrink” (grey et al. 2017b). this http://anthro-age.pitt.edu/ white | 33 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu is a growing concern among people experiencing impoverished conditions or susceptible to fuel poverty. spatial shrink is not just isolated to impoverished cases; i also observed this in the field among older people with mobility issues, particularly among participants with both financial and mobility issues. image 6 illustrates how a research participant’s entire home shrunk to the size of her living room due to economic and mobility issues. the remaining home remains unheated, leaving it exposed to dampness and deterioration. the participant stated: “i never go upstairs anymore because the stairs are too steep, and it costs too much to heat the whole house.” image 6. spatial shrink due to economic and mobility issues. courtesy: author the energy efficiency and quality of homes and products are a large contributing factor to high energy costs and spatial shrink (grey et al. 2017a, 2017b). it is not just older dwellings and poorer participants that are susceptible to this; i interviewed financially stable people who also require more energyefficient means of heating their homes. in many instances, homes were relatively new buildings, however large in scale. in these cases, i observed that spatial shrink was evident as a result of mobility issues. to achieve more energy efficiency, some older people attempted extreme intervening actions and modifications to their homes and products. for example, one participant who covered his fireplace said, “i put my best blanket on the fire because of the cold that comes down the chimney; i don’t light it ‘cos the heat goes straight out the chimney” (see image 7). in terms of product selection and purchase, some older people in my study associated energy-efficient use with using smaller scale appliances such as small tabletop ovens. http://anthro-age.pitt.edu/ white | 34 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu image 7. a research participant managed the issue of heat efficiency in their living room by covering the fireplace. courtesy: author in cases of spatial shrink, it is not just the occupant’s physical home that is affected; people’s selfconfidence and pride may also suffer. my research with older irish people suggests that pride is an everpresent factor concerning household appearance; this pride is seriously diminished when they have to rearrange their living environment due to spatial shrink. this was particularly ubiquitous when older people were restricted to the downstairs floor of their homes solely due to mobility issues. a common occurrence was moving a bed downstairs to the ground floor (as in image 6). participants told me that they felt a deep embarrassment in using their living room or kitchen as a sleeping area due to mobility or cost issues. albeit practical, having a private personal space such as a bed in full view of visiting guests may portray personal or physical weakness. many of my participants said they were less willing to have guests in their homes because of this. being confined to limited rooms of the home also resulted in exposing parts and objects of the home they would rather not, such as mobility aids, which could visually communicate and heighten their sense of vulnerability. implications and requirements for future design post fieldwork, a list of design requirements and features was drawn up for early-stage design conceptualisation, which is shown in table 1. to draw up this list of requirements, it was important to achieve a balance of explicit and implicit meaning. moreover, it was essential to have a set of defined design requirements without diluting the ‘voice’ of the end-user. reinforcing this point, designers karl ulrich, steven eppinger, and maria yang, state that design requirements should be expressed as the language of the end user (2019). table 1 shows the social and emotional requirements list under their assigned ‘requirement or feature,’ and the product category that the requirement falls under, either cooking or heating. the final list of requirements was ambiguous in meaning, which was done intentionally to allow for creative movement at the conceptualisation stage. however ambiguous, the table was a firm advancement in defining what these products should physically embody. http://anthro-age.pitt.edu/ white | 35 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu this list of requirements was used as the basis to create early design ideas through sketch conceptualisation. figure 1. shows an example of one idea that was generated through this conceptualisation. s p a ce h e a ti n g f ir e p la ce /s to v e c o o k e r o v e n c o o k e r h o b social requirement/ feature localised heat for warm gathering points in the home • • promotion of meals for social interaction • • products/features that enhance the ability of the user • • • • family/carer shared controls • • • • emotive requirement/ feature display area to show personal or nostalgic items (reminiscence) • • personalisation of heating products • • warm aesthetic (e.g. traditional open fire) • • products/features that provide comfort in familiarity • • • • areas of cooking products that one could personalise • contemporary aesthetic • • • • traditional nostalgic aesthetic • • • • nostalgia in cooking and baking • • table 1: design requirements and features list http://anthro-age.pitt.edu/ white | 36 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu figure 1. example of an early-stage sketch conceptualisation idea ‘the social and emotional fireplace.’ sketch created by author conclusions domestic products should provide for basic health needs, thereby enhancing well-being and improving older adults’ quality of life. when considering health needs, designers of domestic products should understand and enhance the ‘softer’ functionality that these products offer to help meet social and emotional needs. concerning emotional well-being, this paper encourages designers to consider reflective and visceral emotive connections. this means that, from an aesthetics viewpoint, designers should consider how products can be used as cues to both the past and the future. from a functionality viewpoint, they should consider how products could be designed as reminiscent focal points in the home. future products should be designed with elements of personalisation that can promote positive mental health through acts of reminiscence and add to an older person’s sense of comfort and familiarity within the domestic environment. from a social perspective, this research has shown that both positive and negative social experiences are derived from the inability to use products and poorly designed usability features (e.g., social exclusion from the inability to cook or poor thermostat design). the use of domestic products is an outward gesture of ability, a statement of independence and self-sufficiency, all of which enhance social involvement and maintain pride and individual well-being. participants in this study viewed domesticproduct usability as a balance between independence and social interaction, and new products created should allow for this balance. my research also found that economic factors may have a direct effect on an older person’s sense of social inclusion. this is heightened further when linked with mobility issues, diminishing pride, and negative effects on physical and mental health. this research has highlighted that social and emotional needs should be understood deeper in the future design of products, services, and environments for older people and central to future studies within the field of sociogerontechnology. http://anthro-age.pitt.edu/ white | 37 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu acknowledgements this work was supported by the maynooth university john & pat hume doctoral scholarship award. the author declares that they have no conflict of interest. all procedures performed in studies involving human participants were in accordance with the ethical standards of the institution. consent was obtained from all individual participants included in the study. references basham, meryl, steve 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https://doi.org/10.1080/02701960.2019.1572010. walsh, kathy, and brian harvey. 2011. “report of the commission of older people.” society of st vincent de paul. http://www.svp.ie/social-justice/older-people-s-commission/older-people-s-commission-report.aspx. white, p.j. 2012. “designer as ethnographer: a study of domestic cooking and heating product design for irish older adults.” phd, department of design innovation, national university of ireland maynooth. http://mural.maynoothuniversity.ie/4740/1/phd%20thesis_pj%20white.pdf. white, p.j. 2013a. “concept development board of a domestic heating product for older adults.” ethnographic praxis in industry conference proceedings (1): 407-407. https://doi.org/10.1111/j.1559-8918.2013.00038.x. ----. 2013b. “ethnography in design for older people.” proceedings of the 2nd european conference on design 4 health, sheffield, uk https://core.ac.uk/download/pdf/34614893.pdf#page=62. white, p.j. 2018. “designing a domestic heating product for older people within the concept of ‘contained living spaces.’” in ideas, products, services ...: social innovation for elderly persons. edited by b. and urdaneta worsfold, e., 159-169. edicions i publicacions de la universitat de lleida. https://www.researchgate.net/publication/340967610_designing_a_domestic_heating_product_for_old er_people_within_the_concept_of_'contained_living_spaces. white, p.j., and frank devitt. 2011. “the design and development of novel cooking and heating products for irish older adultsa real health need.” design principles and practices: an international journal 5 (3): 13. https://doi.org/10.18848/1833-1874/cgp/v05i03/38081. white, p.j., and frank devitt. 2021. “creating personas from design ethnography and grounded theory.” journal of usability studies 16 (3): 156–178. https://uxpajournal.org/personas-ethnography-grounded-theory/. http://anthro-age.pitt.edu/ http://www.publichealth.ie/files/file/fuelpoverty_0.pdf https://www.doi.org/10.38018/tildare.2016-02 https://doi.org/10.1007/s10488-013-0528-y https://doi.org/10.1093/geront/gnu071 https://doi.org/10.1080/02701960.2019.1572010 http://www.svp.ie/social-justice/older-people-s-commission/older-people-s-commission-report.aspx http://mural.maynoothuniversity.ie/4740/1/phd%20thesis_pj%20white.pdf https://doi.org/10.1111/j.1559-8918.2013.00038.x https://core.ac.uk/download/pdf/34614893.pdf#page=62 https://www.researchgate.net/publication/340967610_designing_a_domestic_heating_product_for_older_people_within_the_concept_of_'contained_living_spaces https://www.researchgate.net/publication/340967610_designing_a_domestic_heating_product_for_older_people_within_the_concept_of_'contained_living_spaces https://doi.org/10.18848/1833-1874/cgp/v05i03/38081 https://uxpajournal.org/personas-ethnography-grounded-theory/ white | 39 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.364 http://anthro-age.pitt.edu white, p. j., hannah r. marston, linda shore, and robbie turner. 2020. “learning from covid-19: design, agefriendly technology, hacking and mental models.” emerald open research 2 no. 22 https://doi.org/10.35241/emeraldopenres.13599.1. woods, bob, laura o'philbin, emma m. farrell, aimee e. spector, and martin orrell. 2018. “reminiscence therapy for dementia.” cochrane database of systematic reviews (3). https://doi.org/10.1002/14651858.cd001120.pub3. http://anthro-age.pitt.edu/ https://nam11.safelinks.protection.outlook.com/?url=https%3a%2f%2fdoi.org%2f10.35241%2femeraldopenres.13599.1.&data=05%7c01%7cjwoodwa6%40gmu.edu%7c448d190cfc9445603eed08dac99ed29b%7c9e857255df574c47a0c00546460380cb%7c0%7c0%7c638043981228129513%7cunknown%7ctwfpbgzsb3d8eyjwijoimc4wljawmdailcjqijoiv2lumziilcjbtii6ik1hawwilcjxvci6mn0%3d%7c3000%7c%7c%7c&sdata=lpsodjiuggvcoulxspaxd81m67lbxv%2boshulq4bn5%2bg%3d&reserved=0 https://doi.org/10.1002/14651858.cd001120.pub3 33 (2).indd anthropology & aging quarterly 2012: 33 (2) 30 this issue is special, not only because it highlights some of the great work of anthropologists on aging in east asia, but also because, as you the reader have no doubt noticed, aaq has changed in both design and content. in terms of the latter, aaq will no longer function as both journal and newsletter for aage, but will focus entirely on scholarly content. these changes are part of an ongoing process of increasing our professionalization as an organization and providing the best venue for contributors to our journal. i hope to hear more from members on what they think of these changes, and welcome additional suggestions. as scholars of aging and the life course know, maturing is something best done with others and lots of support. i am proud to introduce the first special issue of aaq on anthropology and aging in east asia. east asia is home to the most rapidly aging countries in the world, all of which are highly influential in global aging discourse. in japan, the percentage of the population aged 65 and older rose from 7% in 1970 to 14% in 1994, making it the first nation in the region to experience this rapid shift to a “super-aged society,” but others are not far behind. china’s population is estimated to reach the same benchmark by the year 2026, and south korea even sooner. while other countries around the world are experiencing population aging, they have done so at a much slower pace. it is estimated that the 65 and older population in the united states will reach 14% by the year 2015, having taken 73 years to double in size. in contrast, this change occured in a mere 24 years for japan, and will occur in 25 years in china. this rapid demographic change is the result not only of increased longevity in east asia, but declining fertility as well. as a result, the entire composition of social institutions from families to welfare systems, to employment, healthcare and education must be radically rethought. aging in asia alters the relationships between mothers and daughters as much as the relationships between citizens and states. this issue begins with two commentaries on aging in japan, each bringing a different perspecive to bear on the subject of aging in asia. ayumi takenaka’s commentary highlights the challenges and contradictions of population aging, which has far-reaching implications not only for japanese cultural identity, but for international movements of people and their labor. the state’s gestures towards encouraging skilled migrants is challenged by other’s reluctance to make dramatic changes towards multiculturalism. in contrast to this regional and policy perspective, susan o. long writes about the insights drawn from ethnographic interviews with the very old. these voices offer lessons to anthropologists about what life looks like in old age, as much as they point to the work still to be done. megumi kondo continues long’s reflections on finding meaning in late life, by introducing us to a japanese woman’s last days on the hospice ward. kondo shows how the physical, emotional and spiritual experience of aging and dying is not summed up neatly in a few wise words; the process of making it all meaningful and paying attention to the events around her continued to shape this woman’s life unti lthe very end. wonjee cho and denise c. lewis’s article on south korean aging points out the articulations and dissonances between embodied subjective feelings of aging, cultural beliefs about temporality and political categories of aging. their research on the transition to old age echoes the uneven transitions of societies in flux. each of these articles contributes to the growing literature on aging in asia, and it was a pleasure to put this issue together. my thanks to all of the contributors and reviewers for their hard work in helping to put this issue together, and to aage for their support in for the journal’s mission. jason danely, editor from the editor jason danely, ph.d. department of anthropology rhode island college jdanely@ric.edu book review review of gangopadhyay, jagriti. culture, context and aging of older indians: narratives from india and beyond. singapore: springer. 2021. pp. xxxiii, 132. price: $120 (hardcover); $97 (ebook). ketaki chowkhani manipal academy of higher education kchowkhani@gmail.com anthropology & aging, vol 43, no 1 (2022), pp. 81-83 issn 2374-2267 (online) doi 10.5195/aa.2022.392 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | chowkani | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.392 http://anthro-age.pitt.edu 81 book review review of gangopadhyay, jagriti. culture, context and aging of older indians: narratives from india and beyond. singapore: springer. 2021. pp. xxxiii, 132. price: $120 (hardcover); $97 (ebook). ketaki chowkhani manipal academy of higher education kchowkhani@gmail.com culture, context and aging of older indians examines the subjective experiences of older indians in various cultural contexts. through a multi-pronged approach, this book explores all relevant facets of aging such as inter-generational relationships, filial piety, care within and outside the family, transnational aging and identity, global aging of elite couples in metropolitan india, and aging alone. it is a first-of-its-kind study within gerontology since it adopts a qualitative and multi-sited approach. jagriti gangopadhyay here covers the experiences of older indians living in different regions of both india and canada. this publication is timely and relevant within aging studies and examines how the ‘successful aging model’ is adopted in various ways, through the eldercare homes, to business families in gujarat, to elite couples in delhi, and widowed older adults in kolkata. the book is rich in ethnographic data, which include in-depth narrative style interviews, and each chapter has the potential to become an entire book. as such, gangopadhyay effectively opens up a vast area of research on social gerontology in india. gangopadhyay’s methodology together with her critical gerontological analysis make for some surprising findings. she demonstrates how indian older adults maintain agency over their lives, like the members of the business communities in gujarat (chapter 2) and the elite couples in urban delhi (chapter 4). the older adults in gujarat maintain agency by retaining authority in their family business and over their children’s lives. the elite couples in delhi, on the other hand, resort to the global market of anti-aging to remain healthy and look younger. these findings challenge the notion of dependency and loss of agency in old age. gangopadhyay’s analysis of the role of religion in aging among older adults in saskatoon (chapter 6) is also an insightful examination of the complexities of older adults lives. these older adults deal with grief, loss, and lack of community by turning towards religion. since older adults’ turn to religion is often associated with a manifestation of fundamentalism or conservatism, the author here contrarily points to the ways in which religion can become a source of meaning and comfort rather than sectarianism for these older adults. it is a way for them to sustain and build one’s life. i found “loss of a life partner: self-isolation in urban kolkata” (chapter 5) to be the most interesting chapter. here, the author traces the modes of grieving among indian men and women who have lost a spouse and succeeds in presenting three fascinating insights on the impact of this life event. through her interviews, she notes that today, in an indian context, death and grieving is more of an individual http://anthro-age.pitt.edu/ book review | chowkani | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.392 http://anthro-age.pitt.edu 82 and personal process than a social experience. older people are more likely to grieve in isolation. she uses disengagement theory (cumming and henry 1961) to analyze how older indian adults, especially in kolkata, are detaching themselves from worldly pleasures as well as family ties after the loss of a beloved one. since most of the adults she interviewed were solely engaged in looking after their ailing spouse, the latter’s death rendered these older adults’ lives meaningless. they are faced with the question of how to regain purpose in life. here gangopadhyay surprisingly shows how solitude, selfisolation, and living alone is exactly what helps these older adults overcome their loss, prevent depression, and fight loneliness. through the interviews, she analyses how older adults use activities such as self-development, yoga, listening to music, etc. as aids in overcoming loss. these findings contrast starkly with how governments in the western context are trying to avoid self-isolation and foster increased social interaction among older adults (kislev 2019). thus, gangopadhyay’s book adds to the valuable body of research on aging, living alone, and solitude (see e.g., bella depaulo 2020) by letting her ethnographic data speak back to a hegemonic ethos that equates aging and loneliness with a loss of agency, self-governance, and meaning in life. the second novel finding is that the close encounters with the death of a spouse makes the older adults that are left behind lose their fear of death. the author’s third important contribution to a nuanced understanding of aging, agency, and sociability is the introduction of a cultural reading of this selfisolation. building on previous studies, she coins the term ‘enforced sanyasa1’ as a way to understand this phase of life and the positive role it comes to play. gangopadhyay reads this self-imposed sanyasa as a new form of agency that also enables a detachment from emotional bonds and worldly life. she notes that this form of solitude plays a crucial affective role in older adults’ lives. in tracing these different forms of agency – of solitude (chapter 5), of retaining authority over the family business and children (chapter 2), and of maintaining health and fitness (chapter 4) – gangopadhyay is effectively proving and demonstrating the successful aging model, as well as overturning the popular discourse of helpless older adults. some other remarkable findings in the book would have benefited from a little more analysis. in chapter 4, we see that elite couples, while following global models of aging, continue to perpetuate traditional gender roles among themselves. gangopadhyay provides only a surface account of elite culture and global models, and fails to explicate it further, especially in relation to gender and aging. similarly, in chapter 6, she notes that the indian identity takes precedence over the canadian one among aging indians in saskatoon (canada). gangopadhyay could have analysed the reason for this to provide us an insight into how transnational identities are formed. throughout the book, the author also examines inter-generational relationships, especially between older adults and their adult children. it might have enriched the book to draw on the cultural trope of villainous adult children and elder abuse in indian cinema, of which baghban (2003) is the most famous example, to contextualize this better. methodologically, gangopadhyay adopts a self-reflexivity that is refreshing for an academic book. she recounts how her caste, religion, gender, marital status and educational background inform her interactions with the participants, and in turn affects the data that she collects. this is important because it reveals more about the field, older adults and their perceptions regarding family, marriage, gender, caste, and religion, than mere interviews. the book will be useful to students since it presents them with a model for gerontological research, starting from designing the research to the complexities of fieldwork, self-reflexivity, analysis of data, and possible contributions to theory and recommendations for policymaking. this text must also be read by indian policymakers since it offers important insights into how the state might take appropriate responsibility for its aging population. it will also be of interest to lay readers in india, especially those who are aging themselves, or who have aging parents, http://anthro-age.pitt.edu/ book review | chowkani | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2022.392 http://anthro-age.pitt.edu 83 to understand the issues older adults face. the book, while being academically rigorous, is written in an accessible manner, which is its major strength and will ensure its reach to a wider audience. notes 1. sanyasa is the last phase of the fourfold life cycle in the hindu system. after fulfilling their household duties, an individual gives up all worldly attachment and enters into sanyasa, as a way to achieve salvation. references chopra, ravi, dir. 2003. baghban. b.r. films. cumming, elaine and william henry. 1961. growing old, the process of disengagement. new york: basic books. depaulo, bella. 2020. “old and alone: even professionals do not understand this.” psychology today. https://www.psychologytoday.com/us/blog/living-single/202011/old-and-alone-even-professionals-donot-understand?fbclid=iwar39wheamer6givyqljm8fzj_srp6xx8ilmv5cptyricck21xf3jwcrkyc4. kislev, elyakim. 2019. happy singlehood: the rising acceptance and celebration of solo living. california: university of california press. http://anthro-age.pitt.edu/ book review review of walton, shireen. ageing with smartphones in urban italy: care and community in milan and beyond. london: ucl press. 2021. pp. 208. price: $63.7 (hardcover); $35.4 (paperback); open access (pdf). irina kretser saint petersburg state university kretser@list.ru anthropology & aging, vol 44, no 1 (2023), pp. 115-117 issn 2374-2267 (online) doi 10.5195/aa.2023.473 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | kretser | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.473 http://anthro-age.pitt.edu 115 book review review of walton, shireen. ageing with smartphones in urban italy: care and community in milan and beyond. london: ucl press. 2021. pp. 208. price: $63.7 (hardcover); $35.4 (paperback); open access (pdf). irina kretser saint petersburg state university kretser@list.ru ageing with smartphones in urban italy by shireen walton is a leisurely journey through the ‘nolo’ district, an inner-city neighborhood of milan. the author introduces readers to nolo’s inhabitants, their expectations and practices of aging, and the role of smartphones in their lives. while throughout the book aging is inevitably interwoven with digital space and smartphones, each chapter of the book reveals different angles from which aging is conceptualized and experienced in italian society. the empirical data for the book were collected during sixteen months of ethnographic fieldwork based on participant observation. however, the digital dimension also matters for the research. recognizing the limitations of classical neighborhood ethnographies, the author “foregrounds the neighbourhood and its related (and wider) digital environments as a locus of social life and ethnographic enquiry, [... and] investigates the social economic and digital networks that emanated from within nolo and also traversed spaces of the city of milan, and which operated transnationally” (15). in an introductory chapter (chapter 1) walton explains why transnational and translocal spaces matter in this research. the author starts with a brief description of demographic changes in modern italy and milan – such as the aging population and high rates of both immigration and emigration – and points out that these processes are accompanied by significant developments in digital technologies. the author describes how these processes affect the nolo district and recalls the term ‘super-diversity,’ presenting nolo as a crossroads of different cultures, classes, and architectural styles. what does aging and ‘being old’ mean for different social actors in italy? in chapter 2, the author traces the crucial transformation of the aging policy in modern italy from “active aging” to “active welfare” (24). while the former focuses on the aging process as a failure and a source of problems that need to be prevented or overcome, the latter foregrounds how sociality and community emerge through shared activities such as yoga classes or language courses in multigenerational and multiethnic contexts. in the latter, healthy aging matters, but it is just a part of broader narratives of active welfare, which gives people the opportunity not to feel old and to engage in various activities without considering age classification. for example, adela, one of the research participants, aged 73, says: “i am too busy to be old. i have no time to die” (24). in chapter 3, readers are introduced to the range of activities that form the “spirit of togetherness” (58) among nolo inhabitants. environmental activism groups, guided walking tours, educational activities in the multicultural center, and choirs are some of the opportunities for sharing time, engaging with the community, getting and giving support, and be emotionally connected. in the chapter, we meet luca, a 75-year-old volunteer at italian language courses; giovanna, who sings in the choir after retirement; http://anthro-age.pitt.edu/ book review | kretser | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.473 http://anthro-age.pitt.edu 116 and dahlia, for whom sewing courses become an opportunity not only to improve italian but also to find friends. while at first glance, these activities do not necessarily require digital space, walton points out that whatsapp groups facilitate a certain continuation of the relationships formed in these community spaces, which develop in the online setting in other ways than in the offline one, where some individuals might feel shy or inhibited, for instance about speaking italian, and may be less sociable than in the online environment, in which they may use the forms and practices they like to express emotion and affection and to build and maintain relationships. (54) chapter 4 discusses how traditional perceptions of kinship roles, family life, and the home change in a digital society. walton suggests the “social availability” (61) framework to analyze how people modulate their publicity and privacy in digitalized urban life. the chapter begins with the metaphor of closed shutters on windows reflecting social unavailability and continues with examples of how social availability is regulated in the digital space and with the help of smartphones. for instance, giulia, in her early fifties, turned her home from a private family space into a place for public parties and dinners with the use of a recently developed smartphone application that “draws on the social and cultural appeal of the home space, including the sociality surrounding food and eating together, to create an online-facilitated offline social event at someone’s home in the urban context” (65). while all chapters of the book reveal the smartphone as a tool for engaging in social activities, chatting with friends and family, translating unknown words, checking the weather, navigating, listening to music, and finding recipes, chapter 5, in particular, discusses the smartphone as “constant companion” (84), as well as various discourses of smartphone use. walton’s research participants conceptualize a smartphone as an ambiguous object that is both a blessing, an addiction, and a time and attention thief. the emotions of anna, one of the research participants, reflect this feeling well. the author reports although it is the smartphone that digitally knits her family and friends together, it has not, at least as yet, accrued the positive moral connotations of knitting as a traditional motherly or grandmotherly craft which she undertakes to create clothing for her children and grandchildren, or for the church, meaning that it remains a somewhat ambiguous object that brings about mixed feelings as a ‘companion.’ (84, emphasis mine) in chapter 6, walton traces how digital technologies impact various understandings of health, medical, and family care in the national health care system. she finds that some people use health apps mostly to book doctor appointments or hold insurance documents, while others are interested in remote digital health services to prepare for remaining independent in the future. for instance, 68-year-old enzo sends photos of symptoms to the doctor to monitor his health, while bernardo, in his sixties, wishes he could have regular video consultations with a doctor to avoid the difficulty of getting to appointments. the story of bernardo, who welcomes digital health technology because he does not want his son to sacrifice his life by taking care of the father, reflects an important idea of "technology-aided self-sufficiency" (116), which can expand perceptions about filial piety. following a multigenerational and multicultural perspective, chapter 7 focuses on the life experience of young adults whose parent were born abroad and moved to italy. while it is common that a smartphone becomes a communication tool with relatives living abroad, the author pays more attention to digital flows of culture and identity. for instance, walton's research participants from the hazara http://anthro-age.pitt.edu/ book review | kretser | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.473 http://anthro-age.pitt.edu 117 community in milan listen to persian poetry on youtube or share book translations in telegram. chapter 8 reveals aging as a part of identity process. walton conceptualizes people’s lives as a sequence of journeys through time and space, and “captures how being older was about their individual and collective processes of becoming” (157). from this angle, smartphones play a significant role bringing together different domains of life. for instance, ugo, aged 77, remembers how his father played with him in childhood, asking for the meaning of different words from a newspaper. then, ugo tried to find them in dictionaries and encyclopedias. nowadays, “the wikipedia app has become one of ugo’s favourites and each time he opens it, he feels a warm jolt that brings him into proximity with his father” (146). like the latter quote, this book is warm and conveys affective atmospheres of aging in a digitalized italy. voices and stories of different people sound from every page. walton allows readers to share joy, fears, and dreams with them. besides critical issues, each chapter adds a piece to the mosaic of the life of nolo’s residents: readers learn about the history of the district (chapter 1), weather and seasonal rhythms of life (chapter 3), casa di ringhiera, a particular type of residential apartment (chapter 4), and a recipe for cuccia, typical sicilian dish (chapter 5). i would especially like to mention the idea of supplementing the book’s text with short films, which can be viewed at the website of the project “anthropology of smartphones and smart aging” (assa), of which the reviewed book is a part. short interviews with views and sounds of the city, and italian speech immerses the readers and viewers in the lives of the nolo district’s residents. this book, written in clear language, will be of great value to a diverse audience interested in the interplay between aging, digitalization, and sociality at the level of practices and discourses in multicultural italian society. http://anthro-age.pitt.edu/ may finding the familiar in rural america: how a rural lifestyle helps older karen adapt to life in the united states daniel gilhooly mayuri gilhooly gilhooly@ucmo.edu mayuri.gilhooly@rockhurst.edu university of central missouri rockhurst university abstract the united states resettled over 70,000 ethnic karen refugees between 2006 and 2019 due to a protracted civil war in burma. the vast majority of these refugees have been resettled in urban areas despite the fact that most of them are from rural villages. the refugee-resettlement experience can be daunting, but the challenges are often more acute for elders (johnson 2017). the aim of this study was to examine how a rural lifestyle may help older karen as they adjust to their new lives in the us. our findings suggest that rural living may soften the effects of certain acculturation stressors due to the familiarity of rural living and other factors. in particular, a rural lifestyle may mitigate acculturation stress specifically for elders in three ways: (1) promoting a healthy lifestyle; (2) sustaining or building relationships between elders and grandchildren and other youth; and (3) promoting skills and knowledge that can lead to feelings of self-worth and dignity for older people with a refugee background. in this article, we discuss how the experiences of one community of resettled karen refugees seem to offer a counter-narrative to the “vulnerability trope” (king et al. 2017) that often dominates portrayals of older resettled refugees. keywords: refugee resettlement; karen people; acculturation; elders; rural; aging refugees anthropology & aging, vol 44, no 1 (2023), pp. 1-18 issn 2374-2267 (online) doi 10.5195/aa.2023.399 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:gilhooly@ucmo.edu gilhooly and gilhooly │ 1 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu finding the familiar in rural america: how a rural lifestyle helps older karen adapt to life in the united states daniel gilhooly mayuri gilhooly gilhooly@ucmo.edu mayuri.gilhooly@rockhurst.edu university of central missouri rockhurst university background over 95% of all refugees resettled in the united states are provided housing in urban areas by the us government’s office of refugee resettlement (orr) (singer and wilson 2007), despite the fact that many of these people come from rural areas in their countries of origin. refugees are generally resettled in urban areas because of the availability of public amenities like employment services, englishlanguage classes, and public transportation (bloem 2014). however, resettled refugees often struggle to adapt to their new lives in american cities (see lugar 2010; enos, inserra, and meservey 2017). this is especially true for older individuals with a refugee background (chenoweth and burdick 2001; dubus 2018). karen and other ethnic minorities have been fleeing burma1 due to a protracted civil war that began shortly after the country’s independence from british rule in 1948. according to the united nations high commissioner for refugees (unhcr), the us offers resettlement to the most vulnerable refugee cases including older people (unhcr 2023). the resettlement of refugees from burma represents the third-largest refugee-resettlement program in us history with over 175,000 people resettled from 2006 through 2019. ethnic karen people represent the single largest group resettled from burma with 72,322 individuals having been resettled as of august 2019 (see figure 1). karen resettlement mirrors the us’s overall resettlement strategy with the majority of karen having been resettled in metropolitan areas despite the reality that most karen refugees are from rural villages in burma. figure 1: burmese resettlement by ethnicity (2006–2019). data adapted from worldwide refugee admissions processing system (wraps) (august 2019). http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 2 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu the refugee-resettlement experience may be marked by manifold hardships as refugees adapt to their new country (gil and vega 1996). these challenges often lead to what is known as acculturation stress. drawing on a study conducted by sociologist kerstin lueck and biostatistician machelle wilson (lueck and wilson 2010), we conceptualize acculturation stress as “a reduction in mental health and wellbeing of ethnic minorities that occurs during the process of adaptation to a new culture” (2010, 48). stressors may include, but are not limited to, attaining and maintaining employment, economic hardships, language learning, social and cultural adaptation, building and maintaining friendships, changes in diet, as well as navigating various bureaucratic systems (2010). moreover, newcomers may have to cope with new roles within the family and their co-ethnic communities (segal and mayadas 2005). this research indicates that such changes may be particularly challenging for elders from groups that are culturally distant from the host country (i.e., the resettlement country). this may be because older refugees do not generally have the same opportunities for socialization or english-language development at school or in the workplace. as a result, research indicates that older refugees’ lack of social opportunities may lead to feelings of isolation and loneliness (atwell, correa-velez, and gifford 2007; johnson 2017). in our earlier studies, we found that this is often the case with older ethnic karen living in urban areas in the us (gilhooly and lee 2017). acculturation stress has been studied in multiple immigrant communities (dona and berry 1994; gil and vega 1996; flaskerud and uman 1996; cervantes et al. 2013) and refugee communities (berry 1986; nwadiora and mcadoo 1996; milner and khawaja 2010). a growing corpus of studies specifically examines the acculturation stress that older resettled refugees often experience. for example, in the us, acculturation stress and depression has been documented in a study of 200 arab americans (wrobel, farrag, and hymes 2009). the relationship between acculturation and physical and mental health has also been examined (abu-bader, tirmazi, and ross-sheriff 2011), and the role that english proficiency plays in the acculturation stress of older russian immigrants has been analyzed (tran, sung, and huynh-hohnbaum 2008). however, few current studies consider how a rural setting may affect the experiences of older individuals with a refugee background. this paper aims to fill that gap via a case study of six karen elders living in the rural karen community of sandville (pseudonym) located in the southern us state of georgia. this study is also situated among other literature that focuses on the multiple stories associated with resettled refugees, and our work offers a counter-narrative to what has been described as the “trope of vulnerability” (king et al. 2017). we conceptualize the trope of vulnerability as focusing on the vulnerabilities of older refugees and ignoring their strengths and resilience. following geographer russell king and colleagues (2017), we suggest our study highlights creative ways that older karen refugees are finding to adapt and meet some of the challenges of resettlement. anthropologist monika palmberger’s (2022) study of iraqi, syrian, and afghan refugees in vienna, austria, documents how refugees use internet connected technologies (icts) to stay connected to family in their country of origin or other locations, which is a critical step to “placemaking.” anthropologist nicole newendorp’s (2020) study of how the paid and unpaid caregiving work performed by chinese-born older migrants in the us also describes how this work provides a means for them to act strategically to secure their own support in older age. in this article, we present an ethnographic case study to investigate the role that a rural setting may have in mitigating acculturation stress and promoting well-being among older karen. we first describe the karen people, our focal community, and our methods, before presenting our findings. the following research question framed this study: how has a rural setting affected the resettlement experiences of six elder karen? http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 3 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu the people called karen this study specifically looks at a community of sgaw karen. the history and culture of the sgaw karen are unique, and the path of displaced karen from villages in burma to refugee camps in thailand to third countries like the us is likewise singular. unlike earlier refugee groups arriving from southeast asia (e.g., vietnamese, laotian, hmong, and cambodian), the karen diaspora (i.e., the dispersion of karen to other areas around the world) is not directly related to us military involvement. many karen insurgency groups fought in a 60-year civil war against multiple burmese governments. this protracted civil war led to the internal and external displacement of karen and other ethnic minorities. in 2006, us president george w. bush’s administration decided to allow the karen and other ethnic minorities to begin resettling to the united states from thailand – a decision that was ostensibly made for humanitarian reasons. however, when we consider that the majority of those resettled under the designation burmese are christian karen, christian karenni, or christian chin, the real motivation may lie in the long religious-historical ties between american missionaries and ethnic minorities like the karen, karenni, and chin (see figure 2). figure 2: burmese resettlement by religious affiliation. data adapted from wraps (august 2019). there are multiple karen groups, and the largest are the sgaw karen people. each of our participants identifies as sgaw karen. the sgaw karen people in particular have a long history with the american baptist mission. since the mid-19th century, many sgaw karen in burma have been baptized, and christianity has become a major part of modern sgaw karen identity. this is especially true in sandville, where the sandville karen baptist church (skbc) (pseudonym) is the center of the community’s religious and social life. all of the karen ethnic groups have long lived primarily in the remote regions along the thai-burmese central border in what is the karen (kayin) state. while some karen have become more urbanized, all our participants are from rural areas within the karen state or the irrawaddy delta. for much of their history, the karen people have largely farmed rice and lived off the land. the karen of sandville have maintained many of their traditional practices in agriculture as well as language, recreation, and religious worship. the following offers some description of how a rural environment has helped preserve karen traditions familiar to elder karen members. the karen of sandville sandville, georgia, has a population of approximately 1,200 people and is located in a rural part of the state. as of march 2020, there were 56 karen living in 10 households in sandville, which included four http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 4 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu karen couples over the age of 65; another 85 karen were living in 18 households in the neighboring rural town of pineville (pseudonym). these communities developed after a karen couple was resettled in the area in 2006 by festivity partners (pseudonym), a christian service community that has been active in resettling refugees in the us since the 1970s. the parents, aunts, adult cousins, and friends of this initial couple later followed and members of this family comprise a significant percent of karen in the area. importantly, the sandville karen have established roots in this area. nine out of ten karen families own their home. all of the karen in sandville identify as christian.1 initially, the karen community attended worship services at sandville baptist church alongside the predominantly white congregation. in 2014, the karen community built the skbc, which has become the center of the sandville karens’ religious, cultural, and social life. the neighboring town of pineville has a karen store that sells karen clothing (see figure 3), rice, as well as an assortment of canned and frozen foods, and spices from thailand. local non-karen pastors and congregants have provided the karen community help to purchase land, borrow heavy equipment, and navigate building codes, as well as with transportation and paperwork. they also often attend karen festivals, weddings, funerals, and other karen events locally and regionally. however, anecdotal evidence suggests that other local residents are less enthusiastic about the arrival and growth of the karen community in the area. figure 3: karen clothing. courtesy of daniel gilhooly. methods our central participants are three ethnic sgaw karen couples who were resettled to the us in 2007 (see figure 1) and arrived in sandville between 2009 and 2012. importantly, each of our six participants was born in burma, lived in mae la refugee camp in thailand for over 15 years, and originally resettled to urban phoenix, arizona, before moving to rural georgia. our research participants were selected based on their common experiences in both urban and rural us communities. they were also chosen due to the close rapport they shared with us as researchers: each is a grandparent or relative of one of the children the first author taught as an english-language tutor from 2010 to 2016. from more than 10 years of experience with the community as teachers and researchers, our interactions with other elder karen also inform our understanding of the experiences of elder karen in sandville. our research suggests http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 5 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu that the experiences of the six focal participants are similar to the experiences of other older karen in the area. we interviewed each of the six participants twice. one iteration of interviews focused on the participants’ experiences and attitudes towards urban and rural living in the us. the other interview consisted of biographical questions as well as questions about their healthcare practices. name estimated year of birth employment in sandville employment in az employment in burma eh wah (male) 1953 raises chickens, hunts, fishes, grows and sells vegetables bus boy, stocking shelves farmer, preacher sara paw (female) 1957 retired poultry-plant worker hotel maid farmer kyaw mo (male) 1950 grows and sell vegetables none farmer htoo paw (female) 1947 retired poultry-plant worker grows and sell vegetables none farmer lah lah (male) 1945 makes and sells machetes, bamboo baskets none farmer paw spee (female) 1938 raises and sells chickens none farmer figure 4: karen participants (all names are pseudonyms and gender self-identified) this ethnography also draws on larger studies conducted between 2010 and 2021 (see gilhooly and lee 2017; gilhooly, amos, and kitson 2019; gilhooly and htoo 2022). through the first author’s involvement in these projects, we were introduced to other older karen and their families. from 2010 to 2011, the first author worked alongside three adolescent karen brothers and conducted a needsanalysis pilot study of the karen community in sandville. that study explored issues germane to employment, housing, education, english-language learning, religion, and acculturation using field notes, survey questionnaires, photographs, video files, and interviews. this manuscript is also informed by a second collaborative research project conducted alongside the same three karen brothers. in the summer of 2011, the first author conducted a participatory action research (par) project in karen communities in des moines, iowa, milwaukee, wisconsin, and atlanta, georgia. that study involved interviews, informal conversations, video and photographic data, and questionnaires that also inform the current ethnography. during the organization and analysis of our earlier data, we learned that significant differences exist between the lifestyles and overall well-being http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 6 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu of karen in rural and urban areas. themes specifically related to elder karen began to emerge. it seemed clear to us that elder karen preferred the rural lifestyle offered in sandville. each of our participants indicated in interviews that they had relocated to sandville, in large part, due to a preference for rural living. we conducted follow-up interviews in may 2020 for two weeks. these interviews consisted of openended questions. the data sets from each of the research iterations described above were analyzed using deductive coding, and then we verbally discussed the codes and themes (braun and clarke 2006). for this article, we focused on themes that related specifically to the older participants’ urban and rural resettlement experiences. interviews were conducted in english and karen with various community members assisting as interpreters. questions were first posed in english and then in sgaw karen, if participants asked for clarification. participants’ written consent was obtained to use their images for publication. field notes were also generated in sandville from 2010 to 2016. participant observations with the families were an important source of data, and our field notes document multiple karen homes in which we both worked as volunteer teachers. the first author initially began working with the community when he was hired as a tutor for four karen families. he visited the community over 300 times as a tutor and an ad hoc caseworker, helping karen families with paperwork, applying for services and benefits, and transportation. the second author distributed surveys and interviewed karen households in sandville in 2020. our findings suggest that a rural setting allows for the preservation of cultural practices that are beneficial to elder karen as they adapt to their new lives. rural living was also found to be conducive to a healthy lifestyle, family cohesion, and, most importantly, to maintain self-worth and dignity within family and community. we discuss this in further detail in the following sections. karen elders and rural sandville some research suggests that older refugees are particularly vulnerable to acculturation stress (yee 1992; chenoweth and burdick 2001; mui and kang 2006; lee et al. 2010; lee and yoon 2011; gilhooly and lee 2017). karen elders, like many other older people with refugee backgrounds/from other immigrant groups, often struggle due to a lack of english proficiency, social isolation, and changing roles within their family and community (chenoweth and burdick 2001). however, some sources of acculturation stress seem to have been mitigated in sandville due to the familiarity of its rural lifestyle. here, we use the term ‘rural’ not only in reference to population size but also to the prevalence of farming activities as well as hunting and fishing. each of our participants expressed a preference for rural living. they most often cited the importance of being involved in agricultural practices that were reminiscent of their native villages. they also indicated their preference for the tranquility of rural living. one participant, say-paw, described her dislike of city living: city is too busy and many noise all the time. i never like big city. my village in burma always quiet and i only hear chickens. when i live phoenix we always hearing many noises that scare me. i like quiet. here [sandville] i like garden and many animals like where i live in burma. (interview; june 2016) http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 7 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu they also cited their preference for rural living due to their ability to maintain a familiar lifestyle. each of the couples has a large garden and chicken flocks, and two couples have goats. another couple maintains a flock of ducks much as they did in burma and, in two cases, as they did in the refugee camps but on a smaller scale. participants viewed this familiar lifestyle as an asset to their overall quality of life. we also found that rural living seemed to be conducive to a healthy lifestyle and diet. healthy lifestyle and diet refugees resettled in urban areas often lack access to healthy foods, have busy schedules, and limited physical activity which leads to adverse health outcomes among resettled refugees from a variety of backgrounds (meng et al. 2018). this section addresses how rural living may mitigate some of these adversities by providing a more active lifestyle and healthier diet. physical activity and exercise are widely considered to contribute to better mental and physical health among resettled refugees (purgato et al. 2021). each of the older karen couples in our study engage in more regular physical activity, especially compared to when they lived in urban phoenix. in addition to preparing, planting, maintaining, and harvesting their gardens and maintaining large chicken flocks for eggs and meat, our participants each collect firewood from the nearby forests; they also build fences, animal pens, and other structures. htoo paw, an older karen who has lived in sandville since 2009, compared her physical activity experiences living in phoenix to her life in sandville: when i come to america i live phoenix city four years. i never like. i live in small apartment with my son family and only sitting every day. all day sitting reading bible and sometime watch tv. my son tell to me go walking but i don’t like – i scared. i don’t know. my family work and go school all day. ... now i like garden and many chicken. i like teaching kid [grandchildren]. i always busy. pu (grandfather) [her husband] always say i happy now. (interview; june 2016) figure 5: karen elder collecting wood. courtesy of daniel gilhooly. http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 8 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu when considering urban refugee communities in the us, htoo paw’s experience is not an isolated case. sociologist heather-lyn haley et al.’s (2014) study on health programs for resettled burmese in urban worcester, massachusetts, found that their adult participants lacked opportunities for physical activity (2014, 14). as we learned in our research, karen elders in urban areas tend to be unfamiliar with western-style exercise choices, and thereby often live unhealthy, sedentary lifestyles compared to their rural peers. one grandchild, htoo wah (pseudonym), summed up his grandparents’ disconnect with western-style exercise: they don’t know things like going to the gym. they don’t jog. they don’t exercise like that in burma – nobody does. they work too much in the fields and don’t need the gym. (interview; august 2020) likewise, sociologist akiko kamimura and colleague’s (2017) study for the us national institutes of health (nih) found that fewer than 20% of their karen participants reported engaging in regular physical activity. their study’s findings suggest that regular physical activity should be promoted among resettled karen (2017, 390). this inactivity is most likely due to the karen refugees’ urban confinement, as htoo paw suggests. other resettled refugee groups also seem to have similar issues. for example, older bhutanese who were resettled in urban areas of the northeast us have experienced health-related issues due to a more sedentary lifestyle (bhatta, assad, and shakha 2014). according to nutritionist jessie satia-abouta, dietary acculturation is the “process that occurs when members of a migrating group adopt the eating patterns and food choices of their new environment” (2003, 74). changes in diet can have detrimental effects on the overall health of immigrants and refugees. for example, one study documented a dramatic shift in the diet of liberian and somali refugees resettled in the us (patil, hadley, and nahayo 2009). satia-abouta suggests that the change in living environment from rural to urban areas can lead to an “increase in consumption of energy-rich foods, a decrease in energy expenditure (through less physical activity), and a loss of the traditional social support mechanisms” (2003, 72). these traditional support systems are evident in sandville, which we describe later. in sociologist mandy hughes’ (2015) study on the eating and cooking practices of burmese who were resettled in rural australia, food and cooking are considered to be a way for resettled refugees to reconnect to their pasts and reassert their cultural identity. all of our karen participants in sandville have maintained traditional cooking and eating practices from burma. in general, the food that karen families eat is similar to how they would eat in their native villages, which may help to limit the dietary acculturation stress that could be brought on by the high-fat, high-salt, and high-sugar diet that is common in the southeastern us. as mentioned, each karen family in sandville supports large gardens and grows an assortment of vegetables using the same practices and handmade machetes and other tools used in their native villages in burma. red pepper, fuzzy melon, tobacco, red onions, bitter melon, okra, and long beans are grown in sandville karen gardens. these vegetables are usually cooked using more traditional methods, relying on homemade charcoal for most of the cooking (see figure 6). while some families opt for these homemade stoves to save money on gas and electric bills, elder karen in our study expressed a preference for these traditional cooking methods. “this is the way i like cooking and know how to do,” paw htoo responded when she was asked about cooking outdoors. http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 9 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu figure 6: sandville karen elder cooking. courtesy of daniel gilhooly. hunting, fishing, and trapping are typical activities for sandville karen of all ages. in addition, some members of the community have become adept at collecting dead animals from the sides of county roads (‘roadkill’), a common practice in rural america. elder karen men show deftness in butchering everything from the smallest bird to squirrels, wild hogs, foxes, coyotes, and deer. for some families, fishing, hunting, and collecting roadkill has become a free or low-cost means to supplement their diet with added protein, and many have expressed a preference for this wild game over store-bought meat. vegetables grown in family gardens have become an important source of healthy eating. paw spee expressed her satisfaction with cooking the food she grows, hunts, and collects: now we grow many vegetable, and many thing we like. we have same here [as] burma and more food now when in mae la [refugee camp]. in city i have only small, small garden. here i grow many. and i like eating chickens, my chickens, and pu (grandfather) [her husband] hunting many squirrel. ...i not like food here [in the us]. ... i like cooking how i do in burma and eating with family. (interview; june 2016) research indicates that food is an important part of the resettlement process, and dietary acculturation has gained more saliency in the literature. satia-abouta (2003) offers an important perspective on the role of dietary acculturation among korean immigrants in the us. she argues that a major concern for many immigrants to the us is the change in dietary habits, and a westernized diet can increase the risk factors of several chronic diseases (satia-abouta 2003, 72). this can be seen in the greater karen community in the us, who are increasingly developing complications from hypertension, obesity, and diabetes (bardenheier et al. 2019). in addition to affording a better diet and more opportunities for physical activity, we found living in a rural area had a positive effect on intergenerational relationships. maintaining intergenerational relationships the resettlement process may have a major impact on family structure and the roles of individuals within the family (e.g., yee 1992; schouler-ocak 2015). this can be especially true of the dynamic http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 10 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu between generations, as younger refugees take on responsibilities typically associated with adults. in particular, older people may lag behind their younger relatives in adapting to their host country (lueck and wilson 2010). however, strong familial relationships are generally an important factor in the successful resettlement of refugee families (mccleary 2017, 1465). our research suggests that sandville’s rural isolation has helped to promote close familial relationships. the preservation of traditional family roles allows parents and grandparents to maintain some status and authority within the family, thus mitigating generational dissonance. we have found that, within the rural setting of sandville, parents and grandparents seem to play a greater role in their children and grandchildren’s daily lives compared to karen families living in urban settings. seventeen-year-old sher htoo, who was interviewed as part of our broader study, expressed it best when discussing his behavior in the city compared to sandville: in city i do whatever i want. i really bad and i not listen to no one. i drink, get high every day, every day! and never caring. i just be with friends. but here [sandville] i don’t get into no trouble. i sometimes smoke weed like that but out here like to be with my family and help my mom or grandma. here pi (grandmother) she see everything. (interview; december 2019) here, sher htoo directly addresses the issue of how living in rural sandville has kept him out of trouble under the watchful eye of his grandmother. in burma, many karen grandparents care for grandchildren and often act as surrogate parents while the parents work the fields. urban karen adults often complain about the lifestyles of karen youth in the us (gilhooly and lee 2017). moreover, due to their relative language proficiency and american schooling, children with a refugee background tend to take on the roles of parents, as they are often tasked with interpreting for older relatives. this can lead some refugee children to become resentful of their burdensome responsibilities, eventually developing negative views of older generations and their home culture. as a result, some immigrant and refugee children may actually “downwardly assimilate” (zhou 2001), as sher htoo described. sociologist jennifer mccleary’s (2017) study of karen families in the us found that a lack of parental respect could cause fractures in family relations. however, rural living often provides parents and grandparents with more opportunities to interact, which allows for more awareness of their children’s lives outside the home. children also benefit in other ways from this connection with grandparents. one of our participants, sara paw, shared sher htoo’s assessment of how a rural setting influences children’s behavior: here [sandville] i know what they [children] do. phoenix, i never knowing. they coming, going and i afraid they do bad thing like drug. too many karen kid do like that. in city, many karen kid go to do bad thing. and school bad. but here [sandville] they helping many thing like garden, cooking, washing [clothes] and working with me every day. here they always helping, listen. (interview; november 2017) in our study, many karen adults shared sara paw’s sentiments and expressed a belief that a rural setting allowed them to maintain more parental control. we argue that maintaining their authority as parents is critical to limiting the generational dissonance that often occurs within immigrant/refugee families. in rural sandville, fewer youth choose to join gangs or downwardly assimilate as compared to their http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 11 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu urban peers (gilhooly and lee 2017). in the next section, we discuss how older karen maintain dignity by passing on and using their skills and knowledge. rural knowledge, skills, and dignity many older people with a refugee background can be concerned about being a burden to their families (chenoweth and burdick 2001). these elders may feel incapable of contributing economically to the family and may feel that their skills and knowledge do not translate to contemporary western society. research suggests that they also experience a loss of independence as they rely on children and grandchildren (chenoweth and burdick 2001). yet, as we found in sandville, many traditional roles persevere. in burma, elders have long played an important role within karen villages as arbitrators of disputes and keepers of the village’s history through oral narratives (marshall 1922, 127). stories were passed down orally to ensure that future generations would retain the ancient legends and histories. these htas (oral stories) remain an important means of preserving traditional narratives. in sandville, the narratives – particularly stories related to karen family history, myths, superstitions, and legends – continue to be told by elders and passed down to children and grandchildren. during church sermons, elder karen pastors use the pulpit to address the karen diaspora, telling personal narratives about their own flight from their native village and stories about life in the refugee camps. in karen homes in sandville, elders tell stories of their experiences during the long civil war and their subsequent flight from burma. we also documented our participants telling diaspora stories to their children and grandchildren. for example, lah lah told us: i want they [pointing to his grandchildren] to know they karen people. many kid they don’t remember burma, never know, only mae la [refugee camps]. many kid saying “i from thailand” but they karen from burma. karen have many bad time and we always going, going. burma soldier always coming, coming very bad time. the kid must know. it even happened today in burma and kids must remembering. (interview; december 2019) traditionally, karen elders were responsible for electing a village chief who acted as the patriarch of the village (marshall 1922, 129). analogously, karen pastors and other elders hold similar leadership positions within the karen diaspora and offer cultural, spiritual, and moral leadership. one such elder is lah lah, who often preaches about the importance of cultural and religious maintenance to his congregation and to his grandchildren. this is evident from his quote above, in which he emphasizes that the younger generations should understand their cultural identity and heritage as karen from burma. sandville karen baptist church (skbc) has created various youth, missionary, and language programs for sgaw karen adults and youth. the church has also maintained ties with karen missionary organizations from burma, thailand, and other karen church organizations throughout the karen diaspora. representatives of these groups frequently visit sandville and other karen communities across the us. visitors are often old acquaintances of karen elders. karen elders also return to their native villages in burma to visit family and friends. new stories are exchanged about family and friends back in the refugee camps as well as in their native villages. http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 12 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu each of our participants expressed a desire for their community to retain and maintain karen culture and identity. lah lah spoke of how the rural community in sandville is conducive to this: our people, our culture, language, and we must stay karen. here we teach the kids to know to be karen. this very important for me and many karen old people. we want to stay karen. here [sandville] we can do but in the city the kids not listen and not behaving like karen. here we can [be] karen people and more child respect. many karen people wish they live here, too. (interview; december 2019) this excerpt represents the sentiments of many other karen adults we interviewed. other elder karen in sandville are also important sources of information related to preand postnatal care, diet, traditional remedies for sickness, hunting and trapping techniques, as well as helping to resolve family and community disputes. we found that each of these roles is a way to preserve cultural knowledge and practices. importantly, we found that elder karen in sandville are able to maintain their ‘expert’ status within the family. in addition to teaching gardening and cooking techniques, karen elders often go hunting and fishing with their grandchildren. they show them how to construct the same kind of bamboo fishing poles and nets they used in burma and at the refugee camps in thailand. they also teach youth how to build tools and craft bamboo snares, as well as how to clean and butcher dead animals and preserve meat. this allows the elders to pass along practical survival skills that would likely be lost in an urban environment. being able to pass down knowledge and skills to younger generations seems to help elders maintain important respect and standing within their family and community. chris htoo, a karen youth in sandville, offered this description of her grandfather: i never know my grandfather knows many things about plants, animals, and stuff like that. he never says much but shows me all the time. he always knows how to build things and we help him. he’s old but he can do many things and grows so many things we like to eat. my mom says it’s good for him because he stays busy all the time and can help. and he can really build things like the chicken coop and other buildings we use. he is always proud but never says anything. my dad builds but they always fall apart but not [what] my grandfather [builds]. (interview; december 2019) for older men like chris htoo’s grandfather, passing down important knowledge and skills to younger generations may also be a way to build the elder’s sense of self-worth. sociologist hee yun lee et al.’s (2010) study of elderly cambodians in saint paul, minnesota, found that a lack of “culture-specific knowledge and beliefs” was a cause for depression (327). however, in a rural setting such as sandville, we found that karen elders are purveyors of cultural knowledge and actively pass it down to younger generations. as mentioned in the introduction of this article, the skbc serves as the karen enclave’s spiritual, social, and cultural center, and is a space for karen elders to socialize and maintain active leadership roles within the community. many of these elders are also responsible for teaching karen language classes as well as classes in choir, singing, piano, flute, and guitar (see figure 7). karen elders also teach the youth how to organize and lead various religious and cultural events, and thus train karen youth to be community leaders. http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 13 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu figure 7: karen elder teaching sgaw karen language classes (sandville, ga, 2016). courtesy of daniel gilhooly. while we observed the preservation of these church roles in both rural and urban karen communities, we found that these roles and relationships were more easily maintained in rural sandville. this was due to the ability of the community to maintain very close daily connections, much as they would in burma or in the refugee camps. paw spee described her relations: many karen people always too busy in city. every karen people always working, going, busy, and sometimes we only meet in church, only sunday. i like it here [sandville]. we see family every day and eat and sleep together. in the city family too busy. i like every day reading bible with family and see every day like we do back in burma. (interview; november 2017) as mentioned previously, some older refugees may feel like a burden to their family because of their inability to work and contribute to the family’s finances. yet in sandville, karen elders are also active in the informal economy. while all elders help to sell vegetables, chickens, and fresh and dried meat to urban karen, others sell homemade machetes, woven bamboo baskets, karen clothing, and karen music recordings. each of our six participants also serve important roles as childcare providers for their grandchildren and other children in the community. from our research, we have learned that the rural setting of sandville seems to be conducive to providing elders with an active role in their community. in the rural setting, they can maintain status and dignity that are too often lost to older individuals with a refugee background who are living in urban environments. the ability of karen elders in sandville to continue to play an important role within family and community life is therefore a way for elders to maintain their traditional status, sense of purpose, dignity, and self-worth. http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 14 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu conclusion and implications the karen people of burma represent one of the most recent ethnic groups attempting to create their own ‘american story'. like other immigrants, they face new challenges when living in unfamiliar urban environments. the successes and failures in creating any american story are rooted in the unique cultural and historical experiences of the group resettling. we have found that the elder karen living in sandville are able to preserve traditional practices that may facilitate the adaptation process. our research with elder karen in sandville not only demonstrates how rural living may help to mitigate acculturation stress for people who have been resettled from small villages but also indicates some of the ways that resettled refugee populations are agentive in their resettlement. this counters the “vulnerability trope” (king et al. 2017) that is common in literature about refugees in general and older refugees in particular. as we have described, a rural setting may offset the negative effects of generational dissonance that often occurs within immigrant/refugee families (zhou 2001). karen elders in sandville are able to pass on their “funds of knowledge” (gonzález, moll, and amanti 2006) to karen youth. as a result, all family members seem to benefit from these continued relationships that help all generations cope with the stressors of resettlement. a rural lifestyle also seems to be conducive to easing the process of dietary acculturation and may offer a healthier lifestyle compared to urban settings. by growing their own vegetables and raising their own animals, rural immigrant/refugee communities like the karen enclave of sandville appear to maintain diets that are both familiar and healthier than the host country’s typical fare. working the land through farming also provides physical activity that is associated with better physical and mental health throughout the life course. as we found, maintaining cultural practices and leadership roles within the family and community also seems to help elder karen to manage the transition process and thus limit acculturation stress. policy makers and organizations that assist with resettlement may want to consider the potential of rural placements for similar refugee populations. importantly, our karen participants as well as other karen in our focal community demonstrate great resilience and creativity in making new lives. while they did not downplay the manifold challenges they have faced after more than a decade in the us, many of them told us about their contentment and satisfaction with their current lives. moreover, each expressed how rural sandville has provided them with a safe space where they feel at home. the limits of rural america while all of the karen adults we interviewed expressed a preference for rural living, we also found some negative trends associated with living in a rural setting. for example, sandville’s isolation has kept many older karen from learning english as few english language classes are offered in the area. a lack of english skills can lead to a cultural and linguistic gap between english-speaking youth and their karen-speaking parents and grandparents. transportation continues to be an issue for karen living in sandville. only one of our study participants drives and with no public transportation available in the area, it is difficult for them to travel freely. this can increase feelings of isolation and dependence on younger drivers. sandville also has limited employment opportunities for older karen, as most karen in the area work at one of the many poultry-processing facilities. some elders have been declined jobs because of their physical limitations. while older karen are able to help offset some of the family expenses through gardening and raising livestock, they are often precluded from earning money via external employment and thus are unable to contribute financially to the family. anecdotal evidence from our work suggests http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 15 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.399 http://anthro-age.pitt.edu that gender likely plays a role in in the acculturation experience, as family roles often change after arrival. we believe that this is a limitation in our current work and an important subject for future research to investigate. finally, while the karen of sandville share many of the characteristics of other refugee groups from southeast asia, the rural setting and their strong christian ties with the local baptist community provide them with a singular american experience that has allowed them to maintain much of their cultural heritage while also integrating into the local community. however, for other refugee groups who may not share their neighbors’ religion, conflicts can arise (hasan and mitschke 2017). similarly, while many congregants at local churches have been enthusiastic about the arrival of their new karen neighbors and have supported their settlement in georgia, not all local residents have been so welcoming. some complain of the condition of the karen’s properties and have expressed reservations about the continued growth of the karen and karenni communities in the area. thus, as more karen families relocate to the sandville area, more tensions are expected. our research suggests that a rural environment and the shared religious traditions between karen and their american neighbors may be unique. more research is thereby warranted to investigate the relationships between local residents and resettled refugees like the karen. future research we believe that our research fills an important gap in the literature regarding the experiences of older individuals with a refugee background who are acculturating in the us. but our case studies also suggest that more research is needed to gain insight into the lived experiences of older refugees resettling in high-income western countries. additional studies are warranted to learn more about specific aspects of the resettlement process, such as the changing roles within families and the effect this is having on individual and family acculturation. what are the experiences of older refugees living in rural communities in other parts of the us (and other countries)? as we described, the elder karen in our study were able to find ways to thrive post-resettlement. other studies that highlight how older resettled refugees are successfully coping in unique and beneficial ways would be a welcome contribution to the field of migration studies. finally, more research related to the growing number of refugee communities in rural areas is necessary to better understand the viability and sustainability of rural resettlement. acknowledgements the research presented in this article was carried out under the irb protocols pi: daniel gilhooly, committee: university of georgia irb, institute: university of georgia, approval date: 6/23/2011 – “a comparative case study of ethnic karen resettlement in the us” and pi: mayuri gilhooly, committee: irb committee, institute: rockhurst university, approval number: 2020-17 – “health perceptions and practices of karen refugee families in rural georgia”. notes 1. although the majority of karen people in burma are buddhist, the majority of karen in the us are christian due to the long relationship between sgaw karen and christian missionaries. american and british christian missionaries arrived in burma in the early 19th century and had great success converting many sgaw karen. http://anthro-age.pitt.edu/ gilhooly and gilhooly │ 16 anthropology & aging vol 44 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“when are you going to start having babies?” teased sara1 as we ate breakfast one morning in her house in los cañales, a small town in southern veracruz, mexico. i hedged, “i’ll start thinking about it when i finish school.” i was uncomfortable with the question because as we became better acquainted, sara began to hint – subtly at first, and then directly – that she would be happy to travel to the united states to care for my children once i started a family. i could then help her husband find work and her children learn english while she took care of my children and house. there were benefits on all sides in her estimation. while certainly aware of the potential for exploitation in this kind of labor arrangement – sara had worked in the informal labor sector of the tourist industry in a resort town in mexico – she trusted that i would ensure at the very least less exploitative arrangements. for me, it was not quite so clear cut. my academic training in anthropology and women’s studies included critical a r t i c l e s paying down the care deficit the health consequences for grandmothers caring for grandchildren in a mexican migrant community of origin mary alice scott department of anthropology new mexico state university analysis of global care work chains, and i did not want to become part of those chains as an employer. i also recognized, however, that the imagined benefits of living and working in my house in the united states reflected the intense lack of resources that sara and other families like hers experienced. in the united states, she imagined, her family would have steady income from both parents. her children would go to school in a place where education makes a difference in the kinds of jobs a person can achieve. they would live in a house with consistent running water, heat, and air conditioning – among other things. sara was certainly acting in the best interests of herself and her family, and her expectations that life would improve in the united states were not necessarily unrealistic. my academic study, however, shows a darker side to this kind of arrangement. rather than an individual, mutually beneficial relationship between anthropologist and research participant, sara’s suggestion points to one abstract while significant research addresses global chains of care work from the perspective of female migrant workers engaged in low-paid, unstable domestic labor in “receiving” communities, little research has focused on those who substitute for migrant workers to provide care in communities of origin. this article addresses that gap by focusing on the health consequences of care work for grandmothers in southern veracruz, mexico who assume the primary responsibility for caring for their grandchildren when the parents migrate out of the community. based in the literature on care work and transnational families, this ethnographically-based article argues that grandmothers suffer consequences for their own health in three ways. they must deduct from their own health care resources – including time and money – to provide for their grandchildren. they must concede to the exploitation of already ill bodies to engage in the physical care of children and the household. finally, they must transfer energy for self-care to caring for others thereby exacerbating their own existing health issues in order to meet the physical and emotional needs of their grandchildren. the article calls for further research in this area that aims to develop solutions to the problem of “care substitution” in transnational families. keywords: intergenerational relationships, family, migration, care, mexico 143 anthropology & aging quarterly 2012: 33 (4) mary alice scott paying down the care deficit relationship within a system of exploitation in which immigrant women work for low wages and limited benefits in jobs rendered “unskilled” through a belief in women as “natural” care givers. these difficult personal interactions with sara were likely part of what drew my attention to grandmothers’ care work. in sara’s envisioned world, her children would accompany her as she traveled to another country to perform domestic work for white, middle-class women like me. the reality for many migrant workers, however, is that they go alone, leaving their children in the care of others – often grandmothers. while extensive research interrogates the exploitative conditions for immigrant women engaged in domestic labor in the global north, it often only hints at the consequences of care work for those who remain in communities of origin. my discussion of the health consequences of care for the women who engage in this care work contributes to research that seeks a more complex understanding of global care work chains, in particular health consequences for aging women with prolonged burdens of care. grandmothers’ experiences shed light on some of the lesser-studied consequences of transnational migration. this article begins with an overview of the research setting and methods. it then situates the study in the literature on care work and transnational families, and finally incorporates case studies from research in los cañales to rethink care work in the context of transnational migration. as i explain in more detail below, i argue that focusing on “care deficits” that are left when women migrate and leave their children in communities of origin only offers a partial theorization of global chains of care work. examining the practice of “care substitution” allows for a more complex reading of transnational migration and care, in this case elaborating the health consequences of such substitutions. setting and methods since approximately the year 2000, sugar-cane producers in los cañales have seen a steady decline in income, an issue that has left many with few options but to migrate for work. the majority seek employment in nearby cities or gulf of mexico oil rigs. in such cases, they often either move their entire families with them or travel between work and their homes in los cañales. some, however, head to mexican border towns like ciudad júarez and to the united states. in these cases, female migrants often leave their young children in los cañales. this incorporation of transnational migration as an economic strategy reflects the general increase in migration in the south-southeast region of mexico until 2009. between 1987 and 1992, 8.8% of the migrant population originated from this region. between 1997 and 2002, it increased to 12.9% (leite et al. 2009). the actual number of migrants from los cañales itself is difficult to determine, but it is common to see several houses on a block boarded up because an entire family has left, seeking work elsewhere. the current global economic crisis has significantly reduced international migration to the united states; such migration from mexico alone decreased 27% between 2007 and 2009 (inegi 2009). however, the number of mexicans living in the united states continues to increase (leite et al. 2009), likely signifying an increase in length of stay for multiple reasons, such as increased border enforcement, repayment of increased debts incurred in crossing, or completion of financial goals made at the outset of migration (massey and riosmena 2010; passel and cohn 2009). initial plans to remain in the us for a short period to earn money to build a house or start a business shift to longer term visions, as does the necessity for longer term care of young children in origin communities. the data presented below were collected between 2007 and 2009 as part of a larger ethnographic study of gendered health and illness experiences that involved 72 women in los cañales (representing approximately 10% of households) both with and without migrant family members. data collection methods included participant observation in women’s homes, in health clinics, at community events and meetings, and during transport to larger health care facilities outside of town and in-depth interviewing that included questions about household migration status and experience, household earnings and expenditures, personal and family member health issues and illness experiences, research participant involvement in household reproduction activities, and research participant social network resources. all research participants orally consented to participation using protocols approved by the university of kentucky institutional review board. in this article, i focus in particular on the illness experiences of grandmothers who are caught up in the flows of migration through their care work. my research shows that in los cañales, when their children migrate to the united states, grandmothers often become the primary caregivers of their grandchildren and experience health consequences as a result. theorizing care work: gendered and generational perspectives i follow zimmerman and colleagues (2006: 3-4) in understanding care work as “the multifaceted labor that produces the daily living conditions that make basic human health and well-being possible.” all people, at some anthropology & aging quarterly 2012: 33 (4) 144 mary alice scott paying down the care deficit mary alice scott paying down the care deficit point, have been and will be dependent upon the care of another person (meyer et al. 2000; tronto 1993). therefore, many analyses of care work seek not to problematize the act of caring itself (bubeck 2002), but rather to unmask the naturalization of care as women’s work, particularly the work of women who are marginalized by race, class, and nationality (feder and kittay 2002) and to examine care work as a site of social reproduction of the labor force and the basis for maintenance of social and economic institutions (litt and zimmerman 2003; zimmerman et al. 2006). feminist studies of care work and reproductive labor have proliferated alongside the increasing feminization of (undocumented) labor migration and globalization (see for example anderson 2000; chang 2000; hochschild 2000; mills 2003; parreñas 2001b; romero 2002). care work is a commodity that the wealthy can purchase cheaply in a labor market that relies heavily on immigrant women. while the shift to paid care work increases job opportunities in general for women, it also pushes them towards exploitative care work. as anderson (2000) has argued in detail, national immigration policies frequently lead to informalized, undocumented care labor. women who perform such labor may, for example, be required to relinquish passports and other legal documentation to employers. they are then tied to those employers and whatever conditions of labor the employers impose for the duration of their residence in the country, unless they wish to risk the possibility of being deported. that they often perform care work for middle-class or wealthy white women highlights the ways in which globalized care chains further stratify people by gender, class, race, and nation (feder and kittay 2002; zimmerman et al. 2006). women’s labor migration in such situations often initiates the creation of transnational families – families that are spatially and temporally separated through migration (hondagneu-sotelo and avila 1997) – where care becomes distributed across national boundaries (baldassar et al. 2007; boehm 2008; dreby 2006; parreñas 2001a, 2005; raijman et al. 2003). hochschild (2000) has argued that migrant women often leave “care deficits” in their home communities when they travel for employment in other countries. many women have children or aging parents who require additional care. while some migrant women are able to fill those deficits by employing another woman to perform care work in their homes, many lack the resources to hire a caregiver and instead must rely on unpaid female family members (meyer et al. 2000). research on care work has focused more attention on migrant women than on those who fill the so-called “care deficits” migration leaves in its wake2. research focused on the site of “care deficits,” such as the following analysis, reveals that the concept of “care deficits” risks obscuring the care work activities of women who fill in these gaps. in fact, the care “gap” is in some sense fictional because female kin often immediately fill it. to illuminate the process of filling the care gap, i suggest thinking in terms of “care substitutions” (to borrow from erel 2002). in such substitutions, gendered divisions of labor remain intact, but there is a generational shift in responsibility for doing care work at home. instead of providing local care for their children, migrant women provide care for middle-class women in other countries. instead of receiving care as they age, grandmothers in migrant communities of origin provide care for young children. the consequences of care work substitution for grandmothers include the production and exacerbation of chronic illness, an issue that underscores the need to deconstruct and work against not only the naturalization of care work as women’s work, but also the ways in which such naturalization burdens particular women in specific global contexts. in the following analysis of several case studies, i explain some of the health consequences of “care substitutions” involving aging (although still relatively young) grandmothers by examining how they (1) deduct from their own resources, (2) exploit their own bodies; and (3) transfer care from themselves to others in order to eliminate the “care deficits” that children of female migrants might otherwise experience. “i’m too old for this”: deducting from health care resources “i’m too old for this,”3 said patricia, age 55, sitting on the couch in a house filled with the cacophonous sounds of her four grandchildren. the five-room house was packed with gifts from patricia’s daughter susana who was working in ciudad juárez and her son emiliano who was working in the united states. the living room housed an entertainment center with a large tv, a dvd player, and a stereo; furniture including a small couch, two overstuffed chairs, a rocking chair, and a coffee table; and a motorcycle that patricia recently bought with remittances from emiliano. the motorcycle sat in one corner of the room underneath a hammock that patricia often used to rock her youngest granddaughter teresita to sleep. as the grandchildren loudly maneuvered through the living room and out the door, patricia ran her hands down her face and sighed. she felt “acabada” – which could be interpreted as both “used up” and “finished” with caring for young children – but had limited alternatives and little 145 anthropology & aging quarterly 2012: 33 (4) mary alice scott paying down the care deficit support4. patricia’s younger daughter ofelia had recently developed complications of kidney disease. in addition to caring for susana’s two children, patricia added the responsibility of taking care of ofelia and her two children. patricia’s sister lived next door but was often working in a city several hours away. although patricia experienced a significant increase in material possessions through gifts from susana and emiliano, she, like other grandmothers in los cañales, also experienced an intensification of carework as she became the primary care giver for her four grandchildren and ofelia. patricia often spoke of this caregiving as a burden, particularly because she saw herself as aging rapidly due to type 2 diabetes. i use patricia’s experience here to illustrate the ways that grandmothers frequently must deduct from their own health care resources in order to support the grandchildren in their care. although in patricia’s and others’ cases, the parents sent money for the grandchildren’s expenses, it was often not enough. for example, patricia’s older granddaughter eva had started kindergarten, and susana (eva’s mother) pledged to cover educational expenses. however, she could not always estimate the costs accurately nor could she always send money when patricia needed it: there are things that [susana] is not able to pay, and we help her. like right now, what [eva] takes to school, her food. what i have to put in, i put in. and it’s daily…a juice, a packet of those things… about 10 pesos goes. patricia supplemented these frequent expenses – snacks for school or supplies for a specific school project – that susana did not calculate in her remittances. to cover household expenses , including those of her granddaughters, patricia sold homemade candies and other food items. her husband had also recently acquired a job as a security guard, which paid less than what the family needed to move out of poverty, but did provide a more stable source of income than many families were able to obtain. therefore, patricia did usually cover extra expenses, but her responsibilities extended beyond financial support. she frequently expressed the tension she felt in having to choose between her granddaughters’ care and her personal, including health, needs. during one of our conversations, she said: i told [my daughter] that she should come back5 because i am going to give back her daughters. can’t you see that i am worn out? …because imagine, i have to raise them…to wash for them, cook for them, give them food to eat… and [my children] got married and made their lives. i stayed here with my old man, and it’s as if i were recently married [raising children again]. and now in bad health. patricia understood herself to be “too old” to shoulder additional caregiving responsibilities, a perception that was highlighted by her deteriorating relationship with her husband (who she was convinced had a younger girlfriend because patricia’s age made her no longer attractive to him). she additionally recognized the connection between her additional caregiving responsibilities and the decline in her own health. one day she told me, broom in hand, that she was too exhausted to even sweep the floor. she sat down on the couch rubbing her knee to alleviate the pain that the doctor told her was a result of diabetes-related poor circulation. the accumulation of care work for four grandchildren and her ill daughter left her unable to get up from her chair. however, patricia did not feel that she had a choice in whether to take care of her grandchildren or not – her responsibility as a grandmother left her no other viable options. day care centers existed where susana worked in ciudad júarez, but they were expensive. patricia additionally felt that placing the children in a day care center would constitute neglect because she did not trust the child care facilities in the city. she recounted a conversation with susana: she told me, ‘mom, will you take care of them for me?’ and i told her yes. i can’t force, i don’t want her to put them in daycare…better with me, with their grandmother than there. they rob them from you. rather than place her grandchildren in the care of strangers, in a place about which she had heard frightening stories, she preferred to take care of her grandchildren herself. patricia’s diabetes was worsening, though. the doctor had recently prescribed insulin; diet and exercise alone was no longer an option. this new treatment would add to the long list of medications she was taking for hypertension, high cholesterol, and asthma. already, she took her medication only sporadically due to limited supplies in the free health clinic and her inability to pay for medications at private pharmacies, largely due to the additional expenses incurred in caring for her grandchildren. in order to get an appointment at the public health center, she would have to arrive at the clinic before five o’clock in the morning anthropology & aging quarterly 2012: 33 (4) 146 mary alice scott paying down the care deficit mary alice scott paying down the care deficit with four children in tow to wait in line for one of the few available daily appointments. there was no guarantee that she would get an appointment, nor that the medicine she needed to take would be available in the clinic pharmacy6. therefore, she usually did not even try. patricia directly related her caregiving responsibilities to the deterioration of her own health and indirectly suggested that it was unjust for her to have these responsibilities at this point in her life. yet, she did not refuse to take care of her grandchildren. even further, she took in her adult daughter ofelia, in spite of the fact that ofelia’s husband lived and worked in the community. in the context of gendered concepts of care, his responsibility was to provide economically for the family, not to assist in the daily work of home dialysis and childcare. like other grandmothers in my research, patricia felt she had no choice but to take care of her family even at the expense of her own health. on numerous occasions, she intimated that she was frightened of meeting the same fate as her mother, who suffered the amputation of her leg and later died due to diabetes-related complications. the pain in patricia’s knee reminded her daily of that potential for herself. unable to limit her care giving responsibilities out of both love and duty, patricia, like other grandmothers in this study, deducted from her own health care resources – material, physical, and emotional – to invest them instead in her children and grandchildren. “who was i waiting for?” exploiting the body of the caregiver tamara, age 44, was raising her granddaughter with significant difficulty. she, like other grandmothers, considered her advanced age (in comparison to the young age at which many women in the community become mothers) a factor in her frequent fatigue and inability to muster the energy that she could as a young mother of three. tamara became the primary caregiver for her oneyear old granddaughter, rosita, when her daughter and her son-in-law migrated to the city of veracruz. although they were within a day’s trip from los cañales, they left rosita in tamara’s care several days each week. tamara woke up throughout the night to feed rosita, change her diapers, or comfort her. the activities were similar to those of raising her own children when she was in her late teens and early twenties. however, the experience was more difficult. she recalled being able to take care of her own children while still having time to attend to other household duties as well as to relax at moments during the day. she would carry one child on her hip and allow the other to cling to her leg while she was cleaning up the house or preparing food. then, she still had the energy to play with them when she was finished working. she didn’t have the same energy to take care of her granddaughter. the lack of energy made her feel old even though she was only in her 40s. additionally, tamara’s husband had recently awoken, unable to move due to a temporary paralysis from a chronic back injury. he had experienced this paralysis before, and tamara knew that this time would be no different. she would have to help him do everything. when he was sick, she told me, he was like a child himself. the caregiving responsibilities she had now not only for her granddaughter, but also for her husband, increased her fatigue, pain, and nervios7. when i visited her, she would regularly tell me that she could not even pick up her granddaughter because her back was hurting so badly. tamara was not relieved of caregiving when she was in pain, unlike her husband who demanded attention and care when in pain. like tamara, jesica similarly dealt with pain that left her exhausted, but she had limited options for relieving herself of care work in order to address her own health issues. jesica was 62 years old and lived about one kilometer from the center of town where health facilities were located. she lived with her husband, her son (who is deaf), and two of her grandchildren. her husband had what doctors (according to jesica) said was dementia. her grandson had developmental disabilities. jesica’s two daughters were both migrants. they lived in the city of veracruz during our interviews, but one previously worked in canada for several years. without her daughters present in the household, jesica shouldered the majority of the caregiving responsibilities, reflecting the gendered relations of care common for all the grandmothers in this study. her husband’s dementia required jesica’s constant vigilance and daily care. jesica was often kept awake at night because he experienced insomnia, and in his confusion tried to leave the house. due to his incontinence, she had to frequently wash his clothes by hand, as the family had no washing machine. she also had to assist him in getting dressed, eating, and going to the bathroom. her grandson’s developmental disabilities kept him out of school and in jesica’s care. jesica’s health issues were intertwined with her extensive caregiving. she had experienced the sometimes debilitating pain in her leg for more than 30 years and, although it was reduced with treatment from herbalists and medicine from the social security clinic8, when she worked a large 147 anthropology & aging quarterly 2012: 33 (4) mary alice scott paying down the care deficit number of hours the pain returned. however, she could not rest. as she explained, well, before, yes, it hurt quite a lot because i couldn’t walk. it was a sting, a suffering…i did my daily chores because it doesn’t matter, well, who was i waiting for? ...and, like that many years i raised my children and i was sick… who could jesica wait for given the gendered dynamics of care work that structure her daily lived experiences? that her son or her husband could be of assistance was in many ways inconceivable. although her husband was likely physically and mentally unable to provide assistance due to his illness, jesica never recalled him – even before his illness – engaging in the daily care work that sometimes left her unable to walk. i often observed her son return from a day of work (which was sporadic) to sit down at the table waiting for jesica to serve him a meal. he did, however, frequently run errands into town for jesica, who could not walk or ride a bicycle such a distance. that jesica consistently held the major burden of care work in the house reflects the normalization of this work as women’s work. in an ideal world, jesica would like her daughters to return to los cañales. if they did, jesica would not be burdened with such substantial labor. her daughters could take on some of that burden for her. when jesica’s daughter was in canada, she sent significant remittances, but even from veracruz, she provided more economic support than she would be able from los cañales. such support has allowed jesica to own a refrigerator and to pay for her husband’s medical bills. therefore, while she enjoyed the economic support she received from her migrant daughters, she was also concerned that the distance (particularly if her daughter returned to canada) precluded the kind of support that requires her daughters’ physical presence. they would be unable to accompany her to her husband’s health care appointments or to periodically relieve her duties around the house, for example. tamara’s and jesica’s situations reveal how the normalization of care work as women’s work leads to the exploitation of aging bodies in the context of migration. their daughters, who would likely share the burden of care work in a different situation, had migrated, leaving tamara and jesica with sole responsibility. both women felt that their older bodies could not do what they could when they were younger, but neither could count on assistance from men present in the household – whether husbands or sons. their chronic pain issues, then, are not simply a manifestation of the aging process. they result from a particular positioning of grandmothers as care workers in migrant-sending families. “i think a lot”: transferring care from self to other many grandmothers experienced the exacerbation of illnesses due to caring for grandchildren when parents migrated out of the community as we saw in the cases above. patricia, tamara, and jesica struggled to address their own health issues while also serving the needs of their grandchildren. while they also often transferred care from themselves to others, alicia’s situation most clearly represents the transfer of care i elaborate here. alicia has, in many ways, abandoned her efforts to address her diabetes because her doctor has told her that she must focus on herself in order to improve her condition – something she feels that she cannot do because she must focus her mental energy on her migrant children and on her grandchildren. alicia, age 57, lived with her husband alonso, her youngest son (age 23, single and unemployed) and her granddaughter veronica, age 12. her oldest son, veronica’s father, was working in the united states. when he first migrated, he took his wife and two daughters. after some time in the us, the couple thought that veronica was being exposed to too many “negative influences” – pressures to drink alcohol and use drugs, to have sex, to exhibit bad behavior at home and at school, and to drop out of school. when her older sister confirmed their fears by becoming pregnant at age 16, their preoccupation with veronica increased. they sent her to live in los cañales with alicia and alonso. at the time of my interviews with alicia, veronica’s parents could not send sufficient money for veronica’s care. her father was sick and unable to work. her mother only earned enough to cover their basic expenses in the united states. therefore, alicia and alonso were responsible for all the costs associated with their granddaughter’s care. alicia and alonso had long dealt with complications in securing regular household incomes. alonso’s severe knee pain kept him from working in his former profession as a bricklayer. he could now only sell snacks from a tricycle in front of the elementary school. alicia contributed from time to time with the sale of chickens. alicia and alonso’s economic situation was more difficult during school vacations – he couldn’t work at all, and she had to seek out temporary work like washing clothes to make up the difference. anthropology & aging quarterly 2012: 33 (4) 148 mary alice scott paying down the care deficit mary alice scott paying down the care deficit alicia also had advanced diabetes. when i asked her about her illness she said i am not afraid of death. do you know what i’m afraid of? leaving my kids. i know they love me a lot, you know? they love us…they love both of us. but they think about me more because of this illness that i have. he, i’m not going to tell you that he is healthy. he is also sick, but it’s a slower illness. in me, i feel that it is advancing very rapidly. and the doctor tells me that it is because i think so much…and that i have to take care of myself because my illness is advancing. recently i lost more weight…look how much weight i lost! i can’t control it, i feel badly; like i get the shakes, i shiver…and it’s because of that same illness, the sugar [diabetes], that’s what the doctor has told me. in that context, she also worries about providing for her family, including for veronica. without remittances from her son, alicia and alonso need to feed themselves as well as finance the education, nutrition, clothing, and food for their granddaughter. just before i arrived in los cañales, veronica contracted dengue when, unfortunately, it was also a difficult time financially for alicia and alonso. dengue arrives regularly with the rainy season when the reproduction of mosquitos in standing water facilitates its propagation. but the rains also brought difficulty to alonso in selling his snacks at the elementary school. fewer children went to school because mudslides often blocked several roads, and sometimes alonso could not ride his tricycle through the mud of the unpaved streets in his neighborhood. his knee pain weakened him, and he was unable to push the tricycle through the mud. alicia was preoccupied about providing for her family in these conditions. she needed cash to buy daily necessities. even though she could get credit at the stores, she was aware that credit has limits. she needed to maintain control over the debt to be able to pay it back during the rainy season when sales were more limited. if alicia felt pressure when she needed to buy basic household items at the store, it is perhaps obvious that her worry would be even greater when someone in the family was ill. when veronica contracted dengue, alicia and alonso took her to the doctor, but the only medicine they could give her was acetaminophen and juice to drink. they had to monitor her constantly to ensure that she did not develop a more serious form of the disease, which is more common in older children like veronica. as alicia and alonso often had difficulty obtaining money for their basic needs, an illness like that of their granddaughter creates an even more delicate situation. when they were younger, they were in a better position to look for work. now, in addition to being limited by age and chronic illness, they have financial responsibility for their granddaughter. the lack of money and the well-being of their dependents are preoccupations that became part of their daily lived experience. for alicia, as i mentioned earlier, it had the grave effect of worsening her diabetes – what makes her “think”, said alicia, would quickly bring her to death. the migration of alicia’s son left a major burden of reproductive labor on alicia and alonso, who stayed in los cañales, and this is not an uncommon phenomenon. in fact, what permits migrants to stay in the united states in spite of having poorly paid jobs is, in part, that much of the reproductive labor and support of the family of the migrant happens in communities of origin. even though migration did not produce alicia’s diabetes, it is evident that the situation in which she found herself resulted from the vulnerability that accompanies the migrant and his or her family members. alicia’s “thinking” emerged from the particular structure of undocumented migrant lives that shifts care onto grandmothers thereby exacerbating illness, diminishing well-being, and increasing the potential for early death. conclusion the research presented here suggests that gendered and generational notions of care – who should give what kinds of care, and who is competent to provide that care – place strains on women who have to move beyond the roles they feel competent to fulfill, particularly in the context of poverty and labor migration. establishing new roles (ones which they have no real option but to engage) creates worry, stress, and fear for their own well-being and that of their children and grandchildren. this examination of how caregiving creates such stresses contributes to ongoing cross-disciplinary and cross-cultural discussions of the health implications of grandmother caregiving. for example, there is no clear consensus that caregiving itself necessarily increases poor health outcomes for grandmothers. some studies have shown, for example, an increased risk for coronary heart disease (lee et al. 2003) and increases in stress that contribute to greater health vulnerabilities (cross et al. 2010); while others have shown no significant differences in health outcomes (chen and liu 2012). still others demonstrate a positive effect on grandmothers’ health and well-being, particularly in cases where children are old enough to 149 anthropology & aging quarterly 2012: 33 (4) mary alice scott paying down the care deficit provide assistance with household duties and where they provide emotional support (alber 2004; ice et al. 2008). however, the context and circumstance of caregiving does have an impact (hughes et al. 2007; ingstad 2004), a finding that supports the research presented here. significantly for this discussion, studies have shown that when it is parents’ difficult circumstances – including drug abuse, incarceration, serious physical or mental illness – that lead to custodial caregiving of grandchildren, the grandparents are more likely to experience negative consequences (goodman and silverstein 2002). in the cases described here, the circumstances frequently include not only the stresses of migration but also caring for grandchildren and other ill family members. the health consequences of the tensions that arise in the context of parental migration and increases in already significant burdens of care are at some times more obvious than at others; however, the consequences are real. the grandmothers’ life experiences presented in this article show the ways in which the global process of “care substitution” to aging women who live in circumstances of poverty and chronic illness act to diminish their quality of life. in order to minimally fulfill their responsibilities of care, grandmothers in los cañales must shift their resources – including time and money – into caring for grandchildren rather than using those resources to address their own health issues. as we saw in patricia’s case, waiting in line for a doctor’s appointment is nearly impossible because time does not allow both seeking health care and taking care of grandchildren. additionally because remittances are variable, patricia and other grandmothers have limited financial resources to purchase medication like insulin when supplies are not available in local free clinics. instead of “taking care” of her diabetes, patricia spends time with her grandchildren, buys their snacks for school, provides their meals, and maintains their health. she must, however, deduct from her own resources to do so. although the relationship of power between women and their migrant children is far more equal than that between migrant women and their domestic employers, “care substitution” still places grandmothers in a situation of exploitation. tamara and jesica exemplify this condition, although all the grandmothers experienced it to some degree. both tamara and jesica lived with daily chronic pain that required rest and relaxation, not prolonged care labor. given their responsibilities for their grandchildren and their husbands, neither had the luxury of rest. as i argued above, the normalization of care work as women’s work contributes to this exploitation of ill bodies. in both cases, men were present in the household who could have contributed to the care labor required to satisfy the needs of the very young and the very ill, giving tamara and jesica time to rest, but they did not. in all cases, women transferred self-care to care for others. alicia is a particularly good example of the ways that such a transfer happens. her preoccupation with her family – including both her migrant children and her grandchildren – led to a decline in her own health. her doctor repeatedly emphasized the need to reduce stress so that she could better control her worsening case of diabetes. a combination of poverty, migration, and illness limited alicia’s ability to experience moments free of stress. in a particularly insightful analysis of the consequences of migration and care, alicia argued that she would ultimately die because she “thinks too much.” in spite of, or perhaps because of, care substitution that normalizes women as always already appropriate caregivers, grandmothers sometimes felt that they were inadequate to the task of mothering because they were too old or too ill to take care of children. grandmothers also judged themselves against a notion of motherhood that they were unable to fulfill. migrant mothers could not fulfill it because of distance from their children. for grandmothers, it was fatigue, the potential for health crisis, and pain in particular that limited their abilities to take care of their grandchildren. this tension drew energy away from grandmothers’ self-care, whether that be through preparing diets according to doctor recommendations, attending appointments in the health clinic, or simply getting adequate sleep. however, grandmothers also resisted the idea of being inadequate mothers in multiple, although partial, ways. they pointed out their poor health conditions as unavoidable limitations to mothering and refused to blame themselves for their poor health. fathers and grandfathers were complicit in the construction of inadequate mothering because they offered little if any assistance that might improve care and relieve grandmothers. their resistance to fully accepting the consequences of care work as natural and unavoidable was only partial, and perhaps necessarily so, because such resistance did not lead to changes in the situation of care work. the lack of economic resources grandmothers and their families experienced left them little option but to send some family members away to work while others remained in the community to fill in for the absent laborers. women’s longstanding relationships with their husbands and other family members – in which women were consistently the primary caregivers – left little practical or strategic way for women to shift any anthropology & aging quarterly 2012: 33 (4) 150 mary alice scott paying down the care deficit mary alice scott paying down the care deficit responsibility for care work onto others. in light of the case studies presented here, i would argue we need further research about care substitutions in the context of global migrations in order to deepen our understanding of the situation of grandmothers like patricia, tamara, jesica, and alicia. it is my hope that this research can help direct us towards programs, policies, and other solutions that allow older women to live the lives that they had hoped they could. acknowledgements funding for this research was provided through an nsf ddig grant id#0752896 and a fulbright iie grant. i would like to thank miriam chaiken and two anonymous reviewers for commenting on a previous draft of this article. any errors and omissions are entirely my own. notes 1 names of research participants and of the research community are pseudonyms. 2 there are important exceptions in studies focused on grandparents caring for grandchildren whose parents have died of aids (see for example ice et al. 2008; upton 2003). 3 all interviews were conducted in spanish. english translations are by the author. 4 it should be noted that the narratives of suffering that i present in this article could be read as constructions of a gendered personhood defined and in some ways strengthened by suffering. malkin (2004), for example, describes how mexican migrant men use stories of suffering to enhance their own status as providers for their families. stephen (2001) also argues that women in the co-madres movement in el salvador strategically deployed their roles as suffering mothers to effect productive international political action. in my research, many women focused on narratives of suffering to the exclusion of other kinds of life stories. women’s lives are not wholly defined by suffering, and their narratives are strategic and partial presentations of lived experience (see hunt 2000). however, these partial representations do have real consequences for grandmothers’ health, which is my focus here. 5 susana did, in fact, return to the community at about the time i completed my fieldwork. it was unclear whether she planned to stay or had only come for a visit. 6 elsewhere, i have written in detail about the practical barriers to health care access for women in los cañales who rely on the public health facilities for care (scott 2010). 7 nervios in this context is a chronic illness often characterized by anxiety, headaches, and high blood pressure (davis and low 1989) brought on by continual life stresses (see baer et al. 2003). low (1989) and others (doyal 1995; jenkins 1996) have argued that this idiom of distress expresses confrontation with social, political, and economic exploitation and violence. 8 the clinic is part of the instituto mexicano del seguro social or imss which provides care in los cañales to cane growers both active and retired. references alber, erdmute 2004 grandparents as foster-parents: transformations in foster relations between grandparents and grandchildren in northern benin. africa 74(1): 28-46. anderson, bridget 2000 doing the dirty work?: the global politics of domestic labour. london: zed books. baer, roberta, susan c. weller, javier garcia de alba garcia, mark glazer, robert trotter, lee pachter, and robert e. klein 2003 a cross-cultural approach to the study of the folk illness nervios. culture, medicine, and psychiatry 27(3): 315-337. baldassar, loretta, cora vellekoop baldock, and raelene wilding 2007 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provide sole care for their grandchildren. journal of cross cultural gerontology 25: 371-383. davis, dona l. and setha m. low, eds. 1989 gender, health, and illness: the case of nerves. new york: hemisphere publishing corporation. doyal, lesley 1995 what makes women sick: gender and the political economy of health. new brunswick, new jersey: rutgers university press. 151 anthropology & aging quarterly 2012: 33 (4) mary alice scott paying down the care deficit dreby, joanna 2006 honor and virtue: mexican parenting in the transnational context. gender & society 20(1): 32-59. erel, umut 2002 reconceptualizing motherhood: experiences of migrant women from turkey living germany. in the transnational family: new european frontiers and global networks. d.f. bryceson and u. vuorela, eds. pp. 127-146. oxford: berg. feder, ellen k. and eva feder kittay 2002 introduction. in the subject of care: feminist perspectives on dependency. ellen k. feder and eva feder kittay, eds. pp. 1-12. lanham, massachusetts: rowman & littlefield publishers, inc. goodman, catherine and merril silverstein 2002 grandmothers raising grandchildren: family structure and well-being in culturally diverse families. the gerontologist 42(5): 676-689. hochschild, arlie 2000 the nanny chain. american prospect 11(4). hondagneu-sotelo, pierette and ernestine avila 1997 “i’m here, but i’m there”: the meanings of latina transnational motherhood. gender and society 11(5): 548571. hughes, mary elizabeth, linda j. waite, tracey a. lapierre, and ye luo 2007 all in the family: the impact of caring for grandchildren on grandparents’ health. journal of gerontology: social sciences 62b(2): s108-s119. hunt, linda m. 2000 strategic suffering: illness narratives as social empowerment among mexican cancer patients. in narrative and the cultural construction of illness and healing. cheryl mattingly and linda c. garro, eds. pp. 88107. berkeley: university of california press. ice, gillian h., amy zidron, and elizabeth juma 2008 health and health perceptions among kenyan grandparents. journal of cross cultural gerontology 23(2): 111-129. ingstad, benedicte 2004 the value of grandchildren: changing relations between generations in botswana. africa 74(1): 62-75. instituto nacional de estadística, geografia, e informatica (inegi) 2009 información sobre el flujo migratorio internacional de méxico. aguascalientes, aguascalientes, mexico. jenkins, janis h. 1996 the impress of extremity: women’s experience of trauma and political violence. in gender and health: an international perspective. carolyn f. sargent and caroline b. brettell, eds. pp. 278-291. upper saddle river, new jersey: prentice hall. lee, sunmin, graham colditz, lisa berkman, and ichiro kawachi 2003 caregiving to children and grandchildren and risk of coronary heart disease in women. american journal of public health 93(11): 1939-1944. leite, paula, maria adela angoa, and mauricio rodríguez 2009 emigración mexicana a estados unidos: balance de las últimas décadas. in situación demográfica de méxico. pp. 103-123. mexico: consejo nacional de población. litt, jacquelyn s. and mary k. zimmerman 2003 global perspectives on gender and carework: an introduction. gender and society 17(2): 156-165. low, setha m. 1989 gender, emotion, and nervios in urban guatemala. in gender, health, and illness: the case of nerves. dona l. davis and setha m. low, eds. pp. 23-48. new york: hemisphere publishing corporation. malkin, victoria 2004 “we go to get ahead”: gender and status in two mexican migrant communities. latin american perspectives 31(5): 75-99. massey, douglas s. and fernando riosmena 2010 undocumented migration from latin america in an era of rising u.s. enforcement. the annals of the american academy of political and social science 630: 294-321. meyer, madonna harrington, pam herd, and sonya michel 2000 introduction: the right to-or not to-care. in carework: gender, class, and the welfare state. madonna harrington meyer, ed. pp. 1-4. new york: routledge. mills, mary beth 2003 gender and inequality in the global labor force. annual review of anthropology 32:41-62. parreñas, rhacel salazar 2001a mothering from a distance: emotions, gender, and intergenerational relations in filipino transnational families. feminist studies 27(2): 361-390. 2001b servants of globalization: women, migration, and domestic work. stanford: stanford university press. 2005 children of global migration: transnational families and gendered woes. stanford: stanford university press. passel, jeffrey s. and d’vera cohn 2009 mexican immigrants: how many come? how many leave? washington, dc: pew hispanic center. raijman, rebeca, silvina schammah-gesser, and adriana kemp 2003 international migration, domestic work, and carework – undocumented latina migrants in israel. gender and society 17(5): 727-749. romero, mary 2002 maid in the u.s.a. new york: routledge. scott, mary alice 2010 la mujer se va pa’bajo: women’s health at the intersections of nationality, class, and gender. ph.d. dissertation, department of anthropology, university of kentucky. stephen, lynn 2001 gender, citizenship, and the politics of identity. latin american perspectives 28(6): 54-69. tronto, joan c. 1993 moral boundaries: a political argument for an ethic of care. new york: routledge. upton, rebecca l. 2003 “women have no tribe”: connecting carework, gender, and migration in an era of hiv/aids in botswana. gender and society 17(2): 314-322. zimmerman, mary k., jacquelyn s. litt, and christine e. bose 2006 global dimensions of gender and carework. stanford, california: stanford university press. anthropology & aging quarterly 2009: 30 (2) 25 connecting the anthropology of aging and occupational therapy/occupational science: interdisciplinary perspectives on patterns and meanings of daily occupation margaret a. perkinson, phd sherylyn briller, phd as highlighted by funding priorities articulated in the national institutes on health (nih) roadmap (2003), collaborations across disciplines represent today’s intellectual life at the cutting edge. gerontologists, and gerontological anthropologists in particular, are well-positioned to advocate for and assist in the development of innovative models of interdisciplinary scholarship, given our long-standing tradition of working across disciplinary lines in the attempt to understand aging in all its complexity. anthropologists of aging who work within the anthropology–occupational science/occupational therapy (anthro-ot) intersection are well-versed in addressing these issues. past society for medical anthropology president marcia inhorn (2007) identified the intersection between anthropology and occupational therapy/occupational science (the scientific discipline that informs the application or practice of occupational therapy) as one of the ten most promising areas for future research, and that intersection represents one of the primary foci for the 2009 sma conference, “medical anthropology at the intersection: celebrating 50 years of interdisciplinarity.” in this aaq special issue, we highlight recent dialogue between the fields of anthropology, gerontology and occupational science/therapy to gain a more nuanced understanding of the everyday experiences or “occupations” of aging and to convey the “lived experiences” of confronting the challenges entailed in conducting interdisciplinary work. this special issue contains overviews of papers presented in the conference session: “aging and activity: patterns and meanings of daily occupation,” presented at the 2007 american anthropological association meetings in washington, d.c. the session’s papers illustrate the ways in which these fields continue to inform each other and identify areas for future work. we hope this issue will contribute to the expansion and refinement of this dialogue. a brief overview of prior and current collaborations between the above-mentioned fields will provide context for the papers in this issue. anthropology and occupational therapy/ occupational science share major components of their identities as disciplines. both fields emphasize the importance of a holistic approach to the understanding of meanings within context. as defined by its professional society, the american occupational therapy association (aota), the contribution of occupational therapy (ot) as a field is in “… promoting the health and participation of people, organizations, and populations through engagement in occupation” (aota 2008, p.625). “occupation” refers to participation in “activities … of everyday life, named, organized, and given value and meaning by individuals and a culture. occupation is everything people do to occupy themselves, including looking after themselves…enjoying life… and contributing to the social and economic fabric of their communities” (law et al. 1997, p. 32). occupational justice has emerged as a central, orienting concept of the discipline: “… the profession’s concern with ethical, moral, and civic factors that can support or hinder health-promoting engagement in occupations and participation in home and community” (aota 2008, p. 630). implicit in this orientation is an openness to expand beyond a strictly medical model and embrace community-based rehabilitation and socially constructed models of disability. occupational therapy’s increased attention to social and occupational justice (kronenberg, algado, & pollard 2005; pollard, sakellariou & kronenberg 2009) underscores its shared interests with anthropology in critical issues relating to social equality, social marginalization and the representation of diverse voices. a small but growing number of ot departments count anthropologists among their faculty, and a few leading scholars have advanced degrees in both fields. initial collaborations among anthropologists and ots developed over time and eventually reached a critical tipping point at the 2006 society for applied anthropology (sfaa) meetings in vancouver, where gelya frank (anthropologist) and ruth zemke (occupational therapist) organized an invited double panel, “occupation on the edge: the new discipline of occupational science in dialogue with anthropology,” devoted to the anthro-ot connection. the high level of interest that these panels generated prompted the organization of a three-part anthroot series of panels for the following 2006 society for the study of occupation (sso) meetings, held in st. louis, mo, thereby reaching a larger audience of occupational therapists. momentum continued to build as sessions showcasing the anthro-ot connection were held at subsequent aaa, sfaa, and sso conferences. practicing anthropology devoted a special issue to anthropology and ot (block, frank, & zemke 2008), further highlighting the advancement of theory and practice across these disciplines. the most recent sfaa meetings, held in santa fe, march 2009, showcased ten features anthropology & aging quarterly 2009: 30 (2) 26 features anthro-ot related sessions, with contributions from a world-wide assembly of scholars from the united states, sweden, japan, england, china, brazil, canada, and south africa. given the intense level of interest and the numbers of persons involved, it was only a matter of time before this emerging movement crystallized into a special interest group. a document proposing the formation of the national association for practicing anthropology (napa) occupational therapy and occupational science interdisciplinary special interest group (napa ot–sig) (frank, 2007) summarized the ongoing interactions between anthropology and ot and provided the rationale for further collaborations. the proposal was accepted, and the interest group was officially approved by the napa governing council in 2007. as reported in the executive summary from this new interest group’s first meeting, the napa ot–sig currently focuses on (1) becoming an academic presence at conferences, building alliances and collaborations; and (2) developing an interdisciplinary field school in guatemala for education and collaborative practice between anthropologists, occupational therapists, and disability studies scholars. the napa-ot field school in antigua, guatemala was approved by both napa and aaa and will hold its inaugural session summer 2009. its intent is to “provide a setting where anthropologists and occupational therapists can study, practice, and learn together.” social justice and the political practice of ot across the life course provide the conceptual frameworks that undergird its three areas of focus: neonatal assessment and early child development, disability studies, and communitybased gerontology. the presence of the gerontological component underscores the importance of aging in this intellectual mix. aging issues have consistently been a part of the above-mentioned conference sessions and publications. some individual papers in past conference sessions focused specifically on issues of older adults, such as margaret perkinson’s series of papers on the “exercise and dementia project,” wendy wood’s work on dementia, susan magasi’s work on issues of nursing home residents, and devva kasnitz, russell shuttleworth, and robert pedlon’s work on technology, aging, and disability. others, while not focusing on older adults per se, discussed topics relevant to both aging experiences and community-based disability research (e.g., cathy lysack’s work on community participation, marginalization, and disability and elaine gerber’s work on community-based research with persons who are blind). sherylyn briller and jayne yatczak envisioned new models for cross-training opportunities and interdisciplinary career development for anthropologists preparing for careers in ot research and teaching. however, the 2007 aaa conference session that is the basis for this aaq special issue was the first session with a primary focus on old age to come out of the anthroot connection. the central premise of the “aging and activity: patterns and meanings of daily occupation” session was as follows: “the concept of daily occupation is the focus of the practice profession of occupational therapy and its basic discipline of occupational science. occupations, broadly defined, refer to personally meaningful chunks of activity that are the basis of everyday routines, are organized within or in relation to social structures, and have cultural salience. the development of research on the organization of daily activity and its relationship to health and well-being promises to improve life opportunities for people of all ages. however, this research is particularly salient to older adults, who often find themselves marginalized, denied access to mainstream occupations. this panel was designed to bring together anthropologists and scholars in occupational therapy and occupational science to discuss interdisciplinary concepts, approaches, methods, and data as well as practice implications, in their work as it relates to age and wellness.” two senior scholars in the fields of occupational science/occupational therapy (charlotte royeen) and anthropology and gerontology (mark luborsky) served as discussants for the session. rather than simply providing feedback on individual papers, each of these discussants elected to make broader framing remarks about the emerging anthro-ot intersection and their longer-term vision for interdisciplinary scholarship in this area. charlotte royeen, phd, otr, dean of doisy college of health sciences, saint louis university, presented the ot perspective. as a scholar coming to the anthropology meetings from another discipline, she highlighted the importance of using a common language to frame research questions and operationalize definitions of key concepts. dr. royeen considered shared terminology a necessary prerequisite, not only for discussions of aging and activity-related issues, but, more broadly, for the interplay of these fields and their shared research and practice agendas. dr. royeen concluded these remarks by expressing her enthusiasm for this crossdisciplinary dialogue and her desire to see it to continue to grow over time. mark luborsky, phd, professor of anthropology and director of aging and health disparities research, wayne state university institute of gerontology, employed a strikingly vivid metaphor, the exploration continued on page 41 anthropology & aging quarterly 2009: 30 (2) 41 perkinson and briller, continued from p. 26 of a new house, to convey the experience of venturing into a new place (either physical or intellectual) and thoroughly exploring it, room-by room. this orienting metaphor enabled him to discuss quite eloquently how he viewed the “fun” (aka intellectual excitement) of throwing open the doors and seeing what one finds in these rooms. upon entering each new room, one can see what is already there and the overall dimensions and characteristics of these spaces. sometimes one knows about key aspects of what one will find there, and sometimes one is surprised as well. opening these doors also presents opportunities to think about how the various “rooms” in the house fit together and can be coordinated over time. he captured the excitement that comes at the beginning of such an exploration and recommended paying close attention to all aspects of this discovery process, keeping the “big picture” in mind and never forgetting the fundamentals of each field—e.g., what makes the framing of a particular issue anthropological, and likewise for ot. the “good bones” of the anthro-ot house, with its strong foundation and supporting structures, should provide an appropriate environment that will foster the continued growth of our cross-disciplinary dialogue. in spite of its time slot (i.e., the last morning of the conference), it was clear that the session had an impact. there was much post-session discussion in the hallway about individual papers, the discussants’ comments, and where to go from here; so much so that several people expressed concern about making it to the airport in time to catch their flights. we, as the session organizers, took it as a good sign that this conversation continued, that there was enthusiasm for ongoing exploration of this linkage, and it fortified us for taking this work forward. we hope that you will enjoy reading about these issues, learning about what has been discussed so far, and adding your own voices and perspectives to extending this conversation. references: american occupational therapy association (aota). 2008. occupational therapy practice framework: domain & process. 2nd edition. bethesda, md: the american occupational therapy association, inc. block, p., frank, g. & zemke, r. 2008. practicing anthropology (special issue on anthropology and occupational therapy), 30(3). frank, g. 2007. occupational therapy & occupational science interdisciplinary interest group: a proposal to the national association for the practice of anthropology. inhorn, m. 2007. medical anthropology at the intersections. medical anthropology quarterly, 21(3): 249-55. kronenberg, f., algado, s. & pollard, n. 2005. occupational therapy without borders. edinburgh: elsevier/churchill livingstone. law, m., polatajko, h. baptiste, w. & townsend, e. 1997. core concepts of occupational therapy. in e. townsend (ed.), enabling occupation: an occupational therapy perspective (pp. 29-56). ottawa, on: canadian association of occupational therapists. pollard, n., sakellariou, d. & kronenberg, f. 2009. a political practice of occupational therapy. edinburgh: elsevier/ churchill livingstone. the individuals’ “life opportunities.” in all likelihood, most of them will become practitioners, not researchers, but this experience allows them to see why evidence-based practice is important and how an interdisciplinary lens enhances both their field and others. schatz, continued from page 27 adults’ interest in not only “doing something” but also “being someone”, and for these participants, that meant being recognized as active, engaged, independent and therefore, vital contributing members within american society. going forward in extending this research program, i look forward to drawing upon and integrating a variety of disciplinary perspectives that can inform this work from anthropology, gerontology, occupational science/occupational therapy, and technology studies, to list some relevant areas here. harrod, continued from page 29 p25-26perkinson-briller2009-4 p41_30 (2)may2009-2 anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 103-104 issn 2374-2267 (online) doi 10.5195/aa.2015.97 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review growing up growing old: trajectories of times and lives. nicholas, a. and flaherty, i. eds.. oxford, united kingdom: interdisciplinary press. 2013. isbn: 978-1-904710-94-8, 229 pp. price £19.99 (paper). diane l. brown, ms program manager ii, medical college of wisconsin. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.97 http://anthro-age.pitt.edu book review nicholas, a. and flaherty, i. (eds.). growing up growing old: trajectories of times and lives. oxford, united kingdom: interdisciplinary press. 2013. isbn: 978-1-904710-94-8, 229 pp. price £19.99 (paper). diane l. brown, ms program manager ii, medical college of wisconsin one can find volumes on the different generations and interpretations of each unique group but when turning to our older generation many of the terms used to describe this exceptionable group reflect an end point: of a career (retirement), health, happiness, and life in general. we tend to think of our aging generation as alone, with declining health, with little understanding of how they got to where they are in life void of any type of celebrations post retirement. in growing up growing old: trajectories of times and lives, aging is seen through the eyes of different cultures and belief systems. the book is divided into four parts from “trajectories in time: chronology, age, and visions of the life-course” to “shifts and continuities: reflecting upon time and generation” and provides a series of eleven narratives based on different cultural beliefs. what makes this book unique is the stories presented not only represent events that take place later in life, but within an individual’s overall life course; events that one might take for granted not recognizing the impact each play in defining old age. all the stories in this book share a common interest in the topic of ageing and in the different ways that life-courses may be shaped in different historical and cultural contexts. the authors engage in a fruitful mutual exchange, and they do so from different angles and perspectives. the interdisciplinary approach in this book provides a most promising arena for the discussion of ageing. in many cultures, age is celebrated as a “fundamental” principle of life. chen hee tam presents a narrative about the chinese culture and describes how their society is “age-graded” not only in the way chinese people relate to one another but also in how they describe their individual historical situations in generational terms (pp.47-60). the chinese relate to one another in terms of age hierarchy; not seen as a negative but a placement in society. tam’s story is supported by the idea of the “mannheimian concept” which basically says generations can become distinctive from other generations based on their “participation in life events” (p. 48). mannheim’s concept requires socially meaningful age parameters rather than arbitrarily delineated markers for generations (p. 49). in the narrative entitled “without a centre that holds: contemporary adulthood and the devolving life course “ blatterer (pp. 27-47) defines aging as a linear, 6-step process defined by childhood, education, adulthood, work, retirement, and age and stresses how difficult it is to “dislodge” oneself from this cultural belief. it is interesting to note how many of the authors presented in this book recognize common historical experiences during the formative years of an individual’s life stepping stones for shaping a specific group or generation. looking back to the different generations and how each have addressed aging, for example, the “silent generation” grendell | book review anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.97 http://anthro-age.pitt.edu 102 (circa 1924-1945) this group of individuals basically followed the footsteps of their fathers. they did not make a mark for themselves like those following them (e.g., boomers) have, but transitioned throughout life from childhood to old age, reaching each benchmark in life, but as blatterer describes, found it difficult to dislodge from the traditional belief. when this group approached their early 60’s they assumed work life was over and retreated to the golf courses of arizona or florida and became known as the snowbirds. unlike the boomer generation who celebrated throughout life, continuously growing both personally and professionally, who refuse to stop living (and working) just because they reach a specific age identified as retirement by those who came before them. a major takeaway after reading this book is to celebrate life and the historical events associated to specific benchmarks over time and recognize the impact each has in moving forward and most importantly celebrate life far beyond the age of 65. don’t accept the linear process as reaching an end point; but as a progression and celebration that should continue no matter what age, if alone, or at the end of a career. utilize the ebbs and flows throughout midlife as a period of “reassessment” evaluating one’s achievements, assessing the present and most importantly, plan for the future (p.120). growing up and growing old is not attempting to reach an identified end point based on a linear timeline but recognizing the different shifts presented throughout life and to continue to strive and accomplish things far beyond what generations past have identified as old age. this is a great book for anyone particularly those in midlife who are experiencing initial life changes, who are grounded in the traditional theory of aging as a linear process, who have not “dislodged” themselves from tradition and are struggling with what they have been taught about growing old. the myth of average: active senior citizens in the aomori prefecture in japan motohide miyahara motohide.miyahara@gmail.com institute of ars vivendi, ritsumeikan university; japan centre for evidence based practice abstract japan is known for the highest life expectancy in the world, but there are regional variations within the country. aomori, located at the northern tip of japan’s mainland, is the prefecture characterized by heavy snow in winter and the lowest average life expectancies for women and men. their short life expectancies have been attributed to excessive sodium intake and physical inactivity. in this shortterm reflexive ethnography, i take the postpositivist stance and set up a strawman claim of “all citizens of aomori prefecture are physically inactive” in order to falsify it by providing a counter example. the counter example is a community of very senior citizens over 80 years of age who are physically and socially active in playing indoor golf. my purpose in writing this research report is to share an encounter with a unique community through a contextualized physical activity setting and a reflection on issues related to the community’s survival. the theoretical model of physical literacy has informed my observations, conversations, and reflections that are narrated in the impressionist mode. my narrative demonstrates that there are physically active senior citizens in the aomori prefecture. moreover, my interview with an organizer uncovered that the senior golf players were facing challenges to participate in and sustain the golf program in the future. keywords: ethnography; postpositivism; older adulthood; physical literacy; physical activity anthropology & aging, vol 43, no 2 (2022), pp. 58-66 issn 2374-2267(online) doi 10.5195/aa.2022.408 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. mailto:motohide.miyahara@gmail.com miyahara | 58 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu the myth of average: active senior citizens in the aomori prefecture in japan motohide miyahara motohide.miyahara@gmail.com institute of ars vivendi, ritsumeikan university; japan centre for evidence based practice introduction aomori prefecture123 is located at the north end of japan’s main island, honshu. much of the highlatitude winter precipitation falls as heavy snow, affecting transport and preventing people from venturing outdoors. in the past, food supply was limited during the winter, and people relied on salt as a preservative, which led to the prevalence of a diet that was high in sodium (ehara 2012). even after refrigerators replaced salt’s preservative function, aomori inhabitants still had high-sodium intake (ministry of health labour and welfare 2012). thus, it is no surprise that excessive sodium intake, coupled with physical inactivity, is one of the reasons for aomori prefecture’s lowest in the rankings (47th in japan) with respect to life expectancies (nakaji et al. 2021), which was 85.9 years for women and 78.7 years for men in 2015 (ministry of health labour welfare 2017). population health research typically employs either one of two distinct methodologies: the positivist and postpositivist approaches (carpiano and daley 2006). the positivist approach has been often criticized for its reductionist perspective on the human individual or group as a sum of variables (bergman and trost 2006). for an example, a large-n quantitative research project concerning medical and health-related variables has been conducted in an attempt to improve the health index and average life expectancy of aomori prefecture’s residents (nakaji et al. 2021). positivist scientists consciously manipulate variables to examine the effects of the manipulation (guba and lincoln 1994). in the case of the large-scale quantitative research project, the variables for manipulation are health indicators, such as physical activity levels, with the aim of improving population health and average life expectancy. to date, there is no strong evidence for the benefit of general health checks in adults for reducing morbidity and mortality from diseases (krogsbøll, jørgensen, and gøtzsche 2019). while the natural science model continues to play an important role in modern medicine by describing, hypothesizing, testing, and thus attempting to control desired outcomes, the social science model cultivates practical reasons to provide a richer and more comprehensive understanding of situations that includes nuances and complexities (buchanan 1994). regarding the promotion of physical activity in senior citizens, almond (2010) argues that the prevention of negative outcomes, such as the health and the economic cost of inactivity, is not sufficient to motivate older adults to be more physically active. rather, almond (2010) constructs a social science model of physical literacy as a lifespan issue and maintains that older adults require two positive perspectives: purposeful physical pursuits to energize and enrich their lives and a pedagogy of engagement with enthusiasm, empathy, interest, and confidence. the british heart foundation has implemented and demonstrated effectiveness of these perspectives (almond 2010). in contrast to positivism, the postpositivist approach is based not on a priori measurements of human subjects but on human conjectures or claims (lindlof and taylor 2002). postpositivist researchers seek falsifiable claims and test them by interacting with research participants and obtaining and representing http://anthro-age.pitt.edu/ mailto:motohide.miyahara@gmail.com miyahara | 59 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu contextualized qualitative information from small unrepresentative samples to refine or abandon the claims (dudley et al. 2000; flyvbjerg 2001). in the present study, i adopt the postpositivist stance, and attempt to falsify the claim that the residents of aomori prefecture are physically inactive by describing an “anomaly”—a group of active senior citizens—through the lens of ‘physical literacy’: purposeful physical pursuits and pedagogy of engagement (almond 2010). i also attempt to identify needs for the active senior citizens to sustain their engagement in the activity. regardless of how atypical this group engaging in “best practices” of physical activity may be, i hope to refute the claim of inactivity, while highlighting areas for potential support. methods philosophical perspective and methodology the present study is based on the philosophical perspective of postpositivism (phillip and burbules 2000) and the postpositivist methodology of short-term reflexive ethnography (pink and morgan 2013), which guide the use of observation and reflection as a primary data collection method. in his historical review of positivism, corman (2005) candidly asserts that “positivism is a strawman.” to falsify a strawman claim, according to hicks (2018) citing popper (1968) who used the verbiage that “all swans are white,” a postpositivist needs only to find a single black swan (phillip and burbules 2000; hicks 2018). note that popper has been considered an early postpositivist (corman 2005). in line with this approach, i construct a strawman claim that “all citizens of aomori prefecture are physically inactive” for the purpose of dismantling it. given the low average life expectancy of aomori’s inactive residents who consume high-sodium diets—the white swans—i falsely assert that i cannot expect to encounter any physically active senior citizens—the black swans. i then counter this assertion by describing the black swans, or more precisely, a substantial group of physically and socially active women and men who enjoy playing a sport. it is apparent that the data of the low average life expectancies, high sodium intake, and low physical activity level of people in aomori prefecture are based on the statistical inference about the population means. the statistical inference assumes deviations from the means and the possible existence of outliers. to provide a research motivation as part of my self-disclosure, the core research purpose is not to undermine the statistical statement but to challenge and contrast it against a counter example. in conclusion, i share my reflections on the complex and nuanced issues for the community’s survival. selecting a research setting and gaining access this research project was conducted during a five-month period that i spent in aomori between 2020 and 2021 under the restrictions imposed by covid-19. i had few opportunities to directly observe people, older adults in particular, engaging in physical activities in public spaces. to construct, rather than discover a research field site (burrell 2009), i followed the first step that burrell (2009) proposed and sought entry points rather than sites. these entry points included the sports promotion department of the local city government and city newsletters. i carried out all written and oral communications in standard japanese and translated them into english for this report. following several unsuccessful attempts to reach the organizers of sports events that were announced in the newsletters but canceled due to the pandemic, i eventually succeeded in communicating with an organizer of indoor golf games, mr. spark (pseudonym), by calling the telephone number provided in an advertisement in a city newsletter: http://anthro-age.pitt.edu/ miyahara | 60 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu newsletter advertisement recreated by author. translation: senior citizens get together workshops for new sports: “gate ball” (30 people), “ground golf” (80 people), pétanque (42 people), “mallet golf” (30 people), “target bird golf” (40 people). citizens aged approximately 60 years and over can participate free of charge on a first come, first served basis. to save your place, call this telephone number xx-xxxx. mr. spark answered the phone, listened to my explanation, and communicated his understanding of my research project. he invited me to a ground golf practice on a particular morning. i eagerly accepted the invitation and told him that i would send him written information on the research project and a consent form by post. methods of data gathering, recording, analysis, and representation to ensure focused observation and interaction with selective informants for short-term ethnography (pink and morgan 2013), i was careful not to be intrusive by following mr. spark’s guidance at the indoor golf hall and conducting non-participant observation of golf players first until i felt the players were ready for my participant observation. i then interacted with them in the hope of having short but intense encounters. my observation focused on the overall impression that i obtained from the scenes, or “feelings of the scenes” (angrosino 2007) through observing the participants holistically rather than the identifiable details (e.g., exact number of people, age, gender, name, address and so forth) of the individuals, who remained anonymous. for this reason, informed consent was obtained only from mr. spark before an unrecorded personal interview. ethical approval for this study was obtained from the committee of health science ethics of the hirosaki university graduate school of health science (2018168-1). adopting an impressionist mode (angrosino 2007), i took fieldnotes on sporadic occasions when i encountered impressive scenes in terms of “purposeful physical pursuits” and “pedagogy of engagement” (almond 2010). i present my impressions, self-disclosure, and my reflections in the observations section below. findings from non-participant observations, participant observations, and mr. spark’s interview will be triangulated to reflect the diverse dimensions of the field (flick 2018). http://anthro-age.pitt.edu/ miyahara | 61 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu observations day one: february 4. first field visit accessing the field. it is early morning in my parking lot, i scrape the ice from my windshields, remove the snow that has accumulated on my car, and drive along the snowy road to the indoor golf hall that i have never visited before. despite the continuous snow, the visibility is manageable on the well-guided main road. following my gps, i leave the road, drive towards a small town, and follow a narrow road to the end of the town, surrounded by nothing but snow. the gps directed me to a snow-covered path, and i proceed carefully. eventually, i spot a sign in front of a building that reads, “indoor golf hall.” i park my car, replace my snow boots with my sneakers, and walk to the entrance. it is 8:30 a.m., half an hour before golf practice starts. a small number of older men and women are standing in line, cleaning their hands with sanitizer gel, and writing their names and contact details on the clipboards held by two men who appear to be the organizers. i stand at the end of line and wait. presenting and immersing myself to the field. when my turn comes, i introduce myself to the organizers. one of them smiles and identifies himself as mr. spark, the person i spoke with over the phone. he introduces the man next to him as mr. director (pseudonym) of the indoor golf hall. during this brief interaction, dozens of senior citizens arrive behind me and wait in line. to avoid getting in their way, i enter the hall, find a bench on which i place my bag, and prepare a pen and field notebook. at 8:50 a.m., the indoor golf hall is filled with players, scattered throughout the space and performing warm-up swings. all the players seem to know what they are doing. at 9:00 a.m., mr. spark blows a whistle, and the players gather around mr. director and mr. spark. i stand behind the players facing mr. director and mr. spark. mr. director offers a brief greeting and announces the beginning of the practice session. mr. spark then reviews the schedule and logistics of the morning’s practice before finally introducing me to the players: “miyahara sensei (professor) works for a local university, and he is visiting us today to conduct research on physical activity for senior citizens. please introduce yourself, miyahara sensei.” “thank you, mr. spark. i am miyahara, still 59 years of age, not yet fully qualified to join your group, but please allow me to observe your activity here today.” mr. spark asks whether any of the players object and confirms, “silence is taken as approval.” mr. spark blows a whistle again, and says, “let’s get started.” several groups spread over the two courts and the players in each group begin to take turns at hitting the ball. non-participant and participant observation of practice session 1. to observe the players, i first place myself on the top of a platform outside the courts to avoid obstructing the play. the players wear outfits of assorted colors and styles: some appear to be wearing their casual winter jackets, pants, and outdoor shoes, while others appear to have intentionally coordinated their entire outfits for playing golf, including their hats and scarves. the players use their own golf clubs which they call “my club.” my impression is the players are all financially well-off. after the players take their shot, they move to the location of their ball: some wait until the ball has stopped and walk to the resting ball; others begin walking briskly before the ball has come to a halt and chase after the rolling ball; others run after the ball as soon as they have completed their shot, despite their advanced age. eventually, a ball rolls out of bounds and reaches my feet. i assume that the player needs to collect the ball and go back to where the ball went out of bounds. with the best of intentions, i pick up the ball and hand it to the player, but the player grabs the ball, evidently upset, and explains that the rules state that http://anthro-age.pitt.edu/ miyahara | 62 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu the ball should be left where it lies. i feel embarrassed and apologize. the player then smiles, saying, “it’s just a game.” between shots, players chat pleasantly with one another in their groups, commenting on their own and others’ shots, catching up on each other’s lives, and clearly enjoying one another’s company. after a short time, all groups rotate around the courts. mr. spark blows a whistle and say, “let’s take a break.” interview. during the break, mr. spark and mr. director guide me to a staff office building apart from the hall. there are two desks, a pair of couches facing each other, and a table on which numerous boxes and sheets of wrapping paper sit. mr. spark tells me to take a seat on the couch and he sits on the other side. mr. director excuses himself for wrapping prizes for the upcoming event and designates mr. spark to take my interview. i ask mr. spark to read and sign the informed consent form, so he does. having observed his clear communication style during our telephone conversation, i decide that it is not necessary to audio-record the interview, and that it will suffice to make notes afterwards. i first ask mr. spark about his background and his current role in the hall. he explains that he is the retired ceo of a major merchandising company; since his retirement, he has held the manager position in the indoor golf hall, which is run by the city’s council for social welfare. he and mr. director perform a range of tasks, including planning, recruiting, organizing practices, and running competitions. when i ask how the golf hall is used, mr. spark explains in a clear and logical fashion: the current number of users is approximately 200, much less than the number ten years ago. the present users’ ages range from 80 to 93 years. we are struggling to recruit younger participants aged from 60 to 80 years, which we need to ensure the continuity of the indoor golf activities and to secure city government funding for the hall’s maintenance. the other problem is transportation; most participants share rides with their neighbors, and often the youngest person in the neighborhood serves as the designated driver. when the driver becomes unavailable due to illness or unforeseen circumstances, all intending to travel with that driver must forgo participation on that day. the closest bus stop to the hall is a few miles away in town, and it is not realistic or safe for the older participants to walk from the bus stop to the hall in the snow. because the participants live in different areas of the city, it is impossible to charter a bus to collect them from all over the city. i asked mr. spark why people aged 60 to 80 do not participate in indoor golf activities. he disclosed that he himself falls within that age range and speculates that his generation is not accustomed to group activities. as someone slightly below that age bracket, i am puzzled by his theory, because post-wwii baby boomers seem to me to be significantly more group-oriented than my generation. i decide to hold on to this conundrum as my homework, because the break time is up, and the second half of the golf practice session is about to begin. mr. director, mr. spark, and i return to the hall. non-participant and participant observation of practice session 2. where the players formed groups with their neighbors and friends for session 1 before the break, the organizers have randomly assigned groups for session 2 so that strangers can get to know one another. with the new group members, the players begin a new round. having made the mistake of picking up a ball prior to the break, i have learned not to pick up any approaching balls. i am also on alert to any movement on the ground so that no ball will hit my feet. at one point, i hear footsteps approach me. the owner of the footsteps extends a golf club and ball toward http://anthro-age.pitt.edu/ miyahara | 63 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu me, asking “sensei, why don’t you also play?” behind him, a group of players are watching and awaiting my response. i feel pressured, make up my mind, and say, “i will give it a try.” this represents an unplanned but smooth transition from non-participant to participant observation. in my first attempt, i hit the ball too hard, and it goes out of bounds. the next time, i strike the ball as though the club were a putter, and the ball goes right into the target gate. the audience cheers, but my swing still seems too hard, and the ball goes out of the gate. the audience sighs with me. i feel as though i belong to the group of compassionate and encouraging players and as though i am participating in this activity not as a researcher but as a fellow player. day two: february 9. golf competition observing competition session 1. at 9 am, a line of gift-wrapped competition prize boxes—awards for places from the first to ninth, participation awards, a “booby prize” (i.e., consolation prize), and a hole-in-one prize—are neatly displayed on top of a long table. mr. director gives a brief greeting, and mr. spark introduces me to the competitors as a researcher observing the event. due to the time pressure, i have no opportunity to introduce myself this time, and the indoor golf competition begins. this group of competitors are more serious, chatting and laughing less, than the practice group that i observed on day one. i jot down players’ words that i hear in my fieldnotes, including “shoot! the ball has gone out of bounds.” one player is trying to use psychokinetic powers to influence the rolling ball, pointing at and saying “listen to me. go this way.” one female player approaches me and informs me, “in the group of players over there, there is a 90year-old player. i have pain in my back and legs, but i still play.” i ask, “does your pain improve while you are playing?” she replies, “no, it doesn’t, but i still play.” “do you have fun?” i ask. “i am having great fun!” she replies, with her face breaking into a smile. intermission. both mr. director and mr. spark are too busy with the competition to talk to me, and i continue to observe how the competitors behave during the break. one competitor is standing in front of the awards table, browsing, touching, and lifting the award boxes one after another. realizing that i am watching him, he mutters, “i cannot win any of these.” i ask, “you cannot win any of these?” the competitor explains, “before this intermission, you have to score 30 points.” “is that so?” i say, indicating my understanding. the 10-minute break is approaching its end. i become tired of standing and sit on a bench. a male competitor sits next to me and asks a question, “how many indoor golf teams exist in this city?” “sorry, i don’t know.” i answer honestly. before i finish the sentence, he begins talking so rapidly in the local dialect that i can barely comprehend. i manage to glean only that he is currently ranked seventh, four points behind the player who is ranked first. competition session 2 and awarding ceremony. the competition resumes, and i watch and admire the players’ fierce competitive play. the game eventually ends, and the awarding ceremony begins. mr. spark reads out the winners’ names, and mr. director distributes the awards individually. some players chuckle as the booby prize is presented to one competitor. the awarding ceremony is completed in due course, and the competitors walk toward the exit door. smiling broadly, one of them approaches me, proudly brandishing his box labelled “fourth prize.” i recognize the face of the man who sat next to me on the bench toward the end of the break, and i shout “congratulations!” http://anthro-age.pitt.edu/ miyahara | 64 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu discussion adopting a postpositivist approach, the present short-term ethnographic study sets up the strawman claim that “all citizens of aomori prefecture are physically inactive” and, ultimately, falsifies it by describing and drawing insights from a positively aging anomaly, that is, a community of senior golfers. over the two mornings of practice and competition sessions that i observed, several participants approached me to convey how much they enjoyed playing golf, encouraging me to try it, and exhibiting a competitive edge, a passion to win. these behaviors are interpreted as indicating that the oldest old adults were pursuing the physical activity purposefully, and applying pedagogy of engagement with enthusiasm, empathy, and interest. the interview with the organizer revealed two crucial needs: access to the golf hall and participation of younger players. through the triangulation of non-participant observation, participant observation, and an interview, this ethnography reflected the hopes, aspirations and challenges faced by senior golfers in this community. my narrative of what i observed and reflected on at the golf hall may be open to criticism as a selffulfilling prophecy or pygmalion effect (wineburg 1987); i might be biased toward input that reflected what i expected and blind to the unexpected. indeed, it was possible that the golf players and the organizers just put on a show for me for an altruistic motive, or to appeal to the significance of the activity and their needs. rather than merely acknowledging this bias, i seek to embrace it, as brown (2004) recommends in relation to postpositivist ethnography: “it is a researching self sensitive to the political interests of participants and committed to altering the material conditions that oppress participants” (311). whether the golf players are oppressed or not, i view my representation of the described scenes and my reflections as a product of co-construction by the participants and myself, not an objective reportage (bruni 1995). after writing up my narrative description and reflections, i pondered why the participants were unusually welcoming and friendly toward me. perhaps, my age of 59 years was advantageous, as the players related to me as a potential promoter of ground golf or a future player. however, my understanding of the local dialect was limited, and i sought advice from my local colleague to confirm the meanings of some of the words that i wrote down in my fieldnotes. one of my unexpected blind spots was revealed during a conversation with mr. spark who informed me of the fragility of the group physical activity. had i invested more time in building closer relationships with the participants by learning the local dialect, as a conventional ethnographer would often do, i may potentially have gained different understanding and insight into this and various other issues. however, a high level of immersion could increase habituation (bruni 1995); it was likely because i was attempting to be “the other ‘without concealing what we learn about ourselves in the process’” (brown 2004, 311) that i was able to discover and experience the dynamics at play with fresh eyes, which in itself may be considered an advantage. in this regard, pink and morgan (2013) regarded short-term postpositivist ethnography as “using different methodological, practical and analytical entry points into the lives of others” (2013, 353) from those used in conventional long-term positivist ethnography. the ground golf played by the oldest old people may be viewed as “the best practice” in terms of physical activity to which all should aspire, not necessarily for replication but for guidance: a model of what can be achieved in the public space if older citizens’ interest, mental and physical conditions, accessibility and socioeconomic status, all work together. another factor that deserves some attention is the puzzling finding from this study; why are members of the 1940s and 1950s generation not accustomed to group activity? although research on this issue remains limited, a recent study by tabata (2015) explained that group activities were considered controversial in postwar physical education as part of the pacifist reaction to japanese militarism before and during the second world war. if this is http://anthro-age.pitt.edu/ miyahara | 65 anthropology & aging vol 43 no 2 (2022) issn 2374-2267 (online) doi 10.5195/aa.2022.408 http://anthro-age.pitt.edu indeed why the older adults in this generation refrain from participating in group physical activities, a collaborative support system for individualized purposeful physical pursuits should be developed. in the interim, methods such as short-term ethnography would be a useful tool for assessing current practices and identifying needs among current seniors, as well as other cohorts in the population. acknowledgements i would like to thank all participants for co-constructing ethnography, kitano lifelong integrated education foundation for research funding, masato kadobayashi and makoto teshima who helped me with my funding application, yasuyuki tamai for assisting me with my ethical application, misaki mikami for the interpretation of the local dialect, hiroyuki fukuhara, takashi ono, tannistha samanta, and janis woodward for their helpful comments and suggestions on earlier versions of this paper. notes at the time of data collection and writing the first draft, the author was a faculty member of the department of clinical psychological science, school of medicine, hirosaki university, aomori, japan. 1. in her phd dissertation solomon (2017) represents the culturally unique community of tsugaru region in the aomori prefecture by referring to folk music and vernacular literature. 2. for her phd research in cultural geography brucklacher (1998, 1999) investigated aomori’s apple industry. 3. as a faculty member of the local university rausch (2017) proposes tsugaru studies as a specific area study. references almond, len. 2010. 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"short‐term ethnography: intense routes to knowing." symbolic interaction 36: 351361. popper, k. 1968. conjenctures and refutations. new york: harper & row. rausch, anthony. 2017. "tsugaru gaku as area studies: research plasticity and researcher hybridity." international area studies review 20 (4): 349-359. https://doi.org/10.1177/2233865917719565. solomon, joshua lee. 2017. "the stink of the earth: reorienting discourses of tsugaru, furusato, and place." phd diss., department of east asian languages and civilizations, the university of chicago. tabata, m. 2015. "hokentaiikuka ni okeru shudan koudou no ichizuke to arikata -sengo no ronsetsu ni miru shudan koudou no hituyou/fuhituyouronn no soui to ronri [examination of the need and critique of group action and behavior (shudan kodo) in physical education lessons in postwar japan]." the research bulletin of the faculty of educaiton and welfare science, oita university 37 (2): 225-240. wineburg, samuel s. 1987. "the self-fulfillment of the self-fulfilling prophecy." educational researcher 16 (9): 2837. https://doi.org/10.2307/1175727. http://anthro-age.pitt.edu/ https://doi.org/10.1002/14651858.cd009009.pub3 https://doi.org/10.1177/20503121211002606 https://doi.org/10.1177/2233865917719565 https://doi.org/10.2307/1175727 anthropology & aging quarterly 2014: 34 (4) 264 book reviews lynch, caitrin & danely, jason, eds. transitions & transformations: cultural perspectives on aging and the life course. new york, ny: berghahn books. 2013. isbn9780-85745-778-3 272 pp price $95.00/£60.00 (hardback) transitions & transformation: cultural perspectives on aging and the life course, officially launches berghahn books new book series, entitled life course, culture and aging: global transformations (series editor is jay sokolovsky), that proposes to focus on aging and the life course in anthropology. this is a welcome addition to the growing literature on cross-cultural aging that applies creative and multifaceted approaches of anthropological analysis and inquiry to the wonderfully complex subject of age. while firmly situated within the global urgency of burgeoning numbers of aged individuals worldwide, the chapters in this volume resist the panic trope so often summoned in usual representations of the squaring of age pyramids and ominous dependency ratios that preference doom and ruin over dynamic cultural identities and innovative human strategies. the anthropological stance is uniquely well suited to tackling individual and larger social issues embedded in changing cultural norms and practices, and nuanced treatments of aging across the globe are featured in this volume. focusing on on-the-ground situations within specific cultural contexts, important issues are discussed in the well-written, lively and varied collection of articles displayed here. how to embed meaning, recognize personhood and respect relationships in later years is a strong theme of the volume. in the initial section that introduces the essays of this book, the editors describe their dynamic approach of “transitions and transformations.” in the papers that follow, relationships and changes, the interactions of individual, family, and society through time and flux are highlighted. the chapters claim a connection with earlier anthropological collections that focus on diversity and creativity; at the same time, the articles purport to depart from “reductionistic uses of cultural diversity as points on a scatter-plot” (p 5) and argue for enhanced cross-disciplinary inquiry. organized in sections titled, “frameworks,” “bodies,” “spatiality and temporality,” “families,” and “economies,” the chapters consider an important variety of issues and provide insights to extend the existing literature. an afterword by jennifer cole that focuses on importance of including cross-generational analysis rounds out the volume. “frameworks” includes the introductory chapter by the editors that describes the approach of the book, places the volume in historical context of anthropological writings on age, highlights the importance of the “life course” approach to studies of age, and provides brief summaries of the chapters and their relationship to the unifying thread of the book. following this introduction, mary catherine bateson updates erickson’s developmental stages with “adulthood ii,” a phase of life she characterizes as showcasing “active wisdom.” she considers the necessity of this stage in light of global aging and the expanded period of time of healthy aging so prevalent today in industrialized nations. many of the chapters in this volume echo ericksonian principles of development and psychological growth over time. section ii contains chapters that explore the notion of “bodies” by presenting varied and lively accounts of different subjects rooted in universal biological processes and situated in specific cultural contexts. these chapters examine how individuals cope with chronic pain at different ages in a clinic in the united states and use strategies to construct continuity challenged by the disruption to identify caused by pain (lindsey martin); how chinese middle-aged women construct their experiences with menopause (gengnianqi) to explain and protest through “irritability” and “venting anger” their individual perspectives on growing older in a rapidly changing china (jeanne shea); and how men both young and older describe reaction against and identification with traditional and changing notions of what it means to be masculine and mexican in a rapidly modernizing mexico (emily wentzell). section iii, “spatiality and temporality,” explores the intersection of time and identity and notions of place in relation to individual aging. jessica robbins examines the intimate and intricate connection between the national and personal “moral ideal” of identity in poland, how suffering in old age is entangled with victimization throughout polish history, and the relationship between kin nearby and abroad. frances norwood uses the dutch window bridging the public and private spheres of life as a metaphor to showcase cultural notions and intense “euthanasia talk,” inspired by the rarely enacted legal choice to die. jason danely’s treatment of the temporal world of older japanese notes individuals’ connections “involving mutual recognition with unseen spirits and invisible worlds that structure memories, aspirations, and emotions” (p109). narratives of older japanese individuals as well as various common phrases and sayings emphasize interdependence and exchange across anthropology & aging quarterly 2014: 34 (4) 265 time and place. the fourth section of the book focuses on “families,” and its three chapters explore caregiving by azorean women in brazil (diane de g. brown), puerto rican grandmothers who care for their grandchildren in boston (marta b. rodríguez-galan), and how in sri lanka, complex notions of reciprocity in debt and obligation among generations are displayed in changing and discrepant attitudes about using care institutions for older individuals when they become dependent. these chapters, like others in the volume, include vivid quotes, elicit cultural values, provide national context and specific circumstances, and situate the authors in their ethnographic accounts. the final section, called “economies,” includes chapters on the conflicting meanings attributed to the rise of eldercare institutions in india (sarah lamb), how best to provide seva (respectful service or care) to elderly individuals and manage the dilemmas of these sparring narratives embedded in “the project of being human” (p177). membership and mattering are prime concerns of the elderly factory workers discussed in caitrin lynch’s lively chapter. these workers choose to continue to work, maintain friendships within the factory and thereby preserve a viable identity that seems to cushion old age. it is reminiscent of my ethnographic exploration of elderly new york diamond dealers who find satisfaction and meaning by working whenever possible into their 90s (shield, 2002). the fascinating chapter by jane guyer and kabiru salami describes notions of indebtedness and responsibility examined from the perspectives of their separate studies over decades in rural nigeria. again, mutuality and interdependence are stressed in how changing contexts reframe the meanings of finances, old age, and worth. finally, jennifer cole’s “afterword” explores the important notion of generations within the heterogeneity of age and youth. she warns against the “synoptic illusion” and reductionism of definitional shortcuts that stereotype and damage dynamic differences among ages. this volume is full of good writing, lively situations, some wonderful photos, revealing quotes and stimulating ideas. its readability makes it appealing as a text to be used widely in the undergraduate/graduate classroom. a brief introduction to each section would have been a good addition as another opportunity to remind the reader of key unifying themes. still to be explored by anthropologists are their own relationships to their aging and the subjects with whom they interact, a point i’ve argued elsewhere (shield 2003). a concern is that the volume claims a radical distinction from prior anthropological works on aging considered static and totalizing in contrast. this argument privileges new contributions without fully recognizing some important precedents such as the “life’s careeraging” examination by myerhoff and simić (1978), for example. here the authors attempt “in their analysis of aging to reconcile its culturally stable aspects with its dynamic dimensions conceiving of each particular cultural niche as a distinct and unique resource subject to manipulation and individual interpretation and misinterpretation” (1978: 231). of course, each generation has the challenge of recognizing its own myopia in thinking itself unique as it discovers and rediscovers these insights. these concerns aside, the current volume makes for excellent reading and launches the new berghahn book series admirably. references myerhoff, bg and simić, a. 1978. life’s career-aging: cultural variations on growing old. new york: sage. shield r. 2002. diamond stories: enduring change on 47th street. ithaca: cornell university press. (paperback issued 2005). shield r. 2003. wary partners: dynamics of interactions between nursing assistants and family members in nursing homes. in stafford p (ed.) gray areas: ethnographic encounters with nursing home culture. santa fe (nm): sar press. renée rose shield, phd professor of health services, policy & practice (clinical) brown university chang, heewon, faith wambura ngunjiri, and kathy-ann c. hernandez. collaborative autoethnography. walnut creek, california: left coast press. 2013. isbn 978-1-59874-556-6 200 pp. price $34.95 (paper) heewon chang, faith wambura ngunjiri, and kathy-ann hernandez have collaborated to produce collaborative autoethnography. collaborative autoethnography (cae) is a further elaboration of autoethnography (ae). researchers in both approaches see themselves as both the subject/ informant of the research and the analyst of that research. in cae, the researcher/subject is part of a team that collects and analyzes her/his data. this book is a review of past research in terms of methodology and a handbook on how to do collaborative research. the authors place cae and ae in terms of an evolving field of theoretical interest. researchers themselves have personal and professional lives that are situated in their institutions and culture(s). ae (as well as cae) allows the researcher/subject to turn a lens (p.22—their word) on her/his own life as well as the larger society. ae has addressed abortions, pregnancy, death and grief, and sexual anthropology & aging quarterly 2014: 34 (4) 266 abuse, among other topics (pp.1920.) the book’s authors agree with other students of ae that while rich in data, more can be gained by a more collaborative approach. collaborative approaches allow for more depth as well as personal and community building. at minimum, a collaboration can be two people—the researcher/ subject and another researcher. they propose an ideal team of at least one more member. cae can focus on traditional academic concerns, with a single or several research focuses. it can also extend to performance art, wherein “… autoethnographies are written as theater scripts… [or as] a series of poetry, or performance narratives… (p.51.)” in terms of aage’s mission on aging, i can see many places where cae can be used. a few “personal” examples come to mind. people are doing “story” projects in many communities. often located in museums or libraries, a person tells her/his story. teams of collaborators, whether professionals and/or nonprofessionals trained by professionals, can engage a person or several people to tell their life stories in greater depth. several years ago i taught a discussion class on “generations” through our local junior college’s older adults program. the discussion group was based in a nursing home. it could have easily been based in a senior center as well. the participants reviewed their lives, providing wonderful information on their similarities and differences according to all our “standard” kinds of foci—gender, class, education, region, job, religion, sexual preference, and so on. the data were rich and could easily be used to add to histories of different periods. moreover, the data were enriched by each participant’s interaction with the others when they questioned or reaffirmed or remembered something or some events another had not. hopefully, we can find issues worthy of study that we had not expected as well. as for academic collaborative teams, the authors contend that they work best when the participants are located where they can have continued social interaction. they are located in the same city. they meet for coffee, lunch, dinner, and other events and they meet over time. in terms of proposed methodologies, they suggest different models of collaboration, which can offer differing degrees of complexity. it would be interesting to see what kinds of data and studies can be gained by on-line collaboration or a mixture of the two. as noted above, it may be possible to add that to the repertoire of cae for older people that they can do by themselves or with some help. as they lay out their models for research and their places in theory, they note that many of the studies involve women in the academy, immigrant experiences, and people of color. they situate themselves in all the above ways and especially in terms of motherhood (pp.185-6.) the authors build upon both feminist theory and feminist critique and the whole field of qualitative research. the ends they seek say it all: “it [cae] is a transforming process that allows scholars to build community, advance scholarship, engage in social activism, and become empowered in their social context (p.148.) what makes this book even more interesting is that as the authors lay out their formulations, they share relevant anecdotes about their own lives. the authors also address some of the dilemmas this kind of fieldwork entails. one always has to ask: how much should i reveal about myself? how much should i reveal about others— especially without their consent? how should i present my data? they recognize that collaboration helps reveal issues that are not always apparent to the subject (p.28.) lastly, they see the research process as supportive for the person studied as she experiences or re-experiences trauma or a difficult situation (p.30.) i have several suggestions for the book. first, i think the title should have been collaborative autoethnography: a handbook. that makes it clearer as to what the book is about. second, the authors should tie their research into other related research about the psychology and anthropology of fieldwork experiences, (cf. davies and spencer 2010.) third, in terms of my self-disclosure about my comments, i am an anthropologist as well as a licensed psychologist. i would have liked to see much more of a discussion of the handling of trauma and denial, among other psychological issues (e.g., p.29.) in sum, i would strongly recommend this book for those unfamiliar with this emerging field and who want to do this kind of valuable research. references davies, james and dimitrina spencer. 2010 emotions in the field: the psychology and anthropology of fieldwork experience. stanford, california: stanford university press. richard zimmer sonoma state university anthropology & aging quarterly 2014: 34 (4) 267 ulsperger, jason s. and knottnerus, j. david. elder care catastrophe: rituals of abuse in nursing homes & what you can do about it. boulder, co: paradigm press. 2011. isbn 9781594519079, 222 pp. price $ 28.95 (paper). as the population rapidly ages and people are living longer, today’s boomers are faced with the complex decision of determining who is going to provide proper care for their elderly parents. dependent upon medical, financial, physical, mental and other specific needs, some individuals may decide to care for their parents on their own while others seek out long-term care facilities such as assisted living, adult day care, respite care or nursing homes that provide optimum care. while finding a facility takes time and much thought, the complexity of the issue lies in finding long-term care where elders are treated with kindness, respect, and cared for as human beings; not abused, neglected, ignored or treated as “impersonal, material items” (84). authors jason ulsperger and j. david knottnerus investigate the root causes of abuse in nursing homes and other longterm care facilities based on systematic research and sociological theory to help one understand the different types of nursing home maltreatment. the book is divided into nine chapters. beginning with identifying the bureaucracy that encompasses today’s nursing homes and other long-term facilities, the text transitions into the history of nursing home care. final chapters focus on the organizational dynamics and everyday rituals that can unintentionally lead to elder abuse and neglect. although present in the 1960s, nursing home care and maltreatment drastically emerged as a social problem and came to the forefront in the 1970s. this resulted in the establishment of the nursing home reform movement and efforts by organizations such as the national citizen’s coalition for nursing home reform (nccnhr) to continue to assume important roles in the history of nursing homes. interestingly as the authors point out, even with the development of the omnibus budget reconciliation act of 1987 (obra) also known as the “nursing home reform act” (59) elder abuse and maltreatment continued to plaque our nation and impact the care of aging adults. but why? bureaucracy and rules impact the overall care for our elderly. rules replace compassion. government regulations impact how assigned, everyday duties or “rituals” go unnoticed or undone due to daily tasks assigned to specific employees based on skill/knowledge levels. simple things such as removing dirty dishes from the table in a resident’s room or seeing a resident stranded in a hallway waiting for someone to roll them back to their room may not get done if toplevel employees are the only ones available. i totally agree that in our complex world rules are a necessity. however environments where people are dependent on compassion and quality care at a time in their life when they are alone, afraid, and/or ill, rules can contribute to unethical and inhumane care. this book addresses the core issues of elder abuse and maltreatment and provides case vignettes of everyday situations that long-term/nursing facility residents tolerate due to bureaucratic policies. i was angered when i read many of these short stories which depict bureaucratic induced dehumanization of care. the authors stress the need for culture change; shifting away from the traditional nursing home model (130) to a positive, “resident-centered care” model, thus transforming a facility into a home. the authors remind the reader to acknowledge the elderly for the human beings they are and not “unemotional work products” (83). engage them, don’t isolate and be responsive to individual needs. hire employees who have the compassion and desire to care for the elderly and not just fill bureaucratic positions based on policies/demographics. i would recommend this book to any lay person, healthcare provider, nursing facility employee; or anyone from the boomer generation who may be faced with the decision of one day finding the proper home for a parent. this book should be required reading for anyone working in a nursing home or long-term care facility as a reminder how not to treat those they are caring for. although a quick read, this book provides a wealth of advice and strategies for lessening elder abuse and maltreatment. in one of the chapters the authors compare today’s nursing homes to zoos; stressing the point that residents who are unruly and labeled “troublemakers” are often tranquilized and restrained to protect themselves and those around them much like a zoo keeper would do to a wild gorilla. both have staff ready to contain unruly creatures that cause disruptions throughout the workday, even if the physical welfare suffers. two other types of maltreatment the authors identify is “spoken aggression” and “infantilization” (122). spoken aggression involves speaking to residents in an intimidating, cold tone or calling names (e.g., calling an older female resident a “mean old woman” or yelling at someone to “shut up and eat your dinner”) (123). infantilization is speaking in a condescending way that reduces the status of the resident to a young child (117). healthcare providers need to anthropology & aging quarterly 2014: 34 (4) 268 be attuned to the subtle nuances that can degrade the status of those they are caring for by treating them like children instead of the adults they are. the world around us is aging and providing compassionate care is the model all facilities should strive toward. the authors summarize the book nicely by concluding that in order to provide such care, nursing homes must undergo culture changes that downplay bureaucracy, revise staff policies, counter loneliness and isolation from the inside, empower residents and respond to their individual needs. diane l. brown, ms program manager ii medical college of wisconsin sanjek, roger. gray panthers. university of pennsylvania press. 320 pp.cloth 2009 isbn 978-08122-4137-2 , $65.00; paper 2011, isbn 978-0-8122-2191-6 $26.50; ebook 2011, isbn 978-0-81220351-6,$26.50 studies of elder activism are rare indeed. much more so the kind of rich and detailed account which veteran anthropologist and activist roger sanjek offers us here. gray panthers has much to give those interested in older people, not just because of the quality of the study itself, but also because the panthers to whom we are introduced are themselves experts on aging from whom we need to learn. some professor once taught me that the test of a good ethnography was the degree to which the data it presented could enable another scholar to reanaylze it to answer different questions. i was reminded of this criteria as i read gray panthers. the careful study of the emblematic activist organization is rich enough in data to speak to a dozen different research agendas: relating to the history of left politics in the united states, the activism of older people, social movement organizing, leadership and gender, ideas about older people, intergenerational politics, and insider anthropology, among others. the life history of a social movement, gray panthers traces the story of the eponymous organization from the moment of the group’s inception in 1971 in a fight against mandatory retirement and the ageism it represented. the group grew to represent the interests of older americans in a variety of ways: denouncing living conditions in nursing homes, unethical practices in the hearing aid industry (in collaboration with ralph nader), media portrayals of older people, for example. yet, it has been much more than that. it’s slogan, “age and youth in action,” signals the group’s intergenerational philosophy. it took up pressing social justice issues of the moment, including the war in viet nam, public health care, sexism and racism. it is to this larger critique that the group owes its name, an intentional reference to the black panthers. the story spans several decades and many states, including specific chapters focusing on the panthers in berkeley, new york, and washington. (sanjek originally encountered the panthers in berkeley in 1977. he and his wife both became personally involved with the panthers. the author only later took up the group as an object of study.) the account continues through the organizations various ups and downs, including internal conflict, and the death of its found maggie kuhn in 1995, to the time of writing. for scholars interested in aging, the book is doubly fruitful. there is much to learn about how older people organize and do politics. most striking perhaps is the symbolic politics which the panthers were so good at: intentionally interrupting mainstream views of older people and aging by doing “outrageous” things. another important question for older activists is time. in gray panthers, we see this particular relation to time in at least three ways. first, older people are often retired, thus have more time available to dedicate to their causes. second, older people also benefit from long experience and extensive networks. once and again in gray panthers we see how members make use of expertise and contacts acquired in earlier stages of their lives. one of the most personally compelling aspects for this reader was the way the panthers connect us to earlier activist movements and political struggles that have been all but forgotten in us political memory -in particular the pre-cold war left traditions. third, the activists and their organization have to contend with the fact they are nearer the end of their lives, than the beginning. this can create a sense of urgency, that time is limited. it also creates practical challenges for political organizing. experienced and knowledgeable members are more likely than their younger counterparts to be sidelined by illness, or even to die. the particular strengths of and challenges faced by the elder activists here can thus inform our understanding of the third age more generally. in sum, gray panthers is a book that needed to be written. evidently sanjek was the man for the job. the panthers have played an important role in redefining what it means to be old. this book both describes and continues that project. lindsay dubois department of sociology and social anthropology dalhousie university anthropology & aging quarterly 2014: 34 (4) 269 haber, david. health promotion and aging: practical application for health professionals. new york, ny: springer publishing company. 2013. isbn978-0-82619917-1, 536 pp. price $90 (paper) dr. haber’s text delivers exactly what the title says and more. like most books on aging, this book begins with a demographic perspective of aging in the unites states. it then moves onto a clinical perspective of the current state of health (or disease based on your perception) in older adults. the book continues with a frank discussion of how we as helping professionals should focus on wellness vs. health care (or disease management, again based on your interpretation of the health care system). the text provides examples of evidenced based practical applications of wellness that can be utilized by gerontologists, public health professionals and everyone in between who works with older adults. the book ends with a look at the ever changing public policies and programs for older adults such as medicare, social security, and the affordable health care act. the final chapter provides words of wisdom, ideas, and hope for the future to continue to serve and care for the growing older adult population. one can only hope that policy makers have a copy of this book on their shelves and take dr. haber’s words to heart. health promotion and aging is now one of my favorite books and i look forward to using it in class. it takes many of my interests in the professions of gerontology and public health and combines them all in one book. this is perfect for the jack of trades professional. every health educator, health care administrator, and community planner could benefit from the research and application examples described in this text. this is the perfect “crossover” text for the public health professional who says they don’t work with older adults and the gerontologist who says they don’t focus on health care. this book provides a “big picture” look at our society and how we plan (or have not planned) to meet the needs of the fastest growing segment of our population. this would be an excellent text for an applied gerontology course. it provides valuable examples for future professionals in the world of recreation, wellness, and administration for older adults. as a former senior center director, i particularly liked chapter 13, where dr. haber provides five unique career paths for students. the first one, being to redesign existing senior centers as wellness centers. this book would have been a great asset to assist me in new program development. as an instructor, this book provides examples for future service-learning projects. dr. haber provides ideas for new programs using evidenced based practices and a good amount of detail to write the policies and procedures (if not the actual procedure) to get a new project off the ground without having to reinvent the wheel. as a bonus, dr. haber provides suggestions on agencies for community collaborations. i found the author’s writing style particularly engaging. while reading the text, i felt as if dr. haber were speaking to me as if we were old friends or colleagues. i enjoyed reading his personal insights and thoughts even in areas of the text i would have been tempted to skim just to read what his impression was of a particular topic or situation. there is a wealth of history along with current events described in the text. for those of us who have been around, i really liked how dr. haber provided “then and now” examples. for example in chapter five, dr. haber describes the usda’s new program myplate vs. mypyramid in teaching about balanced meal planning. in chapter four he provides examples of the surgeon generals recommendation for activity that used to focus on targeted heart rates and now focuses on the accumulation of activity most days of the week and explains why we changed from one method to another. if there is a weakness in the book, i have not found it, unless you are not a fan of dr. haber’s style of humor and blunt honesty. jennifer a. wagner, mph, lnha bowling green state university gerontology program anthropology & aging quarterly does not accept unsolicited reviews at this time. if you wish to review a book, film, exhibition or other works of interest to this journal, please contact book reviews editor, joann kovacich jkovacich@ rochester.rr.com. include your name, areas of expertise, current affiliation and status (research, professor, graduate student, independent scholar, e.g.) and any titles you would be interested in reviewing from the last three years. meaning making among older people in the bible belt in the netherlands pien bos sylwin cornielje hanne laceulle p.bos@uvh.nl sylwincornielje@gmail.com h.laceulle@uvh.nl university of humanistic studies utrecht, netherlands abstract in this ethnographic study, we examine how older calvinist protestants in a conservative rural area of the netherlands experience “meaning in life.” we aim to contribute to current research on meaning in life within social and religious contexts. here, we specify the concept of meaning in life as connectedness. the latter is broadly interpreted as an overarching conceptual component of existential meaning. indeed, connectedness appears to be of paramount importance in these older villagers’ experiences of meaning in life. all three authors of this paper collaborated during fieldwork. we analyzed documents such as local newspapers, websites, and (church) newsletters. we visited farms and attended local meetings and gatherings such as churchand community-services, and we conducted qualitative interviews with 29 people. the outcomes of our research point to three forms of connectedness: (1) social connectedness; (2) physical connectedness; and (3) transcendent connectedness. keywords: aging; existential meaning; religious communities; connectedness; the netherlands anthropology & aging, vol 42, no 2 (2021), pp. 68-85 issn 2374-2267 (online) doi 10.5195/aa.2021.282 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. bos, cornielje, & laceulle | 68 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu meaning making among older people in the bible belt in the netherlands pien bos sylwin cornielje hanne laceulle p.bos@uvh.nl sylwincornielje@gmail.com h.laceulle@uvh.nl university of humanistic studies utrecht, netherlands introduction the question, “what makes life meaningful?” touches upon certain fundaments of human existence and has puzzled many people since time immemorial. such existential questions are traditionally connected to religion or spirituality or the lack or loss of it (krause 2008; park 2017a, 2017b). in this article, we examine how older people in the netherlands experience meaning in life. in old age, questions of meaning gain an increased urgency because of the losses aging individuals tend to experience and the increasing confrontation with finitude (krause 2008). in this paper, we examine the interaction between social and cultural context, religious and spiritual outlook, and experiences of meaning in life of older people. the following study is based upon ethnographic fieldwork conducted among older people in a village1 in the netherlands. this village is situated in the so-called “bible belt,” an area stretching from the southwest to the northeast of the country. the bible belt is referred to this way in colloquial speech as well as in the media because of the area’s high concentration of practicing protestant residents, including many orthodox protestant christians (sobotka and adigüzel 2002). the village in which we conducted our fieldwork is characterized by a 15th century bonifatius church tower, which is situated in a spacious, flat landscape scattered with dairy farms. in addition to this iconic church, there are two churches of other protestant denominations in the village. these newer churches were constructed at the beginning of the 21st century because the original buildings could no longer accommodate the increasing crowds during sunday services. the village of our study has 1,800 inhabitants, and each of the three churches currently has around 500 registered members. this illustrates that, although the netherlands is rapidly becoming more secular, not all areas of the country are experiencing a decline in church attendance.2 the old church is considered rather conservative and one of the new churches is considered very conservative orthodox. the latter orthodox church and the non-orthodox church are regional, meaning that people from surrounding villages also come to attend the services. some villagers, however, do not feel comfortable in any of these three churches and prefer a church community in a neighboring village or town. therefore, sunday mornings usually have a weekly rush hour. by bike, car, walker/wheelchair, or on foot—young and old come and go in all directions to attend church services. this paper draws on an ethnographic study that was conducted in the village between 2014–2019. this study set out to explore the lives of older people, many of whom have spent their entire lives in this village. our aim was to better understand the qualitative conditions for aging well in a small rural community.3 we found that our data generated valuable insights into what constitutes—or stymies— http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 69 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu older people’s experiences of meaningfulness. by presenting the results of our ethnographic study in this context, we hope to add to current research on meaning in life and particularly the role of social and religious contexts in older people’s experience of meaning in life. we argue that ethnographic casestudies, which offer conceptual clarification through the exploration of lived experiences (neuman 2014), can contribute to our understanding of the phenomenon of meaning in life. meaning in life the theme ‘meaning in life’ or ‘existential meaning’ is often a topic of interest for various disciplines in the humanities and social sciences. currently, studies on this topic have been slightly increasing. however, they are usually related to formal and informal care-settings or focus on the lack of meaning that some people suffer during old age, resulting in somberness, despondence or, in some cases, a death wish, as for instance in dutch studies about people who believe their lives are completed and no longer worth living (wijngaarden van, leget, and goossensen 2014). studies on the actively shaping and reshaping of meaning in daily lived experiences are seldom related to aging. this is startling because older people aged 65 and above are at a stage of life where their responsibilities related to work and family—often experienced as significant and meaning-generating—begin to decrease or change in nature (edmondson 2015). in addition to changes in social dynamics, older people (65+) are often more radically confronted with transiency and finitude, for instance through loss of beloved ones or one’s bodily fitness. such confrontations may inevitably result in existential questions (baars 2012). victor frankl was an austrian jewish psychiatrist and neurologist and a survivor of the holocaust during world war ii. as a result of his personal experiences in concentration camps, he wrote and published his first work on meaning in life shortly after the war ended in europe (frankl [1946] 2006). frankl became a founding father of contemporary theory on existential meaning or meaning in life, and his insights evoked an upsurge of studies on this theme. despite this increase, however, more recent publications on meaning in life demonstrate conceptual uncertainties while some academics are still attempting to grasp the notion (krause 2008; laceulle 2018; martela and steger 2016). recent studies conceptualize existential meaning as a multidimensional construct (steger 2012). psychologist crystal park (2017a), for instance, distinguishes a person’s “global meaning system” from their “situational meaning.” a global meaning system consists of cognitive, motivational and emotional dimensions that provide people with an encompassing framework to interpret their lives. global meaning systems are always socially shared and individually appropriated by each person sharing the context from which it evolves. religions or political ideologies constitute examples of global meaning systems. situational meaning, on the other hand, occurs in people’s daily lives when events or circumstances generate meaning issues that require adaptation or reinterpretation of one’s beliefs, motivations or emotions. global meaning is more “enduring,” whereas situational meaning is more “immediate” and “transient” (park 2010; steger 2012). situational meaning relates to people’s lived experiences and how they appraise these experiences. park (2017a) further explains that the appraisals of these experiences interact with their global meaning system, in the sense that some situations necessitate renewed reflection on the accuracy of one’s global meaning system. this implies that, for instance, a religious conviction may influence a person’s evaluation of experiences, but that individual experiences may also influence or change their religious conviction and thus a person’s global meaning system. psychologist dmitry leontiev (2017) underscores meaning as a relational phenomenon. he uses the metaphor ‘mycelium’ to indicate hidden and visible connections of different dimensions that relate to existential meaning. psychologists rebecca schlegel and joshua hicks (2017) point to the collective http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 70 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu aspect of meaning by mentioning shared sources of meaning, among which are social relations and systems of meaning, such as religions and worldviews. although experiences of meaning are personal and individual, schlegel and hicks perceive culture as “the ‘ultimate’ system of meaning” and they conclude that “a greater consideration of the role of culture seems warranted” (2017, 30). in particular, because current studies of meaning are predominantly situated in western, individualized, secular countries, and existing measures of meaning show little cultural sensitivity. drawing on work by psychologist roy baumeister (1991) and others, professor of humanism and worldviews peter derkx (2013) distinguishes seven dimensions of existential meaning. in summary, people must experience (1) purpose in life, (2) moral worth, and (3) self-worth, including self-respect and self-acceptance. in addition, people need to experience that their life is under (4) control to a certain extent. they must also experience (5) coherence or comprehensibility, (6) excitement, including wonder or curiosity, and last but not least (7) connectedness. with these dimensions, derkx aims to exhaustively cover the various meaning-making experiences in people’s lives. this exhaustiveness, however, allows for some overlap and the various dimensions are not exclusive per se. although derkx’s (2013) model provides valuable insights into the components that make for an experience of meaning in life, the importance of the social and cultural dimension that schlegel and hicks (2017) and park (2017b) emphasize remains underexplored. this is an omission, particularly since experiences of meaning interact with “both the fundamental embodied nature of human existence and the fundamental socio-cultural constitution of identity” through, for instance, housing, relations with beloved ones, and cultural ideals (laceulle 2018, 25). this calls for a more socio-culturally sensitive approach to meaning in life. as such, meaning in life should not merely be conceived of as a psychological condition attributed to passive recipients. rather, in our understanding, meaning in life is a situated lived phenomenon that is not only experienced but also actively created through daily activities and relations. in other words, meaning is made within the socio-cultural context of people’s lived experiences. in a more recent empirical exploration of the seven dimensions, however, derkx et al. (2020) found that connectedness is probably the most fundamental component for experiencing existential meaning. the authors specifically make a distinction between the importance of social connections, which they describe in terms of significant contacts with other people and/or society, and the connections with an “impersonal other” such as “. . . with god, with nature or with a positively valued transcendent reality” (2020, 42). further unraveling the nature and role of these different types of connectedness could be helpful in addressing the socio-cultural dimension of meaning, both as experience and as an act of meaning-making. in this paper, we have chosen to focus on connectedness, which we broadly interpret as an overarching component of existential meaning. methods although consensus about theories on existential meaning is still lacking among scholars, park (2017b, 70) claims that existential meaning, particularly situational meaning, is “ripe for empirical inquiry.” research methods and approaches, however, are still being explored and assessed. for instance, psychologist paul wong (2017) suggests taking people’s lived experiences into account. additionally, schlegel and hicks (2017) point to self-report, informant report, and behavioral data as a useful way to gain insights. socio-cultural contexts appear important, and academics perceive meaning in life as at least partly and often mainly as a subjective phenomenon. hence, a qualitative holistic approach with combinations of various methods current in ethnography seems appropriate (patton 2015). http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 71 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu ethnographic fieldwork in the village of our study started in 2014. fieldwork was initiated and coordinated by the first author, pien bos. bos was a native to the area. all three authors spoke the language (mother tongue) and collaborated during fieldwork. we analyzed local newspapers, websites, and (church) newsletters, flyers, (document analysis), etc. we attended local meetings and gatherings such as church-services, community services, and the board meetings of associations for older people. we also visited farms and attended funerals. during these participant observations, we also conducted qualitative interviews with 29 people (which included five couples) and engaged in dozens of informal conversations. for ethical reasons, we obtained informed consent from our informants. we anonymized their names and excluded the name of the village. the names of informants mentioned in this article thus are pseudonyms. our sampling strategies changed over time. in the beginning of fieldwork, we used convenienceand snowball-sampling strategies. for instance, we sampled people with whom we informally spoke when attending public meetings, church services, and other events. later on, we sampled more purposefully for diversity, based on criteria such as religious denominations, family-settings (including intergenerational settings), gender, childlessness, or former occupation (including farmers). we interviewed non-orthodox, rather orthodox, and very orthodox people.4 our participants were all members of a religious (church) community. we interviewed some people several times. these interviews were mostly life-stories because, as cultural anthropologist sarah lamb (2008) denotes, “. . . telling a life story, ‘like other forms of talk or communication’ is part of life as lived, for it is lived and experienced, at least during the moments of telling” (16). life stories are appropriate for research on meaning in life because meanings tend to run through life stories and can best be studied through their analysis (mcadams 2011). in the summer of 2018, we organized a focus group-discussion in the village’s meeting hall and invited all interview-participants. five women and six men attended. during this focus group, we shared and discussed our findings in order to validate them. this method also provided our informants with an opportunity to comment on our findings or refute conclusions. the interactions that followed were meaningful data as well and are incorporated into our analysis as such. five different spheres to structure our findings, we distinguish people’s connectedness and how it emerged in five different spheres: (1) the village community, (2) church communities; (3) clubs and associations, (4) the familysphere, and (5) a transcendent sphere. in the first four spheres, we present patterns that stemmed from all our ethnographic sources (documents, observations, interviews). in the fifth sphere, we rely on one specific case (male 90+) who is exemplary of a highly secluded minority of extremely orthodox protestants in the bible belt, to which researchers do not easily gain access. we consider this villager to be an ‘extreme case’ in two respects: (1) he experienced severe social exclusion throughout his life, and (2) by practicing puritanism, he is on the extreme end of a spectrum from liberal protestantism to orthodox protestantism. selecting extreme cases often lead to new observations and understandings (etikan, musa, and alkassim 2016; patton 2015), and discussing this case in detail provides us with insights into the fifth transcendent sphere, which could not easily have been achieved otherwise. 1. village community when strolling through the village, a certain flag attached to many people’s homes tends to catch a visitor’s attention. the flag’s design was created during a village-flag competition held some years ago. three youngsters won the competition because, according to the jury, they managed to embed a symbol http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 72 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu of the historical perspective of the founding family of the village into its natural environment. the flag seems to remind the villagers that they are inheritors of a shared past. hans (77)—who also has the flag waving in his front garden—told us about his past in the village: [in those days,] the doctor had a tiny car, and when the doctor drove in the direction of my home and i walked there, i was allowed to drive with him for a little while. well, from the start, you feel a huge bond with such a village. hans is a retired journalist and shares his childhood memories in an eloquent way. above, he described how “it takes a village to raise a child” and implicitly argued how this social norm was put into practice and how he felt acknowledged by this—in his eyes—notable person offering him a ride. hans’s experience of social connectedness is informed by positive memories from his childhood. a hint of melancholy, however, appeared to color his feelings. he told us that many of his loved ones passed away, and he began to withdraw from clubs and activities as he grew older. the people who were young back then have now grown up; hans is unknown to them. “you are easily forgotten,” he explained. changes in social embedding related to aging seem to affect hans’s connection with the village. yet, he does not want to leave. he wants to purchase a stairlift as soon as it begins to take him longer than five minutes to get upstairs. also anticipating a decline in their health and mobility, marlies (64) and her husband tim (66) rebuilt their house and made it “walker-proof” last year. likewise, els (76) and the two married couples, ada (74) and bert (85) and eva (86) and ties (91), are pleased to have the facilities they need on the ground floor. this enables them to remain in their respective houses.5 the aging villagers to whom we spoke are attached to their houses and the village. many of them were farmers or come from a farming family, and they were born and raised in the same rural setting they still inhabit. as such, their homes are full of markers that trigger memories. bets (83), a farmer’s wife, explained, “my husband died in the same room and in the same bedstead where he was born.” even the local graveyard is mentioned—sometimes explicitly, but more often indirectly or implicitly—as a preferred future destination, which illustrates a deep sense of belonging to the physical setting. marlies (64) explained: i was born and raised here, so i think i belong here. . . . also when i am dead, i belong here in the cemetery. . . like my parents are buried here. actually, i never visit their grave (laughs), but i think they ought to be buried there. the physical environment, the house, soil, and the physical setting as a whole seem to inspire a sense of connectedness. the meaning of such material surroundings transcends social relations. but social connections with one’s fellow villagers are also considered to be of the utmost importance, and they think about balancing these social relations. adjustments in houses illustrate a desire to remain independent as much as possible as they grow older. laurens (68) explained how “handling one’s own affairs” lies at the heart of how the villagers live. as such, living independently is valued, and “burdening” or asking for help outside one’s family circle is not—even when someone else is willing to help. according to ties (91), however, showing interest in each other and looking after each other are great benefits in the village. to him, it is not only family-members and neighbors who look after each other, but villagers in general, who happen to “. . .know much of each other. . . . i’ve been raised here, of course, and i have lived here for 91 years. yes, everyone knows ties.” an orthodox newspaper confirmed ties’s experiences with informal care among villagers: before, people did not greet each other on sundays, but this has changed and nowadays people also greet each other on sundays. according to the villagers, the inhabitants are http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 73 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu tolerant and kind. one villager: “supermarkets or grocery-stores have almost disappeared here, yet villagers shop groceries for each other.” in our observations, people seemed to notice each other and, although this is generally appreciated, there is also a dark side to the large amount of social control. els (76) has never really left the village, not even for a job, because she has always had to work at home. els is a registered church-member of the old church, but not a regular visitor of the church-services. people we spoke to believe that she is an exceptional lady in the village because she regularly goes to the pub on her own. in her living room, a sign hanging above her fireplace reads: “the ‘nice’ thing about living in a hamlet is. . . that when you really have no idea what you are doing. . . someone else, however, does!” she explained that she feels connected to the village and would never want to leave because she knows “everyone and everything.” she wants to “grow much older here.” yet, she dislikes the fact that people talk behind each other’s backs: . . . but you learn to deal with it, you know. it has always been this way. if you hear something from someone, you shouldn’t pass it on. because that isn’t nice for the other one. . . . but there are people who do this, you know. i never do that. i just think, “if i’m allowed to know something, they will come and tell me themselves.” because of the gossiping, els has had to grow “a thick skin” and emphasized that she will not let people interfere with her life. thus, if she wants to go to the pub, then she goes to the pub regardless of whether people regard it as something “not decent” for women to do. she stated, “if men are allowed to go there, then why would i not be allowed to go there? i do nothing wrong, do i?” both for those who want to tell her how to live and for god’s “personnel,” els seemed to have only one message: “i will not let others tell me how i should live.” by responding to and weighing both the pros and cons of living in this tight village community, she appears to actively make meaning of her ambivalent social position. according to laurens (68), who moved from a neighboring village 35 years ago, “standing beside each other” is a norm that stems from christian values, which help form the foundation of life in the village and its region. the value that he considers to be the most important is charity, or the love for one’s neighbors, which he defines as “being concerned about each other.” some villagers express this value in certain daily practices, such as driving a person to the hospital or helping each other with groceries. according to jos (77), charity is a highly regarded and widespread value in his village. during the interview, laurens (68) burst into tears as he recounted how one family explicitly denounced him as a homosexual when he decided to become an elder in the church council. when laurens decided to stand firm and continued to prepare himself for the post, the family left the church. laurens found it difficult to cope with the situation, but he explained that someone else backed him up: then a man, who always sat in front of me [in church], came on the radio. . . to explain what happened. he said, “a married couple left the church because of a homosexual man. unbelievable.” and he told me this on sunday morning. he sat in front of me, turned around, and laid his hand on my knee, saying: “laurens, i’m so happy that you have stayed.” that was unimaginable. this incident seems to have made a huge impact on laurens, and it was decisive for him to continue living in the village. this example demonstrates that it was meaningful for laurens to feel accepted in his church community, and he explained how the experience with the man from his church resulted in feelings of being part of the village community as well. the separate church communities of the three http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 74 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu churches, however, also have their dynamics. 2. church communities it is an unwritten rule in the village that people comply with sunday’s rest, meaning that washing cars, mowing lawns, drying laundry, or any other outdoor chores are not appreciated. this tranquility, however, is suddenly interfered with on sunday mornings when the church bell calls people from their homes. during morning services, hundreds of members chatting with each other before the service starts occupy the church pews. we observed that aging villagers feel socially connected by engaging with their church communities or, as one informant articulated, their “church family.” ben (71) and his wife froukje (71) stressed that their church community should also be understood as a social community to which most of its members actively belong. they attend church with their “tight group,” then linger afterwards and have coffee together. because froukje and ben feel socially connected this way, they do not really fear a future in which they are left to fend for themselves: “even if it’s only from the. . .church community, then you’re being looked after. there’s always a bit of care you have for each other.” aging people also connect with others through religious work. for example, ben was asked to become a mentor for youngsters who want to continue the catechesis—education in bible-texts and instilling religious values—after they reach 18 years of age. as a mentor, he helps these young people read and interpret biblical texts: i find it special that a person of 71 years has been asked to do it [laughs]. to do that. and then there’s a whole band of those youngsters gathering. . . of 20, 22 years of age, who participate enthusiastically. who really appreciate it. so, yes, then you feel that you can still add your value. and i do find that important. i’m not being pushed away like “my time’s over.” that you can also mean something in this way. it seems that ben finds meaning in his mentorship in two related ways. the first is that, by fulfilling his role of mentor he can help to ensure that youngsters continue to practice their faith. evangelization is generally an important mission for christians in this village and also for ben. the second way can be understood as a mission of social connectedness. namely, by mentoring younger pupils, ben bolsters their involvement with his church and its community, guarding this social sphere from a potential outflow of the younger generations in the nearby future. jos (77) and inge (74) explained that, as soon as they moved to the village, they were automatically registered with the church because it belongs to the same denomination as the one in their former town. after some years, however, certain differences in the religious experience appeared too great for jos and inge to overcome. jos did not “feel at home” in a black suit (the common sunday dress code), so he wore a grey suit. because of this provocative act, jos explained that he was regarded—or regarded himself— as rather unorthodox. furthermore, inge told us that she did not experience the heavy tone during services as pleasant; in fact, it sometimes kept her from attending services. eventually, jos and inge decided to leave this church community by withdrawing their formal membership. but much more than a formality, leaving a church is related to a rejection of social relations and religious convictions. people experience and perceive such withdrawal as a statement that similarly resembles a divorce (see paulus’ case below in the section ‘transcendent sphere’). so, their process of leaving was accompanied by painful confrontations, incidents, and emotions. eventually, however, they connected with a less orthodox church community in the village. this time, their endeavor led to http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 75 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu a more favorable outcome. during the interview, they explained that they were now “wonderfully taken care of” by their new community. here, they felt more at home because they could profess their faith in a way that felt safe and that their fellow members of the church community approved. jos explained how he experienced a thoroughly meaningful sense of belonging with this church community because the people share comparable beliefs in god and the afterlife. not everyone in the village, however, appreciated the progressive character of this church. one informant called it a “shoddy church” (een flutkerk). in his eyes, the fact that this church is led by a female minister contradicts the bible, where it is written that women are not allowed to occupy formal religious positions. thus, within the social spheres of the church communities we explored, meaning is made in socially connected ways that can be affected by religious perceptions but feelings of security as well. 3. clubs and associations many of the older people join and contribute to one of the village’s neighborhood associations. it is noteworthy that such a small village is divided into ten different neighborhood associations. to get an impression of its functions, the statement of one of the clubs says: “. . .we mutually sympathize with each other’s ups and downs, new members are welcomed, the ill and some older people are visited; if someone throws a party and we are invited as a neighborhood association, then we join in.” an activity overarching the neighborhood associations is the “community dinner.” every month, about 70 people, aged 55 and over, gather in the village-hall. weddings, funerals, line-dance evenings, bingo, and the like are also held there, but the community dinner is an event that is exclusively organized for older people. the website mentions that the goal of the dinner is “to organize a meal in order to foster social cohesion among people aged 55 years and over.” partaking in a meal costs only a few euros. as some older people put a considerable amount of physical effort into meeting each other in front of the building with their walkers and scooters, they happily express their delight with the event. fred (91), who has been living in the village since his retirement 28 years ago, suffered a stroke two years ago. fred is no longer eager to participate in club activities or join a trip. he is afraid to burden other people in case something happens to his health. however, the community dinner is one of the few activities that he likes to join: sylwin cornielje: do you go there every month? fred: yes. and why? the social contact! because if you don’t go there, you don’t go anywhere anymore. then you lock yourself up, and you pass away. . . [at the dinner,] you become included. and that’s what i find very important. not for me, as if i would need it that much, but you have to stick with them socially. the social attraction of the community dinner appears to be so great to fred that he exerts himself in order to participate in the event despite his hearing impairment, which causes him to merely hear murmurs in a group. els (76) shared a similar sort of commitment: it’s my conviction that if something is organized, you must participate because otherwise the people say: “there is nothing to do around here.” and that, of course, is not how it should be. if they organize something, then you should participate. that is what i assume. both fred and els exhibit a discourse of active commitment and togetherness in the community. here, connectedness is not a mere passive undertaking or acquiescence. it consists of the recurring ‘call’ of http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 76 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu their fellow participants—a call to which they seem to delightfully respond by participating. as such, these older people as a social group are taking care of themselves and reaching out to their fellow peers. they are each other’s condition for achieving connectedness. the significant value that many older people attach to achieving togetherness in clubs is further hinted at by the fact that every event—not just the community dinner, but also the soccer club, swim club, iceskating club, and several other associations such as the “rural women’s association”—are run by volunteers. most of the volunteers are older people as well, some of whom participated in this study. els (76) expressed her sense of togetherness by contributing financially to several of the clubs instead of attending their activities. “you have to do it together,” she said. to her, this is a way to care for the village because she thinks such clubs should continue to exist. according to els, many other villagers solely contribute financially for this reason as well. whereas many older people experience social connectedness with others through ardently contributing to clubs and associations, some quit activities in clubs due to aging. eva (86), for instance, is still a member of the neighborhood association she helped set up but explained that “you become less embedded in the community as you grow older.” she prefers for younger people to take the lead since she has outgrown its activities. furthermore, as senescence causes her to experience a lack of energy and back problems, she does not enjoy “ruling the roost” anymore. she explained that, nowadays, she would rather find meaning in life through the bonds with her friends and family. 4. family family members appear to occupy a central place in many of our informants’ lives. according to eva (86), who has 31 grandchildren and has become a great-grandmother four times, she has developed a certain wisdom that her children seem to value. for instance, she helps when they call to ask for her opinion on matters concerning, for example, relations with their parents. the walls of hans’s (77) living room are decorated with collages of old and new photographs, children’s drawings, and little sayings displayed with impressiveness and intimacy. his daughter and son, who live abroad with their partners, each got married recently. while sharing his story, he pointed to a few pictures. he and his wife miss their (grand)children, especially now that their son has returned home after visiting them for four weeks. “i hope to add another few years to my life. yes, meaning in life to my wife and me is not least our children and grandchildren” he says. lucas’s (76) old farmhouse harbors many cherished memories. as an adult, lucas only left his home for two years due to military service, and thus has spent virtually his entire life on the same farm. he recounted: there is the bedstead in which i was born. i was born during a harsh winter, and the doctor said to my mother: “go to the living room!” there was no other place that could be heated. only here was a stove. the house still appears to fulfill the function of a middle point to which his brothers and sisters return every now and then: to my brothers and sisters, it’s still just lovely to have a bite and a drink together on this old spot. everyone has their own memories, of course. and my parents came here http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 77 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu before wwii, in 1937. they lived next door until they were very old. my brothers and sisters came to visit—they are very concerned with this little spot. . . they still adore it. like froukje (71) and ben (71), the married couple lucas (76) and inde (71) were unable to have children. while froukje and ben seem more confident in feeling a sense of belonging in the communities to which they belong to if one of them dies, inde seemed to be more worried about the risk of becoming lonely, especially since her husband was diagnosed with cancer. she and lucas repeatedly mentioned an older woman living in their neighborhood who is no longer able to walk and whose children are busy most of the time. they explain that, for days on end, this woman does not have anyone to talk to except a nurse. when we discussed a possible future without her husband, inde asked: “but how can you solve this? well, i think that you have to participate in everything that is organized for older people by any means, then. . .” she seemed hesitant to acknowledge such participation as a true ‘solution’ for overcoming her feelings of loneliness in the event of such a loss. thus, inde revealed that connectedness is not something that can be compensated for through participation in activities and associations. while it may emerge to some extent, meaning in life through connectedness may diminish in later life for childless older people like inde. by contrast, fred’s (91) experiences of social connectedness after the passing of his wife emerged from the relationships he enjoys with his son and daughter-in-law. fred and his wife moved to the village several decades ago. during that period, fred’s wife was not well and, therefore, his son and his son’s wife invited fred and his wife to move to one of the houses just one street away from them. to his son’s wife, this was an “ideal” scenario; something for which fred raised his thumbs by means of approval more than once during the conversation. according to fred, it was divine intervention that saved the house from being bought by someone else. fred believed that being able to live close to his son was part of the many “blessings” he received from he “who determines everything, your life, everywhere you go,” and for which he is thankful every day. nowadays, fred takes a walk with his son every evening and, with a little help from him and his daughter-in-law, he can manage his own household. the positive side of fred’s feelings of connectedness, however, was contrasted with an ominous tone when he spoke of the discord he has experienced with other family members. while he almost violently squeezed the leather of the sofa he sat on, he recounted that his parents could not accept that fred and his wife were living happily together. fred did not want to elaborate on this, to anybody. it became painfully clear that he continues to suffer from past miseries. his son tells him to let go of these things, but it seemed to be in vain: time and again, you’re allowed to put it [the discord he experienced] down, but every time it occurs to me again. a while ago. . . my son said, “you must not get old cows out of the ditch.”6 i said, “let me tell you something. those old cows lay rotting in that ditch—they spoil the whole environment. it’s time that someone gets them out!” do you understand what i mean? but they [his family] don’t understand that. . . when asked what he considers to be his biggest wish, fred told that it is to rest, to be able to let go, or to solve his problems. each of these options appear as impossibilities to fred, despite his efforts. the fact that his family doesn’t understand him in this regard adds to a sense of socio-emotional isolation in his sorrow, and this impedes his ability to make meaning by coming to terms with his past miseries. ada (74) and bert (85) live with their son’s family on their dairy farm. although they are officially retired, ada and bert still help to run the farm, which is necessary since there is a lot of work to do, 24 hours a day and seven days a week. before conducting the interview with ada, bert gave us a tour of http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 78 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu their property. we found him feeding the cows in the middle of a shed. he was wearing blue overalls and wooden clogs, and he used a rake to spread the dry food in front of the railings. moving slowly and quietly, bert spread an air of calmness amidst the excitement of the hungry cows. “the cows know me,” he told. “we try to give them a good life.” because his son is unable to do all the work himself, bert wanted “to keep things going, even though it’s becoming less and less.” he said he does not really know what else to say about himself or the world, because his work on the farm covers pretty much all of his life. after finishing the tour, we drank coffee with the raw milk they collect from their cows. when bert went back to help their son in the sheds, ada explained that she hopes to survive her husband. “who is going to take the lead, then. . .?” she asked. before they and their son had their own farm, bert lived and worked with his parents and one sibling on the family farm. after he got married, though, the family had to split up the property and divide the meadows, cattle, and machines, which was far from easy. “in the end, it was all grim. . .” ada explained. the family problems that were an issue in the past appear to still have an impact on how ada and bert relate to, for example, their neighborhood association: ada: we don’t go to these evenings anymore because it’s just not such a. . . bert doesn’t want to meet with them [sibling’s family] anymore. no. back then, many things have been. . . for instance, she said something like, “he’s always just reaped the benefits.” . . .you just come to hear that he was just a “freeloader.” . . . i really found she put me down then. sc: yes, i understand. and this you cannot forget? a: and this i cannot forget. . . . i wish i could forget it. although ada and bert attend the church services, they avoid going to places such as the community dinner where they might potentially encounter these relatives. to them, the most important connection they seem to have is with their son’s family. according to ada, “the most beautiful thing of all is that we can run this farm together.” a few farmhouses over from where ada and bert live, jos (77) and inge (74) live with their daughter, her husband, and their children. jos and inge’s house was separated into two apartments, each with its own front door. they chose this style of living because they wanted to support their daughter in buying a house in a place that she liked. moreover, it was her initiative to live with her parents “next door.” during the interview, however, jos and inge repeatedly stressed that the raison d’etre of this intergenerational set-up was not so they could be cared for as they age. on the contrary, they did not want to let their children care for them. yet, jos and inge do share “a good bond” with their children. they find delight in seeing their daughter and her husband, in having coffee together regularly, and providing their grandson with a shed and tools that he can use to repair engines. however, inge mentioned that, during her former profession in healthcare, she experienced some older people living with their children only to lay in their beds waiting for them to have coffee together. in relation to her own situation, she explained: it was not our initiative because then one could say, “you become a burden to them” . . . if you are really old and your mobility becomes reduced, then i would prefer not to live here anymore. i mean, for them it would be better. because if your children live so near and they couldn’t help with anything – well, then it would get rather painful. . . . http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 79 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu not because they wouldn’t want [to help], but they also have their own lives. . . . and you don’t want to stand in their way. her husband jos also views a future of intergenerational living as an unhealthy situation of “burdening” their children. thus, they would prefer to either make it on their own or receive professional care, which, according to jos, “keeps one young.” therefore, they have decided to move to another house in the near future. when i asked jos and inge to imagine a scenario in which their daughter voluntarily offered her support if needed, they repeated that they do not want to stand in their children’s way. ties (91) has five children, three of whom live in the village. in 2009, one daughter returned to the village with her children and husband to live under the same roof with ties and his wife. in 2013, ties’s wife passed away and ties became rather immobile. but instead of moving to a long-term care facility, he now has his (grand)children look after him “with all their love” every day. they have divided several care tasks between them, such as administering his daily eye drops, washing laundry, cooking food, and grocery shopping. for bathing, he gets professional homecare. yet, feeling “privileged” to live in this intergenerational setting is not all roses for ties. indeed, he is happy to have his children look after him, but he feels dependent; this again appears to be an experience that causes inner conflict. his experiences of dependency contribute to his conviction that his life is completed, and he expresses his wish to die on an almost daily basis. central to the theme of intergenerational living in some of these older adults’ stories is the value of independence and its negative counterpart, being dependent—or, as jos and inge frequently explained, being a “burden.” moreover, the latter’s fear of encumbering their children as a consequence of aging led them to envision precautionary measures. moving away from their children should prevent their fear from becoming a reality, as well as prevent a situation in which their children living nearby may neglect to visit them. jos and inge’s future plans and the underlying image of being an unhealthy burden to one’s children seem to reflect an increasing understanding of old age in what philosopher ricca edmondson (2015, 68) calls “social problem terms.” if older people are unable to conform to society’s prevalent image of successful aging consisting of a self-appropriated, active, and vital lifestyle, then they risk becoming excluded from meaningful participation in their society or community (laceulle 2018). jos and inge could already envision their future in a care institution. thus, they risk becoming deprived of the opportunity to enjoy the meaningful connectedness that they now pursue on a daily basis. it is striking, although not surprising, to note how normal they think it is that old age must lead to a social retreat from their meaningful others. one might expect that the narrative about independence and ‘becoming a burden’ is more characteristic of modern, neoliberal cultural settings, and that the relatively traditional setting of the dutch bible belt would hold different values.7 but our data suggest that this is more complex, and that cultural meanings of dependence and independence in the context of old age are in fact multilayered and often ambiguous. 5. transcendent sphere in the context of this study, older people seem to experience integration and senses of belonging within different social spheres. the sometimes heartening experiences which these persons accounted for often contribute to meaning making in their lives. however, a sense of social connectedness is not always positive. a negative sense of connectedness seems to apply to the case of paulus (91), a tiny man with pale, almost transparent, skin. he lives alone in the front-part of a farmer’s house that he shares with an older widow who raised 19 children. about a decade ago, the woman’s late husband—a member of paulus’s religious community—invited him to move in. http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 80 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu paulus never got married. he is originally from another area in the bible belt and moved to this village at the age of 10. he felt bullied ever since. when reflecting on his youth and adolescence, he described situations of intimidation and disdain: “. . .and as a child, when you play outside, you’re not one of them. sometimes, they hit me on my head and said to me, ‘you don’t belong here.’ that’s what they said to me, do you understand?” during his childhood, paulus felt like an outsider. even later on, he stated, “i was not lucky with who i am, you know. i am only a very tiny man, and people look [down] on you. and i did not do any study. . .” during the interviews, he became emotional several times. “i am a gloomy person, from childhood onwards. some people are born like that. such people are unlucky.” paulus did not feel valued by other people, and this influenced how he experienced life in both the past and present at old age. paulus practices a puritan form of christianity and perceives his earthly life as a temporal stage in which any hardships are consequences of the original sin.8 he and his family initially attended the most orthodox church in the village but, as a teenager, he started to separate from this church and began to join religious home-meetings instead. “i always went to sunday services until i encountered the people who read sermons at home. i also read sermons myself, …we read the old fathers.”9 in dutch, he uses the word scheiden several times, while reflecting on his separation from the church. this word brings a heavy connotation to his story; in dutch, it means both “separation” and “divorce.” both meanings make sense because leaving a church community, especially several decades ago and in a small village, is an intense deed.10 in the home-meetings that he joined, certain ancient interpretations of the bible were and still are fundamental. these texts are based on ideas such as predestination: i.e., that only a few people are elected to enter heaven. paulus has experienced disconnection throughout his life, but the homereaders group that he joined at age 14 offered him a radically different experience of connectedness. a poster of “the wide road and the narrow road” is the predominant decoration in his bedroom. he believes in the metaphor of the wide and crowded road that leads towards hell, and the bumpy, twisting, and narrow road full of hardships and penance that eventually leads to the small gate of heaven. as paulus explained, only “one person in a village and two in a town” will enter heaven, and god elects these people beforehand. paulus joined the religious home-meetings with the group led by a man named mr. berry. in those days, this man was known locally as a person who had had “a vision,” a sign for being elected by god. paulus felt gratified that this man and his family accepted him into their community when he was a teenager. he also described a personal experience, an occurrence that happened to him at the age of seven, when he was practicing writing skills at school. paulus: i was praised for my handwriting. [in those days,] you had to write with thin and thick lines—maybe you remember. that was not easy, and my teacher said: “the pupil who writes the most beautifully will win a portrait.” i won the first prize. i was elected . . . and i received this little portrait. it was made of black velvet, and there in gold-colored paint, it mentioned [gets emotional], written, “reconcile yourself with god [laat u met god verzoenen].” that was what was written. it was then already that . . . you understand? but i did not realize it then. it was then that he said, “this and this person will come to heaven.” pien bos: so, this was a sign that you will go to heaven? http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 81 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu p: yes, sure, yes. but remember, this is bought with blood, with the son of god. . . [long silence] in this conversation, paulus offered a glimpse of a rare earthly success that occurred when he won a contest for the most beautiful handwriting. he also shared the most important holy message that he received, which he acknowledged in retrospect as a sign of ‘election’ to heaven. however, he immediately downplayed what he shared because, according to his faith, vanity is sinful and, compared to god, people are nothing but original sinners from the day of birth onwards. in terms of meaningmaking, paulus is rather ambiguous. on the one hand, he appeared to have extremely low self-esteem, and this seemed to restrain his lust for life and consequently his sense of meaning in life. he appeared depressed during the interview, sharing that he already had “his legs in his grave” and was “in the front row,” which filled him with mixed feelings. when asked, “what makes life worth living for you at this age?” he answered: it is yet the final evening-sob separated from god [‘de laatste avondsnik bij het leven van god vandaan’]. but living life as a human being—that is something that you can’t let go easily, isn’t it? . . . death is a reality for every human being, and that is honest and true. “wie leeft er, die den slaap des doods niet eens zal slapen?” [he quotes psalm 89:19]. the idea of dying worries him, but it also seemed to soothe him that it would also come with relief and salvation. from childhood onwards, paulus experienced disconnectedness with his peers. he felt like a loner in his village, among colleagues when working as a clerk and, between the lines, he expressed that he even felt inferior within his family. as a young teenager, he found an escape. the social embedding offered by this isolated home-reading group seemed to mitigate his social pain. although he also felt inferior in this community, he looked up to leaders who were generally respected as people elected by god, and their status reflected upon him. this social embedding boosted his self-worth. but far more important is the divine connection that he experienced. paulus believes that doomsday is getting close, but he is certain that, by god’s grace, he will receive redemption. this makes sense to him since it is the only meaning in life that counts for him. his global meaning system of extremely orthodox protestantism coincides here with the situational meaning he derives from his beliefs in this situation (park 2017a). conclusion throughout this article, we have focused on connectedness as a form of meaning-making for older people. different types of connections appeared to be of paramount importance in our study of the lives of these older villagers in the netherlands. in particular, the insights from our study point to three distinct forms of connectedness: social, physical, and transcendent. as our analysis in this paper suggests, the village offers strong social cohesion, and older people benefit from being noticed by other villagers. social connectedness occurs in various social spheres, and being known and noticed frequently result in different forms of emotional or practical care. these various forms of social connectedness seem to make life meaningful. however, social connectedness does not always result in positive experiences. the village leaves little room for living in anonymity, and being known and noticed seems to come with its downsides. some older villagers experience intentional exclusion or are the subject of judgement and gossip. since those who are judged or excluded may simultaneously experience a deep connectedness within the social spheres of the village, church, and family, it is difficult for them to remain indifferent and unaffected by http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 82 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu these negative consequences. how does this dark side of social connectedness influence experiences of existential meaning? does being known and noticed, even in the case of nasty gossip, still add meaning in life? how does not being noticed at all lead to experiences that can be described in terms of meaning(lessness)? these questions remain open and require further research. as we indicated in this paper, connection does not only emerge in social forms. some older villagers seemed to experience a deep connection with their physical context as well (cf. rehak 2019). the village environment, with its buildings, houses, meadows, trees, and canals, evoke reminiscences. their physical setting conveys past experiences worth remembering and consequently adds meaning to life on a daily basis. many of the older people were born and raised in this village, and some of them may actually die in the same spot as they were born. as such, these older people appear to experience a strong sense of belonging and attachment to the village. some of them feel deeply rooted and explicitly express their preference to, for instance, be buried in the local graveyard—in almost the same exact soil from which some of them made their living as farmers. this sense of belonging acts as a significant meaning-maker. the physical and material settings in which people live—the dairy farms that provide their income, the animals, the houses—are not merely the impersonal background conditions that shape their lives. instead, they are a source of emotional relatedness and continuity for our informants, who feel responsible for taking care of their surroundings (and each other) in a broad sense. this could be explained by the fact that taking care of the earth and being good to other people as well as livestock is deeply rooted in calvinistic religion; this is sometimes referred to as stewardship (“rentmeesterschap”). “serving” in this broad sense, based on respect for the creation and the creator of life, appears to add to meaning in life. further investigation is required to understand how different religious or spiritual orientations may play a role in transforming conditions of the physical and material world to sources of meaning that seemingly transcend their physicality. the last form of connectedness emerges, paradoxically, from denouncing these forms of social and physical sources of connectedness. sometimes, this is a voluntary withdrawal from the social activities or housing in the community, but other times, exclusion and disconnection fuel the search for different means of connectedness. again, religious orientation may provide a possible explanation for transcendent connectedness. paulus, for example, follows an extreme form of puritan protestantism, and the ideology of this puritanism commands a disconnection with the world. this turns his crisis into a virtue with eternal blessing as a reward. this forecast is his main carrier of meaning in life. with detachment from all worldly candidates that could provide elements of meaning—such as purpose, self-worth, or control, and seeking refuge exclusively in a message of divine salvation—social and physical connectedness seem to be renounced in favor of a transcendent connectedness. this raises interesting questions about the relation between the different types of connectedness as well as the dynamics of social inclusion and exclusion. after analyzing these different spheres, several questions remain for further research. can one sphere compensate for another, or can the withdrawal from one affect a person’s connectedness in another? park (2017a, 16) distinguishes global meaning and situational meaning, and calls for an integrated perspective. her theory resonates inductively and has enriched our analysis. she claims that the discrepancy between the global and situational meaning results in distress, and that such distress may result in changes to people’s meaning-making process. our findings support this theory. for instance, paulus reconfigured his global belief (i.e., religion) as a result of the experiences that he appraised, such as the bullying and the way he retrospectively interpreted the portrait that he won as a child. schlegel and hicks (2017, 29) state that “shared systems of meaning such as religion and culture . . . often provide http://anthro-age.pitt.edu/ bos, cornielje, & laceulle | 83 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu answers.” nevertheless, “. . . people must make personal choices about whether they subscribe to those answers” (29). with the room to manoeuvre and thus with agency in mind, more deductive empirical research is needed; in particular, research that applies park’s theory in certain cultural settings may offer valuable insights into individual differences in the meaning-making process. this is important because, according to schlegel and hicks (2017, 29), individual differences in a person’s need for meaning are often overlooked. as such, we argue that derkx’s (2013; 2020) list of pre-defined meaning-needs should not be considered to be an exhaustive set that is applicable to every person’s life, regardless of their material and socio-cultural surroundings. rather, we suggest that derkx’s needs of meaning should function as concepts that should make researchers more sensitive to investigating older people’s experiences of meaning making in the field. notes 1. the name of the village is – of course – known to the authors. to hide our informants’ identities, all names have been changed or are not mentioned. 2. in the netherlands in 2017, fewer than 50% of the population identified as being a member of a religious community (schmeets 2018). approximately 3% of the dutch population is orthodox protestant. in this village’s local elections in 2018, 82% voted for a christian party. the most orthodox party sgp received 24% of the votes and another orthodox party cu (christian union) 17%. 3. this study took place in the context of a larger interdisciplinary research program “aging well,” which has been conducted at the university of humanistic studies, utrecht, the netherlands, since 2008. 4. people in this village will not use the word ‘orthodox’. they would rather use the word ‘heavy’ in the sense of ‘heavy in weight’ but people will use this word in a negative sense, not for themselves but for somebody else. the word ‘orthodox’ has a more neutral connotation. that’s why we use this word. 5. in 2018–2021, the dutch government supported facilities for aging in place for older people with €340.000.000. https://www.rijksoverheid.nl/onderwerpen/zorg-en-ondersteuning-thuis/langer-zelfstandig-wonen (visited 2021-1-27) 6. fred used a dutch saying “to not get old cows out of the ditch,” which means “to let bygones be bygones.” however, fred elaborated on this idiom by using more metaphors – e.g., the cows rotting in the ditch and spoiling the environment. this may refer to the worsening of family relationships and maybe even his life because of old conflicts. 7. the subject of ‘burdening’ frequently came to the forefront in the life stories. the perception of old age as a burden can be situated in cultural narratives that prevail in many industrialized societies (laceulle 2018). furthermore, international human rights specialist alison kesby (2017, 373) suggests that the social role of older people may be reduced to economic cost (to productivity) or concern through these narratives, which may be complemented by sinister metaphors such as the ‘grey tsunami’ or ‘demographic time-bomb’. the ageism inherent in such depictions of older people seems to have been reinforced in many socio-economic discourses during the covid-19 pandemic (see, for example, søraa, r. a., mandzi, f., kharas, m.w., marchetti, a., massaro, d., riva, g. and serrano, j.a. 2020. othering and deprioritizing older adults’ lives: ageist discourses during the covid-19 pandemic. europe’s journal of psychology 16 (4): 532-541. doi:10.5964/ejop.v16i4.4127). 8. ‘the original sin’ is the doctrine that humans inherit a sinful status through the fact of birth. this sin and guilt that all people hold in god’s eyes is caused by eve and adam’s defiance in eating the forbidden apple in the garden of eden. 9. interpretations of the bible and sermons from a few particular ministers from the 16th, 17th, and 18th centuries. 10. a church community is supposed to be christ’s bride. see, for instance, 2 corinthians 11:2. http://anthro-age.pitt.edu/ https://www.rijksoverheid.nl/onderwerpen/zorg-en-ondersteuning-thuis/langer-zelfstandig-wonen https://dx.doi.org/10.5964%2fejop.v16i4.4127 bos, cornielje, & laceulle | 84 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.282 http://anthro-age.pitt.edu references baars, jan. 2012. aging and the art of living. baltimore: johns hopkins university press. https://doi.org/10.1080/03601277.2013.844023. baumeister, roy f. 1991. meanings of life. new 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"religiosity and spatial demographic differences in the netherlands." research report from university of groningen: research institute som. steger, michael f. 2012. “making meaning in life.” psychological inquiry 23 (4): 381-385. https://doi.org/10.1080/1047840x.2012.720832. wong, paul t. p. 2017. “a decade of meaning: past, present, and future.” journal of constructivist psychology 30 (1): 82-89. https://doi.org/10.1080/10720537.2015.1119085. wijngaarden, els van, carlo leget, and anne goossensen. 2014. “experiences and motivations underlying wishes to die in older people who are tired of living: a research area in its infancy.” omega — journal of death and dying 69 (2): 191–216. https://doi.org/10.2190/om.69.2.f. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2009: 30 (2) 28 features an anthropological approach to an occupational intervention: the exercise and dementia project margaret a. perkinson, phd department of occupational science & occupational therapy doisy college of health sciences saint louis university the growing attention of occupational science/ occupational therapy to issues of social inequality, social marginalization, and representation of diverse voices, as seen in recent publications such as a political practice of occupational therapy (pollard, sakellariou, & kronenberg 2009) and occupational therapy without borders (kronenberg, algado, & pollard 2005), comes at a time when anthropology also is re-considering its central roles and moral duties as a discipline. a selective integration of these disciplinary approaches may synergize efforts to address the occupational needs of marginalized persons. this paper describes an interdisciplinary attempt to work with one marginalized group, persons with alzheimer’s disease and their family caregivers, by encouraging the inclusion of physical activity into the daily routines of persons with dementia and enhancing the occupational role of family caregivers. the shift from a purely biomedical perspective of dementia to one that takes into account the potential for personhood of one with the disease (kitwood 1997) is a critical step toward the de-marginalization of individuals with alzheimer’s. using ethnographic methods to examine life experiences of persons with dementia, anthropologists have served a pivotal role in this shift in perspectives (leibing & cohen 2006; mclean 2007). their work has encouraged a comparable shift in models of dementia care, from simple custodial care to an emphasis on the physical and psychosocial factors impacting quality of life (perkinson 2000). the potential for the experience of personhood, improved quality of life, and engagement in meaningful occupations by persons with dementia were basic assumptions that guided the development of the exercise and dementia project. this project employed an anthropological perspective to develop and evaluate an occupational intervention: a family-supervised, home-based physical activity program for persons with mild dementia (perkinson 2008). based on a multi-dimensional set of baseline assessments, an interdisciplinary team (occupational therapist, physical therapist, and medical anthropologist) developed and evaluated individualized physical activity programs for 30 persons with mild dementia and their primary family caregivers. family exercise supervisors received instructions on the performance and safe supervision of the exercise program and exercised with their relatives three times a week for three months. follow-up assessments revealed significant improvement on various physical measures and general satisfaction with the program. in addition to collecting traditional, standardized assessments of outcomes, the project evaluation documented and analyzed the processes through which the interventions morphed into personal routines and habits. ethnographic observations, exercise diaries, in-depth follow-up interviews, and focus groups with family exercise supervisors indicated how participants learned and performed the exercise programs within the context their everyday lives. data analyses revealed unanticipated physical and social barriers and incentives to performance of and adherence to the intervention. when faced with such barriers, many exercise supervisors adapted by making ad hoc modifications to the exercise programs. they occasionally introduced technical devices to enhance the impact of the program. family supervisors also developed idiosyncratic criteria to assess the adequacy of exercise performance. the meanings that participants ascribed to their experiences of physical activity and to the occupation of exercise supervision were pivotal to adherence and general impact of the intervention. anthropological process evaluation research (butler 2005), with its focus on context, meaning, and process of implementation can provide insight into the manner in which activities of an intervention are integrated into daily occupations and can reveal the meanings and value of ot interventions from the perspectives of its participants. productive partnership between anthropology and occupational science/occupational therapy holds promise for the development of an evidence-based field of practice and body of knowledge that will address issues such as social and occupational justice, which are central concerns for both fields. continued on page 40 anthropology & aging quarterly 2009: 30 (2) 40 acknowledgements: i wish to acknowledge the support of the national alzheimer’s association (gms-4250) for funding this project; the alzheimer’s association st. louis chapter and washington university school of medicine alzheimer’s disease research center for their assistance in recruitment; david sinacore, pt, phd, for the generous use of his lab for conducting assessments; and the generous and dedicated involvement of the project participants. references: butler, m.o. 2005. translating evaluation anthropology. in m.o. butler & j. copeland-carson (eds.) creating evaluation anthropology. napa bulletin 24. berkeley, ca: university of california press. kitwood, t. 1997. dementia reconsidered: the person comes first. buckingham, uk: open university press. kronenberg, f., algado, s. & pollard, n. 2005. occupational therapy without borders. edinburgh: elsevier/churchill livingstone. leibing, a. & cohen, l. (eds.) 2006. thinking about dementia: culture, loss, and the anthropology of senility. new brunswick, nj: rutgers university press. mclean, a. 2007. the person in dementia: a study of nursing home care in the u.s. toronto: broadview press. perkinson, ma. family and nursing home staff perceptions of quality of life in dementia. in r. rubinstein, m. moss, and m. kleban (eds.) the many dimensions of aging. new york, new york: springer publishing company, 2000. perkinson, m.a. 2008. negotiating disciplines: developing a dementia exercise program. practicing anthropology (special issue on anthropology and occupational therapy), 30(3), 10-15. pollard, n., sakellariou, d. & kronenberg, f. 2009. a political practice of occupational therapy. edinburgh: elsevier/ churchill livingstone. perkinson, continued from page 28 widow(er)s holtslander, l.f. & w.d. duggleby 2009 the hope experience of older bereaved women who cared for a spouse with terminal cancer. qualitative health research 19(3):388-400. work research on aging 31(1), 2009: special issue on “employment opportunities at older ages.” new publications, continued from page 37 aging quarterly has been the first venue in which they authored work and it was a pleasure to see their pride as they looked at their very first publication here. finally, another special event for aage in june will be the next aage workshop entitled “aging and the indigenous peoples of north america” to be held at the university of oklahoma from june 5th-9th. it promises to be a very exciting conference and what goes on there will be reported on in the next issue of anthropology and aging quarterly. thanks again to all who contribute your time to make aage activities, such as anthropology and aging quarterly and these special meetings, a reality for our membership. on the subject of membership, now that we have club express up and running, please feel free to invite your students, colleagues, and others interested to join aage and see what we have for them. it’s still a real 21st century bargain! briller, continued from page 24 p28 perkinson (2)may2009-6 p40 (2)may2009-3 anthropology & aging quarterly 2010: 31 (1-2) 14 features toward a contextually valid measure of social support among middle-aged and older african americans in a southern urban community dawn bodo lehman, ph.d. director of education mather lifeways institute on aging 1603 orrington suite 1800 evanston, il 60201 dlehman@matherlifeways.com abstract a gap in the literature on social support among middle-aged and older african americans and limitations in scales measuring social support among this group indicate a need for a new measure of social support that is sensitive to the cultural context in which this population lives. the literature indicates that social support is a multidimensional, fluid phenomenon, i.e., it has many dimensions and each dimension may have significance for individuals and communities at different periods in time and in different geographical locations. the specific goals of this research were to (1) identify the domains and dimensions of support among middle-aged and older african americans, ages 38 to 65, that potentially moderate the effects of psychosocial factors on health outcomes; (2) use the research findings to construct a new, contextually valid scale that measures social support among this population in a southern urban community; and (3) document the methodological process by which the first two goals were achieved. the iterative research process consisted of thirty-one methodological steps in nine phases over a four-year period. six sets of data obtained from a content analysis of popular magazines, five types of interviews, a semi-structured questionnaire, a visual assessment of the community, and participant observation were analyzed for recurrent themes associated with social support. the findings were used to construct scale items that reflect culturally-relevant domains and dimensions of social support that are not typically assessed in traditional scales. introduction there are a number of excellent scales that measure social support in the general population; however, few, if any, have tapped into the unique experiences of older african americans. furthermore, these scales are not comprehensive enough to elicit contextually-based responses from middle-aged and older african americans, ages 3865, who live in a southern urban community. this may result in investigators missing (or worse yet, misunderstanding) important information regarding social support among men and women in this age category and geographical location. a gap in the literature and limitations in current scales measuring social support indicate a need for a new measure of social support that is sensitive to the cultural context in which middle-aged and older african americans live. this study had three goals: (1) to identify, using qualitative and quantitative research methods, the domains and dimensions of support among african americans, ages 38-65, that potentially moderate the effects of psychosocial factors on health outcomes; (2) to use the findings of this research to construct a new contextually valid scale that measures social support among this population in a southern urban community; and (3) to document the methodological process by which the first two goals were achieved. methodology with nia (national institute on aging) grant funding (5p02ag12058-02), the duke university exploratory center (ec) for research on health promotion in older minority populations was established to conduct multidisciplinary pilot research and interventions and to initiate programs of health education and community outreach aimed at improving the health status of older african americans. the scientific emphasis was on the interaction of psychosocial, behavioral, and physiological factors as they affect health and illness in older african american males and females. duke investigators selected hypertension as their research theme. researchers also were interested in filling a major gap in the scientific literature on health and aging in middle-aged and older african americans. duke ec investigators argued that social factors have received little attention in studies of hypertension among this older population. in the proposal stage of the duke ec grant, the nia study section questioned whether the scales previously used by duke (including dressler’s scale of chronic role stressors and the duke social support index) were “comprehensive enough to indicate the real life levels of support and environmental stress in this population, and were thus leading to an underestimation of the association of the ‘environment’ with hypertension.” in response, the duke ec decided to conduct a sub-study to develop new scales to measure stress and social support among older african americans. this research focused on the development of one of the new scales: the african american social support anthropology & aging quarterly 2010: 31 (1-2) 15 features scale. research questions social support refers to having a variety of social contacts as resources for personal benefit. it includes the structure of an individual’s social life (e.g., group memberships, existence of familial ties) and the explicit functions they may serve (e.g., emotional, instrumental support) (cohen et al. 2000; uchino 2006). the conceptual framework underlying this sub-study is based on the assumption that social support potentially moderates the effects of psychosocial factors on health outcomes. to design a culturally sensitive measure of social support, a number of research questions needed to be answered: what are the domains (sources) and dimensions (types) of the support convoy in the study community? how are these domains and dimensions characterized? who/what plays a major role in supporting middle-aged and older african americans? research also focused on questions related to the literature and methodology: will interview, questionnaire, and participant observation findings reinforce the social support literature on older african americans? if so, in what ways and to what degree? will the methods employed provide further insight into widely recognized domains of support among older african americans? will the methods elucidate new domains and dimensions not addressed in the current literature? how will anthropological methods (research and analysis) provide insights into attitudes, beliefs, and behaviors associated with social support among older african american men and women? how will anthropological methods contribute to the construction of a new, contextually valid scale? research design for the most part, this research followed a sequential study design, i.e., one type of research method followed another. the iterative research process consisted of a total of 31 methodological steps in nine phases over a four-year period (see figure 1). each methodological step provided insight into previous data, identified new questions, or informed the next step of the research process. the research methods used in this study provided six sets of data that were analyzed for recurrent themes associated with domains and dimensions of support. throughout the study, a number of men and women provided feedback on the questionnaire, interview protocols, analyses, and construction of the new scale. for example, focus group participants offered suggestions related to word usage, phraseology, questionnaire and scale formatting, and scale item selection. feedback resulted in appropriate modification of the questions in the preliminary semi-structured questionnaire, interviews, and preliminary social support scale. the iterative research process, which included feedback from study participants, was particularly important in this study because research that focused on unique domains and dimensions of social support needed to be sensitive to the cultural context in which african americans live. by including study participants in the research process, there was less likelihood of researcher bias; participants’ feedback continually challenged the researchers to step back and determine the objectivity and relevance of their questions. the triangulation of qualitative and quantitative methods and data sets provided greater assurance of validity. these data were used to construct the new african american social support scale, a paper and pencil instrument consisting of six domains and 96 dimensions of social support. anthropology & aging quarterly 2010: 31 (1-2) 16 features review of academic literature a search primarily of the anthropological (urban, medical), african american studies, theological, psychosocial, historical, medical, and gerontological literature related to social support among african americans was conducted to identify concepts, theories, and empirical findings associated with types, dimensions, and efficacy of social support. data set 1: review of african american popularpress anthropology & aging quarterly 2010: 31 (1-2) 17 features a review of the african american popular press (e.g., essence magazine, black woman magazine, black elegance magazine, ebony, heart & soul) served as an unobtrusive observation method. an opportunistic sample of 839 feature articles from 118 issues of 10 prominent african american magazines was useful for detecting the presence or absence of key themes that may be associated with social support among african americans and corroborating findings from other data sets. this method was particularly insightful because the literature was written for an african american audience. authors openly addressed many issues in the african american community that would not be shared with non-african americans in public forums. a content analysis was conducted by recording the most prominent theme/s emerging from each feature article, developing a list of the most discussed topics, and examining frequencies of mention. to confirm the relevance of the articles in the day-to-day lives of readers, letters to the editors in each issue were examined. month after month, readers praised the editors for providing such needed support. for example, one reader wrote: “just seeing my likeness as i turn the pages motivates me to act on the information i’ve just absorbed. as i read, i sensed that this information was put together just for me by people who genuinely care about me, my family, and the african american community at large. your magazine is like a friend or a relative.” data set 2: focus groups six focus groups, consisting of a total of 26 african american men and women from the study community, were conducted. focus group participants were recruited through word-of-mouth to provide an overview of stress and social support in their community. the focus groups served several purposes. first, they provided access to data that would not be obtained easily with interviews and participant participation. for example, topics and themes emerging in the discussions sometimes were debated, revealing a diversity of attitudes, beliefs, and opinions. second, the focus group discussions provided insight into the natural vocabulary and styles of communication among participants. a deeper understanding of phraseology and body language facilitated future discussions with african american men and women. the first focus group session served to identify general topics and issues of importance to the participants, their families, and the african american community. participants told stories, gave examples, and described their day-to-day lives. the ensuing three focus group discussions explored, in more detail, the key issues (e.g., racism, discrimination, the church) raised in the first focus group. participants discussed the efficacy of social supports in the study community and described the types of support they seek and provide. the last two focus groups were designed to obtain more detailed feedback on the construction of the new scale. data set 3: semi-structured sociocultural questionnaire in order to construct a contextually valid scale that measures social support among middle-aged and older african americans, a 10-page questionnaire was designed to specifically identify the widest range of sources and types of social support among this population. the preliminary questionnaire was administered to all 26 focus group participants who provided feedback on the content and structure of the questionnaire. the final semi-structured questionnaire was administered to 149 participants in the larger, duke ec hypertension study. the questionnaire identified cognitive categories utilized by, and meaningful to, respondents and determined patterns of responses related to social support. questions were based on constructs identified in the academic and popular literature, informal interviews, and focus groups. scales successfully used in other duke ec studies (e.g., the dressler scale of chronic social role stressors and the duke social support index) also were useful in developing these questions. a portion of the questions elicited demographic and social status information, e.g., marital status and living arrangement, educational and employment status, religious background, racial makeup of neighborhood, household income, and organizational memberships. openand close-ended questions associated with social support focused on the influence of spirituality and the church on respondents’ lives, sources of support when respondents have problems, and quality and quantity of support respondents give and receive. several qualitative data gathering techniques were used. a number of questions requested listings (e.g., people from whom they receive/give support, types and amounts of support provided and received, most important person in life, causes of stress, and words associated with church) and written descriptions (e.g., difference between church in past and present, relationship between men and women today, and things they would change in their personal lives, community, and society. an analysis of the study participants’ social networks was conducted using a visual display method. respondents were asked to list the people with whom they spend time and the amount of time spent with each person. after categories of people were identified, and hours of contact per month calculated, categories of people in each support network were listed horizontally in the order of time spent with each respondent. figure ii is an example of the listings in display form. the full display of 149 social networks identified coworker and friend as important sources of social support. anthropology & aging quarterly 2010: 31 (1-2) 18 features figure ii. visual display of participants’ social network spouse son friend mother sister sister friend cousin friend coworker daughter sister coworker friend spouse son mother father coworker brother aunt friend spouse daughter daughter-in-law friend mother son data set 4: interviews four types of one-one-one interviews were conducted over the course of the study: unstructured and nondirective, in-depth unstructured, semi-structured, and in-depth focused. unstructured and non-directive interviewing was conducted in various locations where middle-aged and older african american men and women congregate (e.g., the workplace, church, community cultural center, community events, a wedding). the purpose of this type of interviewing was to get to know “the lay of the land” and build rapport in the study community. interactions, behaviors, and beliefs among african americans emerged from within their own personal and cultural context, i.e., topics of significance to each individual emerged naturally as (s)he talked. typical questions were, “how would you describe your community?” and “what is daily life like here for african americans?” when they described an interaction between men and women or african americans and caucasians, i asked for a description of what happened. informants offered an “audio tour” of daily life. face-to-face, semi-structured, audio taped interviews with 25 study participants were conducted primarily in a community nutrition center where the informants were participating in the larger duke ec hypertension study, and in their homes. these one-hour interviews served as a means by which to learn about issues of importance to middle-aged and older african american men and women and uncover topics of interest that may have been overlooked in the focus group discussions. an interview guide was used to identify individuals’ perceptions and experiences of, and attitudes toward, social support. participants also were invited to tell personal stories. of the 25 interviewees, five were interviewed a second time for a period of two to three hours. the purpose of conducting a second round of in-depth, focused interviews was to obtain more comprehensive explanations of attitudes, beliefs, and behaviors associated with social support and to identify ways in which social support intersected with the stressors in their lives. participant availability and interest determined who would be interviewed a second time. a key informant emerged out of this group. she was always available to answer questions and provide feedback on findings throughout the entire research period. data set 5: visual assessment of community an overall assessment of the community from which the study sample was drawn was conducted in order to gain knowledge of the ecological and structural context in which the subjects lived. the assessment consisted of a “windshield survey” of neighborhoods and available formal (e.g., social service agencies) and informal (e.g., churches) support resources in the study community. this assessment continued throughout the entire research process. data set 6: participant observation participant observation included attending numerous churches; attending events such as weddings, parties, and community programs; and participating in group discussions with older african american women and men at schools, community meetings, and non-profit organizations. throughout the entire research period, these observations informed the development of interview and focus group questions and the construction of the semi-structured questionnaire and final social support measure. discussion the research findings support many of the hypotheses postulated by social support researchers. on a general level, there is a concatenation of sociocultural factors (identified as stressors) that negatively impacts the quality of middle-aged and older african americans’ lives. social support is a mechanism through which african american men and women cope with stressors (e.g., psychological and sociocultural) (kikusui et al. 2006; cohen & pressman 2004; krause 2001; harrison 1995; lepore et al. 1993; cohen and wills 1985; dressler 2000, 1991). the types of support study participants reported collapsed into four primary categories: emotional, instrumental, social (participation), and anthropology & aging quarterly 2010: 31 (1-2) 19 features spiritual. research shows that african american men and women experience and cope with these stressors in different ways at different times in their lives. thus, their need for particular sources and types of support also fluctuates. this study suggests that social support among middle-aged and older african americans is multidimensional and fluid, i.e., each domain and dimension of support may have significance for individuals at different periods of time and in different geographical locations. additionally, ethnic and family bonds, american lifestyle, the black church, and availability of institutional and social resources in the community influence the frequency and quality of support provided to men and women at any given time. the efficacy of support therefore moves back and forth on a not enough/ enough continuum. the findings support the research of taylor and chatters (1989) and antonucci (1985) which shows that the support convoy (i.e., the constellation of support providers) is a dynamic entity that develops and changes over time in response to individual, family, community, and societal changes. the interviews and participant observation findings reveal that men and women have their own decision criteria for seeking support. they have a cognitive map of available supports, and their decisions for selecting sources and types of supports are influenced by geographic relocation, major role changes (e.g., marriage, family, widowhood), accessibility to “trustworthy” coworkers and friends, and personal and family members’ lifestyles. anthropological research methods identify new domains and dimensions of social support at the beginning of the study, two specific methodological questions were posed: will the methods employed provide further insight into widely recognized domains of support among older african americans? will the methods elucidate new domains and dimensions not addressed in the current literature? five of the six methodological data sets provided new perspectives on domains (sources) and dimensions (types) of social support among middle-aged and older african americans in the southern urban community. the range of dimensions identified in each data set varied, yet they complemented each other. the sum of dimensions identified in all of the data sets provided an in-depth picture of the range of sources and types of social support. the cumulative findings from all five data sets reveal that the constellation of support providers consists of spouse, family, friends, coworkers, organizations and clubs, and the church. each source provides one or more types of support to middle-aged and older african american men and women in the study community. the previous duke social support index explored types, frequencies, and efficacy of support provided by family (including spouse/significant other) and friends; however, these sources of support were lumped into one domain. the findings of this study suggest a variation in types of support provided by spouse, family, and friends; thus, each should be explored independently in more detail. furthermore, three additional sources of support emerged from the data: coworker, organizations and clubs, and the church. since these categories were not included in previous social support scales, and the findings show that they are important sources of support, they also should be categorized as independent domains in the new social support scale. study participants provided more contextually rich information about the church than any other source of support. most middle-aged and older men and women believed that the church continues to be the most supportive institution in the community, and it should continue to focus largely on providing emotional, instrumental, and spiritual support to members and nonmembers. in discussing the role of the church with study participants, one key point became clear: the black church must not be essentialized. as argued by baer and singer (1992) and lincoln and mamiya (1990), the black church is not one monolithic entity with one universal set of characteristics. personal values and attitudes of pastors, denominational doctrines, and program emphases may influence men’s and women’s attitudes, beliefs, and behaviors in their day-today lives. differences across denominations in terms of preaching style, sermon message, music selection, outreach activities, and worship practices often are mirrored in the various ways in which men and women attach meanings to their religious experience inside and outside the church. in the same way that the black churches move back and forth on a continuum of dialectical tensions (i.e., shifts in functions and missions), so too do men and women move on a continuum of religious experience. men and women make unconscious and conscious choices regarding the degree to which they are committed to, and participate in, the church. the study findings also support scholars (baer and singer 1992; lincoln and mamiya 1990) who contend that the church is a “pseudo-extended family” mimicking numerous functions of the black family. like the family, the church provides different types of support for each member. anthropology & aging quarterly 2010: 31 (1-2) 20 features sources of support tables 1-4 highlight the sources of emotional, instrumental, social, and spiritual support. each source provides one or more types of support to middle-aged and older african american men and women. table i displays the sources of emotional support identified in each data set. all of the data sets highlighted spouse, family, friends, coworker, and church as important sources of emotional support. organizations and clubs were mentioned in the popular literature and questionnaire. table i. sources of emotional support source popular literature focus groups questionnaire one-on-0ne interviews participant observation spouse x family x x x x x friends x x x x x coworker x x x x x org/clubs x x church x x x x x table ii shows the sources of instrumental support identified by study participants. all of the data sets highlighted spouse and family as primary sources of support. the popular literature, focus groups, and questionnaire findings show that friends and the church also are sources of instrumental support, and the questionnaire findings indicate that co-workers and organizations and clubs are considered support providers. table ii. sources of instrumental support source popular literature focus groups questionnaire one-on-one interviews participant observation spouse x family x x x x x friends x x x coworker x org/clubs x x church x x x as table iii shows, all five data sets identified family, friends, and the church as primary sources of social (i.e., social participation) support. all data sets except the focus groups also identified coworkers, organizations, and clubs as important sources of social support. questionnaire findings showed that 71 percent of women and 58 percent of men said membership in a group had helped them socially. women most frequently stated that membership in an organization or club helped them “become a better person.” spouse did not emerge as a strong source of social support. many study participants attributed the lack of social togetherness to lifestyle choices, overwhelming responsibilities at home and work, and strong “sister” friendships among women. anthropology & aging quarterly 2010: 31 (1-2) 21 features table iii. sources of social support source popular literature focus groups questionnaire one-on-one interviews participant observation spouse x family x x x x x friends x x x x x coworker x x x x org/clubs x x x x church x x x x x table iv clearly shows that study participants considered family, friends, and the church as primary sources of spiritual support. table iv. sources of spiritual support source popular literature focus groups questionnaire one-on-one interviews participant observation spouse x family x x x friends x x x x x coworker org/clubs church x x x x x constructing the new african american social support scale the first step toward constructing the new african american social support scale was to analyze and interpret the questionnaire, interview (focus group and one-on-one), popular press, and participant observation data. this involved identifying emergent themes related to the research questions that crosscut all of the data sets. these themes were further categorized into sources or “domains of support” (e.g., spouse, friends, church) and types or “dimensions of support” (e.g., goes to church with me, takes care of me when sick, prays for me). the second step involved creating lists of all possible dimensions that could be included in each domain. the lists consisted of actual phrases and sentences identified in the data. the dimensions showing the highest frequencies were selected for inclusion in the preliminary scale. each domain consisted of between 7-29 dimensions. a likert response format was developed to measure the amount (none to as much as i want) of support received by respondents. in the third step, the larger lists (dimensions) were collapsed by eliminating redundant phrases, i.e., phrases that were similarly worded. this became the first draft of the scale. the fourth step consisted of gaining feedback on the preliminary scale from focus group participants. they critiqued the scale in the following ways: 1) theme selection; 2) item selection; 3) word usage; 4) sentence construction; 5) appropriateness of the likert rating system and its anchors; 6) sensitivity to the study population; and 7) ease of use. focus group participants prioritized scale items in terms of importance, noted oversights regarding relevant themes, and made further suggestions related to the development of the scale items. in particular, they did not like the long phrases and sentences. focus group participants said the items would be easier to read, more understandable, and less likely to be misinterpreted if words and very short phrases were used. the response format was designed in such a way that individuals could respond along a continuum from no support to as much support as needed. the fifth and sixth steps involved making suggested changes and presenting the revised scale to the same focus group participants. as table v shows, the new scale has several distinct advantages over the previous duke social support index when used with a middle-aged and older african american population. the new scale includes four more domains and 61 additional items. anthropology & aging quarterly 2010: 31 (1-2) 22 features table v. comparison between duke social support index and african american social support scale duke social support index 2 34 3 3 9 1 - african american social support scale 6 95 4 41 37 6 11 domains # of items (questions) types of dimensions type: emotional type: instrumental type: social type: spiritual the duke social support index primarily focuses on quantity rather than types of support. for example, questions ask “how many,” “number of times,” “how often,” “how much,” and “how satisfied.” fourteen of thirty-four questions ask about types of support. african americans constitute a culturally distinct and ethnically diverse population. the domain that speaks most to the cultural sensitivity of the new social support scale is that of the church. study participants reported a wide spectrum of types of support provided by the church, and key themes were included as items in this scale. the duke social support index did not include any items associated with the church or spirituality, and the duke religious participation scale only included two types of support from church: helps me in marriage and helps me in getting ahead in life. study participants identified more specific types of church support: spiritual atmosphere, guidance, relief, strength, peace/calm, comfort, understanding, sense of connection, stability, sense of freedom, and empowerment. men and women reported that in addition to providing spiritual support and guidance, the church connects men and women with their african american heritage, functions as an extended family, enhances self-esteem through historically based messages of empowerment and freedom, fosters and nurtures talents and skills through such ministries as music and teaching, and connects them to other members of the african american community. themes such as “my spouse prays with me,” “my friends go to church with me,” “my family reads the bible with me,” and “my friends offer spiritual support,” translated into culturally relevant scale items. items associated with instrumental support (e.g., scholarships and helping to support the children’s education), emotional support (e.g., physical affection, emotional healing), and social participation support (e.g., connection to the african american community, acts as extended personal family) also are culturally relevant. these items are not included in the duke social support index and other traditional support scales. what sets the new african american social support scale apart from the duke social support index is that it enables the researcher to conduct a more sensitive examination of social support among middle-aged and older african americans, thus potentially picking up new relationships between types of support and mental and physical outcomes. additionally, researchers investigating race, ses, and health can use the scale to determine twoand threeway interactions. such studies will be valuable additions to the burgeoning literature on environmental influences on morbidity and mortality. reliability and validity of new african american social support scale according to house and kahn, when well-designed empirical research confirms theoretical ideas about the relationship between social support and health, confidence in both the theory and measures used to test it is enhanced… the litmus test of the validity of any measure of social support is its relationship to the major causes and consequences of social support (1985:87). toward that end, the african american social support scale was constructed with the intent to conceptualize and measure the experience of social support in a multidimensional, reliable, and valid manner. the new scale was administered to 148 participants and was re-administered four weeks later to a subset of 50 of these participants. the scale was tested for internal reliability, test-retest reliability, construct validity (convergent and discriminant) and predictive validity. internal reliability was tested using chronback’s alpha. chronback’s alpha statistically tests to what degree items within a scale or sub-scale are correlated with each other. the higher the degree of correlations, the higher the internal consistency of the scale, and the more desirable the scale. as table vi shows, results from this testing indicated that internal reliability on the african american social support scale was excellent, ranking in the .90s. anthropology & aging quarterly 2010: 31 (1-2) 23 features table vi. internal and test-retest reliability domain of support internal reliability cronback’s alpha .95 .95 .94 .95 .93 .95 test-retest reliability interclass correlations .89 .73 .64 .70 .84 .75 spouse/partner family/kin friends coworkers organizations/clubs church test-retest reliability was tested using interclass correlations (iccs). interclass correlations provide a conservative estimate of test-retest reliability in that they take into account the mean and distribution of each sample, which pearson correlations do not. table vi shows the test-retest reliability to be good, ranging from .64-.89. slightly lower reliability on the friends sub-scale was observed, which might have been due to some turnover in friends. nonetheless, these correlations were equal to, or better than, those reported for other scales measuring factors that fluctuate over time. construct validity assessed whether the instrument actually measures the construct it is purported to measure. construct validity was assessed by testing for convergent and discriminant validity. convergent validity tests to what degree scales or sub-scales measure the same construct, whereas discriminant validity determines to what degree instruments measure different constructs. convergent and discriminant validity in this study were tested by conducting correlations between the new african american social support scale and the duke social support index (dssi) – a standard, widely used scale that has been used frequently with older populations, including african americans. table vii indicates that the new support scale showed excellent convergent validity with the duke social support index. the expected discriminant validity was also observed regarding the sub-scale of spouse/partner support, since the duke social support index did not include that domain. table vii. construct and predictive validity domain of support construct validity new vs. dssi .23 .51*** .40*** .24* .37* .41*** predictive validity new scale vs. bdi -.13 -.04 -.10 -.16 -.21 -.17 spouse/partner family/kin friends coworkers organizations/clubs church key: *p<.05; ** p<.01; ***p<.001 predictive validity assesses whether scores on one measure predict scores on another scale. the predictive validity of the new african american social support scale was tested by correlating scores on the support scale with scores on the beck depression inventory (bdi) scale. previous research has shown that individuals with lower social support often experience higher levels of depression. stated more broadly, there is an inverse association between social support and depression. as shown in table vii, results from this testing indicate that, as expected, support was inversely correlated with depression scores, although the correlations were not statistically significant. this finding was anticipated with our sample since none of our participants was clinically depressed. hence, the restricted range of scores on the depression inventory would be expected to reduce the likelihood of detecting significant relationships. in summary, tests conducted by duke ec researchers showed that the internal reliability, test-retest reliability, construct (convergent and discriminant) and predictive validity were excellent. anthropology & aging quarterly 2010: 31 (1-2) 24 features cultural relevance of scale the new african american social support scale was constructed with the intent to conceptualize and measure the experience of social support in a multidimensional, reliable, and valid manner. to my knowledge, the new scale is the first to investigate 53 types (out of a total of 95 questions) of support provided by six primary sources of support in the african american community: spouse, family/kin, friends, coworkers, organizations and clubs, and the black church. two primary comparisons can be made between the duke social support index and the new african american social support scale. first, the new scale is empirically derived, i.e., an emic perspective, provided by a total of 245 people, significantly contributed to the development of scale items. second, these data provide insight into a wider and more sensitive range of domains (e.g., church, coworkers) and dimensions (e.g., prays with me, pays for children’s college education) of support among middle-aged and older blacks than previously captured by other researchers. because of its augmented sensitivity, the scale is more likely to identify new relationships among variables; the new scale will enable researchers to explore, in more depth, the relationship between social support and physiological outcome measures. limitations of scale limitations of scale lie primarily in the sample: mostly female (77%), restricted ses, and healthy (with the exception of having hypertension). a higher percentage of participants were married and well educated compared to other residents in the study community. similar to other community-based studies of african americans, males were underrepresented in this study. a disproportionate sample size may occur, in part, because african american men are disproportionately represented among institutionalized populations and because the mortality rate among african american men is high. additionally, many men did not meet the overall criteria for participation in the duke ec hypertension study, did not have the time, or simply were not interested in participating in the study. since this research focused on social support among middle-aged and older african americans, segments of the population that are important in the assessment of prevalence and efficacy of social support in the community (e.g., lowerand upper-class african americans ages 38-65) were not included in the study. men and women from these segments also did not meet duke ec study criteria or were not interested. while the sample was primarily middle class, it must be noted that study participants had diverse economic, social, and educational backgrounds; were affiliated with various predominantly african-american denominations (e.g., african methodist episcopal, national baptist convention usa, church of god in christ); and had varied family structures (e.g., nuclear family, extended family, stepfamily, single-headed family) and functions. thus, there was a universe of information to gather on this subgroup alone. research focused on a subgroup located in a southern community characterized by a unique culture and sociohistorical pathway; therefore, further testing of reliability and validity may be required for studies of similar subgroups in other geographical locations (e.g., midwest, southwest). although the sample was adequate for the purposes of this study, further testing also should be conducted to determine reliability and validity of the scale for use with study populations comprised of african american males, younger adults, the elderly (over 65 years of age), and african americans who are members of other faith communities. future directions include investigations of the relationships between the new social support scale responses and outcome variables of blood pressure, sympathetic nervous system activity (catecholamines/stress hormones), and sodium excretion. considering that african americans are at a higher risk for hypertension than any other ethnic group, further investigation of the effects of social support on health in african americans is warranted. significance of research and scale as many scholars have noted, the experience of support is a complex, multidimensional phenomenon. there are few instruments that attempt to capture the experience of social support in all of its complexity. the new african american social support scale is reliable and valid; it captures the multidimensional experiences of social support among the study population. this scale provides not only an assessment of frequency of social support, but also advances the measurement of social support by providing an in-depth assessment of types of social support across sources of support. statistical multiple techniques can be used by researchers to evaluate potential main effects and two-way interactions of social support among middle-aged and older african americans. potential covariates include age and gender, income, employment status, occupational status, marital status, depression (using the beck depression inventory), and john henryism (a psychological coping behavior). it is expected that the scale will elucidate withingroup variations and provide a clearer picture of the ways in which social support, as a buffering factor, can moderate the effects of stress. anthropology & aging quarterly 2010: 31 (1-2) 25 features a key factor contributing to the success of this research and resultant scale was the research team’s respect for multidisciplinary research methods. being a member of duke ec’s team of scholars in the fields of psychology, sociology, community health, and medicine was an ethnographic experience in and of itself. the only anthropologist on the team, i brought to the table a new perspective and new qualitative research strategies. in order to help colleagues understand these perspectives and strategies, it was important to understand their methods and communicate in their language. as the study progressed, the duke ec team learned that anthropological research took considerable time, and that “thick description” of the environment in which middle-aged and older african americans lived required several types of data collection methods and different types of rigorous analyses. this study was most likely the first to use anthropological perspectives and methods (e.g., participant observation, unobtrusive observation, content analysis of popular literature, and interviews) to inform the construction of a culturally sensitive measure of social support among middle-aged and older african americans. the use of anthropological research methods serves as an example of the ways in which contextual information and culturally relevant language can be used to design culturally sensitive measures of social support among ethnic groups. the methodological process may be of value to urban and medical anthropologists interested in obtaining information from larger, more representative groups of people while at the same time collecting the rich material that comes from ethnographic fieldwork. the methods employed in this study have not typically been used by health and social scientists to construct scales; thus, this research strategy serves as a model for future scale development. it informs health and social scientists how anthropological methods provide a holistic and culturally relevant approach to scientific inquiry. acknowledgements i am grateful to drs. norman anderson, maya mcneilly, and bernard ortiz de montellano, to the duke ec research team, and to the 245 men and women participating in this study. references antonucci, t.c. 1985 personal characteristics, social support and social behavior. in handbook of aging and the social sciences 2nd ed. binstock, r.h. and e. shanes, eds. new york: van nostrand reinhold. baer, h.a. and m. singer 1992 african-american religion in the twentieth century: varieties of protest and accommodation. knoxville: the university of tennessee press. cohen, s., l.g. underwood, and b.h. gottlieb 2000 social support measurement and intervention: a guide for health and social scientists. new york: oxford university press. cohen, s. and s. pressman 2004 stress-buffering hypothesis. in encyclopedia of health & behavior. anderson, n., ed. thousand oaks: sage publications. cohen, s. and t.a. wills 1985 stress, social support and the buffering hypothesis. psychological bulletin 98:310-57. dressler, w. 1985 extended family relationships, social support, and mental health in a southern black community. journal of health and social behavior 26: 39-48 march. 1990 lifestyle, stress, and blood pressure in a southern black community. psychosomatic medicine 52:182-198. harrison, f.v. 1995 give me that old time religion: the geneology and cultural politics of an afro-christian celebration in halifax county, north carolina. in religion in the contemporary south: diversity, community, and identity. white jr., o.k. and d. white, eds. athens: university of georgia press. house, j.s. and r.l. kahn 1985 measures and concepts of social support. in social support and health. cohen, s. and s.l. syme, eds. orlando, fla: academic press. anthropology & aging quarterly 2010: 31 (1-2) 26 features kikusui, t., j.t. winslow, and y. mori 2006 social buffering: relief from stress and anxiety. philosophical transactions of the royal society biological sciences 361 (1476):2215-2228 december. krause, n. 2001 social support. in handbook of aging and the social sciences 5th ed. binstock, r.h. and l.k. george, eds. new york: academic press. lepore, s.j., k.a. allen and g.w. evans 1993 social support lowers cardiovascular reactivity to an acute stressor. psychosomatic medicine 55:518-524. lincoln, c.e. and l.h. mamiya 1990 the black church in the african american experience. durham: duke university press. taylor, r.j. and l.m. chatters 1989 family, friend, and church support networks of black americans. in adult black development and aging. jones, r.i., ed. berkeley, ca: cobb and henry publishing. uchino, b.n. 2006 social support and health: a review of physiological processes potentially underlying links to disease outcomes. journal of behavioral medicine 29(4) august. debate what does aging mean? repertoires and embodied sensoria in person-making cati coe carleton university cati.coe@cunet.carleton.ca anthropology & aging, vol 44, no 1 (2023), pp. 102-106 issn 2374-2267 (online) doi 10.5195/aa.2023.476 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. debate | coe | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.476 http://anthro-age.pitt.edu 102 debate what does aging mean? repertoires and embodied sensoria in person-making cati coe carleton university cati.coe@cunet.carleton.ca sharon kaufman’s prose is so beautiful and clear, the personalities she presents in the ageless self so vivid, and her analysis so compelling, that i find it hard to argue against her. yet, my research in ghana (coe 2005, 2013, 2021) causes me to question her assertion: “when old people talk about themselves, they express a sense of self that is ageless” (kaufman 1986, 7). what i value about her argument is that it draws us as scholars of aging to ask, ‘what is the experience of aging?’ and even, ‘do people experience themselves as aging?’ i am convinced that, in the context that she discusses, people did construct continuities across their life narratives in which aging had little meaning to them and made sense of their lives through an elaboration of their individual personalities. however, kaufman does not qualify her point—that she is talking about those she met in california who lived during the twentieth century—but presents it as a universal truth. this is my basic critique of the ageless self: her statements generalise findings that arise in a particular sociocultural context. in the united states, visible signs of aging are stigmatized and a source of status denigration, thus influencing people to construct themselves as independent persons with continuities in personhood across the life course (hashimoto 1996; lamb 2014; savishinsky 2000). the focus on identity and personality is one in which americans take great delight and are asked to reflect on endlessly in everyday life, at least since the mid-twentieth century, using discursive and material technologies to construct and regulate a sense of self (foucault 1988). since kaufman’s research forty years ago, these individualizing discourses focusing on the continuity of personhood have been elaborated through successful aging narratives and images, which deny decline in older adults. more recent studies (lamb 2014, 2017) have found that older adults may narrate themselves through successful aging discourses, but they also critique the limitations of these distinctions. through this work, we see historical changes in ideologies of the competent, autonomous self and how orthodoxies easily generate heterodoxies (bourdieu 1977; coe and alber 2018). in ghana, in contrast, old age is a powerful cultural category, although one with considerable ambivalence (van der geest 2002). certain kinds of aging are accorded respect and status, like becoming an elder who uses their power and wisdom to handle disputes. respected older adults gather, and distribute, resources widely, and such redistributive power depends on their being active, engaged, and in control of a vital resource. as a result, not all older adults attain the status of elder, are accorded respect and power, or receive care in later life (dsane 2013; stucki 1995; tonah 2009). aging has negative connotations: older people, especially women, can be accused of witchcraft or the power to extract health, fertility, and wellbeing from others for one’s own benefit. people ask, or assume others to be asking, “why else could a person have lived so long, if he or she were not a witch?” even though http://anthro-age.pitt.edu/ debate | coe | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.476 http://anthro-age.pitt.edu 103 witchcraft is stigmatized, it is a kind of power associated with aging, albeit a negative one generating feelings of fear and distance (geschiere 1997). rather than discussing continuities with their youth and constructing an ageless selfhood, aging activists in ghana are currently seeking to re-signify what aging means, bending it towards its positive connotations. they propagate considerations of a long life as a blessing from god, not a sign of malevolent power. in my discussions with older men and women in the course of research for my book on changes in aging in ghana (coe 2021), it struck me that many were highly attuned to their aging bodies. for example, one woman in the town of begoro in akyem in the eastern region said, in a few months, i will be seventy-three years old. when i was a young woman, i was strong. i could go anywhere. i could go to farm and then return to go to school; i could do everything. when i reached the age of sixty, i became weak and feeble, in my knee, my back, my whole body. getting up in the morning, i am as tired as if i had worked all night, and if i try to work, i make no headway. that’s how weak i have become.1 similarly, at a pensioners’ meeting in akropong, another town in the eastern region, a retired teacher crossed the room, and the president of the association, a retired nurse, made fun of how she was walking, in a friendly way. the retired teacher joked back, “i want to show that i am an old woman” (fieldnotes, september 3, 2019).2 these older adults talked explicitly about their bodies in which aging was associated with physical weakness, difficulty moving, and pain, in a context in which walking, physical activity, and the ability to carry and lift loads were necessary for many daily activities, particularly for women. these expressions of physical weakness and pain due to aging were normalized and publicly affirmed as constitutive of one’s identity as an older person. this was not done in a stigmatizing, exclusionary way, but in a teasing, affectionate tone in earlier research, i asked older people to narrate their life stories to me as i tried to understand how certain practices of educational curricula and exchanges of children between households had changed over time. these life stories generally took a standardized form. the more educated men, such as retired teachers, focused on their educational credentials and professional accomplishments, while women detailed the number of children and grandchildren. both women and men highlighted their birth order among their siblings and documented their siblings’, children’s, and grandchildren’s names, pausing for me to write them down correctly, and mentioned the occupations and accomplishments of their children which were worthy of note. (the family black sheep were overlooked in this record of achievements.) retired teachers whom i interviewed during my dissertation research3 were happy to be interviewed, telling me that my visits indicated to their neighbors how important they were, but they were also surprised that, after they had recounted their life story focusing on their individual and family accomplishments, i was interested also in other things, like their experiences teaching primary or secondary school, or in how ghanaian language and culture were taught during different periods of their career. these conversations left both me and the retired teachers confused; our goals were at crosspurposes.4 then i attended my first funeral, a multi-day and expensive celebration with loud music and coordinated clothing. i was handed an elaborate funeral program with pictures and a biography of the deceased as its centerpiece. here was the standard narrative that i heard over and over again in my interviews! given my own cultural background as an american growing up in the 1970s and 1980s, where mortality was not discussed and death was isolated in hospitals (kaufman 2005), i was blissfully unaware that my research participants had been rehearsing their obituaries in their interviews with me, using our conversations to cement their legacies beyond their anticipated deaths. later, in my research http://anthro-age.pitt.edu/ debate | coe | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.476 http://anthro-age.pitt.edu 104 on aging, i pursued this question of advance preparation for death more systematically (coe 2021). many of my aging friends told me that they had already planned their own funerals, from the songs that would be sung and the biblical texts that would be read to the polished life narrative and photographs that would be presented in the funeral brochure given to attendees. thus, i would argue that my research participants in ghana constructed their selves as old, both through their experiences of their bodies which they were willing to publicize and perform for others as weak or in pain and in narrating their selves in ways that presaged the remembrance of those selves after their deaths. they were not constructing an ageless, continuous self, but one which anticipated death and looked backward to their youthful capabilities and achievements, looping time both forward and backward from the present moment. their society gave them the cultural resources to construct their selves in this way, through elaborate and expensive funerals and public recognition of their embodiment and physical presentation. that aging is a cultural construction is a truism in anthropology and one long and well-rehearsed. it was key to margaret mead’s popularization of anthropology within america (mitchell 2002). so in many ways, my critique of kaufman is not a very interesting insight. the concept of culture has also been sharply criticized within anthropology, such that some anthropologists refuse to use it (e.g., abulughod 1997). there are parts of ‘culture’ and ‘self’ that i consider important. i have retained these elements in previous work through the concept of repertoire, a toolbox of practices, skills, and ideologies. repertoire allows me to think about the ways people can activate or downplay various ideas and practices they are familiar with in addressing the problems they encounter in their lives (see coe 2013). it enables me to consider embodied and habitual forms of patterned learning, as well as those that are elaborated in discourse, and the relationship between the body and discourse. like sherry ortner (1997), i think one of the virtues of using repertoire is its synchronic nature. it changes over the life course and through historical time, and can in this way be used as a window onto struggles and contestations. one aspect of that repertoire is the cultural sensorium. kathryn geurts (2002) makes a powerful case for how people’s perceptions of their bodies are affected by cultural concepts; i would argue that their perceptions of their bodies are part of their ever-shifting repertoire. working in ghana, she discusses how people focus on certain senses, or embodied sensations, in their practices and discourses about pregnancy, childbirth, child development, and health. for example, a sense of physical balance is more articulated in ghana than in western contexts and considered a sense in its own right. this sense is elaborated through discourse as well as practice: children from an early age are trained to balance loads on their heads and their ability to balance or stand is a key sign of child development. although geurts did not mention the aging body, but focused on infant and child development, her concept of the cultural sensorium is relevant for the study of aging. in contrast, the physical and bodily aspects of aging do not arise much in the ageless self, probably because kaufman’s research participants did not find them meaningful and downplayed them in relation to their personalities. furthermore, although kaufman emphasized the importance of the “phenomenological understanding of self” (1986, 162), she was quite taken by psychological theories of the life course and symbolic interactionalism (erikson 1959, mead 1934). these theories, popular within anthropology at the time, focused on an understanding of self which marginalized a physical experience of the body. yet, i would argue that this experience of and through the body is part of what we should be trying to discover in the experience of aging. relatedly, but just as important, is an understanding of how the social world—through medicalization, play and other activities, linguistic terms, and everyday commentary—provides language and practices for discerning the body’s wellbeing, level of discomfort, and physical changes. sensory experience can find recognition in others’ eyes, as in the example above, where a person noted another’s unsteadiness or weakness; equally, the sensation of the body may not http://anthro-age.pitt.edu/ debate | coe | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.476 http://anthro-age.pitt.edu 105 always be visible to or affirmed by others, who take other signs of aging as more important—whether wrinkles or years of life. what kaufman’s work pushes us to discover is the experience of aging people. what do they find meaningful in their narrations of the self and the life course? how do they experience their self across time? these are questions worth pursuing. their experiences are both narrativized and embodied. as scholars of aging, we need to frame these processes within the wider world which affects the changing repertoires through which people make up their selves and sensoria, thereby illuminating the stakes in these processes of person-making. notes 1. original in ashanti twi: me nso megyina ha a aka bɛɛ bosome bi na madi aduoson mmeɛnsa. na mmerɛ a.. me sɛnea mehuu sɛ mmerɛ a na meyɛ ababaawa no na me ho yɛ den. metumi kɔ baabi ara, metumi kɔ afuo ansa na mabɛsen akɔ sukuu, metumi yɛ biribi ara. nso menyini duruu aduosia a mereba no hodwodwo aka me, wɔ me kotodwe, me sisi, me ho nyinaa. adeɛ kye koraa na meresɔre koraa wobɛka sɛ mayɛ adwuma anadwo no a, wobɛka sɛ makɔyɛ adwuma a menhu me ho ano, enti na mayɛ bɛtɛɛ (group discussion, july 9, 2014). 2. original in akuapem twi: “mepɛ sɛ mekyerɛ sɛ meyɛ aberewa.” 3. i wrote about these interview failures in coe 2001. 4. my dissertation was on the teaching of national culture in ghana (coe 2005). references abu-lughod, lila. 1997. “the interpretation of culture(s) after television.” representations 59: 109-134. bourdieu, pierre. 1977. outline of a theory of practice. translated by richard nice. new york: cambridge university press. coe, cati. 2001. “learning how to find out: theories of knowledge and learning in field research.” field methods 13 (4): 392-411. _______. 2005. the dilemmas of culture in african schools: nationalism, youth, and the transformation of knowledge. chicago: university of chicago press. _______. 2013. the scattered family: parenting, african migrants, and global inequality. chicago: university of chicago press. _______. 2021. changes in care: aging, migration, and social class in west africa. new brunswick: rutgers university press. coe, cati and erdmute alber. 2018. “age-inscriptions and social change: introduction.” anthropology and aging quarterly 39 (1): 1-17. dsane, sarah. 2013. changing cultures and care of the elderly. saarbrücken: lambert academic publishing. erikson, erik h. 1959. identity and the life cycle: psychological issues. vol 1. new york: international universities press. foucault, michel, luther h. martin, huck gutman, and patrick h. hutton. 1988. technologies of the self: a seminar with michel foucault. amherst: university of massachusetts press.. geschiere, peter. 1997. the modernity of witchcraft: politics and the occult in postcolonial africa. charlottesville: university press of virginia. http://anthro-age.pitt.edu/ debate | coe | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.476 http://anthro-age.pitt.edu 106 geurts, kathryn linn. 2002. culture and the senses bodily ways of knowing in an african community. berkeley: university of california press. hashimoto, akiko. 1996. the gift of generations: japanese and american perspectives on aging and the social contract. cambridge: cambridge university press. kaufman, sharon r. 2005. and a time to die: how american hospitals shape the end of life. new york: scribner. _______. 1986. the ageless self: sources of meaning in late life. madison: university of wisconsin press. lamb, sarah. 2014. “permanent personhood or meaningful decline? toward a critical anthropology of successful aging.” journal of aging studies 29: 41–52. _______. ed. 2017. successful aging as a contemporary obsession : global perspectives. new brunswick, new jersey: rutgers university press. mead, george herbert. 1934. mind, self, and society. chicago: university of chicago press. mitchell, william e. 2002. “communicating culture: margaret mead and the practice of popular anthropology. in popularizing anthropology, edited by jeremy mcclancy and christian mcdonaugh, 122-134. london: routledge. ortner, sherry b. 1997. “the fate of ‘culture’: geertz and beyond introduction.” representations 59: 1–13. savishinsky, joel s. 2000. breaking the watch: the meanings of retirement in america. ithaca: cornell university press. stucki, barbara. 1995. “managing the social clock: the negotiation of elderhood among rural asante of ghana.” ph.d. dissertation, northwestern university. tonah, steve. 2009. “the challenge of ageing in rural and urban ghana.” in contemporary social problems in ghana, edited by steve tonah, 125-146. legon: department of sociology, university of ghana. van der geest, sjaak. 2002. “from wisdom to witchcraft: ambivalence towards old age in rural ghana.” africa 72 (3): 437-463. http://anthro-age.pitt.edu/ anthropology & aging quarterly 2014: 34 (4) 260 argentine tango social dance health ‘to’ you text and photographs by jonathan skinner portfolio anthropology & aging quarterly 2014: 34 (4) 261 anthropology & aging quarterly 2014: 34 (4) 262 argentine tango: social dance health ‘to’ you  these three photos evoke the plaint of life. they are a static portrait of argentine tango dancers mid-movement. this is life and action frozen and memorialized from a long-awaited christmas party in belfast, northern ireland. unlike julie taylor’s (2001) succession of mini-tango moves in her ethnography of tango and argentina, a choreography by flipping, there is only the hint or trace of movement in these photos: the legs in open position with torque on the body, a shoelace working its way free; couples in closed embrace, the leader with motility, the partner with either open or closed eyes, primed to follow their initiations. there is longevity in the pictures from the detail of the marriage rings to the wrinkles on faces solemn with the dance, concentrating but also flowing with solace – ‘relaxed responsiveness’ as richard powers (2013) puts it.   dance described by spencer (1) as that ‘nonutilitarian patterned movement’ can be cathartic, controlling, competitive, communitarian as well as sustaining, maintaining and self-generating. there is solidarity amongst dancers, regularity in the order of attending, learning and performing a dance, and mutual self-affirming of an ontology of being-in-the-world each night when one dons one’s dance clothes and horns a pair of dance shoes. leslie gotfrit (1988) speaks to the nostalgia and longing of a bygone body in women reclaiming theirselves on the boogie floor. the same can be said of the tango couple, rejuvenating under the christmas decorations. there is familiarity and comfort in the sociality of the other in one’s arms, often a life partner of decades moving with you, reassuring walking as one. “i dance to you”: the ‘to’ a linking narrative and a metaphor for corporeal intimacy in the eyes of judith hamera’s (2001) appropriation of irigaray-ian philosophy.  ‘indistinction’ is how jonathan bollen (2001) phrases it as the dancers lean in, support each other, and begin to move in an improvised script to a music from a far-away land and a far-away time. in this case, social dance transports us to argentina in the 1940s. in the beating of the hearts, and the fleetness of the feet, and the alert anti-clockwise lead around the room, there is wellbeing. solace seeps up through the motile feet and calm descends from a labile imagination. argentine tango, a self-selecting social dance, affects the dancers – variously, an anti-psychotic (anon. 2013), a stabilizer for parkinson’s (hackney et al 2007), an omni-therapy (woodley and sotelano 2011). these are just some of the benefits of this genre of social dancing. other social social dancing such as ballroom dancing also has its strengths as a form of ‘serious leisure’ (stebbins 2006) – a personal vehicle for successful ageing (skinner 2013) and can retain muscle density and stave off social isolation amongst other benefits. but argentine tango has the ‘healing embrace’ (berve 2008): it is a resting place for the active. those interested in more tango visuals and in following up on the worth of tango in the medical setting can follow this link to the annual ‘all of us are crazy for tango’ programe put on by hospital borda in buenos aires.  wherever danced from buenos aires to belfast, and carrying whatever condition from physical to mental health issues, this dance addiction can become a boon and adjunct to other fracturing and faltering rhythms in life. dr jonathan skinner university of roehampton http://bigstory.ap.org/article/argentines-teach-tango-inside-mental-hospital anthropology & aging quarterly 2014: 34 (4) 263 references anon. 2013 the “tango therapy,” very special treatment hospitals in argentina. http://www.pineywoodsghosttours. com/the-tango-therapy-very-special-treatment-hospitals-in-argentina.html, accessed 29 december. berve, anette 2008 tango therapy: the healing embrace. the argentina independent, 1 august, http://www. argentinaindependent.com/life-style/society-life-style/tango-therapy-the-healing-embrace/, accessed 6 february 2014. bollen, jonathan 2001 queer kinesthesia: performativity on the dance floor. in dancing desires: choreographing sexualities on and off the stage. j. desmond ed. pp. 285-314. madison, wisconsin: university of wisconsin press. gotfrit, leslie 1988 women dancing back: disruption and the politics of pleasure. journal of education 170(3): 122141. hackney, m. e., kantorovich, s., levin, r., and gammon, m. 2007 effects of tango on functional mobility in parkinson’s disease: a preliminary study. journal of neurologic physical therapy 31(4): 173-179. see more at: http://www.ncpad.org/624/2589/effects~of~tang o~on~functional~mobility~in~parkinson~s~disease#sthash.ph5txpsq.dpuf. hamera, judith 2001 i dance to you: reflections on irigaray’s i love to you in pilates and virtuosity. cultural studies 15(2): 229-240. powers, richard 2013 great partnering. http://socialdance.stanford.edu/syllabi/partnering.htm, accessed 29 december. skinner, jonathan 2013 social dance for successful aging: the practice of health, happiness, and social inclusion amongst senior citizens. anthropology & aging quarterly 34(1): 18-29. stebbins, robert a. 2006 serious leisure: a perspective for our time. piscataway, nj: transaction publishers. taylor, julie 2001 paper tangos. durham: duke university. woodley, karen and sotelano, martin 2011 tango therapy 2, research and practice. cardiff: lulu.com/tango creations. http://www.pineywoodsghosttours.com/the-tango-therapy-very-special-treatment-hospitals-in-argentina.html http://www.pineywoodsghosttours.com/the-tango-therapy-very-special-treatment-hospitals-in-argentina.html http://www.argentinaindependent.com/life-style/society-life-style/tango-therapy-the-healing-embrace/ http://www.argentinaindependent.com/life-style/society-life-style/tango-therapy-the-healing-embrace/ http://www.ncpad.org/624/2589/effects~of~tango~on~functional~mobility~in~parkinson~s~disease#sthash.ph5txpsq.dpuf http://www.ncpad.org/624/2589/effects~of~tango~on~functional~mobility~in~parkinson~s~disease#sthash.ph5txpsq.dpuf http://socialdance.stanford.edu/syllabi/partnering.htm debate the ageless self: a relic or the reliquary? mark luborsky wayne state university mluborsky@wayne.edu anthropology & aging, vol 44, no 1 (2023), pp. 92-101 issn 2374-2267 (online) doi 10.5195/aa.2023.478 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 92 debate the ageless self: a relic or the reliquary? mark luborsky wayne state university mluborsky@wayne.edu sharon kaufman’s the ageless self (1986) contributed greatly to the denaturalization of pernicious stereotypes of old age and helped early cohorts of scholars to erode archaic views of old age as a time for infirm minds and bodies and dimming inner life. energizing generations of scholars, today it presents us with a janus face: a relic, and a reliquary. in this debate piece, i urge scholars to engage the notion of the ‘ageless self’ not as a relic – an ossified thing to preserve. this is how it rears up in the literature: as an idealized static identity, and thereby an analytic category that narrows our gaze. instead, in the sense that a reliquary is a placeholder, a shrine, or a container for something of value but not the thing itself, the ageless self enfolds and opens up spaces of indeterminacy. engaged as a reliquary, it irritates social certainties in ways that can renew curiosity about aging lives. the notion of the ‘ageless self’ urges us toward fresh explorations about the particularities in times, places, and understandings of actual persons aging – to 'leap up and behold’ ethnographically, as sharon insisted in her scholarship and how she lived her life, sharing wordsworth's investment in empiricism. thus, i argue, we should engage kaufman’s ‘ageless self,’ not as a stabilized identity, but as a productive proustian arena, one featuring a lifelong fluid self-biographic "embryonic journey" (apologies to jack kaukonen 1967) of contingent protean meanings in the (un)(re)making. further, i argue that idealizing kaufman’s ‘ageless self’ as a relic promotes a romanticized enterprise for meanings that instantiates western cultural notions of individualism and interiority and concern with sources of meaning and i grappled with writing this essay. its writing touches and entwines my senses with spaces and transformations from the time of kaufman’s the ageless self to now and uncertain futures. sharon is present as i work. a steadfast colleague sharing walks, literal and figurative, through life and its messiness. she insistently sought to meld insights from a spectrum of scholarly disciplines and immersive fieldwork. wordsworth hints at sharon’s spirit. my heart leaps up william wordsworth, 1802 my heart leaps up when i behold a rainbow in the sky: so was it when my life began; so is it now i am a man; so be it when i shall grow old, or let me die … my thoughts below are an essayed reaction to the invitation to consider a passage from “reflections on ‘the ageless self’” and do not aspire to the rigor of critique. http://anthro-age.pitt.edu/ debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 93 continuity. my reflections on the ageless self instead consider its underlying evocation of inner life and its complexities. whence the reliquary for ‘inner life’? it’s important to understand that the ageless self was among the early empirical studies designed to refute the pernicious negative stereotypes of life in old age as a natural, inevitable time of frailty, social and psychological disengagements, sadness and dimming inner life. a marker of early anthropologists' success in creating new foundations for gerontological knowledge is that the national institutes of health funded projects by sharon kaufman, gay becker, linda mitteness, and judith barker were cited as exemplars by directors at the nih/national institute on aging in public testimony to congress to justify increased funding (ory and williams 1984). these were the first studies funded by the nih/national institute on aging that used ethnography to identify opportunities used by subsequently funded multidisciplinary interventions to solve problems that were previously socially and scientifically reproduced as ‘natural’ for old age. kaufman's the ageless self (1986) was rooted in the then-nascent gerontological domain centered inward on the individual's own sense of personal meaning in a lifespan lens. this was a site for scholarship designed to counter the domination of behavioral and biomedical paradigms. as such, a focus on personal meanings introduced a more valid and robust way to define the range of relevant phenomena salient to creating an accurate definition of what constitutes the "case” (ragin and becker 1984) for the analysis and description of aging lives. yet, arguably, notions of an ageless self—a particular instantiation of the construct of personal meaning and lived experience— spring from a deep western cultural heritage which, i argue, overly idealizes the inner self as a well-spring of autonomous meaningmaking unsullied by external public authoritarian forces. figure 1: girl reading a letter at an open window, johannes vermeer (1657-1659) (source: wikipedia) http://anthro-age.pitt.edu/ https://en.wikipedia.org/wiki/girl_reading_a_letter_at_an_open_window debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 94 figure 2: lunch in the greenhouse, louise abbema (1877) (source: artsy.net) this quest for personal meaning is recent in our cultural history. convergent traditions in western culture and history contribute to our taste for the personal meaning-making enterprise. one relevant historical change has been the emergence of subjectivity, interiority, and privacy concepts. where formerly the private and secluded were associated with nefariousness and treason, these became supplanted by modern notions valuing the private and domestic spheres. johannes vermeer's (16321675) paintings that make the quietness of interior domestic spaces and subjectivity visible are indicative of this trend (see figure 1). in the 20th century, historical demographers also chronicled the emergence of the interior and private arenas – spaces of sociality inside the family, household, and individual (ariès 1965; burgière 1987; perrot, ariès, andduby 1990). these private spaces are differentiated from collective public life and from persons as defined by roles in social estates and public statuses. for example, louise abbema's lunch in the greenhouse (1877) centers our eye on such a casual sociality (see figure 2). in our era, processes of meaning-making throughout the lifespan were further differentiated as childhood emerged as a new life stage to replace the conception of children as little adults and as eras of old age were further divided in the third age, youngest-old, middle-old, and oldest-old. in recent centuries a lifespan mode of personal meanings was also introduced in the literary idiom bildungsroman, a story script telling of an individual's coming of age and growing maturity (e.g., charlotte brontë's jane eyre (1847); sue kidd's secret life of bees (2001)). it is now pervasive in popular culture. more recently, extended lifespans bring longer arcs of the self-making enterprise over time. such self-making can tend to the precarious, for example in lives lived with dementia, as depicted in the dire self-portraits by william utermohln (see figure 3). http://anthro-age.pitt.edu/ https://www.artsy.net/artwork/louise-abbema-lunch-in-the-greenhouse debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 95 figure 3: selfportraits, william utermohlen (1967-2000) (source: artesociale) a second tradition emerged in a profound ethos of the individual as autonomous and independent. the individual as ’a-part from’ others replaced the individual that was for long defined as ‘part of’ a group. this modern western ethos grew only after the onset of industrial economic-political conditions created systems of impersonal bureaucratic control over persons' public lives, a radical change that was powerfully characterized by louis dumont (1965). this ideal of independence and autonomy minimizes interdependence in social life as exemplified in the emergent normativity of the nuclear household as self-sufficient (segalen 1986). it underlies western psychological models of the self as a monadic, autonomous, coherent whole (geertz 1986; marsella and white 1982; shweder and bourne 1984). anthropologists kathy ewing (1990) and james fernandez (1986) and historian robert nisbet (1969) offer provocative alternatives by highlighting the rhetoric and metaphoric nature of a ‘whole’ person or culture and the use and misuse of metaphors of development and progress. these two cultural dynamics have informed a gerontology that is largely dominated by the behavioral sciences, and that pursues an uncomplicated culture-bound approach to the nature of experiences and contents of inner meaning-making. anthropologists take pains to document the social, community, and family threads informing ‘individual’ meaning-making, and have as such contributed more nuanced views to understandings of this process. for example, gaylene becker (1993) explored meanings of place http://anthro-age.pitt.edu/ https://www.artesociale.it/william-utermolhen-autoritratto-con-alzheimer/ debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 96 and sociality among older latino, filipino, and cambodian immigrants living crowded in inner-city housing. she identified the complex difficulties that this living situation caused, as well as how intergenerational housing afforded family support and long-term intimate friendships bufferingadversities. this work sheds light on how a range of disparate issues such as memory, place, displacement, social relations, and identity politics merge to comprise the everyday life of these older adults. another important anthropological destabilization of the autonomous aging individual is barbara myerhoff's (1974) ethnography of a senior center attended by older jewish in an urban ghetto. she depicts the vibrant everyday social world they created by weaving multiple elements including their shared histories of immigration, their experiences of integration in the new world, cultures of origin, as well as the local culture they construct together at the center.” the center provided a social space and resources for resilience in the face of poverty, loneliness, and disability. yet, myerhoff was discomforted by the regularity of heated arguments among her informants; they did not interact gently and sweetly in line with prevailing ageist stereotypes. she finally asked her informants why they argued so much. they happily explained that "we fight to stay warm” and, myerhoff wrote, "fighting is a partnership, requiring cooperation” (1974, 184) meaning they worked together to be spirited and to show they took each other's existence seriously. i chose these examples from decades ago to highlight how anthropologists have a long tradition of bringing needed insights to gerontology. even these early scholars might be questioned for being duplicitous in shifting the focus to individuals from the social structures and conditions of life (exceptions include carl cohen and jay sokolovsky 1989; carroll estes and elizabeth binney 1989; mary pietrukowicz and mitzi johnson 1991; susan whitbourne 1986). today, a variety of important, yet incompletely addressed questions remain. one of these sets of questions is: for whom is the desire for an ageless self a salient ‘good,’ for whom not, for whom is it possible? in this paragraph, i have tried to show that critical attention to the historical embeddedness of the scholarly pursuit of an ageless self can reveal its multiple faces. it can serve as an exemplar of progressive research from the era of its creation. it is, however, also clear that the ageless self is also a siren call that is hard to ignore. gerontologists ought to become more resistant to the seductive familiarity of the subjective, internal, and private sphere, and to the simplistic operationalization of it as a fixed, monolithic thing. diverse lifespans, temporalities, places, and societal aspirations1 if the ageless self were written today, we would look for attention to issues of intersectionality and inequality in access to political and economic structures, which may nourish or erode the ageless self. next, i will discuss how the ageless self could be seen as situated in an intersectional conversation, albeit in the context in which it was written, and second, i offer some examples of those earlier modes of thinking about intersectionality and diversity that have been addressed and what opportunities exist to extend them in the future. it should be acknowledged that the ageless self engaged issues of diversity if seen as positioned historically in the context of how such concerns were coming into nascent attention at the time of its writing. clearly, in today's view a robust intersectional approach to the ageless self would ask much more. we would want to think further about for whom and how fully the ageless self as a form of meaning-making supports the person, and whose agendas it serves, and — and importantly in my mind — where and how the ageless self is socially (de)legitimated? the intersectional lens can complicate our inquiries by directing us to consider differences, inequalities, and disparities (braveman 2006) in the http://anthro-age.pitt.edu/ debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 97 social distribution of access to cultural and material resources, living conditions and social positions, developmental and health differences, and layers of lived experiences in a pluralistic world. it is a misjudgment to cast kaufman’s ‘ageless self’ as completely naïve about such issues. in its time, the concept targeted a venomous source of disparities. it faced off against the segregation of older persons as no longer whole persons or citizens, uninterested in life, and old age as a life not worth living. kaufman’s work turned interest to meaning-making of older adults who were otherwise socially disenfranchised and relegated to the bare life of a state-sanctioned zone of exclusion from accountability (agamben 1995; biehl 2005; luborsky 1994). today, william dressler's (2005) conceptual and methodological contribution of "cultural consonance" might provide a fresh path for amplifying understandings of the ageless intersectional self. his work examines how individuals believe and behave in ways that approximate, or are dissonant with, the values and ideals defined by each community's own cultural models. inequalities of social valuation have well-documented consequences; low levels of cultural consonance harm mental and physical health. dressler's strategy may offer another approach for developing more complex notions of the ageless self as constructed in particular contexts through a cultural consonance lens. another mode of discourse on diversity was visible at the comparative system level of cross-cultural and cross-national comparative studies in the time of the ageless self. examples include cultural context of aging: worldwide perspectives (sokolovsky 1990) and the aging experience: diversity and commonality across cultures (keith et al. 1994). many disciplines joined conversations about the 'delicate category' of self, experience, and personhood and especially the cultural boundedness of notions of the self was the site of great debate. cross-cultural studies exploring notions of the 'self' highlighted the social and experiential consequences of different cultures' conceptions of relatedness and independence/interdependence (e.g., hsu 1989/1953; markus and kitayama 1991; marsella et al. 1985). these studies contributed alternative conceptualizations of consociated forms of self that contrast with the western singular individual self. just as these studies moved us beyond stereotypical comparative binary distortions of a 'collectivist' conception of the individual and the unique 'individualistic' euroamerican notion, today we might increase our sensitivity to diversity in forms of later life meaningmaking within local contexts given today's multicultural and globalized world. historical, global, and political eras across the lifetime of persons within one age cohort can create another kind of diversity in the ageless self by redefining fundamental societal life values and meaning. for example, older persons in poland (robbins-panko 2020) complicate our understanding of the ageless self as one that resonates with political-economic and societal changes in the shift from socialism to capitalism. meanings made by the aging self are an alloy forged by the juxtaposition of an ethos from an early life of socialist and soviet-era society and, after its collapse, by capitalist structures and values in a postsocialist society. similarly, david plath (e.g., 1970) provided a nuanced understanding of ways to consider diversities among older japanese persons. one concept is "co-longevity," for older japanese aging as "collectivities" and consociates rather than western autonomous individuals (plath 1970). another finding was that older japanese persons drew resources for meaning making from contrasting cultural eras. the first era was grounded in youth and adulthood defined by the pre-wwii imperial society, and the latter was in the transformed post-war defeat, westernized era. briefly, such diversities in the resources and contextual support for meaning-making in later life require greater attention today. varieties of the ageless self may also arise from displacement or migrating between the sociocultural context of one or several nations across the lifespan and in old age. massive modern global population movements have posed novel challenges to early gerontology concepts of 'aging in place.' consideration of places and spaces of aging under conditions of life migration remains little addressed and is an http://anthro-age.pitt.edu/ debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 98 opportunity for further research and policy attention. older individuals who experience migration potentially have multiple selves, ones grounded in the places they have left and the places they arrive. these places constitute sources of experiencing and remembering. meaning-making is supported or challenged at the level of macro contexts (multiple cultures, social esteem, social positions, languages) and local level settings (communities, ways of life, and daily habits) (becker 2003;johansson et al. 2012.) these amplify and complicate the otherwise normative lifespan dilemmas for building meaningful lives and self-representations. ongoing biographic constructions of the self, notions of the culturally expectable life course, and experiences of transitions across the individual lifetime are shaped by the culture in particular societal times, presenting another arena for diversities. this is discussed in glen elder's landmark children of the great depression: social change in life experience (1974/1998), a longitudinal study of persons living and managing long lives that traverse dramatic societal political-economic transformations in one life. readers here are now personally familiar with the multiple impacts of pandemics, wars, economic calamities, and polarized politics and have been forced to understand that the social implications and personal interpretations of economic, societal, community, or physical events are neither uniform across individuals nor predictable. we ought to consider how the timings of these events impact individuals differently at varying life stages and cultural contexts. the salient elements differ and must be discovered (rather than assumed) in the content of an ageless self's memories, hopes, and values. notably, these elements are defined by each particular life course stage's roles and expectations (e.g., childhood, emerging-adulthood, adulthood), and psychosocial developmental stage tasks (individuation, identity autonomy, generativity). for example, in the case of hiv among african americans or lgbtq populations during the earliest years of the aids epidemic, there was massive social condemnation and dire stigmatization. at that time, those afflicted with aids lived in the knowledge of its lethal nature and lack of medical treatments. because later cohorts acquiring hiv could regard it as a chronic, treatable condition, the biographical story schemas and contents of those aging with hiv today are very different since they acquired the disease before treatments became available (nevedal et al. 2017). similarly, the polio epidemic produced divergent experiences for cohorts of persons aging after polio infections. people who were infected when hiv was widely feared, often fatal, and with no known cause or mode of infection , , had aging lives that contrasted to those acquiring hiv in a later era after the discovery of its cause and a treatment was available (luborsky 1993). where might the many openings that kaufman’s ‘ageless self’ offers be taken next? some suggestions were presented in earlier paragraphs. new scholars should take up the challenge of better articulating issues of its social distribution, varieties, contexts, and salience within individuals over time and settings. further insights might be provided by continuing critical explorations of the underlying historical and cultural traditions entwined in the concept. conceiving the aging self as a reliquary, not a relic, may extend anthropology's capacity to counter gerontology's propensity for a fixed, monadic, approach to the self. to rethink the ‘ageless self,’ we can consider it in light of renato rosaldo's (1993) concept of culture, as busy intersections of several histories, heritages, and notions of human worth in particular places. gerontologists need to be reminded to allow for multiple possible selves (past, current, future hoped for or feared) and of fluid coherence in the construction of a socially and personally valued later life worth living. http://anthro-age.pitt.edu/ debate | luborsky | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.478 http://anthro-age.pitt.edu 99 notes 1. given the voluminous and growing literature on diverse and minority populations and experiences in gerontology, piling up illustrations of such differences, inequalities, and aging disparities, i demur from presenting these. they are readily available elsewhere. 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"does the concept of the person vary cross culturally?" in culture theory: essays on mind, self, and emotion, edited by richard schweder and robert levine. cambridge: cambridge university press. sokolovsky, jay. 1990. cultural context of aging: worldwide perspectives. santa barbara, ca: abc-clio whitbourne, susan. 1986. the me i know: a study of adult identity. new york: springer-verlag. http://anthro-age.pitt.edu/ https://www.jstor.org/stable/1047217 https://doi.org/10.1093/geront/31.1.102 anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 45-61 issn 2374-2267 (online) doi 10.5195/aa.2015.64 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. slowing down medicine the plural worlds of hospice care 2014 margaret clark award for best undergraduate student paper lilly lerer university of chicago author contact: llerer@uchicago.edu abstract this ethnography reflects on a non-profit hospice care organization in the midwestern us where caregivers “slow down” medical care by acknowledging the plurality of forces that constitute the illness experience, philosophically departing from their biomedical, non-hospice counterparts. it demonstrates the ontological effect of “slowing down” and attending to a set of patient problems that extends beyond the biological, or any distinct, domain. the result is a medical world that privileges the embodied, lived expression of disease—rather than the statistical, clinical expression—resulting in medical care that is enmeshed in the variables of everyday life. i therefore situate hospice care in a historical moment witnessing the emergence of a sophisticated and “non-modern” (latour 1991) form of medical care keywords: hospice, care, slow medicine, care, ontology http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu slowing down medicine the plural worlds of hospice care lilly lerer university of chicago author contact: llerer@uchicago.edu introduction two emts wheeled a patient on a stretcher into the hospice inpatient unit where i worked as an intern volunteer. the 84-year-old czech woman1 had fallen and broken her hip, and a blood clot was forming in her lungs. as two nurses worked to stabilize the patient, the social worker and i looked at her admission file. we learned that the patient had had no major health issues until her fall, and that she was a holocaust survivor. the patient had been stabilized for a few minutes when her son slammed open the door. after a glance, he told the clinical director that he wanted his mother to have a hip replacement. the clinical director responded: “with a blood clot in her lung, she can’t go through surgery.” dismissing her, the son demanded to speak with a surgeon. some time later, the son, referring physician, social worker, and hospice clinical director convened a meeting in an empty room down the hall. the clinical director asked me to sit with the patient and care for her, making sure she felt comfortable. when i saw her, the patient was miserable. her arms had pooled with blood, turning the skin purple. her breathing was strained and quick. she knotted her brows tightly, and her eyes were closed. sitting down next to her, i asked if i could hold her hand. she took my hand and clasped it tightly, bringing her other hand over to meet it. “did you ever think life would look like this?” i asked her. squeezing my hand, she shook her head. “would you like me to sing to you?” i asked. she nodded, and as i sang, she began to cry. when her son, physician, and inpatient team re-entered the room, i was singing to the patient, who was clasping my hands tightly and weeping. the patient died the following morning. measured in terms of rates of icu admission within three days of death (teno et al. 2013), instances of chemotherapy administered within fourteen days of death (earle et al. 2004; braga 2011), and high rates of patient death in icus (angus et al. 2004), aggressive medical care at endof-life is a well-studied problem that confounds oncologists, geriatricians, economists, and public officials alike. a host of factors keep the current inclination towards aggressive treatment in place. the sophistication and availability of life-extending medical technology begets aggressive treatment, creating a “technological imperative” (fuchs 1976; koenig 1988) to routinely employ the most advanced means available in the state of the art. hospital reimbursement schemes pressure staff to discharge patients as quickly possible, often employing the invasive means most lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 46 immediately available for treatment. finally, many doctors experience significant difficulty discussing end-of-life planning with their patients. avoiding these conversations can result in patients with no advanced care plans who are treated invasively in hospitals just before dying. in the 1970s and 1980s, europe and north america witnessed the rise of hospice care: a volunteer-led movement dedicated to changing the medicalized, impersonal experience of death that had become the norm. a devout christian and expert in medical pain management, dr. cisely saunders founded the first contemporary hospice in london in 1967 to care for what she called “total pain”: pain that encompassed physical, spiritual, social, and emotional suffering (saunders 1996). as activists and health experts, early hospice advocates fought for holistic care for the terminally ill through an interdisciplinary model emphasizing the patient’s concerns and desires. their movement gradually gained widespread acceptance, and hospice has become one of the fastest growing areas of health care, ballooning from the first american hospice established in 1983 to over 3,000 hospice providers in 2012 (nhpco 2014)2. the evolution of death into a technological, hospital-based event and subsequent rise of holistic care for the dying evidence a weberian dialectic between disenchantment through rationalization and subsequent re-enchantment through individualized means. while the hospice movement has itself grown and fragmented over several decades, this ethnography locates in contemporary hospice care an impulse towards pluralistic, nonscientific, and therefore reenchanted ways of thinking about and caring for patients. this article explores what i have come to call “slowed-down care”: encounters that occur when practitioners engage with the irreducible complexity of their patients’ problems. slowed-down care describes the moments in which nurses and their patients sit down to tea, when they meet cousins and spouses, when appointments last over an hour, and when conversations about patients spill beyond allotted meeting times and working hours. the aim of this article is to consider how the practice of “slowing down” has allowed hospice caregivers to incorporate plural worlds into their practices. it therefore situates hospice care in a historical moment that has witnessed the emergence of a re-enchanted, technologically savvy, and perhaps “non-modern” form of medicine (latour 1991). philosopher isabelle stengers has inaugurated a project within the philosophy of science intending to “slow down thought” (2005, 1). stengers grounds the project in an awareness that “the political arena is peopled with shadows of that which does not have, cannot have, or does not want to have a political voice”—entities rendered nonexistent by even well-meaning systems of thinking and governing (stengers 2005:3). but how can we acknowledge that which we cannot perceive? stengers’ project is to imbue political voices with pause, or “passing fright”—with an insistent nagging that “[we] do not master the situation [we] discuss” (stengers 2005:3). above all, her project insists that we slow down before claiming mastery, considering for a brief moment what might escape us before concluding “and so…” (stengers 2005:3). to illustrate the conditions of possibility for “slowed down” medicine, i first consider the operational logics pervasive within standard biomedical care that birthed hospice’s departure. in hospitals, the pressure to “purify” (latour 1991:11) dying patients into distinct bureaucratic and medical categories leads to an inability to see objects or shadows beyond the presenting diagnosis. in oncology, disciplinary demands result in the treatment of cancer as a strictly physical dilemma, rather than something with explicit social, financial, professional, or personal ramifications. we will see how many aspects of illness experience are excluded within these systems of care. next, i turn to my own observations of hospice care to describe how certain conditions allow caregivers to slow down care and work within plural worlds. lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 47 47 the ethnographic observations come from my time spent at a hospice and palliative care organization in a large midwestern city, where i worked as an intern for four months over the summer of 2013. the organization has a long history and reputation within the city, which furnishes a diverse patient base as well as a thriving volunteer community. during my time there, i functioned as a full-time hospice volunteer, making both home visits to patients (meal preparation, socializing with patients, assistance with housework, keeping vigil at time of death) and working at the affiliated hospice inpatient unit (volunteer training, mealtime assistance, socializing with patients, helping families, assisting with patient hygiene). i accompanied physicians, social workers, nurses, chaplains, music therapists, and hospice aides on patient visits, conducted semi-structured interviews, and chatted continuously with patients and their families. the following stories are accounts of patients, families, and hospice workers as they move in and out of each other’s lives. crisis of categorization: biomedical limits in order to understand hospice as re-enchanted care for the dying, we must first situate rationalized care within standard biomedical practices. in this section, i use bruno latour’s notions of translation and purification (1991), as well as donna haraway’s “cyborg” (1991: 117) to describe forces that often hinder effective medical care for the critically ill. the examples below do not characterize biomedicine broadly speaking, but rather highlight key factors that have lead to the medical crisis of death in america, demonstrating the effect of rationalized disciplinary and bureaucratic structures on care for the critically ill. latour highlights two contradictory processes that define the “modern constitution” (1991: 19). through purification, modern societies sort things into clean, dichotomous categories: human and nonhuman, natural and technological, science and politics. through translation, societies give rise to bizarre and unthinkable hybrids—entities and problems that defy categorization. modern society is organized upon the success of purification, the very foundation of which is threatened by the products of translation. latour posits a firm link between the two processes: the desire to categorize often leads to the creation of things that cannot be categorized. as we organize societal life into categories, hybrid problems become increasingly prolific, menacing, and demanding of our attention. multiplying hybrids encroach on the possibility of these categories on which society has become dependent. who are these hybrid creatures? donna haraway has described the “cyborg” as “a cybernetic organism, a hybrid of machine and organism, a creature of social reality as well as a creature of fiction” (1991:117). haraway describes our modern world as one of blurred boundaries: a world with faltering distinctions between animal and human, organism and machine, women and men. medical anthropologists have not been ignorant of these category-defying entities, which have increasingly come to define the modern medical landscape. the advent of life-sustaining technologies, an ever-expanding cornucopia of pharmaceuticals, and humans chronically dependent on medical institutions in order to live a “normal” life render purifications such as human/machine, natural/technological, and healthy/unhealthy impossible (see dumit 2002; lock 2002; lupton 1999). contemporary hospital medicine relies on abundant purifications in order to operate. in her ethnography about death in hospitals, sharon kaufman (2005) illustrates how bureaucratic pressure forces doctors to diagnose dying patients with treatable illnesses and shuttle them quickly lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 48 through treatment and discharge. for the most critically ill patients, progress soon goes awry; many become dependent on the medical technology employed (such as a mechanical ventilator or a feeding tube), while others do not have specific, treatable diseases. discharge is impeded or physically impossible. dying patients become hybrids resisting bureaucratic purification, confounding the systems designed to handle them. kaufman traces the shift in hospital culture to the year 1983, when medicare diagnostic related groups (drgs) gave diagnoses—rather than individual treatments—fixed reimbursement prices (2005:91). this immediately augmented the importance of categorizing, and therefore purifying, patients. moving away from a fee-for-service model, in which an unlimited number of services could be performed on a patient if deemed medically appropriate, the drgs set a reimbursement limit for each diagnosis: no matter how many procedures were needed, every person with the same diagnosis would receive the same reimbursement. the new billing scheme sent ontological ripples through the hospital system. dying persons were suddenly not recognized as dying—they had to be categorized as treatable, lest the hospital not be reimbursed for their stay. in a treatment-based institution, lingering, waiting, and resting under watchful care are not available services. dying patients become cyborgs: physicians cannot diagnose them, nurses cannot prepare them for discharge, families spiral between hope and fear, and the patients themselves are left to wonder where exactly they hang between life and death. kaufman maintains that death has now become a process completely “structured by hospital bureaucracy” (kaufman 2005:89). when doctors and patients inhabit such a world, the field of institutional attention is constricted to a diagnosis and everything else becomes ancillary, taking on a shadowy quality. if effective hospital care is constrained by medical purification, we can say that care within oncology is often constrained by disciplinary purification. for example, several studies have shown that oncologists often fail to recognize depression in their patients, correctly identifying less than half of their depressed patients as such, and as few as twelve percent (see fallowfield et al. 2001, sollner et al. 2001, passik et al. 1998, hardman et al. 1989). depressed patients incorrectly identified by their oncologists were shown to experience higher amounts of pain and have poorer treatment outcomes than those who were correctly identified (passik et al. 1998). unless depressed patients independently arrange psychiatric or palliative services for themselves, they are handled by a health system that purifies the hybrid problem of cancer into a physical problem. in reality, however, the symptoms of cancer may be as mental, financial, social, personal, and professional as they are physical. when an anxious patient and a busy oncologist sit down to consider a complex disease, there may be no space for the “cosmos”—in stengers’ words, the “unknown constituted by multiple, divergent worlds” (stengers 2005, 3). medical language, social problems, emotional distress of patient and physician, caseloads, and more reduce the size of the patient’s knowable world: there is no time to slow down thought. the inability to slow down thinking results in the exclusion of all entities outside of the biological disease process, and may ironically get in the way of effective care. lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 49 49 slow medicine: the hospice program now regulated and funded largely by medicare, hospice today is a form of medical care aimed at increasing comfort and dignity in dying persons. to enter hospice, a patient must be referred by a physician who estimates that the patient has approximately six months left to live, and is not seeking curative treatment. each patient works with a team consisting of a physician, a registered nurse, a hospice aide, a chaplain, a social worker, and often a volunteer (see figure 1). most hospice organizations administer service through home visits to the patient’s residence. additionally, hospice organizations maintain phone lines, make emergency visits, arrange for medical equipment, provide volunteer support, offer emotional counseling, spiritual guidance, legal assistance (appointing a power of attorney, writing living wills, and certifying resuscitation orders), and more. the host of potential referents that can be signified by the single word “hospice” indexes the wide domain of its operations. the word’s variable deployment in common speech reveals the productive ambiguity of hospice services: families often talk about “when hospice arrived,” “hospice recommended she change nursing homes,” “the hospice brought her meals,” etc., referring to a unified service simultaneously enacted by several different providers. to become accredited as a hospice organization and receive reimbursement by medicare, companies must follow stringent requirements regulating nearly every aspect of care. however, the bureaucratic substructure of hospice care reinforces, rather than undermines, the wide-ranging spectrum of care opportunities. rather than paying for individual services, insurance providers pay a flat daily fee for the entire duration of care. this payment scheme allows for steady medical attention throughout a patient’s time with hospice, rather than episodic treatment for individual medical problems. theoretically, this structure dissolves incentives to overor under-treat patients, as payment is equal for all patients and divorced from the particularities of care. to maintain consistency and quality across hospices, a detailed set of provisions by medicare regulates everything from the minimum number of physician home visits required to the narrative style of evaluation that hospice caregivers must record after visits3. the interdisciplinary focus of hospice acknowledges a world characterized by many forces that cannot be served by a single discipline. the close proximity of so many disciplines and their even deployment within the hospice system represents the beginning of a widening of thought within hospice care. the fact that hospice home aides and physician home visits are both bureaucratic expectations denies that any problem can be handled with only one set of methods. in this model, piles of dirty dishes and laundry sit beside pulmonary embolisms and hip fractures; both sets are acknowledged as injuries to the lifeworlds of hospice patients. conversations with god are invited into conversation alongside pain and nausea. thinking about william james, philosopher william connolly (2005) describes a world that spreads beyond the reach of any single philosophy that might seek to encompass it. rather than a “unified world knowable through fixed laws,” the world james imagines is thoroughly enmeshed in everyday experience, with all of its contradictions and unknowns (connolly 2005: 69). the world is not a rational whole—where cancer, for example, is a biological problem with chiefly biological ramifications—but a pluralistic one, constantly visited by “subterranean energies, volatilities and flows that exceed our formal characterizations of being” (connolly 2005: 73). a philosopher of pluralism is aware of the “abundance of the world over the language through which we describe it” (connolly 2005, 75). what is the philosophy of such a world? connolly writes: lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 50 the disturbing, or beguiling, thing is that such a philosophy is not, in james’s presentation, susceptible to neat, clean delineation. the overlapping forces propelling the world are themselves messy. pluralism is the philosophy of a messy universe. (2005: 69) hospice slows down care for the critically ill by acknowledging the volatile, hidden forces that govern the experience of illness. the bureaucratic recognition of such forces, as evidenced by the imperative to make several care disciplines available to each patient, is central to such a perspective. but while the bureaucratic structure of hospice demands wide-ranging awareness of patient experience and encourages interdisciplinary collaboration, slowed-down care is not the immediate result. true acknowledgement of the uncategorizable, complex forces that constitute the experience of illness requires individual caregivers’ abilities to consider patient experience from a perspective that goes beyond a single discipline. while hospice institutional regulations allow for the central inclusion of many often-ancillary disciplines within medicine—social work, chaplaincy, creative therapy—strictly following a single disciplinary checklist rules out the possibility of slowing down care. rather each individual perspective must expand beyond the boundaries of a single disciplinary vocabulary. new objects of care despite its kinetic nature, my work at the hospice had a grounding routine: every day i visited patients, every week i attended interdisciplinary team meetings, and every month the entire staff gathered for general announcements. a hospice identification card let me enter hospital wards, nursing homes, and apartments, and a friendly self-introduction lead me to many bedsides figure 1. a commonly encountered diagram of the hospice interdisciplinary team assigned to each patient. note that no one discipline is represented as primary or most important. (nhpcp 2014) lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 51 51 and deathbeds in my capacity as a volunteer. my bicycle let me crisscross the city several times per day, visiting patients and meeting staff members strewn across town. over time, i became familiar with the objects and vocabulary that fill the daily lives of hospice patients. i adjusted my vision as the once-strange world of end-of-life medicine became my own daily practice. over and over i noticed that when patients switched into hospice, medical attention previously devoted to a specific diagnosis became dispersed across the patient’s body and life. instead of medical care being fixed on one diagnosis or problem—a hip fracture or pancreatic cancer—myriad objects of care emerged: fear, anxiety, joy, nightmares, the longing to reconnect with a relative, hallucinations, invisible tingling sensations, nausea, loneliness, bedsores, pneumonia, fractured limbs, sepsis, simple tasks out of reach for the bedbound patient, the desire for physical contact, for help calling a friend, or to pass the idle hours. sometimes a newly blind patient needed someone to read to them. these were handled and treated alongside more visible objects, such as pain and the patient’s primary diagnosis. i watched hospice caregivers discover and treat these varied issues with unexpected methods: rearranging furniture, cleaning out the refrigerator to relieve a bad smell, talking to family members, telling stories, administering antibiotics, wrapping wounds, or simply sitting in silence. as a young intern with lots of time on my hands, few formalized responsibilities, and an inoffensive demeanor, i was often dispatched on unbelievable tasks: take this wheelchair-bound patient to the aquarium, celebrate a birthday with this patient who wants to drink cream soda, help this patient eat ice cream. it took time to understand that these activities were often central to the effective care of terminally ill people, and not as ancillary as they initially seemed. the weekly ritual of the interdisciplinary team meeting (“idt meeting”) was the axis around which the hospice turned. in a feat of logistics, idt meetings gathered otherwise mobile caregivers together for an entire morning of thinking about patients. over the course of several hours, each member of the hospice care team shared updates, stories, observations, news, or any significant information about each patient on the census listing. of the 15-25 people in attendance, a few ate breakfast, some rushed out of the room periodically to accept phone calls from patients, and most found a way to make jokes during the meeting. i attended these meetings for months both as an observer and occasional contributor. at idt meetings, the social workers, nurses, chaplains, physicians did not present disciplinary reports—they had conversations. a patient’s name, demographic information, and primary diagnosis were first read aloud. then someone would give an update, state a problem the patient was having, or report on general decline or improvement. if the patient had a new or significant problem over the past week, then a mix of perspectives, stories, and questions poured in. the problems usually exceeded the bounds of a single discipline. for example, a nurse once observed that a patient seemed to be experiencing the side effects of a certain drug, which the social worker noticed was the major factor in that patient’s recent dispute with a relative. alternately, the medical director inquired about the usefulness of a bulky hospital bed recently delivered to a patient’s home. the chaplain, who had paid a visit just after its installment, noticed the considerable stress all of the equipment was inflicting on the patient’s husband. a philosophy recognizing the overlapping forces that constitute illness was employed in an idt meeting when confusion about a patient’s diagnosis arose. “is mrs. solomon’s dementia gaining behavioral disturbances?” the clinical director once asked. “we got a call from the nursing home that she was really agitated last night, hollering out all night. they want to increase her doses.” dr. m, the team physician and an oncologist, responded: “well, she’s agitated certainly, lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 52 but behavioral disturbances? i don’t know. i mean, she’s not happy there, and her family is on the other side of town. they don’t like that very much. well, i’m scheduled to see her on wednesday. i think we have to find a way to transfer her [to a nursing home] closer to her family.” to dr. m, the problem exceeded what could be contained in medical language—it spilled over into the patient’s environment and the new and frightening distance from her family. the experience of illness expands beyond neurochemical “behavioral disturbances” into the patient’s neighborhood (“so far away from the patient’s family”) and her environment (“she’s not happy there”). the idt meeting furnished space for this multidisciplinary problem; sitting around a table with social workers, nurses, physicians, and chaplains, problems were rarely contained by the vocabulary of a single discipline. in this way, hospice caregivers often encounter the messy reality of patient experience. in an interview, a nurse described a recent visit to a patient with congestive heart failure: for a few minutes i checked her vital signs, organ function, blood pressure—the basic stuff. there was some fluid in her lungs, and her breathing was fast, but she said those things weren’t bothering her too much. everything else was stable. i know she enjoys my visits, so i offered to just sit with her for a few minutes and keep her company. i asked if anything was on her mind. and she just came out with it, like: “am i going to suffocate? how is it going to happen?” the nurse did not arrive simply to check on the progress of a diagnosis and depart. rather, the nurse allowed the patient to express a deep fear. suddenly, the most salient aspect of the patient’s suffering was foregrounded. the nurse, who was initially visiting to check on the patient’s organ function, now confronted the patient’s fear as an object of care. the nurse considered the patient’s fear, taking the question seriously without dismissing it with medical facts: i basically just sat with her for a long while and listened to what her fears were. i told her: i’ve watched hundreds of people die, and cared for thousands of dying people. not a single person can say what happens at that moment. we’re going to keep your lungs clear and open, and you’ll breathe just fine. but we don’t know what that moment is gonna feel like. at that moment, the object of care in the patient with congestive heart failure was not her heart, lungs or blood pressure: it was her fear of dying. responding to the patient required that the nurse step outside of disciplinary bounds and confront the patient’s fear honestly. no single discipline could contain the overlapping forces constituting the illness experience of mr. donald, a thin man with a red bandana and two long, grey braids down his back. clearly the envy of his nursing home with a full pack of marlboro reds in the pocket of his denim shirt, mr. donald took the hospice social worker and myself on a tour of the smoking deck, where he lit a cigarette. homeless most of his adult life, mr. donald enjoyed the nursing home. but the stakes for the social worker’s visit were high: the nursing home wanted to kick him out for not quitting smoking and drinking despite having advanced lung cancer. leaning forward, he explained to us: “i’ll tell you one thing, life ain’t life if i can’t live it! i’m sick of them telling me this and that. i’m not stickin’ around for that kind of shit life. throw me out if they want to. look, i’ll do it myself—be a good day for me! [coughs, wheezes].” lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 53 53 we shared more thoughts, including the patient’s advice to the social worker about how to get out of a parking ticket she received last time she visited (“swap your plates!”). when we left, the social worker made a phone call to another nursing home—a place with fewer staff and less scrutiny—to see if they would take him. although not a nursing home that many patients would ordinarily seek out, the nursing home was suited to mr. donald’s character and final wishes. she arranged for his transfer, and when she described the new home to him, mr. donald was thrilled. if his caregivers had seen the world as unified and knowable through fixed laws, then treating mr. donald would have gone differently. medically, smoking with lung cancer can worsen cancer; therefore the team would have required the patient to quit smoking. legally, a patient who does not comply with the rules of an institution should be discharged from hospice. but neither tried to purify him with disciplinary dichotomies such as healthy/unhealthy or compliant/disruptive. slowing down thought at an idt meeting, mr. donald’s nurse explained, “he knows what [smoking and drinking] is doing to him, but life wouldn’t be worth it without it.” as mr. donald’s painful cough worsened and energy waned, he spent several calm weeks in his new nursing home, continuing to smoke. on my last visit with him, he was in bed trying to work out a riddle someone had told him years ago. “it’s called ezekiel’s triangle,” he offered, closing his eyes. “tell me if you ever hear anything about it.” consider mrs. reyes, who was admitted to hospice with metastasized stage iv stomach cancer. the hospice physician’s first visit was quiet. the patient slept most of the time, said very little, and frowned when she was awake. in an idt meeting, the physician shared that the patient was catholic, and her tiny apartment was full of crosses and images of the virgin mary. the patient lived alone and cancer had made her bed-bound, so she hired a part-time aide to prepare meals and help her use a portable toilet. the aide was ukrainian and didn’t speak english very well, so they couldn’t communicate. weeks later, the patient’s discomfort and illness had increased. a nurse had been making bi-weekly visits to massage the patient’s legs to prevent bedsores and blood clots. one day at an idt meeting, the nurse reported: [mrs. reyes] has been opening up to me a little… basically, she has a lot of anger about never getting to retire. she worked her whole life at an insurance company and had been saving all of her money to start a new life after retirement. she had plans to travel, to go to mexico to visit her family, to go to hawaii on a cruise ship. and she just never got to do any of it. she’s very angry at god for making her sick instead. she feels like she’s just waiting to die. if the nurse had visited the patient solely to devote attention to the patient’s legs, she may never have discovered the more “total” pain the patient was experiencing. similarly, if there had been no opportunity for the nurse to share this patient’s total pain with other professional caregivers, it may not have been attended to as carefully. when mrs. reyes’ situation came up at idt meetings, the staff took equally seriously the patient’s negotiations with god, the delivery of the proper circulatory socks, and the removal of acid from her stomach. after nine weeks on hospice care, the patient died of stomach cancer. here we can see how slowed-down caregiving invites in the cosmos—the subterranean energies connolly describes, or the divergent chaos that stengers alludes to. slowly, the team and patient together cared for these unsightly, frightening aspects of the patient’s experience of illness. lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 54 silent, pervasive, and world-destroying, mrs. reyes’ anger eventually began to fade. by the end of the process, the nurse had witnessed a change in the patient: the patient smiled when she arrived and began telling stories of her past. when she became too weak to read, she requested that the hospice chaplain read the bible out loud to her. according to the nurse originally administering massages for the bedsores, the patient died at peace. care and the ontological politics of embodiment anthropological and medical literature have witnessed a prominent (re)surfacing of the notion of care. annemarie mol (2008) criticized the way in which the reification of values such as rationality, autonomy, and choice have created a health care system that understands patients as independent agents who make authoritative decisions about their health based on value-free information. her intervention is to demonstrate that, in practice, there are no such things as “bare facts,” but rather messy complexity, and framing health care as a series of rational choices between neutral options, generates an illusion of control over one’s health that is simply not possible in practice (mol 2008: 43). according to mol, the “logic of choice” ignores the imprecise, unpredictable reality of illness. to return to an earlier question, is cancer simply a physical object, or is cancer an entity that can cause bankruptcy and depression? or does the real cancer hang invisibly between these two, omnisciently manifesting through different channels? moving away from theories of perspectivalism and constructionsim, mol looks at how diseases are “enacted” or “performed” in practice (mol 1999:77). observation is not a passive act that discovers different aspects of an invisible essence: each observation is itself a performance. in fact, mol finds that there are multiple ways of “performing” reality—multiple forms of reality (mol 1999). understanding that illness is performed in many ways, and therefore understood and acted on in many ways, can decentralize preeminence of the clinical performance amidst other performances of reality. hospice care uniquely exemplifies the fruitfulness of this shifting ground: it is a medical practice that takes the embodied performance of illness as the primary way of understanding and treating it. the hospice caregivers i observed privileged the embodied over the clinical, spending their time in patient’s homes instead of clinics and laboratories. they learned about how patients performed and experienced illness in the middle of everyday life, instead of how their biological characteristics deviated from statistical norms. they noticed that a patient was unable to reach the bathroom, and so held his bowels and experienced constipation; that a patient was depressed because her family did not visit; or that a patient believed he would go to hell. the solutions they generated were therefore grounded in everyday practice, rather than yielded from laboratories. this kind of care is no less medical or effective; it simply works on a version of reality that is typically absent from the central concerns of biomedical care. to illustrate the attention paid to the embodied performance of illness and the practical nature of the treatment that results, we can consider the care of mrs. roosevelt, an 89-year-old african american patient with parkinson’s disease. on a hot afternoon, i rode my bike across town to visit with mrs. roosevelt, finding my way to the peacock feather-patterned chair next to her bed. the hospice chaplain had requested that i make social visits to mrs. roosevelt, since bed-bound isolation had left her depressed. over several visits, we had befriended one another easily; she lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 55 55 liked to tell stories, and i liked to listen. her stories meandered slowly as she remembered thirty years of working as an elementary school nurse (“oh, i did love those children…but sometimes you wanted to smack ’em! oh, you know…”). to my surprise, when i arrived that afternoon, the team social worker was also paying a visit. the social worker sat in the kitchen catching up with the patient’s daughter, who was in town on a weekend-long visit. i exchanged greetings with them, and the three of us chatted for a while. the patient was having a bad day, they said, and needed cheering up. when i approached her bedside, mrs. roosevelt looked concerned. “are you an angel?” she asked me. “are you here to take me home?” not knowing how to respond, i sat down next to her and pulled my chair up to her hospital bed. “i’m your friend from the hospice, and i’m just here to spend time with you.” but it didn’t register. she went on asking questions. “but how am i going to get there? how are we going to go there together?” we chatted about possibilities. at one point, she closed her eyes and squinted them, in what i thought was an attempt to imagine what death would feel like. later on during the visit, the social worker asked the patient about her parkinson’s symptoms. the patient had a mild case of the disease, which paralyzed only her left hand. small and dovelike, mrs. roosevelt’s hand perched above the covers in a blanketed nest. she said it was driving her crazy; because she was bed-bound, all she could do was concentrate on the bizarre pulsations and spasms that took place in her left hand, which heightened her delusions and hallucinations. at this point, we thought about treatment. the social worker, the patient’s daughter, the patient, and i thought about the hand-spasms, the delusions, the curiosity about death, the angel-sighting. we slowed down to understand mrs. roosevelt’s fear and boredom. the social worker asked mrs. roosevelt if she wanted to try parkinson’s medication again, but they both agreed it would be better not to (last time she took the parkinson’s medication, she had frightening hallucinations and nightmares). that wouldn’t suit. the social worker paused for a minute, thinking. “why don’t we try massage therapy?” she asked. “even if the mobility in your hand never comes back, maybe juan [the hospice team physical therapist] can teach you how to deal with some of the muscle tension.” mrs. roosevelt liked the idea, which addressed the discomfort she was experiencing in her hand, and left out the parkinson’s medication. “he’s very cute, too,” the social worker winked, “you’ll like him.” slowly, the process of care unfolded, back and forth across multiple hands and people. before leaving, the social worker and i talked to the daughter some more. the daughter worried that her mother’s confusion—benign in company—would turn depressive and scary at night. the social worker pulled mrs. roosevelt’s medication list out of a folder to see if she was taking medication for anxiety and distress—she was. “i’ll talk to dr. m about increasing the doses, so that she is more relaxed at night—these are very low doses.” the daughter was relieved. through conversation, the four of us responded to the embodied performance of illness. it took place in the disorganized world of mrs. roosevelt’s lived experience—her house, loneliness, and the nagging spasms that agitated her—not in a neurologist’s office or a ct scanner. the messy, embodied way of performing disease leads to a set of solutions: the massage therapist will come, doses of medications will be reconsidered, volunteer visits will continue. the solutions are generated from a performance of disease that takes place within the physical world, but also within the cosmological world, with all of its spinning, orbital, and chaotic energies. lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 56 navigating cosmology the theoretical hardship confronting the notion of care is its unboundedness: caring for unquantifiable concerns exists in opposition to the neat, orderly world knowable through science and augmented through purification. as such, it is inefficient and unattractive to instrumentalize care as a precise tool: where does care start and end, what does it require of the caregiver, what problems can truly be cared for (see russ 2003)? is care inextricably linked to femininity and altruism, or can it be mobilized more freely (see mol 2008)? perhaps because it is not a precise science, care has not enjoyed the same ease of deployment as more immediately rational biomedical logics have in modern medical practice. these ethnographic examples have helped demonstrate that the domains of other performances of reality can, too, be successfully navigated. rather than a straightforward obstacle to care, the domain we can label “cosmological” can be cared for when attention is directed towards it. as an example, consider the case of mrs. lillie. on a hot afternoon, the hospice chaplain and i visited a patient with severe alzheimer’s at a state nursing home. the patient experienced frequent and disturbing hallucinations over the course of her care. reverend joe, the hospice chaplain, knocks softly at a door on the second floor of a crowded nursing home. “hello, mrs. lillie! today seemed like a nice day to come visit with you.” we sit on either side of the patient, a 72-year-old african american woman with dementia. mrs. lillie is lying in bed wearing a light blue hospital gown. a nursing home staff member has just removed the tray of mashed potatoes, green beans, and chicken that mrs. lillie picked at. a long silence ensues. “there’s someone trying to kill me here,” she says to us, “one of the new nurses here. he’s waiting ‘til all the other nurses get off their shift for the night, then he’s gonna come in here and kill me. then take my body to the bins out back.” reverend joe looks concerned. “now why do you think that?” he asked. “he killed another patient, right down the hall. now i’m next on his list.” reverend joe shakes his head. “do you know anything else about him?” the patient’s eyes are closed. “he told me he was gonna kill me,” she said. “when did he tell you that?” “two weeks ago.” we sit in a long silence. the patient was performing the lived, frightening reality of her alzheimer’s. in its clinical performance, treating alzheimer’s looks very different: diagnose and treat the pathological mechanism and its checklist of symptoms, in this case paranoid hallucination and agitated behavior. locating the problem in degenerative brain cells, a clinician sympathizes and acts kindly toward the patient, but ultimately fits the variables into a diagnostic category and works primarily within biological and psychological domains. but the lived performance of dementia was the one experienced by mrs. lillie in front of us, and its treatment was far less straightforward. the chaplain listened. the object of care made itself abundantly clear. he was absorbed into her fear for a moment, and then responded to it. reverend joe asks, “may i pray for us, mrs. lillie?” she nods and clasps his hand and mine. after a moment of silence, his prayer begins: “heavenly father, this is your son joe. i’m sitting here with your daughter lillie and your other daughter lilly on this hot summer day. lord, we are your faithful servants. this afternoon we have one great request. please come into this room with mrs. lillie. protect her every breath, when she goes to sleep and lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 57 57 when she wakes up. watch her all day and all night. allow her to know peace in your loving embrace. thank you for listening to us.” mrs. lillie says “amen,” and our hands unclasp. another long silence passes. “you know what that means, mrs. lillie. you’ll be safe and sound in here now.” mrs. lillie rests her hands on her stomach and closes her eyes. she doesn’t say anything for the rest of our visit. the clinical and lived versions of paranoid hallucination are two very different problems. the first can be contained within a neat listing of symptoms, while the second spreads out and encompasses the room in terror. reverend joe treated the embodied performance of dementia: he sat with her, listened to the terrible fear, and responded to it. the chaplain employed certain assumptions about prayer and healing, but he acted on the exact terms—the exact performance of reality—furnished by the patient. he took her fear seriously, he took the threat of death seriously, and he manually eased both by acknowledging them and praying for their dispersal. he worked directly with the rich multiplicity of affective states experienced by ms. lillie. a final example is the care of mrs. rose, a 78-year-old woman who in spite of significant physical decline managed to neatly apply lipstick and comb her grey hair daily. a recent stroke took away her ability to form sentences, leaving her confused and frightened with a diagnosis of aphasia. the inability to make her needs known devastated her family, who maintained a constant presence in her apartment. at an idt meeting, the nurse described a scene: i got there right after, and it was a mess. the patient couldn’t make a sentence, everyone was crowded around her, and she was just panicking. it just broke my heart, the family huddled around her, not knowing what to do, asking her questions right up in her face. some of them were crying and crying. it was a big scene. in this case, the ramification of illness was dispersed through both worried family members and the bewildered patient. the performance of the illness was a room full of chaos. how could this nurse respond to this embodied performance, in the midst of familial panic? in this situation, aphasia is not a malfunctioning of a certain region of the brain, but rather emotional upheaval and panic. the nurse made her way to the bedside, took out her kit, and sat down next to her. in her words: to calm her down, i sat down with her and held her hand first, telling her it was going to be okay. then i felt her pulse, took her blood pressure, tested the strength in both of her arms to make sure she was okay otherwise. i asked the patient if she wanted some medicine for anxiety and she nodded yes. i looked into the patient’s eyes and promised her we would help her feel better. then i talked to the family. i told them it was going to stress her out if they try to ask her questions. yes or no questions—they’ll learn how it works. just sit with her and hold her hand. look at her eyes and you can tell how she feels. you do the talking. hold her hands and watch her eyes. lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 58 conclusion bruno latour hypothesized that to resolve the discord wreaked by purification and translation, society must “slow down, reorient and regulate the proliferation of monsters by representing their existence officially,” and further, that “conceiving of hybrids” actually “excludes their proliferation” (latour, 1991:12). i have maintained that hospice does exactly this by bureaucratically and medically acknowledging that illness exceeds disciplinary classification, as well as by working on its embodied performance. if we believe, with latour, that present crises reveal that society has never actually been modern, then the world has never really been disenchanted. by avoiding purification and acknowledging the hybrid and messy nature of illness, hospice care thus emerges as both non-modern and (re-)enchanted. hospice is admittedly a lucky site to take on such an orientation. perhaps hospice workers, not tasked with the job of curing illness and restoring patients to a baseline, have more room to experiment, or pragmatically just “do whatever works.” but this reading would take society’s present form for granted. in fact, in 2010 a controlled study at massachusetts general hospital revealed that lung cancer patients who were simultaneously enrolled in palliative care and oncology significantly outlived their prognostically-similar peers enrolled just in oncology—even though the palliative care group received fewer rounds of aggressive treatment (temel et al. 2010). the study and its aftermath have begun to provoke discussion within the medical community about the hybrid character of disease. acknowledging such aspects of illness seems to have a demonstrably positive effect on tangible markers of disease, not even considering the intangible ones. as long as the medical community continues to privilege clinical realities over embodied ones—“knowledge over actions” (mol and law, 2004:45)—hospice care will remain a practice outside of medicine, considered not fully medical, but something different. biomedicine and hospice will be to one another like architect and housekeeper: one measuring, creating and building, while the other works on the mundane, quotidian aftermath. but it is the everyday details that make up life—what james calls the “litter” that philosophers so relentlessly try to erase from pristine accounts of the world (connolly 2005:72). as widespread discontent with end-of-life care practices continues, many caregivers have directed their attention towards the everyday experience of illness. when “incompleteness, looseness and volatility” surface in illness, perhaps patients and practitioners will both seek out philosophies that treat these entities with respect and regard them as part of the whole (connolly 2005:72). acknowledgements multiple thanks to judith farquhar, eugene raikhel, robert richards, alex moffett and julia kowalski for their incisiveness and encouragement, and to the anonymous reviewers for helpful feedback. i am grateful for the franklin grant from the department of comparative human development that helped support this research. finally, i thank my undergraduate cohort in the history and philosophy of science for editing all of my writing. lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 59 59 notes (1) all names, locations and identifying characteristics of patients have been changed to protect anonymity. (2) recently, the hospice industry has witnessed the growth of for-profit companies taking advantage of this payment scheme in order to capitalize on “down days,” or days when patients do not receive any service but the hospice receives payment. the advent of for-profit hospice can be compared to the for-profit hospital industry in terms of advantages and disadvantages. the compromised care resulting from profit-orient incentives may undermine the basic tenants of the hospice philosophy, but i do take up problem here. (3) hospice has come a long way from its volunteer-led, activist roots. many have expressed concern that the growth of hospice from a countercultural movement to an institutionalized, bureaucratized, largely for-profit industry is compromising the founding ideals of the movement (mcnamara 1994; james and field 1992). because my participation took place within a single, non-profit, reputable hospice, i cannot comment on the decline in quality of hospice services as for-profit companies capitalize on the unique funding structure of hospice care. i maintain here, however, that such changes have not dismantled the underlying mission of hospice care, which is supported by a novel bureaucratic structure, the often-personal motivations of caregivers, and the still-aggressive status quo of the majority of deaths in america. on the other hand, regulatory encroachment upon the previous freedoms of careworkers during less-regulated years was often invoked as a source of stress and demoralization 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margaret mcdonald, bary rosenfeld, dale theobald, sara edgerton 1998 oncologists's recognition of depression in their patients with cancer. journal of clinical oncology 16(4): 1594-1600. russ, ann julienne 2005 love’s labor paid for: gift and commodity at the threshold of death. cultural anthropology20(1): 128-155. saunders, cicely 1996 a personal therapeutic journey. british medical journal (313):1599-1601. http://www.nhpco.org/sites/default/files/public/statistics_research/2014_facts_figures.pdf lerer | slowing down care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.64 http://anthro-age.pitt.edu 61 61 sollner, w, a devries, e steixner, p lukas, g sprinzl, g rumpold and s maislinger 2001 how successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counseling? british journal of cancer 84(2): 179-185. stengers, isabelle 2005 the cosmopolitical proposal. in making things public: atmospheres of democracy, bruno latour and peter weibel, eds. pp. 994-1004. cambridge: mit press. temel, jennifer, joseph greer, alona muzikansky, emily gallagher, sonal admane, vicki jackson, constance dahlin, craig blinderman, juliet jacobsen, william pirl, andrew billings, thomas lynch 2010 early palliative care for patients with metastatic non-small-cell lung cancer. new england journal of medicine (363):733-742. teno, joan, pedro gozalo, julie bynum, natalie leland, susan miller, nancy morden, thomas scupp, david goodman, vincent mor 2013 change in end-of-life care for medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005 and 2009. journal of the american medical association 309(5): 470-7. portfolio aging into disability/disability into aging: an interview with sophie sartain christine verbruggen ku leuven christine.verbruggen@kuleuven.be sophie sartain filmmaker, katahdin productions, los angeles, ca, usa ssartain@katahdinproductions.com anthropology & aging, vol 42, no 1 (2021), pp. 140-154 issn 2374-2267 (online) doi 10.5195/aa.2021.339 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 140 portfolio aging into disability/disability into aging: an interview with sophie sartain christine verbruggen ku leuven christine.verbruggen@kuleuven.be sophie sartain filmmaker, katahdin productions, los angeles, ca, usa ssartain@katahdinproductions.com “you don’t have to leave me … you can keep me … we don’t have to die, we can keep living” (dona to mimi) introduction now, more than ever, it is likely to know a ‘mimi and dona.’ i met my first mimi and dona in 1984 when i started kindergarten in my home village in flanders, belgium. looking back, a quarter of a decade and many demystifications later, i realize that ‘going to school’ at that age – for a ‘conventional’ kid like me at least – is the most ritualized, predictable, and institutionalized time of your life. being a healthy child, with no economic or social deprivation and no visible, diagnosable or socially disturbing particularities, you just march, as fast as you can, towards deceivingly clear futures. thus, moving forward, you grow up developing a strong sensitivity to what common sensical ‘life’ looks like: when and how one should grow up and age, what maturation means, when to become independent, and how. as richard settersten (2003, 19) reminds: individuals use age-linked ‘mental maps’ to organize their own lives, the lives of others, and their general expectations about the life course. . . . these maps, in turn, serve important human needs for order and predictability. it’s in the margins of our comfort zones, that we make, and thus find, otherness. back then, for me, these margins featured andre, who then appeared to me as a boy, dressed in man-like clothes (a pair of beige pants similar to my father’s, a checkered shirt buttoned all the way up, and brown, leather shoes). andre was always in the company of his mother, adèle, a small woman with medium grey hair, friendly looking, and always holding his hand. in many respects andre and adèle felt out of synch with my world: they were never in a hurry and they showed up at the school gates when no one was picking up or bringing children, when no one came back from work, to ‘just’ watch the children play. they did not ever seem to change, did not seem to have a future that differed much from the eternal present, nor did http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 141 they look properly ‘aged’ to me at that time. quite a sensitive child, i must have asked my mother multiple times, “what is wrong with them?” andre had down syndrome: “it’s a pity, he’s a bit simple, yeah, i feel so sorry for her,” she used to add. at that moment, in a small village like mine, down syndrome must have been one of the only recognized cognitive disabilities. figure 1: family picture, 1973; from left to right: sophie sartain, mimi thornton, bo sartain, and dona thornton. courtesy: sophie sartain “of course,” settersten continues to argue, “lives as they are actually lived may deviate from cultural models of the life course” (2003, 19). mimi and dona, adèle and andre, henriëtte, willem and kees,1 and many others ask us—and our governments—to reconsider our expectations of the life course, to modify our age-linked ‘mental maps’ to include new realities, and to reconsider the diversity of relations between care, aging, and disability that exist and require support. it is to the wide affective resonance and the organizational complexities of aging with disability, in a kin-work and life course perspective, the documentary film, mimi and dona speaks. mimi and dona (2014) is a coproduction of independent television service (itvs) and corporation for public broadcasting (cpb), directed by sophie sartain.2 it was nationally broadcast on pbs/independent lens and was screened on multiple film festivals, such as dallas videofest, the reelabilities festival, and the thin line festival and is now available via kanopy streaming. the documentary gives an intimate portrait of a 92-year-old mother, mimi, and her 64-year-old daughter, dona, who has an intellectual disability, and the reverberations of their relationship in the lives and future imaginaries of a texas family of which sartain is part. mimi and dona’s lifeworld also echoes a relatively new phenomenon concerning aged adult caregivers of people with intellectual and developmental disabilities living to advanced age, while facing the lack of health care and social infrastructures to meet the challenges that come with this new reality. http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 142 in the us, in 2016, an estimate of 7.37 million people had some form of intellectual or developmental disability (idd’s) (medisked and the the arc 2018, 6).3 70% of people with idd live with a family caregiver, of which approximately 20% is 60 years or older (medisked and the arc 2018, 20). this caregiving situation is the consequence of decades of deinstitutionalisation and long waiting lists for specialized facilities, which are furthermore often too expensive for a large part of the caregivers, and/or have a bad reputation when it comes to quality of care. as both the person with idd and the caregiver follow the general demographic trend of an increased life expectancy, this number is very likely to continue to grow: whereas people with idd’s used to have a life expectancy of 12 years in 1940, today, in western countries, there is a median life expectancy of 65 years for women and 66 years for men (forrester-jones 2019, 10). people with intellectual and developmental disabilities are also more likely to develop comorbidities throughout their lives, such as alzheimer’s disease, which require more intense support. as a small-scale study in new forest, south hampshire (forrester-jones 2019) with 21 older caregivers (75 and over) of people with learning disabilities and autism shows, all older caregivers as well as some of their children face one inevitable, vital question: who will take care of my child/me in the future when i am/he or she is no longer able to? figure 2: poster for the film mimi and dona sophie sartain witnesses the watershed moment, that was a long time coming, when mimi nears the end of her caregiving abilities; when mimi too, becomes ‘disabled’ to care. more than six years after the first screening of the documentary film, i invited filmmaker sophie sartain to pause on the origins and her motivations, on the making of, on the ethics of representation, and on the afterlives of this documentary. http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 143 “please don’t taaake, my sunshiiiine, away, waywayway waywayway.” christine verbruggen: in 2008, when your father died from the effects of multiple sclerosis, you went back from los angeles to dallas, texas, to spend more time with your family, with the additional purpose of filming the ‘quirky’ life of your then 92-year-old grandmother mimi and your 64-year-old aunt dona. this coincided with the moment when mimi had finally—after years of denial—given in to the fact that she was no longer able to care for dona. you ended up documenting something that was on the verge of being lost. how would you sketch their daily lives up to that moment? sophie sartain: mimi and dona had a very structured and insular life in their suburban home in dallas. the house itself never seemed to change; it was like stepping into a time capsule from the 1960s. they didn’t seem to change either, with the exception of getting older. my grandfather died in 1968, so it was just the two of them for forty years. their life revolved around television programs and occasional outings, usually to nearby shopping malls, a few restaurants (mostly mcdonald’s and taco bell), the supermarket, and the post office. every saturday at 1:00 pm, without fail, they went to a beauty salon to get their hair done. and every evening, monday to friday, they watched the game show, wheel of fortune at 6:30 pm. they would write down the answers to the puzzles on the show and keep track of how much money each contestant made. many sundays they went to services at a methodist church in the neighborhood, though this became more infrequent as they got older. their main visitor was their friend tony, an older man who had been mimi’s ballroom dancing instructor when mimi was in her 70s. in the 1990s, mimi and tony danced the waltz, tango, cha-cha, and rumba at senior showcases around dallas. when i filmed the documentary, tony was using mimi’s converted garage as a dance studio to teach classes to senior citizens. mimi and dona loved seeing tony when he came over, and we in the family liked it because he would check in on them. cv: the documentary starts with the 92-year-old mimi walking around the house with her back bent at a 90degree angle, as if literally symbolizing the caregiver’s burden. the music in the background –“you are my sunshine, my only sunshine”– however more accurately evokes the atmosphere around the house and curbs these expectations. the recognition of a ‘caregiver’s burden’ is a relatively recent phenomenon, that might well have paralleled the deinstitutionalisation of care and is maybe more accurate to describe the burden of planning good care rather than everyday caregiving practices per se.4 did mimi ever speak of a burden of caring for dona, and if she did, what was the main reason for that? ss: throughout her life, mimi embraced caring for dona and never expressed that it was a burden. fiercely protective of dona, mimi seemed to know, deep in her bones, that she was the only one to care for her daughter. she did not want anyone interfering in their life, including her own family members. in addition, mimi genuinely enjoyed being with dona. however, having said that, we did notice a change in mimi around the time that i started filming. for the first time, at age 92, mimi revealed that it was getting hard caring for dona. outings to the mall or the supermarket became challenging because dona would wander off. mimi, bent over with her walker, couldn’t keep up with dona. one time at the mall, mimi couldn’t find dona, and a security guard had to retrieve her. dona’s behavior also worsened—for instance, she shoplifted candy at the grocery store. when a manager caught her, he asked mimi not to bring dona back. we didn’t realize it at the time, but dona was probably exhibiting the early signs of alzheimer’s disease. so, she was changing, too, and for the first time, caring for her became a source of anxiety for mimi. http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 144 cv: in a case study of a family caregiving situation involving a person with early-onset dementia, his wife, and his children, silke hoppe brings to the fore marilyn strathern’s (1988) “dividuality” as a core concept to understand the mutuality, reciprocity, and systemics of caregiving assemblages (hoppe 2020). in layman’s terms, this would mean that dona is part of mimi, as much as mimi is part of dona. there are multiple moments in the documentary that represent this oft overlooked aspect of caregiving relations. the night before dona will move out of the house is certainly one of the most telling moments in that regard. mimi asks dona, “you allright?” dona answers, “yeah, i’m allright, mum. you allright?” the fact that this is moving, can, i think, also partly be explained by the fact that we are conditioned not to expect this kind of reciprocity in a caregiving relation. how does ‘dividuality’—as a dynamic relational interiority—matter in the relation between mimi and dona and in the broader family system? ss: in the film, my mom tells the story of her aunt who cared for a son with autism and cerebral palsy. when the son died, it was an unbearable loss for my mom’s aunt. my mom remembers being haunted by her aunt’s “deep moaning wail” at the funeral, as if a piece of herself had been brutally torn out. this speaks to the idea of “dividuality”—of mutuality and reciprocity in these family caregiving relationships. in american culture and perhaps other cultures, the goal is for children to achieve independence—to leave the nest. that plays out in my own family. i have two brothers, and between the three of us, we live in california, maryland, and texas. we follow what many consider a successful model because we live independently thousands of miles apart. but is that the best model? what if your quality of life is better by not following this model? what if being a family caregiver brings purpose and meaning to your life? it’s something i wanted to capture in the film—the fun mimi and dona had, the laughs, the quirky routines, and the shared experiences. after she was widowed at age 52, mimi might have hoped to find a new romantic partner later in life or travel the world with friends. but dona was a sweet companion, and they had a symbiotic relationship. ultimately, for mimi, it was not a burden but a joy. figure 3: mimi and dona at a birthday celebration. courtesy: sophie sartain http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 145 cv: you use a powerful medium: (audio)visuals that allow you to show and tell the ongoing story of your aunt dona and your grandmother mimi. penetrating the gaze like that, you do enter a terrain of vulnerability in multiple ways (e.g., the intimacy of family life, representations of disability, bodiliness, etc.). both dona and mimi are, however, clearly aware of the camera and of your presence. one of the most magnificent examples is the evening before the transition when they do their evening ritual and say their prayers on the bedside for the camera. when forgetting the words, in a conspiracy-like manner, mimi says to dona: “well, cover up your eyes, and we will do it like this, and she won’t know we’re not saying the lord’s prayer,” upon which dona agrees: “ok.” how did the camera function for you, for them, and your family? what were the main ethical choices you made while making the documentary? ss: at times mimi and dona seemed aware of the camera. other times they forgot i was filming. they would go about their lives and chat with me as they normally would. as a documentary filmmaker, this is a dream come true; your subjects are completely themselves, not performing or editing themselves for the camera. it helped that it was just me in their home, not a crew and that i shot the film primarily with a small hd camcorder. today, people can be even more unobtrusive with smartphones that take great video. for me, the camera was both a magnet and a shield. it drew me to dallas and made me show up. i was making a film after all. but the camera also allowed me to stay at a distance and suppress emotions. i toggled between being a family member and a filmmaker. the scene in which we left dona at her new home was particularly gut-wrenching when dona begged mimi to take her home. the camera shielded me from the intense emotions of the moment. later, when i watched the footage, i cried. in terms of the ethical choices, those came later in the editing, when we had to decide what to include and what to leave out. there is a lot of talk in the documentary world right now about “extractive” filmmaking, the notion that we risk exploiting our subjects even if we have the best intentions. i welcome this conversation. we have to stay on top of this and constantly ask ourselves if what we are doing presents the truth in a way that uplifts our subjects and the issues they care about. this would not necessarily be the case in a film that exposes corruption or the actions of wrongdoers, but more in situations like mimi and dona’s, in which vulnerable people trust us with their stories. to make the most powerful film, i wanted to show raw and intimate moments, but my hope is that they served the greater good of honoring mimi and dona’s story and paying tribute to their incredible bond. “i am too old to move there, i’m 64” (dona to sophie) “she almost knocked me down; she wants to go around and count cracks in the house, all day long, and that makes her mad when she can’t do that.” (mimi about dona) “i want you to be happy wherever you are.”-“like here?” “yeah, and anywhere else, if there’s some other place, if i’m not here, you can’t live here by yourself.” (mimi and dona) cv: the first part of the film’s subtitle is ‘limited options.’ how would you define the limitations in mimi and dona’s younger life? and how did they persist or change when she and dona grew older? ss: as a child, dona was asked to leave the public school system in dallas. though it was not easy for my grandparents financially, they found private schools for dona to attend. my grandparents also had http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 146 to contend with the attitude in the 1950s that families would be better off sending children with disabilities to institutions. i don’t think they ever considered this for dona. fortunately, our federal laws changed during the course of dona’s lifetime. thanks to the dogged efforts of disability rights activists (captured in the wonderful documentary crip camp (2020) directed by our sound mixer jim lebrecht), all children in the us are now guaranteed a free and appropriate education. i wanted to highlight this change in policy to show that we can make progress and our government can mobilize to support families. figure 5: dona and a classmate at a private school, circa 1960. courtesy: sophie sartain at the same time, we currently face a crisis in housing for aging americans with disabilities. i wanted to spotlight this issue, too. in the film, when mimi’s difficulties in caring for dona increase, my brother expresses frustration about the waitlists at community homes for people like my aunt dona. he says, “three years, five years. we don’t have five years. we might not even have five months.” it was in this context that we had to act quickly to find a home for dona. cv: what did it actually mean for mimi not to be able to care for dona anymore? ss: as mimi and dona aged, their world became smaller. they left the house less frequently because, as mentioned, mimi had a harder time keeping track of dona in public. she couldn’t keep up with her if dona left her side. this was a change. the film shows that dona’s behavior also changed at home. dona always had her interests, bordering on obsessions, such as writing down license plate numbers and serial numbers on dollar bills. these obsessions intensified over the years. mimi complained that dona would pace around the house and count cracks in the ceilings of the rooms. when mimi tried to http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 147 stop dona from counting cracks, mimi said that dona pushed her and “almost knocked me down.” at age 92, mimi was stubbornly independent, but she had become weaker, her hearing had diminished, and she probably shouldn’t have been driving. these developments pointed to her not being able to care for dona, and then the kicker was mimi’s own admission that she didn’t think she could do it anymore. cv: when getting back in the car, after bringing dona to denton state school, both mimi and dona have a very hard time, with dona becoming angry, sad, and therefore aggressive and with mimi ready to get out of the car to take dona back home. at that point, she screams: “y’all made me do this!!” it’s them against the rest, at that point. yet, among family members, there are quite some divergent opinions about what mimi should do or should have done with dona and about dona as a person. can you frame those different opinions? ss: we had different opinions about what might be best for dona, and i’m grateful that my family allowed me to show all sides of the debate—especially when it didn’t paint us in the best light. one of my brothers expressed criticism with mimi for not enabling dona to be more independent. his beliefs echoed those of my father, who felt that mimi should have moved dona to a community home earlier in life. another brother, who has a son on the autism spectrum, voiced more ambivalence and understanding as someone in a situation like mimi’s. “i sometimes feel i have to live forever and outlive him,” my brother said of his son, who is now in his 20s and living at home. my mom’s cousin betty thought dona might be happy living with her in a more rural setting in east texas, but betty had some health setbacks making this impossible. i wondered if we could find 24-hour care for mimi and dona in their home—an expensive option but possible, at least for a while. however, on the few occasions when we tried to bring in people, mimi became agitated and suspicious and demanded that the person leave. she hated having outsiders in her home. my mom (mimi’s daughter and dona’s sister) found herself in the middle of this. “trying to figure out what to do with someone like dona is very difficult,” she said. “there’s not a formula that fits everybody.” figure 5: keith sartain and his son william. courtesy: sophie sartain http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 148 ultimately, our opinions were only that—opinions—because we had to follow what mimi wanted. the minister at her church had recommended the denton state school, a state-run institution, as a place she should consider for dona. he told her that another family at the church had a family member there and they were happy. this had a big influence on mimi, bigger perhaps than what her family members said. in the end, she made the decision to send dona to the denton state school in 2009. cv: there is a strong thread about institutional care with little or no critique to its potential failures, which contrast sharply with the public and academic debate on institutional care. was this deliberate? ss: we had reservations about a state-run institution given the media coverage we had seen in recent decades, dating back to geraldo rivera’s shocking exposé of the willowbrook state school in new york in 1972. the denton state school did not seem ideal to us. and yet, we found ourselves surprised when we toured the facility. it was on a big campus and offered a menu of activities and what seemed like a good ratio of residents to staff members. we really liked the case manager and the team assigned to dona. and again, this was mimi’s decision. knowing this, we may have engaged in some wishful thinking about how dona would do there. we also, at that point, did not know that dona might be in the early stages of alzheimer’s disease. we missed the signs. as far as the film goes, we had a longer section on the controversial history of these institutions, including reports of horrifying conditions and instances of abuse, but we ended up trimming this section for time and to keep the focus on mimi and dona. figure 6: dona and mimi in front of their house in dallas, texas. courtesy: sophie sartain cv: the protagonists in the film are deepened and narrativized in their complexity: e.g., your mother (also for you) becomes a sibling that has a hard time living with a sister like dona and moves out of the house; mimi becomes a woman who makes her own dresses and likes dancing. dona, however, apart from transitioning and adjusting to institutional life and dramatically changing through alzheimer’s disease, stays rather flat and static. it’s only your mother merrily’s cousin betty who says: http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 149 i felt really sad for dona. how did dona feel when she was left in there? that’s what tore me up, sophie. we never knew what dona was thinking or feeling as she got older. and when she was little—when she was playing with the doodle bugs and the wasp and these kind of things. did this resonate with your feelings about ‘voicing’ dona’s feelings and inner world? ss: i love it when betty makes this observation. it is emblematic of the grappling we all did around the decision to move dona and the results of that move. dona was often hard to read, especially as she got older. and from the time i was a child and first remember dona until i started making the film, she did seem unchanged to me. she talked about the same things in 2010 that she talked about in the 1970s – for instance, about the time she saw the beatles in concert and about old boyfriends (real and imagined) and how she wanted me to be the flower girl in her wedding. things like that. looking back now, i realize that i did ask dona everything i wanted to ask her. the problem is that i didn’t listen to her. when i asked her if she wanted to move to denton, she said no. when i said, why not, she said, “i’m 64. i’m too old to go there.” now i see that, even though none of us could have predicted the outcome, dona was probably right. i wish i had listened to her better. i am still grappling with this. the afterlife “everybody wanted me to do it, but they don’t know what it is to give up somebody. i know what it is to give up ozzy when he died. but to give up a young woman like dona.” (mimi the day after the move to denton state school) the first couple of months after the move to denton state school, things seem to go pretty well for dona, and it’s mimi who seems to suffer most from the separation. when sophie comes to visit her, the day after mimi came to see her after her first month home alone, she seems to be integrating quite well, pointing to her picture on the wall in the facility, as if to say: ‘this is where i live.’ when mimi calls, she doesn’t really want to talk too long. however, after mimi’s 93rd birthday, things get worse: dona refuses to eat, is more and more aggressive, and her situation worsens, both physically and mentally. as mentioned earlier, dona seems to have developed alzheimer’s disease, which is common for people with idd’s. the case manager says that the symptoms might have worsened through the dramatic change of moving into the institution and that it otherwise would have happened anyway. figure 7: mimi and dona after dona’s move to the denton state school. courtesy: sophie sartain. http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 150 she has also developed a urinary infection which doesn’t improve. not knowing what to do, they take her home (for a while), hoping that she would feel better and regain some strength. one month later, after the short trip home, she ends up at the emergency room where, miraculously, as her urinary infection is treated, after two weeks, dona is both physically and mentally recovering. sophie’s mother, merrily, is relieved: “so now we can hope again.” but the hope is short-lived, and the help for dona is limited to visits and shared moments at birthday parties until she dies in her sleep, at age 70, in january 2015. sartain’s work bears witness to the fact that dona has left a strong imprint on the lives of those who outlive her. cv: how, in general, did living with dona in your earlier years, as part of the family, change your feel for diversity in your later life? and how, maybe, did this approach change while making the documentary and through the diagnosis of your son ben? ss: it was a gift growing up with dona. as a child, i spent weekends at her house. she and i would catch fireflies and chameleons in the backyard and put them in mason jars. we’d place the chameleons on the green felt pool table they had and watch the chameleons change from brown to green. it was magical to a 5-year-old. dona was so fun. she was my aunt and also my playmate. as i got older, i became confused about dona. i thought that grown-ups were supposed to have jobs and maybe get married and have families. one day when i was about 8 or 9-years-old, i blurted out in frustration to my mom, “dona’s dumb.” my mom corrected me and explained about dona. it was enriching for me to learn about differences and understand that we’re not all alike. i also benefited from meeting dona’s friends. her best friend margie came to the house a lot. margie was a hoot and mischievous like dona. she and dona were my version of lucy and ethel, always scheming and getting into trouble. figure 8: dona thornton in her 20’s, playing music. “she was my aunt and also my playmate.” courtesy: sophie sartain. with my son, who received an autism diagnosis in the middle of making the film, the situation was different—mainly because he’s his own person with his own strengths and challenges (like all of us) and because our world has evolved in its understanding of diversity and autism. one way my http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 151 experience with dona may have informed the situation with my son was in his early diagnosis. knowing that we had autism in the family, i was on the lookout for any signs and didn’t hesitate to get evaluations. my son is now a teenager and in a great school and surrounded by friends who are proudly “autismic” (their term). the other day, he saw a picture of himself at age 12 and joked, “there’s a kid who’s about to lecture you on the inner workings of a steam engine.” we couldn’t stop laughing. cv: there is indeed a ripple effect of ‘autism’ in your family throughout three generations. the documentary, instead of dramatizing hereditariness, focuses instead on lessons to be learned on the sharing of intergenerational knowledge. the most powerful lesson in this regard—and the second subtitle—is ‘limitless love.’ also, in the follow up documentary, sophie and ben, you witness: “what mimi taught me was unconditional love.” do you see intergenerational differences in your family concerning the realization of this love, and, for example, the uneasy relation to (in)dependence and self-realisation? what lessons would you teach your kids when struggling to integrate intergenerational knowledge in contemporary conditions? ss: oh my, you ask good questions! we can be so hard on the generations before us, second-guessing their decisions when it’s almost impossible to understand their circumstances. if, for instance, i had had doctors, teachers, and admired religious figures telling me in the 1950s that i should send a child with idd to an institution, would i have been tempted to follow that advice? i don’t know how i would have reacted. i believe our understanding of the brain will expand exponentially in the years to come and that future generations will shake their heads at how clueless we were. i hope this happens because it would signify progress. but i also hope that future generations temper their judgment with compassion. we are doing our best with the information we have. mimi is a role model for me because, aside from her time-bound circumstances, she embodied something timeless. she was strong, fierce, and rock-solid in her love. i hope i can pass something like that along to my children and grandchildren. at the end of the day, what is more important than that? cv: the film was nationally broadcasted on pbs/independent lens. this surely boosted its public visibility. speaking on the convergence of intellectual and developmental disabilities, aging, care, (de)institutionalisation, family histories . . . you have a lot of potential audiences. who are your audiences (e.g., caregivers of people with idd; schools; nursing homes; disability scholars; gerontologists; policymakers; classrooms; asf.)? how different was the documentary appreciated by e.g., activists for people with idd’s or activists in the field of neurodiversity and professional caregivers or educators? ss: although i started out making a small and personal film about my family, i quickly realized that i had tapped into something much bigger. more often than not, when i would tell someone about mimi and dona’s situation, they would chime in that they knew someone in the same predicament—a cousin, a neighbor, or a friend's sibling, some with developmental disabilities, others with mental illnesses, all struggling to find appropriate care and housing for a loved one. i realized that this was an untold story happening all around us, with caregivers like my grandmother facing agonizing decisions, often with little support or guidance. an early ally and advisor on the film was don meyer, founder of the sibling support project. he identified with my mom, who grew up with unique challenges as dona’s sister. i also received guidance and support from experts in autism and advocates for people with idd. through film festival screenings, community screenings, and the pbs broadcast, the documentary reached millions of viewers, something i couldn’t have fathomed when i first took my camera to dallas in 2009. i heard moving stories from viewers all over the us who had family situations like mine. it was incredibly gratifying. http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 152 once i made the film available to schools and institutions through new day films, i reached new audiences in academic fields and the caregiving world. one professor of a developmental disabilities class at oklahoma state university assigned the film to her students. amazingly, many of them wrote me thank-you notes after watching it. the film screened through state agencies such as the pennsylvania department of health’s bureau of family health, which held nine community screenings for families and caregivers around the state. mimi and dona also screened at conferences such as the american society on aging (asa) conference, where i met gerontologists, social workers, and clinicians who’ve since used the film for training purposes. i’m heartened that it continues to be viewed and used as a teaching tool six years after its broadcast. figure 9: notes from students at oklahoma state university who watched the film in a class. courtesy: sophie sartain. cv: as we speak, you have an audience of researchers and practitioners of a wide variety of disciplines (gerontologists, anthropologists, disability scholars, nurses, social workers, architects, …) ready to run off and see the documentary. thinking about your experiences with mimi and dona, what would you want them to focus on concerning aging into disability/disability into aging? ss: first of all, i want to thank them for their work and for devoting their research and talents to areas that are often overlooked in our society. obviously, as our population ages and people with disabilities live longer, the complex issues of finding care and safe and affordable housing for these vulnerable populations will only grow. http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 153 in terms of an area of focus, i would love to see more research and data about the benefits of caregiving in addition to the important work being done to document its burdens. i’m a storyteller, so it’s beyond me to know if caregiving has measurable benefits, but in my own family, i have seen some positive aspects. my mom was the primary caregiver for my dad in his final years, before he died from multiple sclerosis at age 65. although it was incredibly difficult and heartbreaking to witness his decline, she also told me that it was the closest they ever were in their 42-year marriage. and mimi lived to be 100. it may have been a combination of genes, luck, economic security, and access to good health care. but her life also had purpose and meaning as dona’s caregiver, and this might have contributed to her longevity. not to mention companionship—the idea of “dividuality” that you brought up. mimi and dona had many laughs just sitting in their favorite chairs every night, trying to guess the phrases on their favorite game show, wheel of fortune. it might not have been as exciting as traveling the world, but for them, it was a lovely way to spend an evening. figure 10: mimi thornton turning 100: “her life also had purpose and meaning as dona’s caregiver, and this might have contributed to her longevity.” courtesy: sophie sartain acknowledgements a sincere thanks to celeste pang for her critical appraisal of the movie, to the mother of the first author for reminiscing on adèle and andre, and to janis woodward for careful editorial suggestions. notes 1. kees momma (born in 1965) is a remarkable, witty, and intelligent dutch man on the autism spectrum, who lives in a chalet in the garden with his 80+ parents, henriëtte and willem. director monique nolte first documented kees’ and his family‘s life in trainman (1998), and in 2014 released the award-winning follow up, het beste voor kees [what’s best for kees]. the last documentary film especially focuses on the question central to mimi and dona: who will take care of kees when henriëtte and willem are no longer able to, and what is best for kees? both http://anthro-age.pitt.edu/ portfolio | verbruggen and sartain | anthropology & aging vol 42 no 1 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.339 http://anthro-age.pitt.edu 154 documentary films have served to raise awareness on neurodiversity in the netherlands and keeps attracting a lot of public attention. nolte is now working on the third production with kees momma, kees vliegt uit [kees leaves the nest], documenting kees’ steps towards another episode in his life of supported in(ter)dependence. 2. sophie sartain’s other credits include seeing allred (2018, co-director and producer), above and beyond (2014, writer), hava nagila (the movie) (2012, producer and writer); and blessed is the match: the life and death of hannah senesh (2008, writer and co-producer). 3.the definition of intellectual and developmental disability used in the discussion guide of mimi and dona is: intellectual disability (also known as “intellectual disorder”) is characterized by deficits in general mental abilities, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience. the deficits result in impairments of adaptive functioning, such that the individual fails to meet standards of personal independence and social responsibility in one or more aspects of daily life, including communication, social participation, academic or occupational functioning, and personal independence at home or in community settings. (discussion guide 6) 4. for a critical appraisal of the ‘caregiver’s burden,’ see warren, narelle, and dikaios sakkelariou. 2020. “neurodegeneration and the intersubjectivities of care.” medical anthropology 39 (1): 1-15, doi: 10.1080/01459740.2019.1570189. references forrester-jones, rachel. 2019. confronting a looming crisis: people with learning disabilities and/or autism and their carers getting older. (uk, bath) https://www.bath.ac.uk/publications/report-confronting-a-loomingcrisis/attachments/final_fulldocument.pdf. hoppe, silke. 2020. “the other within oneself: understanding care for a family member with early-onset dementia through the lens of dividuality.” ethos 48 (1): doi: 10.1111/etho.12278. “medisked and the arc.” 2018. disability data digest. published online. accessed february 17, 2021. http://www.inarf.org/uploads/2/5/1/7/25171275/august-2018-disability-data-digest-medisked.pdf. newnham, nicole, and jim lebrecht. 2020. crip camp: a disability revolution. higher ground productions. nolte, monique. 1998. trainman. nolte, monique. 2014. het beste voor kees. [what’s best for kees]. selfmade films. sartain, sophie. 2014. mimi and dona. independent television service (itvs) and corporation for public broadcasting (cpb). sartain, sophie. 2017. sophie and ben. independent lens. settersten, richard a. jr., ed. 2003. invitation to the life course: toward new understandings of later life. amityville, ny: baywood publishing company inc. strathern, marilyn. 1988. the gender of the gift: problems with women and problems with society in melanesia. berkeley: university of california press. warren, narelle, and dikaios sakkelariou. 2020. “neurodgeneration and the intersubjectivities of care.” medical anthropology 39 (1): 1-15, doi: 10.1080/01459740.2019.1570189. http://anthro-age.pitt.edu/ https://www.bath.ac.uk/publications/report-confronting-a-looming-crisis/attachments/final_fulldocument.pdf https://www.bath.ac.uk/publications/report-confronting-a-looming-crisis/attachments/final_fulldocument.pdf https://www.researchgate.net/deref/http%3a%2f%2fdx.doi.org%2f10.1111%2fetho.12278 http://www.inarf.org/uploads/2/5/1/7/25171275/august-2018-disability-data-digest-medisked.pdf https://doi.org/10.1080/01459740.2019.1570189 anthropology & aging quarterly 2010: 31 (3-4) 53 features aage 2010 guide to the meetings: navigating and networking at the 2010 american anthropological association (aaa) and gerontological society of america (gsa) meetings association for anthropology and gerontology (aage) table at aaa: aage members and authors of anthropology and aging related books will be hosting the table beginning thursday at 9a.m. at the booth, issues of aaq, tee-shirts, book displays, and a silent auction of new books for the climo student award will be featured. make a bid for a book (or books) in the silent auction. new books in this year’s silent auction include mary catherine bateson’s composing a further life: the age of active wisdom (knopf, 2010); janice graham and peter stephenson’s edited volume, contesting aging and loss (u. of toronto press, 2010); and satsuki kawano’s nature’s embrace: japan’s aging urbanites and new death rites (u. of hawai‘i press, 2010). interest group event: aaa aging and life course interest group meeting and interlocutor event, friday, 12:15-1:30 (salon 801), 8th floor, sheraton. reception and interlocutor discussion with noted gerontologist dr. anne basting, director of the center on age & community at the university of wisconsinmilwaukee. she will be interviewed by anthropologist jay sokolovsky regarding her new book forget memory: creating better lives for people with dementia (2009). this pathbreaking volume looks at the cultural forces at play in shaping the way we value and care for people with memory loss. aage dinner: friday, 7:30 p.m.. place to be determined and posted on the aage website (www. clubexpress.com/aage). sign up at the aage table in new orleans or e-mail jsoko@earthlink.net. we welcome all to join us. aage business meeting and networking event: saturday, 12:30am-1:30pm in melrose room at hilton new orleans riverside (2 poydras street). students, early career faculty, experienced scholars, practitioners, and others interested in exploring sub-disciplinary professional development opportunities and service opportunities are warmly welcomed. other participating aging and gerontology organizations aaa aging and the life course interest group: the consequences of global aging will influence virtually every topic studied by anthropologists, including the biological limits of the human life span, generational exchange and kinship, household and community formations, symbolic representations of the life course, and attitudes toward disability and death. a major goal of this interest group is to bring together anthropologists whose work addresses such issues both in and outside of academia. membership is free but you must be an aaa member. convener jay sokolovsky (jsoko@earthlink.net) the gerontological society of america (gsa): the meeting of this organization that supports aging research is overlapping in new orleans with the aaa, from nov 19-23 at the hilton new orleans riverside hotel (2 poydras street). the aage networking event on saturday afternoon is at the hilton. in addition, several aaa aging and the life course interest group and aage members are giving papers and posters at this meeting. gsa interest groups include qualitative research, rural aging, international aging and migration, aging in asia, and chinese gerontology. anthropology & aging quarterly 2010: 31 (3-4) 54 features anthropology and aging at the 2010 american anthropological association meeting note: titles in bold are aage key events or featured presentations. abstracts for featured presentations (in alphabetical order by first author’s last name) follow the listing of events. wednesday, november 17 • 12 p.m. alexandra crampton: the circulation of global aging through social intervention work • 12 p.m. xochitl ruiz food, kinship, and growing older in bogotãcolombia • 12:30 p.m. marty martinson critical perspectives on the promotion of older adult volunteerism • 2:15 p.m. jessica robbins moral and memorial narrative practices: aging and memory in a polish rehabilitation center • 3 p.m. michele gamburd migrant remittances: population ageing, and intergenerational family obligations in sri lanka • 3 p.m. elizabeth finnis environmental uncertainty, aging, and migration: examinations of agricultural decision-making in rural paraguay • 3:15 p.m. catrin lynch circulation perspectives on aging, work, and the graying of society • 4 5:45 p.m. session aging, bereavement, death and dying • 4 5:45 p.m. jason danely memorial as the circulation of desire: mourning, subjectivity and the life cycle in japan • 4:30 p.m. elana buch ordering the house of squalor: protecting personhood against pathologizing practice in us home care of older adults • 5 p.m. daniella santoro act your age: local conceptions of health and the aging body in new orleans secondlines • 5:15 p.m. deborah durham making parenthood in turkey: an inquiry into aging parents • 5:30 p.m. j dylan turner out of circulation? late-life exchanges of childless men • 8:30 p.m. matthew lauer from ye’kwana epistemology to an anthropology of growth and human reproduction in amazonia • 9:15 p.m. alexis matza circulating testosterone thursday, november 18 • 8 11:30 a.m. aaa invited double session andrea sankar and athena mclean, organizers circulating the life course: towards an anthropology of care and caregiving • 8 a.m. session, bjarke oxlund, organizer aging and dying • 11 a.m. maria cattell time’s labyrinth: unwinding the thread in western kenya. note: senior anthropologists’ invited session on long-term research (aging and the life course). this session on long-term research, “return to the natives,” was organized by alice kehoe. it will take place on thursday, november 18, 8:00 to 11:30 am. marjorie schweitzer, a past aage president, is listed as a presenter, but marge is busy with caregiving for her husband john and will not be able to go to new orleans. friday, november 19 • 9 a.m. patti meyer care for the careworkers: subject positions and healthanthropology & aging quarterly 2010: 31 (3-4) 55 features seeking strategies of immigrant careworkers laboring in the homes of elders in genoa • 12:15 1:30 p.m. aaa interest group, aging and the life course meeting and interlocutor session: salon 801, eighth floor, sheraton. 12:15-12:30 p.m. reception and presentation of the book authors donating books for the climo memorial student fund. 12:30 – 1:10 p.m. interlocutor discussion with noted gerontologist dr. anne basting on her new book, forget memory, hosted by jay sokolovsky with additional questions from the audience. • 4 5:45 p.m. isabelle joyal poster the retirement of senior executives women: turning points and creativity • 4:30 p.m. andrea nevedal i`m damaged goods: understanding how hiv circulates through the lives of older african americans with hiv • 7:30 p.m. aage dinner. sign up at the aage table. we welcome you to join us. saturday, november 20 • 8 9:45 a.m. poster, organized by peggy perkinson the napa-ot field school in antigua, guatemala: circulating theory and practice across disciplinary boundaraies of anthropology, occupational science/therapy, and disability studies • 10:15 a.m. – 12pm kimberly jones twenty years of universal public healthcare in brazil: a case study from the brazilian sertão • 1:45 to 3:30 p.m. afaa invited roundtable honoring nancy (penny) schwartz dreaming in color about black marys: women’s postmortem agency, transspecies anthropology, elephant drug, and other aspects of kenya luo culture and their broader implications • 3-5p.m. poster, vendelin tarmo simon sexuality among elderly people in tanzania; is it myth or taboo • 4:45 p.m. jeanne shea “i’m not willing to depend on my children”: resistance to later life familial dependence by older chinese women in beijing sunday, november 21 • 9:30 – 11a.m. invitation only brunch for the berghahn series on aging and the life course editorial board and authors. • 10:15 a.m. 12:00 p.m. session, lori jervis and wayne warry, organizers culture, health, aging and native north american communities o sylvia abonyi and marie favel. marie’s story of aging well: toward new perspectives on the experience of aging for aboriginal seniors in canada. o lori l. jervis and william sconzert-hall. abuse, neglect, and the meaning of respect for urban and rural native elders. o wayne warry and kristen jacklin. forgetting and forgotten: dementia in aboriginal seniors. o jessica e. pace. understanding the impacts of culture and cognitive health on contemporary aboriginal peoples’ experience with aging. o j. neil henderson, l. carson henderson, ryan blanton, and steven gomez. perspectives on brain autopsy, diabetic amputations, and end-of-life issues among elderly american indian people. anthropology & aging quarterly 2010: 31 (3-4) 56 features anthropology and aging at the 2010 gerontological society of america meeting friday, november 19 • pre-conference workshop on using film and digital media in aging research saturday november 20 • 12:30 a.m. -1:30 p.m. aage business meeting and networking event: melrose room at hilton new orleans riverside students, early career faculty, experienced scholars and practitioners in the field, and all others interested in exploring sub-disciplinary professional development are warmly welcomed. • 2:30 4:00 p.m. poster, lori l. jervis and william sconzert-hall conceptualizations of mistreatment among american indian elders • 2:30 – 4 p.m. poster, caitrin lynch working retirement: lessons about aging, productivity, purpose, and social engagement from a suburban boston factory • 8 9:30 p,m. short film festival on aging grand ballroom a, $10 sponsored by: the uwm center on age & community. for more information go to www.geron.org/2010 sunday, november 21 • 1:30 – 3 p.m. peggy perkinson, organizer symposium on aging in developing countries o sharon williams & gillian ice. cultural contexts, nutritional transitions: the anthropology of global overweight & obesity trends of older adults o margaret neal, keren wilson, alan de la torre. service-learning and older adults in nicaragua: designing a program that fits o stan ingman & iftekhar amin. developing gerontological educators in mexico: a partnership between usa and mexico o tara mcmullen & candace brown. gage: a non-profit organization bringing gerontological awareness to ethiopia. o discussants: ed rosenberg & margaret (peggy) perkinson monday, november 22 • 9:30 a.m. rebecca berman and madelyn iris innovative technologies for evaluating the development of a caregiver support partnership • 12 p.m. poster, robert w. schrauf and madelyn iris three methods of measuring crosscultural variation in minority groups’ beliefs about dementia • 4 5:30 p.m. poster, iveris martinez a community-based approach for integrating geriatrics and gerontology into medical education tuesday, november 23 • 11 a.m. 12:30 p.m. gillian ice, j. v. yogo, v. heh, and e. juma predictors of nutritional status in grandparent caregivers in kenya abstracts for featured presentations cattell, maria. time’s labyrinth: unwinding the thread in western kenya in the mid-1980s i went to rural western kenya to unwind the thread of samia culture and learn, specifically, about aging and social change in this luyia community. what i learned of social change was derived in part from written sources, but mainly from asking older samia (in interviews and a survey) about their life stories and the “old days” and comparing what they said with what my research revealed of the present. since then i have been “there and back again” a number of times and have learned about social change by observing and recording it for more than 25 years. in those years globalization has made enormous changes even in this remote rural area where nowadays many people have cellphones and use email. ethnography has become social history. i have also done research projects in philadelphia and south africa, but have not made the anthropology & aging quarterly 2010: 31 (3-4) 57 features return visits or maintained relationships in those places. in kenya personal relationships have deepened over time and i have an intimacy of knowledge not achieved elsewhere. over the years my own life experiences have expanded to include becoming a grandmother and a widow, which has given me new perspectives on these topics in my kenya research. doing research in time’s labyrinth, over a period of many years, means that returning to kenya means going home again, even though that home is always changing. it has been challenging, exciting and satisfying. cattell, maria. remembering nancy (penny) schwartz penny schwartz was a long-time member of aage and a faithful helper at the aage booth for a number of years. penny was a practitioner of “retail therapy” for her own down times (which were many, as she was an “academic butterfly” for 15 years before she settled at the college of southern nevada). she was also a born saleswoman. i still laugh when i remember the time penny made a sign for the aage t-shirts: “last day sale: only $10.” the joke was that $10 was the price every other day as well. penny was a remarkable scholar. her fieldwork among luo of kenya (obama’s group) resulted in a monumental dissertation on glossolalia (speaking in tongues) in an african instituted church. over the years she wrote papers about black madonnas, the power of older women, and other gender issues among luo. in recent years her scholarly interests expanded into the area of human-animal relations among luo and in the wider world. the association for africanist anthropology has organized an invited roundtable, dreaming in color about black marys, women’s postmortem agency, transspecies anthropology, elephant dung and other aspects of kenya luo culture and their broader implications in honor of penny schwartz, who died april 24, 2009. penny schwartz received her phd from princeton university in 1989 after writing a magisterial study of the glossolalia practices in legio maria, an african independent church founded by luo of kenya. during her peripatetic teaching career penny schwartz dazzled and inspired colleagues and students in many parts of the u.s. with her shrewd wit and unbridled enthusiasm for anthropology and africa. equally dazzling was a series of papers in which penny, with an appreciation of metaphors and metacommunication and the expressive politics of gender and the marginalized, took princeton-style symbolic anthropology out to the very edges of its human ethnographic possibilities—and then stepped over into other domains of human and animal interaction. she wrote of “magical and mundane powers of african birds,” dealt with african snakes as “charismatic and non-phallic megafauna,” and found “something fishy in lake victoria” in regard to water abuse and political ecology. her papers tickled funny bones and poked holes in what she felt were anthropology’s “anthropocentric” and “logocentric” pretensions. in one paper penny documented ways that kenya luo and luyia women have both preand post-mortem agency. this celebration of her life will confirm that penny also remains “active dead or alive.” perkinson, margaret a. (saint louis u.) with yatczak, j. (e. michigan), kasnitz, d. (society for disability studies), rodriguez, m (wayne state u.), and furgang, n. (u. of new mexico). the napa-ot field school in antigua, guatemala: circulating theory and practice across disciplinary boundaries of anthropology, occupational science/therapy, and disability studies with backing from napa and aaa, colleagues in medical anthropology, disability studies, and occupational science/occupational therapy developed a six-week interdisciplinary field school to enable faculty and students to refine the interplay of disciplines in collaborative research and occupational therapy practice. theories of social and occupational justice within a life course perspective direct and integrate the four components of the field school: pediatrics, disability studies, community-based gerontology, and medical anthropology. with a critical perspective on globalization and development and focus on social and occupational justice, the field school develops leadership for social transformation among its students and faculty. based in antigua, guatemala, our principal ngo partner is common hope, a non-profit working in guatemala for 25 years (www.commonhope.org). common hope employs a community development approach and has partnered with over 8,000 guatemalan children and adults in low-income rural and urban anthropology & aging quarterly 2010: 31 (3-4) 58 features areas to improve education, housing, and health care. our faculty includes guatemalan anthropologists rolando duarte and teresa coello, centro cultural el romero (panajachel, solola), and we collaborate with various guatemalan professionals in health and community development. our students develop skills in research, practice, spanish language communication, and interdisciplinary collaboration in clinical and community field sites that include residential care facilities for older adults, a residential hospital for lowincome guatemalans, an independent living center, an ngo/community development organization for rural mayan families, a guatemalan sign language school, and community-based home visits with local social workers. the poster includes the field school curriculum and brief summaries of faculty and student research and practice. ingman, stan and amin, iftekhar. developing gerontological educators in mexico: a partnership between usa and mexico as low income societies experience rapid aging of their populations, they face major challenges in developing educational policies to prepare their workforce for the future. with over 50 % of the population in poverty in mexico – mostly in rural areas – policy makers and gerontological researchers are joining forces to respond to the “senior crisis” as poverty crisis. in response to global aging across the world, we have a responsibility to assist our colleagues in younger societies to prepare for the aging of their populations. university of north texas faculty and graduate students have joined forces with colleagues in the guadalajara area to expand the number of the applied gerontologist in mexico. this paper reviews the strategies we employed to reach this goal and discuss which ones were successful, e.g. informal certificates, gerontology conferences, and seminars for seniors and health care professionals in the state of jalisco. jervis, lori l., and sconzert-hall, william. conceptualizations of mistreatment among american indian elders the problem of how to conceptualize elder mistreatment goes back several decades. issues of conceptualization are especially important for ethnic minority populations, who may have perspectives that differ from the dominant society. this mixed methods cbpr study, which examined perceptions of mistreatment among 100 urban and rural older american indians, permits a rare glimpse into how native elders themselves understand this issue. here, good treatment emerged as a complex mixture of behavioral factors (being taken care of, having one’s needs met, spending time with family members, and being included in things) and attitudinal factors (being respected and being loved). poor treatment, conversely, was defined as financial exploitation, neglect, psychological abuse, physical abuse, as well as lack of respect. many of the elders who stated, in response to open-ended questions, that they had been mistreated did not endorse abuse items on the structured survey. some of these elders sincerely felt that they were not treated well by family and were quite unhappy about it, but their perceived mistreatment did not come close to the level of a reportable offense. the complaints of these elders often revolved around feeling taken advantage of in a variety of ways (e.g., being unappreciated, financially exploited, babysitting excessively, not getting the help they needed). these findings point to the importance of understanding the underlying constructs that elders have in mind when they describe optimal and suboptimal treatment, and suggest that behavior that is highly distressing to elders may be outside the purview of elder protective services. mcmullen, tara l. and brown, candace. gage: a non-profit organization bringing gerontological awareness to ethiopia ethiopia is the second most populous nation in africa; however, it is one of the least developed counties in the world. recent strategic governmental policies, used to increase life expectancy, lack balance between population growth, resources, the economy, and the age structure. the culture of caregiving is transitioning from familial to social. further, services rendered by current non-governmental organizations are neither well known throughout ethiopia nor available to aging individuals in many areas. to aid with these challenges, gage, a gerontologically focused international organization is assisting with the development anthropology & aging quarterly 2010: 31 (3-4) 59 features and implementation of a community senior center supported within a functional gerontology certification program at addis ababa university. the presence of this organization may bring a greater quality of care and increase life expectancy through educating future gerontologists and the community about the effects of aging. this paper will describe current research and developmental challenges experienced while completing this international project. neal margaret b., wilson, keren and delatorre, alan. service-learning and older adults in nicaragua: designing a program that fits portland state university (psu) recently received a major gift to establish an initiative, “aging matters, locally and globally,” aimed at enhancing the lives of older adults without adequate resources. the gift expands on psu’s partnership with the jessie f. richardson foundation (jfr) in an interdisciplinary service learning course on global aging and health focusing on nicaragua. since 2004, jfr, psu faculty, 100+ students, and nicaraguan government and community stakeholders have worked together to create sustainable solutions to support a growing nicaraguan elder population. this presentation describes the program’s rationale, components, and modifications over time. challenges (e.g., student recruitment; program cost, course content and requirements when students have widely varying backgrounds and interests; coordination of multidisciplinary faculty; in-country resources, logistics and politics) are discussed and potential solutions are offered. strengths (e.g., the partnerships established with local and national organizations) and lessons learned for helping to assure program success are shared. perkinson, margaret a. 2010 gsa symposium: aging in developing countries world populations are undergoing unprecedented changes in age structure due to lower birth rates and death rates associated with the “demographic transition.” the united states and other developed nations have had over a century to deal with issues that accompany aging populations. in contrast, many developing countries are projected to have much less time to address health and social needs of growing numbers of aged. countries still in early stages of this transition have a window of opportunity to lay the groundwork now to ensure that limited resources are used effectively and efficiently to support their older members. what are the roles and responsibilities of gerontologists from developed countries in helping to address the unprecedented demands and opportunities that accompany aging populations in less developed lands? what can we learn from developing countries that might inform our own system of services? this symposium examines aging issues in developing countries and offers strategies and guidelines for partnering with local practitioners and scholars to address those issues without imposing culturally inappropriate models of care. a demographic analysis of population aging in developing societies is followed by an anthropological analysis of the “nutrition transition” and aging in kenya and india. social gerontologists addressing health and social issues through interdisciplinary service-learning-based programs in nicaragua, mexico, guatemala, and ethiopia describe and evaluate their individual models of partnership with local educators, researchers, and practitioners, sharing strengths of each program, issues of sustainability, and lessons learned. an expert in global aging offers a summation and concluding remarks. after attending this session participants will be able to describe and assess the projected impact of the “demographic transition” and the “nutrition transition” on older adults in developing countries; describe a variety of service-learningbased programs that focus on health and social issues of older adults in developing countries; and describe and evaluate different models of partnership between u.s. gerontologists and educators, researchers, and practitioners in developing countries. schrauf, robert w. and iris, madelyn iris three methods of measuring cross-cultural variation in minority groups’ beliefs about dementia in cross-cultural gerontology and in multiethnic studies of aging, researchers make comparisons on some variable of interest (e.g. beliefs about aging, symptom sets for particular illnesses, dietary practices, and so on) with the aim of characterizing how much is shared between-groups and how much is unique to each anthropology & aging quarterly 2010: 31 (3-4) 60 features group. for example, groups may wholly overlap or share some core set of beliefs while differing significantly on others. documenting and measuring this variation is a first step in rigorous cross-cultural research. this poster presents compares three methods of measuring between-group and within-group agreement (weller & baer, 2002). these are: free-marginal kappa, average withinand between-group agreement, and spearman’s method. these measures are applied to beliefs about alzheimer’s disease among three minority groups in the u.s.: african americans, mexican americans, and refugees/immigrants from the former soviet union (fsu). (1) kappa coefficients function like correlation coefficients. in these data, the pairwise agreement on statements about alzheimer’s disease was: african-americans & mexican americans (.521), african americans & fsu (.581), mexican-americans and fsu (.685). (2) a more complex calculation involves finding the average proportion of within-group agreement across all three groups (.484) and the average between-group (shared) shared agreement (.478). (3) finally, spearman’s method estimates the shared knowledge across groups at .48 as well. each method accents different values. kappa correlations emphasize shared beliefs across pairs of groups, while the ‘average’ and spearman’s methods emphasize the overlap across groups. the presentation demonstrates the comparison of critical shared and unique beliefs about the etiology of ad. warry, wayne and jervis, lori. culture, health and aging in native north american communities despite the often-stated value of elders as cultural resources and spiritual leaders, little is known about the actual contemporary social and health statuses of native north american elders. the anthropological and health science literature on older native people is sparse; by some accounts less than two percent of such studies focus on the elder population. this is true despite the fact that in the united states and canada the percentage of older native peoples is projected to double in the next decade. this session brings together anthropologists from canada and the united states who are engaged in research with native/aboriginal elders in order to examine how anthropological approaches may further our understanding of this small but growing component of the native population-one which has traditionally been influential beyond their numbers with respect to their roles as culture bearers and socializers of future generations. this session explores and problematizes issues of theory, policy and practice in culture, health and aging in native cultures. our intent is to examine the boundaries between various forms of knowledge- indigenous and western, medical and cultural-so as to examine the cross currents between behaviour and perception in health and aging. we are interested in research that might lead to better health promotion, improvements in access to health services, and to better systems of community care. we seek to understand the flow of ideas between anthropology and other disciplines (social work, psychology, gerontology and the health sciences) that might lead to improved health outcomes for older native north americans. our research concerns local cultural understandings of healthy aging, how older native people envision the transition to later life, and the challenges that elders face within their communities. as we move to broadening our understanding of these dynamics, our starting point is how elders conceive of and experience various facets of the experience of aging. zimmer, zachary a. demographic analysis of population aging in developing societies this presentation is intended to provide a demographic background for the symposium. population aging will be amongst the most important demographic phenomenon of the current century. it will impact upon every region of the world and almost all countries. however, the pace of aging will vary, as will its causes and consequences, which suggest that related challenges faced are bound to diverge across the developing world. this presentation will discuss current and expected future trends in population aging in the developing world with attention paid to similarities and differences across regions and countries, and specific focus on those highlighted in other papers that are part of the current symposium. the presentation will also make reference to variations in challenges that different countries and regions are likely to face and the types of data and research that will be necessary to confront these challenges. book review review of wendy hulko, danielle wilson, and jean e. balestrery, eds. indigenous peoples and dementia: new understandings of memory loss and memory care. vancouver: university of british columbia press. 2019. pp. 256. price: $89,95 (hardcover); $32.95 (paperback and ebook). britteny m. howell university of alaska anchorage bmhowell2@alaska.edu anthropology & aging, vol 42, no 2 (2021), pp. 166-168 issn 2374-2267 (online) doi 10.5195/aa.2021.365 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review | howell | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.365 http://anthro-age.pitt.edu 166 book review review of wendy hulko, danielle wilson, and jean e. balestrery, eds. indigenous peoples and dementia: new understandings of memory loss and memory care. vancouver: university of british columbia press. 2019. pp. 256. price: $89,95 (hardcover); $32.95 (paperback and ebook). britteny m. howell university of alaska anchorage bmhowell2@alaska.edu with indigenous peoples and dementia: new understandings of memory loss and memory care (2019), editors wendy hulko, danielle wilson, and jean e. balestrery aim to provide the first significant synthesis of the nascent scholarship on indigenous understandings of dementia and memory loss. the book not only includes contributions by indigenous researchers but also stories (19-22) and conversations between researchers and elders (146-177). for example, in the segment titled “a fecund frontier,” an alaskan inupiaq elder and a social worker dialog about their years-long collaboration, including the frustrations that accompany co-presenting at conferences and their struggles to communicate across a cultural divide. in the end, the social worker asks, “do you think what we are doing is going to help at all?” to which the elder replies, “oh yes, it will. if it helps even just one person, it has all been worth it” (175). the dialogic nature of the piece and the hope for possible futures is but one of the decolonizing efforts of this volume. chapter 6, for example, is a highly reflective essay on memory loss among the māori, written by mere kēpa. this indigenous author takes meaningful steps toward decolonizing dementia scholarship by skillfully blending the epistemic value of a traditional prayer with current research literature and her personal experiences of her father getting dementia while she was pursuing her doctoral degree. kēpa’s piece includes use of several māori words and a glossary at the end, but is also a decolonial endeavor in less regionor nation-specific ways: the personal stories and conversations that are not often a major component in the broader dementia literature are here included and lend credibility to this book toward the stated goal of decolonizing academic writing and research. the volume consists of three sections, each encompassing three chapters. the first section covers the prevalence, causes, and discourse around memory loss and memory care among indigenous peoples. the second section details more specific indigenous perspectives on care and dementia prevention. the third and final section addresses ways to apply current theory and knowledge to the practice of dementia care. focusing mostly on canadian first nations peoples, with a chapter each on the us and new zealand, this work does not include research with indigenous peoples of australia, central or south america, or other world regions. instead, the editors privilege the perspectives of first nations peoples with whom they have the most experience collaborating to guide this book. for example, the editors state that their participatory research with secwepemc people revealed the important use of storytelling to teach many aspects of life and culture to the younger generation. their work, however, revealed that the secwepmc http://anthro-age.pitt.edu/ book review | howell | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.365 http://anthro-age.pitt.edu 167 have no stories on memory loss, so the team worked with local peoples to create a culturally-grounded story centered around memory sharing and loss of the coyote (80-83). other dementia practitioners have done similar work to situate memory loss in specific locations and storytelling traditions, such as the river story among the ojibwe (dementia friends wisconsin 2018). these examples illustrate how conducting research about, and working to support the consequences of, memory loss requires a clear understanding of how memory work is done by and for different peoples. indigenous peoples and dementia presents the importance of indigenous research methods and knowledge translation back to communities in decolonizing dementia research and care. for example, the editors emphasize in the introduction the role of relationship-centered care among indigenous populations rather than the eurocentric “patient-centered” model of care for elders (7). however, despite repeated calls for decolonizing methodologies in the text, there were a few places where the editors could have strengthened this point. for example, in chapter 2, j. neil henderson, linda carson, and kama king provide an example of how persons classified as having 100% indigenous genes may have a smaller “genetic load” partially due to the practice of native peoples raiding anglo families and stealing their children (50). this passage left me wondering if there wasn’t a better example that could have been provided for such “admixture.” the same authors also provide a syndemic dementia model for american indians and alaska natives that was a bit confusing (54), since it was primarily based on the realities of “reservation life” (55), which may not fully apply to alaska native peoples who do not hold reservations (ancsa regional association 2020). their syndemic dementia model suggests an interplay between several constructs, but due to the directionality of the arrows depicted in the model on page 54, it appears to lack an understanding of the complex interrelationship between depression and diabetes, smoking, blood pressure, and cardiovascular disease. however, chapter 7, written by these same three authors, presents a biocultural model of depression, diabetes, and dementia that better explicates these relationships. chapter 3, written by suzanne macleod, provides an analysis of how indigeneity and dementia are often portrayed in the media, taking the example of canadian elder, joe. this reflexive poststructural piece truly attempts to decolonize the discourse around dementia by elucidating the ways in which joe, who had advanced alzheimer’s disease, is portrayed as a violent criminal. news coverage stripped joe of his personhood as journalists focused on joe’s indigeneity and aggression as his defining characteristics, whereas other (white) individuals in these stories were often depicted with fuller, richer lives with mention of their military service or work ethic (67-68). for example, joe is repeatedly referred to as an “aggressive alzheimer’s sufferer” while mention of his past career as a canadian national railway worker is given short shrift. this contrasts with how frank (a white man) is depicted in these articles; his career and military service is mentioned nearly twice as often across the 24 newspaper articles analyzed by macleod. this chapter concludes with ways researchers and practitioners can utilize indigenous perspectives to provide culturally-appropriate solutions for senior care. chapters 8 and 9 present specific examples of collaborating with canadian first nations experts to create or improve educational storytelling materials for dementia care. although barbara purves and wendy hulko’s chapter 8 presents a project with a very narrow scope and analysis of only four participants, this work demonstrates how indigenous peoples may conceptualize the loss of their culture and traditional stories as being related to individual memory loss, a thread that runs throughout several chapters and is discussed in depth in the book’s conclusion. there are a few places of redundancy in this edited volume, especially around projected dementia prevalence and the “modifiable” risk factors for indigenous people like hypertension, obesity, and diabetes. these same risk factors are covered in several chapters (ch 1, 2, 4, and 5) but this repetition http://anthro-age.pitt.edu/ book review | howell | anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.365 http://anthro-age.pitt.edu 168 could have been reduced by inserting references to other chapters within the book. additionally, the authors and editors note in several different chapters that indigenous populations simultaneously view memory loss and age-related confusion as a normal part of the aging process while holding negative stigma surrounding dementia diagnosis. although it is unclear if this is true across all indigenous populations (especially ones not covered in this book), such redundancies in the text could have been reduced with citations. despite this, the book makes clear the tension between emic understandings of memory and aging and those commonly held in the medical community. biomedical understandings of aging suggest that cognitive decline, confusion, and significant memory loss are signifiers of abnormal aging that can be partially modified given timely intervention. given that indigenous populations may not agree with this assessment, it is unclear from this text if the dementia practitioner can (or should) attempt to change such culturally-grounded perceptions of aging and memory loss. instead, the book focuses on how to incorporate indigenous perspectives of acceptance into eldercare and applying dementia research to indigenous populations in culturally-safe ways. this may leave the reader wondering if (and how) they should attempt to dispel the idea that memory loss and confusion are a normal part of aging that need not be diagnosed or addressed among indigenous populations. chapters 4 (written by pace, jacklin, warry, and pitawanakwat) and 5 (written by bourassa, blind, jacklin, oleson, and ross-hopley) do clearly demonstrate this conundrum, as caregivers share their stories in which lack of information and denial of dementia led to increasingly problematic symptoms and caregiver burden with little to no support that strained family relationships. nonetheless, this work is a comprehensive synthesis of the burgeoning scholarship of first nations perspectives of dementia. with small contributions from new zealand and the us, this book will have value for scholars working in canada and the northern us. the scope of the book is best suited for researchers and graduate students because the book’s focus on the complicated social determinants of health may be too abstract for the typical undergraduate student. additionally, the authors and editors touch upon a wide variety of viewpoints, often without giving many specifics, which may be difficult for the practitioner to synthesize and act upon. for example, the editors state in the conclusion that trauma-informed policy, practice, and research changes need to occur, leaving people working in the field wondering how to realize such changes. this is likely also due to the nature of the book’s topic; indigenous dementia spans many different cultural groups across several nations with very different policy-making structures and different ways of remembering. overall, this book is an informative read that calls for increasing research into the perspectives of indigenous peoples and memory loss. references ancsa regional association. 2020. about the alaska native claims settlement act. retrieved on june 30, 2021 from https://ancsaregional.com/about-ancsa/. dementia friends wisconsin. 2018. development of the river: a story of dementia. retrieved on july 2, 2021 from https://wai.wisc.edu/wp-content/uploads/sites/1129/2020/05/dfwi-the-river-context-nativeamerican.pdf. http://anthro-age.pitt.edu/ https://ancsaregional.com/about-ancsa/ https://wai.wisc.edu/wp-content/uploads/sites/1129/2020/05/dfwi-the-river-context-native-american.pdf https://wai.wisc.edu/wp-content/uploads/sites/1129/2020/05/dfwi-the-river-context-native-american.pdf anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp.70-72 issn 2374-2267 (online) doi 10.5195/aa.2014.39 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review stafford, phillip, b. ed. gray areas: ethnographic encounters with nursing home culture. santa fe, nm: school of american research press, 2002. isbn 1-930618-30-1, 317 pp. price $29.95 (paper) jennifer a. wagner, mph, lnha gerontology program, bowling green state university http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.39 http://anthro-age.pitt.edu book review stafford, phillip, b. ed. gray areas: ethnographic encounters with nursing home culture. santa fe, nm: school of american research press, 2002. isbn 1-930618-30-1, 317 pp. price $29.95 (paper) jennifer a. wagner, mph, lnha as i began reading this text, i had mixed feelings. at first i was shocked at the culture presented in the chapters on acute care in nursing homes and thought to myself that books such as this are why negative stereotypes of nursing homes continue to exist. perhaps that was the defensive administrator in me. i began working in long-term care in the early 1980’s. i found the perceptions about acute care in nursing homes by doctors and other professionals all too reminiscent of how we used to think and work. i like to believe that progress has been made and will continue to do so. after much thought and reflection on my work experiences as an educator who works with interns and as a volunteer ombudsman, i find that unfortunately some of those negative attitudes by professionals still exist, although not nearly to the same extent as in 2002. as i dove deeper into the book and began to really “hear” the words of the residents, families, and staff being interviewed by the ethnographers, i realized that while staff perceptions have improved, family and resident perceptions have not had the same level of improvement. i found several of the sections to be a valuable resource on how our residents and family members define home and community. despite the great strides in the person-centered care movement, i still think we have much work to do in providing a “home-like” atmosphere as i still hear some of the same concerns in 2014 from residents and their families. this research illustrates how as professionals, our definition of home is very different from those we serve and those discussed in the text. we have beautiful new facilities compared to the harsh, institutional settings of the past, but we have yet to replicate the feeling of “home”. i would enjoy reading a new edition of this text that evaluates whether the nursing home culture has changed since 2002. i appreciated the case about mrs. dorsey described in chapter seven. mrs. dorsey’s room had been newly wallpapered and her pictures had been moved from their original locations. the administration had asked that pictures not be hung on the new wallpaper. mrs. dorsey was very upset about the changes in her room and blamed her daughter. while the facility was looking at improving the physical environment they forgot to take into account the individual needs of the resident. perhaps less dramatic room changes or more input from the resident would have prevented such upset. this story is a great example for later chapters in the text where the researchers attempt to define and differentiate between the roles of family and staff. as in this example, those boundaries can be blurred. our resident’s often cannot tell if decisions that impact their lives and care are made by their families or the staff. they just know and feel that they are no longer in control. these stories from both the professional and family caregivers as well as the residents show the need to find a balance and give more control back to the resident. gray areas is an excellent compilation of research from the perspectives of a variety of helping professionals. this book is a great resource for all who work or live in the long-term care environment as well as policy makers and family members. this book is an excellent qualitative piece that humanizes the people who live in long-term care settings and reminds us that they are wagner | book review anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.39 http://anthro-age.pitt.edu 72 human beings not a diagnosis. this text highlights the continuing need to provide a geriatric rich curriculum to all of the helping professions. this text serves as an important reminder of where we used to be in long-term care and shows us how far we still have to go. with the increased population of older adults, let us hope that history does not repeat itself while the influx of residents needing our care increases and the available numbers of health care professionals decreases. book review book review “cinderella men”: husbandand son caregivers for elders with dementia in shanghai yan zhang harvard medical school, harvard university yan_zhang@hms.harvard.edu abstract traditionally, women had the day-to-day responsibility for eldercare. however, social changes have created alternatives for men to take on what is generally considered a “female duty.” particularly, as the prevalence of dementia has increased in china, men are increasingly becoming the primary caregivers for their kin. yet, we have limited understanding of male caregiving. based on a twentymonth ethnographic study of 60 men taking care of a relative with dementia, this paper examines motivations, practices, struggles and strategies of male caregivers. while acknowledging the gendered nature of caregiving, i argue that eldercare goes beyond solely social construction of gender roles and power asymmetries between males and females. men—both husbands and sons— who engage in caregiving are motivated by love, affection, moral obligation, reciprocity based on past assistance, and property inheritance. male caregivers’ care practices and their responses toward challenges vary from case to case, yet these differences have less association with gender identity but more with cohort variations. the expanding home roles of male caregivers call attention to the social transformation of gendered care practices in china and beyond. keywords: gender roles; men; caregiving; dementia; china anthropology & aging, vol 42, no 2 (2021), pp. 6-20 issn 2374-2267 (online) doi 10.5195/aa.2021.356 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. margaret clark award (2020) winner | zhang | 6 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu “cinderella men”: husbandand son caregivers for elders with dementia in shanghai yan zhang harvard medical school, harvard university yan_zhang@hms.harvard.edu introduction social scientists have documented major changes in gender roles and relationships in china since the mao era. changes in institutions and cultures have played a significant role in facilitating gender equality for education and employment. during the maoist period, the ideology of gender equality was prioritized by the state and women were equally appointed to job positions in both rural and urban china (jin 2006; li 2000; tsai 1996). currently, additional policies are being issued to ensure women’s education and labor rights, which are significantly improving women’s social status (tao et al. 2004; xie 2013). within domestic settings, compared to the traditional patriarchal family structure, some sociological studies argue that women have gained more decision-making power regarding their marriage, birth-control, property inheritance, and labor division (davis 2010; shi 2017; zhang and fussell 2017). however, another school of sociologists agree with hochschild and machung’s (1989) portrayal of employed women as suffering from a double burden: women are simultaneously involved in socioeconomic activities and household labor (such as childcare and eldercare). only studying women ignores the complex interrelationships that form the gender system of a society. increasingly, scholars are recognizing the changes in men’s lives that are concomitant with changes in women’s lives (zhang and fussell 2017). as one of the first five cities to open to foreign trade over 150 years ago, shanghai is the most westernized city in mainland china. women there arguably have the highest status in china in terms of gender equality, at least in the private sphere. it is the norm for women to manage the family finances in shanghai (da 2004; long 1999; xu and yeung 2013). men that engage in domestic care practices such as taking care of ill family members are frequently reported by newspapers and popular magazines (bells 2011; chen 2012; china daily 2006). the media refers to this group of men as nuannan or “cinderella men.” in addition to the percentage increase of employed women, spousal and son caregivers constituted 27.3% and 22.8% respectively of caregivers for the elders in shanghai (yin and zhou 2014). as developed countries have experienced, socioeconomic and demographic trends have led to increasing numbers of men taking on what is generally considered “women’s work” (harris and long 1999; long and harris 2000; miller and kaufman 1996). yet, this strategic gender performance has been overlooked in previous studies of gender structures in china. this paper contributes to our understanding of the changes in the gender system in china by examining male caregivers’ motivations, practices, struggles and strategies during dementia caregiving. i argue that eldercare goes beyond solely social construction of gender roles and power asymmetries between males and females. men—both husbands and sons—who engage in caregiving are motivated by love, affection, moral obligation, reciprocity based on past assistance, and property inheritance. male caregivers’ care practices and their responses toward challenges vary from case to case, yet these differences have less association with gender identity but more with cohort variations. http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 7 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu caregiving as a gendered experience caregiving is structured along gender roles and the process of socialization produces both prescribed and proscribed behaviors. for example, women engaged in care tasks are performing within gender expectations whereas men are supposed to be career oriented. such “appropriate” and “inappropriate” behavioral differentiation may encourage women to adhere nurturing activity and prevent men from engaging in care tasks (montgomery 1992). this gendered approach to family caregiving for elders with dementia has demonstrated statistical differences between males and females. according to the bureau of labor statistics in the us (2019), 58% of unpaid labor were women in 2018. similar results can be found in developing countries. according to the world alzheimer’s report (adi 2009), most patients with dementia are cared for at home with women composing 70-80% of the primary caregivers. these statistics reinforce the notion that gender roles powerfully influence care arrangements globally. while men are becoming involved in caregiving processes, appropriate gender roles further divide care tasks. most personal and hands-on care is provided by women, whereas men are more likely to engage in tasks that require physical labor —such as home repair and maintenance, intermittent assistance, or care arrangement (gerstel and gallagher 2001; russell 2007; sharma et al. 2016). moreover, the social construction of gender roles is further complicated by cultural factors; in japan, even though demographic changes have caused men to participate in caregiving, women are still considered “professional housewives” (vogel 1978) and the main caregivers for seniors (long and harris 2000; traphagan 2003). this gendered division of labor has led to different experiences of caregiving. for instance, in terms of caregiving burden and workload, some research findings suggest man caregivers tend to have less burden and depression than woman caregivers (friedemann and buckwalter 2014; yee and schulz 2000). this is probably due to the assumption that caregiving is a female duty. swinkels and colleagues (2019) also found that secondary stressors related to caregiving (such as relational/financial issues and problems combining different tasks) can lead to wife caregivers experiencing greater challenges than husband caregivers. consequently, female caregivers tend to report lower levels of physical health and more psychiatric morbidity than male caregivers (yee and schulz 2000). in terms of coping strategies, some studies show that men are more likely to be isolated and not utilize social services and support (black et al. 2008; neufeld and kushner 2009; russell 2001). while acknowledging that the social construction approach helps us understand the gendered care practice, power asymmetry between genders and its relationship to caregiving are better illustrated by the feminist approach. feminist scholars argue that care should be viewed as a political concept because the unrecognized work of women in caring for the sick and disabled at home contains public costs (engster 2015; robinson 2011; tronto 1993). these scholars advocate the link of gender and politics by offering a framework for understanding power relations between genders. for example, calasanti (1999) defines gender relations as “socially constructed power relations between women and men, which become institutionalized in various social arenas” (45). these power relations privilege men by disadvantaging women and intertwine with class, ethnicity, race, and nationality. these power asymmetries within family and societies have affected the assignment of care tasks and will reinforce inequalities between genders. indeed, feminisms’ advocates have contributed to the change in the care landscape since the early 1990s, with more men now participating in caregiving. yet, we do not know how men are practically engaged in caregiving and interpret their new home roles. thus, an examination of male caregiving and the http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 8 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu surrounding social context is urgently needed. in societies with rapid social changes, the agenda that women are naturally caregivers for their husbands or parents will not be sustainable owing to the demographic shifts, changing gender roles, and eroding traditional family values in developing countries (jesmin et al. 2011). for example, in china, challenges of family-based eldercare may be exacerbated by the one-child policy, rapid modernization, and eroding family values, resulting in fewer adult children available for providing such care. men, especially husbands, will become an important source of caregiving. yet, we do not know what motivate men to take on caregiving and whether gender identity affects their care practices. if so, are there any individual and cohort variations within the group of male caregivers, e.g., between husbandand soncaregivers in the extent of hands-on care, attitudes toward caregiving, and relations with other family members? therefore, the examination of men’s caregiving experiences will shed light on the dynamics of cultural values, family structure, and social change in china and beyond. methods this paper is part of a larger research project focusing on family caregiving for elders with dementia in shanghai. as the largest city in china, shanghai had more than 14 million residential citizens, of which 34.4% were older adults aged 60 and above in 2018 (srca 2019). family-based eldercare is the primary source for elders who are chronically ill and need long-term support. i conducted in-depth interviews with 144 family caregivers, of which 60 were males, in shanghai from 2014 to 2017. the narratives and experiences exemplified below were primarily collected in 2017. these male caregivers include 20 sons and 40 husbands. ranging from age 28 to 90 years, the majority were in their 60s and 70s. the age cohorts can be found in table 1. among the 20 son caregivers, 16 were caregiving for their mothers and 4 for their fathers. among the 60 research subjects, 16 (6 sons and 10 husbands) were randomly chosen from a community-based dementia care program. they were residents and lived in w community where i did my fieldwork. the remaining 44 male caregivers (14 sons and 30 husbands) were randomly chosen from the list of regular visitors in a memory clinic near w community. due to the comprehensive pension and healthcare insurance systems in shanghai, there were no distinct differences in terms of economic circumstances between caregivers from the community and those from the memory clinic. most family caregivers were born in or before the 1960s. the education levels of family caregivers were generally flat as a result of the cultural revolution and other social movements during the mao era; therefore, education cannot be a reliable factor to distinguish one subject from the other. since most family caregivers have retired, i’m examining their monthly pension or income as a primary indicator of economic circumstances. based on the monthly pension or income, majority of these male caregivers were middle class (n=57) and the remaining relatively poor (n=3). the exact pension varies from case to case due to the years of work history and types of employment. the highest pension reported from one husband caregiver and his wife was approximately 15,000-20,000 rmb [$2,100-2,800 usd] because they participated in the civil war and contributed to the liberation of the country. majority of family caregivers and care recipients had their monthly pension ranging from 3000 to 7000 rmb [$420-980 usd]. while most caregivers had retired, there were 6 son caregivers and 1 husband caregiver at the working age (below 55): 4 had work duties, 1 (age 53) requested an early retirement, 1 (age 52) was temporarily unemployed, and 1 (age 52) completely relied upon unemployment subsidies from the government. among the 60 care recipients, 2 had no pension due to their advanced age and lack of formal work experience. these two care recipients relied on government subsidies valuing 790 rmb [$110.6 usd] per month in 2017. http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 9 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu table 1 characteristics of male caregivers (n=60) characteristics sons (n=20) husbands (n=40) age =<50 51-55 56-60 61-65 66-70 71-75 76-80 81-85 86-90 2 4 6 5 2 0 1 0 0 0 1 0 2 7 9 8 9 4 median age 60 76 care arrangement solo caregiving with home-aide support with siblings’ support with adult-child support 17 3 0 28 3 9 potential female family supporters with the only child with at least one sister with at least one daughter 0 17 12 29 care arrangements are affected by both economic circumstances and the availability of female family supporters. while most son caregivers had sisters, they ended up with solo caregiving for various reasons (as i discuss below). the stories of husband caregivers seemed to be affected by the one-child policy since 12 husband caregivers had only one child. the previous mutual support between generations seemed to continue to decline since only 9 husband caregivers received some support from their adult children. when husband caregivers had daughters, they seemed to withdraw from the traditional caregiving responsibility. the availability of pensions could enable male caregivers to shop on the market for social services, yet only 3 sons and 3 husbands hired home aides for help. most care tasks were still these male caregivers’ responsibility. indeed, these statistics can give us a basic glance of male caregiving in terms of who, how many, or how often interviewees touched on a given issue. however, this study does not aim to quantify their stories. instead, my goal is to understand the social context of male caregiving and the differences between husbandand soncaregivers in terms of their experiences and to conceptualize, theorize, and explain their motivations, practices, struggles and strategies. for interview transcripts quoted here, i provide only the english translations. to preserve confidentiality, i did not give full names for my informants. motivations the rationales associated with care arrangement in domestic settings are related to the question, “who does the care work and why?” husband caregivers often attribute to spousal intimacy and the unavailability of adult-child care, whereas son caregivers claim their moral obligation and anticipated http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 10 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu inheritance of their parents’ property. these different rationales have less to do with gendered ideals than social changes that place this responsibility on males. husband caregivers intimacy-based care was frequently mentioned by husband caregivers when i asked them about their motivations. in traditional chinese culture, spousal intimacy was viewed as a taboo that should not be shown or mentioned in public. in a country going through rapid transformation, notions of spousal intimacy have begun to take on new meanings. most husbands in their senior years openly express their love toward their wives who are chronically ill. when i visited a 90-year-old couple in their home, mr. liu (#w02) pointed to a picture in which he and his wife held hands and said, “what does it mean? baitou xielao [holding hands till the end of our lives]!” unlike some caregivers who often lamented how the onset of dementia had changed their marital relationship, mr. liu expressed gratitude to his wife during their life-long love relationship and considered caregiving was one way that he could pay her back for past assistance. according to liu, they had never quarreled with each other throughout their life. no matter how hard life was, they were able to find love from each other. even though his wife suffered from dementia and could not communicate with him, mr. liu argued that it was the presence of his wife every day that made him very happy. indeed, the physical care and presence of their spouses becomes so valuable for seniors in china who are experiencing an enormous loneliness during rapid social changes (yang et al. 2018). in shanghai, 1.33 million families were senior-spouse-only, of which 369,500 were aged 80 and above in 2018. among the 5.03 million elders aged 60 and above, 310,100 were living alone in 2018 (srca 2019). given the unavailability of adult-child care (as i discuss below), spouses become the most reliable caregivers late in life. while acknowledging that husband caregivers have contributed a lot to taking care of their wives, they also express their need for their wives’ physical presence in their daily life. for example, mr. huang (#015) had taken care of his wife for almost ten years and expressed that he would not let his wife be institutionalized because “our home will no longer be a home if she is absent.” the reality that there is a wife – even with dementia—waiting for you at home makes most husbands feel they are needed. even with enormous caregiving responsibilities and limited personal time, mr. huang continued to spoil his wife and said, “i need her more than she needs me.” similarly, mr. wang (#069) used a couple of lovers in ancient china—liang shanbo and zhu yingtai—to describe his relationship with his wife: a couple where nothing could separate them. since his wife often got lost, mr. wang let her hold his arm wherever they travelled despite the hot rashes on his arm. mr. wang said, “since i married her, i have to take care of her. people suggested me send her to a nursing home. i do not want to because i will miss her.” the intimate marital relationship at late life stage, to some extent, has transformed the caregiving relationship into one of mutual dependence. in addition to the intimacy of senior spouses, the unavailability of adult-child care forces senior husbands to take on caregiving. this is caused by the poor intergenerational relationship, the limited number of adult children, their children’s work-care conflicts, and the nature of dementia itself. unlike the aforementioned intimacy-based care, this group of husband caregivers often pay attention to their family situations surrounding caregiving. some husbands become the primary caregivers when their adult children fail to demonstrate an attitude of care towards their parents. numerous studies on chinese family have documented the decline in parental authority and the increase in youth power during the past four decades of reform (shi 2017; yan 2003). the deterioration of the practice of filial piety has been the focal point of these studies. my fieldwork findings further testify the intergenerational conflict. while the younger generation is often http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 11 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu self-centered and extravagant, the older generation values intergenerational dependence and frugality. these contending values often end up with family conflicts, which force senior parents to relinquish the expectation of adult-child care. in a remarried family, mr. jiang (#w05), who was taking care of his wife, complained about the reluctance of adult children to take responsibility for eldercare. mrs. jiang had two daughters and one son, yet none of them would take care of her after she was hospitalized. when mr. jiang called the three children to show up in the hospital, the senior daughter and the son were busy with their work, and the younger daughter was travelling for fun. when they showed up several days later after mrs. jiang was discharged, none of them were willing to engage in hands-on care. “they just hanged here and saw that their mother was not going to die soon. then they left,” said mr. jiang. “how can you rely on these kind of children? they barely have the sense of responsibility!” while some adult children have the sense of filial obligation and want to contribute to caregiving, their work duties do not allow them to do so, particularly for those who are the only-child. in that situation, husbands become critical and instrumental when their wives needed care. mr. lu (#093) had to take care of his wife because his only daughter and her husband had to travel each week. the lack of female caregivers forced mr. lu to learn cooking, housekeeping, laundry, and other skills in his 70s. these skills were important for him to maintain family function — i.e., taking care of his wife and grandson. mr. lu was conscientiously aware of his critical role: “i cannot be sick. if so, it would be an awkward situation since no one will be available to fill my position to take care of my wife and grandson.” the lu couple was lucky because they lived with the younger generations and maintained a good relationship with them. his daughter could help when she was not busy. many youths in shanghai, however, choose to live separately from their parents or work in a different city or overseas. the geographic separation of family members exacerbates the unavailability of adult-child care. the responsibility for eldercare can only be shifted to spouses. some other push-and-pull factors that drive husbands to become caregivers include the nature of dementia and the poor health condition of adult children. some people with dementia do not like “strangers”—including their adult children, home aides, or service providers—to stay in their homes. mr. xia (#020) was taking care of his wife in his 80s. they had three children, two in the us and one in shanghai. originally, mr. xia thought the daughter in shanghai could provide help. he gave up this expectation because her daughter suffered from severe diabetes, obesity, hypertension, and other chronic illnesses. what made his situation more challenging was his wife did not allow “strangers”— their daughter, son-in-law, and home aides—to stay at their home. mr. xia, even though his own health condition did not allow him to continue to caregiving, said, “i have no choice. i have to take care of her because she only knows me. otherwise, i have to send her to a nursing home. it’s too painful to do that.” son caregivers although spousal caregiving is a preferred arrangement, at some point, widowed elders and senior parents who are too weak to support themselves will turn to their children for help. among the twenty son caregivers, 17 were taking care of their widowed parents. traditionally, adult-child care was structured by the confucian value of filial piety. yet, rapid social changes have transformed the meanings associated with adult-child care. rationales of adult-child care differ remarkably: some sons prioritize their parents’ needs while others negotiate their care obligation and property inheritance rights with their parents. sons’ prioritization of their parents’ needs is based on filial piety yet differs in terms of the power structure between generations. adult sons do not necessarily show obedience or submission. instead, http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 12 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu they emphasize their moral obligation to take care of their parents. mr. li (#028) was the primary caregiver for his mother. unlike other seniors, his parents used to be the sent-down youths in xinjiang, and his whole family stayed there for almost 30 years before returning to shanghai.1 during this period, mr. li and his two siblings all grew up in xinjiang. when they returned to shanghai, they felt the people in shanghai had a shallow qinqing [family affection]: they often sought economic benefits, leaving their parents unattended. on the contrary, mr. li remarked that his family had a deep qinqing, which made them different from local shanghainese. because of their family affection, mr. li and his siblings never quarreled with each other. each contributed to their mother’s care based on their economic conditions. for instance, mr. li’s sister, who was divorced and later had a car accident, had no financial contribution to their mother. his brother, who had limited education and had to continue to work to support his son for college, also contributed very little. mr. li did not complain about his siblings. instead, he actively took on the primary caregiver role for their mother. while mr. li’s economic condition allowed him to do so, he also recognized the occasional contributions from his siblings when he travelled for business: “it’s our family affection that makes me feel we are human beings. otherwise, we are no different from animals.” mr. li’s words demonstrate his strong endorsement of familism and his disappointment with the emerging individualism in chinese society. indeed, parent-primacy care in contemporary china is so scarce that it makes li so valuable. comparing to filial piety, parent-primacy care continues to emphasize reciprocity and sacrifice within the interdependent network of kin. yet, by comparing his own family’s mutual support to those families in shanghai who endorse individualism, li demonstrates his moral superiority, which in turn requires him to sacrifice personal benefits for the whole family. moreover, his strong moral obligation might be built upon the confucian value – baishan xiao weixian, which places filial piety as the foremost goodness among hundreds of good behaviors. the lack of patriarchal relationship between li and his mother renders his motivation into a moral orientation than simply fulfilling one’s gender roles or social norms. contrary to the parent-primacy care, some son caregivers negotiate their eldercare responsibility with their parents and siblings. those who turn to negotiated care believe that the allocation of care responsibility should correspond with property inheritance right. in shanghai, the most valuable property is housing. in my previous study, i introduced a property-inheritance eldercare pattern (zhang 2017). for adult children, their parents are sufficiently resourceful in terms of housing property, which has become an important asset worth fighting over with other family members (davis 2010). moreover, most elders have their own pensions, which enable them to be financially independent from their children. they also have their own bank accounts and manage their property themselves until they completely lose the ability. during my fieldwork, seniors living with their adult children chose to share daily expenses or financially support them. given this context, the negotiated care not only highlights the continuing exchange between generations, but also indicates a transforming care norm in urban china. with sufficient resources, both elders and adult children in shanghai have alternative strategies to negotiate with each other on eldercare. among the 20 son caregivers, 13 received benefits from their parents in the form of pension, savings, and housing property; five cases did not reach an agreement on the division of parents’ property; and mr. li and another caregiver belonged to the category of prioritizing their parents’ needs. most son caregivers, after receiving their parents’ property, devoted their time and efforts to taking care of their parents. meanwhile, they often became solo caregivers due to family disputes during the process of property division. mr. zha (#054) had taken care of his mother for more than ten years. he had a brother who had immigrated to the us and a sister who lived in shanghai. mr. zha became the solo caregiver because his mother gave her housing and pension to him. according to mr. zha, his two siblings rarely came back or contacted him since their mother made this http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 13 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu decision. with enormous care responsibilities, mr. zha felt that he should take all care tasks because of the anticipated property. when i asked him about his solo caregiving status, he smiled and said, “just think of myself as the only child.” mr. zha’s family did not have obvious conflicts regarding eldercare obligation and property inheritance right. yet, six son caregivers who were solo caregiving went through severe family conflicts to balance one’s right and obligation. regardless of family conflicts, as with mr. zha, these solo caregivers often end up with a broken family tie. their engagement in eldercare was motivated by pursuing the individual right and fulfilling one’s obligation rather than masculinity. practices home roles of male caregivers range from the previous tasks that require manual labor to all dimensions of care including shopping, providing transportation, managing medications, housekeeping, cooking, bathing, and toileting. yet, husband and son caregivers respond to the increasing care needs of their elderly kin differently. husband caregivers would take on various care tasks without the hesitation of gender roles, whereas son caregivers often think about the boundaries between “appropriate” and “inappropriate” behaviors. as men taking on caregiving, they may experience it as a discontinuity in their life. i will discuss this challenge in the next section. here i focus on the spectrum of care tasks that men caregivers have assumed in practice. while traditional gender identity does not prevent men from taking on various care tasks, it affects sons more than husbands in their attitude toward cross-gender care practice. the flexible gender ideology in shanghai encourages husbands to continue their expanding home roles by taking on caregiving. as i mentioned before, after several decades of egalitarian education, men have assumed the gender equality in both institutions and domestic settings. my study found that many husbands had already engaged in domestic labor before their wives were diagnosed with dementia. among the 40 husband caregivers, 30 had acquired pre-caregiving skills (e.g., cooking, cleaning, bathing, feeding, and toileting their children, grandchildren, or parents) before they officially took care of their wives. thus, caregiving was a natural continuation of their previous home roles. for instance, mr. feng (#067) took care of his wife who was diagnosed with early-stage dementia. when i asked whether dementia affected his wife’s cooking skills, he told me that his wife rarely cooked even before her diagnosis. mr. feng further explained: don’t judge me based on our appearance. i might look strong, but in reality, i do everything carefully and persistently. she looks tiny, but she often messes things up and has no patience. i do not like her ways of doing things. since we married, i have taken most household chores, and she only takes charge of some cleaning tasks. because mr. feng played a primary role in housework, he felt it was natural to take care of his wife after her diagnosis. the shortage of female caregivers also forces some husband caregivers to assume more home roles. among the 40 husband caregivers, 11 had only a son or sons. among husband caregivers who had daughters, seven had the only daughter due to the one-child policy. meanwhile, the work-care conflicts of those who are the only child mean that their contribution to family caregiving is limited. because of the limited female caregivers, some husbands assume all dimensions of caregiving. for example, due to the unavailability of their only son, mr. wang (#069) had to take all care tasks for his wife, ranging from cooking to personal care. after five years, he felt that caregiving had become his new “job”: “every day is routinized. i treat her as my child, feeding her, guiding her to toilet, bathing her, etc. it’s good to http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 14 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu have something to do after retirement.” the expanding home roles of husband caregivers have blurred the gender boundaries. husband caregivers rarely complained that caregiving challenged their masculinity; rather, their nurturing activity made them feel a return to family life. indeed, gender roles continue to dilute at post-retirement stages of life, which makes husbands getting involved in caregiving possible. western studies on gender roles have found that distinctions between males and females become less salient along with adult development, particularly at post-retirement stages of life (gutmann 1980). building upon this life-course development theory, some western scholars further argue that husband caregivers may adjust their gender roles due to the marital contract and the necessity for sustaining the conjugal relationship (ducharme et al. 2007; russell 2001). this theory can also explain the increasing number of husband caregivers in china. instead of pursuing masculinity that might be characterized by carelessness, all husband caregivers demonstrated their “feminine” nature by engaging in nurturing activities. some husband caregivers expanded their home roles to emotional support. for example, mr. yu (#057) treated his wife delicately by watching her emotions. because his wife felt frustrated with their only daughter who was too busy to get married, mr. yu had to comfort her that their daughter would marry soon. “we are old now and cannot catch up social changes. as long as we are in good health, let our daughter decide her own life. is that ok?” mr. yu gently talked to his wife in the memory clinic where we met. the expanding home roles of male caregivers are also evident in son caregivers. for son caregivers who took care of their fathers, the spectrum of their care tasks is almost the same with that of husband caregivers. yet, unlike husband caregivers who often have acquired some skills for taking care of their wives, son caregivers often encounter many challenges related to gender boundaries, particularly for those taking care of their mothers. mr. sun (#w024) and his two brothers were all divorced, poor, and relied upon government subsidies. as a solo caregiver, mr. sun had taken care of his mother for ten years. originally, he did not know how to take care of his mother and often messed up since his mother lost continence. through trial and error, mr. sun was able to find his mother’s toileting behavioral patterns and eventually figure out a daily schedule of care practice. yet, one thing that constantly bothered him was bathing his mother. previously, he could not overcome the psychological embarrassment and hired someone to bathe his mother. but, given his economic condition and the lack of female caregivers in his family, mr. sun gradually took on this personal care task. some son caregivers—even with the availability of their wives—have to overcome their awkward psychological reservations to bathe their mothers. this is partly due to women’s withdrawal from traditional gender roles and partly due to the often-tense relationship between mothers-in-law and daughters-in-law in china (song and zhang 2012). since his mother became incontinent, mr. tang (#w028) had to take all care tasks for his mother, including bathing and toileting. he shared with me how to maintain a clean body for his mother: in the morning i clean her body with a towel and in the evening, i give her a bath. i guide her to the bathroom every two hours during the day and i use diapers at night. there are no gender differences between mothers and sons. when i was a kid, my mother cleaned for me until i grew up. now, it’s my turn to take care of her. mr. tang indeed received a high reputation based on what he had done for his mother. senior neighbors often applauded his conduct toward his mother and praised him as “the most filial son” in the community. yet, middle-aged women often gossiped his inappropriate behaviors such as bathing his mother. they even picked up a nickname for him, pa laopo, meaning “being henpecked.” mr. tang was “henpecked” because his wife did not help him take care of his mother. even with a wife, mr. tang was http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 15 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu the solo caregiver for more than a decade. his two sisters became estranged after the family dispute about their mother’s housing property. when i asked him about his response toward his wife, mr. tang explained to me: how many daughters-in-law actually take care of their parents-in-law now? i haven’t seen one! fumei [his wife] is good enough because she allows my mother to stay with me so that i can take care of my mother and my own house issues. if she can retreat, i should also retreat and take responsibility for all care tasks so that my mother will not interrupt her. the mutual agreement between mr. tang and his wife demonstrates the withdrawal of women, especially daughters-in-law, from their traditional gender roles in domestic settings. consequently, these actions force men to assume caregiving tasks that are not always consistently with gender role expectations. struggles and strategies the expanding home roles of male caregivers does not mean they encounter zero challenges. they may experience a great deal of stress from their loss of personal autonomy, the discontinuity of their previous life, and the enormous caregiving responsibility. working sons and husbands may also experience work-care conflicts. despite these challenges, husband and son caregivers continue to put others’ needs ahead of their own desires while seeking solutions for their own struggles. by comparing their responses, we also observe variations not based on gender but instead individual and cohort differences. for husbands who previously did not get involved in domestic issues such as housekeeping or cooking, the initial stage of taking on caregiving means a discontinuity of their life (a quasi-“career change” that may occur after retirement). mr. wang (#023) was officially retired on july 1st, 2007. he started caregiving three weeks later since his wife broke her hip and became demented. his two sons worked in the us at that time. due to the sudden deterioration of his wife’s health condition, mr. wang took almost all care tasks. mr. wang expressed his unexpected retirement life during the interview: “i thought we could travel around the world after our retirement. i never thought about being a caregiver so fast. yet, this is our life. since she needs me now, i’ll do my best.” similarly, mr. huang (#015), no matter how much he loved his wife, also expressed the loss of personal autonomy after taking on caregiving. “i have to watch her, and she also wants to be with me all the time. now i have to give up all my hobbies,” said mr. huang. yet, for husband caregivers, their sense of discontinuity was easily made up by their wives’ companionship and their marital contract. another challenge for senior husbands is the deterioration of their own health conditions along with the increasing demand of caregiving. most husband caregivers are at the same age cohort with their wives, meaning that their own health conditions were not always good. with limited support from family members and society, many senior husband caregivers assume all of the responsibilities. mr. zhou (#009) was taking care of his wife who refused to see doctors or take any medicine for treatment. mr. zhou could not hold his tears during the interview: i suffer more than she does. she doesn’t know my pain. i could not sleep well when i thought about her illness. my heart is not good, and i have been hospitalized twice for my heart disease. but i have to continue to take care of her because my only daughter is in america. i have to carry the pills for my heart wherever i go! http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 16 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu the lack of social and family support often puts these senior husband caregivers into a moral dilemma: have i done enough for my wife, or should i send her to a nursing home for a respite? whereas the marital contract or love has bounded senior couples to be willing to sacrifice personal autonomy for the sake of their loved ones, there is an invisible limit of their moral devotion. after several years of handson caregiving, their own health condition will not allow husband caregivers to continue to do so. the deterioration of their health conditions and/or the increasing caregiving responsibility often forces them to consider alternative strategies to take care of their wives. some husband caregivers who are economically abundant will hire home aides for help while others will turn to their adult children for support. even though husband caregivers may employ outside services or turn to their adult children, their caregiving responsibilities are not over. mr. huang (#015) had to sleep with his wife at night because “she wants to be with me in the same bed.” mr. liu (#w03) continued to take care of his wife’s medication even with the assistance of a nursing aide at home. “i am worried about her drugs and the aide might mess up,” said mr. liu. similarly, mr. yu (#w33) only outsourced care tasks that required intensive manual labor. for those who have their adult children getting involved, husband caregivers often complain about their children’s lack of patience or keep an eye open on their motivation. “you have to shixiang [tell whether people like you or not]. they [adult children] have their own family issues and work duties, so you cannot always call them or bring them troubles,” said mr. guo (#w10). so, he only asked his daughter and son to come alternatively each week and brought them some food. because adult-child care is often involved with inheriting parents’ housing property, senior husbands must figure out how to avoid potential conflicts with their adult children when they require support. mr. qiao (#w25), at the age of 90 years old, shared with me his secret to deal with his three adult children and their support: i ask them to come over in turn. each comes here every three days to contribute some labor…you cannot say you love this one or that one. you pretend that you like them all. now i can still manage my finances, so i will not say who will get my house and savings. i will tell them only when i cannot move anymore. for senior parents who are resourceful, they cannot take eldercare for granted from their adult children. they have to deliberately calculate how to balance their children’s performance and the property division. indeed, eldercare has become a battlefield between generations because it inevitably relates to the most valuable asset – parents’ housing property. even among the son caregivers, several have made a point of distinguishing the “modern” sense of care obligation based in inheritance rights from the traditional virtue of filial piety. mr. fan (#030) took care of his mother who suffered from dementia. as with other adult-child caregivers, he inherited his parents’ house and savings. with an increasing care demand, mr. fan had to quit his job to make sure his mother received more care and support. when i met him in a hospital, he told me that each day he woke up at four or five o’clock and then transported his mother to an emergency room for medical care. at that time, he had already been unemployed for nineteen days. when i praised that he was a filial son, he laughed and explained, “i have to do this to show my siblings that i take good care of my parents. otherwise, they will gossip about you among your relatives.” equally worth mentioning is the increasing care demand from parents affects sons who have work duties. the fact that mr. fan didn’t seem to be worried about his work was because he received his parents’ pensions – about 10,000 rmb [$1,400 usd] each month – which was enough to support for his daily necessities. yet, for other son caregivers who do not have such a luxury, they constantly experienced work-care conflicts. mr. qiu (#008) was single and 28 years old. yet, he had to take care of http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 17 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu his mother who unfortunately suffered from dementia. mr. qiu had a brother who had immigrated to the us and his father passed away in 2015. when i met him in the memory clinic, mr. qiu was extremely depressed: he had to quit his current job to find one with flexible hours because his boss would not allow him to be absent anymore. when i learned that his mother’s dementia condition might worsen, i asked mr. qiu whether he minded about personal care. unlike other son caregivers who did not take gender identity as a serious issue, mr. qiu said it had bothered him for a long time. he did not mind cooking, cleaning, and running errands, yet he felt embarrassed to bathe and change the diaper for his mother. “i will hire a home aide to help with personal care,” said mr. qiu. “it’s not that i don’t love my mother. i just cannot overcome the embarrassment.” son caregivers who have expressed this psychological challenge are not uncommon. among the 17 son caregivers taking care of their mothers, 9 expressed a similar attitude toward personal care. whereas most son caregivers had taken on a broad range of caregiving tasks, personal care such as bathing or changing diapers for their mothers was interpreted as gender sensitive and left to their wives or social service providers. moreover, compared to husband caregivers who can deal with their emotional stress by referring to their marital contract or intimacy, son caregivers often do not have a positive association with the increasing care demand from their parents. they spoke regretfully of a loss of the sociability and a sense of failure because of lack of improvement of their parents’ health conditions. some said that they had to figure out some time to read newspapers or watch tv to participate in some elements of their “normal” life, whereas others coped with this sense of loss by reinterpreting caregiving as an opportunity to repay their parents rather than focusing on issues of gender identity. conclusion this paper examined the experience of the “cinderella men” taking care of their ill family members. i argue that the effect of men as caregivers results from demographic changes, notions of intimacy, and kin responsibility more than the social construction of gender roles and power asymmetries between genders. the expanding home roles for males pose the question, “does gender matter in caregiving?” gender seems to matter in terms of socialization. yet, we do not see gender as a strong influence for how caregiving is motivated and practiced. in other words, we cannot simply attribute gender as the answer to men’s attitudes toward caregiving, hands-on care, service utilization, and relations with other family members. the variation should take individual and cohort differences into consideration. instead of furthering the differences between genders, i argue that caregiving serves as a prism to reflect individual personality and moral character of caregivers, regardless of gender roles. variations of nurturing activities of male caregivers occur for reasons other than gender. we have observed differences between husband and son caregivers in terms of obligations and reciprocities. husband caregivers are motived by love and affection. the unavailability of adult-child care also forces them to take the primary responsibility for their wives and cross the gender boundary by assuming a wide spectrum of caregiving tasks. in dealing with the overwhelming caregiving responsibilities, they put others’ needs ahead of their own desires and forcibly adjust to the personal sacrifices. while son caregivers are also acting consistently with the expanding home roles, their motivations vary from case to case. some prioritize their parents’ needs and others are affected by the idea of inheriting property. because of family conflicts, many son caregivers are solo caregiving, which means that they handle a broad range of caregiving tasks without the support from their siblings. in practice, there is a great variation in the tasks they perform. some personal care tasks such as bathing and changing diapers for their mothers are considered gender sensitive for son caregivers, especially for those who are young and unmarried. in that case, these son caregivers either outsource to their wives or hire home aides. yet, some son caregivers have overcome the psychological embarrassment after years of caregiving. http://anthro-age.pitt.edu/ margaret clark award (2020) winner | zhang | 18 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu there are cohort differences in the coping strategies by all the male caregivers that expressed their experiences with caregiving. husband caregivers used social services or turned to their adult children for support, whereas son caregivers received support primarily from their wives or home aides; consequently, siblings—especially sisters—were absent from the caregiving process. again, this care arrangement is due to the property inheritance. even husband caregivers who do not need to fight over inheritance with their adult children are fully aware that if they cannot handle their property well, they will end up with poor relationship with their children. moreover, work-care conflicts among son caregivers often create anxieties that are irrelevant for husband caregivers who have already retired. these son caregivers are more likely to report stress and burden; in addition, given the progressive nature of dementia, some son caregivers could not feel the sense of achievement in caregiving (such as the improvement of their parents’ health conditions). husband caregivers, however, view caregiving as an experience of companionship and an opportunity to repay their wives for their previous assistance; thus, they are relatively easy satisfied with their contributions. despite the individual and cohort differences, men who take on caregiving have a strong sense of commitment and an acceptance of their moral obligation. the fact that they must cross gender boundaries causes caregiving to transition into a gender-neutral experience. the flexible gender ideology allows these male caregivers to reshape the landscape of eldercare in china. with an increasing number of elders who need long-term care, care arrangements within domestic settings will continue to change, which may vary with economic circumstances, family relationships, and living patterns. therefore, gender alone cannot predict the future for family caregiving. it is certain chinese society and family will continue to change as eldercare is restructured and men are inevitably included in the process. acknowledgments this research was funded by the wenner-gren foundation for anthropological research (#9361). notes 1. the sent-down youth was known as the zhiqing. they were the young people who—beginning in the 1950s until the end of the cultural revolution, willingly or under coercion—left the urban districts of china to live and work in rural areas for some state-led projects. after the culture revolution, they gradually returned to their hometown. references adi (alzheimer’s disease international). 2009 world alzheimer report. https://www.alz.co.uk/research/files/worldalzheimerreport.pdf. accessed 06/28/2020. bells, nadine. 2011. “shanghai: home of the world’s best husbands.” yahoo news, march 21, https://ca.news.yahoo.com/blogs/good-news/shanghai-home-world-best-husbands-20110321-122733738.html, access 04/27/2019. black, h., schwartz, a., caruso, c., hannum, s. 2008. “how personal control mediates suffering: elderly husband’s narratives of caregiving.” the journal of men’s studies 16 (2): 177-192. bureau of labor statistics. 2019. “unpaid eldercare in the us—2017-2018 data from the american time use survey.” https://www.bls.gov/news.release/pdf/elcare.pdf. accessed 06/28/2020. calasanti, toni. 1999 “feminism and gerontology: not just for women.” hallym international journal of aging 1 (1): 44-55. chen, xiaoru. 2012. “why shanghai men are in demand.” global times, march 8th. http://www.globaltimes.cn/content/699247.shtml. accessed 04/27/2019. http://anthro-age.pitt.edu/ https://www.alz.co.uk/research/files/worldalzheimerreport.pdf https://ca.news.yahoo.com/blogs/good-news/shanghai-home-world-best-husbands-20110321-122733-738.html https://ca.news.yahoo.com/blogs/good-news/shanghai-home-world-best-husbands-20110321-122733-738.html https://www.bls.gov/news.release/pdf/elcare.pdf http://www.globaltimes.cn/content/699247.shtml margaret clark award (2020) winner | zhang | 19 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.356 http://anthro-age.pitt.edu china daily. 2006. “shanghai men: henpecked or just polite?” july 24th. http://www.chinadaily.com.cn/citylife/2006-07/24/content_647664.htm. accessed 04/27/2019. da, weiwei. 2004. “a regional tradition of gender equity: shanghai men in sydney, australia.” the journal of men’s studies 12: 133-49. davis, deborah. 2010. “who gets the house? renegotiating property rights in post-socialist urban china.” modern china 36 (5): 463-492. ducharme, francine, louise lévesque, lise lachance, marcellin gangbè, steven h. zarit, jean vézine, and chantal d. caron. 2007. “older husbands as caregivers: factors associated with health and the intention to end home caregiving.” research on aging 29 (1): 3-31. engster, daniel. 2015. justice, care, and the welfare state. oxford: oxford university press. friedemann, marie-luise, and katheleen c. buckwalter. 2014. “family caregiver role and burden related to gender and family relationships.” 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shi, lihong. 2017. choosing daughters: family change in rural china. stanford, ca: stanford university press. song, yi, and yan bing zhang. 2012. “husbands’ conflict styles in chinese mother/daughter-in-law conflicts: daughters-in-law’s perspectives.” journal of family communication 12 (1): 54-74. srca (shanghai research center on aging). 2019. “report of the statistics of older population and social services development in 2018.” http://www.shrca.org.cn/news/detail.aspx?id=6892&page=0, accessed 03/10/2020. swinkels, joukje, theo van tilburg, ellen verbakel, and marjolein broese van groenou. 2019. explaining the gender gap in the caregiving burden of partner caregivers. the journals of gerontology: series b 74 (2): 309-317. tao, jie, with zheng bijun, and shirley l. mow, eds. 2004. holding up half the sky: chinese women past, present, and future. new york: the feminist press. traphagan, john. 2003. “older women as caregivers and ancestral protection in rural japan.” ethnology 42 (2): 127-139. tronto, joan. 1993. moral boundaries: a political argument for an ethics of care. new york: routledge. tsai, kellee. 1996. “women and the state in post-1949 rural china.” journal of international affairs 49 (2): 493-524. vogel, suzanne. 1978. “professional housewife: the career of urban middle class japanese women.” japan interpreter 12: 16-43. xie, yu. 2013. gender and family in contemporary china. university of michigan: population studies center research reports 13-808. xu, qiong, and wei-jun jean yeung. 2013. “hoping for a phoenix: shanghai fathers and their daughters.” journal of family issues 34: 182-207. yan, yunxiang. 2003. private life under socialism: love, intimacy, and family change in a chinese village (1949-1999). stanford: stanford university press. yang, fang, with zhang junan, and wang jianping. 2018. “correlates of loneliness in older adults in shanghai, china: does age matter?” bmc geriatrics 18: 300. doi:10.1186/s12877-018-0994-x yee, jennifer l., and richard schulz. 2000. “gender differences in psychiatric morbidity among family caregivers: a review and analysis.” the gerontological society of america 40 (2): 147-164. yin, zhigang, and zhou haiwang. 2014. shanghai shi laonian renkou zhuangkuang yu yiyuan fazhan baogao (19982013) [the demographic status and attitudes toward eldercare report in shanghai (1998-2013)]. shanghai: shanghai academy of social sciences press. zhang, hong, and elizabeth fussell. 2017. “strategic gender egalitarianism in rural china: the impacts of husbands’ migration on gender relations.” american behavioral scientist 61 (10): 1192-1213. zhang, yan. 2017. “contextualized eldercare in the post-reform era of china: cultural categories of elder mistreatment and the potential social causes.” ageing international 42 (2): 169-186. http://anthro-age.pitt.edu/ education of values: marketizing the aging population in urban china yifan wang rice university yifanwang@rice.edu abstract in this article, i examine some of the marketing and sales strategies at gardenview, a newly established eldercare company that ran a few residential eldercare facilities in nanjing, china. there, like elsewhere in urban china, the projected aging demography was mobilized to push for an industrialization (chanyehua)—marketization and professionalization—of eldercare, transforming ideas and experience of eldercare by putting forward a new set of knowledge of aging. to this end, i first ground the rising eldercare industry in the transitioning paradigm of conceptualizing china’s population from population control to demographic aging. then i explore ethnographically how gardenview participated in the eldercare industry in a rapidly aging china. in particular, i look at the floorplans and the marketing stories as devices of the education of values—as prices, the good and desirable, and differentiators—to understand the social, economic, and ethical dynamics instigated by a transitioning demography. these values, as i show, are crucial in linking everyday life and choices with the paradigmatic shift of china’s population. finally, i discuss how understanding the very processes of marketing and sales as an education of values could shed further light on what anthropologist michael fischer calls “literacies of the future” as a socially and economically elaborated and contested world of an aging china. keywords: eldercare; marketization; population; ethics; development; values anthropology & aging, vol 42, no 2 (2021), pp. 36-51 issn 2374-2267 (online) doi 10.5195/aa.2021.305 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. wang | 36 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu education of values: marketizing the aging population in urban china yifan wang rice university yifann.wang@gmail.com introduction in may 2018, not long after settling in the city of nanjing for a short research trip, i came across a poster of a campus recruitment event by a corporation known for its real estate enterprise. the highlight of the event, according to the poster, would be a keynote speech by mr. liu, the chief executive officer. mr. liu would introduce the college audience to the corporation’s wide range of businesses, including gardenview, the sector that was focused on residential eldercare. 1 when i arrived early on the day of the event, the auditorium was already half filled, and it looked like the other half were just queuing in line outside for souvenirs. the majority of the hundreds of attendants were finishing college or graduate school and had just entered the job market. those who scanned the company’s qr code and followed its social media account would be gifted a customized planner notebook—a taste of the corporate culture perhaps—filled with inspirational quotes and blank space for writing down daily, monthly, and yearly goals for personal and professional growth. a charismatic speaker, mr. liu won waves of applause and laughter before the talk even began. the hour-long speech, titled “an idealist venturing into reality,” weaved together mr. liu’s personal, successful, and idiosyncratic career path with the expansion of the corporation. messages of passion, ambition, and entrepreneurship filled the room, promising to set a course for the future where individual and corporate interests would simply coincide. after another round of applause, the host opened the floor for questions. following two rather congratulatory inquiries (how did you find such courage to change your life path? would students of entrepreneurship find themselves to be a good fit for your company?), a graduate history student was selected by the host. he challenged mr. liu’s portrayal of the newly established eldercare business, gardenview, and asked, “hello mr. liu, sending parents to nursing homes is contradictory to the traditional chinese ethics and culture. how can you guarantee your eldercare model works in china?” “i disagree with you,” mr. liu quickly responded, as if he had been waiting for an opportunity to elaborate on a theory of eldercare, first, ethics is historical. what you said might be the view of a certain time, but as time passes and the environment changes, what used to be unethical and immoral in the past could be transformed into the ethical standards of another time. second, aging is also an economic problem. […] with the aging of the parents of the only-child’s generation, only corporate interventions with professionalism and efficiency will be the optimal solution for society. sounding almost unsettlingly familiar, mr. liu’s answers echoed all too many enduring anthropological conversations about contemporary china, touching on the transformation of filial ethics (ikels 2004), http://anthro-age.pitt.edu/ wang | 37 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu the drastically reshaping landscape of residential eldercare (chen et al. 2016; harper 1992; zhan et al. 2008), and a localization of corporate social responsibility that is deeply rooted in a post-socialist modernity (chong 2018). while aging has become an increasingly prominent topic in china’s social and natural sciences (for a reivew in the latter, see o’meara 2020), mr. liu’s response showed that these insights were by no means bound to scholarship—they are fully operational within business practices and feed into foundational corporate stories. in this article, i join the conversation surrounding transitioning eldercare ethics in china by turning to the less examined sphere of the corporate. while filial piety, or xiao, remains the center where eldercare is conceptualized, anthropologists have shown that, since the economic reform and following the birth planning policies, this traditionally male-based virtue of reverence towards the parents has been variously interpreted, cultivated, and mobilized (harrell and davis 1993; ikels 2004; shi 2009; sun 2017; yan 2003; zhang 2006; zhan and montgomery 2003).2 in what follows, i push this insight further by looking at how my corporate interlocutors treated filial ethics as something malleable and capable of being acted upon. whether mr. liu is an opportunist or not, the fact that corporations ground their market activities on premises of ethical transformation merits a close examination of how business practices such as marketing and sales shape and are shaped by moral codes and social values (zelizer 1979). for instance, how do marketing and sales professionals make something sellable and valuable? how do they find consumers, and how do consumers know what they want? and what is the role of corporations or of the market at large in the transformation of the social and the ethical? put differently, instead of seeing the market solely as a reaction to underlying social transformation, what might we be able to see when we understand corporations as agentive forces that actively seek to transform the social and the ethical? to begin to address these questions, in this article, i look at some of the sales practices and marketing narratives deployed by gardenview (one example among many similar new eldercare entities). specifically, i examine the processes and devices of what i call an “education of values” to understand the social, economic, and ethical encounters that are brought forth by the state’s call for societal responses to population aging. here, population aging is understood to be more prescriptive than descriptive. a politically contested arena, the official narrative of the population in china comes with national policies that directly impact ordinary people’s lives and figure into popular perceptions of the future (see also aulino 2017). demography, therefore, needs to be understood as a strong state presence channeled in the naturalized language of demography when the state shifts away from its previous concern with overpopulation to population aging. by turning to these emerging values, i especially pay attention to how—all at once as economic prices, the social good and desirable, and differentiators (graeber 2001, 1–2)—these values are packaged and marketed and link everyday life and choices with this politically charged demography. together, i explore how companies participated in and shaped the eldercare industry that the state actively fosters (chen 2016; feng et al. 2011). towards a known future of aging after a series of communications following the campus event, gardenview’s human resources department and the sales director allowed me to conduct ethnographic research about the company’s daily operations by working as an intern. therefore, this article is mainly based on my researchinternship in the summer of 2018, with corresponding moments drawn from my year-long fieldwork in 2019-2020 conducted in the same department. while i was based at gardenview’s head office, i frequently visited the company’s care facilities to conduct unstructured interviews with staff members from all posts. my work in the head office included attending various training sessions, translating materials between english and chinese, and writing conference summaries, through which i http://anthro-age.pitt.edu/ wang | 38 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu familiarized myself not only with the company’s work routines but also various corporate research projects. at the facilities, i assisted social workers as they organized activities and helped with the kinds of miscellaneous tasks that are common in scenes of caregiving. at times, i also joined managers to check the interior decorating progress at the then soon-to-be opened facilities, where i learned how the space—as a room for care and a floorplan for business—was operated and evaluated in the eyes of sales supervisors. like many chinese real estate and insurance corporations, along with a number of state-owned enterprises, gardenview’s parent company began to explore the largely uncharted waters of commercial eldercare around the early 2010s, citing the year 2013 as “year one” (yuannian) of the chinese eldercare industry. in june 2013, the ministry of civil affairs issued order no. 49, measures for the administration of elder care institutions, which was the first national regulation governing the operation of eldercare facilities (ministry of civil affairs of people’s republic of china 2013). more significantly, in september, the state council issued several opinions on accelerating the development of the elderly service industry (state council of people’s republic of china 2013). commonly referred to as “document no. 35” (sanshiwuhao wenjian) by entrepreneurs, this piece was held to be the milestone of china’s eldercare industrializing (chanyehua). like many ensuing policies, document no. 35 sets the tone by prefacing that “china’s population has entered the stage of rapid aging” (2013). with “194 million” older adults above 60 years of age, it continued to project that “this number will be 243 million by 2020 and over 300 million by 2025” (2013). as the full title suggests, document no. 35 accentuated the prospect of marketizing eldercare in china, presenting the notion of an eldercare industry (yanglao chanye) as an economically promising and socially imperative response to the “rapid aging stage” of china’s demography. in november of the same year, the communist party of china (cpc) central committee released an economic reform guideline, the decision of the central committee of the cpc on major issues concerning comprehensively deepening reforms. among the measures, it proposed to relax the long-standing “one-child policy” and open foreign investment in eldercare. all of these were read as indicators of the state’s efforts in fostering an eldercare industry in the face of rapid population aging. china saw a surge of eldercare service expansion in the following years. in 2013, for example, there were 42,475 residential eldercare institutions in china with a total of 4,937,000 beds (ministry of civil affairs of people’s republic of china 2014). by 2018, the number of institutions had nearly quadrupled to 168,000 with 7,271,000 beds ministry of civil affairs of people’s republic of china 2019). an analysis of the main chinese stock markets (known as the a-share and h-share markets) shows that as of 2018, 82 listed companies extended their business into the eldercare sector. while nearly 40% of this group are real estate companies, the rest are mainly composed of establishments in pharmaceuticals, information technology, finance, and insurance (liu 2018). gardenview, among these self-identified “pioneers,” ran several residential care facilities in nanjing and neighboring cities in the yantze river delta region, one of the wealthiest as well as the earliest demographically aging regions in china. although mobilizing the market to salvage population aging was not ostensibly advocated by the state until the 2010s, population aging and its socio-economic consequences were not new to china’s political discourse. shadowed by the concern of overpopulation and population growth, the question of population aging was more of a footnote and a secondary problem in the state’s “longest campaign” (white 2006) of birth planning since the late 1970s. for example, economist and demographer tian xueyuan, popularly known as the “father of the birth planning policy” (jihuashengyu zhifu), voiced a concern that strict birth planning could lead to major side effects, especially population aging.3 in his 1980 people’s daily article, titled “on the problem of ‘population aging,’” tian specifically addressed http://anthro-age.pitt.edu/ wang | 39 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu the challenges that scholars raised against the implementation of birth planning policies. he acknowledged that curbing the birth rate could indeed lead to population aging, a problem that had already emerged in north and west european countries. yet he argued that in china, the potential transformation of the age structure of the population in the long run would not cancel out the benefit of suppressing population growth. by foregrounding the temporality of demographic transition—that is, by noting that demography entails not only the present but also the viability of the future—tian xueyuan presented birth planning policies as a social mathematics that games with time, addressing the policies as only a temporary and imperfect but manageable experiment that tackles the imperative of “reducing natural birth rate.”4 in particular, he argued that aging was a problem in europe only because of the resulting labor shortage and the burden of “social labor,” (meaning, the labor of eldercare) both of which he dismissed in the context of china. when it comes to labor shortages, tian believed china’s billion-plus population— compared to the few millions in most european countries—coupled with technoscientific development in the long run would ease china’s transition to an aging society. for eldercare provision, tian again emphasized that the policy itself was only temporary and would be modified to encourage childbirth again soon enough. in a 2015 interview, published just a few months before the official termination of the one-child policy, tian admitted that he should have addressed population aging more in depth (feng and xiao 2015). retrospectively, he deemed the one-child policy as a “solution of no solutions” (meiyou banfa de banfa) in the face of china’s population growth, and said its modification had been long overdue. the resulting demographic transformation has become what the world health organization (2015) deemed “dramatic” population aging in china. in the decades following the implementation of the onechild policy, china has grown to be the quintessential site of what is now called “global aging” (united nations 2015; zeng 2012). to put the numbers evoked in document no. 35 on a global scale, in 2012, 13.3 percent of china’s 1.4 billion people were older than 60, nearly 2 percent above the global average of 11.5 percent (unfpa and helpage 2012). demography, moreover, always entails a narrative of the future. demographic models projected that by 2050, the population over the age of 60 in china will have doubled to 33.9% of the total population, significantly higher than the projected global average of 21.8% (2012). these numbers are evoked to entail a near future of labor shortage, pension deficit, and insufficient social services among other social consequences of aging, a future that anthropologist lawrence cohen has called “aging’s premature facticity” (1992), pointing to the telos of development in the conceptualization of aging. it is precisely against such a fate that in 1980 tian xueyuan imagined an alternative course of aging. in his ideal, aging in china would not necessarily be a tragedy of development because of china’s own path to modernization, its sheer population size (when understood as an abundance of human labor power), and vastly improved social reproductivity. yet, the progress of population control did not naturally solve the potential problems of population aging; what has been called upon as the solution is not so much a totality of national economy—the “social productivity” as a whole—but instead a resort to a state-fostered market mechanism. in other words, what now allows a reconceptualization of population aging, from a burden on resources to a future of long-lived and fulfilled life, is no longer a national allocation of resources that tilts towards eldercare but instead individual market participation. by participating in the eldercare industry, gardenview distinguished itself as a professional serviceoriented company against its competitors, who had found their niche markets elsewhere by targeting luxury living environments, professional medical care, or designed social activities among others. as http://anthro-age.pitt.edu/ wang | 40 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu my corporate interlocutors taught me, in this formational stage of the eldercare industry, gardenview’s expectation was not—at least not entirely—immediate profit, but instead to “occupy the market” (zhanyou shichang), which, in practice, meant being known among potential clients and to be on their mind when the time comes. the prospect of growth in the eldercare industry, in some ways, runs parallel to the temporality of what medical anthropologist sharon kaufman calls “longevity making,” that is, a constellation of concerns and calculations—from the framework of prognosis and insurance policies to ordinary ethical imperatives—that makes aging thinkable in a particular course and in a given society (kaufman 2011; kaufman and fjord 2011). for gardenview, maximizing profit at the moment is certainly important, but focusing only on that would be shortsighted. the goal was to be a major player once the market matures. my corporate interlocutors viewed the eldercare market as something in formation and something that would develop into a fully-fledged industry in the near future. to say that companies like gardenview seek to “occupy” the market is perhaps not accurate; it might be more appropriate to say that the process of industrializing eldercare is one where the state and companies co-create the market. on the macro level since 2013, china has modified policies on foreign investment, land use, and preferential tax rates in favor of eldercare-related investments and construction to encourage market participation. more directly, china issued a series of regulations seeking to standardize everything from the quality of texture-modified food marketed for the elderly to the educational background of professional caregivers. in 2019, china also published recommended standards for ranking eldercare facilities on a one-to-five-star scale. numerous policies at the provincial, municipal, and district levels sometimes work as procedures for localizing national guidelines and other times as pilot programs before national implementation. corporate actors have kept close track of the constant modifications in local and national policies while actively forming industrial alliances to advocate their interests, coming to shape a future of aging by drawing the landscape of eldercare. a floorplan of care rather than ask me questions during my initial internship interview, eric (then head of the sales department) gave a lecture on the history of gardenview and the state of the industry. an eloquent and athletic chinese man in his early 40s, eric had previously worked in the foreign trade business and kept the habit of going by his english name. in the search for a suitable business model, he explained to me, gardenview drew most of its lessons from the “japanese experience,” given that japan has the world’s highest aging rate. yet, this turn to japan was far from intuitive. according to gardenview’s foundational story, the company’s research team had examined a number of experienced eldercare provision companies based in north america and western europe, where population aging had been underway for decades. all of those partnerships eventually fell through because, as eric and many of my interlocutors often told me, “chinese people are not ready” and hence “their models of eldercare wouldn’t sell.” the idea that chinese people are “not ready” resonates with mr. liu’s public speech and is part of a common sentiment that traditional chinese views of eldercare are too “behind” (luohou) in the face of the reality of population aging. for example, when mr. liu said that “what used to be unethical and immoral in the past could be transformed into the ethical standards of another time,” he meant that sending parents to residential care facilities, though deemed unethical in the past according to the decree of filial piety, would—and should—be considered in a new moral regime today. and more importantly, as i will show, it is being filial itself—the offering of good care—that should be thought anew. http://anthro-age.pitt.edu/ wang | 41 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu one would not be wrong to read the temporal-spatial metaphor of being “behind” as a cousin of the prevailing “catching-up” narrative that animates the global telos of development. yet, it would be misleading to assume that gardenview’s project was at best a replica of “leading” western practices. eric, for example, compared china’s burgeoning eldercare industry to the manufacturing industry. while the latter had been known by the slogan “made-in-china”—an infamous label now more and more advocated by chinese companies as a source of pride—eric said what inspired him and gardenview was instead the pursuit of “living-in-china.” in the leap from made-in-china to living-inchina, eric echoed the nationalist longing for an industrial revolution that could transform china’s labor and resource-intensive economy to a knowledge economy. for eric, the ultimate goal of an economy is a transformation of living. “western” eldercare models, through this lens, provided little space to address the moral demands occasioned by outsourcing familial care for elders in china. gardenview’s market research thus pointed to something more nuanced than imported business models and lifestyles; it was, from the beginning, a commercial project that was intended to yield social, cultural, and ethical impacts. at the same time, this project would only be commercially viable once it was also socially, culturally, and ethically acceptable. gardenview eventually settled on what they called the “japanese model,” which included forming strategic collaboration with a japanese eldercare company and the active recruitment of chinese managers who were educated in japan and had worked there. what gardenview’s executives and leaders meant by ‘japanese model’ landed as a series of spatial, temporal, and affective arrangements that were most visible in the company’s aesthetic appeal. gardenview’s nursing home rooms were extremely compact, optimizing space to meet the density of demand. moreover, in the face of the rapidly aging population structure japan also provided an ideal model for china to explore how the minimum number of personnel could cover the widest possible service area. anthropologists, once again, are no strangers to this appeal of japan—one of the most studied sites in the anthropological scholarship of aging (danely 2015; lock 1993; lock and kaufert 2001; thang 2001; traphagan 2000, to name a few). margret lock’s now-classic notion of “local biologies” (1993), for example, emerged from a comparative study of japanese and north american women’s differing experiences of menopause. it became one of the most important and timely anthropological contributions in resistance against a universalizing discourse of aging. more recent scholarship looks at new forms of social ties and care configured by rapid population aging and technological innovation in contemporary japan (allison 2017; danely 2016; wright 2018). population aging, as anthropologists show, has become foregrounded in how everyday life is experienced in japan. for my chinese corporate interlocutors, japan, a “western” economy coupled with confucian cultural roots, was simultaneously far enough away to distance from and close enough at home to inspire.5 it was assumed by my interlocutors that japan had much to offer when it came to social and corporate responses to the categorical transformation of eldercare, from a private, filial duty to a public, societal affair. the “japanese model” is a shorthand term for marketing that verbalizes and enacts a set of images that include homeliness, simplicity, professionalism, efficiency, and an eye for detail, among others. to this end, one of the main things that gardenview borrowed was the layout of its senior care centers. each floor of gardenview’s facilities was split into discrete modules that were enclosed as a singular environment, while sliding doors between each helped to create a smooth connection when needed. http://anthro-age.pitt.edu/ wang | 42 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu modules could house a dozen residents, who were grouped according to the level of care they required. in the middle of each module was a service station, which typically included a front desk area, a preparation room, and a small room dedicated to medicines and file storage. the area near the service station was a common space used for dining and activities, while individual rooms were arranged in a circle along the walls. each module also included a few shared bathrooms (though half-bathrooms were available in some rooms as well), and each floor shared a common shower room. most rooms were compact—especially in the dementia wing, where rooms barely had enough space to fit in a twin-size bed, a closet, and a chair. all of these settings were geared towards one goal: to encourage the residents to leave their rooms and socialize in the common area. as the interface between care provision and demand, floorplans were a crucial site of representation and the imagination of care itself. central to this “japanese model” was the idea of “self-supporting care” (zili zhiyuan), which, ideally, prioritized life experience, capacity enhancement, and the dignity of the resident over concerns for safety and efficiency (lin and huang 2018). in practice at gardenview, the essence of self-supporting care was interpreted as maximizing the residents’ own capacity in daily activities by minimizing intervention. gathering in the common room on the one hand encouraged the residents to participate in public activities, and on the other hand greatly facilitated caregivers’ work. with the service desk in the middle creating a panoptic view, caregivers could monitor the entire floor from the desk without constantly interrupting their daily activities. aiming at the higher-end market, gardenview charged a monthly rate starting at roughly $1,286 (cny 9,000) before discounts, which included a single room, meals, and basic assistance (such as distributing prescription medicine) for a resident whose “care level” was deemed to be low. this basic fee was nearly twice as much as the average monthly income of the city’s urban residents, which is about $706 (cny 59,308) (nanjing municipal human resource and social security bureau 2019) and nearly four times larger than the average pension for local retired employees at $426 (cny 2,984) per month (2019). although this high price tag means that only a fraction of the population could actually afford such services, at the first glance, gardenview’s floorplan and service did not confer the privileges that typically come with such price, be it larger spaces, private access, or all-round assistance. one day during a casual chat in 2020, xiao lu (a top salesperson who began at gardenview as a caregiver) joyfully brought up the new client she signed the day before. “i felt like i met our soulmate (womende zhiyin),” she said, after which she mimicked the middle-aged son who had just signed the contract on behalf of his elderly father: “the small single room is just perfect! i like it that it doesn’t have a [private] bathroom. what’s good about a bathroom (yao cesuo you shenme yong)? we need help with toileting anyway!” we all laughed because such smooth transactions did not happen very often. it was such an ideal encounter between the buyer and the seller that it became comical. in xiao lu’s daily work, sales involved the major work of convincing—not only by making explicit the whole set of eldercare ideologies embedded in the floorplan, but also by assuring potential clients that the floorplan was good for the older residents. in this rare case, however, none of this pedagogy was needed. the client was perfectly attuned to the values that were introduced and sold. xiao lu’s joke thus highlighted the widespread dissonance in her work. more often than not, as an employee of gardenview she occupied a drastically different set of assumptions and knowledge about eldercare than her potential clients. by referring to the client as “our soulmate,” xiao lu made explicit an alliance among “us,” who possessed the knowledge of good care, against the uninformed “them.” http://anthro-age.pitt.edu/ wang | 43 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu as i worked side by side with the sales specialists, i came to understand a kind of double vision that such positions cultivated. sales employees were paid on commission, mostly based on the number of beds they sold and the deposit they were able to generate. their job was miscellaneous at best, ranging from distributing handouts on the streets, to curating the facilities for individual and group visitors, to picking up calls at midnight to handle emergencies or mediating between clients and the company in the event of a complaint. experienced sales specialists like xiao lu could tell a potential client from a general inquiry within a matter of seconds. the cost of gardenview itself already implied a certain class background, often made visible through a client’s occupation, car, or neighborhood among other traces that sales specialists would sharply but quietly collect at the first meeting. in the meantime, as they responded to inquires of all kinds on a daily basis, sales specialists were also constantly exposed to the ways of calling gardenview’s market ideology into question. criticisms that rooms were too small, daily activities too centralized, or caregivers’ responsibilities too vague were all questions of the value—both in terms of worth and quality—of gardenview’s eldercare. the salesperson as a position was therefore sandwiched between a duality: a corporate vision from training and working and a vision of the clients from the company’s marketing activities. on the one hand, as illustrated by xiao lu’s “our soulmate” anecdote, sales specialists believed that gardenview’s service model was morally good and identified with these values. they believed that this model provided sustainable care and promoted the health and personal growth of the elder residents. they also embraced a carefully worded corporate culture of anti-ageism by maintaining a set of vocabularies such as “renzhizheng” (literally meaning cognitive illness, a new word for dementia, as opposed to “laonianchidai,” senile insanity) and “zhangzhe” (senior persons, as opposed to “laoren,” the old), among others, while the more common chinese expressions were deemed discriminatory. on the other hand, also exemplified by xiao lu’s pleasant surprise by the rare consensus with her client, the everyday work of sales was not always successful and hence frustrating. in their communications with clients, sales specialists came to see how these provisions were not self-evident, and that what is sold is not simply service, but a whole new understanding of what counted as a ‘good service’ in the first place. it is then perhaps not so surprising that many of the salespersons would joke about their work as “brainwashing” (xinao). they were acutely aware that this emphasis on the japanese model and professional care was at the same time underplaying the shortcomings of these facilities, such as the price, location, and the lack of medical licenses (which most often cause inconvenience for prescriptions and pharmacy pickup). after all, marketing and sales are about strategizing profit-making and maximization. the values of professional care: the story of “grandma li” to turn the knowledge-imbued floorplan into a desirable space of later life, gardenview’s marketing and sales department identified and devised a series of “selling points.” one of them is the notion of professionalism (zhuanye). like many eldercare companies, gardenview formed partnerships with vocational schools and encouraged graduates in relevant majors to intern at the company’s facilities. these graduates comprised the main body of the workforce. the division of labor between care workers, dietitians, nurses, social workers, and rehabilitation physicians was made visible through color-coded clothing.6 for office-based employees, gardenview also ran a vast training program that introduced basic medical knowledge and first aid practices. the idea is that everyone, especially those in the marketing and sales department, should at least acquire elementary familiarity with professional knowledge about eldercare. to encourage participation, the training program also included quizzes and a ranking mechanism that could translate into an internal reward system. professionalism, moreover, is a prevailing technique of storytelling in gardenview’s marketing discourse. it helps shed light on the kind of values that professionalism generate if we recall the http://anthro-age.pitt.edu/ wang | 44 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu “distinction work” noted by amy hanser (2008) in her study of china’s then rising retail service industry. drawing on the work of pierre bourdieu, hanser argues that in the context of post-socialist china, distinction—to be understood as the work of making relational difference—is grounded in a neoliberal transition where the legitimization of private ownership and rapid economic growth not only led to rising inequality and social stratification, but also created a symbolic field of meaning (2008, 11). to invert this insight and see it from the corporate perspective, gardenview’s service in fact carried dual missions: to be sellable and to cultivate a class of clients. while gardenview’s marketing strategies packaged categories of professional care into a bundle of priced services, it is another process, which i will call the education of values, that imparts the knowledge of professionalism to the clients and the broader aging population. in this section, i will focus on the story of “grandma li,” one of the many stories in gardenview’s sales repertoire, to show how an individual’s experience was mobilized to generate meanings and values that would help sell eldercare service. grandma li’s story was also repeated internally within staff trainings, marketing brainstorm sessions, and numerous promotional materials. the company also produced a short film about grandmi li, which played during breaks at various public events showcasing the gardenview culture of care. grandma li’s experience was first noticed by the caregivers working around her, and eventually it was packaged into a story that was circulated across departments. the story went that before grandma li was admitted to gardenview, she was assisted at home by a domestic aid. as her state deteriorated to the point where it was not safe to keep her at home anymore, grandma li’s daughter decided to try institutional care. upon admission, she received a full physical assessment and was placed at a more intensive care level, which meant she needed assistance with performing major daily tasks like eating. although for years grandma li had been fed by her aid, caregivers and nurses at gardenview did not think she needed to be. instead, they believed that with training and practice, grandma li’s physical condition could still allow her to eat by herself. from here, the story took on a different, much more positive tone. at every meal, the caretakers would first encourage her to use the spoon by herself before helping her finish the dishes. while she initially needed help to grip the spoon, grandma li took her first bite on her own within a few weeks, and finally, after a few months, she could eat a whole meal by herself. her daughter, who lived abroad (like many other children of gardenview residents), could not believe her eyes and burst into tears when she first witnessed her mother’s transformation. grandma li’s story became the definitive narrative of the type of professional care promoted at gardenview. but what makes the story so compelling is its success in conveying many of the ideas that gardenview’s (as well as many other similar companies’) marketing specialists struggled to concretize. it is just counterintuitive enough, educational enough, and mundane enough to be perfectly relatable. it is counterintuitive because, for many chinese families, care for elders means to liberate them from house chores and daily tasks—the kind of tasks expected from the domestic aids that grandma li had. similarly, “respecting the elderly” (zunlao) as a “traditional chinese virtue” is often associated with making seats for elders on public transportation. helping elders eat, especially in institutional settings, is a common index of meticulous care within this framework. yet, it is precisely in challenging these assumptions that gardenview invited the audience to rethink the values of care. in the story of grandma li, the value of feeding is inverted. typically, feeding is associated with a paradigm of eldercare in which care is equated with performing tasks, and in this case, a matter of ensuring food consumption. in contrast, the story of grandma li seeks to promote a new approach to eldercare—self-supporting care—in which care means restraining the impulse to http://anthro-age.pitt.edu/ wang | 45 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu intervene. as a story of learning to eat independently, grandma li’s story nudged the audience to picture a different kind of aging, a utopian one no less, of old age where learning is not unique to younger people. it is through learning bodily functions such as eating that the elders’ vitality is best maintained. by defending self-supporting care against claims of negligence, sales specialists performed the education of values: what appeared to be negligence is in fact exemplary of something categorically different. it can no longer be assessed by the virtue of filial ethics; filial ethics itself is transformed as a product of its time, as mr. liu theorized in his talk. eating independently is now an exemplar of professional eldercare. the education of values is crucial because it enables this relocation of the value of care from the filial to the professional. moreover, the achievement of independent eating falls in the ambivalent space between cure and care (mol 2008). although the visibility of grandma li’s change suggests an objective improvement of her physical condition, it is not quite the kind of medical miracle that often redefines personhood. it hardly suggests a medical “recovery,” nor of going back to a fuller state of life. and yet, this rather ordinary miracle exemplifies the values of self-supporting care that gardenview marketed: to care is to make the resident self-supporting. the full value of self-support is only visible when another set of values related to personhood is in place. the scene was so emotional for her daughter because grandma li was enabled by such care to demonstrate her agency, and this agency transformed her into a newly recognized—and recognizable— subject, a subject who strives for a better, high-quality, more dignified, and most importantly, independent life. eating by oneself is thus a mundane yet foundational signal of being oneself: a baby step towards being self-sustaining, literally and symbolically. the value of not feeding is thus embedded in the larger values of care and eventually the values of personhood. as timothy diamond (1992) argues, tacit knowledge about food plays a central role in organizing life in institutional care, both for caregivers and residents. by studying in residential care settings, anthropologists have shown that the treatment of food takes on multifaceted meanings, whether as nutritional values (mol 2010), structures of time (savishinsky 2003), and signs of expertise in care (buch 2013). the value of food itself is also widely recorded and acknowledged across anthropological scholarship. highlighting food’s perishability (see also munn 1992) in her study of the meaning of food in rural china, anthropologist ellen oxfeld highlights food’s capacity of containing and evoking actions, showing that “while food is perishable, the actions surrounding it can create connectedness and sharing, debts and obligations, even resentments and recriminations” (2017, 31). by attending to what people do with/around food, oxfeld traces how, through actions, values are generated and tie together the social world of a village. in all of these studies, food is mobilized to enable and mediate other actions that are beyond food, while the simplest consumption of food, eating, is curiously taken for granted. grandma li’s story is therefore unique in that it provides an opportunity for us to understand action in its most mundane, biological way, and to see how value is generated in the very action of eating. the transformation from feeding to the pursuit of independent dining is crucial. the self-supporting care offered by gardenview is not to be thought of in terms of checking off tasks or serving elders, but instead as the cultivation of new values related to what it means to age. gardenview’s marketing and sales practices show how marketing and sales are vital linkages that enable the making of a market subject—a consumer of valuable eldercare. importantly, this narrativization of grandma li’s case was not only significant as marketing material. the fashioning of the story from just one of the many in the rather enclosed space of care into a public figure mobilized to incite emotional resonance and bring in http://anthro-age.pitt.edu/ wang | 46 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu profit also further transformed the work of caregiving itself. as eric always said and as xiao lu’s own professional trajectory embodied, caregivers were the best salespersons. the industrialization of eldercare therefore not only seeks to capitalize on the relations of care, but also re-invents the work of care itself as one integrated in the culture of entrepreneurship. the irony is obvious, too. on the one hand, self-supporting care at gardenview costs four times the average pension income for nanjing urban retirees, and the cost rises with the intensity of care a resident requires. on the other hand, it should also be pointed out that new care paradigms such as selfsupporting care are not free from economic calculations. one day, for example, i was helping prepare for an activity. when i asked the social workers how they felt about independent eating, to my surprise, their emphasis was not at all on the ethical implications. instead, they asked me in reply, yifan, you think, only one or two of us will be looking over the floor during dining hours. how long would that take if we feed them one by one? and how can we look over other people if we are focused on feeding one person? it would save us so much effort if they could eat by themselves. rather than denying the efficacy of self-supporting care, the staff’s comments revealed the logic of costefficiency that ran parallel to the ideas of good care. that is, instead of seeing economic rationale as the sole determinant of the form of care, the economic and the social are both indispensable in making the desirable way of care. conclusion: education of values in this article, i examined some of the marketing and sales strategies at gardenview, a newly established eldercare company in nanjing, china. there, like elsewhere in urban china, the projected aging demography was mobilized to foster an eldercare industry, transforming ideas, paradigms, and experience of eldercare by putting forward a new set of knowledge of aging. this intimate knowledge about the values of aging embedded in the floorplans and services echoes what karl marx called the “commercial knowledge of commodities,” which marx introduced in the very beginning of the first volume of capital. for marx, this knowledge is intrinsic to the use-value of a commodity, that is, the knowledge about what human needs the commodity could satisfy (1976).7 marx offered his last contemplation of this curious gap of knowledge in a footnote, writing that: “in bourgeois society the legal fiction prevails that each person, as a buyer, has an encyclopedic knowledge of commodities” (1976, 126). in other words, capitalist circulations and transactions presume universal knowledge about the values imbued in the commodity for everyone involved. this insight is perhaps becoming especially true when it comes to the service industry and its immaterial product. knowledge about the service is always a prerequisite. in an industry as new as eldercare in china, as i showed in this article, the work of marketing and sales thus becomes a crucial site where such knowledges are produced, packaged, and disseminated. seeing advertisement as the conveyor of such knowledge, anthropologist william mazzarella analyzes the advertising industry in india and shows how the transformation of social-economic life needs to be understood through the making and propagating of values in a time deemed to be of “value crisis” (2003, 250–51). for mazzarella, aesthetics, or the form of advertisement, links culture with capital, gives commodities meaning, and functions as “a project of education” to “transform the ‘first nature’ of subjective desire into the ‘second nature’ of objective social truth” (2003, 105). in his case, the image of “aspirational indianness” being advertised carries both the social value and the aesthetics of living in http://anthro-age.pitt.edu/ wang | 47 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu postcolonial india—of how one relates to the surroundings—and importantly, the advertising industry is central to the production of such values (cf. fischer 2014, 17). similarly, as xiao lu joked at gardenview, the consumers rarely come to the market with the “encyclopedic knowledge of commodities;” the encyclopedic knowledge of value does not precede the market encounter. rather, knowledge of eldercare is produced and enacted through the work of marketing and sales. whether by selling the floorplan or packaging grandma li’s story into marketing materials, marketing and sales operations coalesce with the making of values. even as eldercare industry professionals make “the market,” the market cannot predate the knowledge of value. in the marketization of residential eldercare, professional care is promoted as an answer to the transition of filial ethics. here, instead of arguing that filial ethics is obsolete in the rise of market choices, it is by the creation of new values of care that the filial is “subcontracted” (lan 2002) and reinterpreted. ethical and economic values are co-produced, and it is by the co-production of values in both realms that a market is cultivated. the floorplan and grandma li’s story are both pedagogical devices; at the same time, they are also both stories of economic rationale where all kinds of values become priced. the lesson behind this pedagogy is that it should not be assumed that monetary value and ethical value are contradictory in the first place. rather, the creation of both are central to what we think of as “marketization.” marketization is not only a process in which services and products are sold but also one in which consumers become a suitable consuming subject (dunn 2004). in the case of eldercare, these processes and transformations are made possible by a historic moment in which population aging has come to be framed as the population paradigm in china. finally, we should also keep in mind that gardenview, like many other similar rising eldercare companies in china, consider themselves to be the driving force as well as future profiteers of ethical transition in contemporary china. when they stepped into the business of eldercare, they were in fact entering into projects of future-making. my interlocutors shifted between schemes of time seamlessly as the work of marketing and sales linked together the present and the future of aging. in his reflections on the social transformation that population aging brought forth in singapore, anthropologist michael fischer argued that as aging becomes the predominant way through which the future unfolds, knowledge of aging “provides a kind of template for literacies of the future, not just of death to come but of worlds opening up to discovery” (2015, 209). understanding the very process of marketization as an education of values sheds further light on these literacies as a socially and economically elaborated and contested future of aging in china. acknowledgments i wish to thank dr. andrea ballestero, dr. svetlana borodina, and dr. nathanael vlachos for their comments and edits on earlier iterations of the manuscript. a section of the manuscript was presented on the panel i co-organized with zihao lin, titled “engineering markets: ethics, entrepreneurship, experimentation” at the 2019 american anthropological association/canadian anthropology society annual meeting in vancouver, bc. i am grateful to dr. andrea muehlebach for her insightful comments and the wonderful discussion. i also want to thank dr. tannistha samanta, janis g woodward, and the anonymous reviewers for their generous feedback and careful edits. the research was financially supported by the wenner-gren foundation dissertation fieldwork grant (#9934) and various rice university institutions, including wagoner foreign study scholarship, the social science research institute, and the department of anthropology. finally, i wish to thank all my interlocutors for sharing their time and insights with me. notes 1. all names of companies and individuals are pseudonyms. due to confidentiality reasons, at a few places i http://anthro-age.pitt.edu/ wang | 48 anthropology & aging vol 42 no 2 (2021) issn 2374-2267 (online) doi 10.5195/aa.2021.305 http://anthro-age.pitt.edu slightly altered the otherwise directly identifiable details, which should not interfere with the presentation of the cases here. though readers familiar with the field might still be able to narrow down the scope, i hope they agree that this article is not so much about presenting a singular case as illustrating some of the common sentiments, vocabularies and discourses shared by the broader industry. 2. historians and philosophers, on the other hand, have also aptly argued that the meaning of filial piety has never been stable in history to begin with (see chan and tan 2004). 3. for a much-detailed account of tian xueyuan’s controversial role in the making of birth planning policy, see greenhalgh 2008. the point here is less concerned with the technicalities of policy making. instead, i contrast two statements made by the prominent scholar to demonstrate how discussions of population aging was peripheral during the implementation of the birth planning program. 4. it should be noted that the imperative of reducing the birth rate was simply assumed rather than demonstrated in tian’s article. for the purpose of this essay, it should be sufficient to say that the population was predominantly conceptualized as the antithesis of natural resources. this conception, however, was only temporary. 5. francis l. k. hsu’s comparisons of filial piety between china and japan, and why it was not a “stumbling block” but “assets for [japan’s] industrialization and modernization” (1971) would have been a favored argument by my interlocutors. 6. the professionalization of care work is at the same time an exclusion of some position that are not considered professional enough. cleaners, for instance, wore different clothes and largely remained anonymous on the floor. 7. economist bertram schefold points out that the “commercial knowledge of commodities” was a rather misleading translation of the original german word warenkunde, which is a discipline in business that deals with “their origins, denominations, compositions, manufacturing processes, properties, kinds, trading marks, indications of genuineness and adulteration and the methods to recognize [commodities]” (2005, 117). references allison, anne. 2017. “greeting the dead: managing solitary existence in japan.” social text 35 1 (130): 17–35. https://doi.org/10.1215/01642472-3727972. aulino, felicity. 2017. “narrating the future: population aging and the demographic imaginary in thailand.” medical anthropology 36 (4): 319–31. https://doi.org/10.1080/01459740.2017.1287181. buch, elana d. 2013. “senses of care: embodying 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relations to family members, friends, and the community change, and their access to different places is challenged by declining health. we show how they continue to belong to others through activities such as preparing seal skin and fishing, but also how belonging can be challenged as one grows older. by doing so, we aim to show how belonging is not given or certain. instead, it can be understood as an expression of agency when facing challenges in old age, not only in relation to others but also in how one sees oneself as an older adult. utoqqaat, avannaani uummannami najugallit, akornanni attuumassuteqarneq (belonging) immikkut ittoq allaaserisami matumani misissorparput. itisiliilluni apersuinerit aamma oqaloqatiginninnerit misissoqqissaarnerisigut utoqqaat allanut aamma sumiiffinnut attuumassuteqarnerat, aamma taakku attuumassuteqarnerat ileqqorissaarnermik aamma tunngavimmik aalajangiisuusumik pissuseqarnersoq misissorparput. utoqqaat ilaquttanut, ikinngutinut aamma inuiaqatigiinnut atassuteqarnerisa allanngoriartornerat ilutigalugu ulluinnarni iliuuserisartagaat paasiniarlugit misissueqqissaarnermi ”acts of belonging” (iliuutsit, attuumassuteqarnermik pilersitsiffiusut) atorparput, aamma peqqissutsip appariartornera ilutigalugu sumiiffinnut assigiinngitsunut attuumassuteqarfigisaminnut peqataasinnaanerat unammilligassaqalersitsilluni. sammisassaqartitsinerit, soorlu ammerineq aamma aalisarneq aqqutigalugit allanut qanoq attuumassuteqartuaannarnersut, aammali attumassuteqarnerit utoqqalinermi qanoq unammilligassaqarfiulersinnaasarnersut misissorparput. taamaaliornikkut attuumassuteqarnerup qanoq naatsorsuutigineqareersinnaanngitsiginera imaluunniit qularnaatsuunnginnera takutikkusupparput. taarsiullugu utoqqalinermi unammilligassanik naammattuuinermi iliuuseqarnissamut kiffaanngissuseqarnermik takutitsinertut paasineqarsinnaavoq, allanut tunngatillugu kisiat pinnagu, aammali utoqqalinermi imminut qanoq isignermut tunngatillugu. keywords: greenland, inuit, arctic, belonging, uncertainty schlütter and jensen │19 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu anthropology & aging, vol 44, no 1 (2023), pp. 19-36 issn 2374-2267 (online) doi 10.5195/aa.2023.414 striving to belong: everyday enactments of belonging among older adults in greenland mette mørup schlütter tenna jensen mms@ph.au.dk tenj@sdu.dk aarhus university university of southern denmark ilisimatusarfik – university of greenland ilisimatusafik – university of greenland introduction karen lived on her own after her children moved out and her husband, whose name she never mentioned, passed away. at first glance, there was no evidence in her house of their marriage, except for a single photograph of karen and her husband at a party, sitting turned away from each other, looking in different directions. the nature of their relationship was always up for negotiation: “he was a nice man, it was just a problem that he had too many women, too much alcohol. he would sometimes go to the bar and not come home for three days,” she said when she described the one time she left him. their children had moved out, so she could no longer find a reason to stay, and without telling him she traveled to denmark and stayed with their daughter, who lived there. she continued: but after two days in denmark, i felt homesick. it was raining and i was crying the entire time. then he said, ‘why don’t you come home?’ he didn’t want to get divorced. i went home, but he kept seeing other women. but i had the house, and he was also very nice. he took care of all the brats my sisters had. i can be thankful to him that they all did so well. and he was handsome. often, she would say something negative about him, but then, follow it up with something positive as if he was somewhere in the room, listening to what she was saying. and maybe, in some ways, he still was. it’s karen’s and other older adults’ experiences of belonging in old age that is central to the analysis and insights that we present in this article. based on ethnographic fieldwork and qualitative research in greenland, we have come to understand sense of belonging as something that changes and must be renegotiated in old age, and as a practice of existential and moral importance. recent gerontological this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. http://anthro-age.pitt.edu/ schlütter and jensen │20 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu research in greenland describes how conditions of old age change the nature of older adults’ relations to others, as well as challenges living in one’s own home(town) and the ability to access certain places – matters that are important when it comes to questions of belonging. thus, while belonging is rarely a stable or certain condition throughout life, the conditions of old age can further destabilize how people consider themselves to belong, particularly as social relations and access to places change. this evokes questions such as: how do i belong to society if i am no longer working? who am i when my children have moved away? who do i belong to now my husband has passed? who am i when i have moved away from the place i belong to? where do i go if my physical abilities no longer allow me to travel to the places where i used to go and catch the food that i’m used to eating and sharing? drawing on anthropologist janne flora’s research in greenland, we approach belonging as a process of constant negotiation. we focus on the everyday acts older adults perform in order to belong. we describe these as acts of belonging. the concept allows us to unfold how older adults actively seek to belong to others, to places, to their community, and to the greenlandic welfare state in ways that are meaningful to them. by striving to continue belonging through these acts in old age, our interlocutors enact understandings and ambitions of aging inherent within broader societal conceptualizations of aging as a lifestage and process that can, and should, be “successful” and “healthy.” these conceptualizations, and the hopes they entail for potential easing of future challenges to national logistics and economics, dominate aging policies in greenland as they do in many other countries. further, we build on anthropologist tine gammeltoft’s (2014, 2018) theoretical description of belonging as a sense of attachment to others produced by joint social practice that can be uncertain, fragile, and ambivalent. she highlights the existential and moral matters that are at stake in her interlocutors’ efforts to be a part of a larger social community. by focusing on belonging as processual acts enacted in unstable social circumstances, we open up to a focus on how older people maintain and create possibilities for belonging as their lives change in old age. in doing so, we aim to create new empirical perspectives on experiences of old age in a greenlandic context and contribute to analytical perspectives on belonging. after introducing the analytical framework for this article, we move on to describing the ethnographic fieldwork and analytical process that has formed the basis for insights offered in this article. then, we describe the role that acts of belonging play in the lives of three older adults in uummannaq: karen zeeb, lars jensen, and christian. we show how they continue to belong to others through activities such as preparing seal skin and fishing, but also how their belonging is challenged as they grow older and also includes exclusion. by doing so, we aim to show how belonging is not given or certain, but instead can be understood as an expression of agency, not only in relation to others, but also in how one sees oneself as an older adult, thus bringing up questions of moral and existential matters. acts of belonging in the following, we provide the analytical framework for the insights offered in this article. we focus on studies of belonging in anthropology as well as anthropological and gerontological research in the arctic that are relevant to the concept of acts of belonging as we use it in our analysis. in recent years, belonging has, from an analytical perspective, gained increased scholarly attention. as a theoretical term, it has been widely used within anthropology, political science, and geography as intersubjective, territorial, or political belonging. belonging refers to people’s sense or practices of attachment to other individuals, places, and to communities. intersubjective belonging has consistently been addressed in kinship studies in anthropology. like the concept of relatedness, intersubjective http://anthro-age.pitt.edu/ schlütter and jensen │21 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu belonging describes how humans connect to one another through different practices. it can be used as an analytical tool that places people in webs of intimate relations, but it also goes further than that by describing how individuals strive to be a part of something bigger. in an arctic context, there are several studies that explore how relatedness among inuit is practiced through everyday expressions of kinship terminology, affection, sharing, working together, and visiting, as well as adoption and name-giving. these studies show that kinship ties can be chosen, just like they can cease to exist if they are not recognized or acted upon. they are thereby never stable, but always up for negotiation. furthermore, intersubjective belonging is closely related to questions of existential matters. while research has shown that there’s a strong sense of personal autonomy in different inuit societies, personhood and personal autonomy is rooted in social relations and communities. cooperation, sharing, and solidarity are seen as important values in individuals. flora (2019) describes that for her interlocutors in a small settlement in greenland, personhood is made of a combination of different entities, such as name and soul, but also relations to people and place. relatedness to others is embedded in the greenlandic language; when you meet strangers, you don’t ask “who are you?,” but “who do you belong to?” or “whose are you?” (“kiuit/kinaavit/kinaatit?” depending on the region). thus, to understand what makes up an individual, it’s necessary to understand how a person is related to others. unlike more conventional categories of identity, which have the tendency to fix people in specific roles (e.g. gender, ethnicity, age, or nationality), intersubjective belonging makes it possible to capture the plural and often contradictory memberships that characterize human lives. territorial belonging attends to the ways people develop, practice, claim, and nurture attachment to places, but also how places can come to define people. in greenland this is present in the use of the affixes -mioq (singular) and -miut (plural) (e.g., someone who belongs to uummannaq, is a uummanarmioq). this term not only indicates where someone lives, but also how someone lives, such as one’s dialect, eating preferences, local landscapes, family relations, and local sociopolitical structures. this doesn’t mean that people never leave a place or that everyone, who is from the same place, acts and thinks the same way. it’s also not set in stone where people consider themselves as being from, and a person can belong to more than one place at once. belonging is, according to flora, enacted through expressions of longing: “for company or for specific people, for particular places in the landscape or on the land (nuna), for foods, for times past, and for potential futures.” as this description of belonging tells us, the distinction between attachment to a place and to a social group is often blurred. people are attached to places, often through the memories, experiences, and connections they have with people in that place, or because they are attached to social groups in certain places. belonging can also be a political issue. political belonging has often been a central theme in studies of citizenship, nationalism, migration, and indigenous rights. questions of citizenship and nationalism are important aspects of belonging, and often a matter of life and death, but are not only confined to formal matters. anthropologist ghassan hage (2002) argues that political belonging is also a question of moral mutuality that attends to how the state recognizes its citizens, and how they in turn feel responsible towards society. consequently, belonging is a concept where matters of identity, place, existence, and morality are all embedded and intertwined. it’s also a concept that indicates a process or negotiation, rather than a stable state of being. in this text, we focus on agency and practices related to belonging through the concept acts of belonging. sociologist ilgin yörükoğlu (2020) uses the concept in her study of queer muslim women of türkish descent, who live in berlin, to move attention from “where” they belong, whether it’s a social or religious group, or specific nationalities, to “how” they belong to seemingly contradictory groups. we use the concept similarly to show how older adults strive to belong, through their actions, to people, http://anthro-age.pitt.edu/ schlütter and jensen │22 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu places, and their community and to live good old lives according to cultural and social norms. at the same time, a focus on the acts of belonging allows us to draw attention to the, sometimes subtle, work that goes on in everyday life, which might seem ordinary, but is important for the well-being of older adults. we do this by asking the following question: how do older adults in greenland experience and create a sense of belonging in daily life? methodology we answer this question through analysis of ethnographic fieldwork carried out by schlütter in different areas of greenland during 2017-2019, and through a continuous engagement from both authors with different communities in greenland. most of the fieldwork was carried out by schlütter over a total of seven months in the uummannaq district in north greenland as part of her phd project. the district shares its name with its largest town. with its fishing factories, health center, police station, large school, retirement home, and administrative center, the town of uummannaq is the heart of the district. the town is vital for the flows of goods, and public and private services that keep the entire district alive. during schlütter’s time in the district, she lived in uummannaq (population: 1,359), but also visited the three settlements in the district – saattut (population: 240), qaarsut (population: 188), and niaqornat (population: 37) – meeting and speaking with older adults there. around 9% of the district’s population were 65 years of age or older in 2018. by spending time at activities for older adults, at the retirement home, and working part-time at different public institutions in uummannaq, schlütter got to know about 30 adults between 54 and 85 years of age, who considered themselves to be “old.” she spent varying amounts of time with these older adults, ranging from a few short talks to spending hours talking, sewing, cooking, playing cards, and other activities in their homes or at their retirement homes, going for walks in the mountains or fishing on the ice. schlütter had close relationships with three older men and two older women. throughout the article, we engage specifically in the stories of three uummannarmiut – karen zeeb, lars jensen, and christian – three of the five older adults that schlütter spent the most time with throughout her time in uummannaq. she spent a couple of hours with them every week, doing everyday activities such as sewing and cooking with karen, fishing and going for walks with lars, and playing cards and reading with christian. she also participated in celebrations on special occasions and other activities with them, for instance, the celebration for greenland’s national day with lars and his family, and gymnastics for older adults with karen. their stories represent a variety of life situations in old age that unfold in the analysis. all three were bilingual (greenlandic/danish), and conversations between schlütter and these three older adults were mostly in danish. a local interpreter was present to assist with translation between greenlandic and danish at most of the interviews with older adults. while everyone was offered the presence of the interpreter, some chose to be interviewed in danish instead. interviews lasted between 30 minutes to 2 hours but would mostly take about an hour. depending on the person being interviewed and the dynamics between the people present, the interview would take different directions and follow themes and topics brought up by the older adults. the analysis is also based on insights gained through a range of ethnographic fieldwork: interviews and surveys carried out at different locations in greenland. schlütter’s phd project is part of the larger research and development project, “ageing in the arctic” (agearc) where researchers from different disciplines carry out surveys, fieldwork, and interviews in all parts of greenland. the quantitative and qualitative insights and results from agearc have guided the analytical focus of the present article. http://anthro-age.pitt.edu/ schlütter and jensen │23 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu returning to uummannaq several times from 2018-2019 and staying in contact with older adults through phone calls, letter writing, and social media has been an intentional methodological choice for schlütter. between each visit to uummannaq, schlütter identified and explored different potential themes in the ethnographic material with supervisors and colleagues at aarhus university, university of copenhagen, and ilisimatusarfik, the university of greenland. upon each return to greenland and in letters, phone calls, and online messaging, schlütter discussed potential themes with older adults in uummannaq to make the research process more collaborative and transparent. the continuous dialogue between schlütter, other researchers, and older adults living in greenland evoked reflections about her position as a danish researcher in a greenlandic context and how this influenced the research process, highlighting the partial and situated nature of knowledge production and representation. the continuous dialogue between project participants and schlütter has been done with the intention of ensuring that the research agenda aligned with the needs, wants, interests, and possibilities of the older adults in question, thus challenging existing “hit-and-run” patterns of arctic research. the analysis in this article was developed through a continuous collaborative process between schlütter and jensen. the analysis focused on ethnographic descriptions based on schlütter’s fieldwork and the continued exchange between schlütter and jensen about this fieldwork. there has been an ongoing dialogue about potential themes and analytical concepts informed by schlütter’s and jensen’s experiences and encounters through fieldwork and research in greenland as well as theoretical knowledge and discussions. after being told about the theme and analysis of the article, karen and lars allowed us to use their real names. both expressed that they wanted their stories to be told and, in order not to make them invisible by blurring their identities, we chose to use their real names. as it was not possible to share the analysis with christian, we use a pseudonym for him. all three signed an informed consent document allowing us to share their stories, as requested by the scientific ethics committee of health research in greenland. by emphasizing the particularities of karen, lars, and christian’s experiences, we will highlight the complexities and nuances of acts of belonging in old age, as we have come to understand them. for karen, who was introduced at the beginning of the article, the work of a hunter’s wife enabled her to feel a sense of belonging to others, to the land, and to the community. in the following, we take a closer look at her story to show how acts of belonging had moral value in karen’s striving for a good life in old age. a hunter’s widow anthropologist pete collings (2001) argues that canadian inuit women are less impacted in their daily lives by physical decline than the men of their communities are. however, some women’s occupations as hunter’s wives are deeply intertwined with their husband’s hunting activities and vice versa: it’s an interdependent cooperation between the two. thus, if the husband is unable to hunt and fish due to physical decline, there would presumably be less work for his wife, and without a wife to receive and prepare the catch, the hunter would be challenged in his activities. status and social relations can come to influence how “successfully” someone ages, as access to kalaalimernit (greenlandic food) is important to older adults. if the husband and his wife were a great hunting couple, the wife might continue some activities as a hunter’s wife even if her husband becomes unable to hunt, because younger family and community members share their catch with them. this was the case for karen even after her husband’s passing. as her husband died more than two decades before schlütter’s arrival in uummannaq, karen http://anthro-age.pitt.edu/ schlütter and jensen │24 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu was no longer actually a hunter’s wife, but as a hunter’s widow, she fulfilled an important role in maintaining traditional activities and knowledge. to her, these activities were a way to practice belonging to her husband, her family, the land, and the community. until karen married her husband, she was a “city girl,” she said, referring to her upbringing in uummannaq as opposed to the settlement her husband was from. she described her younger self as beautiful, but without the skills required to be a hunter’s wife. through their marriage, she became a hunter’s wife and learned the skills needed. even after her husband’s passing, her role as a hunter’s wife was present in the way karen had arranged the home, where she had lived with her husband and raised their children. the house was surrounded by a big porch, where seal skin hung in frames to dry. the entrance had space for the many jackets, coats, and overalls you need when you live in the arctic as well as a freezer for storing fish, seals, reindeer, and other game that her grandsons and nephews had caught for her. in the adjacent utility room, big white buckets covered the floor. karen used these to soak the fat off seal skin in salt water. some skins would lie in water for weeks on end to make it easier to scrape off the hair and use it for arnatuut, the white boots used for some of the greenlandic national dresses. the preparation of seal skin left a distinct smell in karen’s home. “the smell of money, but i like it,” she would say, jokingly, though there was some truth to it. she, like others, earned a little extra money in addition to their pension. other adults repaired or made national costumes, sold dried cod, had a small cleaning job, did some accounting, or volunteered in local organizations. most older adults, including karen, explained that they did these jobs to avoid becoming a burden to their community. these activities were not only productive economically but also had social and cultural value. in the following, we show how karen found value in performing tasks that kept her connected to her family members and to the land. figure 1: karen preparing seal skin in her utility room. photo: mette mørup schlütter http://anthro-age.pitt.edu/ schlütter and jensen │25 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu karen performed and enabled activities that are threatened by the migration of women from smaller communities to bigger towns, cities, and to denmark in their pursuit of education and professional employment – migration that challenges traditional modes of life in greenland. she prepared sealskin, sewed clothes and bags from it, and cut and cooked the meat and organs. many of her nephews, whom she and her husband had taken care of when her sisters were away for work, and her grandsons came to her with the seals they caught. the process of preparing the different parts of the seals kept her busy for months at the time. she would lay out newspapers on the kitchen floor and use her ulu (a woman’s knife) to cut off the seal’s flippers and then cut it open from the bottom up. with steady hands, she would separate the skin from the body by sliding her ulu into the blubber. blood would stain the newspaper, as she pulled the skin away and put it in one of her big white buckets to quickly cleanse it. then she carefully cut out the organs, holding one end of the intestines in her hand, pulling them out, and folding them over again and again until coiled up. with blood-stained hands, she would cut the meat, and finally divide organs and meat into plastic bags, knowing exactly what to do with the different parts: some were good for grilling, others for boiling in soup or fermentation. when meat and organs were put away, she would continue the preparation of the skin by cutting the remaining blubber off and tying the skin onto one of the many frames. there it would hang to dry until she took it down. she would then crumble, chew, and stomp on it, until it was soft enough to work with. karen would sell some skins right off the frame. at other times she would sew bags and clothes from it and sell them. the meat and organs she would either keep for herself or give back to the nephews, who had caught the seal. her nephews either were unmarried or had wives who did not have the time or skills to prepare seal. instead, karen fulfilled the role of a hunter’s wife for her nephews. when bad weather was coming, karen would feel a special kind of pain around her head as a warning. if she knew that some of the men in her family were out fishing or hunting, she would check her phone for news of their return to uummannaq, similar to how women in other parts of the country look towards the horizon searching for signs of their husband’s return from hunting trips. the work she performed not only kept her connected with family members, but she also stayed connected to the land as kalaalimernit became available to her. that belonging to people and belonging to place are intertwined becomes especially evident in the importance of, and access to, kalaalimernit: the way it’s gathered or caught, prepared, and eaten is an important part of belonging to others and to the land. for instance, cod tastes different depending on where in the fiord area it has been caught, and those living in the retirement home away from their settlement would often express that they missed eating the fish from their home fiord. longing for specific foods becomes a way to express belonging to a specific place. kalaalimernit is made available through access to, and knowledge of, different places and it connects people through hunting activities and sharing practices. karen would sometimes talk about where the different seals, whose skin now hung on frames on her porch, were from, or she would talk about going with her nephews on a trip to certain places to catch capelin. for older adults, who can no longer hunt due to physical decline, social relations and status in the community can become determinant for their access to kalaalimernit, as they depend on others to share their catch with them or help them access certain places. this means that those who have weaker social networks or positions within the different communities not only experience isolation in their social lives but are also unable to show and practice belonging to certain places. for karen, her husband’s ability as a hunter was dependent on her abilities as a hunter’s wife, and this relationship left traces even after his death, which made it possible for her to practice acts of belonging in the present. searching for ways not to be a burden for lars, traditional activities held moral values of importance to him. anthropologist claudio aporta (2009) argues that some aspects of inuit identity and culture can be understood in terms of moving; http://anthro-age.pitt.edu/ schlütter and jensen │26 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu moving is considered a way of living and being on the land1 a form of belonging. he describes how trails in arctic canada connect different people, hunting grounds, settlements, and towns. the trails are not just travel routes, but significant in themselves, as they are places to meet others and exchange knowledge about weather, travel conditions and news, and perhaps exchange gas and cigarettes. the trails that people travel along are not permanent. while there are seasons during which busy trails are carved into the snow, they can quickly disappear in heavy snowfalls, or melt away on warm days. before the introduction of maps and navigation systems such as gps, trailbreakers would have to recreate the trail from memory and oral knowledge passed down through generations. this practice signifies an attachment to different communities, where knowledge is kept alive and shared, but also to generations of the past and to the land. collings has described the ability to continue going on the land as important for older inuit men in arctic canada, who defined “successful aging” as the ability to continue fishing and hunting despite physical decline in old age. research among older adults in greenland has also shown that staying active and being able to spend time in nature is important to older adults. however, access to the land is increasingly challenged in old age as the body declines, making older adults dependent on help from others. like older inuit men in northern canada, it was important for lars to stay active despite physical decline in old age. in the following, we look at the role that activities of going on the land played in his striving for a good life. lars lived with his partner and grandchildren in uummannaq. “you know,” lars said, orange fish line in hand, “back in the day, old people used to go out on the ice to die, when they became a burden.” he was standing on the ice, fishing, with every intention of returning to uummannaq later in the day with buckets full of cod. lars would hang the cod to dry on his porch and later sell them or give them away. “why do you think they did that?” schlütter asked to which lars answered: “no one wants to be a burden.” being dependent on others was something many older adults expressed worry about, as they talked about not wanting to be a burden to other family members or the community. http://anthro-age.pitt.edu/ schlütter and jensen │27 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu figure 2: lars at his fishing spot looking towards uummannaq. photo: mette mørup schlütter every year, in late winter/early spring, when the sea ice began to harden, lars was among the first to make it out on the ice. almost every morning, anyone whose house had views towards salliaruseq (the big island) could watch as he and his dog made it out onto the ice walking towards his usual fishing spot. sometimes, other uummannarmiut, who didn’t fish or hunt for a living but enjoyed fishing every now and then, would join him, because he was proof that it was a good spot to fish, and because he always stood within walking distance from the town. not even the never-ending carrousel of temporary foreigners seemed to tire him. most other hunters and fishermen would take their dog sledge or snowmobile and disappear over the horizon, traveling long distances, but lars couldn’t afford this nor would his health allow him to travel that way. instead, he had just a single dog that took him on a small sledge to his fishing spot in the morning and carried him and his buckets of fish back by the end of the day. collings describes how inuit in northern canada believe that living a good and active life makes aging successfully more likely. lars experienced physical decline in old age and often described that he had not lived an easy life. he was no longer able to fish or work like he used to. like many other older adults, he felt how the accumulation of different events in life had changed his overall health. in an accident at work, he had damaged his eyes, causing him to retire early from the workforce. because of issues with his treatment, he lost a lot of money, and he explained that hopelessness caused him to begin drinking quite heavily for a couple of years. when his daughter moved to the city to work, and his two grandchildren moved in with him, he turned his life around to be a good grandfather. in spring, after dropping the children off at the school, he would go on to the ice to fish every day to earn money to pay off debt and give his grandchildren the possibility of better lives. it was the role he wanted to have in his grandchildren’s lives that motivated him. the ice was his solution to support his close relations – and fulfill a role in his family and in the community of uummannaq. however, lars’ acts of belonging were dependent on the presence of sea ice. it always seemed difficult to say exactly when the sea ice would form and how long it would last. in late spring/early summer, lars was one of the last men standing on the ice as it became thinner, and he increasingly expressed worry about the upcoming summer and fall. he did not have the financial means to buy a boat to fish from and his eyesight was too poor for him to sail. the disappearance of the sea ice isolated him on uummannaq island as well as from the activities that kept him busy. “maybe i could get my old job back,” he sometimes pondered. when schlütter flew out of uummannaq in late spring/early summer after a longer period of fieldwork, lars was not to be seen at his usual fishing spot. the ice had become unsafe, and the many tracks that connected uummannaq to other settlements slowly disappeared as the sea ice turned into open waters. lars later recounted summer and fall as difficult times when he sunk into darkness. without the possibility of fishing during these seasons, it was hard to fill time with meaningful activities. he missed the feeling of fresh spring days and crispy snow, and the rhythmic sound of orange string being pulled against the edges of the hole in the ice. but more than that, he missed being surrounded by people, who would come to buy dried cod from him, discuss weatherand fishing conditions or stand with him on the ice, fishing, mostly in silence. thus, not only did fishing during the seasons with sea ice give him more economic leeway, but it was also a way to sustain or create new social relations with the community of uummannaq. he managed to create a place on the ice where uummannarmiut and foreigners could go and connect with the land, each other, and traditional values through fishing. http://anthro-age.pitt.edu/ schlütter and jensen │28 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu due to physical decline and limited financial means, lars was unable to travel far nor along the same trails as most of the fishermen and hunters in the uummannaq district. he still went on the ice to fish, however, in a way that his health allowed; instead of disappearing into the horizon, travelling inland, and along sometimes invisible paths, lars fished in plain sight and close to home. this made it possible for him to achieve belonging similar to that achieved by canadian inuit traveling on the land (aporta 2009). it was his visibility and proximity to others that enabled his belonging, as it made it possible for people to come to him. to lars, the sea ice was a way to belong to the community rather than leave it: to belong rather than be a burden. holding on to stamps the examples of karen and lars show how performing acts of belonging that were considered valuable in the community enabled them to contribute to and participate in their local community. christian, who was one of the youngest residents living in the retirement home, was challenged in performing acts of belonging. in the following, we share his story to make visible how acts of belonging can be challenged in old age as the body declines. figure 3: the table in christian’s room in the retirement home. photo: mette mørup schlütter christian spent most of his days looking out the window of his room on the bottom floor of the retirement home. from there, he could watch as people crossed the town’s square to go to the grocery store or the municipality office. in front of him on the table was an old tv; there was a hospital bed and a collection of books in the room, and a few pictures on the wall, but other than that the room felt empty. christian had worked at the mine and kept postage stamps from the letters he had sent to his daughters when he was away. the stamps had no monetary value as they were used and common, but he held http://anthro-age.pitt.edu/ schlütter and jensen │29 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu onto them anyway. later christian worked at the fishing factory where he performed other kinds of manual labor. in most of his jobs, he had been a valued employee, as he was good at writing and speaking both danish and greenlandic and functioned as both a cultural and linguistic interpreter between greenlanders and danes. he retired early and moved into the retirement home. the many years of manual labor had left his body in constant cycles of pain. his family would visit every now and then, but they were not a part of his daily life. he would play cards with the other residents, but it seemed like an activity that was mostly used to pass time. he knew countless stories about polar explorers and enjoyed telling them when someone asked him to, but few did. while he used to fish, hunt and collect eggs and edible flowers in his spare time, he no longer had the physical ability to perform these activities, limiting his access to kalaalimernit. just by walking down the hallway and taking the elevator to the first floor for lunch, he would lose his breath. when he sat still for too long, his body began to ache. he spent most days watching tv or reading until his body began to hurt. then he would walk down the hallway and stand outside to smoke a cigarette while looking at people running errands in the town square. the majority of christian’s daily interactions were with professional caretakers, or with other residents at the retirement home. he considered his relationship with the caretakers one-sided as he depended solely on them and found it somewhat hurtful to see himself mirrored in the other residents. both things seemed to reduce him to being old and dependent. unlike karen and lars, he was often unable to perform acts of belonging that were valuable in and to the community. the different roles and activities that had tied him to people and society earlier in life were no longer valued in the community on which he had come to depend. christian’s ability to perform acts of belonging was especially challenged by his declining body and his retirement from the workforce. some of the other bilingual older adults in town had part-time jobs facilitating communication between locals and foreigners. this made them able to perform acts of belonging, as they possessed valuable resources for the community, such as working as interpreters between foreign health care professionals and patients in the health clinic. when schlütter asked christian to translate between herself and the caretakers or other residents, he would light up, perhaps because it somehow set him apart from the role of being old and dependent. christian’s, and in some ways also lars’ and karen’s, story shows how belonging can become increasingly uncertain in old age. for lars, his ability to perform acts of belonging depended on the ice and his sense of belonging was challenged when this space was not available to him during summer and fall. then he came to see himself as a burden to the community rather than a part of it. for karen, her husband’s passing caused her to renegotiate her role as a hunter’s wife to become a hunter’s widow and search for ways to continue to belong to her husband, family and community. for christian, it had become increasingly difficult to perform acts of belonging through which he was able to create value for himself and others as his body declined and he often found himself in pain. it made him unable to work or join activities on the land and made it difficult for him to visit family; he was dependent on them to come to him. sometimes, they would come by, but never for long. statistics from the greenlandic national health survey from 2018 show that christian was not alone in experiencing difficulties with remaining connected to people and community. the survey shows that older adults who were mentally vulnerable or had physical limitations in their everyday lives were also most lonely. as we have come to understand it, christian came to see himself as someone who stood outside of the community. perhaps holding on to the stamps from the letters he sent to his daughters was one last try to hold on to a time and a space, and to a family and a workplace, to which he belonged. drawing on http://anthro-age.pitt.edu/ schlütter and jensen │30 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu flora’s description of longing as an expression of belonging, we consider christian’s holding on to the stamps as an act of belonging, adding a temporal aspect to belonging that draws traces of the past into the present. belonging to the past and to the future like christian, karen too shared a presence with people who were no longer there in the way they used to be. not only did her role as a hunter’s widow enable her to perform acts of belonging in the present in relation to her nephews and community, but it also enabled her to practice a sense of belonging that connected her to her late husband. as already described, she would often say something negative about him, then burst out laughing as if it had been a joke or follow up with a positive comment about him or their relationship, as if he was somewhere in the room, listening. some of the coat hooks hung empty out of her reach, and the room upstairs was a closed-off space to visitors. she used to sleep there with him in a big double bed, but after his death, she had rearranged her living room with a single bed: “we had a big double bed, my husband and me. but i search for him,” she said, indicating how she would wake up at night after his death and search for him in the bed. karen never stated any certainty about what she believed happened after someone dies. she said that she was “christian, baptized and confirmed, wedded into that horrible marriage,” and then laughed. later, she told the story of her son who had died in an accident when he was little and returned when his name soul (ateq) had been passed on to a newborn. flora (2019) argues that death in greenland is not a permanent absence, as people return through traditions of name-giving. karen also talked about how her brothers and uncle had died in an accident at sea and that they were now part of nature. she sometimes spoke about their death through a story about three narwhals or a drawing of three blue pine trees. karen didn’t express certainty about how the deceased people in her life were present. instead, their presence was similar to how anthropologist lisa stevenson (2014) describes the presence of a dead relative of a young inuk she met during fieldwork in nunavut. one night, he talked about a raven, whom his sister believed to be their deceased uncle, now visiting them. when asked by stevenson if he believed that the raven really was his uncle, he responded, “i don’t know … it’s still there” (stevenson 2014, 2). it was the same kind of “thereness” that karen shared with the deceased people in her life, and it was a thereness that enabled a kind of belonging that tied the past to the present. this was especially evident in how she expressed belonging to her husband: a constant negotiation about his presence, the nature of their relationship, and her role as his wife, which never seemed to reach any kind of closure. they enabled each other’s belonging: he, through his role as a hunter in their marriage, which was mutually dependent on her abilities as a hunter’s wife. these abilities outlived his death and made it possible for karen to perform acts of belonging with her nephews through her role as a hunter’s widow. but also, the presence of the past was accompanied by an unsettledness in the arrangement of her home, and in the way she talked about him, which kept him present. perhaps the absence of closure also meant that they still belonged to each other. at the same time as her home indicated belonging to her husband, it also had a sense of loneliness about it. there were no couches or dining tables; she slept in the living room, and the kitchen was often a mess. she said that many people didn’t like to come over because of the smell of preparing seals. it wasn’t a home where she could invite her family over for dinner or host a kaffemik.2 she said that it was fine: she wanted to live her life and arrange her house the way she liked it now that she was old and everyone had moved out. she was still healthy enough to visit her friends and her family whenever she wanted to and had so many friends that she didn’t have time to go to all their funerals. but she also said http://anthro-age.pitt.edu/ schlütter and jensen │31 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu that perhaps when she got so old that she could no longer walk, she would get a new husband, who could push her down the aisle of the retirement home. the uncertainty of belonging in the analysis, we have explored acts of belonging for three older uummannarmiut, lars, karen, and christian. a sense of belonging was created as a result of karen and lars’ ability to practice attachment to others, to the land, and to their communities through acts of belonging. karen performed the role of a hunter’s widow for the men in her family. the activities related to this not only generated economic value in the family and the community, but it also created moral value as it kept alive traditional knowledge of seal preparation, the land and hunting possibilities. the interdependence of the roles that karen and her nephews held towards each other made it possible for them to carry out acts that express belonging to each other, to the community, to the land, but also to the past and the future: karen could still belong to her husband, but her activities as a hunter’s widow also kept alive valuable traditions and potential futures for her nephews and the community. while karen was dependent on her nephews, she was more than that in her relation to them: they also depended on her for the preparation of food and seal skin, which we suggest kept her from seeing herself reduced to an old and dependent person. this was important for her well-being in old age. similarly, lars made fishing available to others, an activity that to him held moral value as it kept him from understanding himself as a burden to the community. following hage’s description of political belonging as moral mutuality, it’s possible to understand lars’ and karen’s acts of belonging as ways to live up to a responsibility they felt towards the community. in this way, there are also moral values embedded in acts of belonging that are existential in nature: they keep older adults from feeling devalued by being a burden to others. acts of belonging thus were considered a means to avoid becoming a burden, something that not only karen, lars, and christian, but many older adults were concerned with. in an article about loneliness and social isolation among older adults in danish anthropologist henrik hvenegaard mikkelsen (2019) argues that because the welfare state in denmark provides care for older adults, very few are concerned about being a burden to their families as they grow older and their health declines. instead, ideals about the “good old age” in denmark are concerned with staying both physically and socially active and healthy. these ideals are shaped by beliefs that social isolation and loneliness lead to poor health in old age. in greenland there are similar political and social concerns regarding the health of the increasingly aging population. gerontological research has shown, that vast distances, harsh environmental conditions, and expensive means of transportation, such as sailing or flying, limit older adults’ social interactions with family members who live far way. while the majority of older adults live in the same town or settlement as their children and grandchildren, it is not uncommon to live far away from your closest family members for short or long periods of time, especially if you come from a settlement or smaller town. most parents in settlements send their children off to school in the bigger towns in greenland or in denmark around the age of 14-15 years, and from then, if the child wants to pursue further educational opportunities, they don’t return until they have graduated – and many never return for more than short stays. thus, living away from close family members is an experience many greenlanders have, no matter their age, and as such, it’s not in itself an experience that relates to old age. however, older adults who live far away from family members may experience increasing dependence on others to maintain daily tasks, such as house chores, grocery shopping, and personal care . as their children have moved away, they come to depend on neighbors, friends, or professional care rather than family members in their everyday lives. based on studies of old age in tibetan exile, anthropologist harmandeep gill (2020) argues that problems can arise between older adults and professional http://anthro-age.pitt.edu/ schlütter and jensen │32 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu caretakers, because the older adult can come to see themselves reduced to an old and dependent person with declining health in the relation. a similar negative attitude towards the declining body and dependence in old age can be seen in gerontological models of “successful aging,” that frame the disease-free, independent, active old age as the ideal, something that’s unrealistic for most people . models of successful aging dominate greenlandic aging policies and initiatives that seek not only to improve the well-being of older adults in greenland, but also to reduce expenses for the state and municipalities . as we have seen in the analysis, this dilemma is echoed in the everyday lives of older adults in greenland. older adults often express difficulty in depending on others – that it’s important to stay physically active and healthy and continue to live independently. many describe that they don’t want to burden others and find it difficult to ask for help. only 32% of adults above the age of 75, who live in their own homes, receive professional home care from the municipality . decline in physical abilities often becomes a reality as the body ages, and due to a lack of local care opportunities and retirement homes in settlements, some older adults have to move to bigger towns and cities, causing their dislocation from the places and the people they have belonged to so far . for the older adults schlütter met in uummannaq, their friends and families, as well as local health staff and municipality workers, the category of being old – “utoqqaq” in greenlandic and “ældre” or “gammel” in danish – was not a question of being inactive and unproductive as argued by collings is the case of canadian inuit, where one becomes old when they display “the characteristics of being old: withdrawing from community life, ‘slowing down,’ and ‘feeling lazy’” (collings 2002, 121). karen would say that she had taken care of others her whole life, and now that she was old, she wanted only to care for herself and do things that she found fun. this could be seen as a withdrawal from the community, but as we see in the description of her life, she found it very important to continue contributing to the community despite being old, and she was very productive and active. the acts of belonging were not done just for the sake of staying healthy but were important to stay active in culturally meaningful ways that made her feel like she belonged. in other words, old was not necessarily a steady category, but negotiable and fluid; it was used about and by people in different generations. someone could be old in relation to their younger children, but not as old as someone living in a retirement home. the physical, social, and cultural ability to perform acts of belonging was not a question of whether one was old or not, but instead a question of the ability to strive for a good old age. for christian, who often found himself in pain, performing acts of belonging was a challenge. his declining body made him invisible and unable to perform tasks that he considered valuable to the community. as we see in the analysis, what comes to be at stake in social relations in old age is not only the relationships themselves, but also how changing relations to people and society shape older adults’ anxious self-perception of becoming a burden to others and to the community. karen and lars talked about their everyday acts of belonging as ways to belong to the community rather than being a burden to it, and christian held on to memories of when he was a part of something. in old age, issues of who you are and how to belong are up for negotiation. for some, the changing relations are troublesome and may lead to perceived social exclusion and loneliness, such as in the case of christian and lars when they were unable to perform acts of belonging. not being able to perform acts of belonging was something that karen feared about the future, as she talked about having to remarry if she could no longer walk. if this were to happen, the current acts of belonging she performed would no longer be possible, but a new husband would be able to push her around the hallways of the retirement home in a wheelchair, so she could make friends and have fun. http://anthro-age.pitt.edu/ schlütter and jensen │33 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu in the context of vietnamese women’s reproductive decision-making, gammeltoft (2014) shows how belonging’s contingency becomes evident in moments of crisis: “when routines are suspended, social orientations are shattered and given forms of life are questioned, social membership and loyalties are brought into question too” (gammeltoft 2014, 232). as we have shown through the stories of karen, lars and christian, old age too can represent a crisis that offers insights into what it means to belong. however, rather than a moment of crisis, old age can be described as a prolonged period of crisis: characterized by uncertainty of belonging, where stability is not necessarily possible or expected. there might be moments of stability, but new losses await on the horizon as one continues to age. uncertainty then becomes a part of life rather than a deviance from it, and acts of belonging can be understood as an expression of agency that’s driven by the uncertainty of belonging. as we show, the uncertainty experienced in old age can open for potential new ways to strive for good lives despite aging in a precarious context of illness, social insecurity, absence of kin, and declining health. concluding remarks in this article, we have argued that sense of belonging can become unsettled and unraveled in old age as the body declines and one’s role in the family and the community changes, causing renegotiation of belonging from the aging body. we have explored how the roles of three older adults – karen, lars, and christian – changed in relation to their families, their access to the land, and to their communities as they continued to age. by focusing on every day acts performed to create a sense of belonging, we have shown how they navigated uncertain waters in their striving to understand themselves as older adults that live up to moral and social values in the community and in the greenlandic welfare state. by placing themselves in meaningful and interdependent relations, and by holding on to even small acts of belonging, such as keeping stamps from letters, they were able to renegotiate the importance of their roles in old age rather than seeing themselves as old and dependent, as burdens to others. belonging then is also of existential importance in old age but continues to be challenged as the aging body continues to decline. thus, the uncertainty of belonging in old age is not a momentary crisis, but rather a prolonged phase that continues to demand renegotiation of belonging. seen in this way, acts of belonging can be understood as an expression of agency in the face of uncertainty, and as something that creates new possibilities in old age. acknowledgements first and foremost, thanks to karen zeeb, lars jensen, christian and other older adults from uummannaq and other parts of greenland for sharing their stories with us. we are thankful for valuable feedback from janne flora, nanna hauge kristensen and the reviewers. the phd project from which this article draws is a part of the ageing in the arctic (agearc) project funded by the velux foundation (project no. 14395), institute of culture and society, aarhus university, institute of health and nature, ilisimatusarfik, and the egv foundation (social inclusion of older adults). notes 1 in greenland “on the land” would be the same as being or going on the ice, being in the mountains, or on the mainland depending on the region. as uummannaq is an island, people would use all three or simply talk about spending time in “nature” as opposed to being in uummannaq or other inhabited places. http://anthro-age.pitt.edu/ schlütter and jensen │34 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.414 http://anthro-age.pitt.edu 2 a kaffemik is a gathering on special days such as a birthday, wedding, funeral, first day of school or graduation. it is usually held in people’s homes or in a community house and includes a 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(e.g., shneidman, 1973; kashiwagi, 1985; kawashima, 2011). yet little of this prior research has elucidated issues concerning the bonds between the dying person and those who will go on living. this article explores the spiritual questions some japanese people pose, through the example of one terminally ill female patient. with the spread of the hospice movement in the 1970’s, “deathwatch” in medical facilities became a topic of abstract terminal cancer patients face not only issues unique to their diseases, but also issues rooted in their previous life experiences, including physical, social, psychological, and spiritual pain. this study focuses on the hopes of a terminal patient for “continuing bonds.” much current research emphasizes the importance of “continuing bonds” for the health of bereaved families, but little has looked at the meaning of “continuing bonds” for dying patients themselves. i attended an elderly terminal cancer patient in a japanese hospital, observing and conversing with her as she went through the process of examining her life and faith. the patient granted permission to record and share these observations to shed light on japanese views of “death” and “life.” this research shows that japanese face death not merely as personal issues, but in the broader perspective of continuing family bonds. keywords: death, dying, bonds, self-esteem, transcendence anthropology & aging quarterly 2012: 33 (2) 45 megumi kondo japanese terminal patient’s hope thanatology. figures influential in this clinical practice included saunders and kübler-ross (1969), who conducted research on dying patients in modern hospices and hospital wards. more recent research explored patients’ spiritual questions immediately before death (e.g. tomer, 1994; vickio, 1999). spirituality has become an important concern in american and european palliative care. the word “spiritual” calls up a plethora of meanings and associations--but the english word “spiritual” does not have a direct translation in japanese. the term is often translated into japanese words such as “seishinteki” or “reiteki” reminiscent of the greek “ethos” or “pneuma.” spiritual questions are ultimate, fundamental, and existential questions connected to the passage of time and to interpersonal relationships (murata, 1999a,b). spiritual questions may be painful, threatening the meaning of, the purpose of, or hopes for life. such spiritual problems cannot be readily remedied through mere association with a religion. how can caregivers or family help dying people resolve such questions, especially in modern secular culture? the concept of spirituality covers multiple meanings and interpretations. kashiwagi’s palliative care manual (1992) suggested that three types of spiritual questions for terminal patients include (1) self-esteem, (2) chronological existence, and (3) relational existence. the first type of spiritual question for terminal patients regards self-esteem. patients’ physical conditions influence how they see their own existence. the progression of illness limits the patients’ activities of daily living (adl). unable to function as they used to, their self-confidence and self-esteem decline. they may say, “my body has deteriorated so much; i can do so little now. there is no point in my continuing in this condition. i am just a useless burden.” as a result, they are forced to adjust their perception of themselves. the second type of spiritual question for terminal patients involves the passage of time. nishihira (1993) applied erikson’s developmental theories in his examination of children with muscular dystrophy, noting, “human development is an effort to live a life despite the awareness that people grow up only to die.” similarly, terminal cancer patients cherish each moment. they look forward to the next moment, even though the passage of time means getting closer to death. questions about “life” and “death” are intertwined in such people’s lives. patients may say, “i know i am going to die anyway, so i want to die quickly. if everything is going to end anyway, there is no meaning to life any more. i am just wasting time waiting to die.” they become aware that they cannot avoid death. and this death awareness leads to a fear of disappearance, a loss of meaning, a feeling of emptiness. their questions about the meaning of their remaining time impacts them psychologically. a third type of spiritual question concerns their relational existence. some lose social roles when they resign work due to illness. others lose social connections due to their hospitalization. they may say, “no one needs me. i can do nothing for anyone. nothing will remain when i die.” they question their own worth in society and relationships. they become unable to see their self-worth in social contexts. abundant research on the bonds between the deceased and their bereaved families has focused largely on how the bereaved families fare after losing someone. klass (1996) introduced the idea of “continuing bonds,” refuting freud’s (1917) theories of grief that had encouraged disconnection from the deceased. klass emphasized the importance of the family members’ bonds with the deceased; he derived his idea of “continuing bonds” in part from his observations of traditional japanese culture. in japanese traditional arts such as kabuki, the conferring of familial names on actors as they mature emphasizes the importance of blood relationships. such relationships often provide hints for the spirituality of the dying and bereaved (hattori, 2002; furuido, 2008). recent research (stroebe, 2010) has substantially advanced our understanding of continuing bonds for the bereaved, and increasing emphasis can be seen on qualitative studies in this area (asai, 2010; wilson, 2011). however, these studies focus on the bereaved who are left behind, rather than on the role of continuing bonds for the dying patient oneself. of course, these questions vary from individual to individual. people pose different questions depending on their previous environments and interpersonal relationships (shneidman, 1980). for japanese, spiritual questions are often understood to have multiple meanings about the meaning and future of their existence, not limited to their existence as individual entities, but also including interpersonal relationships with family, friends, and significant others. japanese people tend to prioritize groups (e.g., family) over individuals (watsuji, 1979; hiroi, 1997, 2001), so their lives as patients, including disclosure of diagnosis, determining the treatment, and decision-making around death, are largely influenced by their notions of interdependence (inoue, 1980; ishizaka, 2006). many japanese studies report instances of terminally ill patients posing existential and spiritual questions (kashiwagi, 1985; kishimoto, 1996; arita, 2006). the most anthropology & aging quarterly 2012: 33 (2) 46 megumi kondo a japanese terminal patient’s hope frequent questions pertained to “existence after death,” which includes both social and spiritual connections with their family after their own death (kondo, 2010). questions associated with family bonds were more prevalent among japanese than existential questions. among many questions regarding death, people often wonder about existence after death, asking, “where do we go after death?” and “what happens after death?” some people with terminal illness have concerns about afterlife, often associated with religion and spirituality (cf. kübler-ross, 1988). this fear of death is not only about physical pain before death but also the existence or nature of the afterlife. how do people overcome this fear? interpersonal relationships may suggest answers to life after death, to doubts about religion, and concern about an unfamiliar afterlife. in a japanese social context, not only the possibility of a soul being reborn in heaven, but the possibility of being remembered or even reborn and again and loved on this level pose alternative hopes for post-mortem self-existence. this article shows the role of social interconnections and continuing bonds, focusing on a dying patient and her relationships with family and fellow patients. research methods interview methodology many professional thanatologists learn about their lives of dying patients by spending time with and sharing feelings with their patients. kübler-ross became internationally known for her conversations with terminally ill cancer patients, while glaser and strauss (1965, 1988) became authorities of qualitative research methods by establishing the grounded theory approach. participant observation and dialogue methods are commonly employed to study people during their terminal stages (e.g., carverhill, 2002; wright & flemons, 2002). participant observation in qualitative studies focuses on the dynamics of a dialogue between a participant and a researcher. the researcher inter-subjectively perceives the participant’s internal “thoughts” and “emotions” during the dialogue. kujiraoka proposed that conscientious self-reflection on inner processes of the dialogue could enable the researcher to overcome merely subjective understanding of the participant’s world (kujiraoka, 1998, 1999). along the same lines, i have argued elsewhere that the primary requirement of qualitative research is to expose the researcher’s subjective experience along with the phenomenon presented by the participant. researchers need to grasp the feelings and nuances that are “non-verbally expressed” (kondo, 2010). context and method in the early months of 2005, i did research at a palliative care unit of a general hospital in the nagoya area of japan. the palliative care unit had 19 beds in single rooms, and actively collaborated with other departments of the hospital to meet the needs of the patients and their families. i conducted many 90-minute interviews with terminal patients. while i accompanied a primary physician on his morning rounds, i met all the patients in the palliative care unit. the primary care physician introduced me as a graduate psychology student who was researching to improve psychological care at the palliative care unit. the primary care physician explained that i would ask questions as a part of her study; and that our conversations would be voluntary and not a part of their treatment. then i asked each patient individually whether they would agree to participate in this research. i made scrupulous notes after each interview with cooperating patients, and later attempted to reinterpret them conscientiously based on kujiraoka’s principles. i analyzed our dialogues, making observations on our interpersonal relationships, and on my own subjective experiences that illuminated my interactions with the participant (kondo, 2010). i encouraged the patient/participant to share her thoughts about “daily life” and “recent thoughts,” rather than using a structured interview script. this method was modeled after shneidman’s (1980) research on a dialogue with a terminally ill patient. i employed an unstructured interview in order to explore the participant’s psychological conditions that varied daily. i transcribed the conversation after the interview with the permission of the participant. the primary care physician, the primary nurse, the participant’s family, and the participant herself all reported on her physical and psychological conditions. the participant’s discussion of “self-existence” was extracted and analyzed using an “interactive-observational” interview. the context of the conversation was also considered. ethical considerations the hospital institutional review board (irb) approved this research study. i cleared all interview protocols and procedures with the primary care physicians and nurses, as well as the hospital irb. each patient was given detailed verbal and written explanations of the purpose of the study, the use of the interview materials, and waiving of confidentiality. patients who agreed to anthropology & aging quarterly 2012: 33 (2) 47 megumi kondo a japanese terminal patient’s hope participate signed the consent forms allowing the sharing of all their interviews. i discussed the patients’ conditions with their primary care physician and nurses immediately before each session, so each session was conducted with consideration to the patient’s reported conditions. with the patient’s permission, the transcribed contents of these sessions were also shared with the physician and nurses, in order to further improve their care. background of the case study the case study presented here involved 14 interviews with a 69-year-old patient whom i shall call “kikyo,” dying of rectal cancer which had metastasized to her lungs. kikyo had already lost her parents and husband, but had a married son and two married daughters. her elder daughter was a nurse who served as her key caregiver during her hospitalization. kikyo had undergone an operation for rectal cancer in july of 2000, followed by removal of the inferior lobe of her right lung in july of 2001. in december of 2004, she was hospitalized for chemotherapy, but she was already aware that she was terminal. a friend at her previous hospital had told her about this palliative care unit, so in japanese style, kikyo requested her previous physician to write a letter of recommendation to be transferred to this palliative care unit. at christmastime of 2004, she was admitted to the pcu where she remained until her death on february 26, 2005. she was glad to be admitted, but sad to acknowledge that her life was almost over. her active decision-making in requesting placement to the pcu was atypical of japanese who tend to be less proactive or selfassertive. i conducted 14 90-minute interviews during the last seven weeks of kikyo’s hospitalization in the pcu. i encouraged kikyo to share her “recent thoughts” about “daily life.” rather than using a structured interview script, i employed unstructured interviews to explore kikyo’s varying psychological condition. the content of these interviews, while overlapping, can be loosely divided into (1) spiritual issues, (2) physical issues, and (3) psychological issues, which are introduced in the order in which she confronted them below. each of these issues is totally permeated by a social consciousness which cannot be separated from them. dialogues with kikyo (1) spiritual issues: reincarnation within the family kikyo had resided in the pcu for two weeks when i first met her, accompanying her primary physician on his morning rounds. kikyo had so much fluid in her abdomen that she looked pregnant, but other than her abdomen and swollen legs, she was emaciated. at their first meeting, kikyo was quiet, answering the physician’s questions calmly, displaying none of the physical or emotional pain that many patients do. she neither welcomed nor rejected the doctor’s inquiry about participating in my research study. three days after our first meeting, i asked kikyo if she wouldn’t mind participating in some interviews. when she agreed, i made an appointment to see her again, precisely a week after their first meeting. each time prior to seeing kikyo, i consulted kikyo’s nurse to ensure the interview would not be too stressful for kikyo. when i entered kikyo’s room on the day of their appointment, kikyo was massaging her feet with an electronic massaging machine, as she often did in the afternoon. she welcomed the author, offering her a chair the moment she entered the room. when i asked, “does massaging your legs help?” kikyo smiled for the first time and answered, “not really. but my physician recommend this machine, so i use it.” the tone of her greeting and their small talk during the first week made me feel that some rapport was developing. since her grown children worked full time or were busy as homemakers, kikyo was almost totally alone in the hospital, rarely having visitors. i started to spend time working on daily tasks with kikyo in her hospital room. little by little, kikyo had shared some of her family history. kikyo explained that her biological father had died of stomach cancer, while her husband died after fighting cerebral hemorrhages for five years. she herself contracted cancer while she was taking care of her husband. kikyo had shown very reserved emotion during the first week, but after our first week of contact, she smiled at me and welcomed me. whereas at first she had been close-lipped around me, kikyo was completely different at the outset of these visits; she warmed to the conversation, readily sharing stories about her family. kikyo welcomed my interest, and started to talk about events that occurred on the nights before my visits. she often talked about her dreams. for example, she had told her medical staff that she often dreamed of her deceased husband and her mother. she told me that she often woke up in the middle of the night, and she continued remembering the same dream after awakening for a while. in subsequent conversations, she spoke of her father, children, siblings, and mother-in-law. kikyo talked about her family tree and her husband’s family tree, and visibly brightened when i took out a piece of paper to sketch them out in clearer detail. kikyo asked me to obtain a copy of her family register in order to chart a more precise family tree. when she was discussing her father’s cancer, kikyo started to talk about reincarnation within her family. i had no idea of the significance of this concept at that time, but i was happy to learn more about kikyo’s past. anthropology & aging quarterly 2012: 33 (2) 48 megumi kondo a japanese terminal patient’s hope dialogue 1: reincarnation within the family (february 2) kikyo: do you remember what i was talking about the other day (yesterday)? i was thinking that one family member’s death is connected to another family member’s birth. could you draw a diagram for me? author: yeah, you suggested that when someone dies, someone else is born at the same time within your family. it is mysterious. kikyo: yes, mysterious. author: maybe we could trace those interconnections. why don’t we diagram it some time? kikyo: yeah. i have been thinking about doing so. observation kikyo believed in a particular sect of buddhism that respected family ancestors. perhaps fearing that medical professionals would condemn her religiosity, kikyo was somewhat hesitant to speak of “reincarnation” in the hospital setting (see long, this issue). nonetheless, kikyo apparently pondered and explored this idea daily. it was clear that she cherished the notion of reincarnation within the family. this concept of reincarnation within her family was important for kikyo as she pondered her own living and dying. her concern with this idea led to her asking a relative to obtain a copy of her family register so that i could sketch her family tree. kikyo was not a demanding person, rarely complaining of frustration or expressing fear of death. however, she was virtually obsessed with the concept of reincarnation within her family. kikyo insisted that she wanted me to make a family tree of her family members’ “reincarnations.” she asked her daughter to obtain a copy of her family register instead of relying on her memory to create a kinship diagram. using the kinship diagram, she was able to document that quite frequently, when one family member died, a baby was born to another family member within a few days. when kikyo looked at the family register and discussed its details, it seemed she was seeking to affirm some ■ ● （died on march 13, 1928） ● ■ ● （ died on january 16, 1956） ●（died on october 6, 1999） ■ ● kikyo ■ （born on june, 1928） （died on february 26, 1994） □ ○ ○ □ ○ （ bornh on january 16, 1956） □ ○ （born on february 28, 1994） （born on november 11, 1999） note: ◌female (alive) ●female (deceased) □male (alive) ■male (deceased) figure 1. reincarnation within the family ■ ● （died on march 13, 1928） ● ■ ● （ died on january 16, 1956） ●（died on october 6, 1999） ■ ● kikyo ■ （born on june, 1928） （died on february 26, 1994） □ ○ ○ □ ○ （ bornh on january 16, 1956） □ ○ （born on february 28, 1994） （born on november 11, 1999） note: ◌female (alive) ●female (deceased) □male (alive) ■male (deceased) figure 1. reincarnation within the family kikyo's "family tree," showing dates of births immediately following deaths anthropology & aging quarterly 2012: 33 (2) 49 megumi kondo a japanese terminal patient’s hope primordial faith in the myth of eternal return, and in her ongoing existence within her family. her kinship diagram remained unfinished when she passed away, but is shown in fig 1 (below). kikyo’s belief in reincarnation had two functions for her. one function was to estimate the approximate date of her own coming death. since she expected to be reborn within her extended family, she thought she might predict the date of her own death by finding the date that some relative expected to deliver a baby. but kikyo was unable to find someone pregnant in her extended family. even failing to predict the date of her own death and rebirth, the kinship diagram fulfilled a second function of reaffirming her connections to her absent family. the process of creating a kinship diagram functioned to document her interconnections following the path of her ancestors. the kinship diagram confirmed “the fact that life cycled from generation to generation”. kikyo had lived a life that came from her ancestors and that would be passed on to her offspring. this process assured her of a “place,” an identity and a significance which went beyond time and space. (2) physical issues: comparing her own bodily condition to others’ kikyo was quiet each time her physician came to examine her. she rarely complained of her suffering from fluid in abdomen, though this condition had been conspicuous even before her admission to the palliative care unit. kikyo had learned her diagnosis of rectal cancer on her own. she had stoically undergone outpatient cancer treatment even while she was caring for her husband with a cerebral hemorrhage. kikyo often displayed a surprising objectivity and ability to joke about her illness with me. when she had earlier undergone surgery for her lung cancer, kikyo had shared a hospital room with another lung cancer patient. kikyo repeated to me the conversations she had had with her fellow patient, acting out the role of the other as though she herself were really in pain, imitating her labored breathing. her acting was so realistic--as if she were re-living the suffering of her fellow patient--that it was difficult for me to refrain from intervening. the fluid in her abdomen often caused kikyo to suffer the same labored breathing that her former roommate experienced, sometimes more troublesome than the pain of her cancer. when her stomach rumbled during our conversations, she joked with her abdomen (e.g., “what’s bothering you?”) dialogue 2: dealing with another patient’s death (february 2) kikyo: at the previous hospital, i shared a room with three other patients. a lady with terminal lung cancer had the bed by the window. she said, “you are lucky, kikyo. you can go home as soon as you are able to eat.” i responded, “you will go home soon, too.” but she said, “i don’t think i’ll make it.” when i woke up at night, i saw her sitting up in bed hugging her legs in a fetal position. (kikyo acted like the patient and tried to hug her legs.) author: like this? (i mimicked kikyo.) kikyo: i cannot really do it because my stomach is so swollen. (kikyo looked at her abdomen full of fluid, faking the labored breathing of the deceased patient). author: kikyo, are you all right? kikyo: that lady breathed like this. when i asked her “is it painful?” she said, “yeah.” i was discharged soon after. i tried to visit her when i returned for an outpatient checkup a couple days later, but she had already passed away. her words came back to me; looking back on it, i saw that she knew she was dying. observation ever since she was first diagnosed, kikyo had received periodic treatment for her cancer. because such treatments seemed to work, even if temporarily, she had not considered her cancer life threatening. at the same time, however, she worried that her cancer might become terminal for her as it had been for her father. kikyo did not talk much about her own suffering or pain, but she frequently mentioned her father’s terminal cancer. kikyo had some idea of the metastasis of her cancer, because she had watched her father undergo the same process. she appeared to have wished a greater connection with her family; she wished to share her feelings with her father now that she suffered from the same cancer. kikyo rarely complained of her pain or suffering. this was partly an emulation of her father, who also held back from sharing his suffering or pain. she also refrained from voicing her pain because she had had such a hard time constantly listening to her husband complaining of his pain. in emulating her father’s stoicism, she was also trying to spare those around her from hearing her complaints. i pondered why kikyo did not actively pursue information on the prognosis of her illness. it appeared that kikyo anthropology & aging quarterly 2012: 33 (2) 50 megumi kondo a japanese terminal patient’s hope was trying to estimate her condition by paying attention to her own body, and comparing it to the experiences of those she had previously watched die. her imitation of labored breathing may have been grounded in genuinely labored breathing during the nights when she was alone. as she reenacted her former fellow patient’s departure, she was at the same time preparing herself for her own departure. and throughout the process, she was carefully conscious of the effects of her own words and actions on those around her. (3) psychological issues: humor towards and inferences from others kikyo and i developed some familiar routines. in every session, i would typically sit across from kikyo, moving a chair close to her bed that paralleled the window. once i moved the chair to that location and sat down, kikyo would initiate our conversation. we shared a number of small but memorable occasions. for instance, one day on his morning rounds, the doctor suddenly decided that he would drain her abdominal fluid. both of our stomachs growled as we skipped lunch while we conversed, waiting for the procedure to finish. on another instance, i accompanied kikyo when her pharmacist and nurse discussed her medications with her. this accumulation of small daily conversations led kikyo to open up to me and to voluntarily share her thoughts without prompting. one monday, kikyo was massaging her legs, and i was relieved to see some healthy color on her smiling face. i was already aware of kikyo’s deterioration because she had been struggling with her physical condition in our previous session, and her chart indicated that she had been delirious over the weekend. i asked kikyo to describe her weekend. kikyo smiled wryly as she recounted an episode of the previous friday: witnessing kikyo’s delirium and decline, the hospital staff had asked her family to visit her. the hospital staff explained her condition to her family in front of kikyo. kikyo knew that her family would not initiate visits on their own; their visit and the staff’s explanation was so unusual that kikyo inferred she was about to die. kikyo grew delirious again on the following day, rarely responding to me. the last moment we shared together was listening to her favorite song on a portable taperecorder. then kikyo went unconscious. i held her hand as her breathing grew labored, her shoulders heaving with each breath. she was pronounced dead during the next weekend, when i was not present at the unit. observation constantly seeking cues about their conditions and prognoses from the brief interactions that they are allowed with medical staff, palliative care unit patients often become very sensitive to the conversations and behaviors of their staff and families. it was unusual for kikyo to have many family members visit at the same time. she spent most of the time alone at the hospital. aware of her deteriorating physical condition, kikyo surmised that her death was imminent because the hospital staff had asked her family to come to the hospital. another reason that kikyo thought her death impending was because of her decreased appetite. when she was first admitted to the palliative care unit, she was ecstatic that she was still able to eat and enjoyed her food with a good appetite. though on one level she was emotionally ready to accept death, her dwindling appetite also made kikyo realize that her death was imminent. kikyo often joked about her own death. perhaps she was trying to gradually accept the difficult reality of her own death by joking about it with others. unsure of her true motives, i tried to support kikyo by laughing with her as she joked about the progression of her illness and coming death. i was not merely laughing, but attempting to accept the reality that kikyo faced. concluding discussion: tangible and intangible connections beyond the extant family kikyo smiled and asserted that she was ready to die on the very first day i met her. she was quiet and rarely complained of her physical condition. however, our dialogues revealed that she always reflected upon spirituality and the nature of her post-mortem existence. kikyo had decided to be transferred to the palliative care unit after learning about her poor prognosis. her time at the palliative care unit was the time she chose to face her death. instead of complaining of her pain, exhaustion, or labored breathing, she talked about her dying journey and her internal “dialogues” with those who had died. kikyo’s behavior was largely influenced by her caregiving experiences in the past. she projected others’ dying process onto her own dying process. she used to be a caregiver, and was always the one “left behind”; here at the palliative care unit she was no longer a caregiver “left behind,” but instead she was the dying one. her conversations with the dead, and her reviewing such conversations with me, helped kikyo to confirm her connection with those living and dead. remembering and empathizing with people whom she had watched dying anthropology & aging quarterly 2012: 33 (2) 51 megumi kondo a japanese terminal patient’s hope helped kikyo to face her own death. kikyo was unable to empathize totally with such people who died of cancer, but she re-lived the experience of “dying” by having internal conversations with these dead people. corr (1993) suggested that dying individuals face four types of tasks, viz.: (1) physical, (2) psychological, (3) social, and (4) spiritual. non-spiritual problems include dealing with physical decline (compromised activities of daily living, changes in body image); psychological challenges (accepting one’s own death, anxiety, attitude toward death); and social issues (financial problems due to illness, loneliness or alienation due to weak community ties). conversely, spiritual tasks derive from worldview values, cultural background and lifetimes of experience. indeed, kikyo too confronted each of these issues in her own way. however, the order in which she expressed them was somewhat reversed: first she faced spiritual issues in a japanese manner, only later facing psychological and physical issues. significantly, her social concerns were not a separate set of issues, but inextricably interwoven throughout all of her other concerns--although perhaps particularly prominent in her spiritual concerns about survival. aside from the history of her own illness, kikyo primarily focused her discussions on reincarnation within her family. kikyo did not simply contemplate afterlife or heaven; she pursued “connections” with her beloved family; “connections with others” not only prompted questions regarding her hereafter, but also provided her answers to them. her pursuit of connections is not explicable simply through existential theories. kikyo questioned whether and how she would exist in this world beyond the time of her death: she sought assurance through dialogue and through shared time with those left behind. she talked about reincarnation within the family as an underlying theme of “connection with others.” importantly, her definition of “connection with others” comprised both (1) a connection with her extended family and (2) a connection with former deceased cancer patients. it may be improper to generalize from a detailed study of a single patient, but this study suggests that a japanese approach to spirituality, as well as to physical and psychological self-definition, is more involved with this-worldly social interconnections than with existential or other-worldly issues. future studies may find ways that this cultural tendency can be better understood and utilized in caring for terminal patients. in concluding, i should like to express my gratitude to kikyo for helping me explore the most fundamental questions of human life; 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1999 together in spirit: keeping our relationships alive when loved ones die. death studies 23:161-175. watsuji, tetsurou 1979 culture: a discussion of anthropology. tokyo: iwanami. wilson, sara, and supiano, katherine p. 2011 experiences of veterans’ widows following conjugal bereavement: a qualitative analysis. journal of women & aging. 23 (1):77-93. wright, kristin, and flemons douglas. 2002 dying to know: qualitative research with terminally ill persons and their families. death studies, 26 (3):255-271. debate introduction : care as critique and debating the ageless self christine verbruggen ku leuven christine.verbruggen@kuleuven.be anthropology & aging, vol 44, no 1 (2023), pp. 86-91 issn 2374-2267 (online) doi 10.5195/aa.2023.482 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. debate | verbruggen | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.482 http://anthro-age.pitt.edu 86 debate introduction : care as critique and debating the ageless self christine verbruggen ku leuven christine.verbruggen@kuleuven.be “to think is not to possess the objects of thought: it is to use them to mark out a realm to think about which we therefore are not yet thinking about.” (merleau-ponty 1960, 160) introducing the debate: generating theory with care scholars in the field of aging and the life course generally develop a critical sensitivity for the complex entanglements of multiple temporalities. particularly their aged collaborators teach them, in distinct ways, that the thick of the present is a laboratory for reimagining futures from the fissures of tradition and for saturating pasts with what we, as aging subjects, kin, scholars, activists, practitioners, and companions, care for in the contemporary. as feminist sts scholar maria puig de la bellacasa (2011, 2017) argues, as in care practice (mol 2008; mol, moser, and pols 2010), caring in knowledge production is not a universal and generalizing moral disposition – ‘if only we care’ – but an ongoing practice that entails particularity: taken from where we stand, we care for some things more than others, and can become accountable to the fact that some things need not equal but more care. as such, care can be troubling, critical, and generative (duclos and criado 2019). instead of appropriating, reproducing, or discarding, caring in the staging of things – like theoretical concepts and epistemological traditions – adds to their vitality in a particular way and nurtures some futures more than others (puig de la bellacasa 2011). generative care thus also has a speculative dimension: “to mark out a realm to think about which we therefore are not yet thinking about” (merleau-ponty 1960, 160). it is in this spirit of generative critique through care that anthropology & aging launches the debate as a new annual section in the journal. the debate is designed to animate multiple relations with seminal works in anthropology of aging and the life course and to promote the advancement of anthropological theory. this annual section will take a ‘classic’ text in anthropology and aging or popular-culture media (fiction, film, music, comics, etc.) as a point of departure for a diffractive reading of theoretical issues in interdisciplinary research on aging and the life course. the format is called a ‘debate,’ because, like in a formal debate format, the participants are invited to take a clear stance in favour of or against a central statement. however, the art of debating is here of secondary importance and there are no winners or losers in the end. rather, urging participants to take a stance is a provocation to move beyond calcified consensuses on the meanings and uses of seminal concepts, towards affective engagements with their pasts, presents, and futures. http://anthro-age.pitt.edu/ debate | verbruggen | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.482 http://anthro-age.pitt.edu 87 at stake in the debate is the critical labour of “looking forward, looking back” (zeitlyn 2015). on the one hand, we invite scholars – the debaters – to be mindful of the genealogy of epistemologies, concepts, and critical traditions in the field, of how they are gathered, and of what was excluded (puig de la bellacasa 2011, 2017; zeitlyn 2015). on the other hand, we motivate them to assess the accuracy of these concepts cross-culturally and in a contemporary world with its slowly shifting processes of aging, relating, living, dying, moving, caring, and kinning, and consider what of the past traces in concepts are amenable for particular futures. thus, we hope for this debate to become a resource that introduces different publics to the relevant arguments in debatable statements, to be a place where issues of consensus and dissensus in anthropology of aging crystallize, and to contribute to articulating debates for the future in anthropology and aging that can further diverse aging futures. to achieve these aims we adopt a multimodal approach: the debate consists of a podcast of a (virtual) live debate held with the debaters, and written pieces by the participants published in anthropology & aging. in doing so, we hope this debate section will be a dynamic space for engendering anthropological theory on aging and the life course that can respond to changing times. first debate: reflections on the ageless self for the first debate we invited editorial advisory board members of anthropology & aging to revisit a quote from anthropologist sharon kaufman. her work recently came to the forefront by her passing away in april 2022, although she has of course always been and remained a reference point in the field. kaufman made an invaluable contribution to medical anthropology, gerontology, and the anthropology of aging. among her award-winning work are the ageless self: sources of meaning in late life (1986), a healer’s tale: transforming medicine and culture (1993), and a time to die: how american hospitals shape the end of life (2005), and ordinary medicine: extraordinary treatments, longer lives and where to draw the line (2015). kaufman’s radical empiricism and long-term ethnographic engagements allowed her to articulate and theorize contemporary experiences and practices of aging, caring, monitoring, curing, living, suffering, and dying in the era of biomedicalization. the statement open for debate is a quote from the reflections on the ageless self that kaufman wrote in 1993, a few years after the publication of the book, in generations: journal of the american society on aging. in this way, i heard many older people talk about themselves, their pasts, and their concerns for the future. i observed that when they talk about who they are and how their lives have been, they do not speak of being old as meaningful in itself. that is, they do not relate to aging or chronological age as a category of experience or meaning. to the contrary, when old people talk about themselves, they express a sense of self that is ageless – an identity that maintains continuity despite the physical and social changes that come with old age. … . old people do not perceive meaning in aging itself so much as they perceive meaning in being themselves in old age. thus, my initial research question about the meaning of aging evolved into an inquiry into identity, or the ageless self, and how it operates as a source of meaning in old age. (kaufman 1993, 14) four members of the editorial advisory board of anthropology & aging took the time to critically consider this statement, in the light of their own work and research experience, and mindful of the more than three decades that have passed since the publication of the ageless self. after a first draft of their contributions, they participated in a (virtual) live debate, that was generously moderated by phil kao http://anthro-age.pitt.edu/ https://www.jstor.org/stable/44878413 debate | verbruggen | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.482 http://anthro-age.pitt.edu 88 (which can be listened to be here). the four wonderful short pieces that were finalized after this debate are included in this debate section. bringing in research on aging experiences from very different cultural contexts (japan, india, ghana, and the united states) and diffracting notions of aging, agelessness, selves, and culture from various angles, the debaters provide a kaleidoscopic analysis of the ‘ageless self.’ they also carefully articulate some viable alternatives for interrogating aging experiences in the future based on the starting points in the ‘ageless self’ as an analytic concept. mark luborsky, a contemporary of sharon kaufman, takes the time to honour her, not through empty glorifications but by taking the intentions and the genealogy of her work seriously. taking recourse to art and poetry to substantiate his arguments, luborsky comes out in favour of the statement and he proposes to engage with the ageless self as a reliquary – “a shrine, or a container for something of value, not the thing itself” (luborsky, this issue). kaufman and her colleagues were the first generation to provide alternatives for the then dominant representation of aging as a natural stage of diminishment, loss, frailty, and disconnection. set in this gerontological tradition, her work has a janus face: it is progressive in turning the attention to aging experiences and personal meaning-making in an era where scholars presumed only the abatement of meaning, and it fell prey to the “siren call of the seductive familiarity of the subjective, internal and private sphere” (luborsky, this issue) that is so characteristic of the western cultural tradition of privatization and the monadic self. luborsky further explores the openings that kaufman’s ‘ageless self’ has made for future scholarship on the diversity of aging experiences. he reminds that it would be a mistake to cast kaufman as naïve on issues that we would now call intersectional and that significantly constrain possibilities for meaning-making. for example, the focus on meaning-making in the ageless self at that time contrasted sharply with the prevalent denizenship of older adults and their homogenizing, negative portrayal. kaufman’s focus on life span personal meanings however, luborsky notes, also opens up to other diversities in later life. these include cross-cultural or cross-national comparative studies that challenge the binary between collectivist and individualist notions of self; historical, global, and political diversities in the life course different age cohorts which invoke complex negotiations of self and personhood; migratory realities that motivate assemblages of multiple selves and modes of aged belonging; and diversity in the way critical cultural events (such as the development of hiv medication) impact possible experiences of self across the life course. luborsky contends that by conceiving of the ageless self as a reliquary, it retains its vitality as a provocation of the singular, monadic self that keeps requiring denaturalization in the field of gerontology and anthropology of aging. while having nothing but praise for kaufman’s prose, her analysis, and the thickness of her ethnographic work, cati coe argues against the ageless self as articulated by kaufman. indeed, coe recognizes, the ageless self is hegemonic in the us, kaufman’s homeland and field site: it fits well within ideologies of continuous personhood and independence that have regulated a sense of self since the mid-twentieth century. the ageless self however, coe states, is an emic, not a universal concept to talk about experiences of aging. bringing in alternative orthodoxies of aging from her decades of research experience in ghana, she argues that “old age is a powerful cultural category, although one with considerable ambivalences” (coe, this issue). power in aging has mostly negative connotations in ghana, as exemplified in accusations of witchcraft of older women who are alleged to use their power to disrupt social integrity. yet, aging activists do not propose agelessness as heterodoxy but work to undo the power associated with aging, propagating “considerations of a long life as a blessing from god, not a sign of malevolent power” (coe, this issue). unlike the american cultural context, she finds that the ghanaian cultural context does provide the resources for the articulation of aging selves: older ghanian adults actively perform aging through attending to and making explicit their aging bodies as http://anthro-age.pitt.edu/ https://anthro-age.pitt.edu/ojs/anthro-age/article/view/482/615 debate | verbruggen | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.482 http://anthro-age.pitt.edu 89 weak and in pain, and through actively anticipating death by preparing standardized narratives of their social accomplishments during life. reaching beyond the statement that (aging) selves are culturally specific, coe proposes the notion of repertoire to account for “a toolbox of practices, skills, and ideologies” (coe, this issue) that people draw from to respond to different challenges in life. the repertoire is synchronic in nature – it changes throughout history and over the life course, unlike notions of ‘culture’ or ‘self’ have us believe. importantly, one aspect of the repertoire is the cultural sensorium that calls attention to embodiment, bodily sensations, and references to embodiment in discourse – aspects of aging that receive little attention in kaufman’s work. coe makes a claim for focusing on these sensory experiences of and through aging bodies to analyze experiences of aging and gain insight into which bodily experiences are socially recognized and legitimate, and which are not. being mindful of the cultural sensoria of aging can reveal which factors influence changing repertoires for selfand person-making, and opens up to the politics of aging. the concern for the emic character of the ageless self is echoed in sarah lamb’s debate piece. speaking from an ethnographic engagement similar to kaufman’s, 40 years later, lamb agrees at least in part with her finding that older americans embody an ageless self as a positive source of meaning making in later life, what she in her own work (2014) sometimes calls “permanent personhood.” what is problematic, lamb argues, is that the ageless self is “a particular, even peculiar, cultural-historical construct” (lamb, this issue), not a universal category to analyse all aging experiences. doing anthropology at home without fully destabilizing the doxa – her own doxa – kaufman does not pause on “why north americans might be so particularly inclined to posit a self as ageless” (lamb, this issue). having herself focused on the exacerbation of the ageless self in the “successful aging” paradigm as a ”cultural obsession” (lamb 2017), like cati coe, lamb reminds that the american context does not provide a space for aging selves. it rather promotes the eradication of experiences of aging and the continuity of productivity, health, and meaning as a project of the self to exorcise the deep fear of decline and death. in the us, the aged self is not a cultural possibility. in a privileged position to defamiliarize the familiar with years of ethnographic experience in india, lamb contrasts the ageless self as a cultural ideal with the ambiguities of aging experiences of older indian adults. foregrounding transience and transformation rather than stability as central to human life, aging in india is a meaningful stage of life, as any other. influences of positive aging or anti-aging discourses, practices, and products in india also do not result in a dismay of signs of aging. as one of her interlocutors phrases it: “i don’t mind being called old, because i am old” (amarnath banerjee in lamb, this issue). however, lamb reminds, the ageless self as a cultural ideal, is not uncontested in the us either. echoing much of the ethos of ursula le guin’s statement on aging that “denial serves nothing” (le guin 2017, 17), some of lamb’s us interlocutors also acknowledge the violence of the cultural ideal of transcending aging, arguing instead for a realist attitude towards life and mortality, and for accepting transformation as central to personhood. lamb closes her argument with a call for a continued interest in the particular embodiments (or the absence thereof) of this ideal and invites future anthropologists “to investigate whether and in what ways visions of agelessness over the life course resonate—or not—with the experiences of situated interlocutors” (lamb, this issue). jason danely, coming out against kaufman’s statement, pursues these questions in an aging japan, a cultural context that, similar to the us, provides little cultural space for embodying aging as a meaningful life stage. official and administrative terms, like ‘senior’ (kōreisha), as well as more mundane and traditional concepts, like ‘elder’(rōjin), simultaneously signify looming dependency and frailty in aging, and the responsibility to actively prevent dependence in aging. but does the lack of a discursive space to talk about aging in positive or even neutral terms mean that older japanese adults might identify as ageless? “many, no doubt, would, though not without some hesitance,” danely argues; but this does not make the ageless self a valid analytical concept for aging experiences in japan. all these http://anthro-age.pitt.edu/ debate | verbruggen | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.482 http://anthro-age.pitt.edu 90 terms and their appropriations need historical and political grounding. the fear of dependence that motivates practices of healthy aging for his interlocutors is not inherent to the aging self, but the consequence of historical and sociopolitical contingencies. born a couple of years prior to the postwar baby boom generation (1947-49), his interlocutors, members of a senior center, retired in an increasingly neoliberal climate that forcefully mobilized a discourse of responsibility, prevention, and independence and saw the further pathologisation of old age with the new long-term care insurance system in the 2000s. the grimness of an aging population as futureless is further confirmed and magnified in popular media. the desire of older adults for agelessness would not be too far-fetched in this climate. yet, danely argues, practices and discourses of healthy aging by older adults are not merely reactions to social demands, but are also future-oriented practices. by caring for their health, they are also caring for a care-less future for their own children, taking recourse to paid care and support, and for thickening intergenerational relations so central for japanese subjectivities. additionally, “selves overflow the power of cultural and biopolitical narratives” (danely this issue). conversations with older adults outside the senior center taught danely that aging was practiced as a process of transformation, including experimentation with new rituals, play, and relationships, as well as re-integrations of a changing past, and aspirations for the future. selves were changed through these practices that were often prompted by “existential possibilities” (parish 2008 quoted in danely, this issue). “aging as the process of inhabiting change over time,” danely (this issue) argues, denotes the continuous labor of integration, recomposition, and renewal in – not outside of or in despite of – the conditions of later life. this, danely suggests, is not the kind of labor for which the ageless self is equipped because it finds no meaning in old age. for anthropologists to be able to account for this everyday labor of meaning-making in aging, danely proposes to meet older age as an “existential situation” (le guin 2017, 17) through which aging bodies continuously explore capacities of possible selves. decades after the publication of the ageless self, sharon kaufman has again propelled the invention of anthropological theory of aging. this debate honors kaufman’s timely efforts to excavate experiences of aging and meaning-making in later life from the cellars of gerontology, where these had remained hidden behind the pathologisation of aging as a natural episode of decline. all speaking from their own research backgrounds, the debaters highlight the cultural specificity of the ageless self, as a particularly western, american possibility for identification and meaning-making. they historicize and denaturalize interiority, independence, continuity and – concomitantly – agelessness as standards for meaning-making in later life. for the future, some analytical shifts are proposed – to repertoires, cultural sensoria, and possible selves – to better account for the historically and culturally contingent ways in which people navigate the challenges of everyday life throughout the life course. in sum, this debate is again a reminder for anthropologists of aging and the life course to cultivate a greater sensitivity to the inventiveness of older adults to make, find, and give meaning to their lives through the embodied, experimental and situated appropriation of cultural discourses and identities, whether these be ageless or aged. references coe, cati. 2023. “what does aging mean? repertoires and embodied sensoria in person-making.” anthropology & aging 44 (1): 103-107. danely, jason. 2023. “which self is ‘ageless’?” anthropology & aging 44 (1): 112-115. duclos, vincent, and tomás sánchez criado. 2019. “care in trouble: ecologies of support from below and beyond.” medical anthropology quarterly 34 (2): 153-173. doi: 10.1111/maq.12540. http://anthro-age.pitt.edu/ debate | verbruggen | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.482 http://anthro-age.pitt.edu 91 kaufman, sharon r. 1986. the ageless self: sources of meaning in later life. madison, wi: university of wisconsin press. _______. 1993a. a healer’s tale: transforming medicine and culture. madison, wi: university ofwisconsin press. _______. 1993b. “reflections on ‘the ageless self’.” generations: journal of the american society on aging 17(2): 13-16. _______. 2005. and a time to die: how american hospitals shape the end of life. chicago, il: university of chicago press. _______. 2015. ordinary medicine: extraordinary treatments and where to draw the line. durham: duke university press. lamb, sarah. 2014. “permanent personhood or meaningful decline? toward a critical anthropology of successful aging.” journal of aging studies 29: 41-52. _______. 2023. “who wants to have an aged self if to age is so bad? ageless and aged selves as cultural constructs.” anthropology & aging 44 (1): 108-111. lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. new brunswick, nj: rutgers university press. le guin, ursula k. 2017. no time to spare: thinking about what matters. new york: harper. luborsky, mark. 2023. “the ageless self: relic or reliquary.” anthropology & aging 44 (1): 92-102. merleau-ponty, maurice. 1960. “the philosopher and his shadow.” in signs edited by maurice merleau-ponty, translation r. c. mcleary [1964], 159-181. evanston, illinois: northwestern university press. mol, anne-marie. 2008. the logic of care: health and the problem of patient choice. london: routledge. mol, anne-marie, ingunn moser, and jeannette pols, eds. 2010. care in practice: on tinkering in clinics, homes and farms. bielefeld, germany: transcript. puig de la bellacasa, maria. 2011. “matters of care in technoscience: assembling neglected things.” social studies of science 41 (1): 85-106. https://doi.org/10.1177/0306312710380301 puig de la bellacasa, maria. 2017. matters of care in technoscience: speculative ethics in more than human worlds. minneapolis: university of minnesota press. zeitlyn, david. 2015; “looking forward, looking back.” history and anthropology 26 (4): 381-407. https://doi.org/10.1080/02757206.2015.1076813. http://anthro-age.pitt.edu/ https://doi.org/10.1177/0306312710380301 https://doi.org/10.1080/02757206.2015.1076813 anthropology & aging quarterly 2010: 31 (1-2) 6 aage member news member news column two long-time aage members recently won major awards! congratulations on behalf of the entire membership to: athena mclean, phd, winner of the society for medical anthropology’s 2009 new millennium book award for her book, the person in dementia: a study of nursing home care in the us. university of toronto press. the new millennium book award was established by the society for medical anthropology to recognize and promote excellence in medical anthropology and is given annually to a scholar within the field of medical anthropology for a solo-authored (or co-authored) book published since the beginning of the new millennium. the new millennium book award is given to the author whose work is judged to be the most significant and potentially influential contribution to medical anthropology. maria vesperi, phd, recipient of the aaa/oxford university press award for excellence in undergraduate teaching of anthropology. this award was established in 1997 to recognize teachers who have significantly contributed to and encouraged the study of anthropology: “the successful teaching of anthropology is at the core of producing successful anthropologists. by transferring knowledge and encouraging interest and study, the teacher is able to contribute significantly to the increasing success of the field of anthropology. without such people the growth of anthropology would be stifled.” recipients of the award are nominated by their peers and must demonstrate excellence in terms of their impact, creativity, and influence on the field of anthropology. to share vicariously in maria’s award ceremony, see the youtube clip: http://www. youtube.com/watch?v=pg0vredd53w anthropology & aging quarterly 2010: 31 (1-2) 7 aage member news introducing president-elect of aage, dr. lori l. jervis (ph.d. university of minnesota, 1998). associate professor, department of anthropology, university of oklahoma; associate director, center for applied social research, university of oklahoma. research: principal investigator, exploring the mistreatment of native elders (funded by the national institute on aging). co-investigator, sociocultural validity in the context of dsm comorbidity (funded by the national institute of mental health, jan beals, pi). principal investigator, native elders, dementia, and family caregiving (funded by the national institute on aging). co-principal investigator, winter camp: care in a tribal nursing home (funded by the administration on aging, spero m. manson, pi). co-investigator, epidemiology and service utilization: american indians (funded by the national institute of mental health, spero m. manson, pi). recent publications: jervis, l. l. (2001). nursing home satisfaction, biography, and the life worlds of psychiatrically disabled residents. journal of aging studies, 15(3), 237-252. jervis, l. l. (2001). the pollution of incontinence and the dirty work of caregiving in an american nursing home. medical anthropology quarterly, 15(1), 84-99. jervis, l. l. (2002). working in and around the chain of command: power relations among nursing staff in an urban nursing home. nursing inquiry, 9, 12-23. jervis, l. l., & manson, s. m. (2002). american indians/alaska natives and dementia. alzheimer disease and associated disorders, 16 (suppl. 2), s89-s95. jervis, l. l., beals, j., arciniegas, d. b., & fickenscher, a. (2007). performance on the mini-mental state examination and mattis dementia rating scale among older american indians. journal of neuropsychiatry and clinical neurosciences, 19(2):173-178. jervis, l. l., & manson , s. m. (2007). cognitive impairment, psychiatric disorders, and problematic behaviors in a tribal nursing home. journal of aging and health,19(2): 260-274. jervis, l. l., shore, j., hutt, e., and manson, s.m. (2007). suboptimal pharmacotherapy in a tribal nursing home. journal of the american medical directors. 8:1-7. jervis, l. l., and the ai-superpfp team (2009). disillusionment, faith, and cultural traumatization on a northern plains reservation. traumatology, 15(1):11-22. jervis, l. l., beals, j., fickenscher, a., arciniegas, d. b., cullum, c. m., manson, s. m. (in press). predictors of performance on the mmse and the drs-2 among american indian elders. journal of neuropsychiatry and clinical neurosciences. professional activities: advisory committee member, alzheimer’s association’s 2002 invited conference on research in diverse groups of older people: issues and barriers, 2002. scholar, advanced research institute in geriatric mental health, weill medical college of cornell university, 2005-2006. organizer and program chair, seventh annual meeting of the association for anthropology and gerontology’s annual meeting, aging and the indigenous people of north america, 2009. reviewer, gerontological society of america 2009 annual meeting. guest editor, special issue of journal of cross-cultural gerontology, 2010. statement: although very much a medical and gerontological anthropologist, i have spent my career in a variety of interdisciplinary contexts, collaborating primarily with nurses, psychologists, and psychiatrists. to my mind, bridgebuilding with like-minded practitioners, scholars, and researchers both inside and outside of anthropology is key to growing and sustaining a dynamic organization such as the aage. organizing last year’s annual aage meeting on anthropology & aging quarterly 2010: 31 (1-2) 8 aage member news aging and the indigenous people of north america presented an excellent opportunity to see this process up close, as there are only a small number of anthropologists currently working on this topic, creating an imperative to connect with others outside of the field. in addition to continuing the work of previous aage leaders in fostering interdisciplinary connections, as president elect i hope to further their efforts to attract new scholars and researchers to the field of anthropology and aging—especially crucial given the demographic shift to remarkably older populations both within the u.s. and many other nations as well. the aage is well positioned to play a role here, with connections to some of the best mentors many newer scholars could hope to find. i am eager to help facilitate the continued growth of the organization and broadening of the field through the resources of the aage. visit aage on the web! http://aage.clubexpress.com/ you can renew your membership, read anthropology & aging quarterly, stay up to date on the margaret clark award, and learn about aage’s annual workshop. anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 1-10 issn 2374-2267 (online) doi 10.5195/aa.2015.94 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. neglect of older people in humanitarian response unni karunakara senior fellow, jackson institute for global affairs, yale university author contact: unni.karunakara@yale.edu abstract adapted from keynote address at the association for anthropology and gerontology conference, florida international university, miami. february 7, 2015. an earlier version of this paper titled “humanitarian assistance for older people: does it matter?” (june 2012) was presented to doctors without borders for discussion, and later published in plos medicine (december 2012; 9(12):e1001357) as “ending neglect of older people in the response to humanitarian emergencies.”1 keywords: humanitarian aid, emergency response, disaster, global health http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.94 http://anthro-age.pitt.edu neglect of older people in humanitarian response unni karunakara senior fellow, jackson institute for global affairs, yale university author contact: unni.karunakara@yale.edu in times of humanitarian crises and complex emergencies, our tv screens and mailboxes fill up with funding appeals. charities raising funds to respond to emergencies tend to rely on images of malnourished babies and winsome children to raise funds. there is something about threats to the very young that awakens the protector in all of us. this focus on the very young is perhaps a natural reflex, yet we mustn't allow it to blind us to the needs of older people. as a doctor and a humanitarian worker, i want to challenge our sense that when emergencies arise, we should always focus first on the needs of the very young. at the heart of humanitarianism are the principles of humanity and impartiality—the belief that all human beings deserve a life of dignity, and that all have equal value. it would run counter to these principles to exclude someone on the grounds of nationality, religion, politics or gender. i believe it is time we add to this list, asserting that it also violates the humanitarian ethos, to exclude people on the grounds of age. we have an ethical imperative to respond to the needs of older people on the same principled basis as we respond to those of children and younger adults. why does it matter? there are practical reasons why humanitarian actors such as doctors without borders/médecins sans frontières (msf) must ensure that older people’s needs are addressed in a humanitarian response. older people make up a significant and growing number of those affected by humanitarian crises, and yet they are not sought out, much less prioritized, within the humanitarian response. yet older people play a key role in household livelihoods, both with their labor and with financial and material contributions. they usually remain economically productive for as long as they are physically and mentally able, and for as long as household requirements demand their contribution. in addition, the contributions of older people to family and household duties enable other household members to find employment and income for the household.2 perhaps the most vital role that older people play in household economies is in caring for other vulnerable people, especially children. this is particularly the case in areas where the parent generation is missing because of aids, economic migration, or conflict. in the case of aids, limited data makes it difficult to quantify the prevalence of such “skipped generation” households, but hiv prevalence, the mortality rates of the middle karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.94 http://anthro-age.pitt.edu 2 generation, the number of orphans and the role of extended family structures all suggest that many older people are caring for children in sub-saharan africa.3 similarly, high rates of migration to cities or even other countries in search of work often mean that children are left in the care of grandparents. there are reasons to believe that a child who has a grandmother has a better chance of surviving and thriving; studies show that care by a maternal grandmother improves the child’s nutritional status and increases chances of survival.4 5 last but not least, older people contribute their accumulated experience, knowledge and understanding. this insight not only makes them a valuable resource for their communities, but also makes them important potential partners in designing and implementing humanitarian programs. in order to be principled, practical and relevant, humanitarian agencies must ensure that they are able to provide the assistance that older people need, and to which they are entitled. what is “old”? there is no general agreement on the age at which a person becomes old. in developed countries, the threshold tends to be 65 years. for the un, the agreed cut-off is at 60 years, but in developing countries, where the majority of humanitarian crises take place, we see that 50 or 55 years is perhaps more appropriate.6 the use of a calendar age to define old age assumes equivalence with biological age, and the two are not necessarily synonymous. it is more accurate to understand old age as a relative category, construed in different ways according to a person’s role and status in the community.7 in areas of the world where people do physically taxing labor, do not have adequate healthcare and have a low life expectancy, chronological age is less significant than physical condition as a marker of aging. a lifetime’s exposure to health problems, environmental pollutants such as cooking smoke, and physical labor means that women, in particular, may be seen as old in their forties or fifties. unnoticed but not unimportant effective humanitarian assistance is based on assessment and surveillance data on the affected population and the vulnerable groups within it, and on meeting the needs of those most in need. almost all guidance – whether targeting general audiences (such as the sphere handbook8) or sectorialor agency-specific audiences (such as agency handbooks, sectorial standards or emergency-specific guidelines) – requires collection of sexand age-disaggregated data (sadd). in practice, however, most needs assessment and surveillance data combine data for all adults. this renders invisible the particular needs of older people.9 10 yet health and nutrition needs of age groups differ, so it is crucial to disaggregate data to understand the profile and needs of people of various ages. approaches to measuring disease burden and health impact can also be discriminatory. the disability-adjusted life year (daly) method (which is endorsed by the world health organization and is in common usage) ascribes a value to each year of life according to age, with years lived as a young adult being valued more highly than years spent as a young child or older karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.94 http://anthro-age.pitt.edu 3 3 adult. claiming that life years given to older people are objectively less valuable reflects a concern with receiving a return on investment rather than responding impartially and equitably to needs.11 such age weighting and discounting undermines the principles of humanitarianism. funding institutional donors do not regard humanitarian assistance for older people as a priority. two studies by helpage international analyzed the amount of humanitarian funding targeted at older people through the un consolidated appeals process (cap) and flash appeals in the past five years.12 13 they found that just 0.3% of projects funded included any activity that specifically targeted the needs of older people, who constitute 12.5% of the world’s population. in 21 countries, there had been no projects at all in the previous two years with activities tailored for older people. (those countries included chad, central african republic, south sudan, yemen, zimbabwe, and 16 countries making up west africa.) increasing population numbers demographics suggest that populations facing disasters will include an increasing proportion of older people. about 12.5% of the world’s population is aged 60 or over; 17% are 55 or older; more than 22% are 50 or older.14 moreover, with demographic change (declining fertility rates combined with increasing life expectancy), elderly populations in developing countries are growing faster than in developed countries.15 by 2050, the number of people over 60 is projected to almost triple, from 865 million in 2010 to 2.4 billion, to constitute 21% of the world’s population. by then, more than 80% of older people will live in developing countries – where disasters are more likely to occur and their effects to be greater – compared with 60% today.16 where a generation is missing because of high hiv prevalence, conflict or economic migration, communities have higher proportions of older people. this is particularly common in remote rural areas.17 older people often make up a high proportion of people who choose not to flee in times of conflict.18 hardship associated with a long trip and problems that get worse with age such as poor eyesight and limited mobility make it less likely that the elderly will get out of danger and seek help. moreover, their reluctance to leave homes, land, livestock or orphaned children under their care makes them less likely to receive any assistance.19 a commitment to non-discrimination? old age today is grounds for exclusion from humanitarian assistance. this was indeed the case in the somali capital city in 2011. during the height of the nutritional crisis, nearly all of the screening and therapeutic programmes were directed towards children and their mothers. i observed that a large number of malnourished older people were living in makeshift tents all across the city, yet almost all the people being assessed for malnutrition were children. far too often, older people, invisible to aid providers, are too frail or self-abnegating to seek assistance even when it is being provided a few meters away. this is unacceptable. karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.94 http://anthro-age.pitt.edu 4 among the 100,000 people displaced from sudan’s blue nile state in july 2012, an msf team found that the 50-and-above group, constituting 10.5% of the population, were dying at over five times the rate of those aged 5 to 49 years (3.45 vs. 0.61 per 10,000 per day, respectively) and at over twice the rate of those under the age of 5 (1.26 per 10,000 children per day).20 we now know that three out of four killed by the 2005 hurricane katrina in louisiana, were over the age of 60 even though they constituted only 11% of the population.21 22 similarly, one of three casualties in the 2011 tohuku earthquake and tsunami were over the age of 60 despite comprising just one fourth of the population.23 those above age 60, constituting 9% of the nepalese population, are considered to be among the most vulnerable victims of the 2015 nepal earthquake.24 even allowing for the obvious fact that people naturally die at higher rates when they get older, these are unacceptably high figures and should not be ignored. why are older people invisible to humanitarian agencies? hutton suggests that, “we do not assess older people’s needs, nor do we address their needs through our assistance.”25 maybe we see more inherent value in the life of a child than that of an older person; perhaps utilitarian considerations of the longer-term future of a society come into play; or maybe we simply go with the flow of current aid practice without questioning it. for whatever reason, humanitarian actors do not consider older people a priority, even though they are generally recognized to be a vulnerable group. age and vulnerability health needs age has an important impact on health. older people have limited regenerative abilities and have health risks and needs that differ from younger people’s. the prevalence of chronic and non-communicable diseases increases significantly in old age; global aging is recognized as a major driver of non-communicable disease predominance in developing countries.26 older people in lowand middle-income countries are at especially high risk of cardiovascular disease, strokes, diabetes and dementia. they may require palliative care and end-of-life pain management. evidence from conflicts and natural disasters shows that much excess morbidity and mortality results from the exacerbation of existing non-infectious diseases such as hypertension, diabetes and cancer.27 this was exemplified in a recent survey of some of the estimated 10 million syrians who have been displaced from home since the start of the civil war in march 2011 (7.8 million internally displaced and 2.8 million in neighboring countries such as lebanon, turkey, jordan, and iraq).28 the survey conducted by helpage international and handicap international in lebanon and jordan showed that 54% of older syrian refugees have a chronic ailment while 65% present signs of psychological distress.29 yet the management of non-communicable chronic disease is a rarity humanitarian responses, and there are virtually no guidelines for management of chronic medical conditions after disasters.30 the latest revision of the sphere handbook, however, does recognize the increasing evidence of acute complications from chronic diseases in disasters and supports and encourages their treatment.31 karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.94 http://anthro-age.pitt.edu 5 5 older people may also be at increased risk from communicable diseases. infectious diseases have a specific presentation in older people. this is most obvious with respect to hiv and tb, but it also applies to infections such as diarrhea, pneumonia, and neglected tropical diseases.33 there are also reports of higher parasite loads, and in cases of malaria, a higher proportion of severe forms and an increase in fatal disease amongst older people. preliminary results from a study of data from msf cholera treatment centers in haiti indicate that people over 60 years old are more likely to present with severe dehydration as opposed to mild dehydration when compared with younger adults. in addition, after controlling for other factors, people aged 80 years or older have 11 times the mortality of younger adults in cholera treatment centers.34 preliminary analyses of age-disaggregated fatality rates of the recent outbreak of ebola virus disease (evd) in west africa also suggest poor survival rates among older people when compared with young adults.35 yet older people are rarely if ever identified as an at-risk group for communicable diseases, and infection control programs do not usually consider approaches geared specifically to the elderly population. there is evidence even from settings such as the uk’s national health service that an inverse care law operates: older people generally have higher healthcare needs than other demographic groups, and yet they have a lower provision of and access to medical care.36 nutrition needs few nutrition surveys are carried out among people aged 60 years and above, and, as we have seen, survey data collected in humanitarian crises are rarely disaggregated to show the situation of older age groups. it is generally accepted that measuring the malnutrition of children under five years provides an indicator of whether a nutrition intervention is needed in the general population, but this does not provide humanitarian agencies with enough information on other age groups to inform targeted interventions. in october 2011, helpage conducted a nutrition survey of older people in the refugee camps of dadaab, kenya.37 it showed that older people were also vulnerable to malnutrition, although they were not recognized as such in the other surveys that had been done, and they were not included in supplementary and therapeutic nutrition programs. helpage international recommends the use of muac (mid-upper arm circumference) for assessing the nutritional status of older people and recommends that older people be systematically screened and included in nutrition surveys.38 food rations also need to be adapted for older age groups. although total recommended energy intake declines with age, requirements for many nutrients increase in order to maintain organ systems with declining functionality. inadequacies of micronutrients – such as vitamins b6, b12, c and e, folate and calcium – are common amongst older people and are linked to the risk of chronic disease. adequate protein is also critical for maintaining functional status with age. at the same time, older people may require smaller amounts of iron and vitamin a, nutrients emphasized for maternal and child nutrition.39 as is often the case with older people, however, research on their nutritional requirements is inconclusive. access and capacity many older people are not able to travel to health and registration facilities, stand in queues for food distributions, carry heavy packages of food or containers of water, or compete with younger people for relief supplies. in lebanon, one out of every four older refugee was not karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.94 http://anthro-age.pitt.edu 6 registered, compared to one out of eight children. strength, mobility, eyesight, and hearing decline with age, all of which affect people’s ability to access humanitarian assistance. as a result, older people often depend on support from their families and communities to access care and assistance. what needs to be done? there is a need for academic, research, and practice communities to work towards ensuring that vulnerable groups are not excluded and their needs are met by humanitarian aid. i outline a set of priority areas for humanitarian response, to be incorporated into practice, research, and policy: practice collect age-disaggregated data on who is accessing humanitarian assistance to ensure that older people are not being excluded. ensure that all surveillance, needs, and vulnerability assessment data are disaggregated for older age groups. systematically screen older people in nutrition surveys using muac. provide adequate care in emergencies for chronic diseases and conditions, including palliative care and pain relief. ensure that infection-control programs take into account the differing presentation and needs of older people. research research the optimum nutritional support for older people in emergency settings. conduct operational research into the best way to ensure that older people’s health needs are comprehensively met in humanitarian programs. conduct operational research to determine how best to improve older people’s access to humanitarian assistance both in open settings and in camps. policy ensure that institutional funding bodies include the needs of older people in project proposals where appropriate, and fund them adequately. karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.94 http://anthro-age.pitt.edu 7 7 there is a widespread assumption amongst aid agencies that older people are always cared for within their families. however, in many situations, particularly in crises and disasters, this is a myth. for example, following the 2010 floods in pakistan, the ministry for social welfare estimated the number of older people living without family support at 10% of the older population. similarly, 9% of older people in the occupied palestinian territories live alone. in camps for internally displaced people (idps) in darfur, half of all the older people live alone. special attention needs to be given by humanitarian agencies to facilitate older people’s access to care and assistance and ensure that they are not excluded. conclusion as the numbers of older people affected by humanitarian crises and disasters increase, policy and practice must be adapted to ensure that older people's needs are consistently considered. being old should no longer mean being ignored. aage president iveris martinez (fiu) and dr. unni karunakara at the association for anthropology and gerontology conference on “health disparities in aging,” held february 5-7, 2015. (photo courtesy of iveris martinez) karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.94 http://anthro-age.pitt.edu 8 notes 1. an earlier version of this paper titled “humanitarian assistance for older people: does it matter?” (june 2012) was presented to doctors without borders for discussion, and later published in plos medicine (december 2012; 9(12):e1001357) as “ending neglect of older people in the response to humanitarian emergencies.” 2. helpage international. making a living last longer: insights into older people’s livelihood strategies. 2011. 3 samuels f, wells j. the loss of the middle ground: the impact of crises and hiv and aids on ‘skippedgeneration’ households. project briefing, odi; november 2009. 4. sear r, mace r, mcgregor ia. maternal grandmothers improve nutritional status and survival of children in rural gambia, proc r soc. august 2000; b267; 1453:1641-7.
 5. gibson ma, mace r. helpful grandmothers in rural ethiopia: a study of the effect of kin on child survival and growth. evolution & human behavior. november 2005; 2 (6):469-82. 6. who. definition of an older or elderly person. available at: http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html 7. sanderson w, scherbov s. remeasuring aging, science. 2010; 329:1287-8.
 8. the sphere project. humanitarian charter and minimum standards in humanitarian response. belmont press; 2011. 9. mazurana d, benelli p, gupta h, walker p. sex and age matter: improving humanitarian response in emergencies. feinstein international center, tufts university; august 2011.
 10. du cros p, venis s, karunakara u. should mortality data for the elderly be collected routinely in emergencies? the practical challenges of age-disaggregated surveillance systems. trans r soc trop med hyg 2013; 107:669-671. 11. death at a young age is counted as a greater loss than death of someone older, so the value of a life is discounted by a certain percentage for each year a person ages – 3% seems to be the usual discount in daly calculations. 12. helpage international. a study of humanitarian financing for older people and people with disabilities. 2012. 13. helpage international. a study of humanitarian financing for older people. 2010.
 14. population division of the department of economic and social affairs of the united nations secretariat. 2010. world population prospects: the 2010 revision. available at: http://esa.un.org/unpp.
 15. shrestha lb. population aging in developing countries. health affairs. 2000; 19; 3:204-212. 16. population division of the department of economic and social affairs of the united nations secretariat. op. cit. 17. samuels f, wells j. op. cit. 18. karunakara uk. the demography of forced migration: displacement and fertility in the west nile region of northern uganda and southern sudan. johns hopkins university. drph. 2004.
 http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html http://esa.un.org/unpp karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.94 http://anthro-age.pitt.edu 9 9 19. harrell-bond be. imposing aid: emergency assistance to refugees. oxford: oxford university
press; 1986. 20. du cros p, meredith c, thomson k, downing s, cooney l, siddiqui mr, cramond v. abstract. is it time to stop being crude? elderly mortality rates in a refugee camp maban county, south sudan. msf scientific day. 10 may 2013. http://www.msf.org. uk/sites/uk/files/10._du_cros__older_mortality.pdf 21. http://new.dhh.louisiana.gov/assets/docs/katrina/deceasedreports/katrinadeaths_082008.pdf 22. http://www.un.org/esa/socdev/documents/ageing/iddr2014/pressrelease.pdf 23. http://en.wikipedia.org/wiki/2011_tōhoku_earthquake_and_tsunami 24. http://www.helpage.org/newsroom/nepal-earthquake-older-people-among-most-vulnerable/# 25. hutton d. older people in emergencies: considerations for action and policy development. who; 2008. 26. un general assembly 65th session. note by the secretary-general; 13 sept 2010.
 27. spiegel p, checchi f, colombo s, paik e. healthcare needs of people affected by conflict: future trends and changing frameworks. lancet. 23 january 2010; 375.
 28. idmc. http://www.internal-displacement.org/middle-east-and-north-africa/syria/ 29. helpage international and handicap international. hidden victims of the syrian crisis: disabled, injured and older refugees. 2014. 30 chan ey, sondorp e. including chronic disease care in emergency responses. humanitarian exchange. odi. 2008; 41. 31 the sphere project. op cit.
 32 gavazzi g, herrmann f, krause kh. aging and infectious diseases in the developing world. clinical infectious diseases. 2004; cid 39.
 33 chappuis f, alirol e, worku dt, mueller y (2011) high mortality among older patients treated with pentavalent antimonials for visceral leishmaniasis in east africa and rationale for switch to liposomal amphotericin b. antimicrob agents chemother 55: 455–456. 34 kwok j, swarthout t, fritsch p, raza a, newport m. loving the older people in times of cholera: preliminary findings from a study to analyse care and outcomes for cholera patients treated by médecins sans frontières operational centre amsterdam in haiti and zimbabwe 2008-12. prepublication. available at: http://issuu.com/msfuk/docs/pdf/1
 35. http://www.ebola-anthropology.net/wp-content/uploads/2014/12/older-people-and-ebola-ebolaresponse-anthropology-platform.pdf 36. hart jt, the inverse care law. lancet. 1971; i:405-12.
 37. fritsch p, myatt m. nutrition and baseline survey of older people in three refugee camps in dadaab. helpage international. october 2011.
 38. ibid. 39. tucker kl, buranapin s. nutrition and aging in developing counties. journal of nutrition. september 2001; 131:2417s-23s. http://new.dhh.louisiana.gov/assets/docs/katrina/deceasedreports/katrinadeaths_082008.pdf http://www.un.org/esa/socdev/documents/ageing/iddr2014/pressrelease.pdf http://en.wikipedia.org/wiki/2011_tōhoku_earthquake_and_tsunami http://www.helpage.org/newsroom/nepal-earthquake-older-people-among-most-vulnerable/%23 http://www.internal-displacement.org/middle-east-and-north-africa/syria/ http://issuu.com/msfuk/docs/pdf/1 http://www.ebola-anthropology.net/wp-content/uploads/2014/12/older-people-and-ebola-ebola-response-anthropology-platform.pdf http://www.ebola-anthropology.net/wp-content/uploads/2014/12/older-people-and-ebola-ebola-response-anthropology-platform.pdf karunakara | neglect of older people in humanitarian response anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.94 http://anthro-age.pitt.edu 10 40. helpage international and handicap international. op cit. 41. helpage international. analysis of older people’s ongoing vulnerabilities in sindh, pakistan. 2011.
 42. palestinian central bureau of statistics. elderly people in the palestinian territory: facts and figures. july 2005. 43. helpage international. older people in africa: a forgotten generation. 2008. 44. karunakara u, stevenson f. ending neglect of older people in the response to humanitarian emergencies. plos med. 2012. 9(12): e1001357. anthropology & aging quarterly 2010: 31 (3-4) 65 student column giving and receiving care: an evolving and enduring relation philip y. kao ph.d. candidate university of st. andrews philip.y.kao@gmail.com much has been written about the practice of caregiving and care for the elderly, especially in places like the traditional nursing home (e.g. diamond 1986, savishinsky 1991, stafford 2003, gass 2004). in the united states caregivers commonly refer to those professionals that constitute a cadre of nurses, nursing assistants (both certified and uncertified), therapists, palliative care/ hospice workers—and very often—family members, who help the elderly in a range of activities from adl’s (activities of daily living) to providing companionship, and a host of other tasks. professional caregivers working in long-term care facilities such as nursing homes (skilled nursing facilities) and assisted living homes often struggle to balance the need for personalizing care and doing everything on time, at the expense of treating residents as simply dress-up dolls. cna’s and uncertified caregivers oftentimes look after more people than they can handle, leaving little room for striking up friendly conversation, expressing empathy, and engaging in simple human companionship. family caregivers struggle in different ways, but are just as hard-pressed for time especially when their loved ones suffer from dementia related conditions (e.g. alzheimer’s) that demand care and attention constantly. these family caregivers are sons, daughters-in-law, and siblings who are undoubtedly frustrated, and have little or no time to attend to their own stress and health issues. caregiving in the presence of financial, emotional and family stress also adds pressure to the overall situation. not only are caregivers personally affected, but the caregivers’ families and the people around them are affected by the ensuing stress. it is no surprise then that sociologists and gerontologists have focused their research in the past on such topics as communication between caregivers and the recipients of care, disputes arising between family members and caregivers, and ways to become better, more effective caregivers at home and in the community (e.g. foner 1995, ward 2008). what is interesting for anthropology is a consideration of the caregiving relationship between particular people, and the relationship as a structural feature developing out of a wider social, economic, and historical context. to begin with, my interest in aging has to do partly with the industry and practice of caregiving and what this says about our social and emotional linkages to one another. this is not to say that i am interested in how people are (or are not) culturally obligated to take care of the sick or elderly. rather, it is the intimate and corporeal relationship that unfolds between a caregiver and a care-receiver that illuminates what it means to be independent/ dependent, whole/broken, and social in specific contexts. caregiving then is never neutral; i.e. it can sometimes stand in as a metaphor for an assertion of (bio)power (cf. foucault 2007). i once heard a female caregiver in a nursing home confront a nurse about a particular resident. the cna was trying to convince the nurse that ‘her’ resident was acting up and needed some medical attention. after the nurse neglected to pursue any follow up, the cna walked away noting sarcastically, “well what do i know? after all i am just the caregiver! i am with her monday through friday” in other contexts, caregiving can be operationalized to assert a type of labor identification and experience. caregivers often say to themselves that, “not everyone can be a caregiver. it takes passion; you have to like taking care of people. not everyone is cut out that way”. in caregiving, the emotional dimension is far more complex than the sheer physical job of helping someone get out of bed anthropology & aging quarterly 2010: 31 (3-4) 66 student column routinely, brush their teeth, and getting them to various appointments while making sure that they are ‘toileted’ every two hours. in fact, caregivers themselves have developed a form of dependency as well. i overheard several times that, “if it wasn’t for my residents, i would have quit a long time ago”. there is a creeping suspicion (on my part) that caregivers need their residents just as much as the residents need them. as alluded to above the political economy of caregiving is an evolving and complex enterprise featuring aspects of the government, healthcare (reform), insurance, the medical and legal professions, and capitalism. what i found fascinating during the early phase of my fieldwork was the extreme low pay and the prevalence of caregivers who migrated from other countries such as sudan, kenya, and the bosnia. these people, who were being paid just slightly above minimum wage, had the most direct and intimate contact with someone’s dear mother, father, and grandparent. they were the front line of care and social interaction with the residents in the nursing home. in most cases, they were the residents’ only emotional and social outlet. i began to wonder if post-fordism and the transition to the service economy had enabled people to render care in an assembly line manner. it was during my fieldwork, working and volunteering at numerous longterm care facilities, that i began asking whether or not it is the resident or rather the caregiver that is ultimately becoming increasingly alienated. to shift gears a bit, i would like to address how an anthropological investigation of caregiving can be worthwhile. in addition to the policy and applied research associated with gerontology and sociological studies of aging in society, anthropology can offer a unique perspective toward understanding and describing the ‘caregiver phenomenon’ that other disciplines do not dwell on in quite the same way. take two social settings: support groups and the family as examples of how an anthropological analysis of caregiving and caregivers can begin to inform the social nature and relational aspects of aging. support groups have long been in existence, providing emotional outlets and social networking opportunities for people suffering from hiv/aids to vietnam war veterans looking to ‘reassimilate’ into society (e.g. rhine 2009). support groups have also come into existence for those dealing with loved ones suffering from dementia and alzheimer’s. several support group associations for family caregivers seeking respite have gained increasing popularity over the years as well. in these “how to manage stress as a caregiver” support groups, relationships between parent and child, husband and wife, brother and sister are transformed slightly to caregiver and care-receiver. support groups offer strategies for dealing with everyday situations, by providing frameworks for compartmentalizing and diagnosing their loved one’s conditions. they teach such strategies as ‘creative lying’ in order to alleviate ‘unnecessary conflicts’, especially when short term memory lapses can spiral into uncontrollable repetitions and irrational expectations. caregivers listen to one another’s problems, and shape their own views through the interplay of sympathy and empathy. they are taught by group leaders to ‘enter into the reality’ of their loved ones—even if this reality is distorted. not only do these support group participants share their experiences and personal stories, but by sharing and commenting on them, their own relationships at home are shaped by the support sessions and what they see as constituting appropriate roles and responses for caregivers and anthropology & aging quarterly 2010: 31 (3-4) 67 student column care-receivers. therefore, husband and wife, brother and sister relations are transformed through caregiving into relations of caregiver and care-receiver. one also learns from these support groups that family caregivers are hesitant to ask for help from their neighbors and fellow community church members. the tension between independence and dependence not only matters for the elderly, but also comes into being for caregivers. the cultural push and pull between self-reliance, dependence, and being able to afford ‘professional’ care are issues that rush to the forefront in many support group sessions. additionally, during some of the sessions caregivers are attributed a unique status; they are not quite victims, but instead find mutual support and define membership through their hardships and ‘war stories’. their health and wellbeing is also a paramount issue; caregivers are told that they must center themselves first before they can reach out and connect with their loved ones. the support group message places emphasis on a particular western bounded notion of a person first, rather than any relationship. caregiving as a relation with scripted roles, strategies, and proprieties are imbued with and produce interesting notions of personhood, self care, legal capacity, and the function and nature of social relations within the family. in the second setting which plays out behind closed doors, caregiving by family members in the home brings forth its own set of issues. siblings are often in conflict over how care is administered, and typically the issue boils down to who will actually ‘do the caregiving’. many family caregivers complain that they are overburdened, and that other siblings who are close by should offer more support and care. along with this, issues of family inheritance, financial management, power of attorney, and decision making on behalf of an aging parent are highly contested. turning to the onset of aging societies, children and their parents will spend more time together now as adults (harper 2004). caregiving in this regard produces an unsettling role reversal where the ‘children’ assume parental responsibilities and care over their mothers and fathers. women are still predominantly the family caregivers, but even this generality is changing as some sons have started moving back into their parents’ home to provide care not only for mom and dad, but for some members of the extended family. in this changing situation, old taboos are being replaced by new ones. washing one’s parent and seeing them naked may no longer cause one to blush, but not having enough money or time to provide a caregiver may actually be a larger source of social embarrassment. caregiving is a growing and lucrative service industry of professionals on the coattails of america’s (over)reliance on anything medical and certifiable. in the near future, caregiving will surely continue to develop, and innovate in anticipation of the aging baby boomers and their market preferences. as a result, and this something that we already see today, families will continue to outsource care. children’s daycare for example gained prominence when both parents had to work. checking into a long term care facility such as the traditional nursing home or hiring a fulltime caregiver at home can be seen in a similar vein. family members who are too busy at work, or do not possess the confidence to provide adequate care for their aging loved ones will seek private caregivers outside the immediate nuclear (and extended) family. what is interesting is not the price tag of care necessarily, but that domestic work, which has long been associated with the sexual division of labor, no longer assumes that caregiving for the elderly is automatically part of domestic work. the interaction and relationships born from domestic labor (which is still not accounted for in the national gdp) and caregiving for the aging, is an interesting site for future research and anthropology & aging quarterly 2010: 31 (3-4) 68 student column investigation. what emerges from this brief discussion is a social phenomenon that offers a rich opportunity to explore some of the mainstay anthropological ideas/theories such as kinship, personhood, and social relations. in the post-schneider world of kinship, folk models on the american family are based on the implicit notion that kinship is the network of people who have to care for you when no one else does become problematic (schneider 1975). does paying for an outsider to provide care elicit the same kinship ties and familial emotions as someone who provides care for their own family members directly? what happens if the state takes on more of an active role in caregiving, how will this affect kinship? if caregiving is no longer the domain of kinship and domestic labor, then what becomes of the nuclear and extended families, and how do aging persons view families and their kinship relations differently than before? these are questions that anthropology can address for our own societies and cross-culturally in the wider castings of globalization. if anything, anthropology can help to show that caregiving operates in a social context, and that who and how one becomes a caregiver is sometimes meaningful, and sometimes it isn’t. an anthropology of caregivers can seek to address what actually constitutes care in various cultural settings and societies. is ‘care’ a set of (performative, monetary, et al) functions which simply arises out of reciprocation and/or a moral ethic that forces us to look after the elderly, and in the ways that we do? in the future, will every aging person be assigned a caregiver; what will happen to caregivers as they become older? what will be their expectations for the care and experiences they will have in old age? these are just a few of the questions regarding caregiving and caregivers that anthropology could seek to address more of in the future. philip kao is a phd candidate in social anthropology at the university of st. andrews. he is researching a continuing care retirement community (ccrc) in the midwest, focusing on its history and place in the surrounding community. additionally, he is researching the social relations at the ccrc, with a focus on kinship and personhood. works cited diamond, t. 1986 making grey gold: narratives of nursing home care. chicago: university of chicago press foner, nancy 1995 relatives as trouble: nursing home aides and patients’ families”. in neil henderson and maria d. vesperi (eds.). the culture of long term care: nursing home ethnography. london: bergin and garvey. foucault, michel 2007 security, territory, population: lectures at the collège de france, 1977-78. graham burchell (trans.). basingstoke, ny: palgrave macmillan. gass, thomas edward 2004 nobody’s home: candid reflections of a nursing home aide. ithaca: ilr press. harper, sarah 2004 families in aging societies. new york : oxford university press. rhine, kathryn a. anthropology & aging quarterly 2010: 31 (3-4) 69 student column 2009 support groups, marriage, and the management of ambiguity among hiv-positive women in northern nigeria. anthropological quarterly, 82(2): 369-400. savishinsky, joel 1991 the ends of time: life and work in a nursing home. westport: bergin and garvey. schneider, david m. 1975 the american kin universe: a genealogical study. chicago: dept. of anthropology, university of chicago. stafford, philip (ed.). 2003 gray areas: ethnographic encounters with nursing home culture. santa fe: school of american research press. ward, richard et al 2008 a different story: exploring patterns of communication in residential dementia care. ageing & society, 28: 629-651. aage on display in new orleans 2010 things will be a bit different this year. aaa sold all its booths, so we’ll be down to basic table and chairs—in or near the exhibit hall. all the usual fun and opportunities will be available: • sign up for the aage dinner (friday evening). • take a turn at the table—it’s a fun way to meet people. • buy a t-shirt—our bestseller “broken down by age & sex” is good for laughs at the gym! people get them for their mothers too (though some prefer “aged to perfection” for mom). • renew your membership. • display your book—free in return for staffing the booth for two hours. • please donate your copy to the silent auction which is raising money for the jacob (jay) climo student fund. • bid on the books in the climo fund silent auction. it’s fun, and you might get a good book for a bargain price. any questions? contact maria cattell mgcattell@aol.com hope to see you there! anthropology & aging quarterly 2009: 30 (2) 29 features an anthropological perspective on “occupation”: a study of older adults’ motivations for learning and using computer technology molly harrod, phd post-doctoral fellow, ann arbor veterans affairs health services research and development center of excellence daily occupations consist of activities that provide some type of capital, be it social, cultural, or symbolic (bourdieu, 1977) to the individuals involved. engagement in these activities provides meanings that extend beyond the “doing” and also represent the social roles these individuals find to be culturally salient. but, what is often not known is why individuals choose to participate in specific activities, their motivations and what these activities represent to them on larger social and cultural levels. this study looked at such socially and culturally constructed motivations in addition to the hopes and fears older adults may face when they are learning and engaging in new activities. how older adults defined being “successful” in their everyday occupations was also examined to understand how these notions relate to the larger, macro-level ideas about what it means to be a “successfully aging older adult” within the united states. using classic anthropological methods, i studied older adults’ ideas about fears, hopes, and successes regarding computer learning. for this brief description, i will focus on the culturally constructed notion of fear to demonstrate how better understanding the capital sought and provided by activities can offer deeper insights into individual and collective notions of success and how older adults go about reaching their learning goals through taking on new activities. seniornet®, an older adult-oriented computer learning center was the research site for this study. during this study, i found that seniornet® views older adults as having special needs when it comes to learning technology. these special needs are thought to include fears that must be overcome if older adults are to be successful in their technological learning. to give just one example, seniornet® had devised specific teaching strategies to address the program’s overall perception that older adult computer learners would be fearful of breaking the computer. from the older adult computer learner perspective, one of the most common fears mentioned was the “fear of being left behind”. many older adults interviewed felt that society was technologically “moving beyond” them and that this situation would impact their social relations with family and friends. but, this fear also motivated them to learn the computer thus maintaining a “sense of control”. during participant observation in the seniornet® computer lab as well as in interviews, these adults described attempting to locate themselves in a technological environment that they often perceive is playing a much larger role in the lives of the younger generations. for instance, being able to “talk technology” gave these older adults a highly relevant topic for communication with younger family members and sometimes helped prevent the feelings that they were “losing touch” with younger family members. over time, i learned that fear went well beyond the notion of simply breaking the computer and incorporated how the older adults wanted to view themselves in addition to how they wanted others to see them in this society. to extend this point further, the older adults in this study felt that they “needed” to learn to use computers in order to help maintain their social roles and continue to feel “vital” within american society. they did not necessarily need to become experts at computer usage, it was enough for them to be able to demonstrate to themselves and more so, to others, that they could learn new things and continue to participate at all levels of society. in the educational habitus studied, they sought to acquire cultural capital associated with being a specific kind of older adult namely, one who can learn and use the computer. for some, this path was much easier than for others. however, most continued to work at mastering the computer because they wanted to be seen as the kind of older adult who is an active, independent functioning participant in american society, engaging in the same way as younger members. it is important to note here that this study did not focus on older adults who chose not to engage in computer learning in this seniornet® environment. understanding why some older adults choose not to engage in certain occupations, including computer learning and new technology adaptation, will be an interesting question to consider in future research. through this gerotechnology related example, i have aimed to show how anthropological methodologies and use of theory can contribute to better understanding how daily activities come to be incorporated into older adults’ daily lives. as indicated above, this includes understanding their motivations, fears, learning processes and successes they gain through engagement. these types of understandings can aid in constructing programs that support older continued on page 41 anthropology & aging quarterly 2009: 30 (2) 41 perkinson and briller, continued from p. 26 of a new house, to convey the experience of venturing into a new place (either physical or intellectual) and thoroughly exploring it, room-by room. this orienting metaphor enabled him to discuss quite eloquently how he viewed the “fun” (aka intellectual excitement) of throwing open the doors and seeing what one finds in these rooms. upon entering each new room, one can see what is already there and the overall dimensions and characteristics of these spaces. sometimes one knows about key aspects of what one will find there, and sometimes one is surprised as well. opening these doors also presents opportunities to think about how the various “rooms” in the house fit together and can be coordinated over time. he captured the excitement that comes at the beginning of such an exploration and recommended paying close attention to all aspects of this discovery process, keeping the “big picture” in mind and never forgetting the fundamentals of each field—e.g., what makes the framing of a particular issue anthropological, and likewise for ot. the “good bones” of the anthro-ot house, with its strong foundation and supporting structures, should provide an appropriate environment that will foster the continued growth of our cross-disciplinary dialogue. in spite of its time slot (i.e., the last morning of the conference), it was clear that the session had an impact. there was much post-session discussion in the hallway about individual papers, the discussants’ comments, and where to go from here; so much so that several people expressed concern about making it to the airport in time to catch their flights. we, as the session organizers, took it as a good sign that this conversation continued, that there was enthusiasm for ongoing exploration of this linkage, and it fortified us for taking this work forward. we hope that you will enjoy reading about these issues, learning about what has been discussed so far, and adding your own voices and perspectives to extending this conversation. references: american occupational therapy association (aota). 2008. occupational therapy practice framework: domain & process. 2nd edition. bethesda, md: the american occupational therapy association, inc. block, p., frank, g. & zemke, r. 2008. practicing anthropology (special issue on anthropology and occupational therapy), 30(3). frank, g. 2007. occupational therapy & occupational science interdisciplinary interest group: a proposal to the national association for the practice of anthropology. inhorn, m. 2007. medical anthropology at the intersections. medical anthropology quarterly, 21(3): 249-55. kronenberg, f., algado, s. & pollard, n. 2005. occupational therapy without borders. edinburgh: elsevier/churchill livingstone. law, m., polatajko, h. baptiste, w. & townsend, e. 1997. core concepts of occupational therapy. in e. townsend (ed.), enabling occupation: an occupational therapy perspective (pp. 29-56). ottawa, on: canadian association of occupational therapists. pollard, n., sakellariou, d. & kronenberg, f. 2009. a political practice of occupational therapy. edinburgh: elsevier/ churchill livingstone. the individuals’ “life opportunities.” in all likelihood, most of them will become practitioners, not researchers, but this experience allows them to see why evidence-based practice is important and how an interdisciplinary lens enhances both their field and others. schatz, continued from page 27 adults’ interest in not only “doing something” but also “being someone”, and for these participants, that meant being recognized as active, engaged, independent and therefore, vital contributing members within american society. going forward in extending this research program, i look forward to drawing upon and integrating a variety of disciplinary perspectives that can inform this work from anthropology, gerontology, occupational science/occupational therapy, and technology studies, to list some relevant areas here. harrod, continued from page 29 p29 harrod (2)may2009-7 p41_30 (2)may2009-2 anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 67-70 issn 2374-2267 (online) doi 10.5195/aa.2014.40 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review wilmoth, janet & ferraro, kenneth, eds. gerontology perspectives and issues. (4th ed.) new york: springer publishing company. 2013. isbn 978-0-8261-0965-1. 331 pp. price $80.00 (hard copy) ruth n. grendell, dnsc, r.n. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.40 http://anthro-age.pitt.edu book review wilmoth, janet & ferraro, kenneth, eds. gerontology perspectives and issues. (4th ed.) new york: springer publishing company. 2013. isbn 978-0-8261-0965-1. 331 pp. price $80.00 (hard copy) ruth n. grendell, dnsc, r.n. the contributors have advanced degrees in sociology, psychology, anthropology, law, economics, gerontology, public health, and other related content areas. the central theme of the text is “gerontological imagination” (gi), a term that suggests a new paradigm for describing the way of thinking that identifies the key elements regarding the aging process as perceived by multidisciplinary gerontologists. the key elements include: aging as a multifaceted change; genetic influences on aging; heterogeneity in aging; aging as a lifelong process; accumulation of disadvantages over the life course; and aging in the social and intellectual climate. the 15 chapters are divided into three main classifications on these related gerontology issues: the physiological aspects, the social aspects of aging, and public policy and service provision in meeting the needs of elders and their families. research has indicated that biological, environmental factors and specific life events have great impact on the aging process. the patterns of cognitive decline are, often, due to biological changes that interfere with a person’s sense of independence. however, elders can learn to use alternative methods for processing decisions and performing daily functions. the decrease in social partners can result in a variety of emotional responses to life events, and can determine a person’s sense of well-being. yet, elders retain the social relationships that mean the most to them, and most elders effectively adapt to the changing life phases and are satisfied with their lives. studies have, also, revealed the heterogeneity in the aging population, and the differences in managing emotions and behaviors. the text authors/researchers suggest using a life course perspective for studying healthy longevity. the core principles are: o life patterns are established during the early years, and human lives unfold over long periods of time. o an individual life course is influenced within a social-world historical context. o humans are linked together within complex relationships of work, family, friends, and community. o the life course is determined by the individual’s decisions in situations and/or conditions. some life course research has begun; however, many relevant topics have not been explored. although, longitudinal studies can be very costly, much can be learned that could be valuable for the future. “the primary goal of life course research is to understand long-term patterns of stability and change as they unfold in social and historical contexts” (p. 168). grendell | book review anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/aa.2014.40 http://anthro-age.pitt.edu 69 age is usually the defining factor in the research literature related to functional abilities in daily life and a sense of well-being. the authors recommend using an integrated model when exploring the many aspects of socio-emotional aging. the social input model includes three main foci: (1) personal characteristics of age, gender, race, regulation of emotions, and a future time perspective; (2) the social network and the quality of the relationships with partners that are readily available; (3) and extrinsic factors that include stressors and partner responses. the model would be an effective method for studying how older individuals transition to retirement; and how they maintain social relationships using telephone, social media, and other technologies. anthropologists are particularly interested in understanding how the elderly respond to the technology challenges. the model could, also, be useful in examining the intergenerational family relationships within cultural groups. of most importance would be learning how elders regulate their emotional responses and the strategies they use when coping with negative experiences associated with the aging processes. a study of lifetime medical histories of centenarians revealed that 38% of the oldest old were survivors of at least one major disease prior to the age of 80. delayers (43%) were individuals who were free from any major disease until after the age of 80. escapers were identified as people who were free of any major disease until after they reached 100 years of age. actually all of the centenarians had a strong disease resistance that declined in the tenth decade of life (p. 33). however, research with this age group can be difficult due to the loss of long-term recall of life events, actual age validation, or the presence of concurrent diseases. researchers considered innovative approaches for studying longevity in animals for comparison purposes that resulted in new ways of thinking about the human aging processes. some important discoveries indicated that biomarkers, such as peak bone mass during the second and third decades of life have a great influence on the probability of bone fracture in later years. researchers have, also, discovered that elevated blood cholesterol at age 50 may be an indicator of developing alzheimer’s disease at age 70. however, if the cholesterol level is higher in the seventh decade, it may serve as a protective mechanism against the disease. obesity in the young and middle aged adults is commonly associated with diminished life expectancy; in contrast, studies have shown it does not have the same effect for people over 60 years of age (especially in men). these and other similar findings indicate that optimizing the timing of interventions may alter the course of health/disease management throughout the lifespan. there is a world-wide concern regarding the unequal geographical distribution of aging populations and available resources. the demographics of aging have been of great interest to several disciplines related to world-wide economic issues, the transitioning of elderly to different geographic areas, availability of resources to meet the needs of the aging population, cross cultural issues and the changes in intergenerational relationships over time, as well as the aging leadership in countries, and scarcity of future leaders. future research may help provide solutions to these issues including public policies and services to protect the interests and needs of the aging populations throughout the world. there is a great need to see aging as a dynamic changing system rather than a continued downward trajectory. the text is an important resource for introducing research and innovative methods using interdisciplinary teams in providing care to these very special complex and diverse groups of people. book review book review debate who wants to have an aged self if to age is so bad? ageless and aged selves as cultural constructs sarah lamb brandeis university lamb@brandeis.edu anthropology & aging, vol 44, no 1 (2023), pp. 107-110 issn 2374-2267 (online) doi 10.5195/aa.2023.479 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. debate | lamb | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.479 http://anthro-age.pitt.edu 107 debate who wants to have an aged self if to age is so bad? ageless and aged selves as cultural constructs sarah lamb brandeis university lamb@brandeis.edu i agree in part with sharon kaufman’s insightful finding, based on her ethnographic research in the late 1970s, that many older americans identify as having an “ageless self” that operates as a positive source of meaning in older age. i, too, found in my own fieldwork forty years after kaufman published the ageless self that older americans often convey a sense of an ageless self, an aspirational identity i have sometimes termed “permanent personhood” (lamb 2014). i would like to argue, however, that sharon kaufman’s compelling book the ageless self, and her later essay “reflections on ‘the ageless self’” (1993), do not make fully transparent the cultural embeddedness of the prevailing u.s. “the ageless self” ideal. underlying the u.s. ageless self model is a confluence of factors—including particular cultural ideologies of personhood and the life course, and a deep stigmatization of oldness—quite unique to north america. in sum: i see “the ageless self” as an emic category useful for understanding u.s. ideals and experiences. to enhance the productiveness of the concept, however, we must denaturalize it, to more fully recognize “the ageless self” as a particular, even peculiar, cultural-historical construct. although kaufman does not foreground the ageless-self idea as an american cultural construct, she does acknowledge that the sixty participants in her study—white middle-class californians over age 70—“share some cultural characteristics” and “certain dominant american goals, values, and expectations” (1986: 21). in particular, kaufman finds that self-esteem for her interlocutors is intimately tied to finding ways to maintain american values deemed essential to social worth – including activity, productivity, and “keeping busy,” and individualism, independence, and self-reliance (1986, chapter 4, “values as sources of meaning”). much of kaufman’s prose, however, suggests a universal ageless self, as an experience and analytic category useful to gerontology and aging studies in general, without highlighting the cultural embeddedness of the ageless-self ideal. for instance, in her “reflections” essay, kaufman writes in general terms about how when “old people talk about themselves, they express a sense of self that is ageless,” and of how “old people do not perceive meaning in aging itself” (1993, 14). she emphasizes the positive and cheerful consequences of agelessness as a cultural ideal: how nice it is that older people can draw on a positive ageless-self ideal to bring meaning to their lives and uphold a sense of an ongoing, continuous, stable self that does not need to change radically in old age. in such dialogue, kaufman rarely specifies or reflects upon the fact that her research focused on older americans. perhaps for this reason kaufman does not puzzle over why north americans might be so particularly inclined to posit a self as ageless. http://anthro-age.pitt.edu/ debate | lamb | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.479 http://anthro-age.pitt.edu 108 but to this anthropologist, who came to u.s. research after years of studying aging in india, the agelessself idea is very particularly american. my own research with older americans has focused on probing the “successful aging” paradigm that has become so popular over the past few decades that it has become a naturalized cultural obsession (lamb 2017). successful aging envisions postponing or even eliminating the changes of old age, through individual effort (lifestyle choices, healthy diets, exercise, positive attitudes), as a project of the self. the popular premise that ‘you don’t have to act or feel old’ conveys a vision of the ideal person as not really aging in later life, but rather maintaining the self of one’s earlier years. in such perspectives, to be “old”—as in different from a younger self and specifically to experience decline—is not a natural or meaningful part of the life course, but rather an outrage that can and should be eliminated. the end result, if all goes well according to this paradigm, is the elimination of oldness from the life course itself, as one goes straight from vibrant, good health—a stable self—to a swift and painless end. anthropologists and cultural historians have surmised that those who prize individual independence, central to north american visions of the self, may be especially preoccupied with the self’s putatively stable, enduring qualities (e.g., clark 1972; cole 1992; lamb 2014; mcintosh 2009). we certainly find such a preoccupation with a stable, enduring self in the anti-aging, anti-decline aspirations of successful aging. because sharon kaufman pursued all of her own anthropological research in her own home setting of the united states, it may have been difficult for her to recognize the peculiar cultural qualities of the ageless-self ideal. kaufman’s interlocutors’ sense of maintaining an ageless self may have felt very natural and familiar to her, resonating with how she herself envisioned the unfolding of her own life course. but one of anthropology’s core aims is to make visible that which can seem so ordinary and taken for granted that it can be hard to recognize, to defamiliarize the familiar. one core issue that i find sharon kaufman does not explicitly recognize and critique is how the idea of an ageless self resonates so strongly for so many americans because of how deeply stigmatizing and terrifying it is to be ‘old’ in u.s. society and culture. who wants to be or have an ‘aged self’ if being old is culturally regarded as terribly bad? in north america, to show signs of being truly ‘old’—as in different from one’s younger adult self—is culturally regarded as so embarrassing, stigmatizing, and devoid of positive meaning, that it is for many much more terrifying and destructive of a sense of an ongoing, valued self than even death itself (lamb 2018). because of this, old age is the one phase of the life course that americans have wished to erase. to help readers recognize a different perspective, i will share just a few quick observations from india. in india, old age is a named, recognized, and meaningful part of human life, with its own positive and negative features like any other life stage (lamb 1997, 2000, 2014). in the classical hindu model, two of the four life stages (fully half of the human life cycle) constitute old age. hindu perspectives in general emphasize transience and change as fundamental to personhood and the human condition, including growth and decay, birth, aging, and death. indian hindus and muslims both also tend to regard needing forms of care in later life as perfectly normal and expected, and even often valued, just as north americans tend to regard needing and enjoying care as a child as normal and valuable. although dying one’s hair black has long been popular among older indian women, and some are taking up globally circulating anti-aging products, such as youth-enhancing face creams, few convey a desire or expectation to remain young or ageless. some of my indian interlocutors, aware of u.s. ‘healthy’ and ‘successful’ and ‘anti’ aging trends, can be a bit puzzled: “are americans trying to pretend being old doesn’t happen?” “is it because people in the west want to live more and don’t want to die?” amarnath banerjee, a retired bank official at age 70, remarked, “i don’t mind being called old, because i am old,” and emphasized: “birth and death lie hand in hand in nature.” samrat ghosh, age 80 and a retired industrialist, commented: “i enjoy the company http://anthro-age.pitt.edu/ debate | lamb | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.479 http://anthro-age.pitt.edu 109 of the young, going out to eat together, sharing with them, having fun together. but this doesn’t mean i’m trying to be young. … you can’t stop aging. you may as well enjoy it.” resistance to the ageless-self model is not absent in the united states either. on all the age-denying talk in everyday u.s. social-cultural life (“oh, you’re not old!” “you’re only as old as you think you are!” “you don’t look your age!”), author ursula le guin reflects in an essay written at age 83: “to tell me my old age doesn’t exist is to tell me that i don’t exist. erase my age, you erase my life—me” (2017, 14). she acknowledges that she’s speaking only for herself: “i don’t begrudge the fairy tale to those who want to believe in it.” but her own advice remains: “let age be age. let your old relative or old friend be who they are. denial serves nothing” ( 17). several of my own u.s. interlocutors—especially those who have experienced serious illness or become quite advanced in years—also critique ageless-self and permanent-personhood paradigms. i mentioned to cancer-survivor dora koenig, age 72, the notion of permanent personhood that i had discerned in north american visions of successful aging, a model implying a sense of enduring permanence as a person rather than embracing change through aging. dora interrupted, oh, i believe permanent personhood is an evil idea. because it is so wrong! it is just not true. and it is like never-never land and princesshood. it just doesn’t help you be a person. she reflected that she is striving to cultivate instead “a very rich relationship with reality, namely mortality, and what do you want to make with the time you have now?” lilian warner, a christian minister, age 76, tries to spread the message to her fellow residents in a retirement community about how aging can be an exciting, rewarding phase of life. at the same time, she emphasizes change: i’ve been asking, ‘what is the new normal for us as we reach our elder years?’ if we still want to be what we were at fifty, we are defeated right out of the box. we can’t be. i can’t be fifty again. frankly, i don’t want to be fifty again if you want the honest truth. anthropologists are increasingly conducting fieldwork in their own societies, as sharon kaufman accomplished before “anthropology at home” had become popular (peirano 1998). this is terrific, because anthropology, through its ethnographic fieldwork methods and critical lens, has much to offer its home communities. however, to do anthropology at home makes recognizing doxa or taken-forgranted assumptions more challenging. comparative ethnographic exploration, through fieldwork and dialogue, can help us see what may otherwise be hiding in plain sight. the ageless self concept in many ways beautifully captures prevailing u.s. aspirations regarding the life course. the concept encapsulates both the widespread u.s. desire for continuity, permanence, and stability of self as well as commonplace, deep fears about change, old age, and decline. within a broader tradition of the anthropology of aging and the life course, future anthropologists would wish to investigate whether and in what ways visions of agelessness over the life course resonate—or not—with the experiences of situated interlocutors. the ageless self is not a universally applicable analytic category but a culturally grounded emic one replete with its own unusual and provocative assumptions. it behooves us to recognize not only its inspirational qualities but also the ways it rests on a deeply american cultural discomfort with oldness and human conditions of frailty and transience in ways that can obscure other paradigms of aging. http://anthro-age.pitt.edu/ debate | lamb | anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.479 http://anthro-age.pitt.edu 110 references clark, margaret. 1972. “cultural values and dependency in later life.” in aging and modernization, edited by d. o. cowgill and l. d. holmes, 263-274. new york: appleton century crofts. cole, thomas r. 1992. the journey of life: a cultural history of aging in america. new york: cambridge university press. kaufman, sharon r. 1986. the ageless self: sources of meaning in late life. madison: university of wisconsin press. kaufman, sharon r. 1993. “reflections on ‘the ageless self’.” generations 17 (2): 13-16.lamb, sarah. 1997. “the making and unmaking of persons: notes on aging and gender in north india.” ethos 25 (3): 279-302. _______. 2000. white saris and sweet mangoes: aging, gender, and body in north india. berkeley: university of california press. _______. 2014. “permanent personhood or meaningful decline? toward a critical anthropology of successful aging.” journal of aging studies 29: 41-52. _______. 2018. “on being (not) old: agency, self-care, and life-course aspirations in the united states.” medical anthropology quarterly 33 (2): 263-281. lamb, sarah, ed. 2017. successful aging as a contemporary obsession: global perspectives. new brunswick, nj: rutgers university press. le guin, ursula k. 2017. no time to spare: thinking about what matters. new york: harper. mcintosh, janet. 2009. the edge of islam: power, personhood, and ethnoreligious boundaries on the kenya coast. durham, nc: duke university press. peirano, mariza g.s. 1998. “when anthropology is at home: the different contexts of a single discipline.” annual review of anthropology 27: 105-128. https://doi.org/10.1146/annurev.anthro.27.1.105 http://anthro-age.pitt.edu/ https://doi.org/10.1146/annurev.anthro.27.1.105 anthropology & aging quarterly 2013: 34 (3) 52 here i would like to discuss the potential limits of two popularly adopted theoretics of the body that are applied in the study of aging—nancy scheper-hughes and margaret lock’s three bodies and the mindful body and donna haraway’s cyborg model (scheper-hughes and lock 1987 and haraway 1991).1 the three bodies and cyborg models focus on ontologies that blur, mix, hybridize, or bridge dualisms, specifically western dualisms. an unintended result of this focus is that in detailing what is being blurred, these authors inadvertently both lend legitimacy to the characteristic features of the very dualisms that they purportedly deny and proceed to limit their own analysis to these same categories.  when applying the three bodies or cyborg analytic to the study of aging bodies the body will be ontologized as a coming into relation of two otherwise disparate entities such as the social and individual, mind and body, human and machine, nature and culture. this analytic may be useful for investigating the politics of coming together of different spheres such as the social and individual, particularly in regards to the social symbolic or `meaning-filled` dimensions of aging and its individual embodiments. however, it fails to capture the dynamic ensemble of forces at work that lay outside the purview of the dualistic categories being mixed. by adopting an analytic suggested by the philosophy of gilbert simondon (1980, 1992), we can shift away from explications of the ontologically mixed state of the body and onto questions concerning the aging body as process, becoming, or ontogenesis.  this commentary stems from doctoral dissertation research into japan’s aging society crisis (shōshi kōreika mondai) and the attending concerns about how best to c o m m e n ta ry from being to ontogenetic becoming: commentary on analytics of the aging body ender ricart department of comparative human development university of chicago analytically approach old age as a process that extends beyond the individual, body, society, and the resulting politics of representation. i conclude with an introduction to simondon’s theory of ontogenesis and its potential applicability to the study of aging, particularly for attending to the many different and contributing forces at work in the becoming of old age. the three bodies and the mindful body  in “the mindful body: a prolegomenon to future work,” nancy scheper-hughes and margaret lock (1987) discuss three conventional heuristics of the body utilized for conceptualizing the relations between the individual and society: individual body-self, the social body, and the body politic. their notion of the mindful body, which they suggest as a guiding concept for future research, is intended to firstly collapse the mind – body dualism of cartesianism into one-concept and secondly bring together the three different theoretical approaches and epistemologies of the body (1987:8, 28-9). scheper-hughes and lock write: we lack a precise vocabulary with which to deal with mind – body – society interactions and so are left suspended in hyphens, testifying to the disconnectedness of our thoughts. we are forced to resort to such fragmented concepts as the bio-social, the psycho-somatic, the somato-social as altogether feeble ways of expressing the myriad ways in which the mind speaks through the body, and the ways in which society is inscribed on the expectant canvas of human flesh (1987:10).  however, i suggest here that the problem is not the lack of a precise vocabulary to express the myriad of interactions between the mind and society through the anthropology & aging quarterly 2013: 34 (3) 53 ender ricart from being to ontogenetic becoming body. the problem is that they are confining their analysis to the interactions of “mind” and “society,” through the mediating medium of the body. they are displacing a cartesian dualism of mind – body with a dualism of interior – exterior, and much like the pineal gland, the body functions as mediator between an internal-mind and external-social. under such an analytic it is impossible to represent the ontology of the body as anything more than a continual tug of war between two poles played out over the course of time.  scheper-hughes and lock define the individual-body as “the lived experience of the body-self” (1987:7). while conceptions of this individual body (specifically in relation to social others) may vary according to society and culture, they state that it is safe to “assume that all humans are endowed with a self-consciousness of mind and body, with an internal body image, and with what neurologists have identified as the proprioceptive or “sixth sense,” our sense of body self-awareness, of mind/body integration, and of being-in-the-world as separate and apart from other human beings” (1987:14). we could therefore draw from their explanation the conclusion that there is at the core of every bodily being some notion of an individual. in their discussion of the social body scheper-hughes and lock state that the body is both a physical and cultural artifact. they give the example of mary douglas’ (1966) observation that social categories determine how nature and the body are perceived. (1987:7). the body and its biological manifestations are made meaningful through the embodiment of socio-cultural values (age, class and gender normative behaviors). they write, “our point is that the structure of individual and collective sentiments down to the “feel” of one’s body and the naturalness of one’s position and role in the technical order is a social construct” (1987:23). the body is therefore subject to degrees of socio-cultural determination, which presumes the existence of some exterior and independently existing social order that is exerting agency.  the body politic in scheper-hughes and lock’s article attends to the matters of power and control in the relationship between individual and social bodies (1987:23). echoing foucault’s concept of biopolitics and biopower, it refers to a society’s “regulation, surveillance, and control of bodies (individual and collective) in reproduction and sexuality, in work and in leisure, in sickness and other forms of deviance and human difference” (1987:7, 8). within a body politic, culture is like a disciplinary script that domesticates the individual body to conform to the needs of the social and political order (1987:26). it is likewise in part the responsibility of the individual to remain culturally savvy and conform to and maintain the body according to social expectations.  in sum, the body is at once individual, social, and political. the individual body-self represents the individual apart from society, but even this individual, its physicality, sense of individuality, and being are determined by socio-cultural categories. the body political is the power struggle for control over the meaningful representations, interpretations, and actions of the individual body as a social body. the individual body is the terrain on which socio-political power struggles lobby for control over individual embodiments of certain cultural categories; the individual body is, as they write, “a locus of personal and social resistance, creativity, and struggle” (1987:31). scheper-hughes and lock therefore only nominally replace western dualisms of the mind – body, individual – society, and structure – agency with a tripartite of the mind – body – social. their final addition to the discussion is a suggested fourth concept: the mindful body. the mindful body is a body infused with emotions, feelings, and affect that bind together and flow into the social, political, and individual dimensions of the bodily-self. the mindful body, they suggest, is a “‘missing link’ capable of bridging mind and body, individual, society, and body politic” (1987: 28-9). the mindful body is therefore their neologism for the body as medium between an internalmind and external-social. the three bodies, pivoting around the uniting principle of the mindful body, does not actually do away with cartesian or western dualisms but actually reproduces the self-same characteristics in a different incarnation. cyborg model    donna haraway’s cyborg model (1991), which incorporates bodily relations with technology, perhaps possesses the potential to transcend the hyphenated pivot of scheper-hughes and lock’s mind – body – social. however, like the mindful body in scheper-hughes and lock’s formulation, haraway prefaces that the cyborg is a hybrid, a blurring or merging of dualisms. ian hacking (1998) notes that, in stating that the cyborg’s ontology is a merger, blend, or bridge, this model ultimately re-inscribes a fundamental distinction, an essential being to these very same dualisms which it purports to abolish (cited in lamarre 2012:79). the cyborg, as a blurring of dualisms, is therefore limited to demonstrations of this blurred nature, that is, it is confined to perspectival pivoting between the essentialist entities that it brings into relation. as i will demonstrate, these essentialist entities are once again a social and an individual; only here the bridge is the body and technology. anthropology & aging quarterly 2013: 34 (3) 54 ender ricart from being to ontogenetic becoming for haraway, the cyborg is an analytic for understanding the realities of what she believed to be an emerging information society of the 1980’s and early 90’s. in the information society science and technology provide new sources of power and also fresh sources of political action. informatics of domination, communication technologies and modern biotechnologies, share a drive to translate the world into a problem of code that can be disassembled, reassembled, invested, and exchanged. these informatics of domination embody and enforce new social relations, new social meanings, and re-craft our bodies.  she writes that most socialists and feminists fear high technology and scientific culture, seeing in them only the intensification of western dominating dualisms, urging us to regroup behind our organic bodies. haraway instead sees in technological and scientific advance not just the potential for increased domination but also the possibility of resistance and positive change. she urges us to become cyborgs, informational semiologists weaving together new identities, new and potentially revolutionary relations, by drawing together disparate packets of information or code that are not controlled by the informatics of domination (haraway 1991:181).  the cyborg’s revolutionary potential stems form its hybrid nature, blurring all previously held concrete binaries such as machine and organism, nature and culture, public and private, male and female, self and other. as such it “suggests a way out of the maze of dualisms in which we have explained our bodies and our tools to ourselves” (1991:181). because of the cyborg’s hybrid nature it possesses revolutionary potential that, for haraway, provides a way for individuals to reclaim a degree of agency over the meaning and significance of bodies and tools, i.e. technologies, escaping political domination in the age of information. what is of interest to us here is, firstly, how the body and technology are positioned as vehicles of social and subjective signification and therefore control. secondly, what the body and technology are drawing into relation—an individual and a social order locked in a power struggle for control over the meaning and significance of bodies and tools.  for haraway, the physicality of the cyborg is a merger of body and technology. in an information society, there is no longer an easy delineation between body and technology as both are transformed into coded text that can be differently written and read for socially or subjectively meaningful value (1991:152). she writes, “it is not clear who makes and who is made in the relation between human and machine. it is not clear what is mind and what body in machines that resolve into coding practices…biological organisms have become biotic systems, communications devices like others. there is no fundamental, ontological separation in our formal knowledge of machine and organism, of technical and organic” (1991:177-8). both technology and the body are mediums of meaningful social and self-signification as well as material embodiments; they are, as she states, both myth (symbolically charged) and tools (material instruments for enforcing meaning) (1991:164). in the cyborg model, technology and the body are simultaneously an embodiment and conveyer of meaning. they are in varying degrees more or less faithful mediums through which a message about the self is conveyed to society and, in reverse, a medium through which individuals are socially regulated and controlled by governing forces. the cyborg model is grounded in the assumption that an interior-self and exterior-social are engaged in a power struggle for control over the meaning of the body and things. it is because the cyborg model treats an interiorself and exterior social as essential entities that it can then conceptualize them to be in relationship to one another (simondon 1992:312). much as two separate points are connected by way of a bridge, here the relational bridge that forms between the exterior-social and interior-self is imagined to be a body and technology. analysis that regards the body and technology as relational bridge can do little more than discuss the contestation between an individual and a social over the meaning of things. applications of cyborg model to study of aging and aging body when either the mindful-body or the cyborg model is applied in the analysis of the aging body, one inevitably pivots around essentialized dimensions of an interior and exterior. that is interior or subjective questions of how one feels about aging or external-oriented questions about how one is perceived or made-meaningful within a given society. this is because the cyborg model and mindful body operate according to underlying presuppositions of the human condition that likewise divided the self into interior-self, the bridge of the body (or technologized body), and exterior social-world.  as has been discussed, the mindful body and cyborg model focus on the relationship between two substantialist entities like “the social” and “the individual” and represent the relational bridge as the body or technologized-body. when applying the cyborg model of analysis to the study of aging bodies and assistive technologies there is a tendency to regard such technologies as supplement anthropology & aging quarterly 2013: 34 (3) 55 ender ricart from being to ontogenetic becoming or bodily prosthesis, incorporated into the aging body itself, blurring supposed boundaries between human and machine to form an age-specific cyborg. this cyborg model of prosthesis is rather lacanian insofar as it assumes a prior lack or loss, which is eternally compensated for but never quite fulfilled. the technological supplements a lacking body to approximate a lost “full” body that is independent and active. social scientists who have studied aging bodies and assistive technologies regularly preface the contextual environment within which this culture of attention takes shape. biomedical discourses of normalcy frame aging and old age as disease and in need of technological and scientific intervention for continual improvement and restoration (joyce and mamo 2006).  in such social scientific investigations into aging and agerelated technologies, analysts emphasize how technologies convey social meaning about the self and incur a degree of social stigmatization onto the self (joyce and loe 2010; long 2013; and joyce and mamo 2006). when the human and machine unite, the human is liberated, as the technology enables the human to continue to function at a level they would not otherwise be able to. these elderly cyborgs are enabled in their relation with technology, however, precisely because biomedicine frames the elderly body as incomplete or lacking. the use of such assistive devices indexes that the person is no longer a fully functional human agent. the ontology of the aging body as lacking or failing is therefore tied to the discursive framing of programs and technologies as assistive— supplement and prosthesis. here, once again we find that under the aegis of the cyborg model, analysis pivots around a quasi-semiological analysis of technology and bodies as both a medium and message, asking questions about what it means within a given society and as an aging individual to be an aging body and use technologies. from the individual point of view, using assistive technologies may be empowering. however, at the level of society, particularly an overwhelmingly biomedical society, such technologies may signify a loss of normalcy. that is, analysis continues to pivot between two essential entities of the individual and the social through the medium of the body and technology. it fails to capture processuality because under this ontological framework one is focused on the relational-bridge as a drawing together of two poles. there is no change other than a tug-of-war between an external social and an interior-individual. ontogenesis and processes of emergence what i am interested in demonstrating here is the potential analytic utility of the ontogenetic model of analysis to the study of aging. ontogenesis is an approach differentiated from the study of ontology, or the study of being, as the study of becoming. by adopting the ontogenetic approach, we focus not on the relationship between substantialist entities like “the social” and “the individual” as a blurring, mixing, or hybrid; but on the processes and practices that come to differentiate and shape some “thing” in the first place.  gilbert simondon employs the term transduction to denote processes of emergence that are initiated when previously disparate realities come into contact and restructure across a temporal and topological or conceptual interface (1992:312). when speaking of “disparate realities,” it is not an admission of substantialism, which inevitably represents such coming together as sequences of isolated exchanges that cannot and do not fundamentally change the core being of either entity. rather, it is the recognition that these “disparate realities” or “things” are themselves a collective network of forces that came into relation and, with the course of time, underwent an extensive and continual process of negotiation, resolving incompatibilities into a meta-stable state. when these meta-stable “things” as previously disparate realities come into contact with others, they are fundamentally changed. they are no longer and can never return to their prior form as they are now involved alongside other previously metastable things in the shared becoming of something new.  ontogenetic becoming does not occur because a thing (human, non-human, even conceptual) “is in relation to something else (to an exterior milieu, for instance), but because it is the ‘theatre or agent’ of an interactive communication between different orders” of being (mackenzie 2002:60). a “thing” is in-formation, as a transductive process it is continually resolving incompatibilities, manifesting as a series of phases of matter-taking-form in which disparate meta-stable things are articulated together (2002:49). the object of study in ontogenesis is this matter-taking-form; the negotiation of different meta-stable things and their systematic unfolding and enfolding into a shared becoming through a series of phases. matter-taking-form eventually slows as a metastable state of reciprocal compatibility is attained within a collective, forming a unit-phase referable as “thing,” “order of being,” or “reality.” these “things” or “orders of being” are not complete and therefore substantial units but phases of meta-stability which can easily undergo further ontogenetic changes.  indeed, the commencement of ontogenesis requires some problematic, a conflict or incompatibility between anthropology & aging quarterly 2013: 34 (3) 56 ender ricart from being to ontogenetic becoming two or more of these “orders of being” or “disparate realities” (this can be internal, as in the process of thought, or an external conflict with a surrounding environment or other meta-stable things). when one or more meta-stable thing or order of being are brought into relation it results in these beings or realities phasing out of one meta-stable state and engaging in the becoming of something new. ontogenetic becoming is a matter of adaptation and flexibility between numerous orders of potentialities as these units come together within a higher order collective and a larger structured becoming (simondon 1992; lamarre 2012; combes 2012; mackenzie 2002). transduction is, therefore, not the becoming of an isolated “thing,” it enlists a field of interrelations and transformative change with its surrounding environment, which simondon has termed milieu. in order to grasp this higher order of ontogenetic becoming and the temporality and topology of transduction, simondon writes, “we must consider the being not as a substance, or matter, or form, but as a tautly extended and supersaturated system, which exists at a higher level than then unit itself….” (1992:301). when a meta-stable “thing” is engaged in a transductive process of ontogenetic becoming, it is enfolded in a new topology of interrelations and a new futurity which insights change.  there are, then, layers upon layers of transductive process of becoming, as each new becoming triggers the modification and structuration of its prior form, environment, and a recruitment of other meta-stable things around it. each meta-stable thing brought into contact with others and recruited in a larger order of becoming will have its own phases of becoming that worked to resolve previous conflicting orders of being (1992:312). this notion of genetic temporality inherent in transduction opens discussion up to questions of futurity and emergence. the temporality of ontogenesis is not a matter of “conditions of possibility” that a priori limit or constrain forms and expression of becoming, but, not unlike heidegger’s theory of gestell, is a praesenti an opening up, the bringing forth, and emergence of something new elicited by a coming together of previously disparate orders of being. simondon writes: transduction is characterized by the fact that the result of this process is a concrete network including all the original terms….following the dialectic, transduction conserves and integrates the opposed aspects. unlike the dialectic, transduction does not presuppose the existence of a previous time period to act as a framework in which the genesis unfolds, time itself being the solution and dimension of the discovered systematic (1992:315) so, while “things” can be discussed as more or less distinct, this distinction is belied by a topologically thick network of integrated forces united towards a common becoming. the units in this collective have their own genesis of transductive problematics of contradiction and resolution. there is a futurity of ontogenetic becoming, a movement towards some meta-stability, and the latent potential for emergence through incorporation into new collectives.  ontogenesis is the study of mediation ongoing between an amalgamation of diverse realities including political, economic, corporeal, emotional, social, cultural, and technical that are shaping and molding (in-forming) one another into a larger meta-stable unity (mackenzie 2002:18, simondon 1992:312). the benefits of the ontogenetic model is that it allows us to pull away from relational and comparative analysis of two or more “things” as a blurring, mixture, or hybrid that nonetheless inevitably reproduces essentialisms in the midst of refuting them, to regard the aging body instead as undergoing and partaking in processes of becoming. if we regard aging as a transductive process we can apply the ontogenetic approach to investigate what forces and meta-stable things are brought together as a unit of becoming. what are these units’ genesis stories? what tensions and conflicts have arisen and how might they resolve? what is the topology and temporality of this becoming?  the body as a meta-stable being undergoing a transductive process of aging embarks on a path of becoming and in that process of becoming engages and triggers the systematic changes and transformations of those “things” surrounding it in a cascade like effect. we can therefore attend to questions of such as, “as the biological body undergoes transformations (resolution of internal problematics) associated with age, what new incompatibilities arise with surrounding living environment? how are these incompatibilities (problematics) being resolved and through what processes? is there a higher order of becoming that encompasses the aging body of the individual and its immediate milieu? what other elements are undergoing transformative change in mutual becoming towards this potential larger transductive process of becoming?”  certain “things” that were in a meta-stable phase prior to enlistment in a higher order of becoming have now been brought into relation within the theatre of becoming that is aging. age-related assistive technologies, for example, prior to and outside of this complex ensemble of conjoined forces that is the transductive process of aging, might not have been assistive at all. a popular assistive technology anthropology & aging quarterly 2013: 34 (3) 57 ender ricart from being to ontogenetic becoming in japan, the silver car, began as a stroller, having been designed by the same companies (its technical term in japanese is hōkōki which mutually means baby-walker), to be, like a stroller, a small, lightweight, aluminum wheeled cart that provides an elderly person (almost exclusively marketed and sold to elderly japanese women) with mobility support inside or outside (mostly used by persons living in metropolitan areas).  the silver car has its own genesis of individuation, which is not erased or eclipsed but very much alive and an important force in the present collective becoming. from its previous form as a baby-stroller, it has undergone a process of change together with the aging body and living environment. there are over 300 models of silver cars on the market at the moment. most models feature thicker tires designed specifically for crossing over railroad tracks (lest an elderly person get stuck while trying to cross one of the many railroad crossings in tokyo). a person can sit, carry groceries, lean on the silver car, push it, drag it, park it, get it wet, wash it, bring it inside, outside, get it repaired, and customize it with attachments and adornments. it too has its own milieu: assistive technology sales and rental agents, assistive technology specialist and consultants, care managers, assistive technology user-trainers, product designer and developers, regional comprehensive care centers, elderly care consultants, architects, engineers, strollers, gerontologists, the elderly themselves, their physicality (height, weight, and age), the living environment of the home, community, and climatico-geographic locality (not readily used in areas with hills or heavy snow fall), and finally sociality.  while it is beyond the scope of this paper to go into greater detail, the ontogenetic model demonstrates potential to add new insights and greater depth into our study of aging as a process and the aging body as information. while the three bodies, mindful body, and cyborg model have applicable relevance for imagining confrontations between two forces such as the social and the individual, it does not extend these relations into a larger context of emergence (fisch 2013:324). the ontogenetic model potentially gives voice to a multiplicity of forces beyond the scope of dialectical confrontations. the ontogenetic approach grants the aging body both an analytical autonomy, as an ontological becoming that has its own set of relations with its surrounding environment (associated milieu) and its own genesis story behind it’s meta-stable becoming, but furthermore leaves it open to dynamic participation in larger order of becoming, what i hope to develop in future works as the aging society crisis (shōshi kōreika mondai). aging bodies like assistive technologies, like the health care industry, and like “community building” (machi zukuri) 2 are units in a larger collective that are mutually undergoing a process of change and transformation towards a new becoming that is, as a kind of organizing principle, the aging society crisis in japan. it is by adopting the ontogenetic approach that we can grapple with that which makes the being develop or become, the process of being-in-formation, or matter-taking form, and perhaps look for larger orders of becoming into which various parts have been enfolded and are now in-formation. notes 1. for examples of aging studies which have applied the three bodies and mindful body model see lock 1996; lock and kaufert 2001; and traphagan 2000, 2002, 2004. for studies which have applied the cyborg model to the study of aging see joyce and loe 2010; long 2013; and joyce and mamo 2006. 2. “community building” (machi zukuri) includes the concerted efforts of local government, national government, and gerontological scientific research to develop and build certain kinds of living environments in regional municipalities that support and promote “healthy aging.” that is, to encourage an active and informed lifestyle and continued social participation within and between generations to help foster a sense of integration and reciprocity amongst not just the elderly but all residents. references combes, muriel 2012 gilbert simondon and the philosophy of the transindividual. thomas lamarre, trans. cambridge: the mit press. fisch, michael 2013 tokyo’s commuter train suicides and the society of emergence. cultural anthropology 28(2): 320-343 hacking, ian 1998 canguilhem amid the cyborgs. economy and society 27(2): 202-216 haraway, donna 1991 simians, cyborgs and women: the reinvention of nature. new york: routledge. anthropology & aging quarterly 2013: 34 (3) 58 ender ricart from being to ontogenetic becoming joyce, kelly, and laura mamo 2006 graying the cyborg: new directions in feminist analyses of aging, science and technology. in age matters: realigning feminist thinking. toni calasanti and kathleen slevin, eds. pp. 99-122. new york: routledge joyce, kelly and meika loe 2010 a sociological approach to ageing, technology and health. sociology of health and illness 32(2):171–80. lamarre, thomas 2012 afterword. humans and machines. in gilbert simondon and the philosophy of the transindividual. thomas lamarre, trans. pp. 79-108. cambridge: the mit press lock, margaret 1993 encounters with aging: mythologist of menopause in japan and north america. berkeley: university of california press. lock, margaret and patricia kaufert 2001 menopause, local biologies, and culture of aging. american journal of human biology 13:494-504. long, susan 2012 bodies, technologies, and aging in japan: thinking about old people and their silver products. journal of cross-cultural gerontology 27:119-137 mackenzie, adrian 2002 transduction: bodies and machines at speed. new york: continuum. simondon, gilbert 1980 [1958] on the mode of existence of technical objects: part 1. ninian mellamphy, trans. ontario: university of ontario. simondon, gilbert 1992 [1964]. the genesis of the individual. zone 6: incorporations. pp. 297-317. jonathon crary and sanford kwinter, eds. mark cohen and sanford kwinter, trans. zone books. traphagan, john 2000 taming oblivion: aging bodies and the fear of senility in japan. new york: state university of new york press. traphagan, john 2002 senility as disintegrated person in japan. journal of cross-cultural gerontology 17(3):253-67. traphagan, john 2004 the practice of concern: ritual, well-being, and aging in rural japan. north carolina: carolina academic press. discussion katrina l. moore lecturer, school of social sciences university of new south wales katrina.moore@unsw.edu.au ender ricart’s contribution on the aging body raises some important issues about how we think about technology and aging. japan is experiencing the development of a wide range of technologies focused on aging, from pacemakers and motorized wheelchairs to walkers and telemonitoring. this development has been accompanied by significant ambivalence toward the use of medical devices and assistive technologies in later life (long 2012). on the one hand, technologies facilitate independence for older persons, enabling them to live longer in their own homes. they also enable older persons to project a desirable identity of self-reliance, claiming they can manage to live independently without burdening their families. but the use of these technologies invariably pushes elders to adapt to new relationships of dependence and care. the technologies often demand new commitments from their users: they must adjust to the technology’s own rhythms, capabilities, and occasionally breakdowns (pols 2010). in the process, older persons may feel they lose a sense of autonomy, as they negotiate new social relationships and identities mediated by their reliance on technical devices. ricart’s analysis provides us with some intriguing ways of thinking about these effects, and the complex social worlds through which technologies take on meaning in japan. she proposes that we move away from using the dialectical confrontations of society and individual, and body and self to theorize aging, and instead make sense of the aging body in more dynamic terms. she invites us, moreover, to investigate the multiplicity of forces implicate older persons and the unfolding interactive communication between different orders of being. she claims provocatively that the ontogenetic model gives voices to the relations between aging bodies and these orders of being. these orders of being would include new discourses of healthy aging, discourses of independence in old age, and technologies that purport to enhance well-being. this is a welcome intervention into the study of aging bodies. my questions for ricart are primarily anthropology & aging quarterly 2013: 34 (3) 59 ender ricart from being to ontogenetic becoming methodological. what field sites does she propose for exploring the different orders of being of the aging body? what innovative methodologies might she draw on to capture these orders of being? my secondary questions consider the relationship of the aging body to materiality. more detailed analysis of the ways aging bodies are constituted through material arrangements would be of great interest because it is in and through such material arrangements that bodies acquire subjectivity and agency. references long, susan o. 2012. bodies, technologies, and aging in japan: thinking about old peopand their silver products. journal of cross-cultural gerontology 27: 119–37. pols, jeannette. 2010. the heart of the matter: about good nursing and telecare. health care anal. 18:374-388. anthropology & aging quarterly 2013: 34 (3) 60 ender ricart from being to ontogenetic becoming anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 103-105 issn 2374-2267 (online) doi 10.5195/aa.2015.65 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review vital relations: modernity and the persistent life of kinship.susan mckinnon & fenella cannell, eds. santa fe, nm: school for advanced research press. 2013. isbn 978-1-93864501-3 360 pp price $39.95 (paper) casey golomski, phd university research council postdoctoral fellow, university of the witwatersrand http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.65 http://anthro-age.pitt.edu book review vital relations: modernity and the persistent life of kinship.susan mckinnon & fenella cannell, eds. santa fe, nm: school for advanced research press. 2013. isbn 978-1-93864501-3 360 pp price $39.95 (paper) casey golomski, phd university research council postdoctoral fellow, university of the witwatersrand vital relations is an edited volume by a group of professionally senior anthropologists. their major argument is that conceptualizations of euro-american modernity have long rested on presuppositions about pre-modern and modern societies where kinship is central to the former and erased, sidelined, or subsumed by more powerful social forms in the latter. through historical processes of epistemological "domaining," kinship was separated from politics, law, economics, science and religion. ethnographic research confounds this separation, and the contributors consider how kinship has grounded, interpenetrated, and fomented social, politicaleconomic, and religious change. the second chapter by susan mckinnon anchors these introductory claims by tracing how a quasi-evolutionary model of kinship influenced late nineteenthand early twentieth-century anthropological theories, positing that pre-modern societies structured by kinship systems and obligations progressed toward modern, secular societies structured by impersonal contract. to show this, she describes how certain forms of kinship like cousin marriage and sibling exchange were central the expansion of western corporate entities, but were increasingly stigmatized as such forms “became inappropriate— indeed, scandalously out of place—in a world whose progressive modernity was measured by the standard of their presumed separation” (54-55), that is, the separation of kinship and economy. like mckinnon, each of the volume’s authors’ then pays close attention to kinship in their respective cases so to render these categorical domains untenable and unstable. while the lucid writing and theoretical overview of kinship is impressive, the related categories of age, aging, generation, life course, and life cycle do not appear in the index, and none of the authors take these topics as central to their arguments. anthropologists of aging and the life course, cross-cultural gerontologists, and interested practitioners will have to sift more carefully through each case to unearth what the authors’ claims about modernity and kinship might warrant for their own topical concerns. thus, the focus of this review is to point out select chapters from the total eleven in vital relations for anthropology and aging readers in which they might find some initial ground to engage their age-related interests. these most relevant chapters interestingly involve thematic intersections of temporality, descent, and ethics. using mormonism as her case, fenella cannell critiques david schneider’s analytic separation of blood and law in american kinship, “since mormon ontology does not oppose the material and the immaterial to each other in any simple fashion” (225). one might read her case through a life course lens, to consider how social relations and family formations spiritually extend beyond the mortal life of an individual person. contemporary mormon ideas about golomski | book review anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.65 http://anthro-age.pitt.edu 104 reproduction, adoption, and marriage, for example, account for children’s premortal belonging in the world and the possibility of continued familial reproduction after death in the “celestial kingdom” (227), posing a distinctive “time horizon” (236) for intergenerational continuity within church families. thus the religious temporality of mormonism compels scholars to rethink how relatedness is made through time and across spiritual and physical worlds, and how people understand and envision themselves to change vis-à-vis others along that way. similarly, danilyn rutherford jumps off from the cliché of “what about the children” to investigate a "rhetoric of descent" within popular environmental discourses, which says resource (mis-)management in the present will potentially undo conditions for and relations with future generations. are these children and future generations doomed due to our mistakes, or are they our salvation? such discourses entail ideas of potential rupture between present and the future populations and “elicits an intergenerational form of what david hume called ‘sympathy’: the bringing of another’s passions and perspectives into intimate proximity with one’s own” (262). such rhetorical moves also push us to consider how different notions of the future are constructed and collocated, and she contrasts two examples of temporality using rupert stasch’s discussion of future-oriented kin relations in korowai, west papua, and cormac mccarthy’s literature about post-apocalyptic survivorship. her overall analysis suggests that future children and generations are not the only ones who are potentially doomed. “a broader vision of ethics and temporality” (281), she notes, forces us to acknowledge our own participation—or perhaps self-destruction—in shaping the world today and the world yet to come, as well as the ways our successors might dwell in it. michael lambek sees kinship as a series of ethical, performative acts, pointing out later in his chapter that these acts continue across the “life cycle.” in this account, kinship is both "immoderate"--meaning that it beholds a "surfeit of meaning, relations, and sentiment" and symbolizes a "wholeness that is always already compromised or lost" (242-243)--and "immodern"-meaning that while it was as certainly subsumed by modernist domains of law and economy, it has also been reconfigured by authority and power in historical epochs other than modernity. indeed, he suggests that, “every generation looks back with nostalgia to the imagined richness and interaction experienced by the preceding generation” (243), pointing out how social differences and similarities consistently involve and are remade through kinship acts. in contrast to modernist, static definitions of persons or groups, difference, similarity and identity are relational and more fluid, and he invokes the “life cycle” to give this fluidity a temporal scope. in his account, however, the life cycle is relatively undefined and seems to be taken as a given (248249), rather than one constructed via the intersecting forces and subjectivities of a particular historical era. i think, following jason danely and caitrin lynch (2013:4), this approach would productively ask instead how “the individual’s life-course experiences and the social, cultural, and historical structures and meanings that shape the life course" or kinship for that matter within the scope of modernity, "interact with and permeate each other." finally, it is fair to offer brief descriptions of a few other chapters for their potential topical relevance to issues of age, life course, and generation. sylvia yanagisako shows how italian families’ fashion businesses expand transnationally in china while maintaining lineal solidity, a business model their chinese counterparts find ambiguous. elana shever argues that kinship is central to understanding modernist histories of argentinian nationalism and oil industries, detailing how the political economy of paternalism assured social reproduction for workers’ families. lastly, gillian feeley-harnik, using the case of anthropologist lewis henry golomski | book review anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.65 http://anthro-age.pitt.edu 105 105 morgan’s extended family, argues that professional and personal projects of genealogy emerged in the post-civil war united states alongside legal concerns about who was a free person and who was enslaved. besides her chapter’s wonderful use of archival images and the lovely book cover by the singh twins, other figures supplementing the rich ethnographies would be appreciated. taking cue from the introduction’s title “the difference kinship makes,” the next step might be to ask what “the difference aging or life course makes” to a project of rereading kinship through a deconstruction of modernity narratives. lambek notes in his chapter that under modernity, “family” surpassed “kinship” as an object of regulatory concern, but jennifer cole and deborah durham (2007:2) remind us that age and generation link “world historical economic and social change,” like modernity, “to intimate spaces of caring and obligation within the family.” indeed, as kinship and notions of it transformed under conditions of modernity, we might presume that similar transformations occurred surrounding ideas of aged persons, bodies and the life course and the practices that rendered such ideas concrete. describing how this occurred through and beyond politics, economy, law and religion, as vital relations has asked for kinship, is the task set for contributors to anthropology and aging and similar venues. cole, jennifer, and deborah durham 2007 age, regeneration, and the intimate politics of globalization. in generations and globalization: youth, age, and family in the new world economy. jennifer cole and deborah durham eds. pp. 1-28. bloomington, in: indiana university press. danely, jason, and caitrin lynch 2013 transitions and transformations: paradigms, perspectives, and possibilities. in transitions and transformations: cultural perspectives on aging and the life course. caitrin lynch and jason danely, eds. pp. 3-20.new york: berghahn. anthropology & aging quarterly 2012: 33 (3) 112 book reviews nature’s embrace: japan’s aging urbanites and new death rites. satsuki kawano. honolulu, hawai’i university press. 2010. isbn 978-0-8248-3413-5 pp 220, $27.00(paper) satsuki kawano’s nature’s embrace: japan’s aging urbanites and new death rites is an account of the production of a new mortuary rite, the dispersal of ashes into the sea or wilderness. this new mortuary rite is offered as an alternative to the interment of these ashes and, ideally, their perpetual veneration, in a family grave. in conversation with the growing literature on the emergence of a “new urban elder culture” (for example, morioka kiyoshi, 1994), kawano persuasively traces the complex connections between this new ritual practice and japan’s low birthrate and mass longevity. the author elegantly illuminates how individuals’ experiences of not only their late adulthood, but of their postdeath trajectories are transformed by demographic change. the book, based on some ninety interviews and extended participant observation, focuses on a single organization, the grave free promotion society (gfps), a volunteer-run social movement founded in 1991. while conventional interment rests on the acceptance of the generation contract— the care of the dead is entrusted to the living, ideally to a married eldest son who will tend to and eventually inherit the family grave—gfps encourages its members to forgo burial and instead “return to nature” after their deaths. this approach removes the burden of ritual care from the next generation, and thus reorders the relationship between the living and the dead on the deceased individual’s own terms. thus, kawano suggests, the movement is significant as, through their mortuary choices, gfps members transform themselves from “future recipients of care in a strained system of reciprocity into rewriters of the generational contract […] in other words, they contest their overdependence on the living after their deaths” (169). a particular strength of the text is that, while kawano carefully traces the connections between demographic change and shifting ritual practices, the story she tells is not one of declining filial piety; the feared neglect of the young does not solely drive the decision to abandon the family grave. instead, it is the story of a lively social movement, of activism and agency. gfps volunteering, is, kawano suggests, “driven not only by members’ wish to “return to nature” after their deaths, but also by volunteers’ desire to find a new, meaningful place in society in late adulthood (108).” kawano’s analysis is nuanced; she points out that her interlocutors’ conception of agency is complex. the choice to scatter ashes cannot be understood as a shift to western-style individualism, kawano argues, but instead reflects values of appropriate interdependence, and a distinctively japanese articulation of personhood, and the family and its obligations. while kawano’s overviews of historical transformation are consistently elegant (chapters one, two, and five), the ethnography— in chapter three, on the day-to-day organization of gfps, and in chapter four, on ash scattering ceremonies—is unfortunately sometimes rather thin. beyond an extended description of ash scattering ceremonies in chapter four, there are few detailed examples and quotations. there are moments of real ethnographic richness, but the reader is left wanting more. in chapter four, for example, the author discusses the mixed reaction to the requirement that relatives pulverize bones before they are scattered. while some gfps members saw the requirement positively—as an act that literally put mortuary practices back into the hands of the bereaved, in contrast to commercial funerals that rendered them merely passive recipients— some relatives were horrified by what they perceived as violence against the dead. ethnographic scenes such as this persuasively render the complex reactions to this new ritual form, but they were unfortunately rather few and far between. the book is most valuable, i would argue, as a study of how civil society organizations function in japan, and particularly as an account of the growing activism of urban elderly. however, because of the scarceness of ethnographic material, the reader does not get to know any particular gfps member in detail. the book also lacks tabulated data, photographs, and interview transcripts, so the reader is left not only without a sense of what motivates individual gfps members, but also unable to grasp how significant gfps really is. is the organization, as kawano ambitiously suggests, a new subculture that marks a radical rethinking of the relationships between the generations? while the historical chapters persuade—clearly, an examination of mortuary ritual can provide a powerful lens through which to view a changing society—the importance of this particular movement is not always convincingly articulated. a further point of critique: while the book’s title speaks of “nature’s embrace,” “nature” is entirely untheorized. ruth e. toulson, department of anthropology, university of wyoming, rtoulson@uwyo.edu mailto:rtoulson@uwyo.edu anthropology & aging quarterly 2012: 33 (3) 113 aging, society, and the life course. by leslie a. morgan and suzanne r. kunkel. 4th edition. springer publishing company. 2011. isbn 978-082611937-7 pp353, $90.00 cloth, $52. kindle e-book. undergraduate coursework on topics pertaining to aging are housed in departments of psychology, sociology, anthropology, gerontology, and women’s studies, as well as in interdepartmental programs or certificate programs such as “aging studies” or “human development.” accordingly, there are a number of texts on the market geared for both specific disciplinary audiences and general gerontology or aging studies classrooms. morgan and kunkel’s text, aging, society, and the life course, now in its 4th edition, is framed as a sociology of aging text, but may be appropriate for both sociology and general aging studies audiences. the current edition, written for an undergraduate audience, is comprised of twelve chapters on a variety of topics pertaining to the sociology of aging. the introductory chapter provides an overview of frameworks for thinking about age and provides a general understanding of the relationship between the sociology of aging to gerontology. such a framing is important for undergraduates to develop an understanding of the breadth of the aging field as well as the role of sociology within. the second chapter of the text focuses on research methodology and is a substantive and thoughtful approach that i have rarely seen in comparable textbooks. this is one of the strongest chapters in the volume and would be useful reading for undergraduates in any social science course. the remaining chapters take a more topical focus, and address traditional sociological subject matter such as demography, work, family structure, economics, healthcare, and governance. each chapter presents a brief introduction to the topic, a chapter summary, key words, discussion questions, and web resources. many of the chapters also incorporate an “applying theory” section which bridges theory with specific examples to help students understand the importance of theory in understanding gerontology. the chapters “global aging” and “aging and health” may be the most compelling to an anthropological audience. the transnational aging chapter addresses demographic and cultural factors which affect the aging experience in three nations, china, germany, and kenya. this ethnological approach is accompanied by a brief section on the “exotic other”, but lacks the depth an anthropology-authored text would provide on cultural relativism, race, ethnicity, and identity. the chapter on aging and health is nicely balanced and provides general information on health issues among older adults, variability in health outcomes, and healthcare financing. it avoids going into excessive detail on specific age-associated disorders and is accompanied by a thoughtful essay on antiaging and consumerism in the u.s. context. overall the book has a number of design features that make it a good fit for faculty and students alike. the chapter format of the text is easy to divide over a semester calendar; each chapter provides some useful discussion-generating questions that could be used for in or out-of-class engagement. chapters also feature student friendly sections such as chapter summaries and key terms. it may be helpful to students if future editions provided a formal glossary rather than relying upon context for definitions. the book is nicely produced and the e-book version may be attractive to some students. the e-book version does have voice-to-text capability, which is an important value for students who are visually impaired. anthropologists teaching general aging studies or gerontology courses will find this a good choice. samantha solimeo, phd, mph formative evaluation core center for comprehensive access & delivery research and evaluation (cadre) iowa city va healthcare system if you are interested in writing a book, film, journal or exhibit review for anthropology & aging quarterly, please contact the book reviews editor, sherylyn briller, s.briller@ wayne.edu. include your name, areas of expertise, current ation (research, professor, graduate student, e.g.) and any titles you would be interested in reviewing from the last three years. aaq does not accept unsolicited reviews. book reviews mailto:s.briller@wayne.edu mailto:s.briller@wayne.edu anthropology & aging quarterly 2012: 33 (3) 114 book reviews remembering home: rediscovering the self in dementia, by habib chaudhury. baltimore, johns hopkins university press. 2008 isbn: 0-8018-8827-1 117 pp. $20.00 (paper) concepts of the “self” are a topic of much debate in the humanities and the social sciences. the process of negotiating a “sense of self” becomes particularly important for persons with dementia or other related diseases who may experience a diminished sense of self, especially in societies prioritizing cognition. a diminished sense of self can come about for many reasons, including being removed from familiar surroundings. environmental gerontologist habib chaudhury argues in remembering home: rediscovering the self in dementia that memories of home can connect persons with dementia to their past and can be used to aid them in adjusting to present circumstances such as a new living environment. like many others, chaudhury calls for a reframing of the relationship between caregivers and persons with dementia from a “medical-model” of patient care to a “person-centered” model. he asserts that understanding the person with dementia’s past experiences, gleaned from stories of home and photographs, can greatly help with relating to that person. chaudhury contends that in order to create a meaningful living environment for the person suffering from dementia we need to identify the unique identities of the individuals as reflected through their personal pasts. chaudhury suggest that this approach can be of benefit in two ways. “first, guided reminiscences can anchor residents in remembered places, activities, and events even as their disease threatens to leave them adrift in a present they may no longer recognize or understand. second, home stories can enable caregivers to better understand and engage residents as persons” (102). remembering home is divided into five chapters. the first two chapters set the foundations for the chaudhury’s argument presenting multi-disciplinary scholarship on place, aging, and concepts of the self. drawing on these literatures, chaudhury argues that the person with dementia should be viewed as a “whole” person, with a life, character and set of interests that predate the onset of dementia. chapter two focuses on home as one of the most significant “places” in persons’ lives with both psychological and emotional frames of reference. memories of “home”—including childhood home, a home in which one may later create and raise a family in, and the neighborhoods in which they are embedded— are complex and layered as he argues that these places have become part of the self. chaudhury contends that working with persons with dementia to recover a sense of self through memories of place supports, and possibly even improves, quality of life. he argues that this aspect is very important in the face of the many losses associated with dementia. in chapter three, themes in the recollection of homes and related life experiences are drawn from interviews with 13 individuals with dementia and members of their families carried out in four care facilities in wisconsin. here chaudhury develops his concept of “home story” as a placebased, home-related biographical sketch including photographs and artifacts that synthesize a resident’s memories of home and serves as a tool for guided reminiscences. the goal is to avoid depersonalizing the individual and to instead treat them with compassion, dignity, and respect while appreciating the self that is still there. chapter four presents five focused biographies using stories told by residents, family members, friends, and caregivers during guided sessions using photographs of past homes as triggers. in care settings, chaudhury argues that these stories can be used to stimulate conversation and build rapport between staff and residents. in addition, specific prompts may trigger more memories which can add to the well-being of the person and aid the staff in developing innovative ways in caring for the person. chapter five offers practical strategies and suggestions for using home stories and biographies for caregivers who want to (re)connect with and enhance quality of life for sufferers of dementia. scholars in gerontology and social sciences may find chaudhurry’s theoretical arguments compelling. however, this book is also useful as a guide for health care professionals and activity leaders in long-term facilities, assisted living facilities, adult day centers. family members and anyone interested in understanding and relating to people with dementia will also find it useful. for anthropologists, this book does not draw much on our discipline’s considerable writings on dementia and material culture studies but it is still worth reading to see how a scholar from another field approaches these topics. mary durocher, ph.dc. anthropology department wayne state university ph.dc anthropology & aging anthropology & aging, vol 36, no 2 (2015), pp. 135-144 issn 2374-2267 (online) doi 10.5195/aa.2015.98 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. embedding engineers in elderly care homes when researching new technologies for care greet baldewijns1, tom croonenborghs2 & bart vanrumste3 1, 2, 3 ku leuven technology campus geel, advise, belgium 1, 3 ku leuven, esat-stadius, belgium 1, 3 iminds medical information technology department, belgium 2 ku leuven, department of computer science, dtai, belgium contact: greet.baldewijns@kuleuven.be abstract as the number of people above 65 continuously grows the demand for appropriate support to allow this group of people to live independently increases as well. consequently, a lot of research effort is focused on the development of new technologies that can provide this support. in contrast, only a limited number of these new developments are successfully launched on the healthcare market. in order to facilitate this penetration of the healthcare market, an intense collaboration strategy between healthcare workers, older adults, informal caregivers and engineers is proposed in this paper. keywords: aging, healthcare, collaborative research, technology http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by/3.0/us/ mailto:greet.baldewijns@kuleuven.be anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu embedding engineers in elderly care homes when researching new technologies for care greet baldewijns1, tom croonenborghs2 & bart vanrumste3 1, 2, 3 ku leuven technology campus geel, advise, belgium 1, 3 ku leuven, esat-stadius, belgium 1, 3 iminds medical information technology department, belgium 2 ku leuven, department of computer science, dtai, belgium introduction due to a combination of both high birth rates in the 1950s and 1960s and increasing life expectancy, the number of people above 65 continues to grow. this results is an increase in the demand for long-term specialized care. however, at the same time the group of professionally active people gets smaller. it is estimated that in 2060 for each person older than 65 there will only be two working age people as opposed to four which is the case now (european commission, 2014). as there is already a shortage in the number of available nursing rooms, and care professionals are already heavily burdened, it is questionable if long-term care will remain affordable for the growing group of older adults. to compensate for this shortage, policymakers as well as care professionals and informal caregivers look towards the technology sector to provide additional support. they expect clearcut technology-based solutions for a wide variety of problems coupled with old age. as a response to this question, a lot of technological research groups are focusing their research efforts towards technology which can alleviate the burden of healthcare workers and support older persons who want to live in their own home as long as possible. this research is focused on a wide variety of application areas within elder care. these areas include for example detection of early onset dementia (rashidi 2013), monitoring of the fall risk of a person (baldewijns et al. 2013, mertes et al. 2015, howcroft et al. 2013) and automatically detecting fall incidents (bourke et al. 2007, xiaodan 2009). for these different application areas, a variety of sensors is used such as radar (phillips et al. 2012), both 2d and 3d cameras (baldewijns et al. 2013) and audio sensors (xiaodan et al. 2009). the results of this research focus on elder care applications is mainly visible in the large increase in the number of published papers. this is the case for instance in the number of published papers concerning fall detection, an important application area within the technology for elder care research field. to illustrate this increase, figure 1 gives an overview of the number of papers published per year concerning fall detection as listed in the medline database. baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 136 figure 1: number of published papers concerning fall detection through the years as listed in the medline database it is thus clear that technological research groups can produce long lists of published papers and thus seem to be successful in fulfilling the wishes of the healthcare sector and policy makers. on the other hand, when these new developments are introduced into the healthcare market, caregivers and older adults are often reluctant to buy them. pitfalls when researching technology for elder care as previously mentioned, technological research groups are achieving their aims and can produce large numbers of success stories concerning technology for elder care. in contrast, only a limited number of these developments are successfully introduced into the healthcare market. one important cause for this lack of success is the technology push approach (a new invention is pushed into the market without proper consideration if it satisfies the user’s needs) that is often used by technological research centers. other causes are the limited number of validation tests that are performed and the lack of large-scale clinical trials. the next paragraph discusses these causes in more detail. 1950 1960 1970 1980 1990 2000 2010 2020 0 20 40 60 80 100 120 140 160 year n u m b e r o f p u b lic a tio n s baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 137 137 firstly, there are a very limited number of studies concerning the needs of different stakeholders with regards to elder care technology. it is consequently difficult to gain insight in these acute needs when using literature as a research base. because of this lack in the number of studies, researchers often use their own perception concerning the desires and needs of healthcare professionals, older persons and their informal caregivers as a starting point for their research. this often results in novel technologies that do not match with the actual needs of the different users, which in turn leads to a lot of user disappointment when testing these new applications (chan et al. 2009). this is for instance the case when data resulting from new technologies is not integrated in existing frameworks, making it difficult for care providers to access the data. often only a limited validation study is performed to validate if the new technology reaches all the technical requirements. when considering for instance fall detection algorithms, the tests are often performed in an artificial setting where an often young test subject is asked to perform some basic falls and some walking and bending exercises. based on these activities, an algorithm is trained and validated to detect falls that do not trigger a high false alert rate. when the majority of these simulated falls are detected and the number of false alerts is low, the algorithm is considered successful. older persons however usually do not fall in a ‘textbook’ way. moreover, they perform a large variety of other activities that could trigger false alerts that are often not simulated when validating the algorithms. consequently, the performance of these validated algorithms would not be reduced after an introduction in a real life setting (debard et al. 2012), thus often resulting in an algorithm that looks good on paper, but is not acceptable for a launch in the healthcare market. baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 138 lastly, failure to provide tests on a large group of users often results in a failure to convince healthcare professionals on the validity of the new technology. as with a new drug healthcare professionals demand successful large scale clinical trials before advising their clients on the use of certain technologies. the academic world on the contrary often strives towards a successful proof of concept. furthermore, clinical trials are very time consuming and difficult to finance, so they are often not done and consequently leaving a lot of healthcare professionals skeptical towards new developments in this research field. this technology push approach, which is often used in research groups combined with the limited testing and lack of clinical trials furthermore results in a hesitation with companies to invest in the results of these different technological research groups. hence, the new developments often do not reach the healthcare market and the consumer. how to avoid some of these pitfalls? in order to avoid the previously mentioned pitfalls, an intensive collaboration between care providers, healthcare workers, older adults and researchers is needed. ideally, this collaboration should be set-up during the whole research phase resulting in demand-driven developments instead of the now often used technology push approach. however, research which is further advanced can also benefit from input of the different stakeholders. the input of these stakeholders concerning this further advanced research could still provide important insights in the usability of the technology, giving the researchers the opportunity to guide their research in a different direction when needed. both the demand-driven approach and the guiding of the research when it is more advanced should result in technology that better fits the needs of different stakeholders, therefore eliminating user disappointment when the product hits the market. furthermore, such collaboration opens the door to more extensive user testing of the different technologies as all stakeholders are already involved in the research process. from this testing, researchers will gain important insights in the technical limits of their system, giving them the opportunity to resolve issues which would previously only come to surface after a market launch. it will also provide researchers with the arguments needed to convince companies to take the new technology in production as well as to convince healthcare workers that the new technology can be used successfully. setting-up a collaboration between healthcare workers, informal caregivers, older adults and researchers setting up such an intensive collaboration between the different stakeholders and the researchers is the aim of the engineers@carehomes-project through the installation of an engineering lab in a nursing home (baldewijns et al. 2015). in practice, a biomedical engineer will be present in the nursing home for one to two days a week. during these days the engineer will test drive several technologies together with the different stakeholders. to insure that these tests are performed efficiently and that the information exchange is optimal an action plan consisting of three work packages was implemented. firstly, there is a baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 139 139 work package in which the short-term collaboration is set up. next, there is a work package in which three different technological use-cases are defined to test drive the short-term collaboration set up. lastly, there is a work package in which the long-term collaboration is set up, based on the outcome of the first two work packages. the ‘engineers@carehomes’ project started in january 2015, and even after its two-year period of initial finance, long term collaboration set ups are still being envisioned to take hold over the medium term future. short-term collaboration set up in order to insure that the information between healthcare workers, older adults, informal caregivers and engineers starts to flow as soon as possible, a short-term collaboration strategy was devised. first, two co-creation sessions were scheduled in which different groups of stakeholders were consulted concerning the project and the various technologies that will be used in the use-cases. these sessions were informative and offered the participants the opportunity to voice their opinion concerning both the project and proposed technologies. this shed insight into some of the issues that could arise when looking for participants in technology trials. most of the raised issues however could be resolved by giving enough information to potential participants. overall the participants of these co-creation sessions showed a positive attitude towards the project and the technology trials. four of the five older adults present at these sessions were furthermore interested in participating in the technology trials. during the remainder of the project, similar co-creation sessions will be set up to allow the older adults, their informal caregivers and healthcare workers to voice opinions concerning the different systems and further steer the research when needed. baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 140 although these sessions were and will be very informative for all participants (stakeholders as well as engineers) in this kind of intensive collaboration the information should also reach the engineers, through other channels. to reach this goal, a more informal approach is devised. through the presence of the engineer in the nursing home and in the different wards, informal contacts between the different stakeholders and the engineer follow naturally. during these informal contacts, the different stakeholders can be more inclined to voice certain concerns in an open way than during formal meetings, providing the engineer with different kinds of feedback. technological use-cases to explore the knowledge transfer between different stakeholders and engineers, three different use-cases were selected. during these use-cases, the short-term collaboration set up will be tested, and adjusted when needed. as one in three older adults older than 65 falls at least once a year, falls are a major problem in the older population (milisen et al. 2004). the first use-case therefore aims to test drive different fall detection technologies both present on the commercial market as well as systems which are currently under investigation in different research centers. although a lot of research has already been performed concerning fall detection, the input from the different stakeholders can still be valuable for the engineers. as a result of this use-case, engineers will gain insight into what is still needed to develop a fall detection system which is both technically sound (e.g. detection of the majority of fall incidents but with a low number of false alerts) and which the target audience is willing to use. care providers will gain insight in what is technically feasible, ensuring that the expectations from the care providers match the technological possibilities. the next use-case focuses on fall prevention rather than fall detection. by automatically assessing the fall risk of a person and triggering an alert when the risk is elevated, appropriate fall prevention strategies can be put in place to reduce this risk, consequently preventing fall incidents. during this use-case, several algorithms currently under investigation to automatically assess the fall risk of a person will be validated. on the technical level this use-case will look for the best parameter to assess the fall risk of a person. in addition, important questions such as which information to provide to caregivers and when and how to present this information will be answered. again the input of health-care workers, informal caregivers and older adults will provide important insight to answer these questions. the last use-case will focus on the malnutrition problem in the older population. as 60% to 85% of the older adults living in nursing homes are at risk of malnutrition, this can lead to diminished muscle strength as well as to wounds that do not heal properly (donini et al. 2013). similar to the automatic fall risk estimation system, the first step is to identify older adults at risk of malnutrition by automatically monitoring their food intake. after this, preventive measures can be taken to reduce this risk. in spite of the severity of this problem, the research concerning automatic monitoring of food intake with older adults is sparse. because of this, the use-case will provide a starting point for the development of such a monitoring system. different sensors that could be used to monitor food intake will be validated on technical soundness as well as on usability for the older adults and the care providers. baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 141 141 long-term collaboration set up lessons learned from the different use-cases will be used to establish a long-term collaboration between health-care workers, older adults, informal caregivers and engineers. questions that will be answered based on the experience of all the stakeholders include:  which communication format provides the most valuable information?  which information can be gathered from the different stakeholders in the different technology development stages?  how can the different stakeholders (health-care professionals, older adults and engineers) be convinced to participate in such projects?  which communication format works best for each stakeholder?  what are, outside these use-cases, important needs of the different stakeholders and future research questions? the project aims to list all the lessons learned and provide a guideline to inspire other multidisciplinary research groups to set-up similar collaborations. these results will furthermore be used to improve the further collaboration between the partners in the ‘engineers@carehomes’ project. this future collaboration can be implemented in different forms. first, there are new project proposals that will be submitted, based on additional wants and needs from different stakeholders. next, there is the possibility to provide additional support to local companies that want to approach the healthcare market. advantages to the proposed collaboration for different stakeholders the main advantage for the healthcare professionals is the opportunity to provide valuable feedback that will be used to steer the technological research. as a result of this steering, the new technologies will better fit their needs and will thus enable the introduction of this technology in their work environment, possibly alleviating some of the burdens associated with their jobs. for the engineers, there is the possibility to test drive the technology in a real life setting and hence receive accurate information regarding the technical soundness of their developments. additionally, a better assessment can be made of the acceptability of their technology. moreover, the engineers can now include the suggestions of the stakeholders in their research process. the combination of these advantages will subsequently allow for a better valorization and more successful introduction of the finished product on the healthcare market. while the advantages for professional healthcare workers and engineers are quite clear, the advantages for older adults and their families are initially unappreciated. however, as was apparent during the first co-creation sessions, older adults and their families are quite aware of the importance of their participation in this research for helping future generations of healthcare workers and older adults. this in itself seems to be a huge driving force for participation in the presented project. baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 142 project risks the success rate of the project will mostly depend on the commitment of the different stakeholders in the project. the initiative for this collaboration came from the engineers who felt the need to gather input from all the stakeholders during the research process. not all health care professionals who will come into contact with the project will therefore be convinced of the usefulness of this project. however, critical voices concerning the project aims, use-cases and project set-up are also needed. by engaging with not only friendly users but also skeptical users, a well-balanced view on the project and the different technologies will be developed. engaging with skeptical users in an early stage of the development process steps furthermore allows countering their remarks in the final product. although the suggested method will result in a better product, the approach can be time consuming. it could therefore be challenging to convince companies or other researchers to cooperate in the project. the hope is, however, that more companies and researchers can be convinced to participate in future collaborations when they see the results from this first project. lastly, implementing a multidisciplinary research approach could provide additional information for all stakeholders. combining the engineers approach with that of a business analyst or a specialist in user-centered design could lead to a better overall view of the researched technologies. in future projects such a multidisciplinary approach will certainly be test driven. conclusion although technological research groups can produce long lists of successful research projects, the results of these projects often do not penetrate the healthcare market. to improve the marketability of these new developments, an intensive collaboration between engineers, healthcare workers, older adults and informal caregivers is needed. the aim of the ‘engineers@carehomes’-project is therefore the setup of such an intensive collaboration by installing an engineering lab in a nursing home. the collaboration will be test driven for three previously determined use-cases. the results of these use-cases will subsequently be used to put in place a long-term strategy for the proposed collaboration. acknowledgments the ’ingenieurs@wzc’ project was funded by ’provincie vlaams-brabant’. project partners are ocmw leuven, ku leuven, advise and innovage. the authors would like to acknowledge the following projects: iminds fallrisk project, iwt-erasme amacs project, iwt tetra fallcam project, ict cost action aapele and the profound network. references baldewijns, g., sabbe, p., rombouts, k., peeters, k., mondelaers, a., hekking, j., croonenborghs, t., and vanrumste, b. baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 143 143 2015 establishing a collaboration between care providers and engineers, proceedings of the engineering for society conference, leuven, belgium. baldewijns, g., debard, g., mertens, m., devriendt, e., milisen, k., tournoy, j., croonenborghs, t. and vanrumste, b. 2013 semi-automated videobased in-home fall risk assessment. in assistive technology: from research to practice aaate 2013, encarnação, p., azevedo, l., gelderblom, g.j., newell, a., mathiassen, n.e. eds. pp. 59-64. ios press. bourke, a.k., obrien, j.v. and lyons, g.m. 2007 evaluation of a thresholdbased tri-axial accelerometer fall detection algorithm, gait and posture, 26(2):194-199. chan, m., campo, e., estve, d. and fourniols, j.y. 2009 smart homes current features and future perspectives. maturitas 64(2):90-97. debard, g., karsmakers, p., deschodt, m., vlaeyen, e., dejaeger, e., milisen, k., goedemée, t., vanrumste, b., and tuytelaars, t. 2012 camera-based fall detection on real world data, outdoor and large-scale real-world scene analysis. lecture notes in computer science, frank dellaert, jan-michael frahm, marc pollefeys, laura leal-taix, and bodo rosenhahn, eds. pp. 356-375. 7474. donini, l.m., scardella, p., piombo, l., neri, b., asprino, r., proietti, a.r., carcaterra, s., cava, e., cataldi, s., cucinotta, d., di bella, g., barbagallo, m. and morrone, a. 2013 malnutrition in elderly: social and economic determinants, the journal of nutrition, health and aging, 17(1):9-15. european commission 2014 the 2015 ageing report underlying assumptions and projection methodologies. european economy 8|2014. howcroft, j., kofman, j. and lemaire, e. 2013 review of fall risk assessment in geriatric populations using inertial sensors, journal of neuroengineering and rehabilitation, 10(1):9. mertes, g., baldewijns, g., dingenen, p-j, croonenborghs, t., and vanrumste, b., 2015 automatic fall risk estimation using the nintendo wii balance board, biomedical engineering systems and technologies milisen, k., detroch, e., bellens, k., braes, t., dierickx, k., smeulders, w., teughels, s., dejaeger, e., boonen, s. and pelemans, w. 2004 falls among community-dwelling elderly: a pilot study of prevalence, circumstances and consequences in flanders, tijdschr gerontol geriatr 35(1):15–20. phillips, c.e., keller, j., popescu, m., skubic, m., rantz, m.j., cuddihy, p.e. and yardibi, t. 2012 radar walk detection in the apartments of elderly, engineering in medicine and biology society (embc), 2012 annual international conference of the ieee, 5863-5866. http://ec.europa.eu/economy_finance/publications/european_economy/2014/pdf/ee8_en.pdf baldewijns, crooneborghs & vanrumste | embedding engineers in elderly care homes when researching new technologies for care anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.98 http://anthro-age.pitt.edu 144 rashidi, p., mihailidis, a. 2013 a survey on ambient-assisted living tools for older adults. biomedical and health informatics 17(3): 579-590. xiaodan, z., jing, h., potamianos, g. and hasegawa-johnson, m. 2009 acoustic fall detection using gaussian mixture models and gmm supervectors, acoustics, speech and signal processing, 2009. icassp 2009. ieee international conference, 69-72. 29(2).indd anthropology & aging quarterly 2008: 29 (2) 35 features lessons for successful aging: a centenarian’s lifestyle in a mexican community of aging josé azoh barry, ph.d. consejo social de la frontera norte, ac, nuevo leon, mexico jhazcool@yahoo.com abstract it is clearly established in the scientific literature that an appropriate lifestyle is key to achieving and maintaining optimum health and functional status in old age. in this frame, the practice of physical activity on a regular basis fits into the active aging paradigm, a notorious shift away from aging as a dependent stage of life. through a longitudinal case study conducted in the outskirts of monterrey, nuevo leon, mexico, an aspect of the lifestyle –physical activity – of a centenarian who lives permanently in senior-only housing, has been documented in contrast to his coresidents’ lifestyles. extensive open-ended interviews and direct observations of a convenience sample of residents of a community of aging, from 1999 to the present, allowed for a triangulation and saturation of data. in contrast to his peers, who predominantly displayed sedentary lifestyles, the centenarian consistently had a related physically and socially active lifestyle. i suggest that the attitudes of fellow residents can be understood in light of the theory of planned behavior (fishbein and ajzen 1975). fieldwork also provided the opportunity to document how fitness and independence affected the quality of life of the centenarian. this individual is atypical in his environment and the external validity of this study is analytical rather than statistical. however, it suggests that non-institutional barriers may challenge the promotion of an active aging paradigm. introduction according to projections by the consejo nacional de población [national population council] of mexico, the current population of 7.8 million aged 60 and over will double in 2020 to 15 million and, in 2050, will rise to 36.2 million (zuñiga et al. 2003). such estimates are congruent with trends already observed or predicted by specialized agencies (united nations 2002) for less industrialized regions (e.g. asia, latin america), where aging is predicted to occur at a faster pace. in a context of rapid demographic and epidemiological transitions, chronic and degenerative diseases associated with aging are increasing considerably. moreover, diabetes mellitus is expected to take its toll in mexico in the coming years. in fact, diabetes mellitus has progressed so rapidly over the past years, that it is now the main cause of death among older adults, especially women (zuñiga et al. 2003). therefore, healthy aging gives rise to serious concerns in mexico. considering the high cost of chronic conditions such as diabetes, osteoporosis, and cardiovascular disease for the health care system and the resulting suffering, frailty, disabilities, and dependency for the patients, promoting successful aging strategies is of utmost importance (who 1997). behavior is therefore a key factor, and, fortunately, lifestyle is amenable to change (odphp 2000). changes in lifestyle, such as regular use of preventive health services, proper nutrition, the regular practice of physical activity (even initiated later in life), risk taking reduction related to the use of safety belts and helmets, elimination of smoking and limited alcohol consumption, positively impact health and impairment statuses, and, thus, quality of life. according to the findings and conclusions of an interdisciplinary research program carried out in the united states of america, maintaining good physical condition is probably the most important thing elderly can do to be in good health (rowe and khan 1999). furthermore, health experts indicate that physical activity among older adults (50 years of age and over) results in immediate and long-term benefits at the physiological, psychological, social, and cultural levels (who 1996). in mexico, research on the elderly is not incipient. however, this population is not homogeneous and research studies on the elderly have not consistently acknowledged them as a diverse group. centenarians are among the oldest old, and should be of particular interest to gerontologists and other scientists. interestingly, in japan, currently considered the country with the fastest rate of elderly growth, one such study has been conducted in okinawa (wilcox et al. 2001). okinawa, a prefecture consisting of 44 inhabited islands, has the longest life expectancy and the highest prevalence of centenarians (42 per 100,000 inhabitants) with an age range of 100-111 and a mean age of 101.6 (willcox et anthropology & aging quarterly 2008: 29 (2) 36 features al. 2001). the authors put the uniqueness of this situation into perspective by noting that in most industrialized countries there are estimated ten centenarians per 100,000 people. in mexico, the instituto nacional de estadística geografía e informática [national institute of statistics, geography and informatics] defines population aging as an increase in the proportion of people aged 60 or older. it attributes this to a decrease in general mortality and fertility, with international migrations being an additional factor. almost half of the population between 60 to 64 years of age is still participating in the work force. this is more related to the low social security coverage and very limited amount of old-age retirement benefits, than to elders opting to continue working (inegi 2005). dickerson (2007) contrasts these figures with elders in the united states, where 18 percent of seniors are in the work force and describes the streets of the mexican capital as places where begging and subsistence jobs in the underground economy are sources of income generation for the aged (dickerson 2007). as indicated by the inegi (2005), indigenous populations of mexico are aging at a faster pace and their precarious situation gets more acute for those 60 years of age and older. however, these studies do not specifically focus on lifestyle choices that have resulted in a relatively high number of centenarians in states such as nuevo leon. in mexico in general and particularly in nuevo leon, little is known about centenarians. usually, they are brought to the public sphere to illustrate longevity and to document historical events as witnesses. the elderly in general are often the focus of the mass media 1.) when they are celebrated during specific events, 2.) when they are victimized by strangers or loved ones, and 3.) on special occasions as beneficiaries of specific programs. information about their lifestyle is commonly limited to diet. the diet of centenarians is an object of curiosity and often considered to be the secret of their longevity, while other clues for successful aging are often overlooked. this study aims to describe regular physical activity as a component of the lifestyle of a centenarian in a nursing home in nuevo leon, mexico. accordingly, i also address how other residents of the nursing home perceive his unusually active lifestyle, and discuss coresidents’ attitudes toward their own involvement in physical activities. methodological concerns the case study is a method of scientific inquiry applicable to a positivist epistemology among other orientations relevant to the examination of atypical phenomena. knowledge gained inductively and deductively is not mutually exclusive and concern for the validity and reliability of any mix of data diversely yielded prevails (winegardner 2000, yin 1993, yin 1994, bradshaw and wallace 1991). this case study is longitudinal for being conducted over a considerable period of time (from 1999 to 2007). data presented are primary and were generated through a qualitative approach seeking to gain an emic perspective and involving an emergent design. the description of phenomena under study and construction of their meanings are based on lived, felt experiences and observed and reported facts. the main study site in accordance with its naturalistic approach, the study was mainly conducted at the permanent senioronly-housing residence of the centenarian. this kind of nursing home, commonly called locally “asilo” [literally asylum, but referring to old people’s home], is a nongovernmental facility located in the metropolitan area of the state capital and formally considered a residential unit. as a not-for-profit nursing home, it is usually home to elderly without old-age security or supportive family environments. living independently is an important requisite for being admitted. staff obligations are limited to cooking meals, securing the main door of the residence, and cleaning washrooms and bathrooms. no caretakers are available since it is not an assisted-living residence. the number of residents varies between15-18. however, the capacity of occupation is much more. the procedure extensive fieldwork in a natural setting was key to conducting the case study. the opportunity for entering the field presented itself in the year 1999 thanks to a geriatrician. since that first step, gaining entry and establishing good rapport with the participants has been a carefully handled and successfully achieved priority. utilizing triangulation as a combination of data collection sources and techniques and measuring behaviors through repeated observations provided a basis for attaining an interpretative validity of data. in accordance with a triangulation perspective, a few other places in the neighborhood, considered natural settings for this population beyond the nursing home, were also visited in order to directly observe some reported behaviors and cross-check the information gathered through self-reports at the nursing home. anthropology & aging quarterly 2008: 29 (2) 37 features sampling, sample size and data sources sampling was purposeful and the population of reference consisted of all the residents of the nursing home. the derived two-level sampling consisted of the centenarian as the main case and a within-case sample involving a non-predetermined number of participants selected more on a voluntary basis than at random. there is an average of 17 elderly residents in the home every year. since the beginning of fieldwork, about 12 have died and one has been transferred to another nursing home for medical reasons. about three-quarters of the residents were interviewed. since triangulation confers robustness to research findings, eight other informants living outside of the residence, but familiar with the lifestyle of the central case, were added. data collection techniques and materials direct observations of lifestyle occurred inside and outside the nursing home and some pictures were taken with a non-digital camera. interviewing inside and outside the nursing home stemmed from informal conversations (open-ended) to more focused ones. the centenarian was videotaped during the first two years of fieldwork. trust built over time made the conversations with some participants more spontaneous. interviews taped and transcribed every year were compared to identify differences or changes in the verbatim over time. data management and analysis due to the conventional format in research reporting, data management and analysis are artificially separated from data collection. verbal and non-verbal data consisting of descriptions and narratives from observation grids, taped and not taped interviews, and pictures were transcribed and/or reviewed. they provided feedback relevant, not only to writing data in an organized manner and capturing emerging categories or features for analytical purpose, but also to orienting and/or refining the process of data gathering. both analytic and reflective styles are used to report the recurrences and variability observed in behaviors and discourse. therefore, data are presented under various forms that are visual, anecdotal, condensed verbatim, and tables. no specialized software was used because data were handled manually. in the explanation building process, no scale was used in relation to attitudes, and data saturation accomplished through long-term observation was important. ethical aspects the study was neither intrusive about participants’ intimacy, nor threatening to their privacy, dignity, and integrity. all the residents of the nursing home agreed to be taped (audio and video) and have photos taken without hiding their faces. anonymity is preserved with the use of pseudonyms rather than the real identity. their free and informed consent about data collection and dissemination was verbally obtained because people are cautious about signing written documents, and the elderly are more enthusiastic about oral communication. who is the centenarian? don longevo was born in 1900, more exactly on june 24, and has a relevant document to prove it: his birth certificate. so, he has lived in two centuries and witnessed the mexican revolution (1910-1917) as a volunteer enrolled in francisco (pancho) villa’s army in chihuahua, northwestern mexico, his native land. he is slim and short (squat) and considers his corpulence as light: “my body is slim and light”. he is the youngest of a large family of 14 children. he has two brothers older than him in ciudad juárez, chihuahua, his hometown that he left when his mother passed away at the age of 112. hi father died at the age of 113: “dad lived till the age of 113, one 13 and mom up to 112, one 12. they were really strong. may they rest in peace. dad was teaching boxing to everyone. god gave me strength by inheritance. i come from good wood.” he used to practice sports when he was a young boy, especially collective games (handball, baseball, volley ball). he completed six years of schooling and dedicated himself to a variety of lucrative activities such as tailor, taxi and bus driver, and tourniquet operator in the railway to make a living. he is the father of four children (three males and one female) who live in california. he is the oldest of the residents and is immediately followed by octogenarians. he has been living in the nursing home for about seventeen years. he had the opportunity to engage in a sentimental relationship there and got formally married. although his second wife, maría, has passed on, the consequences of marrying her continue to affect him: some years ago, one of his sons –the oldest-came with a grandson to visit him at the nursing home. the plan was to take him to the usa for good. but when the son heard that he got married to maría, the relationship with his family took a different course. they got mad at me because i married maría. but their mom died a long time ago. they have not talked to me for about 11 years. maría got sick from the heart. she died at the metropolitan hospital. my family did not come. when my older son came with a grandson and got angry at me, he said we rather leave him without money. we will no longer come here. my daughter used to send me up to 100 dollars. anthropology & aging quarterly 2008: 29 (2) 38 features he believes in god, but does not really practice any religion or identify with a religious denomination. he does not consume tobacco and alcohol and his consumption of coffee is minimal. he avoids beverages served by the kitchen because he finds them too sweet and prefers sugarless tea. his opinion about coffee is that it alters the nervous system and interferes with sleep. he knows how to cook and enjoys cooking soups in his room where he has a mini stove. he usually cooks vegetable soups. since he is not really fond of red meat, he adds chicken wings to the soup to make it tasty. he also has breakfast in his room consisting of eggs, fruits, milk and cereals. he socializes with some residents from the neighborhood who are much younger than him. he also has friends who invite him to social events and pave the way for him to appear on television. two historians once took him downtown for filming. appearing on television brings him some benefits: i appeared on channel 2 doing some push-ups and sit-ups. many people in monterrey know me. they bring me red meat, chicken, sugar, marmalade, a kilo and a half of soap, clean clothes… for my wedding, i received a madeto-measure suit as a present. i go out for a walk. i visit my friends. they give me meals. i earned those sympathies. rather than bought, friends ought to be earned for one’s own qualities, way of being, how one naturally manages things. general findings four most recurrent aspects to be highlighted about the centenarian and his coresidents are the following: 1. the discipline of don longevo: an outstanding feature of don longevo is his active lifestyle established through performing a daily routine of physical exercises inside and outside the nursing home. he usually wakes up at five o’clock in the morning. after drinking a cup of herbal tea (anthemis nobilis or citrus aurantium) he infuses himself, his day starts with a warmup session of about 20-30 minutes. sport facilities are not available at the residence. so to get started, he uses an area at the back of the kitchen he calls “mi campo de entrenamiento” [my training camp]. after the stretching and rotation exercises, don longevo begins a three-kilometer trajectory through the streets adjacent to the residence. it consists of a fast and vigorous walk for about half an hour that he refers to as “las vueltas de las manzanas”, meaning to go around the blocks. in his own terms: “i go up to eloy cavazos, these are 60 blocks and more. i go down through serafín peña where the statue is. i go up to the clinic 29. i jump up and down until the other road, juarez, passing more than five blocks.” not having any interest in the gossiping that takes place among some coresidents (and often ends in discords), don longevo dedicates the rest of the day to gardening inside the residence and to more outdoors activities when he feels bored. his desire is to have some sports installations to exercise inside the residence. walking is very important to him: “i am always in action. i fix my garden up, later i go for a walk. walking is a therapy i impose on myself as if i were a doctor. tomorrow, i will spend the time here with the pickaxe.” 2. an acknowledgement of don longevo’s good health, physical condition, and functional fitness: don longevo is experiencing a healthy aging process confirmed by the physicians who attend the residents of the nursing home. he is free of any physical and mental illness or impairment. according to him, what the physician used to say is the following: “don longevo no, nunca le da. no necesita pastillas, medicinas para nada.” [don longevo no, he never gets sick. he does not need any pills or medicine at all.] he feels perfectly fine: “me siento como nuevo a pesar de que dios me ha consentido tantos años de vida. estoy bien de todo. mi cuerpo está perfectamente bien.” [i feel like brand new although god gave me so many years to live. i am fine with everything. my body is perfectly fine.] most of the coresidents are suffering from chronic and degenerative diseases, especially diabetes mellitus which they refer to as “azúcar” [sugar]. as a result, deficient sight and amputations affect their free anthropology & aging quarterly 2008: 29 (2) 39 features movement. the residents acknowledge that don longevo enjoys good health and most note his fitness despite his advanced age: “está bien conservado” [he is keeping well]. he is physically fit and most importantly, able to function in everyday life. his coresidents ask him to help them out sometimes. case example: the saint valentine gift bags on a february 14, saint valentine’s day or, in mexico, “día del amor y de la amistad” [love and friendship day], pre-school children from the locality visited the nursing home. after singing and conversing with the residents, the children were instructed to present the gifts they brought for the elderly. at the end of the visit, one of the residents was not able to lift two bags of gifts he received. he got up from his seat and asked don longevo to bring him a crane to have all the bags taken away: “tráeme una grúa para llevarme todo esto”. finally, he asked for his assistance: “don longevo, ayúdame a llevar estas bolsas a mi cuarto.” [don longevo, help me to take these bags to my room.] don longevo, without any difficulty, lifted the bags while his co-resident could hardly walk using a cane as a support. the benefits don longevo reaps from his discipline do not seem to motivate his coresidents to initiate an active lifestyle through physical exercises. most believe that they cannot exercise due to their age “ya no puedo. soy muy grande para eso.” [i can no longer. i am too old for it.], or “no tengo 25 ó 30 años. tu puedes, te doy 25 ó 30 años.” [i am not 25 or 30 years old. you can, i think you have 25 or 30 years.] others invoked their health conditions. don longevo, who disagreed with such beliefs and convictions, expressed this by indicating that you can get it if you really want it: “querer es poder.” an anecdote by the centenarian: the push-ups challenge don longevo and a young adult publicly challenged each other to perform some push-ups. the young man was the first one to begin the exercise, but acknowledged that he could not keep up with his challenger. he was an 18 years old boy and grown, i had no doubt that he was going to win, so young and me 99 years old. a religious group came, they were about 30 people and they went to the dining room. some were saying he is old, he cannot. there was a woman who said the boy was going to teach me. she said, ‘don longevo, we brought you a contender’. i asked him, ‘do you begin or i do?’ he said, ‘i will begin’. he was doing them so poorly. since the first one, i realized that he was pure potato. his body was not straight. the body must remain straight. i gently spanked him and told him ‘get down, i will teach you. you will not be able to compete with me.’ i did the push-ups without interruption for about three minutes. he said that i had won. here, no one does pushups like i do. the teacher madonna brought her students and said, ‘prove to them that i am not telling lies. i told my boys that you do push-ups and they do not believe me.’ don longevo enjoys doing the push-ups: “lo hago a diario. no, eso no me cansa. lo hago cantando como las águilas.” [i do it daily. no, it does not get me tired. i do it singing like the eagles.] 3. the indifference and misperception of the coresidents repeated conversations with don longevo, interviews with the residents, and direct observations revealed that none of the residents seems to be inspired by the example they have under their roof. as a matter of fact, no change was reported in terms of joining don longevo for exercising, joining other residents for exercising, or exercising on their own. don longevo considers it a self-punishment: “siempre están sentados. sólo se están imposibilitando. yo le digo a uno como es de mi tierra: despierta, date una vuelta, camine, camine.” [they are always sitting. they are only making it impossible. i told one, because he is from my hometown, wake up, go for a walk, walk, walk.] although residents note his old age and good condition, they do not necessarily approve of his daily routine. performing outdoors activities such as walking is perceived as wandering rather than as part of an exercise routine or being physically active: “es un vago, nunca asiste…” [he is a vagrant, he’s never here.] “siempre anda en la calle.” [he is always in the streets]. another anthropology & aging quarterly 2008: 29 (2) 40 features negative perception of walking is its association with fatigue. a few years ago, don longevo was taking his late wife for a walk as a sort of therapy because she was strongly depressed by not hearing from her family. she was imagining that her daughter was persecuted in the usa, where she went so many years ago and never came back. but, according to some residents, he was using her for begging in the streets and they considered it an abuse that physically exhausted her. 4. the status quo: life in the nursing home is routinely lived with almost no major changes over the years. living together is accompanied by long-lasting interpersonal conflicts. they go out sporadically. from time to time, some groups visit them. once a month, all the residents socialize when some teachers from a state institution visit them to play bingo. they also talk to each other before and after religious services. a few years ago, they lost an on site income generating opportunity which also served as an occupational therapy. don longevo is desirous of working again: “quiero volver a trabajar otra vez si dios me conceda porque la ley es trabajar.” [i want to work again if god grants me because working is the law.] with the exception of don longevo, lifestyle in the nursing home is sedentary. the common routine consists of sitting watching television and mending clothes from time to time. going to the dining room and the washroom or clean-up activities provide some limited opportunities for moving the body. continuity and change in don’s training routine constancy in his physical practice including the preliminary conditioning exercises has been selfreported. however, over the past days, some changes have been occurring, especially in the warm-up routine. although august (2007) has been a rainy month, the rains did not interfere with his outdoor activities. the difference in the routine is noticeable in the decreasing number of stretching and flexibility exercises and how he feels about performing them: “i feel a little bit strange in my chest because they take me here and there and i am not concentrating. now i do 40, 30, up to 15 push-ups. i have never missed my practice. i do not know why i am lowering. it never happened to me before, only this month. now i feel tired doing them.” during the month of august, he has been invited to participate in many events directed at the elderly and to dine out. he did not decline any invitation and “partying” seems to have some repercussions on his regular resistance and productivity as far as performing a routine without exhaustion is concerned. yesterday there was a celebration at inapam, formerly insen. they took me there. a professional came for me. earlier today, they took me for lunch in a fancy restaurant in mexico. today i woke up completely full. i do not know what they call the meals on the menu. i had a tasty stew and then soup and a delicious assortment of desserts. i had a glass of water rather than a soda. i did not feel like having a soft drink. last time they took me to an elegant restaurant. i do not know the name. the dif takes me to several places. i am the one who transmits messages this is why they take me. i talk about aerobics, sit-ups, and the revolution. his discourse on exercising over the years has not changed in essence. the same holds true for the friendliness and generosity toward him that is corroborated by other sources. in the morning i go out for a walk for about 40 or more blocks. what am i doing here? this is what keeps me alive. i am always fine as i am. thanks to god, i have not got sick. this is what i thank god for. yesterday the mayor came to celebrate me. they brought me a new mattress, two pairs of shoes, clothes, bed sheets, many things. she wanted to know about my needs. i am thankful with god and with everyone. discussion many studies have demonstrated that the regular practice of physical exercise and programs for body strengthening reduce frailty and disability among people aged 85 and over (cdc 1996). physical exercise is one aspect of don longevo’s lifestyle that sharply contrasts with his coresidents’. diabetes mellitus is a real threat to anthropology & aging quarterly 2008: 29 (2) 41 features routine movements efforts some benefits frequency satisfaction warming-up stretching, twisting flexibility, blood circulation, muscular activation, muscular, relaxation daily enjoys series of push-ups, situps and other flexibility exercises stretching, flexibility and balance movements muscular strength and resistance, muscular tissues reconstruction daily enjoys long walks low impact aerobics; moderate intensity heart/cardiovascular system daily enjoys gardening stretching, bending resistance, flexibility, strength, muscular tissues reconstruction, horticultural therapy regular (as hended) enjoys table 1: physical activity of don longevo who regular activity movements/efforts two women kitchen helpers warming tortilla, sweetening, and serving coffee majority laundry putting clothes in the washing machines and tumble dryer. take the clothes off the machines a few mending clothes the sight and the hands majority personal higiene (shower) movement: room-bathroom-room. body washing and drying. all self-feeding movement: room-dining-room-room. take the plate from the kitchen to the table and take it back to the kitchen. put the food into the mouth and masticate majority room cleaning sweeping the floor, fixing the bed some talking mouth movements majority playing bingo using the hand to place the matching piece or token table 2: coresidents’ routines years frequency (warm-up) number of push-ups number of sit-ups 1999 daily 60 50-60 2000 daily 60 50-60 2001 daily 60 50-60 2002 daily 60 50-60 2003 daily 60 50-60 2004 daily 60 50-60 2005 daily 60 50-60 2006 daily 60 50-60 2007 daily 60 mid august: 40; 30; 15. 50-60 table 3: warm-up routine anthropology & aging quarterly 2008: 29 (2) 42 features their independent living, a requisite for being admitted as a resident of the nursing home. a regular practice of physical activity is part of the treatment for a successful control of this chronic disease. however, the intensity of their daily body movements seems to be so low, that the activation of their basal metabolism appears to be minimal. some mentioned their chronological age as an impediment to initiate a physical activation. such selfevaluation of their inability to engage into regular physical exercises does not support the findings of a recent study on successful aging, where the issue of learning new things in old age is presented as a myth, labeled “you can’t teach an old dog new tricks”. it is reported as a “mistaken notion that seniors are set in their ways and won’t willingly move out of their comfort zone” (rowe and kahn 1999). also, it must be noted that some elders voluntarily participate in some programs of physical activity directed at them and sponsored by the state and some municipalities in nuevo león. this confirms that they can learn new things and enjoy their practice. this is the case for tai chi, considered to improve balance and gait among other benefits (wolfson et al. 1996, lai et al. 1995), or catchiból, an adaptation of volleyball to the aged with the use of a special light ball. studies carried out on centenarians in the usa summarized some characteristics common to them in various areas such as health, lifestyle and attitudes. among the similarities that have been consistently found (rowe and khan 1999, as kemp et al. 2007 note), the following appear to match with don longevo: centenarians are not obese. centenarians rarely smoke. centenarians seem to have delayed or avoided age-related health problems such as stroke, heart attacks, cancer, and diabetes. centenarians are engaged – they do something, have an interest, are involved. centenarians have an ability to cope with loss (and the longer you live, the more you lose-family, including children, friends, sight, hearing, driving), and still go on with life. a medical model and functionalist lens in sociology reducing old age to a medical, economic and social problem prevailed for many years (borrowsky et al. 1998, blaikie 1999). in essence, such tendency conceives of aging in terms of body, mental, and productive decay leading to retirement. there is abundant scientific evidence about aging as a normal process within which physiological, psychological, sensory changes occur (saxon and etten 1994, fiske and chiriboga 1990, timiras 1994, kirkwood 1999). however, such changes do not necessarily impede the desire for and attainment of good health and quality of life. they also do not condemn elders to functional limitations. following this path, a shift in this aging paradigm from a stage of an unproductive and dependent life to an active aging, within which the elderly remain involved in productive social and economic activities, occurred. don longevo’s lifestyle is compatible with this new active aging paradigm. his discipline and outdoor activities lead to a triad of interrelated components consisting of an enjoyable physical activity, social activity, and health maintenance. active and healthy aging go hand-in-hand and are likely to protect or rescue the elderly from the lucrative pharmaceutical industry. the misinterpretation of his long walks by other residents of the nursing home displays an unfavorable attitude toward an active lifestyle and healthy aging. it appears to be a mental barrier likely to undermine lifestyle and quality of life. according to fishbein and ajzen (1980), intentions are the best predictor of behavior and are influenced by three factors: 1.) attitude toward a given behavior, in this case physical activation through a routine, 2.) subjective norms being what the others –coresidents— do, and 3.) the control of the perceived behavior, implying how easy or difficult it is and what will be the result. the first factor could refer to the negative association of don longevo’s routines with vagrancy “es un vago” [he is a vagrant.] the second factor could relate to sedentary lifestyles as a norm in the residence, while the third one may have to do with the efforts necessary to train an aged body. walking does not bring social benefits if it is devalued and framed in derogatory terms: it is only wandering. i have documented the active lifestyle of a centenarian resident of a nursing home who is aerobically active on most days or better said all weekdays, in contrast to his coresidents’ minimal levels of activity. the case example relating to the st valentine’s gift bags provided anthropology & aging quarterly 2008: 29 (2) 43 features a clear-cut evidence of his functional fitness and social productivity more than vigor. the negative perception of his atypical lifestyle by his coresidents and their own suitability for physical exercise, have also been explored. not only is don longevo a living testimony of the benefits of practicing physical exercises regularly and safely at an advanced age, but also of an achievable healthy aging. his lifestyle choice, far from being antisocial, ought to be emulated to avoid the marginalization and medicalization of the elderly. eliminating the probable mental barriers would be an action favorable to a positive and long-lasting change. this suggests a need for additional studies on health motivation among the elderly with a focus on the influence of intra and interpersonal factors. adding years to life and life in good health to years are not mutually exclusive and involve personal habits among other factors. this has proved true in many other parts of the world and this mexican case study represents additional evidence. acknowledgements i am grateful to all participants in the study, especially the centenarian. i am also thankful to dr. raúl gutiérrez, don arturo goytia, and francisco chaires aguayo (technical support). references blaikie, andrew 1999 ageing and popular culture. cambridge: cambridge university press. borrowsky, allan, sol encel, and elizabeth ozanne 1998 ageing and social policy in australia. cambridge: cambridge university press. bradshaw, york, and michael wallace 1991 informing generality and explaining uniqueness: the place of case studies in comparative research, international journal of comparative sociology, 32 (165). cdc 1996 physical activity and health: a report of the surgeon general. atlanta: u.s. department of health and human services, centers for disease control and prevention, national center for chronic disease prevention and health promotion. dickerson, maria 2007 elder care lands with a boom on third world. cantonrep.com. a service of the repository canton, oh. electronic document http://www.cantonrep.com fishbein, martin, and icek ajzen 1975 belief, attitude, intention and behavior: an introduction to theory and research. california: addison-wesley. 1980 understanding attitude and predicting social behavior. new jersey: prentice hall. fiske, m., and d.a. chiriboga 1990 change and continuity in adult life. san francisco, ca: jossey-bass, inc. inegi 2005 los adultos mayores en méxico. perfil sociodemográfico al inicio del siglo xxi. inegi. electronic document. http://www.inegi.gob.mx kirkwood, thomas 1999 time of our lives: the science of human ageing. london: weindenfeld and nicolson. lai, js, et al. 1995 two-year trends in cardiorespiratory function among older tai-chi chuanpractitioners and sedentary subjects. j am geriatric soc. 43:1222-1227. littlejohn, stephen 2002 theories of human communication. california: wadsworth thomson learning. odphp, nhic 2000 healthy people 2000. progress report for physical activity and fitness. office of disease prevention and health promotion. washington: department of health and human services. rowe, john, and robert kahn 1999a successful aging. new york: dell as metz d. 2000 notes in innovation to prevent dependency in old age. british medical journal, editorials 30: 460-1. 1999b successful aging, as kemp, gina, white, monika, segal, robert (2007) note in help guide aging well: a lesson from centenarians. electronic document. http://www.helpguide.org/lifelong_wellness.htm saxon, sue, and mary jean etten 1994 physical change and aging: a guide for the helping professions. new york: tiriserias press. timiras, paola 1994 physiological basis of aging and geriatrics. boca raton, florida: crc press. winegardner, karen 2000 the case study method of scholarly research. the graduate school of america. electronic document http://www.tgsa.edu/online/cybrary/case1.html willcox, bradley, craig willcox, and makoto, suzuki 2001 evidence-based extreme longevity: the case of okinawa, japan. © okinawa centenarian study. wolfson, l, et al. 1996 balance and strength training in older adults: intervention gains and tai chi maintenance. j am geriatric soc. 44: 498-506. world health organization 1996 the heidelberg guidelines for promoting physical activity among older persons. geneva: who. world health organization 1997 the world health report, geneva: who. yin, robert 1993 applications of case study research. newbury park, ca: sage. continued on page 43 anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 26-44 issn 2374-2267 (online) doi 10.5195/aa.2015.81 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. tokens of trauma the aging experience of shoah survivors in a jewish support center 2014 margaret clark award for best graduate student paper ben kasstan durham university, uk contact: ben.kasstan@durham.ac.uk abstract this paper explores the traumatic memories of aging shoah survivors who attend a social and therapeutic support facility in london (uk). the study investigates the perceived differences in trauma within a diverse group of members who partake in the day center. i discuss how this gradient is shaped by a controversial dialogue over who is ascribed the status of “survivor.” differences in shoah experience contextualise how survivors of ghettos and concentration camps possess a salient relationship with food, notably bread which acts as an enduring symbol of catastrophe for participants. a conscious strategy of care is provided to these elderly survivors by returning elements of their pre-war lives in eastern europe, and by metaphorically reinscribing lived experience of violence with new meanings. this study then details how religious and cultural elements of judaism, which are made available to aging survivors and refugees within the field-site, mediate the trauma that has become thoroughly embodied for participants. the case study presented here offers a novel contribution to the anthropological study of genocide and the consequences which come into sight with the passing of time. keywords: shoah, trauma, embodiment, aging, food http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu tokens of trauma the aging experience of shoah survivors in a jewish support center 2014 margaret clark award for best graduate student paper ben kasstan durham university, uk contact: ben.kasstan@durham.ac.uk introduction nestled amidst london’s sprawling suburbia is a day center which offers social and therapeutic support to aging jewish shoah1 survivors. in order to honour the anonymity promised to the center’s administration, the true name of the field-site has been replaced with the hebrew pseudonym of bitachon. this word conjures an image of safety, trust and faith. it emulates the ethos of the service, and how the support staff say they attempt “to create a space where survivors can be themselves, [and where] they are always heard.” for these reasons the center is sentimentalised as a “second home” by many of its members. the convenors of bitachon tell me that “the safety [offered in-house] is the sensitivity and understanding shown” to members on the part of staff and volunteers, the program of events, and the all-important “open door policy” which enables survivors to “come in and say anything and everything.” moreover, the center’s convenors stress that this latter belief is perpetuated “because for all old people the sense of loss [o]f identity, control and independence is incredibly hard. for survivors and refugees who[se] dominant life experience was having all those things taken away from them, they are more sensitive around this issue.” as many shoah narratives focus on bearing witness, the issues of what it means to be a survivor and the effects of surviving are often overlooked. conducting field-work at bitachon then offered an invaluable insight into understanding the aging experience of survivors of genocide. moreover, it offered an opportunity to explore the ways in which an ethno-religious care organization addresses the needs of an aging and traumatized community, especially those which come into sight with the passing of time. this paper follows classic attempts to understand “lived jewish spaces” and “jewish strategies of place-making” (lipphardt, brauch and nocke 2008:2), specifically in the context of an aging demographic. in her seminal ethnography number our days (1978), barbara myerhoff championed the cause of jewish ethnography and conducting anthropology at “home.” her study portrayed the senior jewish members of a us day club, many of whom were refugees of eastern europe, as “survivors twice over” by first escaping the shoah through emigration and then by living into old age and “surviving their peers, family, and often children” (myerhoff 1978:23). jillian gould (2013) later explored the ways in which elderly jews (re)create feelings of home and hospitality when moving into institutionalized care homes with shared spaces for public gathering. these studies provided an influential foundation when attempting to navigate kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 27 27 figure 1: glass artefact in bitachon. photograph by the author. how jewish members of non-residential day centers reconcile past traumas with the present day. departing from related jewish ethnographic studies of aging and space, this paper describes how the service at bitachon offers the members a token and taste of their pre-war lives from a time before the shoah and the personal as well as collective tragedies which ensued. bitachon when arriving at the center for my first day of fieldwork in january 2013, i stood on the outside of what appeared to be an ordinary brick building with tinted windows reflecting the currents of london’s quotidian life. the mezuzah2 discreetly fixed to the door post – a typical marker of jewish homes and institutions – welcomed me into an open plan space. it first appeared humble yet somewhat plain until i noticed the artwork produced by members which had been proudly framed and exhibited on a sidewall. a stained glass light-box illuminated an image of intertwined hands striving to grasp a menorah3 –an ancient and enduring symbol of judaism and appeared to me as a metaphor for the struggle and journey of survival which many of my (soon to be) research participants had embarked upon (see figure 1). it was only once the members arrived that the space was really brought to life; each person bringing with them a different presence, language, nationality, conversation, concern, or personal request from the chef who diligently prepared – and amenably tailored – their lunches. the availability of familiar food was arguably the hallmark of bitachon and its social and therapeutic program. himself a refugee of the 1992-1995 bosnian war, the chef offers a menu that is not only culturally appropriate but a conscious strategy of care for the jewish elders who frequent the center’s café. the kitchen conforms to the dietary laws of kashrut and only provides parev (yiddish, ‘neutral’) and dairy-based meals, the latter of which must be chalav yisrael4. upholding this high standard of kashrut on the premises means that “all jews are comfortable eating here,” the support staff said, and enables both members and staff to eat together regardless of their level of ritual observance or secularity. as will be discussed later in this paper, the centrality of the café in bitachon is equally telling of how food is a deeply rooted and lingering issue for aging survivors of genocide. the elders at bitachon comprise a diverse community of people originating from poland, hungary, france, germany, austria and czechoslovakia (but who are often now british citizens). kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 28 whilst the members i encountered were exclusively ashkenazi in origin, i was not made aware of any sephardi survivors who lived through nazi occupation or persecution and who may have had a considerably different relation to the material under study5. the composite nature of the center means that social and cultural differences remain between the members. although english is the vernacular language of the center, sub-groups can often be identified through the use of common languages. many elders also continue to speak yiddish, particularly those of polish, hungarian and to a lesser extent german origin, and the yiddish conversational group is the most lively and frequented activity on a wednesday. when attending one session i was categorically told by a survivor that one does not come to learn yiddish, one comes to speak it. like the café at bitachon, the yiddish conversational group is a successful feature of the social and therapeutic program because it enables the eastern european elders to engage with their pre-war lives. as confirmed by ariel, a polish-born member, the yiddish language provision “reminds us of the heym, the home, it reminds us of the home.” this meant that the opportunity to hear and speak yiddish brought members back to a pre-war era; “back all the way that life used to be,” claimed isaac, a hungarian-born survivor of auschwhitz-birkenau. such statements exemplify how the social and therapeutic service at the center attempts to restore elements of the elders’ former lives and customs in eastern europe, and can perhaps be considered an interpretation of “culturally-appropriate” care for this particular group of aging victims of violence. the religious practice of participants ranges considerably, from orthodoxy to reform or non-observance. although most are not religiously observant, i was told by a member of support staff that “religion or being jewish” remains a prominent part of the service offered to the members through guest speakers as well as celebrating all religious holidays. similar to the high standards of kashrut maintained in-house, orthodox rabbis tend to frequent the center for religious discussions or services because the “core members tended to come from religious or traditional families,” note the conveners. catering to orthodox standards in jewish institutions, even when the majority of jews might not be ritually observant, is common and reflects practices observed in the wider ethnographic study of jewish topographies (see gould 2011). of the 450 or so members on record, the regulars will frequent the center for particular activities offered during the sunday-thursday period rather than linger around for the day. a quarter of this number receive support from the therapeutic and counselling wing of bitachon, which i did not have access to. the weekly social program includes, but is not limited to, bridge, art, creative writing, israeli dancing, keep fit, yiddish, guest speakers and discussions, as well as a spouse’s group. the latter group was particularly interesting to understand how peer or social support is directed to the marriage partners of shoah survivors, which is considered necessary because, as hindi, a british-jewish spouse, remarked, “we all have the same, i wouldn’t say a problem, but experiences. it’s not a normal life.” the center is within easy reach of london’s jewish suburbia and most members arrive by public transport or pre-arranged taxis, though members who lived further afield remarked that they were less inclined to schlep [yiddish, arduous journey] over to bitachon for regular activities or gatherings. many of the members are prominent personalities in the united kingdom’s jewish social body, speaking regularly in jewish as well as mainstream schools and public institutions, and kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 29 29 frequently featured in national and local press. the demand for members who can narrate their experiences of the shoah is intense, and peaks around commemorative events such as holocaust memorial day and yom hashoah6. as part of the research i was able to accompany various survivors as they spoke at schools across london and saw the tiresome impact of constantly renarrating and revisiting their escape from death. in spite of this, many of the more active members resolutely continue to speak in schools because of their respective personal obligations, either to lost family and relatives, youth education, or the perceived threat of “holocaust deniers.” although bitachon is administered by paid members of staff and supported by a network of volunteers, there are elected committees which are designed to give the members more autonomy over the space they use and the service provided to them. the center’s advisory committee allows the staff to liaise with elected individuals and negotiate how to continuously meet the needs of the center’s members and appropriately respond to challenges that emerge over time. in addition, there is a separate representative sub-committee for survivors of the camps and ghettoes to advise on the delivery of services and commemorative events to this particular demographic. during my initial induction i was told that there are “different groups of survivors” who come to bitachon. membership is inclusive of those who were made refugees owing to nazi antijewish and persecutory policies in germany, austria and czechoslovakia from 1933 onwards; children who arrived in the uk by kindertransport7; hidden children (who tend to be the younger demographic); camp and ghetto survivors; and spouses. the support staff also made it clear to me during the induction that the center accepts members on one condition: “if you were jewish enough for hitler you are jewish enough for the service.” this means that the center does not base membership on the strictly matrilineal definition of a jew according to religious law (halachah), but anybody who was defined as jewish according to the nuremberg laws of 19358 and experienced nazi persecution accordingly. however, the title of survivor which is ascribed to all members equally by the organization remains a contested term amongst the tacit communities or groups within the center9. this questions the extent to which “non-survivors” in the center (i.e., its administering staff) generate – and enforce – subjective perceptions of what constitutes a survivor and how this compares with the perspective held by those who were incarcerated in the ghettoes and concentration or extermination camps. research methods the ethnographic research and semi-structured informal interviews presented here comprised my postgraduate thesis, the fieldwork of which was conducted continuously between the months january-august 2013. ethical approval to conduct this research was granted by durham university, and permission was also granted by the parent organization which oversees and funds the services provided at bitachon. oral or written informed consent was obtained from research participants. the names of all research participants who contributed to this paper have been replaced with pseudonyms in accordance with the ethical guidelines outlined by the association of social anthropologists of the uk and commonwealth (see asa 2011). kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 30 data was drawn from twenty-three interviews; one conducted with a deceased member’s spouse; five with conveners, staff and volunteers of the center; five with members who came to the uk by kindertransport or as refugees; and twelve with camp and ghetto survivors. by using the method of participant-observation i was regularly in the center to “hang out,” acquaint myself with the members, and build rapport over activities such as rummikub or the bridge tables. it was somewhat common for school and university students to volunteer in bitachon, and i was often mistaken as being a young volunteer, which led me to continuously remind members of my role and intent as a postgraduate researcher. the sensitive nature of the research project meant that i was careful to first develop strong relationships with the survivors before pursuing interviews. it was during an informal discussion with daniel a survivor of auschwitz-birkenau and the death marches that i truly valued the contributions which participants felt able to make to this study when he said, “it’s painful. it’s not easy to talk about it, there’s a lot of pain to sort of turn the pages and talk about those days. so every word said is gold, diamonds.” l’dor vador: generation to generation i was initially motivated to conduct this study as my paternal great-grandmother was deported from france to auschwitz-birkenau in 1942, and my grandfather and his sister lived through the nazi occupation of france and french complicity in the shoah. this visceral link to the research matter caused a genuine willingness to learn about the lives and biographies of the members in bitachon. as a number of the elders i encountered harbored a wish to impart their testimonies in younger generations, conducting multiple interviews in london and maintaining correspondence from durham meant that long-lasting and personal relationships formed over time. i was then welcomed into the homes and lives of participants to the extent that my own name (ben) became “benjy” or simply “bubbeleh” [yiddish; term of endearment, dear or sweet] and i was regarded by some of the elderly female members as an adoptive-grandchild, rather than a researcher and they, in turn, became akin to grandparents. trauma anthropological studies of embodiment have been greatly impacted by the philosophical tradition of phenomenology, and particularly by maurice merleau-ponty’s notion that the body can be considered as a “disclosure” of individual experience and the social world (2008[1945]). here, the body is seen as less of “an object to be studied in relation to culture, but is to be considered as the subject of culture” (csordas 1999:5). uses of embodiment within anthropology have consequently positioned the body as a true reflection of lived experience, and as a social artefact which becomes inscribed with the ordeals and marks of time (see fassin 2006). as discussed in the context of genocidal legacies in a mayan village in guatemala, survivor “communities face a fundamental challenge in how to reconcile deep, inescapable mourning over the traumas of the past with hope for a better future” (manz 2002:295). in working with the members at bitachon it could be inferred that the aging process presents a challenge to that “hope for a better future” (cf. manz 2002:295), as some of the elderly survivors would look back on their lives rather than forward to their futures. although the social and kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 31 31 therapeutic program attempts to mediate traumatic expressions of lived experience of persecutory violence, the shoah can feel irreconcilable with the present day for some elders: i went through a very hard time darling because i lost my mother, father. i lost my fiancé. i was engaged; he was 24 and i was 21. people died, why not me? why am i still here at 90? we are all damaged goods. we don’t have a normal life, not with our past. (mara, hungarian survivor of auschwitz-birkenau) a well-documented issue of working with testimony is the potential for over-lapping individual and collective narratives of genocidal experience, and the consequent need to “decipher and decode the meanings in people’s stories, to sort out the public voice and concealed, unspoken thoughts” (manz 2002:299). the individual and group reflections of escaping death were indeed harrowing as the elders carefully shared their testimony of lived experience of genocide, but the interview process enabled me to ask further questions about how these memories persist over time as an embodied trauma and genocidal legacy: with a white glove on he [dr mengele] was pointing left left, left – all without asking any questions. suddenly when he came to me, he stopped and asked “wie alt bist du?” [how old are you?]. i said sixteen […] i will always remember that millisecond, he thought to himself “well alright, i’ll believe you” and he pointed me to the right. it was as close as that to death in those times; life was literally at the whim of somebody’s feelings or thoughts. as far as i’m concerned, most of the survivors do have some sort of haunting experiences which reminds them literally day by day – either loss of family or any other tragedy. (isaac, hungarian survivor of auschwitz-birkenau) a community of survivors the center was created by a founding group of members who expressed a shared need to be with survivors who carried similar experiences of trauma in a specifically jewish space. abigail, a survivor of auschwitz-birkenau, remarked that a key motivation in initiating bitachon was the reality that many survivors felt unable to talk about their past experiences to “normal citizens, [because of the perception that] they wouldn’t understand what we went through.” another one of the founders is rachel, who was deported from hungary to auschwitzbirkenau in 1944. she remains an active member of the advisory committee, which, as mentioned, brings staff and representative members together to discuss the running of bitachon. it is important for her to be involved in the center’s leadership because, as she says, “in a way it’s like my baby! when you build up something from nothing then it is very important to carry on that.” rachel recalled a time when survivors could not, and had never, spoken about their experience; a reluctance which also resulted from a perceived feeling that “nobody wanted to listen.” as rachel went on to say, part of the issue for survivors living with embodied trauma resulting from the shoah is the subjective belief that “it is very difficult to live with it and to also have a life, [and] in the beginning you could not do the two things together.” many of the elders who lived through the concentration and extermination camps discussed the initially slow and painful process of meeting informally with fellow survivors and opening up to each other. the resolve for rachel was to nurture a timely intervention which began as a peer-led bagel brunch kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 32 group and eventually became bitachon in 1992, she said, “there was a need to do something, to build something, for now as we age. today it is a lifesaver for quite a lot of people.” when interviewing the elders at bitachon it became clear that there was some diversity in how they perceived the issue of past trauma presenting, or becoming more acute, with age. many elders felt that the past was persistent over time, and isaac (a hungarian survivor of auschwitzbirkenau) noted how “hardly days go by without some sort of recollection or remembrance of either before, during, or after the war.” according to rachel, the replaying of trauma from her incarceration in auschwitz-birkenau is independent of age and is not an issue of becoming “more difficult, but [that] it is difficult to live with.” however, the experiences associated with moving through the later stages of life (such as entering retirement, losing partners, and transitioning states of (dis)ability) can indeed make the latent feelings of loss from the shoah feel more acute. as abigail told me: i feel more in need of company now than ever before. when i was young, before i retired, i was a very busy woman! i had no time to feel lonely or to think too much about the holocaust. but since i retired, i have a lot more time and also getting older is not a very pleasant experience. so i need people more than i ever have. the center has since brought a once disconnected group of people together to that effect, but i was told by avi (a viennese survivor of auschwitz-birkenau and bergen-belsen) that bitachon is not a depressing place to be for the elders. on the contrary, he said, “when you see the people here, they are all optimists! they are all happy people, it’s a wonderful place and we enjoy being here.” for these reasons bitachon is regarded as a “lifeline” by participants and the criteria of “one of us” nurtures a sense of trust between members, as suffering is shared yet understood without speaking. this sentiment was echoed by many members i interviewed, and was seen as a quality that was not perceived to be granted by people outside of the center or the non-jewish world: after all the years i lived in non-jewish surroundings, it’s almost like being born again for me. because, for all of a sudden i am with people that i don’t have to explain anything to. (leah, german refugee) i have a chance of coming across people who had the same experience and they know exactly how i feel and we reminisce a lot. it helps us tremendously. (ariel, polish survivor of buchenwald and mauthausen) if you’ve gone through the holocaust or gone on the kindertransport you have a different life. you went through experiences in your childhood and your adulthood which are not like other people’s [experiences]. so there is a whole block of your life which is not something that other people can relate to. (esther, granted a special child visa to leave france for the usa in 1941) kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 33 33 degrees of suffering this is not to say that all survivors are considered as equal survivors; in fact, it would be more accurate to say there is a “hierarchy of suffering”10 between the different groups who use the service. this was raised during a pair-interview which alluded to the experience of two women: i never felt that i had gone through anything they [camp survivors] had gone through. (naamah, kindertransport) i very often feel that really i don’t belong, from their point of view not from mine. from my point of view, i very much belong because for years and years i thought about nothing else; i dreamt that i was in a concentration camp, that i knew what a camp was like. but i really feel like i don’t belong because i haven’t been through anything. i even think there is a difference between her and me, she [naamah] lost her parents and i am still living in the house my parents bought! (leah, refugee) this discussion introduces the gradation of suffering that some members felt existed, not only when compared with camp survivors, but also amongst each other. not all the elders in bitachon chose to define themselves as survivors, and when i questioned michal about her past she was quick to correct me by saying “i am not a survivor because i came out with the kindertransport.” moreover, i sometimes found using the term survivor obstructive when discussing the research project and my intent to interview the elders. this was especially the case amongst members who came to the uk by kindertransport or as refugees, and some of whom needed additional prompts and reassurance that i was just as interested in their narrative as i would be in anybody else’s. i was then interested to ask whether a range of members from the different type of groups felt there was a sense of community at bitachon: look, i’ll tell you what is the community here; the proper survivors from the camp. (michal, kindertransport) the people who were in the camps sometimes don’t feel the same kinship with the people who came over as refugees. in the beginning there was almost a separation because they feel that they suffered in a way that others didn’t. they don’t understand that somebody was put on a train by her parents and never saw them again, it’s a tremendous loss. (esther, granted a special child visa to leave france for the usa in 1941) there is a terrible difference between us, we should be separate groups. the so-called “survivors,” they were refugees. they had a perfectly normal life here compared to us. (mara, hungarian survivor of auschwitz-birkenau) the kindertransport don’t understand the people that were in the camps for instance. the refugees they can’t, it’s not possible to understand what the camp survivors went through. they came with their parents, their families, and their goods and valuables – they were in a different position altogether. they said “we all suffered the same, suffering kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 34 is suffering” but there is a big difference. (deborah, polish survivor of auschwitzbirkenau and bergen-belsen) taut encounters or exchanges between the different groups of members were few and far between, but were nonetheless awkward to observe when they did occur. on one such occasion i sat for tea with two members when one of the ladies present, shifra (a spouse of a deceased member), commented that “it must be so nice to be young and twenty-one, i wish i was young again.” mara then sharply responded “that is the difference between you english and us survivors. god forbid, i couldn’t be again twenty-one years old. i had the most horrific experiences at that time.” whilst i was startled by mara’s frank statement and sharp use of “you” and “us,” the encounter was demonstrative of how the gradation of suffering or sense of difference between the groups in the center was enacted. tensions between members were not always restricted to hierarchical claims and counter-claims of suffering, or debates of who was entitled to membership. confrontations between camp survivors appeared to be buffered by their deep sense of fraternity when they occurred. on one occasion during a yiddish session i sat with daniel, who was once one of the center’s most temperamental members but was also, i sensed, one of the most vulnerable. after a heated exchange between some of the participants during the yiddish group one wednesday which resulted in daniel exiting the center, a male elder turned to another and asked “can’t we banish him?” to which his peer responded, “what can we do? he’s one of us.” although bitachon is widely appreciated by the members as a “second home,” there remains a contentiousness of bringing together a spectrum of experiences under one survivor’s term and one roof, with assertions of exclusive rights as to who is or who is not a survivor. for members that were incarcerated in the camps, there is a sense of resentment when sharing the status of survivor with those who did not experience their lives in the nazi concentration camps. at the heart of this disjuncture between the members clearly lies a difference in suffering, but also a perceived lack of understanding between the groups regarding the trauma and loss that kindertransport and refugees experienced. this hierarchy of suffering can in fact be considered a response to the establishment’s practice of ascribing the status of survivor to all members. this occurs even though members of the kindertransport of refugees were not subjected to the constant threat of extermination within the nazi ‘state of exception’ (see agamben 1999, 2005), by virtue of the fact that they had escaped its dominion. during an interview with the convening staff, i was told that the difference between members was largely an issue belonging to the past and the center’s initial conception twenty years ago. i learnt from naamah, who has been associated with the center since 1992, that the groups originally kept to separate times, days, and even social programs, but as more of the elders died the separate services were no longer feasible. kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 35 35 the administering staff of bitachon claimed how, at that time, “people were arguing about who was entitled to come here and who wasn’t, which is a strange thing now because we break down all those barriers.” however, the observations and quotations outlined above certainly question that claim, and it is evidently the case that a discrepancy continues to exist between some elders within the different groups who use the services at bitachon. this indicates that there remains a conflict between the subjective ideas of what constitutes a survivor between the center and the members themselves. to a similar effect there is a tacit dress code at the center and notably a “no-stripe shirt policy.” this intervention is enforced by the management with the intention to avoid causing what is considered undue distress to survivors, who typically wore striped uniforms whilst being confined to the camps. by honest mistake i flouted the implicit prohibition by wearing a pinstripe shirt on one occasion during the fieldwork, and was reprimanded by center staff accordingly. the policy is also demonstrable of traumas that are projected at bitachon, and is a controversial intervention enforced by staff as it is believed to impact upon the wellbeing of camp survivors. not only did some male members dress in striped shirts when attending scheduled activities (figure 2), but the policy actually aroused unsupportive reactions amongst one survivor of auschwitz-birkenau: figure 2: the marks of time. photograph by the author. kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 36 we actually ask people not to wear stripe shirts because it triggers the memory of the striped uniforms for some. (support staff 2) it’s stupid! if i see a proper uniform, a uniform from the camp, then it gives me a knock to the heart but stripes? men wear striped shirts all the time! (deborah) i struggle with this one. there is a belief that that these things [stripes] could have impacted our member’s sensitivity. since i don’t recall an incident where this happened you sometimes wonder if we project certain things or are we just intuitive? (support staff 1) although members of the center hold the staff in high regard and vice-versa, it is evidently the case that the staff operate at a heightened level of sensitivity which is not always congruous with the survivors they seek to protect. the discrepancy between the subjective “triggers” aired by the staff of bitachon and the true tokens of trauma that survivors feel burdened with reiterates the need to deconstruct the testimonies shared by survivors and draw out the issues that members themselves detail as enduring reminders of the shoah. the contest of defining an authentic survivor in bitachon is reflected in the contemporary anthropological discourse of medical certificates and how they legitimize the embodied trauma of asylum seekers in europe. didier fassin and estelle d’halluin (2005) chart how clinical investigations are deployed to identify and validate the physical traumas harbored by the body as evidence in claims for asylum. in these instances, embodied trauma is investigated and formalized as an “inscription of truth” when “narratives are less often believed and more proof is often requested” (2005:598). the body can then be considered as the “ultimate evidence,” and “the place in which individuals” truth about who they really are is experienced” (2005:597). this discussion of embodied authenticity can be applied to the tacit dichotomy that is felt by the different groups of survivors at bitachon. here, camp and ghetto survivors are considered – and arguably consider themselves – to be ‘proper’ survivors by virtue of the numbers indelibly etched on their arms or their testimonies which clearly recount their lived experiences of the camps (figure 2). the absence of which gives rise to embodied boundaries within bitachon, and explains why the kindertransport or jewish refugee groups are not considered equal survivors by the former based on the fact that their embodied experience cannot testify to the same extreme horrors of the nazi “state of exception.” gould recently relayed how jewish elders in a canadian institutionalized care home were differentiated as being “real immigrants” or those who were “western-born jews” (2013:192). however, the reflections made by members of bitachon take us beyond relevant examples in jewish ethnography or the wider anthropological discourse. we can see how boundaries within a mutual space are created by virtue of different experiences of trauma, but also how marks of lived experience are mobilized to revoke allocation of the term survivor by those who consider it undue to share. the taste of affliction as the lunch-time period approaches the open-plan space is transformed into a café decked with tables and chairs, offering a break between the scheduled activities. the café forms kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 37 37 the core of the center and is a shared and social space; conversation fills the air along with the smells of heym [yiddish; home] as fresh and subsidized food is prepared in house by the chef. foodways play an implicit role in demarcating the aforementioned groups by virtue of their diverging experiences. the support staff inform me that this is particularly the case for survivors of the ghettoes and camps, for whom “tasteless food is an insult but not enough food is traumatizing.” satiety is not just a physical or caloric requirement in bitachon, but is fundamentally an emotional state of being with traumatic reflections that are directly related to shoah experience for camp and ghetto survivors. the importance of the center’s café cannot be understated for some of the elders, and for some of whom, the lunches on offer might even be their main meal of the day. conducting an interview with naamah (kindertransport) affirms the particular significance of food for camp survivors rather than refugees, illuminating the graded difference between the members of bitachon: “i think food is far more important for people in camps who really were starving.” this statement is supported by recollections of life in auschwitz by rachel, who remarked that “now you will see grass there, but there was no grass or else we would have eaten it. that was the situation.” such extreme recollections of lived experience and trauma were common amongst the camp and ghetto survivors, as also expressed by baila who tells me that, in the lodz ghetto, she received a “ration that wasn’t for living but for dying.” as a result of years spent in a violently enforced state of starvation where life and death were hinged on having bread, this particular food is leavened with meaning for survivors of the ghettoes and camps. a resolve of bitachon is to always have a basket of bread besides the kitchen which is free of charge and constantly available. these slices were often wrapped into a napkin and tucked into a handbag or blazer pocket “just in case”; a learned survival strategy which is also reflected in notable shoah testimonies (see levi 1987[1947]). bread came in forms that were familiar to the ashkenazi jewish elders, including rye-bread with caraway seeds or braided rolls (challah) at lunch, and sweet cakes or rugelakh (a pastry typical of ashkenazi baking) would also be served during particular activities or times in the day. whilst interviewing deborah in her london flat, she told me that food waste is common in her kitchen yet bread is to be saved at all costs as “people were dying for a crust of bread.” the inextricable associations of bread and bondage were common, perhaps because, moshe tells me, bread was “important because this is what we got every morning when we got up [at auschwitzbirkenau], a slice of bread.” however it was clear from many interviews conducted that bread continues to sustain traumatic memories of the camps and ghettoes. whilst being escorted to london’s wiener library in russell square by chaya, she recalled a fairy-tale of hansel and gretel that she recited to children under her care in the orphanage of the lodz ghetto. except the fairy-tale was retold in a way that made the staple of bread, rather than the luxuries of gingerbread, dreamful: the only difference was that instead of children finding a lovely house made of chocolates and sweets in the middle of a forest, the house was made of bread and they could just go in there and eat as much bread as they wanted. that bread can act as a barometer of experience between survivors of the camps or ghettoes and those who escaped nazi persecution as refugees from 1933 onwards can be inferred kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 38 from a further reflection by chaya. she went on to share an anecdote from her married life, as her husband had left poland for the united kingdom in 1939: as a student [in england] he had no money. he was telling me sometimes for lunch he had to have a bar of chocolate and that’s where our differences started when i was telling him about bread, and then he told me about chocolate! chaya goes on to tell me how much she values bread to this day, also stating that this particular food can ‘never’ be wasted because of its importance during her incarceration in the lodz ghetto. the meanings ascribed to bread by camp and ghetto survivors also recount an ancient narrative of subjugation and redemption for jews that is annually commemorated through the eight-day festival of passover (pessa’h). this marks the narrative of the ancient israelites who, in their desperation to escape enslavement by the pharaoh king of egypt, took their dough before it had leavened and journeyed endlessly into the wilderness. the uncertainty which they encountered along the way caused the israelite community to long for the bread and sustenance they once had, and there they complained to moshe and aaron: “if only we had died by the hand of the lord in the land of egypt, when we sat by the fleshpots, when we ate our fill of bread” ([tanakh] exodus 16:2-3)11. following the biblical narrative of exodus, it is forbidden to consume leavened bread and derived-products or even allow a single crumb of leaven to remain in jewish homes over the holiday of pessa’h. during this time jews are instead instructed to consume unleavened bread (matzah) which is metaphorically considered to be the “bread of affliction” in judaism and marks their ancestral tale of bondage and eventual emancipation. foodways can therefore be considered an integral part of evoking memory in judaism, as to remember (hebrew; zachar) “is often a verb of action rather than simply thought” (berlin and brettler 2004:315). the intimate connection between bread and memory has been recorded in notable anthropological studies, particularly by david e. sutton’s (2001) account of “remembrance of repasts” in the greek island of kalymnos. for one of sutton’s athenian research participants, bread evoked “the image of children and desperate people during wartime crying out in desperation psomaki [a little piece of bread]” (2001:32). this example relates deeply to the reflections of bread explored above, and its status as the definitive “taste of affliction” since the time of exodus to the extermination of the jews. krupnik soup although the bread is freely available, a daily menu offers a nourishing choice of meals at a subsidized cost to members. one recommendation is the polish barley soup, the recipe of which is supplied by deborah. during an interview in her living room, she unfolded a piece of paper from a tin and recites: “my homemade barley soup […] is thick and nourishing, and what did we get in the camp? water with a piece of turnip swimming around, if we were lucky.” the bowl of thick and textured soup in front of me stirs up a journey of survival. as deborah recalls, the soup in the camps was weak, watery, and lacking sustenance, but now at bitachon the survivors are served a warm and wholesome soup that “represents where they have kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 39 39 come.” the polish barley soup ladles a memory of the heym in the physical sense of the term ‘home’, but also a lost place of origin, time and pre-war life for the ashkenazi jewish elders at bitachon. not only is the soup a conscious strategy of care that is culturally appropriate, but in some way it also offers a historical counterbalance or re-inscription for members of ashkenazi origin. in this sense, the soup is more than a familiar culinary memory of the heym; it also overrides the taste of suffering experienced by survivors of the camps and ghettoes with a relished and lasting taste of survival. collective experiences of political violence are known to give rise to emic categories of somatic responses, such as people complaining of a heart that was “spoiled” and “torn apart” by the tragedies and suffering that ensued during the sierra leone-guinea border conflict (henry 2008). in a similar expression and embodied response to lived experience of violence, bread can be interpreted as a vernacular and enduring token of trauma in bitachon because of its role in continuing to mark the threshold between life and death in the ghettoes and camps. moreover, the specific way the center’s social and therapeutic program features foods that are not only familiar but re-inscribed with meaning demonstrates how a form of care that is culturallyappropriate or historically-significant can be delivered to traumatized victims of political or social violence. in the context of the shoah or exilic narratives more broadly, sephardi and mizrahi jewish memoirs also point to particular foods as offering a taste and memory of their former lives (see rodent 1997). for iraqi jews especially, date fruits not only mark the taste of dispossession and being uprooted from their home cities of baghdad and basra, but also the difficulties and discrimination experienced when being re-sown in israel as an ethnic sub-group largely after 1950 (shaba 2009; benjamin 2007). just as the shoots of iraqi date palms that were transplanted to israel yet failed to flourish as they once did, iraqi jews too were sown: into the new soils of israel. and this land, they say, seemed unaccountably hostile to middle eastern and north african jews – so they didn’t grow right, either (shabi 2009: 3) the foods associated with jewish communities, claudia roden notes, recount ancient tales of ‘an uprooted, migrating people and their vanished worlds’ (1997: 3). considering the fact that food brings the past and continuity into alignment (see roden 1997), age-related care settings should be considered ideal spaces to explore how foodways feature within the needs of aging communities and particularly those elders who have been uprooted from their formative lives. annemarie mol (2010) has explored the key role that food performs in delivering “good” care in dutch nursing homes, and identified how nutritional and palatable qualities are “interdependent” as much as “in tension.” as “survival comes in cultural inflections” (myerhoff 1978:257), the attention paid to food in age-related care settings which cater to aging and traumatized victims of violence should be emphasized. moreover, the way in which the café at bitachon offers a metaphorical taste and token of the heym as a conscious strategy of care adds a novel interpretation to studies of “jewish topographies” (cf. lipphardt, brauch, and nocke 2008). several landmark studies have furthered current understandings of the impact of suffering over time, and, based on the experience of war-rape in the bosnian conflict and greek civil war, calls have been made for interviews to nurture “a better understanding of the impact of trauma on the victim’s later life” (van boeschoten 2003:47). as observed in bitachon, lived experience of violence continues to shape the behaviors and foodways of elderly victims of kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 40 genocide and persecution. here, former survival strategies from concentration and extermination camps continue to be enacted, demonstrating how “people’s inner states reflect lived experience within everyday worlds” (biehl, good, and kleinman 2007: 5). the embodied trauma of aging survivors at bitachon, marked through sensitive and acute relationships with bread, is a visceral example of how, as dider fassin argues, “history is not merely a narrative or the sum of competing narratives. it is also what is inscribed within our bodies and makes us think and act as we do” (2007:xix). narratives of embodied trauma are evidently of great relevance to anthropological studies of aging and genocide, as “even when violence has lapsed, the memory of violence permeates the subjective experience of any number of people around the world” (biehl, good, and kleinman 2007:11)12. concluding reflections this paper has illustrated how a dedicated support facility with a social and therapeutic service attends to the embodied traumas held by aging jewish shoah survivors. in bitachon, culturally-appropriate care feeds memories of a lost way of life, predominantly for jews of eastern and central european origin. as ariel notes, the center and its staff “are just extraordinary, who devote everything to give us back a life which we had before the war.” the data can be used as a strong foundation for further research with survivors of genocide, and enhance our understandings of the tokens of trauma which remain permanently harbored. food is evidently a powerful indicator and metaphor of suffering for members at bitachon, and its feature in the social and therapeutic program is a conscious strategy of care which offers both emotional and nutritional sustenance to the ashkenazi elders i encountered. refugee and survivor communities more generally may possess culturally-significant relationships with food that are poorly understood by those perceived as being external to the group. the ethnographic research presented here now furthers the bold enquiry made by alexander laban hinton (2002) where he asked how an “anthropology of genocide” might be envisioned, and how anthropologists might contribute to the interdisciplinary study of genocide. he pointed to a (then) gap in anthropological understandings of genocide; how victims feel affected, and particularly the ways in which they respond to their individual or collective traumas. however, as a result of the limited design of this study, the conclusions presented here can only serve as an indicator of lived experience for a group of aging survivors of genocide. conclusively, analysis of the narratives shared so generously by the members of bitachon demonstrates the intimate ways in which genocidal legacies can affect the later stages of life. i intend the findings to be of particular methodological and theoretical benefit to the design of current and future welfare policies for survivors of mass killings and genocides. the testimonies that i refer to illustrate how a group of elderly jewish people contend with their lived experience of the shoah almost seventy years after the liberation of nazi occupied europe. as relayed by the inviting and inspiring members of bitachon, the shoah is a truly embodied phenomenon. the narratives that are inscribed here are nothing but a token of the trauma experienced by my remarkable research participants, but they are a token that has nonetheless been shared from “generation to generation." kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 41 41 acknowledgments with gratitude to dr claudia merli (department of anthropology, durham university) for her diligent supervision and support during the field-work. this research was funded through a postgraduate studentship granted by the center for medical humanities, durham university. endnotes . hebrew; translating specifically as “catastrophe,” “annihilation,” or more generally as “calamity”. 2. hebrew; encased parchment affixed to doorways as instructed by religious law. a mezuzah denotes that (typically observant) jews reside, own or use such a building. 3. a menorah (hebrew, lampstand) has seven branches; three either side of a center point (see [tanakh] zechariah 4: 1-6), and remains an enduring symbol of judaism as well as an emblem of the israeli state. 4. kashrut involves a system of food preparation and consumption. the meals served in the center are dairy/parev in compliance with kashrut and the ritual separation of “meaty” and “milky” foods as well as cooking facilities. parev foods are classed as being neither meaty nor dairy and this food group includes, for example, fish, eggs, and vegetables. chalav yisrael dairy products are certified as having been produced under jewish supervision to ensure that the products derive from an animal that is considered kosher. 5. jews of the ashkenazi sub-group trace their origins to central and eastern europe. the sephardim (pl.) is a collective term for jews whose origins are spanish or iberian, and extends to the jewish population who were expelled in 1492 and later resettled in mediterranean regions such as the balkans peninsula. during the second world war, sephardi jewish communities in these regions were brought under varying experiences of nazi persecution but also faced deportations to extermination camps. elements of bitachon, such as the yiddish conversation group or ashkenazi foodways, would consequently not hold the same significance for jews of sephardi origin. mizrahi (eastern) jews have origins in the middle east and deeply rooted jewish communities in, for example, yemen, iran, iraq and syria. 6. holocaust memorial day is marked on 27 january in the uk; the date auschwitz-birkenau was liberated. yom hashoah (hebrew; translates in english as holocaust remembrance day) is a common abbreviation of “holocaust and heroism remembrance day.” it was selected by the government of israel to be commemorated on 27 nisan in the jewish calendar; the date of the warsaw ghetto uprising. 7. german; children’s transport. a “humanitarian program” which brought 10,000 children – predominantly jewish – to the uk from germany, austria and czechoslovakia (see hmd n.d.) 8. not defined by religious observance or affiliation but by the amount of jewish grandparents one descended from (see rice university n.d.) 9. corresponds with the yad vashem definition of a survivor (see yad vashem 2015). situated in israel, yad vashem regard themselves as the official “holocaust martyrs” and “heroes’ remembrance authority.” kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 42 10. term raised through an interview with support staff 1. 11. tanakh; canon of the hebrew bible. 12. this chapter appears in an edited version (see kasstan 2015) and is re-formed here with permission from both scripta instituti donneriani aboensis and anthropology & aging. references agamben, giorgio 1999 remnants of auschwitz: the witness and the archive. new york: zone books. 2005 state of exception. chicago: chicago university press. association of social anthropologists of the uk and the commonwealth (asa) 2011 ethical guidelines for good research practice. http://www.theasa.org/downloads/asa%20ethics%20guidelines%202011.pdf, accessed august 6, 2013. benjamin, marina 2007 the last days in babylon: the story of the jews of baghdad. london: bloomsbury. berlin, adele, and marc zvi brettler 2004 the jewish study bible. oxford: oxford university press. biehl, joão, byron good, and arthur kleinman 2007 subjectivity: ethnographic investigations. berkeley: university of california press. csordas, thomas j. 1990 embodiment as a paradigm for anthropology. ethnos 18(1): 5–47. fassin, didier, and estelle d’halluin 2005 the truth from the body: medical certificates as ultimate evidence for asylum seekers. american anthropologist 107: 597–608. fassin, didier 2006 the politics of life: beyond the anthropology of health. in medical anthropology: regional perspectives and shared concerns. francine saillant, and serge genest, eds. pp. 267–288. oxford: blackwell publishing. 2007 when bodies remember: experiences and politics of aids in south africa. berkeley: university of california press. gould, jillian 2011 shiva as creative ritual in an institutional home. in revisioning ritual: jewish traditions in transition. simon j. bronner, ed. pp. 317–337. oxford: the littman library of jewish civilization. http://www.theasa.org/downloads/asa%20ethics%20guidelines%202011.pdf kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 43 43 2013 a nice piece of cake and a kibbitz: reinventing sabbath hospitality in an institutional home. home cultures 10(2): 189–206. henry, doug 2006 violence and the body: somatic expressions of trauma and vulnerability during war. medical anthropology quarterly 20(3): 370–398. hinton, alexander laban 2002 annihilating difference: the anthropology of genocide. berkeley: university of california press. holocaust memorial day undated the kindertransport, http://hmd.org.uk/genocides/kindertransport-refugees, accessed february 18, 2015. kasstan, ben 2015 the taste of trauma: reflections of aging shoah survivors on food and how they (re)inscribe it with meaning. theme issue, “religion and food,” scripta instituti donneriani aboensis 26(1): 349–365. levi, primo 1987[1947] if this is a man. london: abacus. lipphardt, anna, julia brauch, and alexandra nocke 2008 jewish topographies: visions of space, traditions of place. aldershot: ashgate publishing limited. manz, beatriz 2002 terror, grief, and recovery: genocidal trauma in a mayan village in guatemala. in annihilating difference: the anthropology of genocide. alexander laban hinton, ed. pp. 292–309. berkeley: university of california press. merleau-ponty, maurice 2008[1945] from the phenomenology of perception. in beyond the body proper: reading the anthropology of material life. margaret lock, and judith farquhar, eds. pp. 133–149. durham: duke university press. mol, annemarie 2010 care and its values: good food in the nursing home. in care in practice: on tinkering in clinics, homes and farms. annemarie mol, ingunn moser, and jeannette pols, eds. pp. 215–234. bielefeld: transcript. myerhoff, barbara 1978 number our days. new york: e.p. dutton. rice university undated the nuremberg race laws, http://www.owlnet.rice.edu/~rar4619/nuremburg.html, accessed february 18, 2014. http://hmd.org.uk/genocides/kindertransport-refugees http://www.owlnet.rice.edu/~rar4619/nuremburg.html kasstan | tokens of trauma anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.81 http://anthro-age.pitt.edu 44 roden, claudia 1996 the book of jewish food: an odyssey from samarkand and vilna to the present day. london: penguin group. shabi, rachel. 2009 not the enemy: israel’s jews from arab lands. new haven: yale university press. sutton, david e. 2001 remembrance of repasts: an anthropology of food and memory. oxford: berg. van boeschoten, riki 2003 the trauma of war rape: a comparative view on the bosnian conflict and the greek civil war. history and anthropology 14(1): 41–54. yad vashem 2015 how do you define a shoah survivor? http://www.yadvashem.org/yv/en/resources/names/faq.asp#!prettyphoto, accessed april 16, 2015. http://www.yadvashem.org/yv/en/resources/names/faq.asp#!prettyphoto anthropology & aging quarterly 2010: 31 (3-4) 61 features the 2010 aaa aging and life course interest group guide to key resources jay sokolovsky university of south florida jsoko@earthlink.net new texts: harper, s. 2006 ageing societies. oxford, eng: oxford university press. sokolovsky, j. (ed.) 2009 the cultural context of aging: worldwide perspectives, 3nd ed. westport, ct: praeger/ greenwood. www.stpt.usf.edu/~jsokolov p. stephenson and j. graham (eds.) 2010. anthropology and aging: contesting the paradigm of loss, toronto: university of toronto press. hot off the presses: alber, e. van der geest, s. and s. reynolds whyte, eds. 2008. generations in africa: connections and conflicts. berlin, ger: verlag. bateson, mary catherine. 2010. composing a further life: the age of active wisdom. new york: knopf. harper, s. and r. goodman, eds. 2008. ageing in asia. london: routledge. kanamoto, i. 2010. aging among japanese american immigrants: activating ethnicity new york: routledge. kawano, s. 2010. nature’s embrace: japan’s aging urbanites and changing death rites. university of hawai’i press. lamb, s. 2009. aging and the indian diaspora: cosmopolitan families in india and abroad. bloomington: indiana university press. lloyd-sherlock, p. 2010. population ageing and international development from generalisation to evidence. bristol, uk: policy press. mcnally, m. 2009. honoring elders: aging, authority, and ojibwe religion. new york: columbia university press norwood, f. 2009. the maintenance of life: preventing social death through euthanasia talk and end-of-life care lessons from the netherlands. durham, nc: carolina academic press. rowles, g. and h. chaudhury, eds. 2008. home and identity in late life: international perspectives. new york: springer. sanjek, r. 2009. gray panthers. philadelphia: university of pennsylvania press. schr€oder-butterfill, e. forthcoming. ageing, networks and exchange: old-age support dynamics in indonesia. oxford: oxford university press. solimeo, s. 2009. with shaking hands: aging with parkinson’s disease in america’s heartland. piscataway, nj: rutgers university press. stafford, p. 2009. elderburbia: aging and a sense of place in america. westport, ct: praeger. united nations. 2007. world economic and social survey 2007: development in an ageing world. new york: united nations. available at: www.un.org/esa/policy/ wess/wess2007files/wess2007.pdf newer books and ethnographies on aging: aboderin, i. 2006. intergenerational support and old age in africa. new brunswick, nj: transaction. aguilar, m. ed., 2006. rethinking age in africa: colonial, post-colonial, and contemporary interpretations of cultural anthropology & aging quarterly 2010: 31 (3-4) 62 features representations. lawrenceville, new jersey: africa world press. bledsoe, c. 2002. contingent lives: fertility, time and aging in west africa. chicago: university of chicago press. cliggett, l. 2005. grains from grass: aging, gender and famine in rural africa. ithaca: cornell university press. crews, d. 2003. human senescence: evolutionary and biocultural perspectives. cambridge:cambridge university press. eschenbruch, e. 2006. nursing stories: life and death in a german hospice. n.y.: berghahn. francis, d., l. kellanher and g. neophytou. 2005. the secret garden. ny: berg. freidenberg, j. 2000 growing old in el barrio. new york: new york university press. guo, z. 2000. ginseng and aspirin: health care alternatives for aging chinese in new york. ithaca, ny: cornell university press. ikels, c. 2004. filial devotion: practice and discourse in contemporary east asia. stanford: stanford university press. kaufman, s. 2005. and a time to die: how american hospitals shape the end of life. new york: scribner kreager, p. and e. schröder-butterfill (eds.) (2005) ageing without children: european and asian perspectives on elderly access to support networks, oxford, uk: berghahn. lamb, s. 2000. white saris and sweet mangoes: aging, gender and the body in north india, berkley, ca: univ. of california press. available as an ebook leibing, a. and l. cohen. eds. 2006. thinking about dementia: culture, loss and the anthropology of senility. new brunswick, nj: rutgers university press. leidy, l. (2006) menopause: a biocultural perspective. new brunswick: rutgers university press. margolies, l. 2004. my mother’s hip: lessons from the world of eldercare. philadelphia: temple university press. mclean, athena (2006) the person in dementia: a study of nursing home care in the us. orchard park, ny: broadview press. newman, k. (2003) a different shade of gray: midlife and beyond in the inner city. new york: the new press. oliver, c. 2007. retirement migration: paradoxes of ageing. routledge rawlins, j. 2006. midlife and older women: family life, work and health in jamaica. kingston: univ of west indies press. rodwin, v. and m. gusmano, eds growing older in world cities: new york, london, paris and tokyo.. nashville, tn: vanderbilt university press. savishinsky, 2000. breaking the watch: the meanings of retirement in america. ithaca, ny: cornel university press. sievert, l. 2006. menopause: a biocultural perspective. new brunswick, nj: rutgers univ press. stafford, p. ed., 2003. gray areas: ethnographic encounters with nursing home culture. new brunswick: school of american research press. thang, leng leng (2001) generations in touch: linking the old and the young in a tokyo neighbourhood. ithaca and london: cornell university press. traphagan, j. (2000) taming oblivion: aging bodies and the fear of senility in japan. albany, ny: suny press. -------(2004) the practice of concern: ritual, well-being, and aging in rural japan. durham: carolina academic press. van willigen, john and n.k. chadha. 1999. social aging in a delhi neighborhood. westport, ct: bergin and garvey. woolfson, p. (1997) old age in transition: the geriatric ward. westport, ct.: greenwood press. classic comparative resources: aguilar, a., ed., 1998. the politics of age and gerontocracy in africa: ethnographies of the past and memories of the present. lawrenceville, n.j.: africa world press. albert, s.m. and m. g. cattell. 1994. old age in global perspective: cross-cultural and cross-na tional views. new york: g.k. hall. amoss, p. and s. harrell. eds. 1981. other ways of growing old: anthropological perspectives. stanford, ca: anthropology & aging quarterly 2010: 31 (3-4) 63 features stanford university press. beyene, y. (1989) from menarche to menopause: reproductive lives of peasant women in two cultures. albany, ny: state university of new york press. clark, margaret and barbara anderson (1967) culture and aging: an anthropological study of older americans. springfield, il: charles thomas. cole, j and d. durham. 2007. generations and globalization: youth, age, and family in the new family in the new world economy. bloomington, in: indiana counts, dorothy and david counts (eds.) (1985) aging and its transformations: moving toward death in pacific societies. new york: university press of america. cowgill, d. and holmes, l.d., eds. 1972. aging and modernization. new york: appleton-century-crofts. crews, d. and r. garruto. 1994. biological anthropology and aging: perspectives on human variation over the life span. new york: oxford university press. fry, c. 1980 aging in culture and society: comparative viewpoints and strategies. brooklyn, ny: j.f. bergin. -------(1981) dimensions: aging, culture and health. brooklyn, ny: j.f. bergin. fry, c. and j. keith. 1986. new methods for old age research. south hadley, ma: bergin and garvey. hareven, t. (ed.). (1995). aging and generational relations over the life course: a historical and cross cultural perspective. hawthorne, ny: walter de gruyter & co. henderson, j. n., & vesperi, m. d. eds. 1995. the culture of long term care: nursing home ethnography. westport, cf: greenwood. holmes, l. and e. rhoads, eds. other cultures: elder years. (2nd edition) newbury: sage 1995. keith, j. 1982. old people, new lives: community creation in a retirement residence. chicago: university of chicago press. keith, j., c. fry, a.p. glascock, c. ikels, j. dickerson-putnam, h.c. harpending and p. draper. 1994. the aging experience: diversity and commonality across cultures. thousand oaks: sage. kerns, virginia and judith brown (eds.) (1992) in her prime: new views of middle-aged women, 2nd edition. urbana: univer sity of illinois press. myerhoff, b. and a. simic (eds.) (1978) life’s career-aging: cultural variations on growing old. beverly hills: sage. prendergast, d. 2005. from elder to ancestor: old age, death and inheritance in modern korea, kent, eng: global oriental monograph series. putnam-dickerson, j. and j. brown. 1998. women among women: anthropological perspectives on female age-hierarchies. champaign, il: university of illinois press. rowles, g. and n. schoenberg, eds. 2002. qualitative gerontology: contemporary perspectives. new york: springer. rubinstein, r. anthropology and aging: comprehensive reviews, kluwer, 1990. p. silverman (ed.). 1987. the elderly as modern pioneers. bloomington, indiana university press. schweitzer, m. 1991. anthropology of aging: a partially annotated bibliography, greenwood,. simmons, l.w. 1945. the role of the aged in primitive society. new haven, conn.: yale university press. key pre-1999 ethnographies becker, g. 1980. growing old in silence. berkeley, ca: university of california press. francis, d. 1984. will you still need me, will you still feed me, when i’m 84? bloomington, in: indiana univ press. kaufman, s. 1986. the ageless self: sources of meaning in late life. madison, wi: univ of wisconsin press. cohen, l. 1998. no aging in india, berkeley, ca: university of california press. counts, d. and d. counts. 1996. over the next hill: an ethnography of riving seniors in north america. petersborough, ont.: broadview. hazan, haim 1980. the limbo people. boston: routledge and kegan. myerhoff, b. 1978. number our days. new york: e.p. dutton. rasmussen, susan . 1997. the poetics and politics of tuareg aging: life course and personal destiny in niger. dekalb, il: northern illinois university press. anthropology & aging quarterly 2010: 31 (3-4) 64 features savishinsky, j. 1991. the ends of time: life and work in a nursing home. new york: bergin and garvey. shenk, d. 1998. someone to lend a helping hand: women growing old in rural america. newark, nj: gordon and breach. van willigen, j. and n.k. chadha (1999) social aging in a delhi neighborhood. westport, ct: bergin and garvey. vesperi, m. (1998) city of green benches: growing old in a new downtown. 2nd edition. ithaca, new york: cornell university press. teaching: shenk, d. and j. sokolovsky. 1999. teaching about aging: interdisciplinary and cross-cultural perspectives, 3rd edition) jointly published by aage and aghe – details at: http://www.stpt.usf.edu/~jsokolov/ guide.htm s. e. johnson. teaching project using the hraf files: “culture and aging: a research project in completed fertility & subsistence practices, productivity & aging, and social networks & aging.” http://www. yale.edu/hraf/culture aging.htm cohen-shalev, a. 2009. visions of aging: images of the elderly in film, sussex academic press. key socio-demography resource kevin kinsella, k. and w. he. 2008. an aging world 2008. washington, d.c.: u.s. census bureau. http://www.census.gov/prod/2009pubs/p95-09-1.pdf journals journal of cross-cultural gerontology www.springerlink.com/content/102929/ note: recent special issues on: intracultural variation , the middle east; social change in africa and biological anthropology anthropology and aging quarterly http://aage.clubexpress.com/content.aspx?page_id=86&club_id=497336 aarp international: the journal (www.aarpinternational.org/journal) professional societies / networks: aage: association for anthropology and gerontology, http://aage.clubexpress.com/ iuaes commission on aging leng leng thang, chair. aging in developing countries network, http://adcnet.psc.isr.umich.edu/links gateway web sites: aarp global aging page www.aarpinternational.org the cultural context of aging web page www.stpt.usf.edu/~jsokolov the aging in developing countries network http://adcnet.psc.isr.umich.edu/people/ key reports: older americans 2010: key indicators of well-being www.agingstats.gov/agingstatsdotnet/main_site/data/2010_documents/docs/oa_2010.pdf national institute on aging, 2008 an aging world: 2008. international population reports health welbeing and aging in latin america and the caribbean: www.ssc.wisc.edu/sabe/docs/informefinal%20ingles%20noviembre%202004.pdf the comparative study of aging and health in asia (aha), http://aha.psc.isr.umich.edu/research.html gender and aging in se asia and the developing world, www.phishare.org/partners/genderaging/ the global aging initiative (center for strategic and international studies) http://csis.org/node/13319/ publication gateway to new reports on china, latin america and post-industrial societies. 33 (2).indd anthropology & aging quarterly 2012: 33 (2) 31 feature aging & anthropology in east asia i remember an advertisement in time in the late 1980s or early 1990s for at&t, a “reach out and touch someone” ad with a japanese twist. the ad portrayed a middle aged, successful businessman, who was apparently in the us on business and was calling home to his aging mother in japan. that image of filial behavior, created or reinforced by gerontologist erdman palmore’s famous study of aging in japan (1975), unfortunately remains the impression many americans today have of a happy japanese old age in which families remain close and younger generations behave respectfully toward their elders. although there is increasing recognition that japan has become an aged society with numerous social and economic problems, if my own students are any indication, the old images die hard. of course until assigned to do so, they have not read studies of japanese old people in nursing homes (bethel 1992, thang 2001, wu 2004) or retirement communities (kinoshita and keifer 1992), or of strategies people adopt to find security in their coming old age (hashimoto 1996, jenike 2003, 2004, lebra 1984, traphagan 2000) or be remembered after death (danely 2012, kawano 2010, suzuki 2000, tsuji 2006). these studies demonstrate that regardless of their physical well-being, old people remain active agents, making choices and adapting to new circumstances. the reality of their lives needs to be more central in the ethnography of japan. the topics of aging, dying, and the lives of old people are interesting and important pieces of life in japan today, and as the population continues to age, will become even more significant to understanding japan in the future. given world-wide demographic trends, our collective work in these areas contributes to understanding the human experience more broadly with what david plath (1980) foreshadowed in his discussion of japan as a society of “mass longevity.” c o m m e n t a r y ruminations on studying late life in japan susan orpett long john carroll university this essay reflects on how these questions relate to anthropology and the study of japanese society. over the past two decades i have been engaged in two distinct studies related to aging and dying that have offered me perspectives on approaches to studying those in their last stages of life, and the people around them. one (long 2005) focused on those directly facing death (regardless of age), and the other (long 2008, 2011; long, et al. 2010) on caregiving of frail elders. here i am not reporting on the results of this research, but rather ruminating about what they have together taught me as an anthropologist of japan. i first reflect on the different methodologies of the two studies. then i will consider some of the things that i have learned that have led me to new perspectives on japanese society, and my own. methodologies the study of end-of-life decisions in japan was ethnographic in approach. i conducted solo fieldwork primarily in the hanshin area in homes and in three different types of institutions where very sick people received treatment and care: a national hospital, a private university hospital, and an in-patient hospice that was located within a large, private hospital. i hung out, watched, listened, occasionally did something helpful but more often was moving out of the way; i interviewed patients, family members, and staff. it was about as classic a fieldwork methodology as it could be in late 20th century urban japan, given the topic. the elder care project was a large quantitative and qualitative study that grew out of discussions with several japanese and american colleagues concerning the newly instituted long term care insurance system. with such a vast new policy and tremendous increase in the availability anthropology & aging quarterly 2012: 33 (2) 32 of nursing and assistive services, how could it not make a difference in the way frail old people and their care are viewed? my social gerontologist colleague, suda yuko put together a multidisciplinary research team and we got to work. she and tmig geriatrician takahashi ryūtaro received funding from the japanese ministry of education, culture, sports, science and technology, and the ministry of health, labor and welfare for a longitudinal study of the impact of the long term care insurance programs on elder care in two locales, one in tokyo and one in northern akita prefecture. suda-san asked for my participation in the project as an expert on qualitative research and felt my perspectives as an anthropologist would be helpful, despite my lack of formal methodological training or gerontological background. some of the research team members planned and conducted a survey in 2003 of people who qualified for long term care services who were living at home, with a related survey given to their primary family caregiver. the survey was repeated in 2005 and 2007 in an attempt to capture changes in the health and functional status of the old person and in service use over the years. where i come in is that some members of the research team interviewed a subset of 30 those old personfamily member pairs who had responded to the survey in order to provide more in-depth case studies and to help interpret the results of the survey. the initial plan was to interview the families on the same schedule as the survey in alternate years. my main methodological contribution was to fairly insistently suggest that every two years was not enough to accomplish what we wanted. fortunately the decision was made to re-interview yearly in people’s homes, for as long as they were willing and the older person was alive. also at my suggestion, when possible we did one interview with the family member subsequent to the death if prior to the end of the study. what did i learn? one is that i missed doing ethnographic fieldwork. as well as we came to know the families we interviewed, some five times, i never felt grounded. every year i had trouble finding their homes. how badly i wanted to stop and talk with the small tobacco shop that served as my landmark for one home, or to speak with the “bad son” who lived upstairs but never helped his parents (though he did sometimes take care of the dog). on the occasions we could see or hear a broader context, it was immeasurably helpful: the chance to speak with a non-co-residing son, the opportunities to “follow” several old people after their move to a nursing home or hospital, a granddaughter who started to come for our annual interviews. but most of the context for what we were learning had to come from a different type of data, the survey. we also learned what anthropologists would probably suspect—people don’t always say the same thing in response to a survey as they do when you are speaking with them in a more relaxed setting. despite a time gap of only a month or so, we found differences in responses to what were sometimes simple and straightforward questions such as the medical diagnosis or how often the person went to day care. this was a matter of consternation to my quantitatively-oriented colleagues, and we were able to use the yearly interviews to try to clarify and explore some of these inconsistencies. the last point i want to mention about methodology is the question suggested by the film, can’t go native? (plath 2010) about anthropologist keith brown’s “long engagements” with his fieldwork site in mizusawa and its families over decades. the richness of keith’s ethnography cannot be duplicated by any other approach. despite the problems with the elder care project’s methodology from my perspective, what it did accomplish was to provide at least some time depth that for me turned out to be one of the most interesting aspects of the project. even in five years, we were able to observe changes not only in symptoms, but in relationships and attitudes. in retrospect, i have wondered how i could have obtained that time depth in the earlier end-of-life study. people died. they became unable to communicate. that study could only have been synchronic, and i had to create the relationships between my informants and myself over an artificially short period of time. i do not think that i went into the project with as much awareness of that as i might have, though ethnographically my regular presence in the institutional setting helped to telescope not only my observations, but also my emotional ties. when family members came for a visit half-way though my fieldwork, i took a week off to travel with them in japan. the night we got back to osaka, i received a call from a physician-mentor. a young woman with whom i had become particularly close died unexpectedly while i was gone, and i spent that evening in tears. was i mourning for her, or for the lost opportunity for a “long engagement”? lessons about japanese culture i do not know a lot of people in the us in their 90s. in our elder care project, most of the people we interviewed were in their 80s, and even the first year, i interviewed three who were already in their 90s. what was life like for them? how did they experience the changes in their bodies and the constantly changing world around them? here i give thought to what my combined experience in both projects has taught me about late life in the context of contemporary japan. susan o. long ruminations on studying late life in japan anthropology & aging quarterly 2012: 33 (2) 33 pleasures and worries when we asked what in their life gave them pleasure, some of our elderly informants responded, “nothing.” the following interview excerpts from woman in their 80s exemplify this type of response: 87-year old widow: there is nothing good about getting old. (#0004611, 2007) interviewer: what do you do for enjoyment? wife: [without hesitation] nothing. interviewer: what did you enjoy doing in the past? wife: in the winter, knitting. once a month i and my friends from jogakkō used to get together for a shokujikai [they took turns making meals for each other]. i really enjoyed this and we continued to get together for years. but we don’t any more because we’re all getting old, and our husbands are getting frail and it’s harder for everyone to get out. (#3204009, 2003) a slightly more positive, alternative expression of that “nothing” response was gratitude for just being alive. one woman noted, “i’m happy, i have no pain. that alone is happiness.” (#00063114, 2003) others referred to their children or grandchildren’s visits. some of the women expressed appreciation for the daughter-in-law [in the room, often] who cares for them. for example, 94 year old widow: we suffered in the past, but now things are better… i’m alive because of my family’s care. i have a good daughter-in-law; i’m grateful to her. (#3200309, 2003) woman in her 60s immobilized by severe arthritis: i can’t go out, so everyone comes over here…. so i see that whether i am here or not makes that kind of difference. if i wasn’t here, no one would come gather here, so being bedridden and staying still here, i sometimes think that even so, there are good aspects about it (#3201706, 2007) interviewer: is there anything you have gained because you are older, like something good with the way you think now, or do you feel lighter, is there anything like that? mother in her 80s who had moved to her daughter’s home due to parkinson’s: ahh. interviewer: when do you feel that way? mother: when i see that my children are all living happily. myself too. since i came here i’ve been doing well, so i am happy about that too (#0007401, 2007) a few people answered the question about pleasure with a physical activity, “eating,” or “bathing.” several said that continuing a hobby (calligraphy, painting, writing senryū—all men) or watching sumo (a woman) were their “fun.” a few mentioned that they enjoy talking with people at day care. their greatest concerns often were the converse of those pleasures: would the grandson about to graduate from college find a job; could a wife ever be found for the 40 year old son of an akita farm family; finding good spouses for children or grandchildren. one younger man in his late 60s who was dying from complications of alcoholism joked, “one of the employees [at day care] is a young woman who is not married. i’ve wondered about getting her and my second son together!” (#0009006, 2003) some of the old people with whom we spoke expressed worries about their declining health which forced them to give up things that they had enjoyed in the past, like the woman in her 90s who loved to sing but could no longer get her voice to come out, or the woman with a broken hip in her late 80s who loved to play shamisen but could no longer sit seiza-style. of particular anguish was when these disabilities led to increased dependency on others. interviewer: is there anything you wish for? stroke victim: ashi ga hoshii (i want legs!) (#0001600, 2003) a daughter-in-law caregiver explained that the family’s graves are nearby and she sometimes takes her mother-inlaw, but that recently, the mother-in-law hasn’t wanted to go. the mother-in-law suddenly joined the conversation, “that’s because i always have to go to the toilet!” later in the conversation she added, “in the past, i went to the mountains and to hokkaido. but now i don’t want to ask people’s help; they’re already doing so much for me in the house.” (#0006314, 2003) a few mentioned concerns about who will care for them when they were unable to do anything for themselves, or for a spouse after their death. occasionally, they noted anxiety about graves or who would care for the family property or the grave after their death, or they worried about dying and the impact of their death on others. one woman told us that a when a neighbor died, they couldn’t find her hanko. she went on, susan o. long ruminations on studying late life in japan anthropology & aging quarterly 2012: 33 (2) 34 i want to make sure the family knows where things are but they tell me not to talk like that [about dying]. i think it’s better if everyone knows, so there aren’t problems when i die like with the neighbor. another woman spoke in more religious language of her concerns about dying, but ultimately it was still about the trouble she was afraid she was causing for others by her wish to remain alive. really, in order for one to live, one has to die, but my wish is to live a little bit longer. so i encourage myself, saying i need to stay strong…. i really think that i don’t understand many things anymore. but you know, i’m old. i’m 94 now. i think i may have lived a bit too long…. i just don’t want to cause any more trouble before i die, for anything, all i want is to cause as little trouble as possible. once you age, it can’t be helped that you cause trouble, but i want to try not to do that …. i don’t have long to go, so i want to die, but i don’t dare say “i want to die, i want to die” when everyone is working so hard to take care of me…. once one passes 90, it’s natural to think about your death. just really thinking that you don’t want to die, well, being human, i guess that feeling is just natural ….[interviewer: i heard that you always pray for a very long time.] yes, that i can say…. as long as you say ”nammyohorenge”, it will communicate, so i thought i should just do it for longer. i try to do that as much as possible. (3202401, 2007) differences and similarities understanding what life feels like, what is important, how the world looks to old-old people is one important element of an anthropological perspective on old age and aging in japan. another approach is to consider the ways that life experiences have shaped that world view. this includes consideration of gender, social class, family structure and relationships, religious experience, residence (urban vs. rural), and occupation. neither of my research projects was designed to answer these questions, but here are a couple of observations and hypothesis. 1) gender did not seem to make much difference in attitudes toward and decisions about therapies at the end of life. people expressed a wide range of ideas about death and about how to die, but they did not appear to be tied to gender. gender, however, does seem to matter more in people’s experience of old age based on lifelong gender roles and continuing gender stereotypes. being male or female may call forth different caregivers, for example, the wife when a husband needs help but less often vice versa. it may make a difference in the extent to which people worry about being a burden, with women more likely to express that as a concern. women may find it more difficult to discontinue their main pre-frailty tasks since they must now be done for them by others (men would have already retired from their main culturally sanctioned responsibilities). for example, in describing how she used to make otsukemono [pickles] and mochi [pounded rice] and was a great cook, one woman in her late 80s, commented, “now i can’t do these things so i feel sabishii [lonely]. i see that my daughter-in-law is busy and i wish i could help.” (#0004611, 2007) women may benefit from stronger emotional ties to children and grandchildren than men who perhaps did not cultivate these relationships in the same way when they were younger. i remember one elderly couple in which the wife, who was quite immobile due to a stroke, spoke of her daughter’s frequent visits and the grandchildren crawling into her hospital-style bed with her. the husband, in a separate interview, noted that when the grandchildren came around, it was only to receive otoshidama [new year’s gifts] from him, there’s not much more to the relationship. there are many more possibilities regarding the way gender shapes the experience of old age, such as discussion of a husband’s desire to repay/reciprocate for his wife’s care, or the lack of that sensibility. 2) my japanese colleagues, in designing the elder care study, set up an explicit urban-rural (center-regional) comparison. my response was that japan must surely be beyond that distinction in the 21st century, with a cell phone in every ear, common television and radio programming, and widespread internet access. but they were right, at least for northern akita prefecture. daughters-in-law there were more likely than in the tokyo sample to be caregivers, and to voice that they were doing so because “its my job” and to express resentment at the obligation. we saw a couple of examples of loving mil-dil relationships in akita, but for the most part, they seemed to play out cultural expectations of tension-filled relations. the rural environment combined with poverty to introduce complications to the picture of idyllic aging among the rice fields, in particular, the long absence of many husbands from daily family life in order to leave for labor in other parts of the country. limited educational opportunities of the past and current poverty limited access to the wider world of information and resources, although all the homes we visited had televisions. for many of the old-old in akita, television programs were nearly in a foreign language, that is, standard japanese, about a culture (urban, youth-oriented) they did not understand. even for someone who grew up speaking standard japanese rather than a strong regional dialect, television programs, as one woman put it, “are aimed at the young whose interests are different from mine.” this type susan o. long ruminations on studying late life in japan anthropology & aging quarterly 2012: 33 (2) 35 of experience of the world cuts across the variability in experiences of aging i have discussed. becoming ill and becoming dependent were universally seen negatively. another cross-cutting element among today’s old-old is the impact of history on these age cohorts. shared memories, even in tokyo, of a less complex childhood catching fireflies, singing songs with school classmates, and fishing in the river, serve as markers of the technological and social changes they have experienced in the course of their lifetimes. the greatest shaper of these cohorts was undoubtedly the war. in many life stories, the war represented the end of the happy days and brought the death of husbands, siblings, and fathers. its end marks, for most, the “bad old days” of food shortages and burned out houses, and provides memories that offer the view that “things are good now.” the old-old people of the future will not have this experience from which to generate a positive counter-response to the negatives of aging. a final cross-cutting element of the last stages of life which i have noted is the concern for death, graves, and memorial. actually, in neither study did i hear much concern for the state of being dead, but rather, with the process of dying and with the trouble it causes the survivors. for older people without a family grave, the decision about and purchase of a gravesite gave them a sense of accomplishment. even for those with family graves, there remained for some decisions about with whom they wanted to be buried due to geographical distance or strained relationships. in other cases, people had questions about whether they would be remembered, whether rituals would be performed for them and the ancestors who had been in their care for so long. one woman described how her brother had converted to christianity and baptized his children. even though he was the oldest son, it was clear to their father than he would not take care of the grave at the buddhist temple. and so ojiichan came to me. by ojiichan, i mean my own parent, my father. he came to seek my advice and so i promised him that i will look after [the family grave]…. that’s all i can think about recently…i made a promise, but after i die, who is going to look after it? well, i can’t do anything about it. but that keeps coming up in my mind (#3201706, 2007) some people, both those with dementia and those without, spoke of communicating with deceased relatives, such as the cancer patient who was certain her father was coming back from the other world at the upcoming obon holiday, an occasion for families to reunite across the boundary of life and death, to take her back with him. in neither study did i pursue these ideas about a post-death existence, but my impression is that it suggests a peacefulness not present in their current lives, and a reunification with loved ones (cf. smith 1999). it is the betwixt-and-between state of painful illness or lack of social personhood due to dependency that worried people as they looked forward. lessons about japanese culture through studying late life beyond studying the elderly and dying themselves, certainly a study of significance in this era of changing demographics world-wide, what does this work teach us about japanese culture? first, and perhaps most obviously, it reminds us that there is a large portion of the population whose exercise is tossing a large rubber ball in a rehab class rather than working out at a fitness center. they often cannot see well enough to watch television, much less play video games. for reasons of illness and cost, they are not eating sushi or drinking beer. i find that talking about old people in class provides students a deeper perspective on japanese society that makes it easier for them to think critically about their beloved j-pop as a commodity in a larger political-economic context. simple cell phones with giant numbers may be the fad of the future! a second lesson is the reminder of how little we know about family relations in japan despite all that has been written about the structure and functions of the corporate household (ie). we talk about stem families and so focus on parent-heir relationships, contrasting mother-son and father-son dyads. merely substituting a nuclear family model for the older three-generation one does not allow us to better see relationships that exist along side those that are structurally important. as scott clark noted a decade ago, our japanese colleagues tell us the vertical tie of descent is more important than the horizontal tie among siblings, so we have not given significant attention to sisters (for example). both of my projects have shown that siblings remain important to people regardless of the type of household. with parents long dead, ties to siblings may take on special meaning as their link to their past and the continuity of their lives despite migration and frailty. many old people in the elder care study report that they speak with their distant siblings by phone since they can no longer visit, and how painful, what a narrowing of their world it is when even this becomes too difficult. one elderly caregiving wife reported being angry when her husband once taunted during an argument that she could leave; his sister would take better care of him than she did anyway. susan o. long ruminations on studying late life in japan anthropology & aging quarterly 2012: 33 (2) 36 susan o. long ruminations on studying late life in japan the flip side of the complaint of caregiving daughtersin-law that their husband’s siblings interfere with care decisions is that someone thinks they do have a moral right to a voice in those decisions. i was surprised to learn that it was not only the oldest son and descendents who show up at the deathbed, but ideally all of the dying person’s children, with their spouses and kids as well. end-oflife decisions are made not necessarily by the person we would expect based on the structure of the japanese family we learned in japanese society class, but in one case by a 14-year old son, in another by an elder daughter over the ideas of her chōnan [eldest] brother, and in yet another by a collaborative team of the wife and sister of a dying man. perhaps no one told them sisters-in-law aren’t supposed to get along. another relationship that has received virtually no attention in the english literature on japan is grandparentgrandchild relations. at least among the people i have interviewed, their own children might be supportive or they might visit rarely if at all. they were grateful to those who provided care and complained about those who came occasionally and only out of obligation. but grandchildren were for many their source of joy, whether via in-person visits or photos received in the mail. their college admission, marriage, or obtaining a job were the matters of worry on one hand and pride on the other. in one family, the elderly woman widowed just after the war had supported herself and her children as a nurse. her granddaughter had also become a nurse. in addition to the medical knowledge she brought to the family caregiving situation, she and her grandmother felt a special bond through their shared occupation. in a couple of other cases as well, a grandchild or grandchild-in-law provided assistance, knowledge, and care directly. it is perhaps because the social lives of the dying and very old have narrowed to such a degree that our attention is drawn in these cases to these relationships. better study of sibling and grandchild-grandparent relationships will lead to a deeper understanding of the meanings and lives japanese families. i have no doubt that we will see some of great intimacy and respect, as well as those based on resentment and grudging tolerance. on a final note, for americans, there are some practical applications to the study of japanese aging. social class may help shape the ways that japanese old people see the world, but socioeconomic status does not prohibit their access to good, high-tech medical care or to nursing homes, the working class families who constituted the majority of our participants in the elder care study are just as likely to get treatment for medical problems as the wealthy. lack of social capital does not keep them from obtaining medication or in-home care services. how the government will be able to continue providing medical and elder care in a society in which 1/3 of the population will be 65 and older by 2050 remains a huge policy challenge; anthropologists can and should contribute to these discussions in japan, and in their own countries. concluding thoughts my intent here has not been to draw conclusions about people in the last years or months of their lives as much as to consider what i have learned from the two projects in which i have been involved that might move the study of such people forward. in studying old people, we might want to be more selfconscious about the special methodological issues raised by the limited time span and the various physical and intellectual limitations of this population while retaining the benefits, and the fun, of ethnography. this can be accomplished in part by the sharing of personal reflections and field experiences among anthropologists of aging. in the second part of this essay, i raised a variety of topics and questions to which i hope my work is contributing, but i know is far from providing definitive answers. the work of eliciting the world views and understandings of people in the last part of their lives is a fascinating task, particularly well-suited to anthropological research. it is one that is critical for understanding not only japan today but many societies in the near future. we know, too, that these understandings are shaped by experiences through their lives, and that seeing the impact of gender, social class, occupational background, and family relationships will be basic parts of our work. nor can we discuss the experiences of people who are frail and ill without considering the broad political-economic and technological settings which frame those experiences. i hope that as we bring together our interests in individual lives with broad societal concerns, anthropologists will contribute our analytical skills and humanizing perspectives to public policy debates about medical and elder care. anthropology & aging quarterly 2012: 33 (2) 37 susan o. long ruminations on studying late life in japan references cited bethel, diana l. 1992 life on obasuteyama, or inside a japanese institution for the elderly. in japanese social organization. takie s. lebra, ed. pp. 109-34. honolulu: university of hawaii press. danely, jason 2012 repetition and the symbolic in contemporary japanese ancestor memorial ritual. journal of ritual studies, 26(1): 19-34. hashimoto, akiko 1996 the gift of generations: japanese and american perspectives on aging and the social contract. cambridge: cambridge university press. jenike, brenda robb 2003 parent care and shifting family obligations in urban japan. in demographic change and the family in japan’s aging society. j.w. traphagan and j. knight, eds. pp. 177-202. albany: state university of new york press. jenike, brenda robb 2004 alone in the family: great-grandparenthood in urban japan. in filial piety: practice and discourse in contemporary east asia. c. ikels, ed. pp. 217-44. stanford: stanford university press. kawano, satsuki 2010 nature’s embrace: japan’s aging urbanites and new death rites. honolulu: university of hawaii press. kinoshita, yasuhito and kiefer, christie w. 1992 refuge of the honored: social organization in a japanese retirement community. berkeley: university of california press. lebra, takie sugiyama 1984. japanese women: constraint and fulfillment. honolulu: university of hawaii press. lee, kristen shultz 2010 gender, care work, and the complexity of family membership in japan. gender & society 24: 647-671. long, susan orpett 2005 final days: japanese culture and choice at the end of life. honolulu: university of hawaii press. 2008 someone’s old, something’s new, someone’s borrowed, someone’s blue: tales of elder care at the turn of the 21st century. in imagined families, lived families: culture and kinship in contemporary japan. akiko hashimoto and john traphagan, eds. albany: suny press. 2011 tension, dependency, and sacrifice in the relationship of an elderly couple. in faces of aging: the lived experiences of the elderly in japan. yoshiko matsumoto, ed. pp. 60-86. stanford: stanford university press. long, susan orpett, ruth campbell, chie nakamura, and hiroko kodama 2010 nihon no kōreisha kaigo: jikan, henka, soshite kaigosha no shutaisei no shiten kara (time, change, and agency in japanese elder care). in zaitaku kaigo ni okeru kōreisha to kazoku: tōshi to nōson chiiki ni okeru chōsa bunseki kara (the frail elderly and their families: a research study of those living at home in urban and rural communities). takahashi ryūtaro and suda yūko, eds. pp. 200-229. tokyo: minerva. palmore, erdman b. 1975 the honorable elders: a cross-cultural analysis of aging in japan. durham, n.c.: duke university press. plath, david w. 1980 long engagements: maturity in modern japan. stanford: stanford university press. smith, robert j. 1999 the living and the dead in japanese popular religion. in lives in motion: composing circles of self and community in japan. susan orpett long, ed. pp. 255-282. ithaca, ny: cornell university east asia program. suzuki, hikaru 2000 the price of death: the funeral industry in contemporary japan. stanford: stanford university press. thang, leng leng 2001 generations in touch: linking the old and the young in a tokyo neighborhood. thaca, ny: cornell university press. traphagan, john w. 2000 taming oblivion: aging bodies and the fear of senility in japan. albany: suny press. 2003 contesting co-residence: women, in-laws, and health care in rural japan. in demographic change and the family in japan’s aging society. j.w. traphagan and j. knight, eds. pp. 20328. albany: state university of new york press. 2004 the practice of concern: ritual, well-being, and aging in rural japan. durham, n.c.: carolina academic press. tsuji, yohko 2006 mortuary rituals in japan: the hegemony of traditionn and the motivations of individuals. ethos 34(3): 391-431. 2011 rites of passage to death and afterlife in japan. generations 35(3): 28-33. wu, yongmei 2004 care of the elderly in japan. london: routledge. 30 (2).indd anthropology & aging quarterly 2009: 30 (2) 30 features new perspectives on old ideas: viewing the anthro-os/ot nexus in aging studies as a landscape for conceptual innovation rebecca m. aldrich, ma, otr/l malcolm p. cutchin, phd victor w. marshall, phd university of north carolina at chapel hill in our paper “residential care as a therapeutic landscape and the role of occupation,” we used data on older adult ccrc residents’ occupational engagement to expand the health geography concept of “therapeutic landscapes.” in addition to physical, cultural, and other dimensions already subsumed under the idea of therapeutic landscapes, we suggested that understanding patterns of occupational engagement may further illuminate the ways in which people’s relation to place is linked to health and well-being. our paper not only represented a new interpretation of therapeutic landscapes as a concept, but it also demonstrated the utility of taking that concept across disciplinary boundaries for further application and expansion. the research agenda discussed in this special issue of anthropology and aging quarterly highlights the necessity of such boundary crossing for the continued development of our disciplines and our scholarship. the introduction to this issue underscores the importance of multi-/interdisciplinary research and scholarship for extramural funding, and it underlines extant relationships between various anthropology and occupational science/ occupational therapy organizations. the events that culminated in this special issue established clear support for anthroos/ot collaborations, both within and outside the field of aging studies. the benefits of continued collaboration— which this special issue will surely stimulate—include the opportunity to disseminate, dissect, and develop ideas that each contributing discipline brings to the table. our paper provides an example of that opportunity by introducing a discipline-specific concept (therapeutic landscapes) to a new interdisciplinary topic (older adults’ residential transition) and augmenting it with another discipline-specific perspective (occupational engagement). the opportunity to carry concepts across disciplinary lines is beneficial for many reasons. not only does it provide a form of ‘advertising’ whereby disciplines are exposed to similar theoretical strains used by collaborators, but it also offers a venue for fine-tuning concepts and strengthening their application to theoretical and practical issues. if the way of the future for research and scholarship lies in interdisciplinary collaboration—defined as the meeting of multiple disciplines to create something new—then the research agenda outlined in this special issue will be well-served by additional attempts to amalgamate useful concepts from anthropology and occupational science/occupational therapy. correspondence information: rebecca aldrich, division of occupational science, cb #7122 unc-ch bondurant hall, chapel hill, nc 27599-7120, (919) 966-2451, rebecca_aldrich@med.unc.edu aage member news submitted by margaret perkinson congratulations to sherri briller, phd, for being awarded tenure! the publication of her most recent book, briller, s. and goldmacher, a. (2008) designing an anthropological career: professional development exercises. walnut creek, ca: altamira press, no doubt contributed to her promotion. for all young and aspiring anthropologists of aging, accolades accrue when you become president of aage! anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 106-107 issn 2374-2267 (online) doi 10.5195/aa.2015.96 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review with a little help from our friends: creating community as we grow older. beth baker. nashville, tn: vanderbilt university press, 2014. isbn10: 0826519881 256. 256pp. price $24.99 (paper) $9.99 (ebook). richard zimmer sonoma state university http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.96 http://anthro-age.pitt.edu book review with a little help from our friends: creating community as we grow older. beth baker. nashville, tn: vanderbilt university press, 2014. isbn10: 0826519881 256. 256pp. price $24.99 (paper) $9.99 (ebook). richard zimmer sonoma state university what will i do when i get older? where will i live? how will i live? will i have family and friends around? will i have support services? how much will i have to pay and can i afford it? these are the questions beth baker addresses for those of us getting older and those who study and/or work with older people. we, baker suggests, can live in retirement communities, co-housing, with our children (and grandchildren), among affinity groups, with strangers who become friends, and in-place. her central contention, however, is that we need social life and activities, appropriate supports and funding, accommodations that help us adjust to changing circumstances, and , particularly for americans, a government that recognizes the needs of older people in terms of values, policy, and funding. baker strongly argues that we should take charge of the decisions and circumstances that affect our later lives: "...aging in community doesn't begin when we turn a particular age...it begins right now, whatever our age, forming relationships, lending a hand, sharing a laugh, knowing you're there for each other”(218). these decisions can require re-evaluation and change, as for, example, when a person who has lived in place or in a retirement community must go to a higher level of care and/or be closer to family. we need to be prepared for all these choices and see them as part of our life story. as noted, above, our options have become increasingly varied. baker goes through in significant detail the pluses and minuses of these choices. the village, for example, "... an organized way where neighbors can help each other remain in their homes..." (29), has a combination of paid and volunteer staff. it can work well--and it can fail because, as she quotes one member, "'...because of marketing, or your business plan is not as solid as you'd hoped, or you don't have the technical know-how to make it all work” (36). co-housing, where people buy a house or unit and share common facilities, requires members to participate extensively in decision-making processes. eventually, for some people, that can "damage commitment" (46.). baker goes through all the alternatives--family, friends, residence sharing, communities without walls, affinity groups, such as gay housing, and artist communities. for many, economics determines the choices. for others, physical and/or mental limitations constraint choice. she notes that americans have fewer choices compared to europeans, because their governments provide much more planning, funding and consideration of their aging populations. she suggests future policy directions for the united states in these areas, including changes in zoning laws that make it easier and financially possible to build a variety of housing formats for older people. these include new concepts in "granny units" and units which are zimmer | book review anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.96 http://anthro-age.pitt.edu 107 107 more practical for older people, such as single floor facilities--bathrooms, laundry, and kitchens. baker further suggests ways in which government policy must encourage providers to address the needs of people who are aging. she notes: "...we need a concerted effort to entice more professionals to the geriatric field, or it will be impossible for many people to stay in their own communities as they wish." (178. see also cumbler, et al, 2008). this book is an invaluable resource for several reasons. it covers these alternatives in clear, welcoming, and supportive language. (baker is a popular writer with a long list of publications geared to the lay public.) it provides contact information for those wishing to study more of these options and/or plan for their future. it complements baker's earlier work on reforming nursing homes to make them places in which we would want to live, instead of feeling warehoused (see baker, 2007). a few comments to add about this book. as noted, above, future researchers can see opportunity to look at these evolving alternatives. it would be fruitful to have these studies integrate with other studies in anthropology that focus on the nature of work for older people, such as caitrin lynch's study of vita needle, a factory which employs workers who are over 65 (2012.) a personal note as well: i am a psychologist as well as an anthropologist. i would like to see future studies address the alternatives, needs, and social lives of certain populations, such as people with asperger's syndrome, because they generally have less social interaction. there are also other psychiatric and medical conditions which should also be studied, such as people with visual impairment (cf. http://www.ne.nfb.org/node/579.). moreover, people with co-occurring conditions should be included in terms of studies and alternatives as well. one example is people who are bipolar who, in addition, have hearing difficulties. bibliography baker, beth 2007 old age in a new age. vanderbilt university press. nashville, tennessee. cumbler, ethan, glassen, jeffrey j., and wald, heidi 2008 alternative solutions to geriatric workforce deficit. american journal of medicine. volume 121, issue 10, october. page e21. lynch, caitrin 2012 retirement on the line: age, work, and value in an american factory. cornell university press. ithaca, new york. national federation of the blind of nebraska 2015 older blind and visually impaired persons. http://www.ne.nfb.org/node/579, accessed april 2, 2015. http://www.ne.nfb.org/node/579 http://www.ne.nfb.org/node/579 anthropology & aging quarterly 2010: 31 (3-4) 44 aage member news member news column margaret a. perkinson, phd saint louis university two aage members, one well-established in the field, the other an up-and-coming scholar, recently received national recognition. this issue’s column showcases their work and awards: congratulations to dena shenk, phd, director of the university of north carolina charlotte’s gerontology program and past president of aage, who recently received national recognition for her many contributions to gerontology and anthropology. the association for gerontology in higher education (aghe)—the educational branch of the gerontological society of america—has chosen her as the recipient of the 2011 hiram j. friedsam mentorship award. this distinguished honor, named for a former aghe president and an outstanding mentor in gerontology, is given to an individual who has made significant contributions to gerontological education on a national level through excellence in mentorship to students, faculty, and administrators. dena is thefirst anthropologist to receive this award. the award presentation and lecture will take place at aghe’s 37th annual meeting and educational leadership conference, which will be held from march 17 to 20, 2011, in cincinnati, oh. visit www.aghe.org for further details. dena is a fellow of aghe and the gerontological society of america and has conducted research and program development and evaluation in denmark, costa rica, peru, turkey and the united states. her past and current research interests include rural older women, direct care workers, communicating with and caring for people with dementia, and use of narrative approaches and photography. (dshenk@uncc.edu) kudos to tam perry, university of michigan anthropology doctoral candidate (teperry@umich.edu)!! she is one of four distinguished doctoral students to be accepted this year into the national hartford doctoral fellows program. each hartford doctoral fellow receives a $50,000 dissertation grant plus $20,000 in matching support from their home institutions, which enables awardees to concentrate fully on their dissertation research projects over the next two years. fellows also receive supplemental academic career guidance and mentoring, as well as professional development to help them successfully launch an academic career in gerontology and social work. tam’s research interests include: discursive practices in nursing homes between residents and caregivers, financial well-being of older persons, and housing transitions faced by older persons. her dissertation topic is: leaving home in late life: negotiating moves among older adults and their networks in the mid-western united states and her dissertation chair is ruth dunkle. anthropology & aging quarterly 2010: 31 (3-4) 45 aage member news keep in mind upcoming awards and a book publishing opportunity sponsored by aage! aage sponsored student awards the jacob climo award: this fund honors the memory of jacob (jay) climo by supporting student participation at meetings in which aage is active. jay was a long time member and former president of aage. he was professor of anthropology at michigan state university, where he taught social and medical anthropology and served as a dynamic mentor to generations of students. jay did fieldwork in ethiopia, israel, mexico and michigan. his research focused on intergenerational relationships, the ethnography of memory, aging and elder care around the world, grandparents parenting grandchildren, and narratives about aging parents in the u.s. and their adult children in israel. jay had several books to his credit: distant parents (1992), the labyrinth of memory (1995), and social memory and history (2002). how to contribute: write your check to aage, write “climo support fund” in the memo line, and mail to maria cattell, 486 walnut hill rd., millersville, pa 17551. the margaret clark award: aage sponsors an annual margaret clark essay award. cash prizes of $500 and $250 will be awarded to the most outstanding graduate and undergraduate essay respectively. the competition aims to support the continued pursuit of the insights and practice ideals demonstrated by margaret clark, a pioneer in the multidisciplinary study of socio-cultural gerontology and medical anthropology. an extended summary of the winning manuscript will be published in aaq. the jurors may select papers for honorable mention; these authors receive one year’s free membership in aage. please consult the aage website for more information. aage sponsored publications new book series: life course, culture and aging: global transformation. the book series is being published by berghahn publishers in collaboration with aage and the aaa interest group on aging and the life course. mission of the series: late life and adult maturity set in the context of the life course, culture and community. this focus will be set within the powerful global transformations now taking place. the series will consist of both ethnographies and edited books with a goal of 2 books a year. manuscript ideas/manuscripts can be submitted to either the editor, jay sokolovsky (jsoko@earthlink.net) or the publisher, marion berghahn, marion.berghahn@berghahnbooks.com anthropology & aging quarterly 2010: 31 (3-4) 46 aage member news a warm welcome to the newly elected secretary-elect of aage, dr. eric miller! introducing eric... eric miller (ph.d., university of pittsburgh, pittsburgh pa, 2004), study abroad coordinator & instructor, center for experiential learning, loras college, dubuque, iowa. current and recent research: “compromises of old age: power and independence in rural north china,” funded by wenner-gren foundation, 1998-9. my research area is support for the aged and intergenerational relationships in rural north china. i also previously worked with the hospital elder life program and the yale school of medicine’s program on aging. that work focused on training m.d.-ph.d. students to conduct research in geriatrics and on hospital quality of care issues dealing with aged patients, and on delirium. recent publications: village life in rural zouping. in change in rural china: american scholars research in zouping county, shandong. [chinese]. jinan, shandong, china: shandong people’s press, 2008. ‘living independently is good’: residence patterns in rural north china reconsidered. journal of long term home health care. 2007. filial daughters, filial sons, comparisons from rural north china. in filial piety: practice and discourse in contemporary east asia. charlotte ikels, ed. stanford, ca: stanford university press, 2004. professional activities: reviewer, journal of cross-cultural anthropology, 2001-present board member, china health network, yale school of medicine 2004-5 statement: i have found aage to be a supportive place where those interested in anthropology and aging can find a supportive network at all stages of their career. i hope that aage continues to be a welcoming organization that is international, intergenerational and incorporates all subfields of anthropology. aage can also motivate us to come together around common interests in anthropology and aging studies so that we can continue to share ideas, present papers and publish in these fields. it is important that we continue to keep anthropology in aging studies and aging studies in anthropology. given my current work with international education and experiential learning, i also hope that in my role as secretary i can also help us think about connections between anthropology and aging in study abroad and service learning. anthropology & aging anthropology & aging, vol 35, no 1 (2014), pp. 1-26 issn 2374-2267 (online) doi 10.5195/aa.2014.35 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. modernization, aging and coresidence of older persons the sri lankan experience amarasiri de silva1 and w. m. j. welgama2 1 department of sociology, university of pittsburgh 2. department of social sciences, sabaragamuwa university, sri lanka. contact information: email: mwadesilva@gmail.com abstract this paper examines the effects of the modernization on the living arrangements of elderly people in six selected communities representing urban, semi-urban, estate, rural, colonized settlement and fishing villages in sri lanka. the paper concludes that the modernization of the economy and society has exacerbated an intergenerational rift leading to an intensification of tensions between elderly people and other family members, despite the fact that the percentage of older people living with their children remains high. such coresidence or intergenerational living comprises many types of living arrangements, and leads to mixed results for care of the elderly. many elderly people have developed mechanisms to counteract the negative effects of coresidence: seeking independence during old age, by earning their own income and living alone or living with the spouse, indulging in behaviors such as drinking, spending time outside the home with friends of similar age, or creating their own living space within coresidence. keywords: coresidence, intergenerational problems, sri lanka, modernization, http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx mailto:mwadesilva@gmail.com de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 1 modernization, aging and coresidence of older persons the sri lankan experience amarasiri de silva and w. m. j. welgama aging in sri lanka sri lanka is experiencing dramatic changes in its socio-cultural landscape following the implementation of development and modernization programs. the development of tourism, employment in the middle east and in the private sector in industries such as textiles , have increased work opportunities for women in particular, leading to changes in family structures, in residential patterns and in intergenerational support systems. modernization and development have led to higher levels of social differentiation, which have had a great impact on older people, their residential patterns and their status and role within their families and communities. sri lanka has been aging faster than any other nation in south asia with an annual average increase of 3.3% in the population aged 60 and above between 1981 and 2001 (siddhisena 2005). sri lanka’s elderly population of 60 years and older has increased from 11.8% in 2009 to 12.5% in 2013 (united nations 20091 and 20132).according to the world bank,3 the population aged 65 and above in sri lanka was 8.41% of the total in 2011. as measured by the department of census and statistics of sri lanka, in 2001, 8.9% of the population was aged 60 years and above (gunasekera 2001), and this had increased to 12.3% in 2012 (census and statistics 20124). population projections show that, by 2030, the proportion of the population aged 60 years and above is expected to increase to 21.5% (siddhisena 2005). the population born between the 1950s and 1971-the baby boom in sri lankahas contributed to the present as well as the projected increase in the elderly population. the achievements in economic, health and social development have contributed to higher survival rates among the elderly population in sri lanka. the literature on aging in sri lanka that describes its socio-cultural implications often paints a gloomy picture with reference to the care of the elderly, the erosion of traditional homebased family care, inter-generational problems arising from aging (amarabandu 2004), the lack of social security coverage, the reduced effectiveness of traditional family support systems for old people, and the disempowerment of old people in relation to family and community matters. because of poverty, the elderly are often forced to work late in their lives (world bank 2008). often those negative developments are regarded as consequences of modernization. modernization, old age and coresidence it is generally accepted that the socio-political processes following modernization have fostered a devaluation of older people and that the effect of demographic transition and ‘subtle and complicated sociological processes’ has been their relative degradation (cowgill 1974). among the processes of change, urbanization, mobility and civil wars have affected older people, and have weakened extended family and communal ties. in modern times, families have become smaller and more dispersed. the young are employed in market-based employments, often away de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 2 from the parental home (world bank 1994), which can affect residential patterns, especially in relation to coresidence among the elderly. although there is no consensus as to the definition of ‘modernization’, it is often used to refer to the stages of social development which are based upon industrialization and their outcomes such as urbanization, economic development, increased education and the spread of mass communications and literacy (cowgill 1974; cowgill and holmes 1972; inkeles and smith 1974; lerner 1958; palmore and manton 1974; bendix 1963). when dealing with processes of change from a traditional to a modern society, cowgill’s conceptualization, which is a synthesis of many definitions of modernization, seems most appropriate. cowgill (1974: 127) defines modernization as ‘the transformation of a total society from a relatively rural way of life based on animate power, limited technology, relatively undifferentiated institutions, parochial and traditional outlook and values, toward a predominantly urban way of life based on inanimate sources of power, highly developed scientific technology, highly differentiated institutions matched by segmented individual roles, and a cosmopolitan outlook which emphasizes efficiency and progress’. like the ideal type of weber (antonio, shils, and finch 2011), modernization theory derived in europe and ‘abstracted from the process of western capitalist development’ (bendix 1963) is based on specific cultural experiences, and, if it is to be applied in developing countries, it must be adapted to suit their different cultural circumstances. although it has been argued that modernization theory reflects ‘the western experience [of] the first historical example of modernization, and therefore can provide a paradigm for the study of the process in nonwestern societies’ (bendix 1963), this paper holds the view that developing countries such as sri lanka, where the history of development has taken an entirely different trajectory, do not conform to the model of modernization as it developed in the west. bendix’s own description of urbanization in india (bendix 1963) is an example that illustrates the problems of simply applying this western model. regarding modernization as a social process emanating from socio-economic changes generated by scientific and technological advancement has heuristic advantages, particularly when analyzing social transformations taking place in developing countries (inkeles 1969 and 2013). it can be used to explain social marginalization, if modernization is treated as the main driver of change in a society. such an approach helps explain why certain groups of people fall behind the main currents of social change prompted by the processes of modernization. if the theory of modernization is situated in its proper context in a particular society – in communities in sri lanka in this case – it can be used to examine development as a historical process emanating from the introduction of modernization, and also to examine the factors and forces or ‘pressing needs of the situation’ (bernstein 1971) that led to the introduction of modernization. thus, critiquing modernization theory, in this essay we try to explain the social outcomes of modernization among the elderly in sri lanka focusing on residential patterns and the quality of life in six different communities representing cultural ecological zones of the country. cowgill and holmes (1972), in their cross-cultural study of modernization and in subsequent studies in 1974 and 1986, postulate that, as societies modernize, the status of the aged declines. we disagree because this hypothesis is based on the romanticized idea that old people in pre-industrial or rural societies enjoyed high status. bengtson et al (1975: 689) also critiqued the modernization and aging theory of cowgill et al as suffering ‘from a romanticized or naive portrayal of eldership in pre-industrial societies.’ most ethnographic studies on south asia (for de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 3 example, goldstein and beall 1981; harlan 1968; ranade 1982; rajan and kumar 2003) support the idea that old people in rural communities work hard physically, and do not depend on their progeny for support until they become frail. it is their ability to work hard, in their farms and households, which allows them to retain control of property and resources and their families. hard physical labor among the elderly in pre-industrial societies, however, is not consonant with their prestige in society as postulated by modernization theorists. linda martin (1990), in her review of the status of south asia’s elderly, states that there is no strong evidence that the status of the elderly in south asia has declined nor that it was uniformly high in the past. acceptance of cowgill’s assumption that the elderly in rural areas and in pre-industrial societies enjoy high status tends to overlook the difficulties and abuses that the elderly experience in their coresidential arrangements, extended families, neighborhoods and communities. studies done in the 1940s do not confirm that the elderly in pre-industrialized societies enjoyed high status in extended family settings or coresidence (simmons 1945). goldstein and beall (1981: 50) in their study of sherpas in nepal – a preindustrial society – found that those aged over 70 were physically fit, carried out heavy agricultural work and household chores. all but one owned their land and lived independently in the village. although sherpa culture confers high status on the elderly, the authors observe that ‘despite their high level of economically productive activity, their relative fitness, and their ownership of agricultural land, many elderly helambu sherpas overtly expressed unhappiness with their lot. several spontaneously volunteered that they wished they were dead, and others commented that their children had abandoned them and that the young in general did not care about the elderly. almost all of those living alone drank home-brewed liquor daily and a few consumed three or more cups per day’ (goldstein and beall 1981: 51). harlan (1968: 475) notes that the elderly occupied precarious positions in the indian villages which he studied and which he characterized as a ‘pre-industrial agricultural community, little affected by urbanization’. ranade (1982: 84) states that work participation rates of people older than 65 in india in 1982 were as high as 77% in rural areas and 55% in urban areas. he further observes that, in rural areas, most of the working elderly were engaged in heavy manual work connected with agriculture, and that they worked until their health deteriorated to such an extent that physical activity was not possible. coresidence of elderly people with their grownup and married children is seen as a preferred living arrangement for the elderly in south asia (escap 2007; martin 1990). uhlenberg (1996), in a study based in rural settings in sri lanka, found that 75% of the elderly coresided with spouses or children. nugegoda and balasuriya (1995), in their semi-urban area study, found that 85% lived in coresidence with children, while an urban and rural based study by andrews and hennink (1992) and the marga institute (1998) shows that the figure was above 83 per cent. siddhisena (2005) observes that ‘there are no significant rural urban differentials of this pattern’ of coresidence, and that ‘there is no strong preference for living with a son or daughter in later life’. however, findings of another study (siddhisena and degraffe 2009) state, in conformity with uhlenberg (1996) and nugegoda and balasuriya (1995) that ‘traditionally, and still the most common pattern by far, elderly parents live with one of their children, often the youngest son who typically inherits the family home and is expected to care for his parents in return’. it is hypothesized that ‘coresidence rather than the kinship tie is more important in determining the pattern of caregiving’ (tennstedt et al 1993). the literature on coresidence in sri lanka does not examine how the educational achievements of children correlate with coresidence. in the us, de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 4 however, it was found that children with college degrees are less likely to live in coresidence with or near their mothers (compton and pollak 2009). based on demographic data showing a growing percentage of the elderly among the population, a low rate of population growth, and increasing life expectancy, it has been postulated (perera 1999, siddhisena and ratnayake 1998 and uhlenberg 1996) that the change from the extended family system to nuclear families in sri lanka has given rise to ‘problems in providing better care to aged parents’. these issues are exacerbated by factors such as rapid urbanization including the shifting of residence from rural to urban locations, and women getting employment locally and abroad, all of which make it difficult for nuclear families to provide care for older people. the early stages of modernization in sri lanka began to appear when the europeans captured sri lanka (then ceylon): they established new administrative and revenue systems, and introduced christianity and new economic activities, plantations, and urban centers. these programs significantly changed the mode of production and land tenure, particularly the systems of inheritance and ownership of land. for the first time in the country’s history, under roman dutch law, women were regarded as legitimate heirs to parental property resulting in new authority structures and residential patterns. the new law made it possible to transfer and sell land, which had hitherto been considered family property to be passed down from one generation to the other. the introduction of waged labor, the creation of new employment outside the original villages and new forms of labor organization, technological innovations, road links with urban centers and cash crops converted subsistence agriculture into a market-oriented enterprise. these changes have had a tremendous impact on the elderly population, particularly in their residential patterns, living arrangements and work and income generation activities. an appreciation of the impact of modernization on residential patterns of the elderly requires a closer look at how the elderly live in their communities. the study employed an anthropological methodology aimed at capturing the effects of modernization on coresidential arrangements of the elderly in sri lanka. methodology in this study, we employed a qualitative – quantitative mix approach for data collection. the data were collected in early 2013 over a period of six months. the communities chosen for the study were taken from six cultural ecological zones in sri lanka: urban, semi-urban, traditional rural, estates, colonized schemes,5 and fishing communities, and the results were weighted by population percentages obtained from 2011 census data for urban (18.3%), rural (77.3%6) and estate (4.4%). the selected areas were located in the districts of colombo, kalutara, rathnapura and matara. one village headman division or grama niladhari (gn) division from each of the six cultural ecological zones was chosen for the study. the gn divisions selected were jambugasmulla in colombo district, alubomulla in kalutara district, kumbalgama, rassagala, budugala and welipothayaaya (these two villages form one unit) in rathnapura district, and mirissa in matara district. in each gn division, 80 families with at least one elderly person were randomly selected (using a random number table) for the study, from a sampling frame of elderly persons over 60 years of age that were recorded with the respective grama niladhari. in addition to the sample of 480 households, a further 50 households were randomly chosen as de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 5 potential replacements in case any respondents in the original sample were not available for interview at the time of the survey. as the village originally chosen to represent the rural community (kumbalgama) had fewer than 80 families with elderly persons, the adjoining gn division (muththetuwegama) was also taken into account in selecting the rural community sample. during the initial phase, 60 open-ended interviews were carried out in the six communities selected for the study with elderly people and their family members to enable the authors to get a thorough understanding of the socio-cultural aspects of old age as they apply in different communities in sri lanka. the older people for open-ended interviews were selected from the list of households maintained by the gn. however, in some cases, the randomly selected person in the household was replaced by another willing respondent and therefore, we ended up having more male than female interviewees (38 compared with 22). on many occasions early in the interview process, we found that it was difficult to isolate the interviewee from other members of the household. however, when we made appointments for a subsequent interview, the interviewee agreed to meet us individually, often outside the house under the shade of a tree or in an outhouse in the same garden. in the fishing village, most of such interviews were held on the beach. based on the qualitative data collected during the first phase of the study, specific topics and variables were identified for detailed examination using semi-structured interviews with a random sample of 480 persons or 19% of the total population aged 60 and over across the selected locations. twenty-three households initially selected for the survey were replaced later for variety of reasons (for example, because they had moved out of the village or the elderly people were not present at the time the interviewers visited). of the 23 households that were replaced from the initial list, 19 were located in the rural, estate and colonized communities. the data were computer analyzed using the spss program, while qualitative data were translated into english and manually analyzed for this paper. the survey instrument used in this study comprised 12 major domains with variables identified under each domain for the collection of data. the major domains included in the survey instrument were household demography, physical arrangements and facilities, living arrangements, work and occupation, education, relationships with family and others, intergenerational aspects, attitudes towards life, time use and leisure, and household chores carried out by the elderly. this article concentrates on those variables from the survey data that pertain to coresidence and living arrangements. nine variables on attitudes and behaviors of older people that were identified as crucial to elderly life in the qualitative interviews were enumerated in the survey using a 5-point likert scale and analyzed using the reliability analysis program available in spss. the nine variables were used to create an anxiety scale using the multiple response analysis method in spss. the traditional system of residence, inheritance and coresidence in order to examine the changes that have taken place in residential patterns of the elderly in sri lanka, it is imperative to know about the traditional arrangements as documented in ethnographic research. in sri lanka, traditional residential arrangements involving living in one’s own patrilocal residence (gedera) or with family (paula) are widely practiced among both the sinhalese and tamil populations. paula comprises father, mother, children, and married children de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 6 with their spouses and grandchildren living in the gedera or family house. occasionally, there are close relatives such as sisters and brothers of the mother and the father also sharing the family house. traditionally, a household or gedera ‘is used …to refer to a group of people whose food is owned in common and who share a single cooking fireplace’ (robinson 1968). traditional coresidence arrangements typically took the form of horizontally extended families known as compound groups. robinson (1968), studying a traditional village in kandyan provinces in the late 1960s, shows that the traditional practice of village exogamy led to the creation of ‘compounds’ where the married sons took up residence in separate but adjacent houses on the same parental property. robinson’s work in morapitiya, a kandyan highland village, and leach’s research in puleliya in north-central province (leach 1961) have documented such practices. compounds of a somewhat similar nature comprising households established by married sons and sometimes daughters on parental property were found in most of the traditional villages in the low country as well. robinson (1968) describes the practice of traditional coresidence of compound groups saying that ‘people [become] members of a compound group if they live on a particular named piece of land. the patterns of kinship and inheritance of land determine an individual's right to the land and hence to compound group membership’. there were two forms of marriage with different implications in relation to residence and inheritance. many daughters tended to live in their husband’s village, a practice known as diga marriage. however, other married daughters stayed in their own village, – a traditional practice (binna marriage) that was used to accommodate the married daughter and her children into the patrilocal family, especially when there were no sons in the family to inherit the parental property. in the latter arrangements, which were considered derogatory, the children took their mother’s family name. since the introduction of roman dutch law allowing females to inherit property, this practice of daughters living in the parental property has become an accepted practice, and did not require children born of such marriages to take their mother’s family name. living in compound groups is still regarded as the norm in rural sri lanka where married children tend live in newly constructed houses adjacent to their parental house or within the parental property. it is against this background of traditional patterns of inheritance and residence that we examine the coresidence of elderly people as it is practiced now in the six different communities that represent various cultural ecological zones of sri lanka. findings of the 480 elderly people surveyed, 50.2% were female while 49.8% were male. the average age of the people in the sample was 73.7 years with a standard deviation (sd) of 7.3 years. the highest mean ages were found in the fishing community (75.9 with 7.8 sd) and the traditional rural community (75.5 and 7.9 sd), while the urban community had the lowest (71.5 with 6.5 sd). the youngest respondent was 60 and the oldest was 90. the distribution by gender did not differ significantly across the communities. the young old (60-64 years) comprised 8.8% of the sample, while old (65-74) and old-old (75+) comprised 47.8% and 43.5% of the sample de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 7 respectively. the percentage distribution of the three age groups did not differ significantly across the communities that were studied. in this article, we report only a selection of the information collected, particularly examining the effects of modernization on the residential arrangements of the older people in the locations we studied. table 1: older people and gender distribution in the sample locations name of community total population sinhalese tamils muslims and other total 60 years and above females 60 and above males 60 years and above urban 5,870 5,402 253 215 833 (14%) 499 334 semi-urban 3,151 3,109 28 14 447 (14%) 277 170 traditional village 2,127 2,118 7 2 270 (13%) 143 127 estate community 3,358 2,126 1,232 327 (10%) 196 131 colonized community 1,900 1,900 304(16%) 147 157 fishing village 2,661 2,661 327 (12%) 160 167 total 19,067 17,316 1,520 231 2,508(13%) 1,422 1,086 a decrease in coresidence? a breakdown of our data using the sector-wide weighted average method shows that the percentage of elderly people living in their original homes with their spouse or children has not changed very much from 2003 (64.4% according to siddhisena 2005) to 2014 (61.3% in the present study). this is contrary to the world bank (2008) suggestion that ‘as income and education increase, coresidence with children may decline in sri lanka’. when analyzing the six communities as separate units in table 2, it can be seen that a large percentage of elderly people lived in coresidence in the colonized (85%) estate (82%), urban (82%), and fishing communities (85%). elderly people living in coresidence with children in semi-urban and the rural community had 71% and 74% respectively. however, if proximity were used as a proxy for coresidence in rural areas, the percentage of coresidence would have increased to 90% as many children of older parents live in separate houses close by, sometimes built on land owned by the family. the emergent popularity of coresidence in urban areas (nugegoda and balasuriya 1995; andrews and hennink 1992; marga institute 1998; and the present study) is shown in the qualitative data. an elderly person from an urban community explained that, after his son was selected for a new job in the university, they sold their village property and bought a house in de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 8 jambugasmulla, because his son did not have sufficient savings to purchase a house in the urban community. another person said ‘we came from kegalle in 2001 and now we live here with my son in jambugasmulla’; a retired bank officer said ‘we were in kamburugamuwa in matara district, when i got the transfer to colombo, which was the last phase of my job; we decided to buy a house in this area…my son also lives here with his wife and child.’ those who were living in their original family homes in the urban and semi-urban communities stated that their children continued to stay in the parental house after marriage, which is another reason for the high percentage of coresidence in urban and semi-urban communities. …when my son finished university, he did not have a proper job … he conducted tuition classes for students doing the gce al examination7 in a room at the temple. this class became popular, and my son wanted to build a classroom outside the temple which later became a larger building. my son continues to do his tuition classes and live in this house after marriage… (man, aged 78, in urban community). …. buying land in this area is very expensive… therefore i decided to build an extension to the original house of my parents… i got a bank loan and built my annex and we now live here... (man, aged 45, son of an old person in urban community). most parents bequeath their property, preferably to the youngest son, keeping a life interest in the property, in the expectation that the child in question will live with them and look after them during their old age. often, parents who retain a life interest in the property continue to be legal custodians of it. some parents retain full ownership of their property until very late in life, or die intestate, which sometimes makes coresidence a necessary requirement for the designated child (usually the youngest son) to inherit the property. usually in such situations, the house and property of the parents is given to the son or daughter who looked after them in their old age, and therefore, caring for old parents in such situations can be materialistically driven. traditional villages are different from the urban communities in terms of land availability and coresidence. when they get married, sons stay in their parental house for a year or two and then construct their own house close to the parental house on the same plot of land or nearby where they commence their new life. the need for coresidence for parents does not arise in such circumstances, as family members frequently visit each other – a reason for the lower percentage of coresidence of elderly people in traditional villages. this practice can be seen as a continuation of the traditional ideology of community living arrangement known as ‘compounds’ to suit the present circumstances. heterogeneity of living arrangements the families of coresidence typically take the form of beanpole families (bengtson, rosenthal, & burton, 1990), vertically extended families with multiple generations but few people in each generation. the families we came across in the sample communities where old people lived comprised, on average, three generations, i.e. the old parent or parents, the son or daughter with his/her spouse, and children. the beanpole family in the sri lankan context is different from the traditional extended family because there is no horizontal expansion of the family with many members of the same generation living in the same household or on the same land in different houses and sharing family resources. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 9 our findings show that 80% of the elderly people in the sample reside in verticalized families with one of their sons or daughters, and grandchildren (table 2). our findings reaffirm what was found by martin (1990) who states that ‘family being the traditional social institution for care of the elderly persons’ allows older parents to ‘co-reside … in rural and urban areas’ the family structures that we see in our sample are far from being nuclear families or extended families in the traditional sense, but a complex institution with different characteristics. they are social networks created by families to provide for the various requirements of the elderly as well as of their sons and daughters. the families include a vast range of structures such as single-person households where only old father or old mother lives alone, the old couple live by themselves (neolocal), living in the original family home or other house with one of the sons and his wife and children (filiolocal), living in their own home or other house with the daughter and her husband and children (filialocal), living in the original house or rented house with unmarried sons and daughters (bilocal). the experiences of elderly persons in filiolocal settings mostly reported hostile relationships with family members in their households. an old woman, aged 82, in the semiurban community in filiolocal residence said that my daughter-in-law tries to impose restrictions and rules on me… i don’t like that…this is my house and she must understand that she is here because she is married to my son… as long as i am here, i should be in control of things in this household… of the 48% of our interviewees who live in filiolocal residence, most report authorityrelated issues at the household level. the issues have risen as the daughters-in law took over the management of the house, which was formerly run by the old woman. most women who are married and live with their husbands and parents-in-laws are employed and contribute to the family budget and household management. their work might be in garment factories, government departments, or private sector institutions, while some are school teachers. as such women are busy with their employment and are out during the day, the mother-in-law is entrusted with household tasks such as cooking, washing, and childcare, and these are seen as tasks imposed on the older people by the daughter-in-law. the modernization process has thus created a renewed tension between older parents and the younger generation which correspond to mother-in-law and daughter-in-law conflict in traditional society. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 10 table 2: living arrangements of older persons (60 years and over) in sample communities type of living arrangement lining sector total urban semi urban traditional village estates colonized schemes fishing village n eo lo ca l (a) living alone 4(5%) 7(9%) 7(9%) 4(5%) 5(6%) 4(5%) 31(6%) (b) with spouse only 9(11%) 14(18%) 12(15%) 5(6%) 5(6%) 8(10%) 53(11%) fi lio lo ca l (c) with son (and his family) in the original home 30(38%) 31(39%) 26(33%) 39(49%) 40(50%) 45(56%) 211(44%) (d) living with son (and his family) in son’s home 4(5%) 2(3%) 7(9%) 2(3%) 2(3%) 2(3%) 19(4%) fil ia lo ca l (e) living with daughters (and her family) in the original home 16(20%) 16(20%) 5(6%) 8(10%) 10(13%) 12(15%) 68(14%) (f) living with daughter (and her family) in her home 9(11%) 3(4%) 10(13%) 6(8%) 3(4%) 3(4%) 33(7%) bi lo ca l (g)with unmarried son/daughter in the original house 7 (9%) 5 (6%) 11(14%) 11(14%) 13(15%) 6 (8) 53(11%) (h)other 1(1%) 2(3%) 2(3%) 5(6%) 2(3%) 0 12(3%) total 80(100%) 80(100%) 80(100%) 80(100%) 80(100%) 80(100%) 480(100%) some elderly persons in the (c) to (g) rows are living with their spouse as well as children. in filialocal residence, one old woman aged 74 stated that i have no encumbrances such as home management etc. as they are all done by my daughter and son-in-law. i enjoy the company of my grandchildren… i look after them when my daughter is away at work. i have the freedom to do whatever i wish in this house although it is not my house. i observe religious meditation on full moon days, and frequently visit the nearby temple …. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 11 about 21% of the elderly people we interviewed live in filialocal residence with their daughters and sons-in-law and their children. the tensions between mothers and the next generation were seldom reported in filialocal residences where the elderly lived with the daughter and son-in law where the ownership issue of property and authority issues did not arise. ‘kin in contact’ and coresidence the traditional linkages within extended families are now being performed through various newer forms of communications and relationships. modern communication methods such as cell phones and internet-based social media programs have made it easy to link family members even when they live in different and distant locations. the extended networks of relationships or ‘kin in contact’ sometimes include distant relatives of the older persons who provide support and talk to them over the phone to inquire about their health situations and requirements etc. the survey data show that a large percentage of middle class elderly persons use telephone and internet-based social media facilities to contact their children and other relatives who live in distant places, and so communicate their grievances, seek help and complain about their problems. one woman in the semi-urban area said that when she runs short of money, instead of asking her son with whom he lives, she contacts her daughter who is working in the middle east to send her money through a wire transfer. another woman from the fishing community said …. when i have problems … when my daughter-in law scolds me, i do not go and fight with her… instead, i call my daughter who lives in colombo and tell her about it and she calls my daughterin-law and settles the matter…when i tell my daughter-in-law that my daughter in colombo is going to visit us (she usually calls me before she sets off) my daughter-in-law takes measures to wash the toilet, clean my room and make the home tidy… this is a good tactic for me to control my daughter-in-law… another elderly woman from the semi-urban community said my children live in different places. one of them is in korea. they all connect with me through the internet. they call me in the evening or in the morning at their convenience … they inquire about my health, what i’ve been eating, and so forth… if i need money, then they send it to my bank account which i can operate with a card. … i don’t feel as though they are not nearby or in my house…. they are always there for me to contact if i need to do so… my concern however is that i cannot feel and embrace my grandchildren… in the circumstances, physical distance is not crucial in distinguishing present family relationships from those in, for example, extended families. in the new era of communication technology, an older person has the ability to create his/her own network of relationships, which determines the nature and type of the family structure or ‘kin in contact’. this, however, is an option available mostly to middle-class families; most rural families do not enjoy the benefits of new technology to improve their support systems. some elderly people nevertheless felt that being together in one family or in close proximity is the best choice, as it allows them to see each other, and to personally attend to individual requirements. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 12 rural-urban difference in coresidence the percentage distribution of coresidence found in our analysis revealed a significant difference between rural and urban communities. higher levels of education and smaller family sizes are important characteristics of elderly persons in urban and semi-urban areas who live in coresidence, as shown in tables 3 and 4. of the 19 graduates in the total sample of older people, 18 were found in the urban or semi-urban communities. of those who had smaller families with one or two children, 67% were found in the urban or semi-urban communities. in urban and semi-urban communities, education level and number of children are the most robust predictors of coresidence. as we have not recorded the educational achievements of the children of the elderly people whom we have interviewed, it is not possible to comment on how children’s education affects coresidence. due to their close proximity to work and the exorbitant prices of land and houses, after marriage, the children of urban parents in our sample often make arrangements to share residence with their parents.8 table 3: level of education of elderly persons in urban / semi-urban communities vs the other communities in the sample urban and semi-urban communities (n=160) all other communities (n=320) percentage cumulative percentage percentage cumulative percentage graduate 11.2 11.2 0.4 0.4 gce al passed 20.6 31.8 6.2 6.6 gce ol passed 32.6 64.4 11.2 17.8 below gce ol 33.1 97.5 59.7 77.5 no schooling 2.5 100.0 22.5 100.0 table 4: average number of children per family of elderly person by community type community type average number of children per family of elderly person urban 2.2 semi-urban 2.9 traditional village 5.1 estate community 4.5 colonized community 5.2 fishing community 3.3 all six communities 4.0 interview data show that elderly people in urban and semi-urban areas often visit libraries, meet friends, attend societies of which they are members, enjoy window-shopping in the recently established shopping malls in the city, occasionally go to the cinema or the theater, de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 13 and attend the public gatherings and political meetings which are widely available in the city. some old people in the urban areas are actively engaged in community work or religious societies, and participate in social welfare activities. table 5: average agreement with the statement ‘do you participate in community activities?’ (1=rarely; 4=frequently) participation type of activity urban and semi-urban rural participate in political activities 3.3 2.1 active in social welfare and religious work 2.1 2.5 attend meetings 3.4 2.3 office bearers in societies 3.8 3.1 visit friends 3.0 1.9 the elderly people in rural communities (traditional, estate, colonized community and fishing community taken together) are involved in welfare and religious activities more frequently compared to those in the urban and semi-urban communities. elderly people in filiolocal coresidence in urban and semi urban communities report relationship issues with inlaws living in the households more often than those in the rural setting. work and coresidence elderly people in traditional villages continue to work in paddy fields, cultivate vegetables and keep themselves physically active. having their children resident nearby provides the labor required during the cultivation and harvesting seasons. on many occasions, we have observed that, although the sons and parents live in different houses, they cultivate the same paddy land that the family inherited from their forefathers and jointly own. 52% of the elderly people (69% of men and 35% of women) in the sample were engaged in income-earning activities, as shown in table 6. most of the women who work do so as agricultural laborers in their own paddy and vegetable farms, while the men work as paddy farmers and share croppers or are engaged in wage labor and fishing. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 14 table 6: current income earning activity of elderly persons by gender activity gender total male female retired (employed before) 67 28 95 agricultural work 70 57 127 fisheries 35 0 35 self-employed informal 29 19 48 government 8 4 12 other 1 0 1 private sector 22 4 26 unemployed (never employed) 7 129 136 total 239 241 480 most of the elderly people who are physically able to work continue to live in their own homes, even if their children living in urban areas have asked them to move in with them. some older people have opted to live alone in order to avoid the problems that may occur when living in coresidence with children. an old person, aged 69, from the tea growing community said that i have three acres of tea and two amunas9 of paddy in my village. i get about 25,000 rupees a month from my tea estate. my wife and i both work on the tea estate as well as in the paddy field. the paddy gives us enough rice for the two of us as well as for my children, who are married and live in kandy [117 km away]. my day-to-day expenses are covered by the money i get from the tea estate. i sell all my raw tea leaves to the nearby tea factory at rs. 40 a kilo. my children, two daughters and a son are employed in kandy and are married and live there... when i am very old and unable to look after my property, i will rent it out. i hope that the two of us will be able to look after ourselves, without troubling our children. appuhami, an energetic elderly person, aged about 80, is able to attend to his personal needs and care, and lives alone in his 10-room house in his village. he owns a large piece of land in the village. his daughter and son are both married and live in the urban area of badulla. appuhami lost his wife several years ago. being a widower at 80 and living alone in the house, appuhami now feels somewhat lonely. however, he doesn’t like to stay with his son and daughter-in-law in their urban house, and doesn’t want to live in a home for the elderly, because he regards such facilities as being for the poor and the destitute. his wish is that his son should come and live with him in his house, which is not possible due to the son’s work. he thinks the best option for him would be for his son to visit him at least once a month and talk to him, show respect, and address him as ‘appachchi’ (‘honored father’). if the husband is alive, very often, an old couple stays together in their own house as long as they can work and support each other. if the wife is dead, the widower suffers badly, as de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 15 he is not accustomed to doing household chores or babysitting in the households of his sons and daughters. in the new domain of relationships with sons and daughters, the role played by the grandparents in urban and semi-urban communities has become a supportive one, rather than an authoritative or a production-oriented one. if the mother is a widow, she often stays in the household of a married son or daughter and looks after the grandchildren, prepares food, and attends to household chores such as washing clothes in the absence of the children who are out at work during the day. coresidence: dependency or independence? due to modern technology, in communities where paddy agriculture and fisheries are practiced, traditional knowledge has become redundant. the exploitation of fishing resources with new technology attracts young, physically fit and able fishermen, while the traditional fishermen who are now old and physically weak are marginalized. some traditional old fishermen have become absentee owners of fishing boats which helps them economically. however, the majority of old fishermen, who did not have the money or political power to own boats, have become dependent on their sons, which they dislike. they continue to live in their own houses with married children, but they work hard to make themselves independent of their sons. most of such old fishermen are engaged in inshore fishing, or work as night watchmen in boats, or work mending nets and repairing boats and engines. this pays for their daily expenses such as for tobacco and liquor. although the majority of old fishermen live with their sons in the original house, or in the houses owned by sons or sons-in-laws, they lead a life of discontent. … i meet all the needs for my father… i have told him not to go fishing or do any physical work... but he never listens to us… he comes home late for dinner and sometimes for lunch… he never uses his room to sleep… instead he sleeps on the verandah … every day he drinks … (fisherman son of an old fisherman, mirissa) drinking toddy and smoking are habits of most elderly men in the fishing villages, as well as in the colonies and estate communities. after drinking, the old fishermen spend time on the beach until late in the evening. one old fisherman told me that he had owned three large fishing canoes and a boat, but now he cannot go deep-sea fishing due to his poor physical strength. however, he uses his small canoe (küda oruwa) and fishes in the shallow seas. the money he gets from selling those fish is used for tobacco and liquor. we are nowhere (nannaththara vela)… we cannot go fishing in trawlers (tanki boattu)… they [young trawler fishermen] think we are physically weak… we are not important for the young people…. we are like pennies… (api sathe gaanata vatila)… i don’t like to depend (yapenna) on my children for my needs… i somehow earn my money and i look after my needs… (elderly fisherman, aged 71) elderly people in agricultural colonies, traditional villages and tea plantations hold similar views. the majority of older people in such rural communities continue to work into their old age and earn money for their living. the survey data show that 52 % of older people in the sample communities are involved in income generation activities, many of which demand physical labor. the research shows that physically demanding work among elderly people was more prevalent in agricultural, fishing and colonized communities. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 16 coresidence, preference for sons and care during old age table 7 shows that 59% of the elderly people in the sample villages live with their sons, while about 32% live with their daughters. however, a higher percentage of elderly women (39%) live with daughters in coresidence, compared with only 26% of older men who live in coresidence with their daughters. of the 101 widows in our sample, 60 live with married daughters and 13 live with married sons while others live on their own and some with unmarried children. of the 11% of all women who live with both son and daughter [row (g)], some live with their unmarried children. table 7: type of residence of older people by gender gender total type of residence male female living alone 13 (5%) 18(8%) 31(6%) living with spouse only 39(16%) 14(6%) 53(11%) living with son in original home 110(45%) 101(43%) 211(44%) living with son in his home 10(4%) 9(4%) 19(4%) living with daughter in original home 31(13%) 37(16%) 68(14%) living with daughter in her home 4(2%) 29(12%) 33(7%) living with both son(s) and daughter(s) in original home 28(11%) 25(11%) 53(11%) other 9(4%) 3(1%) 12(3%) total 244(100%) 236(100%) 480(100%) some elderly persons in the (c) to (g) rows are living with their spouse as well as children. widows are found in (a) and (c) to (h) rows. the finding of this study that elderly people more often live with sons is consonant with the cultural practice of bequeathing the parental house to the youngest son of the family. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 17 table 8: the provision by gender of elderly care to those who live in coresidence gender type of care provision always sometimes never male children provide food 48.8% 22.1% 29.1% children provide money 33.7% 18.6% 47.7% children provide emotional support 60.8% 12.1% 27.1% children abuse old parents 10 8.0% 1.5% 90.5% children do not respect old parents 7.5% 1.0% 91.5% female children provide food 75.1% 12.4% 12.5% children provide money 70.1% 8.5% 21.4% children provide emotional support 60.7% 13.9% 25.4 % children abuse old parents 14.4% 1.5% 84.1% children do not respect old parents 9.5% 0.0 90.5% with regards provision of food, monetary assistance, and emotional support to elderly people living in coresidence, around 30% of the elderly surveyed denied that they received such support from their children. the breakdown of elderly care by gender shows that there is a significant difference between male and female in receiving care from children. compared to male older people, female elderly are provided with more support and care by their children. abuses and poor respect by children towards the elderly were mostly reported by the female elderly. coresidence – a form of ‘bonded harassment’? often coresidence is seen in aging research as the best form of residential arrangement or ‘aging in place’11 for the elderly as it is assumed that it ensures the care and wellbeing of the elderly people. in sri lankan communities, coresidence cannot be seen as a substitute for paid nursing care, simply because paid nursing care in not a widely available option for the care of the elderly.12 as our data shows, coresidence is often a kinship and family based arrangement negotiated between parents and their children. our study further shows that coresidence does not guarantee good care for the elderly (table 8), and the presence of coresidence therefore has not necessarily resulted in high quality elderly care in sri lanka. reciprocity in care between parents and children is a widely established cultural norm among the sinhalese, and this is an important factor leading to the practice of coresidence. there are many adages, sayings and proverbs among the sinhalese that reinforce these behavioral obligations. children who fail to look after their elderly parents are socially condemned in the villages, more so than in urban areas. our study reveals that ‘reciprocity’ (cultural agreement) and residing in one household (physical arrangement) are fast becoming two separate concepts and are not necessarily linked as they used to be in the past. in one semi-urban family, a widow aged 87 lives with her son, daughter-in-law and granddaughter, but, in practice, she lives by herself in a separate room in de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 18 the house, cooks for herself in a shared kitchen, and manages her own expenditure. this shows that coresidence does not necessarily mean that children spend time with their parents or take care of them. living in coresidence often gives rise to additional work for elderly people as they have to attend to household chores and the needs of their grandchildren. as one elderly widow from the urban community explained … my daughter and son-in-law are working. they are not at home during the day. their two children spend time with me. i take their daughter to her montessori class and i keep the young boy on my lap until the class is over. then we come home and i feed the two children. i prepare lunch before we leave for the montessori class, as it is easier for me. you know children – they want to eat as soon as they come home… (widow, aged 68) one elderly woman in the fishing community said that i love these children so much… i take full care of them when my daughter, a teacher, goes to school in the morning … my son-in-law leaves home early in the morning to go fishing in the boat (tanki boattuwa), and comes home sometimes after several days. these two boys are very naughty … they never sleep in the afternoon and never allow me to have a nap… my only solace is sleeping at night after 10pm after the boys have gone to bed…. (widow, aged 71) an old woman living with her son and daughter-in-law in a semi-urban area said that my daughter-in-law is not good with me… she never shares her cooked food with me… i cook my food when they are not using the kitchen… when i don’t have vegetables, my daughter who lives elsewhere helps me to buy vegetables. when coconuts are plucked from trees in this garden, they keep them for their own consumption and don’t give me any… after all, this is my house although my son owns it now after my husband’s death… my daughter-in-law turns off the main tap during the day because she doesn’t like me washing my clothes and bathing… she is more concerned with the water bill than my cleanliness and health… when my other children call me, she disconnects the line before i come to the phone…’ (widow, aged 90). in one family in a rural community, the elderly father said that he does not speak with his daughter-in-law and never eats food that she has cooked because she had plotted and married his son without the consent of his parents. he said ‘i never allow her [the daughter-in law’s] parents or kinsfolk to visit my house… they have cheated us…’ our research reveals that the generation gap and cultural differences can have an impact on the expected reciprocity. old parents’ habit of getting up in the middle of the night and early in the morning, their lack of attention to the clean use of toilets, their adherence to traditional ways of eating and preferences in relation to food and clothing, their use of tobacco and chewing betel leaves and spitting are some of the aspects of their behavior that were detested by the younger members of their households. in urban and semi-urban communities where parents live in the home of their son or daughter, these problems are more frequent than in situations where they live in their own homes. sons or daughters, migrating to urban areas and aspiring to middle-class lifestyles, expect their elderly parents also to live by such mores. the imposition of behavioral changes on parents in such instances creates misunderstandings and problems for the older people living with their children. de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 19 a high-ranking government officer took up residence in an urban area after he was appointed to a new position, and brought his elderly father to live with him in his new house. the researchers met the father one early morning walking with difficulty towards the bus station and asked him where he was going. the father had come to live with his son, and his daughterin-law had brought him to their house a week earlier, but he did not like living with them as he felt it was like a prison (hirakuduwak). they were trying to control his behavior: they did not allow him to walk around in the neighborhood, or to wake up early in the morning; they did not prepare his morning cup of tea until quite late, and did not allow him to chew betel, and so on with many more complaints. therefore, he had decided to go back to his own house in the village and live by himself, and this was why he had left his son’s house in secret early that morning. one elderly man living in a semi-urban area was critical of the way that young people behave towards the elderly and said: some young people oppose what we say. people of the new generation keep their distance, and they have attitude ‘who cares about the old farts’. they are arrogant and neglect us. ... it’s true that the new generation does not respect the old. now see how they pay their respects: just bend, or touch the feet in the ‘indian’ style. it is not the way elders should be bowed to in our culture. this bad behavior has spread through television dramas (man, aged 68) a middle-aged person who followed us on our way back home after interviewing an old couple in the semi-urban community said that they were badly treated by their children. their son picks all the coconuts and sells them to the nearby boutique, never allowing his mother to use them. the mother cooks food for the whole family at her very old age and at her own expense, and her daughter-in-law frequently scolds her for not keeping the house tidy. the old parents were not allowed to switch on their tv or radio on full moon days (poya days) to listen to buddhist sermons as they would very much have liked to, on the grounds that it disturbed the school work of their granddaughter who was preparing for the gce al examination. the old couple did not disclose any of these problems to us in our interview, although they looked somewhat depressed and miserable. an urban elderly widow who lives alone in her own house expressed her view that older people have their own ways of thinking and doing things, which are different from those of the new generation. she said: i do not expect my children to be around me 24 hours a day. i have to entertain myself. i am responsible for my own happiness. i have friends on facebook. it’s so much fun! my niece puts pictures on facebook. i do not depend much on them [her children] for my happiness. i am not bitter. i know a lot of old people … they complain about their children. if there is a roof over my head …that’s enough for me (woman, aged 78) analysis of likert scale data on attitudes, behaviors and life satisfaction of older people shows that 85.0% of elderly women and 89.7% of elderly men were highly concerned with (1) feeling lonely, (2) loss of desires (including the desire to eat tasty food, wear attractive clothing, and sexual desires), (3) feeling bored, (4) loss of appetite, (5) anxiety about death, (6) getting respect from young people, (7) feeling happy and content most of the time, (8) feeling that other people live a better life than me, and (9) the presence of orthopedic problems. based on this data de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 20 we hypothesize that the prevalence of depression among the elderly in coresidence is much higher than what is reported by malhotra et al in 2010, who found that the prevalence of depressive symptoms among the elderly in sri lanka was 27.8% overall (24.0% for men and 30.8% for women), which is considered a high rate for an asian population. we observed that levels of anxiety increased with the duration of stay in coresidence conclusions modernization theories postulate the spread of nuclear families, a reduction in the proportion of adults living with their parents, and the disassembling of extended families. however, contrary to this, in sri lanka we have witnessed a large percentage of the elderly coresiding with their adult married children with very little change over the past decade. the proportion of elderly people living in their original house with their children and/or spouse has not significantly changed from 64% in 2003 (siddhisena 2005) to 61% in 2014 (current study). weighted averages show that in rural areas (all the communities except the urban and semiurban and estate communities), coresidence of the elderly was 82%. in the urban and semi-urban communities, it was 77%. the proportion of living alone or living with the spouse has increased from 11% (siddhisena 2005) to 20% in the present study, which can be seen as a recent development particularly due to the difficulties in coresidence experienced by the elderly. those who have opted to live alone lead an independent life, but at the risk of poorer care, support and security. as shown in this article, married children of older parents in urban communities live with their parents in parental homes due to their inability to purchase or build a house of their own. such forced coresidence has given rise to intergenerational problems and relationship issues making living in coresidence problematic for the older people. the older people also find that there are less elderly homes in sri lanka with facilities suitable for them to live an independent life – another reason for coerced living in coresidence. the changes in coresidential arrangements and many problems in such living arrangements including exacerbation of tension between the daughter-in-law and mother-in-law that existed in traditional times, and the increase in the proportion of living alone witnessed in this study can be seen as results of the limited nature of modernization in sri lanka particularly in relation to elderly care and management and provision of alternative living arrangements. conceptualizing coresidence as a means for the care of the elderly is somewhat misleading in sri lankan context. as shown in our research, coresidence occurs for a variety of reasons. often old parents are used to take care of houses and grandchildren while their married sons and daughters are out during the day. living in coresidence also assures the property rights of sons and daughters: elderly parents transfer their property into the name of their children, while retaining a life interest in the property, and this forces them to live with their children in their old age. the elderly enjoy little freedom to decide on their residential arrangements as few options are available. many elderly agree to live in coresidence because of the lack of any alternative, although it does not help them to fulfil their expectations for life during old age. coresidence is often the only way that an elderly person can live out their old age and it is the ‘aging in place’ in sri lanka. a number of social forces – the low availability and high price of land, the need for both husband and wife to go out to work, and the need to look after grandchildren in the absence of their parents – have all contributed towards forced coresidence de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 21 between elderly people and their descendants. this coerced living in coresidence has given rise to many different arrangements (such as living alone or with the spouse, cooking separately and living in a room of the main house) that have been developed by the elderly and their children in order to overcome the tensions and relationship issues that have emerged as a consequence. acknowledgements the authors thank ms. a.h. nirosha priyanthika for collection of data on the fishing village. the authors are grateful to dr. p.w.s. de silva and an anonymous reviewer for their comments on earlier drafts of the article. fellowship support from the institute of international education and the university of pittsburgh helped data analysis and writing of this article. the fieldwork done for this study is also the basis for a thesis which is being prepared by the second author of this article for a research degree. notes 1 http://www.un.org/esa/population/publications/wpa2009/wpa2009_workingpaper.pdf seen in july 2014 2http://www.un.org/en/development/desa/population/publications/pdf/ageing/worldpopulationageing201 3.pdf seen in december 2014 3 world bank 2011 http://www.tradingeconomics.com/sri-lanka/population-ages-65-and-above-percentof-total-wb-data.html seen in july 2014 4 http://www.statistics.gov.lk/pophousat/cph2011/pages/activities/reports/cph_2012_5per_rpt.pdf 5 colonized or colonization schemes are settlements established by the government for landless peasants. early colonization schemes were established by the british in 1930s, and there followed a series of colonization programs after independence in 1948 (see details in farmer 1957). 6 the percentage distribution by sector is based on the census of 2011. fishing and agricultural colonization villages are included in the rural sector (census and statistics 2011). 7 students are admitted to universities in sri lanka on the basis of marks obtained in the general certificate of education, advance level examination ( gce al examination) 8 recently in the us it has been observed that the adult children of middle-aged families tend to reside with their parents in the same households, a new development that has arisen due to high rates of youth unemployment (source: personal communication professor john marx, department of behavioral and community health sciences, public health, university of pittsburgh). 9 one amuna is equivalent to 2-2.5 acres of rice paddy fields. 10 abuses (as perceived by the respondents) of parents by children include scalding, restricting their movements, not allowing parents to use household facilities such as tv, radio or electronic http://www.un.org/esa/population/publications/wpa2009/wpa2009_workingpaper.pdf http://www.un.org/en/development/desa/population/publications/pdf/ageing/worldpopulationageing2013.pdf http://www.un.org/en/development/desa/population/publications/pdf/ageing/worldpopulationageing2013.pdf http://www.tradingeconomics.com/sri-lanka/population-ages-65-and-above-percent-of-total-wb-data.html http://www.tradingeconomics.com/sri-lanka/population-ages-65-and-above-percent-of-total-wb-data.html de silva and welgama | modernization, aging and coresidence of older persons anthropology & aging vol 35, no 1 (2014) issn 2374-2267 (online) doi 10.5195/ aa.2014.35http://anthro-age.pitt.edu 22 equipment, use of parents for childcare, use of parents’ income and earnings for household expenses by children, use of mothers as servants to cook food, wash clothes, etc. 11 “aging in place” is a term used in aging research to denote living in the original home with children and community with a degree of independence as opposed to “residential care”. 12 as at 2007, there were about 200 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"intergenerational support in sri lanka: the elderly and their children." 1996: 462-482 in tamara k. hareven (ed.), aging and generational relations over the life course: a historical and cross-cultural perspective. new york: walter de gruyter. united nations. world population ageing 2009. department of economic and social affairs world bank. sri lanka addressing the needs of an aging population. report no. 43396-lk. 2008. human development unit south asia region. modernization, aging and coresidence of older persons abstract modernization, aging and coresidence of older persons aging in sri lanka modernization, old age and coresidence methodology the traditional system of residence, inheritance and coresidence findings a decrease in coresidence? heterogeneity of living arrangements ‘kin in contact’ and coresidence rural-urban difference in coresidence work and coresidence coresidence: dependency or independence? coresidence, preference for sons and care during old age coresidence – a form of ‘bonded harassment’? conclusions notes references department of census and statistics, sri lanka. 2012. census of population and housing 33 (1).indd anthropology & aging quarterly 2012: 33 (1) 18 book reviews mclean, athena. the person in dementia: a study of nursing home care in the u.s. peterborough, ont: broadview press. 2007. isbn – 13: 978-1-55111-606-8. 312 pp., $27.95 (usd and cad) using the comparative method, athena mclean beautifully illustrates the sharp contrasts between two distinct models of “care” for cognitively-impaired adults in a large, multi-unit nursing home on the eastern u.s. coast. in this book – which won the new millenium book award from the society for medical anthropology – mclean uses ethnographic techniques, case studies, and robust theoretical and historical framing to describe and explain the care philosophies and practices employed in the two nursing home units she studied. one of the units is characterized by a regimented, task-oriented approach to elder care that ignores the resident’s remaining cognitive and relational abilities. in the other unit, a holistic, personcentered approach is in place in which attention is paid to resident needs, desires, and overall well-being. mclean successfully demonstrates the success of the person-centered care model in terms of resident outcomes, as well as employee and family satisfaction. the six case studies focus on the resident-staff microcosm as a way to explore personhood and illustrate differences in nursing home unit culture. mclean identifies and explains key unit differences as a function of the autonomy, background and approach of each unit’s head nurse. the unit of analysis, the resident-staff dyad, frames the presentation of the data to capture her theoretical and empirical interests with precision. readers from many walks of life will find this book compelling. some chapters will appeal to social scientists and gerontologists, while others will attract health care and aging professionals and/or those interested generally in the elderly in american culture. in many ways, this book is a work advocating for solutions to the deficiencies in the long term care system in the u.s. indeed, the book’s strong conclusion about respect for the whole person recommends a particular path for dementia care in the future. as someone with a new and growing interest in long term care, but engaged in organizational issues throughout my career, this book prompted me to think about alternate ways of exploring the culture of mclean’s field setting. i believe that her priority and focus on particular roles (e.g., nursing home resident and caregiving staff) could be enhanced and extended by researchers who bring an organizational-culture lens and an applied orientation to long-term care organizations. this dual emphasis might include an analysis of roles, but would likely explore roles in relation to organizational relationships, strategies, and functioning. for example, i kept wondering why the two systems of care co-existed, why there was little to no transfer of knowledge or personnel across the two units, and whether the presumed efficiencies of the regimented, taskoriented approach collided with the described superiority of the personcentered approach. mclean is clearly interested in policy – changing the way older persons with dementia are treated. she offers a whole section of recommendations for change. yet the absence of an organizational research component and an approach to organizational change diminishes, to a certain extent, the effectiveness and practicality of her recommendations. an organizational research design ideally would have included an examination of the larger nursing home administrative structure, ideology, and behavior. that vantage point would have illuminated the cultural patterns, skillfully described by mclean, within the context of rules and resources available to the larger organizational entity. organizational researchers would have focused on those factors that allowed the variation in unit care to continue, thereby shedding light on broader nursing home goals, decision making, and internal conflict. moreover, the metrics used to evaluate the performance of all roles within the nursing home hierarchy – including those in the management chain – would have been gathered to compare unit behavior with overall organizational expectations and effectiveness. in mclean’s study, nursing home management appears not to have been actively involved in the study or in its output. an ability to fully learn from the two-unit comparison, and innovate based on the results, seem to have been lost. these criticisms are actually compliments to the author. she has powerfully shown how the culture of nursing homes and the treatment of older adults with dementia need to change. her important, insightful, and well-written book is a call to action – but that action may in part require a different approach and orientation for the anthropologist or gerontologist, not just the nursing home. elizabeth k. briody, ph.d. founder and principal cultural keys llc anthropology & aging quarterly 2012: 33 (1) 19 book reviews jacoby, michael. ten more good years. new york, ny: look out films, 2008. 71 min. $15.95 (home version) $195 (institution with educator guide), $75 (community groups and non-profit organizations with educator guide) “i’d like to know would you really like to show me where you live, i’d like to know were you really ever there and when it all goes down i hope you’ll still be there.” these lyrics from the opening song in ten more good years, performed by sorenson & mechlowicz, speak to the often misunderstood experiences of gay elders in america—a segment of our population whom social science scholars often call “invisible”. in this documentary, michael jacoby presents views of growing old in the gay community through ethnographic interviews with four lgbt (lesbian, gay, bisexual, transgender) elders. why does the aging experience of gays merit an in-depth look? in his article, honoring our pioneers, jacoby relates that in his younger years, after forming a friendship with an elder gay man he learned about the plight of “a whole generation of men and women out there who had been left behind and forgotten . . . . they came out of the closet at a time when they could lose their jobs, family, and friends and even get arrested for doing so. they are the men and women who survived the aids crisis, battled government, and built lgbtfriendly communities in major cities across america . . . . it boggled my mind that so many of our heroes were facing such an onslaught of so many unfair circumstances with so little support and so few resources to turn to” (the advocate, sept. 12, 2009). contemporaneously incorporating some of the commonalities and challenges of aging experiences in america, the film also explores some important particular realities of aging for gay elders. jacoby presents a tapestry of personal stories, media clips, and factual data with an interweaving of expert testimony and commentary from what he offers as a series of reputable sources. included are representatives of sage, ny (service and advocacy for glbt elders); new leaf services, san francisco; the task force, ny; brian devries, phd, director of gerontology at san francisco state university; nclr, san francisco, (national center for lesbian rights); and the ny chapter of now (national organization of women), among others. commentaries by these experts highlight numerous injustices facing members of the gay community as they traverse the unknown terrain of growing old, shedding light on some unique challenges facing gay elders. terry kaebler (sage) explains why aging experiences can be different and present some particular challenges for those in the gay community. these challenges include an erroneous assumption by some care providers that all elderly are straight. this scenario can lead to difficulties or even an inability for some gay elders to access programs and services. other evidence shows how social service agencies, even those which receive federal dollars for senior services, too frequently indicate that “they are not accepting of gay elders.” jacoby’s sensitive exploration into the lived experiences of gay elders often speaks to the loneliness, isolation, and many losses—of life partners, financial security, health, and housing. he documents how some gay seniors, who were at the forefront of the gay rights movement in the 1970s, now find themselves, in their “golden years” returning to the closet—to secure housing, access community resources, and find acceptance. this film reveals a compelling truth: despite these harsh realities of what it means to be gay and old, there is often resilience among gay elders, an understanding of what it means to be different. a common thread among those interviewed is one that confirms, “we will take care of our own.” jacoby’s portrayal of being old and gay demonstrates their determination, survival, and pride in identity—giving voice to an oftenoverlooked segment of the american population. a strength of ten more good years is its inclusion of personal life stories of gay elders and testimony by gerontologists and lgbt experts. a weakness is its primary focus on aging gay males’ experiences, too often “hiding” aging lesbians’ experiences and perspectives. a more accurate portrayal of the lived experience of gay american elders would also have more diversity represented in terms of socioeconomic differences, rural vs. urban experiences and so forth. as a gerontologist, novice anthropologist, and member of the aging gay community, jacobys’ film opens the dialogue for continued exploration into what it means to age in america, and what it means to be human. this is an important film for anyone interested in lgbt, gender, and aging studies. ten more good years raises societal awareness, answers questions, and calls for programs and services that are sensitive to the needs of all elders, including those within the gay community. terri ann liller, mba, phd student department of anthropology wayne state university anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 82-100 issn 2374-2267 (online) doi 10.5195/aa.2015.84 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. personhood-based dementia care using the familial caregiver as a bridging model for professional caregivers michael gabriel fetterolf university of pittsburgh abstract with biomedicine at the forefront of our culture’s understanding of illness, personal healing is often neglected. it has become common practice to place elderly persons living with alzheimer’s disease in nursing homes or long-term care facilities that do not always regard their well-being as a top priority. this article draws from familial caregiving roles as a basis for understanding personhood, which i take to be a bridge between the world of a caregiver and the world of a person with alzheimer’s. furthermore, through the modeling of professional caregiving in familial caregiving strategies, i show how one might form meaningful relationships in long-term facilities, and likewise provide the aging and afflicted person with forms of healing. keywords: aging, personhood, caregiving, alzheimer’s, healing. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu personhood-based dementia care using the familial caregiver as a bridging model for professional caregivers michael gabriel fetterolf university of pittsburgh introduction the devastating effects of alzheimer’s disease are not limited to just the diagnosed. family members witness the vigor and personality of their loved ones “fade away, leaving behind a shell” (lock 2013:19) of the person they once were. amidst the biomedical drive to discover the biological mechanism that will cure alzheimer’s disease and family members’ search for their own explanations, the real needs of the person are often forgotten. the confusion, hopelessness, and loss of meaning which persons experience as a result of alzheimer’s must be accounted for. these persons need healing. for clarity, my usage of the term “healer” is adapted from the definition in curing and healing: medical anthropology in global perspective (strathern and stewart 2010). for strathern and stewart, a healer is defined as one who “restore[s] wellness to the body or person as a whole” (2010: 32). this definition must not be limited to one who “treat[s] specific conditions” (strathern and stewart: 2010: 32) which would be described as one who “cures.” the distinction is important for the argument of my paper. many symptoms of alzheimer’s can be treated separately by modern medicine, yet the disease as a whole remains incurable. as a result of the diminished ability to communicate, people with alzheimer’s are socially defined by their illness, rather than being a person with an illness. due to the state of being that the disease incurs, they are commonly not able to intervene on their own accord, or so we’re told, because it is thought that they cannot communicate effectively. yet, further research (basting 2001, jenkins and price 1996, lock 2013, o’connor, et al. 2007, strathern and stewart 1998) has shown that by turning to personhood, a guide to healing can be attained. this paper is primarily concerned with two caregiving settings: professional, long-term, care facilities (nursing homes) and at-home or familial settings. caregivers in a professional caregiving facility often experience high workload, low pay, and understaffing. nearly 60% of nursing home caregivers in a study stated that they are understaffed, have too much to do at one time, and have too little time to spend with residents (cocco, et al. 2003:82). understaffing in particular has been found to be associated with “more quality of care deficiencies” (harrington, et al. 2000:284). some of the shortcomings are being remedied by the ‘culture change movement’ in nursing home care that “goes beyond superficial changes to an inevitable reexamination of attitudes and behavior” (rahman and schnelle 2008:142). some examples of this movement are briefly mentioned below. susan eaton’s (2000) work explores the connection between economics, human resources, and the quality of care provided to the residents of nursing homes. she found that recent “regenerative community” initiatives such as the “the eden alternative” and “sisters of providence/ mt. st vincent care facility” are examples of care which oppose the conception that fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 83 83 people who enter nursing homes are in a state of “permanent irreversible decline” (eaton 2000: 608). although the above mentioned examples constitute a fraction of the 16,000 nursing homes in the united states, these examples depict situations in which a simple change in “managerial philosophy [had] transform[ed] nursing homes from impersonal institutions into safe, caring communities” (lopez 2006:55). lopez describes this transition as “culture change management.” in her discussion of the eden project, eaton attributes the principle that, “people need to give care as well as receive care to feel valuable,” to the founders of the eden alternative (eaton 2000:603). this principle is undoubtedly a very important aspect of eldercare that requires further research and implementation for caregivers and residents alike. this article is primarily concerned with quality of care and a route to provide individualized care in the current predicament of elderly caregiving and its institutional shortcomings. as an undergraduate student of anthropology, my research fieldwork consisted of volunteering on an alzheimer’s/ dementia-care floor of a nursing home in the northeastern united states during the summer of 2014 in order to investigate personhood amidst the manifestation of alzheimer’s. after just a short time at the nursing home, it became clear that i had not categorized the residents as the members of “the alzheimer’s unit”; rather they were frank, maria, rita, and leroy. there was something about each person that separated their symptoms and illness experience from each other. this realization allowed me to focus on each person’s illness narrative with a discursive network of meanings and expressions. i examined how their personalities, desires, expressions, and thoughts were still resonant in their present actions despite the progression or state of their dementia. bereft of a personal history or a familial relationship to an individual with alzheimer’s, a caregiver can still establish a sense of personhood with a sufferer of this disease. by encouraging an individual to express him or herself, and through a mindful-interpretation of his or her words and actions, one can relate to the person on a deeper level. this interpretation of a person with alzheimer’s present state of being, in relation to our society and to themselves in the context of their own life course, is that individual’s personhood. “personhood,” as defined by tom kitwood (1997), is “the standing or status that is bestowed upon one human being, by others, in the context of relationship and social being” (kitwood 1997 in o’connor, et al. 2007:1). establishing personhood with individuals with alzheimer’s can be the bridge to their world, the foundation for a caregiver-care receiver relationship, and an avenue to provide a sufferer with a sense of personalized healing. the frontiers of healing amidst incurable illness alzheimer’s disease remains an incurable illness that emphasizes the momentous importance for a focus on healing as opposed to biomedicine’s present infatuation with finding cures. toombs (2008), a sufferer of multiple sclerosis (m.s.), and the primary caregiver for her husband in his final years (who ultimately died of oral cancer) provides the reader with vital insight into the struggle of healing from an insider’s perspective. like alzheimer’s, both illnesses were deemed incurable by modern biomedicine. in living at the boundary: healing and incurable illness, toombs describes healing as: fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 84 whole person care, to the preservation or restoration of a sense of personal well-being, dignity and integrity that is not dependent upon the physical integrity of the body. even in the absence of a cure, it is possible to promote – and receive – healing (2008:2). toombs lays out the cultural implications of healing. four themes that are most applicable to alzheimer’s disease are the sufferers’ relationships with others, communication, connectedness, and culturally prescribed role of personhood. our society’s need to “de-emphasize relationship[s], placing inordinate value on autonomy and self-reliance” (toombs 2008:9) becomes particularly problematic for individuals with alzheimer’s whose existence hinges on the care provided to them by others. as a result, persons with alzheimer’s are stripped of their sense of self and status in a society; they are often referred to as “lost” and even hopeless causes. a distinction made by toombs that is particularly applicable to those with alzheimer’s is the dichotomy between “‘doing’ [as opposed to] ‘being’[…] a person’s worth is judged according to the capacity to produce (to be useful) or the ability to achieve a professional status” (toombs 2008:9). the culturally constructed sense of personhood assigned to those with alzheimer’s is not (and should not be) the only form of personhood that one is able to achieve in a lifetime. the recognition of this assertion can be especially fruitful in the attempt to provide them with healing. toombs suggests that placing the emphasis on being instead of doing will encourage loved ones to “look beyond the disease to the person” (toombs 2008:10). toombs’ ideas were largely developed from her interactions with her husband; they shared an interpersonal history spanning thirty-one years of marriage. the interaction between a caregiver and care receiver is confounded when one can no longer share this personal history, or learn about a one’s history (in the case of a trained caregiver for an individual with alzheimer’s). in a research study on caregiving for patients with alzheimer’s disease, jenkins and price assert, “dementia poses a number of fundamental challenges, not least of which is the fact that the caregiver can no longer be sure whether the care he/she delivers is as the patient would have wished” (jenkins and price 1996: 84). this presents a troublesome and counter-productive interaction for both parties involved. toombs’ ideas of healing, however, can become relevant in the discussion of alzheimer’s if we can establish a link or bridge from the perspective of the caregiver to the world of the care receiver. this link is personhood. for individuals who act as caregivers for their spouses or loved ones, there is a reciprocal sense of healing that motivates them to provide care. what motivates/ provides meaning for caregivers in long-term care facilities? suhonen et al. (2012) state that caregivers “perceptions of work satisfaction are positively associated with perceptions of individualized care” (suhonen 2012:486). individualized care is the belief that “all patients are different and require potentially different interventions to meet their individual needs” (radwin and alster 2002 in suhonen et al. 2012:481). in other words, in professional facilities which equip and encourage caregivers to provide individualized care, they experience a greater, more meaningful, and rewarding work satisfaction. individuals such as anne basting, dr. bill thomas and his wife (of the eden alternative) serve as models for the values and techniques that a professional caregiver should display. fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 85 85 professional (non-familial) caregiving a relatively recent study assessed what “professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia” (kalis, et al. 2005:1). the research found that the majority of participants mentioned “peace and quiet” as the most important quality representing a “good life” for individuals with dementia. the authors note that this makes a caregiver’s work “easier and more pleasant to do” (kalis, et al. 2005:40). this seems to present a problem. although ‘peace and quiet’ may be mutually beneficial for keeping agitation to a minimum and making the professional caregiver’s role easier, it should not be the defining factor for what constitutes a “good life” for a resident. the environment that managers shape for their workers produces the belief that ‘peace and quiet’ is the quintessential aspect of good nursing home care. eaton found from interviews with nursing home managers that they “did not trust their workers” and classified caregivers as being part of a “low-wage, high turnover cycle” profession (eaton 2000:597). by not placing value in quality of care, but rather in the ability to maintain sanitary and quiet environments, empathetic caregivers are often undervalued for their contributions. the satisfaction, or lack thereof, which caregivers feel regarding their place in the care provider chain has been positively correlated to effect the “support of patient individuality, individuality in the care provided, and knowing the person” among other independent variables (suhonen et al 2012:487). the establishment of a displeasing work environment may result in the hiring of unsuitable applicants. in a separate study which investigated nursing home staff members’ view of residents with dementia, 85.1 percent viewed residents with dementia as “behaving in a completely aimless way” (brodaty, draper, and low 2003:586). by judging the actions of dementia residents as “aimless”, nursing home caregivers are denying the potential of extracting meaning from residents’ actions. without seeing meaning in the residents’ actions, the prospect of individualized care is hindered. finding the bridge: fieldwork and first impressions i have chosen to write this article in an analytic autoethnographic style. a great deal of the literature on caregiving is survey or questionnaire-based analytic research. my writing and fieldwork benefit from the analytic autoethnographic style in that by bringing the reader into a moment of a sufferer’s illness narrative, he or she is brought into conversation with my article. this allows the reader, just as i have, to interpret the scene as they see fit. analytic autoethnography allows one to ‘set the scene’ and guide a reader to a conclusion, by using and introducing relevant literature to bound one’s observations within a cultural context. in addition it is “made possible by being a part of a culture and/ or by possessing a particular cultural identity” (ellis, adams, bochner 2011). finally, i feel it is nearly impossible to encompass the vast diversity in personality, interaction, and response to care in a questionnaire or by more rigid forms of data collection. leon anderson states that the five key features of analytic autoethnographic style are: “complete member researcher, analytic reflexivity, narrative visibility of the researcher’s self, and commitment to theoretical analysis” (anderson 2006:378). although this type of data collection is fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 86 “limited in its practical utility […] the social world under study gives the researcher an added vantage point for accessing certain kinds of data”(anderson 2006: 389), kinds that may often be missed by survey. my mode of gathering data consisted of participant-observation on an alzheimer’s/ dementia care floor of a nursing home in the northeastern united states. as a volunteer at the unit, spending time with the residents was my only task. other than occasionally wheeling residents to a common room, bathroom, or cafeteria for holidays (such as thanksgiving), i had no other duties or responsibilities. it immediately became clear that there was a wealth of knowledge to be unearthed having been afforded the ability to interact without many restrictions, communicate with the residents (in an array of different ways), and to participate in their daily lives. after each day that i spent on the floor and upon returning home, i wrote down everything i remembered in a journal. i wrote down things that seemed important (and conversely less important), things that impressed me, names, actions, ideas, short stories, interactions, impressions, etc. during my writing sessions and reflecting on my journal entries every night, i noticed that the residents’ actions no matter how nuanced or subtle starting taking on a new light. this enabled me to explore patterns and micro-behaviors during my following visits. the unit i volunteered at was a thirty-seven-bed floor of a nursing home. the home provided services such as: arts and crafts, pet therapy, religious services, music, sensory stimulation, and daily exercise. in the common room, where i spent most of my time, there was one caregiver who was responsible for ten to fifteen residents who were usually in the room, some were able to come and go as they pleased while others required more attention. if a resident’s behavior became too unruly for the staff, they were placed into what was called the “cool down room.” it was a somewhat dimly lit room with a recliner and a tv, adjacent to the common room. directly outside the common room there was an elevator that could only be used after the input of a code. intersecting the common room and elevator was a long hallway with residents (some in recliners, some in wheelchairs) scattered on either side of the hallway against the wall. the residents’ bedrooms branched off of this main hallway on both sides. on my first day on the alzheimer’s/ dementia-care floor, my first impressions matched up to what i had expected. after getting off the elevator, one of the caregivers led me to the common room where i spent most of my time during my stay at the facility. the common room contained ten to fifteen people sitting around (and facing) a television. the television typically showed a man singing live in an easy-listening concert. many of the residents ignored the television, while others seemed to be in a daze – looking out of the window or staring off into the distance. yet, some stared at the television (although i got the feeling that they were not really watching it, but rather looking at the tv because it seemed like that was what they were supposed to be doing). some residents seemed to be very uncomfortable in the room; they looked around constantly and usually kept to themselves. the mood of the room was very static; most residents were in wheelchairs or recliners and were advised by caregivers to “pick a chair” or would be asked if they were “in or out.” on the wall, there was a large poster with the date, month, year, and the weather outside. the caregivers who were on duty spoke very loudly to the residents encouraging them to introduce themselves to me; some did, while most of them ignored the suggestion. fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 87 87 the range of severity of dementia from resident to resident varied. i have chosen to convey the stories of leroy, frank, rita, and maria because these individuals were those which i had the most interaction with over the course of my stay at the unit. these four were always in the common room where i volunteered, and this allowed me to observe and participate in their daily lives day by day, which led to a greater understanding of how their life narratives and personhood intertwined and materialized. leroy the first resident that i came to interact with regularly was named leroy. he was known around the home as leroy “the singer,” and was introduced to me as such. leroy sported a white five o’clock shadow and typically wore a plaid button down, grey sweatpants and white socks. leroy was confined to a wheelchair but had no trouble using it to get around. running into people with his wheelchair to get one’s attention was not out of the ordinary for leroy. on my first day in the unit, one of the caregivers encouraged him to sing for me. after some time of hesitation he grabbed my arm with his shaking hand, looked me dead in the eye, and began to belt out a song. while never losing eye contact, he peered up at me as with a gaze that seemed to be waiting for approval of some sort from me. i had no idea how to react or what to say, so i just smiled and bobbed my head to his melody. after he concluded, the only words i could mutter were “that was amazing, do you know any sinatra?” he nodded his bald head as if he understood my question, and then proceeded to sing the same song again. he sang with the same intensity and once again sang for the purpose of gaining my approval. at this moment, while his hand was latched onto my arm, leroy and i were engaging in what toombs would describe as “healing communication.” although, this interaction contrasted to typical cultural and societal norms and roles, leroy demonstrated his newfound personhood, and i as the listener, validated this personhood. even for just that moment communication occurred on the basis of “touch, gesture, through facial and bodily expressions, through demeanor and attitude”. (toombs 2008: 8) although leroy was not demonstrating his culturally prescribed cultural role he connected with his surroundings and me in that moment, expressing himself in a way in which he felt most comfortable. leroy craved attention. often times he demanded it, regardless if i were talking to another resident. he implored that i listen to him by tapping me or yelling “hey!” he would become very agitated if i did not give him my full-undivided attention. one day, after demanding my attention several times, he began to repetitively ask me if i had heard an impersonation he knew. regardless of my answer, over the course of about ten minutes he repeated the introduction to the ed sullivan show. each time he asked me about the impersonation, the same progression of events transpired. first was the demanding of attention, followed by asking whether i had heard his impersonation, and finally the ed sullivan introduction itself. from time to time, i would explore a bit with my answer. i took note of how he would respond to each answer. it became clear that interaction with leroy was very difficult. it was very one sided; he seemed to act for his audience, and he paid no attention to any response, other than praise. one really had to follow his lead; you could not change the direction of the interaction. it seemed as though he had a few scripted acts that he was confident in and would not veer off the fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 88 path. i began to wonder if these types of communication were those, which received the most validation from caregivers in the facility, resulting in leroy’s comfort in performing them. another very interesting thing that i noticed about leroy was that every so often, he would turn over his shoulder and yell “alright!” in a very perturbed, aggressive tone. you could expect it to happen at least one time during every interaction that one would have with him. it was as if someone was nagging or reprimanding him, and he would respond with a curt, agitated, response. no one, however, was provoking him. i wondered if this was a subconscious window into leroy’s past. obviously he had some very vivid memories, of the ed sullivan show for example, yet this reflex could also possibly shed light on his background and personality. not wanting to assume that this reflex was just a meaningless side effect of the disease, i took note of it and tried to interpret it later. upon further reflection, i explored the possible causes and nature of the reflex, as opposed to how it could be physiologically explained. possibly, someone in leroy’s recent past had probed him to remember things, or had ridiculed him for his lack of memory. is it possible that this was a residual response to that? also, this type of response seemed to fit his personality a bit too well to be considered coincidental. his quick-tempered, impatient, and attentiondemanding personality would seem to go hand in hand with a reflex such as his perturbed “alright!” in retrospect, i wish i had allowed myself to give leroy more of a chance. i feel that i may have been somewhat reluctant to really form a relationship with him due to his irritable personality, but given more time i think he was definitely someone who could have shown me what healing means to him. in order to provide leroy with day-to-day care and healing one must take the time to understand his enacted personhood and note the subtle clues of his reflexes, responses, and actions. exploration into these subtleties, and recording and tracking them as the alzheimer’s progresses may prove to be very useful. furthermore, they may lead to more individualized healing strategies and therapies. frank the next resident i would like to introduce is frank. frank was a very lively man who was always smiling. he had a very warm and comforting smile; one of the caregivers called him the “mayor” of the unit. frank typically wore grey sweatpants, a white t-shirt, white socks, had a full head of grey hair, and stayed in a reclined chair. he always struck me as very cramped in his reclined chair as he constantly moved around in a seemingly endless search for comfort. beginning the first day i met frank, he always greeted me as if he had known me forever. he was a very personable man who loved to talk. as with many of the residents, each had certain topics and words that they were confident talking about, which would allow them an opportunity to open up. in many cases, including frank’s, it was the name of one’s hometown. frank was from anthracite, pennsylvania and loved to talk about it. even though many times he was not necessarily discussing about the town specifically, something about hearing its name triggered a familiarity for frank, which allowed him to confidently jump into a story. in many cases, bringing up the name of his town would elicit, “you wanna hear a story?” frank’s propensity to tell stories and interact is indicative of his inclination to perform. furthermore, frank was one of the most popular residents around the caregivers because of his fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 89 89 outgoing and jovial nature. as a result, frank received somewhat more attention from the caregivers. frank’s stories were many times referred to as “gibberish” by caregivers. his story would start off in a specific direction, then he would lose his spot or forget in which direction he was going, and implement an alternate progression of the story. for example, i was told by one of the caregivers that frank was “quite the football player in his day.” once after asking frank about his football playing days, he began to talk about football, and then just a few seconds later he was giving directions to a neighboring town, stating road names and giving distances on certain roads. often times, frank would yell “c’mon albert!” during a story without being prompted. i learned from the caregivers that albert was the name of his son. similar in nature to the “alright!” of leroy, this seemed to be reflex of some sort for this man. these reflex-like outbursts seem to be personalized and continuations of past conversations. frank, just like leroy, did not seem to pay the outburst much mind. i did notice it often marked a change in direction of his story (or segue into another impersonation in the leroy’s case). i never quite knew how to respond to frank’s stories. i would often just rotate through affirming and reassuring responses from “yeah,” to “i see,” to “ahhh,” and to “interesting.” furthermore, i found two more subtle practices on my part that were important to encouraging frank to continue his dialogue. first, was to always keep eye contact. as long as i kept eye contact, i found that frank felt that i was following along with his stories. the second thing i would sometimes do would be to act confused and somewhat perplexed, and then a few seconds later act as though his story had provided me with understanding. he responded to this, and i believe it gave him confidence in his discourse, and conveyed to him that we were connecting. frank would many times look down while telling a story and then trail off to see if you were still listening, but if i were to say something like “oh of course!” his vigor would return. perry offers a similar example in his research on spousal care, when he says, “some things, such as whistling a few notes of a hymn or laughing appropriately at a story or joke, were meaningful to spouses and regarded as competence” (perry and o’connor 2002: 58). by engaging myself in frank’s disconnected story, i “maintained continuity” and “supported his competencies”, essential principles posed by perry and o’connor. frank liked to tell stories. although i do not know his personal history, i was able to deduce that even amidst his condition, his inclination to tell stories was his “medium used for creative expression” (basting 2006:16) as well as an expression of his present-personhood. like many of the other individuals in the unit, the delusion of being able to leave the unit was a pretense that many of the caregivers would allow the residents to buy into as well as play along with. frank would ask me as well as the other caregivers if we could give him a ride home. the common response among caregivers was usually “sure when i’m finished my shift, frank,” and i myself after sometime learned to play along with it. at times, however, the residents did have a notion that this was not a temporary stay for them. for example, one day frank said to me, “hey you, down the hall, and two rights, and that’s my room, see my memory isn’t so bad.” this particular phrase struck me because it called a few things to my attention. first, i interpreted it as recognition of his state of mind. this phrase seemed infer that he understood his memory was fleeting. secondly, if even just for that moment, since he knew he had a room at the home, he knew his residence there was not simply a short stay. frank often displayed a conscious effort to prove himself and his memory capacity to others. at this moment, he was in the present, but he could lose touch with this reality within a matter of seconds. fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 90 rita rita was a resident at the nursing home who was very personable and fairly easy to talk to. from day to day, the conversations that i had with rita were very similar as a whole in content. typically, the conversation would start off with her asking where i was from. i had found out that rita was from a town adjacent to my hometown. but i discovered later that no matter where i said my hometown was she would say “is that by lavazza (the name of her hometown)?” rita seemed to have a very good grasp of her childhood and adulthood. she described that her father worked in the coalmines but was an alcoholic. her story was consistent from time to time, always reflecting the same elements. then after talking about her past for sometime, she would ask “so where are you from?” and the conversation would begin again. in addition to this, rita always told me that i was good looking and then went on to state i was her boyfriend. i always assumed she intended this in a joking manner. however, if i were to talk to other female residents, she would often get jealous. rita’s awareness of the present confused me. she seemed to remember my presence there, and that she had met me, but it seemed as though when a conversation broke, asking where i was from was her way of leading us back to a somewhat scripted dialogue. similar to the reflexive outbursts of frank and leroy, rita also had one. at times, during a conversation or when she was alone, she would yell “ouch!” and then start rubbing her hand. if i were talking with her, while this happened and asked, “are you okay?” she would sort of just ignore my question. it seemed like her outburst surprised her and her uncertainty to what happened and lack of control of her actions may have frightened her a bit. maria one of the women at the unit, maria, was a resident that i spent a lot of time interacting with. maria was still able to communicate verbally however she could very easily get lost in conversation. she was a resident whose emotions could fluctuate very quickly. in seconds, she could transition from laughing to irritated, crying, and aggressive. to complicate matters, in the weeks before i arrived at the unit, maria had fallen and broken her leg. her leg was cast up and she was propped in a reclined chair at all times. she often forgot that she had broken her leg, and when she would become irritated she would try to get up to leave, resulting in greater stress and confusion. this presented a challenging obstacle for the caregivers of the unit. they had to find ways to divert her attention away from her current unease and tried to relieve her anxiety. i interacted with maria frequently while being at the unit. as a volunteer, and since she needed constant attention, i sat with her and kept her calm. by calm, i made an effort engage her and keep her in a manageable state where she was not at risk of further harming her leg. i felt anxious my first time being presented with this task. i did not think i was ready for the responsibility and i was nervous that i would say the wrong thing, or that she would try to get up and further injure her leg (because as a volunteer i was not able to be involved with helping restrain residents). when conversing with maria i always tried to talk about things in the present, such as the weather, what was happening on the tv, or what she was wearing. i never wanted to frustrate or confuse her by asking her questions about her past. i found that keeping our discourse in the present was a very difficult task. fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 91 91 one day while i was talking with her, i said that i really liked her sweatshirt. it was a black sweatshirt with a black train on it. she responded saying, “see this train?” while pointing to the train, “my dad worked on this train.” i remarked that it was interesting and said i wish i had a sweater like that; she then went on to say that she had “100 of the same one, and 100 pairs of black shoes to go with each sweater.” when i said, “wow, really?” she responded, “well yeah! they’re in my closet at home.” after saying this, she then casually tried to get out of her chair. i immediately became nervous knowing she had a broken leg and could not get up. i told her that she could not get up and asked her what she needed, and she said, “well, i’m going home.” as she struggled to get up, she became very frustrated and started crying. the chair she was in was locked in a reclined position and her leg was set which made getting up difficult. during her struggle i called over one of the caregivers to help. the caregiver asked her where she was going and maria kept repeating “home. i’m going home.” what the caregiver said next surprised me. she said, “but maria, the bus isn’t here until three.” after hearing this, along with the reassurance that the caregiver would let her know when the bus arrived, maria calmed down. i was uneasy after the caregiver left, and did not know what to say so i said, “i like your sweatshirt, maria” and she responded, “see this train, my dad worked on this train…” the reflexes of personhood frank, leroy, and rita, all exhibited what i refer to as a seemingly involuntary “reflex”. after getting to know each person better, their respective reflexes seemed to suit them and their personalities quite well. clifford geertz’s (1994) notion of the duality of “meaning” behind a “wink” relates here. the reflexes that these individuals displayed varied and were enacted in group settings. residents with alzheimer’s experience a different perception of the world around them, just as geertz points out “culture is public because meaning is” (geertz 1994: 219). these public displays, whether “controlled” or not, had a deeper significance. it made sense that leroy – an irritable, quick tempered and aggressive resident – would have a rapid, irritated reflex such as “alright!” whereas, frank, a family oriented man who enjoyed talking about his hometown, would have a reflex pertaining to his family. finally, rita was a woman who seemed to be a rather emotional resident who enjoyed attention, pity, and often displayed signs of jealousy. a cry for attention or care, “ouch!” seemed fitting for her. as i stated above, i do think each of the reflexes were involuntary, yet the specificity of each reflex and its correspondence to a personality was more than mere coincidence. none of these observations would have been immediately obvious to me without first getting to know each resident thoroughly beforehand. it is possible that my own interpretation of each may be askew, because i do not have the background/history and context, which could provide a deeper meaning and foundation for each reflex. this describes an instance in which familial care would be useful. a family member who has grown to know one’s past and understanding one’s nuances and idiosyncrasies, may have insight that a caregiver would not be able to attain. they may be able to describe and respond to such reflexes more productively. as a result family members could recognize agitation or other subtleties in discourse more easily and respond in sympathetic ways more quickly. a second commonality among all the residents was the desire to go “home”. it seemed to transcend all of their other desires. although the mental states of the residents seemed to fluctuate, the constant feeling of being an outsider in an unfamiliar environment was fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 92 ubiquitous. i noticed that the only residents who really never spoke of going home seemed, in my opinion, to be the most ‘separated’ from the group. this made me wonder whether a sense of acceptance has come over these residents, or have they experienced despair that they withdrew from their social environment. in particular, maria’s plea to go home was the one that hit me the strongest of all, because of the deep intense emotion with which she pleaded. as described above, maria’s desire to go home was a frantic and very striking display of displeasure. maria exhibited intense panic and confusion, which struck me as one of the most eye-opening and heartbreaking experiences of my time volunteering on the alzheimer’s floor. when i saw the exertion and urgency she put into her attempt to leave, it struck me, “wow, this is real genuine pain and emotion.” her memory may be fleeting, she may be losing touch with her grip of reality, but the confusion, sadness, helplessness, and despair she felt in that moment was painfully real. maria seemed to be more prone to these emotional fluctuations as compared to other residents. it took a very specific style and type of interaction to calm her to the point that she was not a danger to further harm herself. the caregiver at the time acted with such a clinical efficiency and resolve that it had made me realize that this probably happens fairly frequently. the immense emotion that hit maria was more often than not a daily occurrence. how would this be different if she were at a place she called and knew as home, around individuals that know her and know how to comfort her? i can say with certainty that a great deal of pain would be avoided. in contrast, frank was very calm when he inquired about leaving. i think this calmness can be attributed to frank’s comfort with talking and being in social/group settings. he asked me multiple times, “hey, can i get a ride home with you?” it did not seem to be a pressing matter for him. it appeared he understands his current situation, but the next moment he seemed to lose touch with the desire to leave. frank’s intermittent moments of clarity intrigued me. but if nothing else, they evoke the constant stress that this desire can play even on a typical jovial and upbeat person. for maria, there is no resolution to her illness. a doctor cannot cure the biological mechanism that accounts for her symptoms, however, there is an opportunity for healing for people like maria. anyone can provide healing. it is tough for family members to be able to interact with a person who is a shadow of the person they once knew. however, maria did laugh, she could interact and feel happy. at first, i was a little bit appalled at the caregiver’s white lie that a bus would be coming. this did, however, provide maria with a much-needed peace of mind and calm in a distressed situation. i would refer to this type of work as healing. caregiver response to these interactions seems to take on a “weather the storm” mentality, which all things considered, makes sense. the caregivers of the unit, one being responsible for ten to fifteen, obviously form relationships with the residents and do get to know them in quite personal ways. the caregiver’s primary concern, however, is to maintain order, to keep the residents calm, and prevent them from hurting themselves or others. when a caregiver’s role is essentially to function as a babysitter, there seems to be something counterintuitive to any idea of healing. there is not much room for learning in an environment such as this. i was told that many of the residents’ families either do not visit or have moved away. the emotional stress of ‘losing’ a loved one to alzheimer’s also plays into one’s ability to detach themselves from a sufferer. if one can no longer interact on an emotional level, it may be easier to withdraw from them. an option to remedy this situation may be to create a set of fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 93 93 classes, as singh et al. suggests regarding india, that a family member or loved one could attend to enlighten them on the progression of the disease, and instruct them as to ways in which they could relate throughout the progression of the illness. ann basting calls this the “emotional level”. these classes would comprise of “behavioral management techniques, including problem solving, memory training, and reality orientation” (singh et al. 2013:55). mindful understanding and application of these themes would play an important role in maintaining and transitioning one’s relationship along with the progression of the disease as opposed to having the relationship and person “fade”. personhood-based caregiving in american culture, how would one recognize, or on what basis, would one assert that a person is truly capable of partaking in personhood? societal expectations in american culture may offer up the following: decision making ability, consciousness, or in light of toombs work, the ability to “do” as possible responses. yet, curiously all of these seem to infer a static definition of personhood, thereby allowing personhood to “fade” with age or declining health. there is no doubt that these social expectations dictate how care proceeds in professional care. through analyzing the frames of interaction between caregiver and care receiver, the type of personhood, which exists in a certain settings, emerge and take shape. frames of interaction are “definitions, of what is going on, which give meaning to behavior” (tannen 1985: 327). the frame of interaction that was established between caregivers and the residents in the nursing home was that the caregivers were the decision makers and residents were the passive receivers of a group-focused quality of care. the frame of interaction that caregivers created was focused on cultivating an environment that is beneficial for the group as opposed to the individual. caregiving was shaped by: cleanliness, peace and quiet, and keeping the private, less desirable, traits of these persons out of the public eye. this “framing” was a “ filtering process through which societal-level values and principles of conduct are transformed and refocused so as to apply to the situation at hand” (gumberz 2001 in park and takanashi 2011:185). in this setting, caregiving is enacted in terms of providing an environment that seems to mold the residents into passive subjects. in the familial caregiving model, there seems to be a more dynamic view of personhood. by the term dynamic, i refer to the tendency that with age or declining health, personhood can be founded or maintained on new principles as one ages or as one’s capacities change. as mentioned above, this depends on the culture in which the caregiving is provided. familial caregivers frame interaction with their loved ones somewhat differently than professional caregivers. their frames of interaction invoke a sense of meaning because the interaction between family member and the individual with the illness exhibits a sense of personhood that is mutually intertwined in both the personhood of the familial caregiver and the individual with the illness. the investment and effort to establish new interactions of personhood is a mutually beneficial endeavor (i.e., personhood aides in the healing of the sufferer as well as maintains meaning for the caregiver). in this setting, nurtured personhood is allowed to evolve. in an effort to provide a personhood-based caregiving model that establishes a more dynamic view of personhood for professional caregivers, i have adapted some of the most fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 94 important tendencies of familial caregiving models into a flow chart in the next section. however, i feel it is important to note that there is a pre-requisite to the incorporation of this chart. although i did notice how certain societal expectations dictated the macroscopic trends in caregiving in the nursing home that i volunteered, there were instances of sympathetic caregiving, which struck me as exemplifying “true care.” these were the non-scripted behaviors between caregiver and care receiver, which provided healing to persons in moments of agitation. the white lie to maria (about when the bus would arrive), the occasional rubbing of a shoulder of a resident, or always maintaining a smile regardless of how frustrating the caregiver’s task may be, would be examples of these behaviors. these were the redeeming aspects of genuine sympathetic care that were evident in the facility that i volunteered, providing crucial aspects for a familial caregiving model. bridging the gap in instances of familial caregiving, the socially stigmatizing effects of alzheimer’s are often kept to a minimum. in such situations, the actions of the individual with alzheimer’s are understood and personhood is maintained (perry and o’connor 2002, singh et al. 2013). whereas in a culture where the illness has become hypermedicalized, the afflicted are often placed in facilities which define them solely in terms of their disease. the loss of autonomy which accompanies the loss of familial and personalized care may be responsible for some of the socially stigmatizing effects that are often present among individual with alzheimer’s; one of the most notable being agitation. agitation is common among alzheimer’s patients in long-term care facilities (kalis, et al. 2005 and wang and herman 2006). further research on the topic of whether personalized familial caregiving would decrease agitation would be beneficial. a possible avenue to explore this topic would be to observe the frequency of episodes of agitation and ranking the severity of the episodes on a consistent scale, among familial caregiving and professional caregiving environments. one would need to also take into account the progression of the illness in the subjects of each group, to maintain consistency and minimize the amount of potentially conflicting variables. at its core, the disregard for the well-being of the elderly and dementia sufferers in conjunction with the lack of healing is one of the biggest problems facing our aging population. in america, medical rationalizations largely account for the increasing population of elderly individuals inhabiting nursing homes as opposed to home care settings. in contrast, the “culturally appropriate” search for healing of alzheimer’s in india is to: “design a program for family and kinship caregivers in the management of these diseases” (singh et al. 2013: 62); a program that “has reduc[ed] the level of agitation and anxiety in patients with dementia” (brodaty & gresham, 1989; haupt, karger, & janner, 2000, in singh et al. 2013:62). in america, the majority of money for alzheimer’s and dementia research is geared toward “prevention by means of molecular manipulations” (lock 2013:8). lock asserts that this approach is also of “direct link to the interests of big pharm” (lock 2013:8). these opposing approaches, beg one to consider whose real interests are at stake. despite the beneficial effects of familial caregiving, it is unrealistic to expect a shift in culture to occur in which the population will drastically increase the percentage of familial care cases. as mentioned by toombs, much of american culture is centered on “doing” which fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 95 95 decreases available time to deal with illnesses of loved ones. the duty to care give becomes burdensome and is placed in the realm of medicine, which delegate it to professional facilities such as nursing homes. yet, valuable information for professional caregivers can be gained from settings in which individuals with the illness are cared for by loved ones. in situations of familial care in united states, they are treated as “an intact person who has a disease rather than just a source of stress and burden […meanwhile] the overall goal of preserving personhood appears to benefit both [caregiver and care receiver]” (perry and o’connor 2002: 60). the point of this paper is not to devalue professional caregiving, but to call attention to some of the well-researched shortcomings of professional caregiving and propose an interim solution. to address the current problem of caring for the elderly, we must first consider the state of the caregiver. job satisfaction, understaffing, and turnover rate of caregivers have been addressed and must be acted upon. suhonen et al. (2012) believes that improving the work satisfaction of nursing home caregivers will ultimately lead to an increase in quality of care provided to the residents and allow caregivers to “stay committed” to their work (suhonen et al. 2012:487). a parallel assessment from castle et al. offers up the possibility of “care pairs” (permanent assignment of caregivers to residents) as well as more social activities (castle et al.2006:9) as solutions. ultimately, a greater sense of individualized care needs to be the goal of a nursing home. eaton states that “the typical resident spends at least ninety-one of 112 waking hours a week doing nothing whatsoever in the traditional facility” (eaton 2000:599), this needs to change. there are benefits to professional caregiving, if family members remain attentive and a part of their loved ones life. research has shown that some family members who admit loved ones into caregiving facilities are able to transition their efforts from aiding in their loved ones in tasks such as: “getting in and out of bed, dressing, getting to and from the toilet, bathing, [etc.]” (ory et al. 1999:181) to relating to their loved ones on a more emotional level. (alzheimer’s association 2014:33) furthermore, “residents who receive monthly visits…[achieve] a higher life satisfaction” (mitchell and kemp 2000 in port et al. 2005: 87). this is a very suitable and beneficial arrangement for one with alzheimer’s. however, this is not my target audience. i am primarily concerned with those who have minimal interaction with family members after being placed in a professional caregiving facility but still need the emotional relationship that family members can typically provide. professional caregivers can develop methods to care for individuals with the illness in ways that transcend personal hygiene and bodily maintenance. conclusion how does one provide healing for alzheimer’s sufferers, such as leroy, frank, maria, or rita, without having personal histories from which to contextualize their actions? i struggled with this question for some time because i had difficulty separating my understanding of healing from the heavy biomedical influence which has shaped it. familial caregiving serves as my model for “ideal” caregiving. i suggest that by juxtaposing the literature with my fieldwork one arrives at a particular conclusion, that personhood is congruent to culture in an institutional setting. one must see the person in a historical context. fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 96 figure 1 describes a flow chart that i propose will bridge the gap between caregiver and sufferer. immersion refers to the initial contact with a sufferer of alzheimer’s. i learned very quickly at the alzheimer’s unit that the disease is a spectrum, and no two patients exhibit the same symptoms or have the same actions. one must immerse themselves in who the person is at that moment in time. one must eschew preconceptions of what they expect the person to do or act like; let the person establish the direction of the relationship. for example: listen to leroy sing, focus attention on frank’s story, and allow maria to guide the path of the conversation. in other words, by immersing yourself in the actions of the resident one can establish a sense of personhood in their terms. the discussion of frames of interaction again becomes appropriate here. just as roles and expectations change from person to person, for example, between friend and parent, expectations of the residents differed from one resident to the next. understanding frames of interaction, which will best suit the expectation of the resident, is crucial to providing healing communication. after one arrives at a tentative understanding of how the resident acts and in which ways they prefer to establish a relationship, one can engage with them in different ways. one cannot simply passively sit and listen to residents. communication is a two-way street, this principle holds for interaction with an individual with alzheimer’s as well. one must look for meaning in what they do; avoid treating everything as a symptom of the disease; analyze reflexes; try to understand personalities; and find competencies. for leroy, it could be very easy to passively let him perform for you, but responding to his performances in different ways can unveil different avenues of communication. similarly, although frank and rita’s stories were difficult to follow, you must pay attention, affirm that you’re listening, and ask questions. rita could usually hold interaction as long as i was engaging her, but breaks in discourse usually signaled a tangential interaction or would seemingly “restart” the conversation. for frank, his stories typically went in different directions, but the reassurance that you were listening was very important to him. allow the resident to create and display their personhood with you and not for you. exploration, by definition, can lead to undesirable outcomes from time to time. it is important to remember things that agitated residents or gave them a feeling of uneasiness. adapting your role in the interaction to one that caters to their personhood and wellbeing becomes very important. here one must remember perry and o’connor’s themes of “supporting competencies, protecting from incompetence, and strategizing encounters.” it’s the caregiver’s responsibility to know and protect the resident from potentially harmful or distressing episodes. when maria became distraught about going home, knowing how to calm her in a second’s notice was critical. arriving at a solution for this type of episode obviously required some significant figure 1. non-familial caregiving flowchart fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 97 97 exploration but proved to be invaluable for providing her with a sense of peace, as well as fostering healing communication. it is important not to expect a conversation to make logical sense, rather appreciate it for what it is, a form of interaction. these “expressions of physical affection, and mutual pleasure in appearance, provide an area of meaning for lay care” (jenkins and price 1996:89). i became aware of the subtleties of their personhood, just as family members would know them. by serving as this corporeal memory for each person, interaction with each of them every new day, was easier and much more fluid. the healing had become a discourse and the discrimination between the disease and the person began dissolving. in the end, my limited research has provided basic awareness that non-familial caregivers can form relationships with individuals with alzheimer’s that mimic the care that can be provided from a family member or spouse. the ‘non-familial caregiving flow chart’ (figure 1.) is a fusion of toombs’ principles of healing for incurable diseases (relationships with others, communication, connectedness, and culturally prescribed role of personhood) fused with the strategies presented by perry and o’connor in spousal caregiving scenarios (maintained continuity, supporting competencies, protecting from incompetence, and strategizing encounters), mixed with my own ethnographic findings (however brief). this flow chart is meant for caregivers who do not know the personal histories of their residents, but wish to establish a relationship focused on meaning and personhood with the sufferer of alzheimer’s. research has shown that being at home doesn’t necessitate feeling “at home”. cutchin, owen, and chang have concluded, “meaningful activity in place is central to overcoming disruptions in the personplace relationship” (cutchin, owen, chang 2003: 242). in other words, for an individual to feel at home in the care they receive, they don’t need to be at their physical residence being cared for by a family member. it is meaningful caregiving that can establish this peace of mind. with the adoption of the methods mentioned above, i have no doubt that 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carolina academic press, (2010). suhonen, riitta, andreas charalambous, minna stolt, jouko katajisto, and markku puro caregivers’ work satisfaction and individualised care in care settings for older people." journal of clinical nursing 22(no. 3-4): 479-490. tannen, deborah and cynthia wallat. 1987 interactive frames and knowledge schemas in interaction: examples from a medical examination/interview." social psychology quarterly ??: 205-216. toombs, kay 2008 living at the boundary: healing and incurable illness. 2008 medical humanities lecture. baylor university, texas. 15 oct. 2008. lecture. fetterolf | personhood-based dementia care anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.84 http://anthro-age.pitt.edu 100 wang, kris l., and carol hermann 2006 pilot study to test the effectiveness of healing touch on agitation in people with dementia. geriatric nursing 27(1): 34-40. anthropology & aging quarterly 2010: 31 (1-2) 9 new publications in anthropological gerontology maria g. cattell let me know about your publications: mgcattell@aol.com. abbreviations: ai=ageing international; ijahd=internatl.j.aging & human development; jag=j. applied gero.; jah=j.aging & health; jaha=j.aging, humanities & the arts; jccg=j.cross-cultural gerontology; jg=j.gerontology; jg/ps= jg/psychological science; jg/ ss= jg/social science;qhr=qualitative health research; sir=social indicators research. *name in boldface indicates aage member. congratulations to *sherylyn briller for her new book, designing an anthropology career: professional development exercises (lanham md: altamira, 2009) (with a. goldmacher). *philip stafford for his new book, elderburbia: aging and a sense of place in america. see environment & housing. book reviews—of members’ books / by members review of *maria g. cattell & *marjorie m. schweitzer, eds., women in anthropology: anthropological and historical narratives (left coast press, 2006) by n. j. parezo in american ethnologist 36(4):799-800 (2009), & another review by c.m. counihan in rapportage xi:92 (2009). aging berger, k.s. 2008 the developing person through the life span, 7th ed. ny: worth. carr, d. 2009 aging in america: the link between productivity and resources in the third age. ai 34(3):154171. carstensen, l. 2009 a long bright future: an action plan for a lifetime of happiness, health and financial security. ny: broadway books. classen, a., ed. 2007 old age in the middle ages and the renaissance: interdisciplinary approaches to a neglected topic. ny: walter de gruyter. dagg, a.i. 2008 the social behavior of older animals. baltimore: johns hopkins up. henderson, t.l., k.a. roberto, y. kamo 2010 older adults’ responses to hurricane katrina: daily hassles and coping strategies. jag 29(1):48-69. krause, n. 2009 meaning in life and mortality. jg/ss 64b(4):517-527. krause, n. 2010 close companion friends, self-expression, and psychological well-being in later life. sir 95(1):199213. roszak, t. 2009 the making of an elder culture: reflections on the future of america’s most audacious generation [boomers]. gabriola island bc: new society publishers. sanjek, r. 2009 gray panthers. philadelphia: u of pennsylvania p. thomson, d.m. 2009 “are we there yet?”: challenging notions of age and aging through intergenerational performance. jaha 3(2):115-133. uhlenberg, p. 2009 children in an aging society. jg/ss 64b(4):489-496. aspects of caregiving abramson, c.m. 2009 who are the clients? goal displacement in an adult care center for elders with dementia. ijahd 68(1):65-92. eckert, j.k. et al. 2009 inside assisted living: the search for home. baltimore: johns hopkins up. golant, s.m. & j. hyde, eds. 2008 the assisted living residence: a vision for the future. baltimore: johns hopkins up. park, n.s. 2009 the relationship of social engagement to psychological well-being of older adults in assisted living facilities. jag 28(4):461-481. qualls, s.h. & s.h. zarit 2009 aging families and 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a populationbased study [winnipeg, canada]. jah 22(1):27-47. meri-esh, o. & i. doron 2009 aging with pride in israel: an israeli perspective on the meaning of homosexuality in old age. ai 34(1/2):42-59. noël-miller, c. & r. tfaily 2009 financial transfers to husbands’ and wives’ elderly mothers in mexico: do couples exhibit preferential treatment by lineage? roa 31(6):611-637. norwood, f. 2009 the maintenance of life: preventing social death through euthanasia talk and end-of-life care—lessons from the netherlands. durham: carolina academic. oliver, c. 2007 retirement migration: paradoxes of ageing. ny: routledge. raja, i. 2009 rethinking relationality in the context of adult mother-daughter caregiving in indian fiction. jaha 3(1):25-37. rasmussen, r.o. 2009 gender and generation: perspectives on ongoing social and environmental changes in the arctic. signs 34(3):524-532. sayer, l.s. & j.c. gornick 2008 older adults: international differences in housework and leisure [australia, canada, france, norway, slovenia, sweden, uk, us]. sir 93(1):215218. saxena, d. & g.f. sanders 2009 quality of grandparentgrandchild relationship in asian-indian immigrant families [in us]. ijahd 68(4):321-337. *schrauf, robert w. 2009 intracultural variation in crossanthropology & aging quarterly 2010: 31 (1-2) 12 new publications in anthropological gerontology cultural gerontology. jccg 24(2):115-208. *schrauf, robert w., ed. 2009 special issue of jccg: “addressing intracultural variation in gerontology.” simpson-young, v. & c. russell 2009 the licensed social club: a resource for independence in later life [australia]. ai 34(3):216-236. sung, k-t. & r. dunkle 2009 roots of elder respect: ideals and practices in east asia. jaha 3(1):6-24. tang, c.s., a.m.s. wu, d. yeung, e. yan 2009 attitudes and intention toward old age home placement: a study of young adult, middle-aged, and older chinese. ai 34(3):237-251. tetley, j., g. grant, s. davies 2009 using narratives to understand older people’s decision-making processes [uk]. qhr 19(9):1273-1283. tsuno, n. & a. homma 2009 ageing in asia—the japan experience. ai 34(1/2):1-14. wangui, e.e. 2009 livelihood strategies and nutritional status of grandparent caregivers of aids orphans in nyando district, kenya. qhr 19(12):1702-2715. comparative perspectives: ethnicity in the u.s. & canada eunju, h. 2008 exploring aging-in-place among chinese and korean seniors in british columbia, canada. ai 32(3):205-218. fiori, k.l., n.s. consedine, c. magai 2009 late life attachment in context: patterns of relating among men and women of seven ethnic groups [us]. jccg 24(2):121-141. müller, n. 2009 aging with french: observations from southern louisiana. jccg 24(2):143-155. logsdon, r.g., j.r. sharkey, a.k. hochhalter, eds. 2009 “promoting cognitive health in diverse populations of older adults.” special issue, gerontologist 49(s1). *hegland, mary elaine 2009 losing, using, and crafting spaces for aging: iranian american seniors in california’s santa clara valley. in the cultural context of aging. *jay sokolovsky (praeger), ed. pp. 301-323. liang, j. et al. 2010 evolving self-rated health in middle and old age: how does it differ across black, hispanic and white americans? jah 22(1):3-26. park, n.s. et al. 2010 transportation difficulty of black and white rural older adults. jag(1):70-88. reynoso-vallejo, h. 2009 support group for latino caregivers of dementia elders: cultural humility and cultural competence. ai 34(1/2):67-78. *schrauf, robert w. 2009 english use among older bilingual immigrants in linguistically concentrated neighborhoods: social proficiency and internal speech as intracultural variation. jccg 24(2):157-179. sims, r.c. et al. 2009 an examination of de-differentiation in cognition among african-american older adults. jccg 24(2):193-208. weitzmann, p.f., k. ballah, s.e. levkoff 2008 native-born chinese women’s experiences in medical encounters in the u.s. ai 32(2):128-139. demography li, q., m. reuser, c. kraus, j. alho 2009 ageing of a giant: a stochastic population forecast for china, 20062060. j.population research 26(1):21-50. [open access at springerlink.com] taylor, j. 2009 indigenous demographic and public policy in australia: population or peoples? j.population research 26(2):115-130. education ligon, m., k. ehlman, g. moriello, e.a. welleford 2009 oral history in the classroom: fostering positive attitudes toward older adults—the aging process. jaha 3(1):59-72. environment & housing *stafford, philip b. 2009 elderburbia: aging and a sense of place in america. westport ct: praeger. gender issues *hegland, mary elaine 2008 a discourse of complaint: precursors to a mass women’s movement in tajikistan? l’homme 18:47-65. history of gerontology anthropology & aging quarterly 2010: 31 (1-2) 13 new publications in anthropological gerontology andrews, g.j., l. campbell, m. denton, k.s. mcgilton 2009 gerontology in canada: history, challenges, research. ai 34(3):136-153. humanistic perspectives buettner, d. 2008 the blue zones: lessons for living longer from the people who’ve lived the longest. washington dc: national geographic. chittister, j. 2008 the gift of years: growing old gracefully. ny: bluebridge. finch, c.e. 2009 herodotus on diet and longevity: how the persians fed on dung and lived to 80, while the tall, handsome ethiopians ate boiled meat and lived beyond 120. jaha 3(2):86-96. graham, b., ed. 2009 eye of my heart: 27 writers reveal the hidden pleasures and perils of being a grandmother. ny: harpercollins. hughes, h.j., ed. 2009 beyond forgetting: poetry and prose about alzheimer’s disease. kent state up. narratives/life review gardner, p.j. & j.m. poole 2009 one story at a time: narrative therapy. jag 28(5):600-620. religion & spirituality idler, e.l., j. mclaughlin, s. kash 2009 religion and the quality of life in the last year of life. jg/ss 64b(4):528-537. research issues cagney, k.a. et al. 2009 neighborhood-level cohesion and disorder: measurement and validation in two older adult urban populations. jg/ss 64b(3):415-424. curry, l., r.r. shield, t. wetle, eds. 2006 improving aging and public health research: qualitative and mixed methods. washington dc: american public health association & gerontological society of america. feldman, s. & l. howie 2009 looking back, looking forward: reflections on using a life history review tool with older people [australia]. jag 28(5):621-637. jg 64b(supp.1), 2009, special issue on the national social life, health, and aging project. schumm, l.p. et al. (including *sharon r. williams) 2009 assessment of sensory function in the national social life, health, and aging project. jg 64b(supp.1):76-85. suzman, r. 2009 the national social life, health, and aging project. jg 64b(supp.1): 5-11. *williams, sharon r. & t.w. mcdade 2009 the use of dried blood spot sampling in the national social life, health, and aging project. jg 64b(supp.1):131-136. *williams, sharon r., g. pham-kanter, s.a. leitsch 2009 measures of chronic conditions and diseases associated with aging in the national social life, health, and aging project. jg 64b(supp.1):67-75. retirement giandrea, m.d., k.e. cahill, j.f. quinn 2010 bridge jobs. roa 31(5):549-576. theory dillaway, h. & m. byrnes 2009 reconsidering successful aging: a call for renewed and expanded academic critiques and conceptualizations. jag 28(6):702-722. ferraro, k.f. & t.p. shippee 2009 aging and cumulative inequality: how does inequality get under the skin? gerontologist 49(3):333-343. morse, j.m. et al. 2009 developing grounded theory: the second generation. walnut creek ca: left coast press. widows gillen, m. & h. kim 2009 older women and poverty transition: consequences of income source change for widowhood. jag 28(3):320-341. work czaja, s.j. & j. sharit, eds. 2009 aging and work: issues and implications in a changing landscape. baltimore: johns hopkins up. davis, m.h., l.a. kraus, s. capobianco 2009 age differences in responses to conflict in the workplace. ijahd 68(4):339-355. anthropology & aging quarterly 2012: 33 (3) 74 feature aging & anthropology in east asia introduction the population of older individuals has increased significantly in the past decade. this, coupled with increasing longevity, offers more opportunities for young adults to have contact with older individuals. research in western societies has indicated that young people construe communication with non-family older adults as often dissatisfactory and problematic (see hummert, 2010; williams & giles, 1996). consequently, younger interlocutors are often conversationally avoidant of older adults but, nonetheless, report it necessary to be respectful (gallois et al., 1999; ryan, kwong see, meneer, & trovato, a r t i c l e young adults’ perceptions of intergenerational communication: mongolian and american data christopher hajek, ph.d. department of communication university of texas, san antonio 1992). this profile is cross-culturally resilient to the extent that it spans an array of different cultures having disparate religious and social traditions (e.g., mccann, ota, giles, & caraker, 2003; ota, giles, & somera, 2007). the current study also aims to examine communicative behaviors that occur between generations. while the interaction between younger and older adults has been given a considerable amount of attention, there has been little, if any, examination of the encounters between young adults and middle-aged adults. this study will contribute howard giles, ph.d., d.sc department of communication university of california, santa barbara abstract this study examines mongolian and american young adults’ perceptions of intergenerational communication, specifically with respect to age stereotypes, norms of respect, communication behavior, and communication satisfaction. using the communication predicament of aging model as a theoretical framework, the relationships between these variables are investigated using regression analyses. young adults from both cultural contexts were asked to evaluate prior interactions with both middle-aged and older adults. the findings indicate a difference between how each generation is perceived, and the unique role of the middle-aged generation in mongolia is evident. key words: age stereotypes, age norms, vitality, benevolence, politeness, deference, respect, avoidance, communication satisfaction, communication enjoyment, middle-age, older adult, mongolia charles w. choi, ph.d. communication arts department george fox university d.sc anthropology & aging quarterly 2012: 33 (3) 75 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication to this line of research by investigating how young adults perceive interactions across the lifespan, with middleaged and older adults. due to a programmatic commitment to understanding intergenerational dynamics across cultural contexts, the current study compares mongolia a country with a recent history rich in political, economic, and social change – to the usa, applying a model of attitudinal and behavioral factors in intergenerational communication. in mongolia, the development of a recent democracy has replaced an older foreign system of government. this has created a shift toward the revitalization of traditional mongolian values, particularly with regard to how each generation is perceived, along with role adjustments for the different generations today. the evident cultural difference of mongolia, as compared to the usa, is also a reason to investigate this context. the unique upbringing of mongolian young adults should affect the intergenerational interactions with other generations (nomintushig, 2011). interestingly, little communication data has emerged from this nation, let alone as it relates to intergenerational exchanges. communication predicament of aging model the communication predicament of aging model (cpam: harwood, giles, fox, ryan, & williams, 1993; ryan, giles, bartolucci, & henwood, 1986) offers a theoretical perspective on communicative behaviors that can be found in intergenerational interactions. the cpam (see figure 1) proposes that when a young adult interacts with an older adult, a negative stereotype may be triggered by age cues associated with the latter. the physical and communicative characteristics of the older adult target (e.g., physiognomy, hair color, and voice quality) and the context of the interaction (that can make age salient and/or highlight a particular age subtype) will influence the stereotyping process (hummert, 2010), and have personal implications for the older individual (e.g. selfesteem). once these typecasts are triggered, the speech of the younger adult is adjusted in a way to accommodate the relational partner’s assumed deficiencies (hummert & ryan, 1996). the communicative behaviors seen in this interaction are best explained by communication accommodation theory (cat: e.g., giles, coupland, & coupland 1991; gallois, ogay, & giles, 2005). cat explores figure 1. communication predicament of aging model (cpam) (ryan et al., 1986). reprinted with permission from elsevier publishers. anthropology & aging quarterly 2012: 33 (3) 76 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication the ways in which individuals vary their communicative behavior to accommodate others given where they believe others to be, their motivations for so doing, and the social consequences arising. accommodative communication fosters a climate where conversational partners listen to one another, take the other’s views into account, desire to understand their conversational partner’s unique situation, and explain things in ways that “sit right” with their partner. an accommodative climate also features pleasantness, politeness, and respect and is predictably more positively perceived by the interactants involved (as well as thirdparty observers) than nonaccommodative messages (e.g., myers, giles, reid, & nabi, 2008). nonaccommodative communication can occur when the differences between the communicators are accentuated. the goals or motivations of this communication style include signaling disapproval or emphasizing social distance, which has the potential to make communication problematic (see coupland, wiemann, & giles, 1991). predictor variables of intergenerational communication satisfaction using cpam as a guiding theoretical framework, a program of research across different cultures has emerged to investigate intergenerational interactions further, and to determine the predictors (for young people) of the communication behavior within and how they, in turn, predict perceived satisfaction when talking with older adults (giles, dailey, sarkar, & makoni, 2007; giles, hajek, stoitsova, & choi, 2010; giles, makoni, & dailey, 2005). more specifically, intergenerational conversations are first regulated by the existing stereotypes of vitality and benevolence (hummert, garstka, shaner, & strahm, 1994), and the general norms of politeness and deference attributed to the various age groups (mccann, dailey, giles, & ota, 2005). these perceptions work as a psychological starting point, and then determine whether young adults will either communicatively show respect or decide to avoid such contact. subsequently, these communication behaviors produce the varying levels of fulfillment and satisfaction in these kinds of encounters (harwood et al., 1993). what will follow is a description of each of these concepts, how they fit within the theoretical model of cpam, and how they also work together to influence the overall success of an intergenerational interaction. age stereotypes: personality and benevolence. young adults have certain impressions about the physical ability and health of other age groups, and as the target age groups become older, this leads to attributions of decreased personal vitality. in contrast often, stereotypes of benevolence that include attributed wisdom, kindness, and generosity of a particular target age group correspondingly increase as the target age group becomes older (harwood et al., 1996; see also hummert et al. 1994; zhang, hummert, & gartska, 2002). filial piety. this is a cultural norm that prescribes looking after and respecting older family members, as well as older individuals in general (barker, giles, & harwood, 2004). while this type of respect is shared across different cultures, the extent of its influence has been seen to vary (see gallois et al., 1999). the concept – its recent erosion notwithstanding (giles, mccann, ota, & noels, 2002), has traditionally been associated with east asian (and other) cultures (e.g., ho, 1994; sung, 1995) such as the people’s republic of china, hong kong, japan, and taiwan. mccann et al. (2005) found that young adults would subscribe more to norms of politeness and deference toward older adults than their same-aged peers, and that these norms acted as predictors of communicative behaviors with non-family older adults. communicative behaviors. a key aspect of an intergenerational interaction is the communicative respect conveyed during conversation, and this can be understood from a cat perspective (see above). the level of accommodation that a speaker demonstrates through his/her communication can reflect the degree of respect apparent in the interaction. communicating respect is an outcome variable that can determine the success of an intergenerational exchange (giles & gasiorek, 2011). the cpam (see figure 1) underscores the importance of this behavior particularly for the older adult. the amount of respect conveyed in a young adult’s communicative behavior affects the self-concept of the older individual. specifically, the accommodating communication of a young adult (if perceived as authentic) counteracts the vicious cycle inherent in cpam. the amount of appropriate accommodation used in such interchanges has also been proposed as one reason the outcome can be perceived as either communicatively satisfying or dissatisfying (barker et al., 2004). a contrastive set of behaviors relate to decisions to avoid intergenerational encounters. avoidance is a broad concept that includes not only staying away from an interaction, but also finding ways to exit conversation or avoiding saying what one wants to say (cai, giles, & noels, 1998). ryan et al. (1992) conducted a study where young adults would engage in or avoid an interaction with an older adult based on impressions of physical ability. the resulting negative communicative output (i.e., under or overaccommodating communication) led to negative impressions of these interactions. even with more positive attempts, a younger adult may not feel appreciated for anthropology & aging quarterly 2012: 33 (3) 77 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication their accommodating efforts, or an older person may feel incompetent by the overaccommodating efforts. in these situations, both parties can feel discouraged. consequently, interlocutors may be deterred from seeking out these types of intergenerational encounters, and may avoid them altogether (giles & gasiorek, 2011). when predicting the overall satisfaction experienced by young adults in these intergenerational encounters, this line of research has, as mentioned above, been pursued in south africa and ghana (giles et al., 2005), india (giles et al., 2007) and, most recently, in bulgaria (giles et al., 2010). each of these cultural contexts offers variations on what predicts positive evaluations. for instance, in the usa, communicative respect and avoidance predict intergenerational satisfaction whereas, in india, age stereotypes are stronger predictors of this outcome variable (giles et al., 2007). the following section will offer a background to the mongolian context and its unique intergenerational context. mongolia: cultural parameters like many of the other cultural contexts previously analyzed, mongolia has also endured societal changes and political shifts that have had a significant impact on intergenerational relationships. over the last 100 years, mongolians have been influenced by different strands of social thought: the native nomadic way of life; buddhism; the communist state; the more recent democratic government; and the ongoing modernization of the country that is underlined throughout all of these systems (brunn, 2006). these changes and political shifts have had a significant impact on the mongolian culture as a whole and, in particular, the way various generations communicate with one another. these transformations have resulted in large-scale value and experiential differences between younger, middle-aged, and older generations; new social identities in regard to generational characteristics are being forged together with some desire to break with tradition (de la sablonniere, tougas, & lortie-lussier, 2010). over the centuries in mongolia, age came with a certain amount of prestige and respect. as people grew older, they would increase their ability to gather wealth and status in their communities. however, the influence of communism began essentially to separate the connection between age and wealth (pedersen, 2006). the more recent onset of democracy and capitalism similarly deteriorated this traditional connection. as a result, there is a growing tendency, especially in more urban parts of mongolia, to demonstrate less reverence toward older adults (cheng, chan, & phillips, 2008). the rise in more individualistic ideologies is apparent and older generations are expressing a growing concern for the future of these traditional practices (stol & adiya, 2010). additionally and in more urban contexts, older adults are not as much of a presence in the family unit. many older adults are choosing to stay in the countryside while their children’s families are moving into larger urban areas. this adds a unique dynamic to the intergenerational relationship in mongolia. urban adolescents seem to be growing more disrespectful toward this older generation, partly due to a lack of contact with older adults and, instead, it is the middle generation that is more often revered and constantly looked upon for leadership (pedersen & hojer, 2008). in regard then to the middle-aged, mongolia provides a unique setting where the middle-aged, in comparison to other age groups, has been given a significant amount of authority and status. due to the extreme political and economic changes that have occurred since the dissolution of the soviet union, the middle generation has, arguably, been forced to adapt to these changes the most over any other generation, and has also been viewed as the most influential and authoritative generation during this transition toward capitalism (stol & adiya, 2010). specifically, it is the increased group vitality of those who are middle-aged, and the limited exposure young adults have with older adults that create a unique status for this particular generation. in light of all the cultural changes experienced by the mongolian people, there now seems to be the growth of a conflicting paradigm, and a rise in efforts to re-establish the status afforded the older generation. the eldest men of a community are explicitly associated with the past, and there is a growing belief that the past before both communism and democracy was a morally superior age in comparison. as a result, modern mongolians are attempting to balance a revival of cultural tradition with the recent memory of two influential political structures in an efficient communist government and a potentially lucrative democracy. the tension begins with the idea of recapturing a culture and tradition that has been lost as a result of foreign government, followed by an understanding that communism provided quality in education and consistency in annual monetary earnings and, finally, that modernization through democracy provides an opportunity for a more promising future (brunn, 2006). there seems to be a split in sentiment toward the desire to become modernized and the value of mongolian traditionalism. the aim of this investigation is to identify evidence of these trends and to attain a better understanding of the intergenerational communication found in mongolia. anthropology & aging quarterly 2012: 33 (3) 78 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication predicting behavior: communicative respect and avoidance in the usa, young adults’ stereotypes of older adults’ personal vitality do, in fact, predict the reported avoidance of encounters with older adults (mccann et al., 2005). findings have indicated that the more stereotypical benevolence and personal vitality (i.e., positive perceptions) young people attribute to older individuals, the more these older adults are respected and not avoided. in various cultural contexts described above, the existing norms of politeness and deference have also been seen to predict communicative respect for older individuals (giles et al., 2010). according to the cpam (see figure 1), the existing stereotypes and norms of behavior should function as predictor variables for the communicative behavior found in intergenerational encounters. in addition, the cultural norms of intergenerational politeness and deference that exist in a given context should predict the communicative respect exhibited by a young adult toward middle-aged or older target age groups (mccann et al., 2005). hence, the following is predicted: h1: when young americans communicate with either middle-aged or older adults, communicative respect will be predicted by normative politeness and deference, while communicative avoidance will be predicted by normative deference and negatively by stereotypical personal vitality. returning to the mongolian context, due to current changes in political and economic infrastructure, the middle generation continues to grow as an influential age group leading mongolia in this post-soviet era. the stronger group vitality of the middle-aged (see giles et al., 2000) in comparison to other age groups in the current mongolian context should have an impact on the predictor variables that have emerged in previous research. specifically, a different pattern of predictive relationship might be expected to emerge between age stereotypes, age norms, and communication behavior. in order to identify what patterns emerge when middle-aged targets with high group vitality are inserted into the evaluative frame, the following research question is proposed: rq1: when young mongolians communicate with either middle-aged or older adults, will age stereotypes and age norms predict communicative respect and avoidance? predicting communication satisfaction as stated earlier, cat offers insight into the overall satisfaction that may be perceived within an intergenerational interaction (barker et al., 2004). as a young adult accommodates a middle-aged or older adult, this communicative respect may lead to a satisfying encounter for both parties involved. on the other hand, nonaccommodative behavior (i.e., underaccommodation or overaccommodation) should be negatively associated with communication satisfaction. regarding the predictive power of avoidance (i.e., nonaccommodation) in these previously found interactions, high communicative avoidance was found to be responsible for dissatisfaction in all settings, whereas communicative respect was potent only in africa (giles et al., 2005). with consideration of this significant nuance, the stability of communicative avoidance’s impact and the effect of communicative respect should be considered. therefore, the following hypothesis is proposed: h2: when young americans communicate with either middle-aged or older adults, intergenerational satisfaction will be predicted by communicative respect (and negatively by) communicative avoidance. with regard to intergenerational encounters in mongolia, prior research in this area offers some indication of the predictor variables that may be influential in intergenerational satisfaction (i.e., communicative behavior). it is unclear, however, how young adults might communicate with other generations in mongolia, and the role of both communicative respect and avoidance on the overall satisfaction in this interaction. therefore: rq2: when young mongolians communicate with either middle-aged or older adults, will communicative respect and avoidance predict communication satisfaction? method to test the hypotheses about intraand inter-generational communication perceptions, individuals from the two nations (usa and mongolia) offered self-assessed reports across three different target ages. using a within-subjects design, questionnaires asked participants to indicate their interaction experiences with non-family members or nonclose friends regarding middle-aged, and older adults. this design allowed for the analysis of more observations and an increase in statistical power. two orders of these age targets were presented for half the sample respectively: middle-aged, and older adults in contrast to older, and middle-aged adults. order effects were not apparent and these data were subsequently collapsed. anthropology & aging quarterly 2012: 33 (3) 79 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication participants undergraduate students (n = 409) from universities in mongolia and the united states participated in the study. the mongolian sample (n = 181; 93 females) was comprised entirely of ethnic mongolians, who ranged in age from 17 to 29, with a mean reported age of 20.12 (sd = 2.00). the participants were all volunteer undergraduate students from the capital city, ulaanbaatar, mongolia. the united states sample (n = 228; 100 females) was drawn entirely from communication undergraduates at a western university who received extra course credit for their participation. the majority of these participants were caucasian (53.5%), the remainder being of latino/a (12.8%), asian/pacific island (10.2%), east indian (2.6%), middle eastern (2.2%), african-american (.9%), and “other american” (2.2%) descent. their ages ranged from 18 to 34, with a mean reported age of 20.22 (sd = 1.85). the respondents were not asked to specify their citizenship or residential status. procedures and instruments for each target age, the questionnaires included measures of perceived stereotypes of the age group, norms of respect (i.e., how they believe they should generally interact with the age group), communication behaviors (i.e., how they actually behave during interactions with the target age), and communication satisfaction with the age group. participants were allowed to self-define these age ranges (i.e., middle-age adulthood, and older adulthood). respondents were allowed to self-define the age range(s) of the specified targets (e.g., middle-age adulthood begins at x years and ends at y years), as opposed to working from pre-specified target age ranges. the perceptions of “middle-aged” and “older,” were evaluated from relative standpoints using a within-subjects design.1 the scales were translated into mongolian and then backtranslated into english for validation. all items (7-point likert format) for these scales (as well as their original sources) are provided in mccann et al. (2005). separate analyses were conducted for the mongolian and american samples. confirmatory factor analyses revealed the same factors and general loading invariance between the two nations, and the same factors across target ages, for age stereotypes, norms of respect, and communication behaviors, and these were, indeed identical to the factors revealed in past studies and described above (e.g., giles et al. 2005). for the data collected in this study (both the usa and mongolia samples), the reliability coefficients (cronbach’s α) for the factors by each target were calculated (see below). age stereotypes. participants’ stereotypes regarding each age group were assessed (e.g., harwood et al., 1996) through a nine-item semantic differential scale: personal vitality (α = .67) and benevolence (α = .61). the personal vitality factor included six items about the physical ability and vitality of members from the target age group (e.g., strong vs. weak), and the benevolence factor included three items regarding the personality characteristics associated with a target age group (i.e., generous-ungenerous). norms of respect. participants’ beliefs about how they should act with each age group were assessed through seven items (gallois et al., 1999). the politeness factor (α = .88) refers to norms people feel they should enact during interactions with the target age group and included three items (e.g., “i should speak politely to them”). the deference factor (α = .75) refers to a restraint of behaviors during interactions and included four items (e.g., “i should restrain myself from arguing with them”). communication behaviors. communication behaviors during interactions with the three target ages were assessed through two dimensions: respect and avoidance across the nations and target ages. the respect factor (α = .74) included six items (e.g., “i accommodated to them”), and the avoidance factor (α = .72) included three items (e.g., “i did not know what to say”). communication satisfaction. this was assessed with each age using two items: “i enjoyed my conversation with them” and “i was not satisfied with my conversation with them.” the second item was reverse-coded so that greater scores indicated greater satisfaction and enjoyment. although these items were correlated in the american data from moderate to high degrees (r = .389 to .599, p < .01), not surprisingly, the correlations were much weaker in the mongolian data set (r = .198 to .279, p < .01). the entire data set, which included both the mongolian and the usa sample, showed too low of a correlation (r = .277 to .393, p < .01). previous use of this scale in ghana and south africa (giles et al., 2005) separated the two items when the reported correlations were too low (for older targets, r = .25 for ghana, and the correlation was nonsignificant for south africa). since the correlations in the mongolian sample were similarly low, and the reliability coefficients were inadequate, these items were assessed separately in the analyses (as communication satisfaction and communication enjoyment). results predictors of communicative respect and avoidance in line with mccann et al. (2005) and giles et al. (2007), separate regression analyses were used to determine whether the two stereotypes and two normative factors anthropology & aging quarterly 2012: 33 (3) 80 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication predicted the extent to which communicative respect and avoidance were reportedly enacted with middle-aged and older adults. h1 found only partial support. specifically, the predictors of communication toward older adults confirmed the hypothesis; however, when communicating with the middle-aged group, young adults reported some differences. the mongolian data also revealed some similarities and differences (rq1) across the two nations (table 1-4) that will be reported next. older adult targets. both politeness and deference significantly predicted respect toward older adults in the american data: self-reported displays of respect increased as participants’ beliefs regarding politeness and deference about older adults increased (table 1). the politeness finding was reflected, even more so, in the mongolian data (table 2). however, for mongolians, deference did not predict respect. when predicting avoidance of older adults, the stereotypes of personal vitality and the norm of deference were significant for the american data. that is, as participants’ views of older adults decreased in vitality, avoidance during interactions with older adults increased; avoidance also increased as the norm of deference increased. in contrast to the american participants, vitality and deference did not predict avoidance in the mongolian sample. in sum, and as one might expect, age stereotypes and norms are important predictors of intergenerational communicative outcomes, albeit less so for the mongolian participants. middle-aged adult targets. in the usa data set, norms of politeness about middle-aged adults significantly predicted respect toward the middle-aged: self-reported displays of communicative respect increased as participants’ beliefs regarding politeness when interacting with middle-aged adults increased (table 3). the norm of deference, however, did not predict communicative respect as predicted. from the mongolia data, it was norms of politeness, which was the only significant predictor of communicative respect (table 4). regarding communication avoidance, while americans reported that the norms of deference were a significant predictor, stereotypes of vitality did not seem to influence communicative avoidance. in mongolia, neither the reports of stereotypes nor the norms of politeness had any impact on avoidant communication. table 1 regression results for usa data (older adult targets) anthropology & aging quarterly 2012: 33 (3) 81 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication predictors of communication satisfaction and enjoyment in line with previous work in this arena, separate multiple regressions were conducted to determine the predictors of communication satisfaction and enjoyment with older and middle aged adults for each nation. h2 received partial support and the findings pertaining to rq2 offered additional insight into how mongolian young adults interact differently with the middle-aged in comparison to older adults. older adult targets. when the communication behaviors were used to predict communication satisfaction and communication enjoyment with older adults in the american sample (table 1), only avoidance was significantly related to satisfaction, while both respect and avoidance predicted communication enjoyment. therefore, h2 was partially supported. the same predictors were found in the mongolian sample (table 2). an increase in both satisfaction and enjoyment was related to a decrease in avoidance, and there was a significant relationship between communicative respect and overall enjoyment. middle-aged adult targets. in the american sample (table 3), identical to the evaluation of older adult targets, the predictors of communicative respect and avoidance impacted the overall evaluation of these encounters. communicative avoidance negatively predicted communication satisfaction: as avoidance decreased, the levels of communication satisfaction increased. for enjoyment, both respect and avoidance were found to be predictors. in the mongolian sample (table 4) avoidance similarly predicted satisfaction, however it was only respect that predicted enjoyment. unlike the usa sample, communicative avoidance did not predict the evaluation of enjoyment. when speaking with middle-aged adults, mongolians reported that a decrease in avoidance predicted an increase in satisfaction, but a decrease in avoidance did not predict overall enjoyment. discussion this study investigated the variables that influence the communication and the perceptions that young adults have about previous intergenerational encounters. when evaluating past interactions with various target age groups (i.e., middle-aged adults and older adults), the perceived table 2 regression results for mongolia data (older adult targets) anthropology & aging quarterly 2012: 33 (3) 82 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication stereotypes of each age group, the norms of how members from each group should be treated, the perceptual reports of the communication behaviors that occur, and the overall reported outcome of these interactions varied by the cultural context. the evaluations of these concepts identified predictor variables for communicative behaviors and evaluations of satisfaction and enjoyment when speaking with target age groups. cpam (figure 1) describes how the negative stereotypes, which are initially triggered by age cues, determine the communicative behaviors within an intergenerational encounter (hummert, 2010). the findings in this study demonstrate and support this phenomenon, but also indicate a difference in cultural behavior regarding how each generation is perceived. these data indicate the importance of cultural influences in any given context, demonstrate a need for more analysis of the predictor variables found within intergenerational encounters, and finally provide further insight into the patterns of behavior described in cpam. american young adults seem to adhere more to a norm of deference toward an older generation, but in mongolia, young adults reported that a norm of deference did not contribute to their efforts in creating an accommodating climate for the same target age group. the findings also described the unique status of the middle-aged generation in mongolia when compared to the same target age group in the usa. nonaccommodative communication predicted negative evaluations for all other intergenerational encounters in both contexts; however, even with the presence of this negative communication behavior, mongolians still reported that their interactions with the middle-aged group were enjoyable. the group vitality and position of this middle-age group in mongolia seems to outweigh nonaccommodating behavior. in a post-hoc analysis2, mongolians showed the same level of respect in their communication to the middleaged group as they would a member of their own target age group. similarly, the findings showed only a minimal increase in avoidance between young adults and the middle-aged in comparison to the more drastic increase seen in the u.s. sample. middle-aged adults tend to hold a significantly higher level of group vitality within a society (giles et al., 2000, ota, mccann, & honeycutt, 2012), table 3 regression results for usa data (middle-aged adults) table 4 regression results for mongolia data (middle-aged adults) anthropology & aging quarterly 2012: 33 (3) 83 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication and this appears evident in the cultural and historical characteristics of mongolia. this intergenerational quality seems to influence the communicative dynamic with the middle-age generation. the hypotheses and research questions of this analysis were generally supported. the predictor variables were found to be wide-ranging in both contexts for the communication behavior, evaluation of satisfaction, and perceptions of enjoyment. when comparing the usa and mongolian findings, these data proved to be helpful in more comprehensively understanding the impact of culture and historical influences within these interactions. additionally, the analyses of intergenerational communication offered insight into the array of influences that produce such interactions. let us now turn to discussing findings for each culture separately and as they relate to reported between-age group interactions. usa sample: intergenerational communication the first two hypotheses in this study pertained to the usa sample, and both were partially supported. similar to a previous analysis (mccann et al., 2005), both stereotypes and norms were seen to be predictors of the communication behavior found within an intergenerational encounter (h1). within the usa intergenerational setting the expected norms of politeness and deference determined an adjustment in communication by young adults toward communicative respect, thereby creating an accommodative climate. unfortunately, as also predicted, the same age cues also led a young adult to be more avoidant of these interactions (gallois et al., 1999). specifically, the stereotypes of personal vitality toward this older generation predicted nonaccommodative communication with older adults. just as the cpam proposes, when the stereotypes toward a particular age group become more negative, there is an increase in detrimental and avoidant communication behavior. when predicting the perceived satisfaction and enjoyment of an intergenerational encounter, this analysis looked at the communicative behavior as predictors (h2). for the current usa sample, identical patterns were reported when american young adults communicated with the middle-aged group. the findings indicate that a positive communicative adjustment, or accommodative communication, led to the overall enjoyment of these intergenerational encounters. cpam identifies the benefits of an accommodative climate for the older interlocutor, but being respectful seems to contribute also to the enjoyment experienced by the young adult as well. as for communicative avoidance, this variable clearly predicted both satisfaction and enjoyment. as the stereotypes, driven by age cues, triggered more nonaccommodating behavior, young adults seem to experience a reduced sense of overall satisfaction. cautiously applied, value may be obtained from these findings as they pertain directly to making intergenerational encounters more pleasant for both parties. mongolia sample: intergenerational communication in the mongolian sample, rq1 and rq2 address how mongolian participants evaluated interactions with middle-aged and older adults. the political and economic transformation of this context has resulted in a largescale shift in values over the past several decades, and interactions with older adults have increasingly been evaluated as negative in mongolia (pedersen, 2006). as in the usa, and according to cpam, the findings show that the norms of politeness predict communicative respect toward both middle-aged and older adults. within an intergenerational encounter a young adult is reminded of the cultural and/or contextual expectation of how an older adult should be treated (i.e. norms of politeness), and as a result a communicative adjustment toward accommodativeness occurs. however, even though norms of politeness were reported in these reflections upon intergenerational communication, a norm of deference seemed to have no impact on communicative behaviors in the mongolian sample. this actually demonstrates a distinct cultural difference between the usa and mongolia that may be caused by a rise in more individualistic ideologies throughout mongolia’s recent history (stol & adiya, 2010). furthermore, the lack of relevance of deference toward older adults to communication behaviors in the mongolian context is a surprisingly unique phenomenon in this cross-cultural line of research. previously collected data in both the usa (mccann et al. 2005) and india (giles et al. 2007) demonstrated that the norms of deference predicted accommodative behavior. however, this apparently is not the case in mongolia, and these young adults reported that a norm of deference did not contribute to the efforts in creating an accommodative climate. as feared by older adults in mongolia (pedersen & hojer, 2008), this finding offers evidence that young adults seem to be lacking in deference for this older generation. once again as elsewhere (i.e., usa, india, and south africa), the most potent predictor of intergenerational communication satisfaction in mongolia was communicative avoidance and, more importantly, the findings confirmed that communication behavior played a significant role in determining the perceived outcome anthropology & aging quarterly 2012: 33 (3) 84 c. choi, h. giles & c. hajek young adults’ perceptions of intergenerational communication of these interactions. the regression analyses showed that there was much similarity between the usa and mongolia in regard to what predicted both satisfaction and enjoyment, especially when older adults were the targets of evaluation. in answer to rq2, the predictor variables were identical in the mongolian sample as they were in the usa when evaluating communication with older adults. communication avoidance was the only predictor of satisfaction, and communicative respect and avoidance appeared as predictors for communication enjoyment. a difference, however, was reported when middle-aged adults became the target of communication. for the mongolian sample, communicative avoidance did not act as a strong predictor of satisfaction, nor did it play a significant role in predicting enjoyment. in every other context reported (i.e., the usa, india, s. africa, ghana, bulgaria, and when interactions with an older target age groups were evaluated) less avoidant communication, or underaccommodation, predicted more overall satisfaction and enjoyment. when young mongolian adults reported on communication with the middle-aged target age group, this was not the case, and it is possible that this may be caused by the overall group vitality of the middle-aged generation (giles et al., 2000). the findings from the mongolian sample seem to indicate that this middle-aged generation holds a unique position of authority in the social hierarchy of age groups. the group vitality of the middle-aged group in mongolia seems to negate the impact of even nonaccommodative communication. even with the presence of this negative communication behavior mongolians still reported that their interactions with the middle-aged group were enjoyable. the status of the middle-aged target is so high in mongolia that young adults report enjoyment from these interactions regardless of this negative communicative factor. this provides further evidence as to the differences between the two cultures, and specifically in regard to how this middle-aged group is perceived. limitations and future research these findings should be interpreted in light of some limitations, not least of which is the reliance, as before, on student populations. the experience of urban living college students with higher levels of education should be considered to be a unique perspective on intergenerational communication. the amount of contact that college students in mongolia have with the older generation may be significantly different than those who live in more rural areas. relatedly, the amount of contact should be included as a moderating variable and/or controlled to determine its influence on the existing stereotypes and norms of behavior when young adults interact with other generations. another limitation of this study was that the existing political attitudes of participants in the sample were not independently assessed. mongolia is unique in that the country has gone through considerable political and economic changes in just the past few decades. how young adults perceive communism and the soviet union may have an impact on their stereotypes of older generations who were contributors of this past political system. negative attitudes toward communism and how those political ideologies affected mongolian history, may be associated with older adults as an age group, and these negative impressions may have the potential to determine the evaluation of intergenerational encounters. despite these limitations, this study provided valuable data with an under-studied population in intergenerational communication research, and this mongolian setting is deserving of more focal empirical and theoretical scrutiny. yet again, this line of research has not been able to locate a cultural setting where the communication climate for older people holds any appreciable advantage for them. clearly, there is a need to further investigate the factors that incline young people to avoid older individuals (as in the usa) – or where they are less deferent (as in mongolia) and what adverse outcomes arise as a consequence. future work should continue to investigate all pertaining factors that work within these important intergenerational interactions. acknowledgements we are grateful to tamara afifi and rene weber for their comments and assistance and to the editor and reviewers for their incisive feedback on earlier drafts of this work, as well as to both christine park and tulga enhbaatar, in mongolia, for their assistance in the data collection process and the translation of scales. notes 1 perceptions of “young” “middle-aged” and “older,” were evaluated from relative standpoints using a within-subjects design. further 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http://ubpost.mongolnews.mn/index.php?option=com_content&view=article&id=6972:psychology-shaped-by-educational-system&catid=88888940:community-top&itemid=68 http://ubpost.mongolnews.mn/index.php?option=com_content&view=article&id=6972:psychology-shaped-by-educational-system&catid=88888940:community-top&itemid=68 http://ubpost.mongolnews.mn/index.php?option=com_content&view=article&id=6972:psychology-shaped-by-educational-system&catid=88888940:community-top&itemid=68 anthropology & aging quarterly 2010: 31 (1-2) 27 features just kill me when i’m 50: impact of gay american culture on young gay men’s perceptions of aging rob jay fredericksen, phd, mph boston university department of anthropology university of washington center for aids research 1312 s. dawson st. seattle, wa, 98108 rob.fredericksen@gmail.com the older you get is like a death sentence. [carlos, 28] after 30, that’s like gay middle age, right? [corey, 25] just kill me when i’m 50. [roger, 21] introduction young gay men’s negative perceptions of growing older have been indicated in prior research [bergling, 2004; jones & pugh, 2005; cohler & galatzer-levy, 2000]. a recent resurgence of hiv infection rates among young gay men [mitsch et al, 2008] calls into question whether these negative perceptions contribute to a lack of future-oriented health investments; i.e., a “live for now” outlook. strength of future orientation has repeatedly predicted risk aversion [mccabe & barnett, 2000], hence, it is of great social and public health value to ask: what does aging mean to today’s youngest generation of gay men? how do cultural norms in the gay community inform how today’s young gay men imagine growing older? this research explores these questions. background there is plenty of evidence to suggest that, for american gay men, one’s sense of growing older may differ from their heterosexual counterparts. despite advances in the gay and lesbian civil rights movement, the anticipation of homophobia continues to limit career options and mobility [barrett, pollack, & tilden, 2002]. gay “baby boomers” report being more worried about their financial outlook than their heterosexual counterparts [metlife mature market institute, 2006]. gay men face an economic disadvantage in the u.s., contrary to popular myths of affluence [badgett, 2001]. the institution of marriage, unavailable to most same sex-american couples, renders it a less definitive lifemarker of imagined future identity than it is for heterosexuals. finally, research among gay “baby boomers” has revealed anticipation of discrimination and/or unhappiness in old age; more than half [n=1000] were not confident that they would be treated “with dignity and respect” by health care professionals [metlife mature market institute, 2006]. at best, these factors create a sense of an ambiguous future; at worst, a dismal one. unfortunately, aspects of gay male culture add to these insecurities. the gay “mainstream” culture represented in gay men’s print, televised and online media, does little to resolve fears about aging. images of younger men are disproportionately featured, as with its counterpart in popular american media. the images perpetuate the notion that youthfulness, athleticism, muscular physique, and sexual power are a community standard. these standards of beauty are often reinforced in communities and spaces where gay men congregate, such as retail corridors in gay neighborhoods and entertainment venues. meanwhile, american popular media representations do little to create a positive sense of gay male future, as most gay characters on television lack long-term development as individuals, existing more visibly on the situationcomedy front, to provide little beyond comic relief [raley & lucas 2006; fouts & inch 2005]. the following analysis of the relationship between young gay men’s beliefs about aging and gay male culture is divided into four themes: young gay men’s experience of time, body, community, and personal resilience. methods individual interviews were conducted with a convenience sample of young gay-identified males living in the metropolitan seattle, wa area, ages 18-28. recruitment of men occurred through the use of posted fliers, seattle’s craigslist.com, and by recruiting from the “seattle citywide 1” room on gay.com. fliers were posted at every major university, and throughout the main gay-oriented retail neighborhood. anthropology & aging quarterly 2010: 31 (1-2) 28 features following informed consent1, hour-long semi-structured interviews were conducted in public venues [i.e., coffeehouses] with 42 gay-identified men. the interviews explored experiences and perceptions of time, and of the gay community. these men were paid $25 for the interview.2 many of these interviews lasted well over an hour, by choice of the participants. all interviews were audiotaped, and conducted by this author. the participants were made aware of the author’s identity as a gay man, in hope of establishing rapport and increasing the men’s comfort level in discussing issues and experiences specific to gay men. given that the subject matter concerned aging, it is worth noting that the author was in his mid-thirties at the time, older than these men, a factor which may have influenced responses. the men who participated in the one-on-one interviews closely represented seattle’s ethnic diversity [census bureau, 2006]. asian-americans were overrepresented [24% of study participants, compared to 13% of seattle’s population], and included members with chinese, filipino, vietnamese, samoan, thai, and cambodian ancestry. the latter six were second-generation [parents were born abroad]. the sample also had 12% mixed ancestry, 8% africanamerican, 7% native american, and 7% latino-identified. just over two-thirds identified as caucasian. with respect to age, respondents skewed a bit older. 43% of men were between ages 26-28, while 28% were 23-25, 24% were 21-22, and 22% were 18-20. approximately one-third were seattle-area natives, typically from its suburbs or adjacent counties. onefourth were from western states, particularly california, oregon, and montana. the remainder were from points further east. approximately 40% had had substantial exposure to gay culture in other large cities, either through living there or frequent visits. in the area of academics, 40% had no higher-education aspirations or experience; the remaining 60% did. of the latter, 60% were [or planned to be] liberal arts majors. the remainder were divided roughly evenly between the sciences and mathematics. two-thirds of participants were employed at least part-time. 15% of the men identified themselves as artists. the remainder were primarily in school. three were in substance abuse recovery, two from crystal meth, and one from alcohol abuse. two identified themselves as hiv-positive. audiotaped data was transcribed and coded for themes within the categories of “experiences/perceptions of time” and “experiences/perceptions of community”, using inductive, open-coding. two separate categories arose from this coding process: experiences of body and experiences of resilience. themes within these two new categories were also coded using this method. young gay men’s experience of time the developmental context in which gay men’s identities emerge creates a perception of time unique to their heterosexual counterparts. due to widespread stigmatization of homosexuality in adolescence, many young gay men, for social and physical survival, must conceal their true identity. opportunities to date other men came later for the men interviewed heretypically once relocating to an urban or college environment. those who had done so expressed an intense need to “make up for lost time”: as a teenager, i had no vision of the future as a gay man. i didn’t know what to do with myself. i wanted a life partner. i didn’t know where to look. i hid from peers in high school, because i knew i’d be stigmatized. finally, when i got to the city, i just wanted to explore the sensory aspect. like a kid in a candy store. [frank] often, “making up for lost time” came at the expense of planning for the future: when i first came here, i was partying a lot [with gay friends], doing a lot of cocaine, smoking more, not really caring about what happened to me, just kind of having fun and living for the day…i didn’t want to worry about what was going to happen down the line. i didn’t want to be old or worry about tomorrow. [corey] three of the men even turned down college scholarships, two of them full scholarships, prioritizing the need to concentrate on their newfound freedoms. two of them explain: law school sounded so ordinary, so lame. my parents are furious of course [about declining the scholarship]; they’ve cut me off financially. i can understand. but i’ve worked really hard to do well in [high] school, hit all the right marks, save money, be responsible. i was trapped out in the suburbs for so long...i don’t want to be weighed down like that anymore. it’s my turn to have fun. [andrew] 1 boston university irb approval #1633e. 2 funding provided by the boston university department of anthropology. anthropology & aging quarterly 2010: 31 (1-2) 29 features i turned down full ride minority scholarship to [rural in-state university]…but i got so caught up in making money, being out [as a gay man] and on my own terms, i lost track of that. i couldn’t get into the idea of being out there in the middle of nowhere. [curtis] from the comments of these men, the need to experience and explore this aspect of themselves heavily informed decision-making. the isolation of young gay men in their adolescence prevents opportunities for learning from experiences of flirting, dating, or interacting with same–sex romantic partners. the delay has been called a “developmental disruption” [kertzner 2001, p.80]. youth-focused standards of beauty boost the importance of this exploration period as critical for seizing dating opportunities. in the young gay male perspective of time, the period of one’s late teens and early twenties comprise a highly compressed period between post-isolation and pre-“oldness”; a limited window to avail oneself of the opportunities afforded by youth and freedom. at the cultural level, this creates both a dynamic yet high-pressure environment for partner selection and dating. some, like those who forewent college scholarships, discounted the future in order to concentrate on meeting these developmental needs. some men felt pressured to attract long-term relationships in their twenties while it is still felt to be possible: once you get out of your 20s i think people start considering you to be too old. like you’re not going to be wanted, won’t be able to get a boyfriend. [david] the type of guy i’m looking for is out there somewhere. but sometimes i’m like, if it’s not going to happen now, when is it going to happen? [corey] the need to “make up for lost time” in one’s twenties stands in contrast to the heterosexual experience, in which goals of marriage, child-rearing, and career mobility are pursued during this same time period. by contrast, heterosexual life is often viewed as normative and stable “in relationships and markers of aging…social status and a sense of place in life”, accounting for why some middle-aged gay men have described feeling “off sequence” relative to their heterosexual peers [kertzner, 2001, p. 85]. similar sentiments have been expressed by gay men in their 30’s [cohler & galatzer-levy, 2000]. for some, the lack of clear expectations or longitudinal structure in gay male identity was discomforting. a common fear was that they would remain feeling unhitched to anything, i.e., careers or romantic partners, or that they would never figure out “what it is [i’m] supposed to be doing”. as one man lamented: “there’s no handbook of gay life. you figure it out as you go.” it has long been theorized that gay men undergo an accelerated sense of middle and old age compared to heterosexual men due to a sense of “role loss” [francher and henkin, 1973], which leads gay men to go from a kind of “youth” to “not-youth” with little gradation in between. this resonates today: recent research has found “old” in gay subculture to mean age 40, and sometimes as early as the mid-30’s [bergling, 2004]. the sharp transition between what it means to be “young” vs. “old” was echoed in some of the men’s comments: …the point where you turn 30. that’s when you’re considered old. [frank] i’ve felt like i’ve had to hang out in [older men’s gay bar], since i’ve been losing my hair, i look older. [michael] temporal perceptions like these front-load one’s post-adolescent years with a sense of urgency to meet intimacy and relationship goals before one is “old”. this leaves the period after age 30 to be regarded as frighteningly ambiguous territory, as young gay men find themselves facing the prospect of diminished self-worth and quality of life in the future. as will be discussed in the next section, young gay men’s experience of community adds to the ambiguity to one’s sense of self in the future. young gay men’s experience of community all of the men interviewed for this study had migrated to large cities or college towns to live, from contexts of relative isolation from other gay men. this move was often eagerly anticipated: when i was a teenager it felt like gay culture was just a matter of getting there…it seemed like another nation was waiting, pride flags and all. [michael] anthropology & aging quarterly 2010: 31 (1-2) 30 features the “pride flag” michael references is a multi-colored “rainbow flag” well known to most gay americans, meant to convey a gay cultural attribute of embracing cultural, ethnic, and sexual orientation-based diversity. however, this attribute was felt to be more aspirational than actual, particularly to men of color: the idea that we [as a community] actually stand up for everyone that’s just like us is false. [tyson, africanamerican] this week’s pride parade…diversity [refers only to] sexual orientation in ‘gay pride’ terms. we don’t really accept everyone. we’re in fact fueled by race, by age…the irony of the alphabet soup [of lgbtq3], the pink elephant, is that we don’t embrace diversity. we’re not all ‘one’.” [mark, asian-american] while most men felt it important to be a part of a gay community, nearly all reported feeling “outside” of both gay male culture and community. this was best summarized by adam: i feel more like i’m part of a [gay male] culture than a community. i see a lot of [the same] people, but i don’t know a lot of people. when i think of ‘community’ i think of first name basis, support…i don’t really feel that …we don’t hit it off because of our sexuality necessarily…this is an illusion. in fact, alienation was a strong theme among men’s discussion of gay men’s culture and community. the men’s emotional connections with the gay community followed a common pattern: initial fear/dread of being publicly known as gay men, typically before migrating away from family-of-origin; pre-migration excitement and anticipation of connection to an idealized gay community; subsequent “let down” when expectations are not met upon arrival; and acceptance/integration of expectations with reality. the men represented all parts of this continuum, with most in the “let down” phase. some had hoped to have already established a long-term relationship, but had not, or had experienced heartbreak along the way. others had envisioned a stronger sense of interpersonal connection. others had hoped for more stimulating night life. gay men’s bars bore the brunt of the blame for these “let downs” and feelings of alienation, and were widely resented as what was felt to be a “default” social outlet: the power of the bar is enormous in gay life. when it’s good you’re all ‘this is the best time ever!’, but when it’s bad, it’s devastating. [stephan] unless you’re out in the bars, you feel like you’re invisible….[carlos] another observed the irony of bars as a default social setting: …we hunker down and go to bars by default, but then complain because we feel like we are around ‘bar people’. [matthew] unmet utopian expectations may resonate at the cultural level as collective disillusionment, sometimes to the point of disdain, for gay men and gay culture. some of the older men had moved beyond the “let down” period and began to accept the realities of gay culture, both positive and negative. many, however, remained in a state of disappointment, still positioning gay cultural realities against their previous utopian ideals. the unmet expectation of belonging within a culture or community, and the resulting disillusionment, has negative implications for young gay men’s visualization of the future. the prospect of isolation leaves the quality of one’s future in question, again, rendering aging as something to be feared. finding older gay male role models sometimes proves difficult. few of the men interviewed acknowledged knowing any older gay men. there is a documented lack of communication between generations of gay men [bergling 2004, peacock et al., 2001] confirmed by this research. this is at least partly attributable to the very different social climates in which each generation of gay men came of age: the sexual revolution and prior repression; the devastation of the aids epidemic; advances in human rights; the rise of the gay consumer market [bergling, 2004; bohan, russell, & montgomery, 2002; kertzner, 2001]. it has even been suggested that a “generation” in gay life “is a matter of a few years rather than a matter of decades” [bohan et al 2002, p. 21]. there was a lack of desire to connect with older gay men. reasons for this included perceived bitterness and pessimism, especially about monogamy: 3 lesbian, gay, bisexual, transgendered, and queer community. this acronym is commonly used describe these parts of the community. anthropology & aging quarterly 2010: 31 (1-2) 31 features guys in their 30s and 40s seem bitter and harsh. if you’re only in an open relationship because you think you can’t have monogamy, that’s not good. [michael] some [older gay men] are bitter that some young guys have more powers such as coming out in early age, have more rights than they did when they were our age. [jeff] the perception of older generations as less monogamous fed into a more general stereotyping of older gay men as promiscuous and predatory of younger gay men. it’s a rarity of connection, across generations. some of them just go, oh, so you’re a young stud…imagine the possibilities. [tyler] there was also a perception of older gay men as socially exclusive. some men felt it was difficult to connect with older men when attempting to participate in social activities beyond the bar scene, many of which were felt to be more for older men: [gay resource center] has coffee talks, but who wants to sit around. i just prefer more active social things. there is [running group] and gay hiking, but these are a lot older guys…certainly not anyone college age. i don’t like that bar or online feels like the only way to meet single guys…it’s tough to interact in those settings. i wish there were other social things that weren’t way out of my age range. [michael] when you’re in those groups, it’s hard to break through [to a personal level] to make strong friendships/ relationships…easy to join, hard to connect. it feels like exhausting work. [clark] guys who are older have their own little circle. there’s not much interaction in between generations, not a lot of opportunities. [matthew] in general, perceptions of gay male life past 30 are based on stereotypes. the impact on imagined futures of younger gay men are easily apparent: absence of role modeling, and difficulty visualizing positive older versions of oneself. the sum of these perceptions, suspicions, and experiences, limit opportunities for young gay men to glimpse positive futures through their older peers. young gay men’s experience of body the prospect of deviation from a youthful, muscled standard, amplifies a fear of aging, which becomes associated with “loss”: i’m afraid of losing my looks. you lose your worth in gay society. 40% of your angle is your looks. people don’t really want to lend you a hand, but step up to the plate if you’re cute. [jake] i feel like after you kind of reach a point it’s all downhill…you get older, you get gross. [roger] when i get older, i guess i’ll ...dye my hair, change my diet, work out, get plastic surgery. [derek] gay male culture mirrors itswestern host in its high value of a youthful, fit physique. gay media equates male desirability with youth, sexual skillfulness, athleticism, confidence, aggressiveness, and strength [wierzalis, barret, pope, & rankins, 2006]. muscled pectorals and torsos are a key convention in gay media advertising as well as gay male pornographyseveral of the men expressed concerns over meeting and/or maintaining this standard of beauty: if you don’t have an a & f4 body, it’s like you don’t exist. [nick] acceptable gay standards are very limited and very small. abercrombie, 6ft 180, white, muscles, athletic, 4 abercrombie & fitch, a clothing retailer catering to young men. their advertisements frequently feature shirtless young men, typically caucasian, with muscular bodies. anthropology & aging quarterly 2010: 31 (1-2) 32 features straight looking. i feel bad about this sometimes, but i see a fat gay guy and i think, oh, that’s unfortunate…he doesn’t get laid very often. my friends and i will even joke around about it. [corey] i was a very chubby child. i’ve lost a lot of weight. i got addicted to working out. but i noticed that you get treated really differently. i’m really caught up in that, it’s bad. but it’s good too…it’s such a release for me. [curtis] at the opposite end of the spectrum, todd describes his experience of stigmatization for being “too skinny”: i was at revival [local club], i never go there, but decided to check it out on a sunday. it was a total meat market, muscle market. a meat factoryi couldn’t help but feel like the grade b meat mixed in by accident… some men recognized the irony of being both owner and object of the male gaze: as “objects”, resentment was high over the felt need to conform to high standards; as “owners”, desire for people and products perpetuating these standards persists. while many noted that seattle felt less pressured than other places in terms of conforming to body image, all felt the effect of these expectations from mainstream media, and gay media sources, which heavily promote this body type. while weight control and building muscle reap positive health rewards, intimacy rewards, and psychological benefits, perception of the quality of one’s future is bound tightly to one’s perception of their conformity to this ideal. the prospect of deviating from this ideal threatens one’s anticipated quality of life. again, the implications are a perceived loss of community, perceived loss of citizenship in gay culture, and loss of personal self-worth. young gay men’s resilience as predictive of the future all of the worrisome aspects of gay male culture, taken in total, create a fairly dismal picture. each of the men i spoke with had been deeply affected by one or more of the future-inhibiting factors listed in this paper. in addition, the men survived violence, family disownment, workplace discrimination, clinical depression, accidental drug overdoses, addiction, hiv infection, and/or suicide attempts. only 14% of these men had not been affected by at least two of these factors. yet, resilience prevails. most gay men do reach their 30’s without contracting hiv, without succumbing to drug or alcohol addiction; careers advance, relationships flourish; positive sense of self as an older individual strengthens. literature provides strong evidence that things get better for gay men. nearly all studies of older gay men indicated satisfaction with age [bergling, 2004, p. 56]; a meta-analysis of studies found a trend of positive adjustment, rich lives, strong social networks, and long-term relationships [wierzalis et al., 2006]; a 1982 study found that there was no difference in levels of depression compared to the general u.s. population [berger, 1996]; this is especially compelling since those men came of age, in far more repressive times. this finding also proved true for the gay elderly [dorfman et al., 1995]. adding to the chorus, cruz [2004] found gay men over 55 to be vibrant, well-connected, not lonely, reporting high quality of life [n=125]. in addition, gay men may parallel the trend noted for the general population of middleaged adults, who “increasingly perceive themselves and their relationship to the social world with greater cognitive complexity and a heightened appreciation for paradox, ambivalence, and uncertainty in life” [kertzner, 2001, p. 78]. younger age sets, by contrast, may feel uncertainty to be more of a threat. confidence in one’s capacity for resilience is critical for a positive long-term future outlook. the men regard gay culture itself as a dynamic and resilient force in recent history, given the de-criminalization of homosexuality, response to the aids crisis, and the movement for equal treatment and rights. before these men migrated to the city, gay culture was a beacon for a better life: more acceptance, less isolation. several men interacted with others online on gay-themed social networking sites. gay-specific online venues such as gay.com helped several of the men navigate the “coming out” process, through informal supportive friendships with men around the country. these contacts, through chat rooms and social networking sites, helped facilitate the [typically] mid-to-late adolescence moment where their validity as a human being was realized, and where negative or homophobic messages received by family, religion, or media were rejected. many drew, and continue to draw, strength from this powerful moment. when i first came out, i felt betrayed by god. how could all that i believe be suddenly so suspect? but [homosexualty] didn’t feel like a disorder, so i questioned religious messages. i became more aware of gay culture, found out what i was taught didn’t connect to reality. it was a definite turning point. if i can make it through that, i can make it through anything. anthropology & aging quarterly 2010: 31 (1-2) 33 will power. just keep going, going. don’t stop, don’t let anything discourage you. i have done a good job at not letting things hamper what i think i can achieve. this comes from my family always telling me that i won’t be anything. it drives me. [evan] the men drew strength from having seen the gay community directly confront discrimination at national and local levels, and followed suit in their own environments: freshman year someone wrote fag on the white board on my door…so i asked my ra to call a floor meeting. i lectured all these straight college men about, ‘you need to accept me for me…i’m not here to get with you. i’m here for me. to have to put up with that shit …i basically let them know that you can spray paint my door, you can harass me, i’m still gonna be here…deal with it’. [todd] for some, a history of being the lone gay person in many past and current settings prepared them leadership roles: it was really weird [as the only openly gay man on campus] because when i came out, people were like ‘you have to be an activist on campus’…so i became one. i even got quoted in the newspaper. [clark] i became a cheerleader in a high school in a very small town. if you’re going to be looked at as different, you might as well just go for it and try out. [philip] another form of resilience was the use of humor to negotiate hetero-normative or homophobic space. witty banter and exchange of one-liners and insults, celebrated in gay male culture, serve the dual purpose of reducing the tension in relationships with other gay men and the heterosexual world alike. scott explains: when you deal in a homophobic environment all the time, you’re always…distrustful. is this person going to make fun of me? that’s why i think gay men are so catty. we’re catty to stave off those who would do us harm, either emotionally or physically. strike back before you get struck. gay men’s selection of careers in the expressive and liberal arts were spoken of as a means of distancing from, critiquing, and meaningfully participating in the world: what brought me out of feeling bad about being gay? in my senior year of high school i was encouraged to write. i was told i was good at it….writers, artists in general that i like are commenting on society from the margins. i like that art gives pop culture the [middle] finger. the arts are good for gay men because they can be ‘in it’ but not ‘of it’. i like the fact that some gays don’t completely assimilate. [dylan] dancing for me is a real expression of empowerment…it’s the time when i feel most attractive. no one can stop me when i’m out there on the floor. i feel like i’m exuding happiness, warmth, that i’m in the reality when i dance. i’m both more desired and desirable. [todd] making music is what keeps me from blowing up things. [antoine] some men entered helping professions, particularly education and social work, as a form of personal resilience: [i went into youth social work because…]i have a sense of devotion to people. i really believe the only reason for my being is to give back…to help people stand up when they fall down is really just what i want to do. i’ve seen the suffering and understand it. [joe] i wanted to teach because i want there to be a positive place for kids to come to school and not be afraid to go to school because they’re different. to have a great place where they won’t be pointed at and laughed at. [seth, 21, sign language interpreter] features anthropology & aging quarterly 2010: 31 (1-2) 34 features the physical body also acted as a conduit for symbolizing and conveying strength and resilience, to oneself and others. this may be a positive aspect of the pursuit of fitness and muscularity. alteration of the gay male body has been described as a landscape for asserting power which directly fuels self-validation [jones & pugh, 2005]. resilience is also performed through sense of personal style and dress. vincent, tyson, tyler, andrew, nick, clark, and manuel all described their style choices in terms of self-empowerment and resistance against constrictive mainstream male and gay male style norms. these styles include tattoos, large earring plugs, black gothic clothing and make-up, gender-blurring style, and thrift store wear. i’ve run out of skin space [for tattoos]…but all of it is about being more clear on who i am, clarity, more realization. [clark] for me doing drag [at night] is a form of empowerment… a way of celebrating my femininity. doing drag was a way of accessing pride i guess. before that i grew up feeling accepted, but not proud….[later] i got into activism as [my drag persona]. i decided ‘if you’re gonna look at me, you’re gonna hear from me’. [manuel] i really appreciate people who take clothing seriously. style is power…like my friend rachel, she has her own distinct look and works at it. it’s a decision you make. clothes are a language of their own, a way of communicating, being in the world. [vincent] several men were highly skilled at social networking. in earlier development, it is possible that the use of personal qualities to distract from, or unravel, homophobia, such as sense of humor, academic wisdom, or ability to hold court among a group of people, translates later into professional skills in the fine and liberal arts, politics, business, or the ability to simply reinvent oneself in a new place. the ability to manage other people’s perceptions translates into all of these skills as well. the idea of personal resilience, and of belonging to a culture made up of others who are resilient, was also a structuring force in guiding a new philosophy of living, including delineation of personal boundaries regarding what is/is not acceptable treatment, placing life’s challenges in perspective, and bolstering altruism. conclusion young gay men face a particularly difficult mix of barriers against constructing a positive view of aging. to review: this includes the general stigma against aging in mainstream society; lack of clear institutional markers of age progression; limited and/or perceived limited career trajectories; the anticipation of discrimination and/or unhappiness in old age; the association of aging with loss of control and lack of physical appeal, bolstered by gay male cultural valuation of the muscled, youthful physique; lack of media representations of future-oriented gay men; effects of previous isolation creating a bias toward present-oriented, sensory reward when dating finally becomes viable; and lack of intergenerational trust and connection within the gay community. clearly, this is a lot to navigate. thankfully, for those that survive these disillusionments and pressures, resilience prevails. for these men, this transpired through forming alliances with others experiencing similar challenges; through manipulation and management of public perception; through focusing efforts on moving to and surviving in a more urban environment; through physical alterations; through self-selection into helping professions, education, liberal/fine arts, and careers that would minimize their experience of homophobia and afford them a critical distance from society; through serious revision or complete abandonment of homophobic religious beliefs. these experiences foster a high degree of personal re-invention, creativity, innovation, analytic skill, and adventurousness. gay men’s contributions to several industries, including fine arts, fashion, entertainment, non-profit development, politics, higher education, and entrepreneurship are byproducts of this resilience, and institutions both within and outside the gay community reflect this. to the extent that these experiences are shared and communicated, a dynamic community can emerge which interrogates and transcends that which holds it back. young gay men survive both in spite of and because of gay culture. the rapid change of social and legal status adds a mix of ambiguity and hope, as young gay men imagine growing old. references badgett, m.v.l. 2001 money, myths, and change: the economic lives of lesbians and gay men. chicago, il: university of chicago press. barrett, d.c., pollack, l.m., & tilden, m.l 2002 teenage sexual orientation, adult openness, and status attainment in gay males. sociological perspectives 45(2): 163-182. anthropology & aging quarterly 2010: 31 (1-2) 35 features berger, r.m. 1996 gay and gray: the older homosexual man. urbana, il: university of illinois press. bergling, t. 2004 reeling in the years: gay men’s perspectives on age and ageism. binghamton, ny: haworth press. bohan, j.s., russell, j.m., & montgomery, s. 2002 gay youth and gay adults: bridging the generation gap. journal of homosexuality, 44(1): 15-41. cohler, b.j. & galatzer-levy, r.m. 2000 the course of gay andlesbian lives: social and psychoanalytic perspectives. chicago, il:university of chicago press. cruz, j.m. 2003 sociological analysis of aging: the gay male perspective. binghamton, ny: haworth press. dorfman, r., walters, k., burke, p., hardin, l., karanik, t., raphael, j., silverstein, e. 1995 old, sad and alone: the myth of the aging homosexual. journal of gerontological social work. 24(1-2): 29-44. fouts, g., & inch, r. 2005 homosexuality in tv situation comedies: characters and verbal comments. journal of homosexuality, 49(1): 35-45. francher, j.s., & henkin, j 1973 the menopausal queen: adjustment to aging and the male homosexual. american journal of orthopsychiatry, 43, 670-674. jones, j., & pugh, s. 2005 ageing gay men: lessons from the sociology of embodiment. men and masculinities, 7(3): 248-260. kertzner 2001 the adult life course and homosexual identity in midlife gay men. annual review of sex research, 12, 75-92. mccabe, k. & barnett, d. 2000 first comes work, then comes marriage: future orientation among african-american young adolescents. family relations, 49(1): 63-70. metlife mature market institute 2006 november out and aging: the metlife study of lesbian and gay baby boomers. westport, ct: metlife mature market institute. mitsch, a., hu, x., harrison, k.m., durant, t. 2008 trends in hiv/aids diagnoses among men who have sex with men -33 states, 2001-2006. morbidity & mortality weekly report, 57:681-686. peacock, b., eyre, s.l., crouse-quinn, s., & kegeles, s. 2001 delineating differences: sub-communities in the san francisco gay community. culture, health, & sexuality, 3(2): 183-201. raley, a.b., & lucas, j.l. 2006 stereotype or success? prime-time television’s portrayals of gay male, lesbian, and bisexual characters. journal of homosexuality, 51(2): 19-37. wierzalis, e.a., barret, b., pope, m., & rankins, m. 2006 gay men and aging: sex and intimacy. in d.c. kimmel, t. rose & s. david [eds.], lesbian, gay, bisexual, and transgender aging: research and clinical perspectives: 91-109. new york, ny: columbia university press. anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 108-109 issn 2374-2267 (online) doi 10.5195/aa.2015.96 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. book review the upside of aging: how long life is changing the world of health, work, innovation, policy and purpose, paul h. irving, ed., with project editor rita beamish. hoboken, new jersey: john wiley & sons inc.. 2014. isbn 978-118-69203-5 (hard cover); 978-1-118-69190-8 (epdf); 978-1-118-69191-5 (mobi). price: $39.95 ruth grendell, dnsc, r.n. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.96 http://anthro-age.pitt.edu book review the upside of aging: how long life is changing the world of health, work, innovation, policy and purpose, paul h. irving, ed., with project editor rita beamish. hoboken, new jersey: john wiley & sons inc.. 2014. isbn 978-118-69203-5 (hard cover); 978-1-118-69190-8 (epdf); 978-1-118-69191-5 (mobi). price: $39.95 ruth grendell, dnsc, r.n. authors of the 16 chapters hold professional degrees and serve in leadership positions related to psychology, gerontology, medicine, not-for-profit organizations, economic and technology groups, and universities; many are members of task forces on global aging issues, and public health. the chapters are situated within three categories: (1) opportunities and innovations; (2) a changing landscape; and (3) perspectives and possibilities. the over-arching themes indicate that longevity is here to stay and that aging is a universal experience; however, the path varies widely for each person. global society leaders need to rethink the value of longevity and successful aging; as well as, prioritizing initiatives for the future of aging societies, the changing population demographics, and economic issues in health and illness. scientists have determined that genetic variants, the environment, family predispositions, and personal motivators play important roles in the many aspects of the healthy aging process. therefore, rather than adhering to the traditional health care model, attention must be directed toward personalized aging and the initiation of precision or personalized medicine to ensure quality of life within safe environments. the major goals, then, for the 21st century, should be prolonging the healthy aging span of life and fostering independence. the authors state that within the past 50 years, each generation cohort has been healthier than the previous one. the future may include a mature workforce along with opportunities for active participation in social and political leadership. the power of the aging mind is demonstrated by the number of older scientists who have received the nobel prize, and valuable contributions by older national leaders. future retirement transitions may greatly differ from the societal norms of today. global aging is, also, challenging leaders in universities “as an object of study, as a source for students, and as a source of participants in teaching and research” (p. 165). it is important to tap into the rich resources that are available. challenges faced by global aging societies include identifying measures to meet the demographic changes of intergenerational communities, and multi-cultural populations. ethical, ethnic, legal issues, age discrimination, and new alliances bring many important factors to the decision tables. allocation of economic resources to ensure safe and quality lives for all is a major concern world-wide. yet, these factors that change the landscape can, also, bring new perspectives and unique solutions to future global societal problems. grendell | book review anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.96 http://anthro-age.pitt.edu 109 109 although, the focus of the text is on healthy aging and well-being, the authors agree that chronic physical and mental health problems are inevitable. researchers must continue to search for methods to minimize the impact of these problems on the health status of all citizens. the text can be an excellent resource for collaborative discussions among educators, scientists, policy makers, and other society leaders in finding solutions. anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 22-25 issn 2374-2267 (online) doi 10.5195/aa.2015.82 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. portfolio: grand performances building self and social ties through theatrical performance stephanie may de montigny university of wisconsin oshkosh http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.82 http://anthro-age.pitt.edu grand performances building self and social ties through theatrical performance stephanie may de montigny university of wisconsin oshkosh . for people who perform at the richly historic grand opera house of oshkosh, wisconsin, narratives attach to place (basso 1996); they build memories and shape understandings of self and community. the grand, built in 1883, has ridden waves of economic prosperity and decline, changing as the city itself has changed (de montigny 2010). residents call it a “treasure” of oshkosh, an “anchor” in the downtown while a few call it a drain on public money. today, beautifully restored, the theater intertwines itself into the lives of oshkosh residents. memories abide of youthful experiences attending films and performing in high school musicals. older residents continue to perform, attend shows, and volunteer. an active community theater draws people to the stage, some for the first time, some over and over again. de montigny | grand performances anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.82 http://anthro-age.pitt.edu 23 one “oshkosh on broadway” performer said, “i would never have thought of myself as being an onstage person back in high school. i was too timid, too shy . . . it wasn’t until some of the folks in the kiwanis said, ‘you can sing. why don’t you come up on stage with us?’ that i decided to give it a try, and, hey, i found out i can do it, and i do enjoy it.” for him, the liberation from “normative constraints” inherent in the anti-structure of theatrical performance allowed for such self-transformation (turner 1982: 44-48). a woman recounted this revelation: i thought, i’ve always wanted to get back on the stage at the grand, and i was about 50 by then so i wondered if i could still remember lines. i played a part in “steel magnolias” with tons of dialogue. it was hard . . . we had two great nights . . . the third night i skipped six pages of dialogue! backstage, people were frantically trying to decide if they should turn off the lights, enter, wondering what to do? [another actress] onstage with me helped get us back on track. i tell people, it was like being in a jet plane going down. pure panic! but people in the audience said they couldn’t tell. it was really amazing. but anyway, that’s an experience i will not forget on the stage of the grand. it was awful…and it was wonderful! while it may have been “awful,” she learned about her own determination to memorize lines and carry on through adversity. she discovered the intersubjectivity (turner 1982) that saved the plane that was “going down.” she enveloped communitas and the “intensity of performance” (schechner 1985: 110) in the following: you know this wonderful thing that happens. you’re kind of in a bubble that whole time. and you love each other, you and the other people in the cast. and you depend on each other. it’s a team thing. it’s an interdependent thing . . . de montigny | grand performances anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.82 http://anthro-age.pitt.edu 24 you’re part of a group, but you’re out there alone, and you have to produce, or it lets everybody down including yourself. i think that type of experience for kids is just irreplaceable . . . it becomes very important to you in your memory. memories emerge behind the scenes as well, outside the focus on performers that lies in schechner’s performance sequence (schechner 1985: 16). a long-time volunteer told this story. every time we had a show, my husband and i . . . ran the bar . . . well, then one night, during a performance, people are in the restrooms, and . . somebody said, “oh, my god. there’s water bubbling up in the men’s room.” there’s a drain in the floor, and the water is bubbling up out of there. . . well, it was almost at the end of intermission anyway. . . and every time somebody would flush the toilet, it would start to bubble. well, we finished the show, and then we’re trying to figure out what to do about this. and [the stage manager] said, “well, we gotta get a plumber.” and i said, “i’m not authorized to call a plumber.” . . . i said, “we can’t just leave this. if it gets worse,” i said, “the whole downstairs could flood.” at that point in came [the city manager] with a friend of his. i said, “ ‘oshkosh on the water’ [the city’s motto] is one thing, but the grand under water isn’t gonna cut it. . . he said, “get somebody out here now.” i said, “o.k.” so we called roto-rooter, i think, and they came out. . . well, in the meantime, we decided, well, we’re not leaving. so i was there, my husband, a couple of our really dependable volunteers . . . i said, “o.k. people, it’s going to be awhile.” so we ordered pizza. . . we broke out the beer and the pop. we’re sitting in the lobby having pizza and drinks when the roto-rooter man came. . . well, my husband’s down there, and he said, “don’t stand there,” ‘cause when he took this thing off, the water just shot out. . . we mopped up, and we all finally went home about one o’clock . . . but all those crazy things that would happen that you don’t expect. i mean you’re a volunteer. you’re not getting paid to do this. but my whole life was the grand. de montigny | grand performances anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.82 http://anthro-age.pitt.edu 25 such experiences and stories grow out of personal and intimate engagement with the grand opera house. involvement in theatrical productions in this beautiful, historic treasure of oshkosh lends meaningful material to memory and personal history, builds ties with others, and fortifies the self. acknowledgements special thanks to susan vette for reviewing and commenting on this draft. thanks also to mrs. vette and joe ferlo, director of the grand opera house foundation, for supplying the photographs references basso, keith 1996 wisdom sits in places: landscape and language among the western apache. albuquerque: university of new mexico press. de montigny, stephanie may 2010 building and rebuilding community: public memory and the grand opera house of oshkosh, wisconsin. buildings and landscapes. 17(2): 73-95. schechner, richard 1985 between theater and anthropology. philadelphia: university of pennsylvania press. turner, victor 1982 from ritual to theatre: the human seriousness of play. new york: performing arts journal publications. photo credits  joe ferlo in les miserables, 2014.  john and susan vette, oshkosh on broadway, 2009.  susan vette, oshkosh on broadway, 2009.  all photographs courtesy of the grand opera house. . portfolio: grand performances building self and social ties through theatrical performance grand performances building self and social ties through theatrical performance stephanie may de montigny university of wisconsin oshkosh anthropology & aging quarterly 2010: 31 (1-2) 36 book reviews abel, emily & subramanian, saskia. after the cure: the untold stories of breast cancer survivors. new york university press. 2008. isbn 13: 978-0-814-0725-8. 183 pages $22.95 (hardcover) after the cure: the untold stories of breast cancer survivors is a collection of post cancer ethnographies of women who are breast cancer survivors. the book details the physical and emotional side effects of contemporary breast cancer treatment (surgery, radiation and chemotherapy). central to these ethnographies is a chronicle of the lack of recognition by the biomedical community of post cancer treatment side effects. abel and subramanian make clear that there is an urgent need for post operative and post chemotherapy aftercare therapies for women otherwise “cured” of breast cancer. the book draws from a study of thirty-six african american and thirty-eight white women, both young and middle aged, who were interviewed from one to three hours (abel and subramanian 3). the stories reveal how unexpectedly life altering cancer treatments as well as the post treatment side effects (lymphedema, loss of short-term and long-term memory, other cognitive dysfunctions, and debilitating fatigue) can be, even after cancer recedes (abel and subramanian 33-34). the authors are succinct in answering a difficult question: how can medical practitioners who treat hundreds of breast cancer patients annually fail to recognize a pattern in recurring post treatment complaints? the authors write, “readers may wonder why symptoms with such profound implications for survivors’ lives may lie in the way drugs are tested” (abel and subramanian 5). they suggest that this is, in part, motivated by pharmaceutical companies who wish to get food and drug administration (fda) approval for drugs must first prove these drugs are both safe and effective. clinical trials of chemotherapeutic agents tend to focus on survival rates rather than side effects (abel and subramanian 5). the book was written from a critical perspective, but also one that reflects the personal life trajectories of its authors. six months after breast cancer surgery, chemotherapy, and radiation in 1993, abel experienced severe side effects from the treatments. when she shared her problems with other survivors, several expressed their own difficulties. when abel, a historian of medicine and public health, met subramanian, a medical sociologist and a women’s studies scholar whose own mother had died of breast cancer, they began to converse about breast cancer, its treatments and side effects. ultimately, abel suggested they collaborate on a study to examine how women who have completed breast cancer chemotherapy and radiation cope with ongoing problems doctors failed to take seriously (abel and subramanian 2). many of the women they talk to were never told of the possibility of chronic, life altering side effects – a problem that seemed unreal in the face of the medical community’s obsession with informed consent. the authors faced the challenge of epidemiologically describing the problem while simultaneously “legitimizing” individual women’s complaints of side effects. the study, however, became unwieldy. the authors write, “even if a study identified a population, how could we know whether it was caused by the cancer in a particular case?” (abel and subramanian 3). their attention turned towards the women’s stories themselves. abel and subramanian are effective in conveying the suffering felt by individual women, however one weakness of the book is its lack of focus on the important role of the nursing profession in aftercare. for example, when one of the women in the study is given information from a doctor about lymphedema, the patient says, “he told me well you got to soak it [the arm] in warm water.” the patient continues, “i stopped by to chat with the nurse, and thank goodness, she was there. hearing the doctor’s recommendation, the nurse exclaimed no, no, no!” (abel and subramanian 58). given the centrality of the nursing role in the context of cancer aftercare, it seems something that needs even further careful analytical consideration. the authors do point out the gendered aspects of care, and why it is important to think in–depth about how this dynamic matters in understanding this particular healthcare context. race and gender seem to be two (sometimes competing) axes in the book. given this, sometimes the ethnographies in the book could benefit from longer engagement, and more in depth analyses. one story that stood out was a conversation with ida jaffe, a fifty-eight year old african american woman, who stated, “she did not know that black women got cancer.” the statement by jaffe shows how difficult it is to reconcile morbidity rates in african american women with the realities of being diagnosed with breast cancer. it did seem odd, however, with the detail (both physical and social) the authors offered to describe white women (eye color, dress, affect, etc.) and the lack of the same detail when describing african american women. with these critiques in mind, it is important to point out that abel and subramanian have taken on an ambitious and important topic, and do so in a highly thoughtful manner. a few chapters that stand out as the most thought provoking are “like talking to a wall” and “narrowed lives.” both chapters demonstrate the long haul that breast cancer treatment really is. in these chapters, the authors stress the need for repositioning the idea of a former cancerfree self with a new notion of the cancer survivor – a process that can be as grueling as the cancer therapies themselves. in after the cure: the untold stories of breast cancer survivors, abel and subramanian show us not only that breast cancer patients are surviving, but also what survival looks like far from public view. for those interested in anthropology and aging, the topic of how women deal with breast cancer and its side effects over time is highly relevant. as more women live longer and experience breast cancer and aging post breast cancer, this book has much new information to offer on that critical topic. mary hollens development administrator, school of law anthropology student wayne state university anthropology & aging quarterly 2010: 31 (1-2) 37 book reviews dagg innis, anne. the social behavior of older animals. the john hopkins university press. 2009. isbn 13:978-0-8018-9050-5, 240 pages, $35 (hardcover). the social behavior of older animals, by anne innis dagg, addresses the various effects of aging on older animals that live within social groups. focusing on large mammals and birds, the book discusses the differing roles that older animals can play within their social groups. it considers how the remaining presence of these animals, after the age of reproduction, is probably due to their contribution to the survival of their species. dagg makes the argument that older animals are, for some species, imperative to their survival, and for others they still play a significant role in their social groups. dagg briefly mentions the difficulty in finding supportive information on older animals, attributing this to older animals being overlooked in past research studies. she also points out that older animals in the wild, either on land or in the water, were often poached or hunted out of existence. however, the older animals that do exist in the wild are considered to be “winners, because most of their peers have long since died” (dagg 2009, 11). dagg supports this statement with several reasons such as, genetic inheritance in terms of reproductive success and behavior within the social group, and a lifetime of knowledge about the environment they live in. other reasons that older animals may remain in a social group, when they have passed the age of reproduction and the purposes served are further explained. for example, dagg discusses several ways that older animals participate in the success and survival of their species which include being leaders and teachers in behavior. they may act in important ways such as calming a group down, and serve as a source of past knowledge therefore deciding where to best find resources. interestingly, these points may seem quite familiar to those who are aware of the gerontological literature that has advanced similar ideas about the roles of older humans specifically. dagg addresses the stages of older life looking at changes in reproductive success, social interactions, aggression and behavior, and death and dying. the arguments dagg made for the role of older animals, certainly offer a possible explanation for their remaining in their social group long after reproductive age. in short, much documentation is offered throughout to show how older adults play an important role in the continuation of their species through their usefulness as leaders, owners of important knowledge and life lessons, and by lending a “helping hand” in their social groups. throughout this book, the examples given for older animals in social groups are very enlightening and it is hard to understand how we have truly overlooked such an important aspect of animal behavior. the many interesting and revealing stories of the complex nature of animals and also the similarities that we humans share with them are truly eye-opening. with so many other species on this planet, it is important to see the similarities that we have as a reminder that we are not all knowing about animals, and that they are, just as humans are, very diverse and complex. this book fits into the study of gerontology by covering important changes in older animals socially, physically, and mentally – as well as contemplating the roles they play in their social groups. georgia richardson-melody, m.a. student department of anthropology wayne state university 33 (2).indd anthropology & aging quarterly 2012: 33 (2) 53 feature aging & anthropology in east asia introduction rites of passage, often associated with reaching a particular chronological age, define entry and exit from roles and responsibilities assumed in one’s life. in the south korean concept of annual time passage, there is a 60-year cycle with each year bearing a particular name. the 60th birthday, called hwan-gap, marks the beginning of the second cycle of life whereby years are “repeated.” oftentimes, children provide elaborate celebrations as a parent reaches this important rite of passage. hwan-gap was once a celebration of longevity but now it marks the beginning of a nebulous five-year period of transitioning to elderhood. a r t i c l e s transitions and time dissonance between social and political aging in south korea wonjee cho, m.s. department of child and family development university of georgia during the past five decades, south korean society has experienced dramatic demographic changes including the rapid growth of those aged 65 and older, from 3.8% of the population in 1980 to 11% in 2010 (choi 1996; kim 1996; national statistical office 2010). population aging is expected to continue in the next two decades, reaching 15.6% in 2020 and 24.3% in 2030 (national statistical office 2006). social policies have adapted to current aging patterns and longer life spans with age 65 as the official entry point into elderhood. for example, people aged 65 and over are classified as ‘the elderly’ and are eligible for a variety of social benefits through the long-term care insurance act, old age pension act, law for the welfare of the aged, and road traffic law, along with other acts or laws. eligibility at age 60 applies to only four health and denise c. lewis, ph.d. department of child and family development university of georgia abstract this study explored multidimensional meanings related to “becoming old” for the young-old in south korean society. six persons aged 62 to 68 were interviewed in-depth. they chronologically, physically, and socially experienced the transition to old age at different times determined through “hwan-gap” (at age 60) and through current social policies that define entry into elderhood (at age 65). however, most did not psychologically accept their own aging as beginning at age 60 with “hwan-gap.” they reported that they were “forced” to become old at that time, even though they did not yet qualify for old age benefits provided by the south korean government. in addition, they did not consider others’ perceptions of them as “old” as a psychological obstacle to defining themselves as young. knowledge about young-old persons’ dissonance between their identities and sociopolitical views of entry into elderhood is important for understanding their experiences during the five-year gap between sociocultural entry into old age at age 60 and entry into the nationally defined elderhood at age 65. key words: aging, korea, transition to elderhood, young-old, hwan-gap anthropology & aging quarterly 2012: 33 (2) 54 wonjee cho & denise c. lewis transitions and time social programs: early dementia detection project, an eye examination project, leisure welfare center for elderly, and a free meal service for the elderly (chung 2011, 2012). yet, hwan-gap continues as the traditional marker for an aging self and little is known about the five years between the traditional and policy-mandated designation as an elder. with increasing social interests in aging-related experiences of old people in south korea, most attention has been paid to their declines and losses in physical and mental health and their attitudes toward the end of life (cho 1997; kim et al. 2003; seo 2008). neugarten (1996) emphasized the significance of classifying old people into three groups (i.e., young-old (age 65-74), old-old (age 75-84), and oldest-old (age 85+)) for understanding diversity in old age. she explained that the young-old were differentiated from the middle-aged by the fact of retirement and were reluctant to accept their own aging, contrary to the old-old and oldest-old who fully accepted that they had entered elderhood. in addition, the young-old were portrayed as more healthy and active than the old-old and oldest-old (baltes and smith 2003; chou and chi 2002; neugarten 1996; smith et al. 2002). however, research on south korean elders assumes a more homogeneous population who share similar experiences of aging-related changes and attitudes toward death, such as declining functional capability, loss of social roles and responsibility, and (cho 1997; choi 2009; kim et al 2003; lee and rhee 2004; yang 2012). although neugarten’s classification of ages was developed for a western population, it is equally salient in this consideration of south korean elders who are experiencing aging in a rapidly changing sociocultural climate. researchers also have focused on issues relevant for a productive and successful later life by highlighting the need to maintain physical health and strength and the benefits of engaging in social activities (bae and park 2009; chung 2007; jeong and shin 2009; kim and kim 2009; kwon and kim 2008). in spite of the body of literature on aging in south korea, little is known about young-olds’ experiences of becoming old and their reconstruction of a sense of self as an older person. this study illuminates how the young-old experience and interpret entry into old age and age-related psychological, physical, and social changes. literature review multidimensional quality of time time is a means to measure temporal flow and duration, usually employing clocks and calendars, and as an index variable to designate “age” among populations. however, increasingly researchers also have begun to view time also as a socially constituted reality. time and temporality reflect socially-shared norms and expectations relative to normal timing and sequencing of major events across the life course as well as personal concepts and sense of time that emerged through experiencing temporal events and changes within a society (hendricks 2001; sorokin and merton 1937). researchers recognized that quantitative and linear dimensions of time taken for granted in previous research are not entirely sufficient to understand how an individual perceives the passage of time and life changes and how they interpret personal experiences of time. the recognition of this shortfall underscores the need for formulating time as a temporal structure containing multiple facets and modes (hendricks and peters 1986; sorokin and merton 1937). hendricks and peters (1986) employ maltz’s time schema to propose diverse aspects of time and classify time into ecological, individual, social, and ideational modes. they assert that the ecological mode refers to a temporal structure representing chronological changes from the outset of events and activities in the natural world and provide a calendar as an index of time reckoning and passing. individual time is a temporal construct comprising one’s own meaningful and private events, which affect personal awareness of external events and objects and personal life. social time is used to identify a temporal regularity of social activities and events based on socially shared norms and expectations about life transitions or life events. age-graded events and roles serve as reference points in systematizing and ordering individual experiences of time. finally, an ideational dimension is a historical temporality specifying significant traditions and historical events. such an approach to time could provide a deeper insight into human experiences of time and could tell us more about the meaning and implication of lived time in personal life. present time in old age older adults begin to be aware of finite time and inevitable death and simultaneously to refashion their own sense of time through reflecting on their lives and organizing them in meaningful ways (dittmann-kohli 1990; mcadams 1990). personal concepts and sense of time are crucial in adjusting to age-linked changes as well as affecting the construction of an aging self, health management behaviors, and emotional well-being (lennings 2000; rappaport et al. 1993; showers and ryff 1996). however, research on time and aging has often dealt with older people’s orientation toward time and its relationship with health and psychological well-being (bouffard et al. anthropology & aging quarterly 2012: 33 (2) 55 wonjee cho & denise c. lewis transitions and time 1996; lennings 2000; nurmi et al. 1992; rappaport et al. 1993). although older adults tend to focus on occurrences and goals in the present and the near future (lennings 2000; nurmi et al. 1992; rappaport et al. 1993), their sense of the future is viewed as a crucial component affecting attitudes toward aging and dying, health behaviors, and life satisfaction (bouffard et al. 1996; lennings 2000; rappaport et al. 1993). these studies display limited understanding of older adults’ perceptions and interpretations of temporal experiences such as age-related changes and declines in the present. further, these studies investigating temporal attitudes and experiences of the overall elderly population demonstrate a limited grasp of temporal experiences of the young-old who recently transitioned to elderhood. it is recognized that the young-old differently perceive their temporal changes and their locations in the aging process through fewer changes in health and social resources (baltes and smith 2003; chou and chi 2002; smith et al. 2002). older people’s attitudes toward death and future time perspectives are a major issue in south korean research on time and aging (cho 1997; kim et al. 2003; lee and rhee 2004). these studies also provide a limited insight into the young-olds’ reconstruction of an aging self through temporal experiences of age-linked changes. life course perspective on the entrance to old age the young-old are relatively healthy and free from physical impairments and illness compared with the oldold and the oldest-old (baltes and smith 2003; chou and chi 2002; smith et al. 2002), but becoming an older adult within a society is a key transition and is simultaneously a great psychological challenge in adjusting to changes in social roles and activities. life course perspective is employed to understand the changing contexts of lives experienced by the young-old. life course perspective provides a way to illustrate the meanings of these changes in the aging process in that it focuses on processes and changes of individual development (elder and johnson, 2003). in addition, it highlights that individual lives are linked to the social and historical contexts in which they are embedded and the individual life course is considered as an outcome of interactions among multiple temporal, individual, and sociocultural phenomena over time (elder 1998; fry 2003). because aging is a lifelong process embedded in social contexts and historical time, life course perspective provides a theoretical framework to gain insight into variable and patterned aging-related experiences of the young-old within south korean society and meanings of temporal experience in aging process. this study explores young-olds’ experiences of time and age-related changes in south korea in order to better understand their lives during the five-year transition between “forced” elderhood and nationally defined elderhood. methods sample this pilot study, conducted in 2006, used a purposeful sampling strategy for selecting young-old participants (lecompte and preissle 1993; patton 1990). inclusion criteria were those who with recent entry into elderhood and who were relatively healthy, independent, and require no particular care for health-related issues by selfreport assessment of health status and activity limitation level. the first author is from south korea and conducted all interviews in the korean language. through her personal contacts, twelve individuals were contacted and were asked if they were willing to take part in this study. university-approved human subject protection protocols were followed and basic demographic information and socioeconomic status were collected. because several were similar in socioeconomic status and only three women agreed to participate, all but three men were excluded. these three men were chosen based on holding similar occupations as the women (with the exception of “housewife” as all men are or were wage earners). therefore, a total of six were finally selected for in-depth interviews so that information from this pilot study could be used to inform a larger, ethnographic study conducted in 2009. a sample of three men and three women, aged 62 to 68, was interviewed using a semi-structured interview guide about their experiences regarding time passage and age-related changes [table 1]. interviews took place in the participants’ homes. each of the six participants was interviewed for one and a half to two hours. for obtaining accurate transcription of data after interviews, all interviews were digitally recorded and transcribed verbatim into texts. all persons described in this study were assigned pseudonyms. data analysis inductive analysis, a general approach for qualitative data analysis without the restraints imposed by structured methodologies (dey 1993), was used to identify the frequent or dominant themes that emerged from the participants’ narratives surrounding time-related changes associated with entry into elderhood. this analytic strategy was suitable for developing concepts and meanings that were not derived from previous theories or research outcomes (polkinghorne 1995). for familiarity with the transcribed data, the entire data set was carefully read and reread in detail with field notes added for increased richness. open coding was used to capture all potential codes across the merged interview/field notes data. for analyzing at the broader level of themes, the initially coded data were sorted and clustered into potential themes and anthropology & aging quarterly 2012: 33 (2) 56 wonjee cho & denise c. lewis transitions and time were assessed for differences and similarities among the participants. results chronological changes in aging after age 60, most participants began to recognize the effects of their increasing chronological ages (hendricks and peters 1986) and perceive being in their sixties as an important life event relative to the transition to elderhood or the aging process. in the past when average life expectancy was lower than age 60, hwan-gap was a special birthday to celebrate longevity of those turning 60 and to wish them a long and prosperous life. more particularly, age 60 signified a starting point of the later stage of life. now, however, hwan-gap is viewed less as a celebration of longevity by those reaching age 60 and more as an unwelcome transition to “old” age. for example, 63 yearold soyeon choi described her experience and emotions when she was 60 years old. after hwan-gap, i began to feel old. before hwan-gap, i couldn’t feel my age. hwangap made me feel old. hwan-gap itself represents “being old,” doesn’t it? i felt my body and mind became old [at that time]. hwan-gap was internalized as a special year leading to entry into old age rather than celebrating a long life in that she perceived physical declines and changes and had felt old since reaching age 60. it was a critical, socially defined, indication of a shift from mid-life to old age and created an increased awareness of aging-related changes where none had been acknowledge before the hwan-gap celebration. eunkyeong kwon, aged 66, also emphasized that age 60 served as a starting point for the transition to elderhood and for experiences of being old. she explained, “[i first experienced being old] just over age 60. after 60, i can’t control my body and am sick. after 60, my leg hurts, and my knee hurts… my body aches all over.” she portrayed physical declines and pains as conditions caused by turning age 60. in addition, 68-year-old jinho yoon viewed time left to live after age 60 as a new and different period from adult life and mid-life. he said, when i was 60 years old, my youth was slipping away. now, in my 60’s, in everything… in mental things… i became limited in my abilities. emotionally, i’m willing to do anything, but physically, i can’t. at the age of 60, he experienced a transition to elderhood and no longer viewed himself as a young adult or a middle-aged man. he underscored physical and mental limitations in abilities and motivations as a significant identity change that he experienced with increasing chronological age. for these participants, turning age 60 was a significant life event indicating the entry into elderhood. reaching the chronological age of 60 was a new period of facing a variety of age-related changes and was critical in self-identity as an old adult. it was important to recognize that the traditional transition year, the celebration of age 60 with hwan-gap, did not coincide with the nationally defined transition year, age 65 (shin et al. 2003). this created confusion as to one’s place in the aging continuum because one was often socially defined as old before one was nationally recognized as such. physical changes in aging the participants began to perceive changes in physical functioning and strength almost immediately following hwan-gap and highlighted their difficulties in physical activities in everyday life. in addition, they considered these physical changes and difficulties as significant agerelated phenomena in their lives. for example, 63-yearold soyeon choi commented on increasing physical pains after age 60 and thus physical and psychological troubles in everyday life. after hwan-gap, i physically feel so bad. because i have a pain in my legs, i can’t walk well. if someone asks me about climbing together, i can’t. my legs are so painful and hard to move. the ankles are so painful, so i hobble away. she described increasing pains in her legs and ankles as an emerging change after hwan-gap and the impacts of physical pains on both her everyday and social activities. painful legs and ankles led her to experience difficulties in walking and climbing and, at the same time, a decreased range of activities. moreover, these physical pains and troubles negatively affected her psychological attitude regarding her present-time self. in addition, physical changes were found in other participants’ remarks. jinho, aged 68, described declining lung function during daily activities: “going up the stairs, i feel old. running out of breath, i realize i’m old. so, the older we get, the smaller lung capability becomes.” he indicated that he immediately perceived the decline of lung capability and began to experience some difficulties in going up and down the stairs as age-related changes in his current life and thus began to self-identify as old. in addition, these physical declines were viewed as natural and inevitable changes as he aged and he did not seek treatment. 63-yearold sooyoung park also referred to physical changes and his views about how those changes reflected his presentday circumstances. [i feel old] not by any specific event. i feel the amount of sweat is different from before… i physically feel tough [laugh], everything is okay. i don’t have any problem handling everything [requiring mental capabilities], only physical things. anthropology & aging quarterly 2012: 33 (2) 57 wonjee cho & denise c. lewis transitions and time sooyoung did not experience specific physical ailments like soyeon and jinho; instead, he began to perceive overall declines in physical capability (i.e., loss of physical strength attributed to sweating). his perceptions of physical limitations were based on reaching age 60 and his internalized self-identity was an “old person” who was forced to accept growing old earlier than expected. it was not that he identified a particular illness; instead, the idea of aging created an internal propensity to attribute normal biological functions (such as sweating) with physical declines due to age. his contradictory statement regarding feeling physically “tough” and his problem handling physical things indicated ambivalence in his acceptance of elderhood. that is, at age 60, he entered elderhood based on beliefs associated with hwan-gap; however, his physical strength seemed to continue. the mixed message he and others received led to confusion over expectations and actualities associated with aging (adams-price et al. 1998; bae 2009; shin et al. 2003). with physical declines, jeongmi lee, aged 62, described an age-related disease and its impact on her experiences of entry into elderhood. “my 6-year-old grandson said ‘grandma, hold me’ and ran. but, i couldn’t run so long. ah, my strength. i’m ill… [with] osteoporosis, so…. i feel old.” she perceived that she became old because she had osteoporosis, a chronic illness often associated with women and aging, which affected her abilities to engage in play with her grandson. although well ahead of the nationally defined age of elderhood, physical declines she associated with the disease, rather than chronological age, were crucial to her perception of her own aging process. that is, the limitations of osteoporosis were of higher importance than her chronological age in her entry into elderhood. moreover, disease, not age, defined her aging process. in addition, jinho, aged 68, demonstrated emerging health problems after age 60. he said, “now, the only thing i’m concerned about is… health. often, i physically feel strange.” after age 60, he began to focus on various diseases including diabetes, high blood pressure, leg numbness, and prostate disease and to recognize deteriorating health conditions. he perceived these health problems as age-related phenomena but was concerned about dramatic changes in health status and its associated sufferings. with increasing physical loss and decline, the emergence of physical health problems was his transition to elderhood; a transition he scarcely noticed happening prior to age 60. new social title as elders changes in others’ attitudes toward the participants and shifts in their socioeconomic positions forced them into becoming “old” within south korean society. recognition of others’ attitudes brought the most significant social change to their lives. soyeon choi remarked on young people’s changed behavior toward her on the bus. when young people yield their seats to me, i say i’m fine and try not to sit. but… when my legs hurt so much, i sit in the seat. if my legs feel less sore, i think ‘oh, don’t your legs hurt? do only ours [people age 60 and older] hurt? yours [might hurt] too. you need to take a rest.’ i feel like this, so i don’t accept their favor. when young people yield to a senior, being old is not bad. on the other hand, young people are exhausted too, so i’m wondering if i deserve this kind of favor only because i am old. for a long time, “jangyuyuseo,” a hierarchical order between young and old that emphasizes the respect and acquiescence the young should give to the aged, has been considered a central virtue in interpersonal relationships between the young and the old. south koreans have been disciplined to honor elders, yield to elders’ wills, and place elders’ needs before their own. the practice of “jangyuyuseo” led soyeon choi to perceive herself as an older adult. however, she felt uncomfortable with being treated like an elder by the young because she felt that they, too, might physically need the rest. she was resistant to the label the younger adults assigned to her of respected (but also frail) elder in need of assistance. sooyoung remarked on changing his social title within south korean society and described his attitude toward the changed title. when i went to a museum, i didn’t know if i should pay admission. but, later, i knew that others had paid the fee. so, i asked a staff member. she said, “halabeoji [an honorific meaning old man or grandfather], you are free.” that meant i’m old. i felt upset. realizing that the free admission was for the aged, he perceived that he was categorized as a member of the elderly population. his reaction to the free admission was negative because he saw that “benefit” as only offered to elders under the assumption that the elder had limits to financial security. the shift to an identity as an elder who was financially at risk was not a voluntary movement but a socially-mediated, forced transition that failed to recognize the heterogeneity of those entering young-old elderhood. change in social position was also experienced in the workplace. for example, 62-year-old jeongmi referred to people’s image of and attitude toward older teachers in school and its impact on her transition to elderhood. parents and people’s solidarity for participatory democracy said that teachers’ retirement age had to be cut down and older teachers should be retired. social views on older teachers hurt me. i thought it was wrong. i have anthropology & aging quarterly 2012: 33 (2) 58 wonjee cho & denise c. lewis transitions and time done my best to teach children. but, i’m wondering why i should be treated that way. should they do so because i’m old? this organization’s assertion reflected a social viewpoint on older teachers. that is, even though older teachers accumulated teaching-related knowledge and experience over time, they were socially considered as incompetent and unqualified, based solely on reaching age 60 even though government-sponsored old age benefits were not offered until age 65. such a policy could have severe consequences for those forced leave their careers prior to qualifying for benefits. sooyoung also mentioned a limited opportunity of older and retired teachers for contributing to the educational field. even though he retired at the nationally recognized age of retirement, he stated that, from the moment of his retirement, he no longer contributed to society. it was not because he was unable to contribute; instead, it was because he was thought by others to be “too old” and “without value” when he reached age 65. he described his perceptions of being discarded: when i retired at age 65, the saddest things was, even though i had know-how from rich teaching experience for the past 40 years, such knowledge was thrown away. i want to tell my knowledge to someone and to help, but there is no way to do that. i think, socially… we need to find some way to use the know-how. it seems both school and other workplaces have needs to find [qualified teachers]. he described his social position as a retired and older teacher. he interpreted his retirement to mean that society no longer saw value in the wisdom of elders in a workplace setting. it was a form of forced disengagement that made little sense in light of unmet needs for experienced workers and the rich body of knowledge he possessed. entering into old age or not the participants commonly experienced a variety of age-related changes, but most of them psychologically resisted their transition to elderhood and still described themselves as young. for example, despite his experience of changing physical appearance, sooyoung remarked on his psychological refusal to enter elderhood. [i’m] about 50. [it’s] 10 years younger [than my actual chronological age]. i feel like 50. [laugh]. it’s true. compared with same-aged persons, i physically look older than them. and, my gray hair makes me look older. but, i don’t feel older than them because i still think like a young man. he admitted that age-related changes in physical appearance contributed to perceptions of age-related developmental changes. he was confident, however, compared with peers of the same age, that his mind remained sharp and “like a young man.” in this sense, he resisted a label of elderly man and retained an image of himself as young, based on his mental acuity, not his graying hair. this demonstrates a reluctance to accept movement into old age based solely on appearances and, simultaneously, defines the conditions necessary for him to accept his own aging. in other words, when he no longer thought in a youthful way, he would then see himself as an older adult. similarly, eunkyeong assessed physical and psychological “self” as being 16 years younger than her chronological age of 66 years. she reported, “i can walk as much as others… i can participate in activities… i just feel like 50.” she based her age on her experiences as a healthy person who continued to experience few difficulties in everyday life and social activities. carrying out daily activities as much as others significantly younger than she was an important determinant for psychologically resisting a definition of self as an elderly person. instead, she viewed “age” as it was related to health and well-being. similar to sooyoung, who gauged his age based on his abilities and delayed his acceptance of a label of elder; she experienced a psychological delay in the transition to elderhood through viewing herself as a 50-year-old woman. the emergence of physical difficulties in everyday life was her expected transition to elderhood. taehyun was the only respondent who perceived himself as an older adult in the current moment. he revealed that, “psychologically, i don’t feel younger than same-aged persons because there are many healthier persons than me. i’ve seen many healthy persons around me.” of all the respondents, he was in poorer health condition than same-age peers. just as good health created resistance to accepting a social definition of “aged”, poorer health led him to accept an identity as an elderly person. although his chronological age was only 63 years at the time of this interview, his ill health accelerated his self-defined psychological shift to old age. the degree of difficulties or ease in cognitive and physical functioning were pivotal factors individuals used for determining psychological acceleration or delay in the shift to old age. discussion and conclusion oftentimes, in research on aging, the young-old are portrayed as more healthy and vigorous than the oldold and the oldest-old and as different from the middleanthropology & aging quarterly 2012: 33 (2) 59 wonjee cho & denise c. lewis transitions and time aged in the event of retirement (baltes and smith 2003; choi 2009; chou and chi 2002; neugarten 1996; smith et al. 2002). indeed, all six participants reported they were in good health when they were contacted for interviews. although most of the participants were in relatively good physical and mental health, most also had begun to focus on physical ailments. while they may be successfully aging as discussed by chung (2007) and kim and kim (2009), we found that there was considerable ambivalence and dissonance between their inner (self-defined) and outer (socially defined) experiences of being old. several participants were undergoing changes related to entry into old age and being old. chronologically, physically, and socially, they were placed into a category of “old” simply because they have reached age 60. the psychological response to the socially enforced agingrelated experiences is distinct in two ways: denial or acceptance of aging. most of the participants, who expressed a sense of continued youthfulness in physical and mental capabilities, did not psychologically define themselves as being old. however, only one, who reported poorer health status than age peers, psychologically identified himself as old after age 60 but before age 65. although the participants in this study experienced chronological, physical, and social changes in relation to growing older, they reported that they look and perceive themselves as much younger than what they might have expected as elders. similar to the discussion by kwon and kim (2008) and yang (2012), these participants described their own confidence in physical and mental abilities related to activities and social involvement and their desires to remain active participants in south korean society. that is, experienced changes in relation to being old were not recognized as a significant limitation of their abilities and activities. in addition, confidence in their physical and mental abilities allowed them to retain their psychological status as a young or active person, not as an old one. turning age 60 and of being in their 60s was a key change in relation to the process of becoming old. participants viewed their 60th birthday, hwan-gap, as a socially mediated and socially enforced transition to old age. just as described by hendricks and peters (1986), the chronological and ecological measure of time greatly influenced their individual and others’ perceptions of aging, similar to the arguments of bae and park (2009), hendricks (2001), and sorokin and merton (1937) also link societal changes to perceptions of aging. several participants in this study accepted a socially imposed identity of “elder” and simultaneously began to feel old. just as dittman-kohli (1990) and seo (2008) describe, elders began to focus on physical and mental changes as they aged. this is important because chronological age has been used to measure ecological influences or temporal progress, so that individuals fit an ecological template or age category (hendricks and peters 1986; neugarten 1996). this “forced fit” plays a significant role in affecting personal experiences of aging and definitions of self-concepts. perceptions of health and experiences of ageism (jeong and shin 2009) upon turning age 60 shifted identities toward elderhood. this critical life event or transition marked the boundary between middle age and old age (choi 2009). declines in physical and mental vigor were also key features associated with reaching age 60. those who were experiencing declines felt that they almost immediately grew older. it is interesting that they experienced the beginning of old age at age 60, not at age 65, in that gerontologists and policymakers in south korean society regard age 65 as the entry age into old age (choi 1996; chung 2011, 2012; kim 1996). this illustrates that traditional patterns still hold salience in south korean society, even as national policies only recognize “elderhood” as occurring 5 years later. a chronological age of 60, rather than age 65, was used as the starting point in a definition of “being old” within the changing context (chin 1991; elder 1998; fry 2003; shin et al. 2003) of south korean society. several participants expressed that they had not thought of themselves as old until hwan-gap and, only then, developed their own selfimage of getting older. thus, the ideational dimension of hwan-gap is shown to strongly influence meanings of age and aging (chin 1991; shin et al. 2003). regardless of the social age norm related to being old, they encountered the experience of entering old age and of growing older in their early 60s, a time that in many circumstances was defined as late middle age, not as elderly. this also shows that the social agreement of age 65 as the beginning of old age overlooks experiences of people who are nearly forced to become “old” in their early 60s. this ideational dimension is unlike the findings of several researchers (e.g., bouffard et al. 1996; cho 1997; kim et al 2003, 2010; lee 2010; lee and rhee 2004; lennings 2000; rappaport et al. 1993; seo 2008) who focus on perceptions of death, health behaviors, and life review but do not consider older adults’ contemporary perceptions of aging. such a forced movement into a liminal position—old as defined by tradition, but not yet old as defined by policy— gives limited insight into the individual transition to elderhood and the process of growing old within south korean society. toward a deeper understanding of experiences of aging, gerontologists and south korean policymakers might be well served to pay more attention to the significance and social implications of chronological anthropology & aging quarterly 2012: 33 (2) 60 wonjee cho & denise c. lewis transitions and time age as a turning point in the young-olds’ experience of aging. moreover, a view of self may not necessarily be relevant as an index for measuring temporal passage or of categorizing age. instead, it is important to consider the lived experiences of young-old persons. narratives about physical changes revealed that these changes were a salient feature in the process of growing older. indeed, physical changes were perceived as the most crucial event for marking the transition to old age. life course theory (elder 1998) provided an infrastructure for linking these transitions to the trajectory of an aging person as the person was compelled to take on the role of elder. this is also important in that their perception of physical changes reflected their own meaning and image (hendricks and peters 1986) of launching into old age and of being old (lee 2006). old age, to these participants, was internalized as a continuous process of deteriorating health and physical abilities based on the social-ecological context of hwan-gap. in addition, they perceived these physical declines and health problems as a negative experience in that they often were unable to manage their own physical situations. because the realities of physical infirmity underlie negative aspects of aging, they also negatively affected the reconstruction of a sense of self and the expectations for the future transition to old age. this shift in a sense of self (lennings 2000; rappaport et al. 1993; showers and ryff 1996) is off time chronologically based on national policies but on time based on social context. while the participants in this study felt they were relatively healthy prior to hwan-gap, once they “became old” they became more aware of finite time (mcadams 1990) and of declining health. thus, it is increasingly important to consider young-old people’s stereotypical image of being old, their view of self, and a new transitional life stage. in addition, it is imperative that researchers move beyond interests in physical changes as the key feature of being old to design research and programs that help the young-old obtain knowledge about the aging process. knowledge of aging processes may reduce their fears of powerlessness and inability in old age. this research also emphasizes the effect of a new social title as an elderly person. others’ perceptions influence their own understandings of what it means to become old. the forced label of an aging self, mediated through social views on and attitudes toward them, caused them to focus on their own aging within the context of others’ actions in south korean society. they became socialized to old age, even when they did not “feel” that they were old. socialization into old age was not a cheerful experience for several in that they learned that being old meant that they were assumed to be frail, dependent, and incompetent (lee 2006; yang 2012). contrary to the social image of elders, and because they still thought of themselves as healthy and youthful, they did not readily accept social benefits (lee 2008; shin et al 2003; yang 2012) normally provided to elders (such as accepting a younger person’s seat on the bus). in addition, they resented that their work-related knowledge and experience were considered useless and unworthy of recognition. they internalized that, even as a holder of valuable work knowledge, they were no longer needed by work or by society. in this process, they perceived that they were set aside, no longer socially useful and no longer productive and active in a society. the change in status, often associated with hwangap, was the catalyst for entry into old age and for their acceptance of their own aging as a nearly immediate event. this study shows that participants expected to have opportunities for their activities or productivities and to retain value in society. instead, the social title of young-old, as defined by their age, led to an undervaluation of their current ability and productivity (lee 2006; shin et al 2003). socially restricted opportunities led them to experience isolation and frustration. moreover, these restrictions negatively affected their reformation of identity as elders in the psychological transition to old age (shin et al 2003; yang 2012). although this is a small study, it shows that gerontologists and south korean policymakers need a profound rethinking of young-old people’s aging-related experiences so that this phase in life is understood to be qualitatively different from the experiences of old-old and oldest-old people. the young-old are aging (a process), not already aged (a culmination of the process). thus, a reconsideration of young-old people’s aging processes and aging experiences is required. it is also important to provide social opportunities for maintaining their sense of youthfulness through participation in socially meaningful activities. because this study was to explore the meaning of living in the present for the young-old, a process that little is known about in south korean research on aging, the sample size is limited. this allowed the researchers to capture indepth narratives regarding a select group of experiences and perspectives on aging. the findings from this study point to the need for expansion to include more young-old persons with a greater diversity of socioeconomic statuses. in addition, future studies should include elders across all three categories of old age (i.e., the young-old, the oldold, and the oldest-old). such studies could provide a deeper understanding of the meanings of aging for elders transitioning to elderhood because of hwan-gap, as well as those who are transitioning into old age as defined by south korean national policies. taking the findings from this small study could serve as a springboard for larger studies so that policies and practices associated with aging in south korea reflect the actual lived experiences of aging. anthropology & aging quarterly 2012: 33 (2) 61 wonjee cho & denise c. lewis transitions and time references adams-price, carolyn e., tracy b. henley, and melanie hale 1998 phenomenology and the meaning of aging for young and old adults. international journal of 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1990 unity and purpose in human lives: the emergence of identity as a life story. in studying persons and lives. albert i. rabin, robert a. zucker, robert a. emmons, and susan franks, eds. pp. 148-200. new york:springer. national statistical office 2006 jangraeinguchugye: 2005~2050 [population projections for korea: 2005~2050]. seoul: national statistical office. national statistical office 2010 korean statistical yearbook 2010. seoul: national statistical office. neugarten, bernice l. 1996 age groups in american society and the rise of the youngold. in the meanings of age. dail a. neugarten, ed. pp. 34-46. chicago:the university of chicago press. nurmi, jari-erik, harry pullianen, and katariina salmela-aro 1992 age differences in adult’s control beliefs related to life goals and concerns. psychology and aging 7:194-196. patton, michael quinn 1990 qualitative evaluation and research methods. newbury park:sage. polkinghorne, donald e. 1995 narrative configuration in qualitative analysis. in life history and narrative: influence of feminism and culture. j. amos hatch and richard wisniewski,eds. pp. 5-24. washington: falmer. rappaport, herbert, robert j. fossler, laura s. bross, and dona gilden 1993 future time, death anxiety, and life purpose among older adults. death studies 17:369-379. seo, gi soon 2008 noingeonganghaengwiwa gwanryeonyoinganui gwangye [health behavior in the aged and related variables]. journal of the korea gerontological society 28(4):1201-1212. shin, kyung rim, mi young kim, and young hye kim 2003 study on the lived experience of aging. nursing and health sciences 5: 245-252. showers, carolin j., and carol d. ryff 1996 self-differentiation and well-being in a life transition. personality and social psychological bulletin 22:448-460. smith, jacqui, markus borchelt, heiner maier, and daniela jopp 2002 health and well-being in the young-old and oldest-old. journal of social issues 58(4):715-732. sorokin, pitirim a., and robert k. merton 1937 social time: a methodological and functional analysis. american journal of sociology 42(5):615-629. yang, yunjeong 2012 is adjustment to retirement an individual responsibility? socio-contextual conditions and options available to retired persons: the korean perspective. ageing & society 32: 177-195. anthropology & aging quarterly 2012: 33 (2) 63 wonjee cho & denise c. lewis transitions and time appendixes table 1 participant characteristics name gender birth year marital status educational level previous occupation current occupation jeongmi lee female 1944 married college professional retired /part-time jinho yoon male 1938 married high school blue-collar miscellaneous work sooyoung park male 1943 married master’s degree professional retired soyeon choi female 1943 married 8th grade blue-collar housewife eunkyeong kwon female 1940 married 8th grade housewife housewife taehyun sung male 1943 married none blue-collar blue-collar anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 11-19 issn 2374-2267 (online) doi 10.5195/aa.2015.85 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. back in the saddle again ethics, visibility, and aging on screen maruta z. vitols media studies, olin college of engineering contact: maruta.vitols@olin.edu caitrin lynch anthropology, olin college of engineering author contact: caitrin.lynch@olin.edu abstract this paper engages with filmic portrayals of older adults in the u.s. in order to ask questions about the impacts of mass media on reproducing, critiquing, or interrogating mainstream values and assumptions about aging. the study considers the recent hollywood works the expendables (2010) and r.e.d. (2010), as well as the independent documentary young@heart (2007). we forefront questions of visibility, invisibility, and recognition both in terms of what experiences and realities are rendered visible or invisible by mass media, but also in terms of the subjective experiences of many older adults in the united states. keywords: age, visibility, the expendables, r.e.d., young@heart. http://creativecommons.org/licenses/by-nc-nd/3.0/us/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu back in the saddle again ethics, visibility, and aging on screen maruta z. vitols media studies, olin college of engineering contact: maruta.vitols@olin.edu caitrin lynch anthropology, olin college of engineering author contact: caitrin.lynch@olin.edu with the inevitable aging of hollywood’s most successful stars, such as bruce willis, arnold schwarzenegger, sylvester stallone, and morgan freeman, the industry has been faced with a dilemma: how to continue profiting off celebrities who risk losing their cultural currency in a youth-obsessed field? one answer may be found in recent box-office triumphs, including r.e.d. (dir. schwentke 2010) and the expendables (dir. stallone 2010), both of which spawned sequels in 2013 and 2012, respectively. in these two films, actors in their sixties and seventies behave as if immune to the effects of time (with the exception of a few gray hairs). indeed, the only limit these characters experience are united states’ society’s stereotypes about aging. as media scholar klaus dodds notes in his study of gender, aging, and resilience in skyfall, the 2012 james bond film, [...t]here has been a growing number of films (such as the wrestler [dir. aronofsky, 2008], up in the air [dir. reitman, 2009], red [sic, dir. schwentke, 2010], and the expendables [dir. stallone, 2010]) that have addressed the role of aging men (and some aging women) and their lived experiences in neoliberal and authoritarian times (boyle and brayton). through their relations with others, these films explore the subjective positions that might make their rehabilitation as a form of resilience rather than disposability. (dodds 2014:120) these films and other recent movies seemingly challenge previous mainstream cinematic representations of older adults as crotchety, lethargic, or irrelevant to contemporary society. yet, these hollywood films actually perpetuate established stereotypes regarding aging in u.s. society in other ways. their “solution” to the social anxiety caused by aging and death is to deny the realities of experiences of aging. hollywood films make invisible the actuality of how people grow old in the u.s. one recent documentary problematizes these mainstream visualizations of older adults, giving a voice to this marginalized group. young@heart (dir. walker 2007) provides nuanced portraits of older adults, making visible both the joys and challenges of aging. the film counters dominant views of this demographic, offering compassionate and multi-dimensional portrayals of older adults as human beings. this paper engages with filmic portrayals of older adults in the u.s. in order to ask questions about the impacts of mass media on reproducing, critiquing, or interrogating mainstream values and vitols & lynch | back in the saddle anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 12 assumptions about aging. we forefront questions of visibility, invisibility, and recognition both in terms of what experiences and realities are rendered visible or invisible by mass media, but also in terms of the subjective experiences of many older adults in the united states. ultimately, this paper is concerned with the politics of the erasure of multidimensional portrayals of older adults as human beings. mass-market films tend to perpetuate stereotypes regarding the geriatric in u.s. society by denying the realities of experiences of aging. in so doing, they render invisible the actuality of how people grow old in the u.s. however, the more nuanced portraits in works such as young@heart make visible the joys and challenges of aging. by making the realities of aging evident on screen, such films create a more ethical space for an often overlooked group. with inspiration from discussions in political theory of the capacities of the visual in forging ethical publics (cf. hannah arendt’s the human condition), we call on mediamakers to consider how their own work erases or forefronts groups of people as moral, recognizable entities. the concept of being "back in the saddle," which appears in two films under consideration in this paper, serves as a metaphor for the visibility and engagement in society that mediamakers enable or disable in their portrayals of aging. why this research and why now? this study focuses on u.s. cinematic production at a time when the perspectives and experiences of baby boomers inform the dominant ideological paradigm in mainstream fiction filmmaking. the aging baby boomers’ sense of self, how they are seen, and how they see themselves all contribute to the popular cultural vision of growing older in the u.s. more now than ever, hollywood’s images of older adults strive to limit the signs of aging to some grey hairs and a few wrinkles, offering a popular public an optimistic but, in truth, unattainable portrait of how older people should behave and look. while art house cinema, particularly films from the u.k. such as philomena (dir. stephen frears, 2013), the best exotic marigold hotel (dir. john madden 2011), and calendar girls (dir. nigel cole, 2003), provide improved depictions of older adults to a niche market, these representations are still problematic, embracing the notion of aging as an idealized renaissance of the body, mind, and spirit. though no mediated representation of older adults will ever be entirely free of shortcomings, documentary film currently supplies one of the most constructive public spheres for addressing aging and its cultural perception. this comes as no surprise, since nonfiction filmmaking has provided a “voice” for the socially marginalized since the era of john grierson and his work with the empire marketing board film unit and the general post office throughout most of the 1930s. in regards to a film made under the auspices of grierson by edgar anstey and arthur elton, documentary theorist and historian bill nichols explains: housing problems (1935), for example, gave slum dwellers the opportunity to speak for themselves, in a synchronous sound interview format set within their own homes. the actual workers appeared on british screens for the first time, a sensational achievement in the days long before television or reality tv. (nichols 2010:212) though housing problems raised ethical concerns regarding the victimization of documentary subjects, this ground-breaking film’s insistence on allowing the subaltern to speak in their own words shaped the social issue nonfiction film as we know it today. the mission of championing the disenfranchised continues today in the nonfiction filmmaking realm, and recent documentary efforts echo a general growing social consciousness regarding the visibility of older adults in society. as academia moves towards expanding aging vitols & lynch | back in the saddle again anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 13 13 studies, documentaries are at the forefront of changing the conversation, increasing the prominence of older adults on screen in a manner that provides an important and useful step in the right direction. nonfiction films, such as elaine stritch: shoot me (dir. chiemi karasawa, 2013) and carol channing: larger than life (dir. dori berinstein 2012), present a more holistic view of older adults, a trend already present in young@heart, which screened in 2007. one goal of this study is to encourage the creation of more media representations that follow young@heart’s lead, simultaneously acknowledging the limitations and existing problematic aspects of portraying older adults in the u.s. these forward-thinking documentaries grant an opportunity for media makers to complicate the cultural conversation about aging, dependency, personhood, and human rights. in other words, this is the moment for ageism to capture the attention of media makers, with the aim of accomplishing what filmmakers have already achieved vis-à-vis the representation of racism, sexism, homophobia, xenophobia, etc. in a context in which older adults confront everyday “ageism,” media creators have an opportunity to create more accurate portrayals that critique ageism but simultaneously question the overzealous positive expectations embodied in the discourse of “successful aging.” in a recent essay, anthropologist sarah lamb (2014) has contrasted a u.s. paradigm of “successful aging” (characterized by individual agency and control, independence, productive activity, and permanent personhood) with a more nuanced paradigm of the aging experience in india (embracing perspectives on “meaningful decline”). lamb suggests that the experiences and perspectives of many older adults are rendered invisible by the united states ideal. in light of the cultural as-sumptions and unspoken values underlying the successful aging discourse, it would be easy to understand the sense of inadequacy experienced by an older adult in the united states who can-not or does not want to skydive in her 90s, or by someone whose macular degeneration means he must stop driving his car in his 70s. are there no in-between, more nuanced and subtle, paths to portraying older adults that confront the realities of meaningful decline, illness, and death, but also the richness and variety of growing older? in her recent research among older adults in the northeast united states, caitrin lynch has often encountered older adults lamenting that old people are invisible in u.s. society. for example, some people narrate experiences at restaurants or shops, when the staff will look to an accompanying adult child for information on the elder person’s requests or needs—as if the older adults have no voice or desires. during an interview with lynch, an eighty-five-year-old woman named esther martin eloquently described this experience of invisibility: you just feel like you’re a fifth wheel when you’re with a younger group…. they don’t let you join in in anything. . . . you’re just sitting on the outside, looking in. and i felt that almost the day after my husband died, that feeling. it’s just depressing. i remember being over at my son’s around easter day, and my husband died in february. i remember being over there for easter, and i was joining in, but i felt like a fifth wheel. (lynch 2012:66) esther and many other older adults in the u.s. struggle to make sense of their changed social roles and personal experiences and desires in the context of widespread cultural assumptions that characterize youth as a time of activity and vitality and old age as a time of decline, decrepitude, and death. theater and aging scholar anne davis basting has called the attitude of many dementia caregivers toward their patients “chronic underestimitis”—a tendency to assume that someone cannot do things, that he or she is best ignored and put in a chair facing a vitols & lynch | back in the saddle anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 14 window (basting 2010; cf. basting 2009). this term can apply broadly to how many people in u.s. society tend to assess the potentials of older adults. more generally, there are many aspects of everyday life in the united states in which older adults experience “ageism,” a term coined by gerontologist robert butler in the late 1960s. butler wrote: ageism can be seen as a process of systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish this with skin color and gender. old people are categorized as senile, rigid in thought and manner, old-fashioned in morality and skills....ageism allows the younger generations to see old people as different from themselves; thus they subtly cease to identify with their elders as human beings. (butler 1975:12) in another publication, butler wrote that ageism “reflects a deep seated uneasiness on the part of the young and middle-aged—a personal revulsion to and distaste for growing old, disease, disability; and fear of powerlessness, ‘uselessness,’ and death” (butler 1969:243–44). this sense of dehumanization of older adults, perhaps as a result of fear of what is to come, is what esther and others feel when they are rendered invisible by their own families, and by what they do or do not see reflected about themselves in mass media representations. while actual older people seem invisible in u.s. culture, popular visualizations of aging in the media grow increasingly pervasive, as the baby-boomer generation enters retirement and struggles with stereotypes of what it means to become older. mainstream hollywood film provides one revealing arena where aging on screen offers insight into how u.s. society addresses the role of older adults in our communities. initially, both r.e.d. and the expendables appear to celebrate aging, suggesting that there is much to be learned from the wise and experienced. in r.e.d., the generational conflict appears throughout the film’s plot, frequently used as a comic device at the expense of the naiveté or cockiness of younger generations. bruce willis’ character, frank moses (willis was 55 at the time of filming), has been forced into retirement by “some thumb-sucker,” as described by the c.i.a. archivist played by ernest borgnine (age 93 at the time of the film’s release), while willis’ younger c.i.a. counterpart and temporary nemesis, agent cooper, twice refers to him as “grandpa.” a young secret agent wielding a shoulder-fired missile calls marvin (played by fifty-six-year-old john malkovich) “old man,” before marvin promptly kills the agent and responds: “old man, my ass!” repeatedly, the protagonists of the film demonstrate mental acumen, quick reflexes, and an impressive sagaciousness that the younger generation painfully and obviously lacks. though the generational conflict is less overt in the expendables, its traces appear in the relationship between barney ross (played by sylvester stallone, 64 at the time of filming) and the rest of his mercenary crew. ross is the eldest member of the group, and consistently makes “the right” choice when evaluating potential jobs and dangerous situations. meanwhile, his younger colleagues are all marked as somehow flawed within the film’s logic of uber-masculinity. gunner jensen (played by dolph lundgren) uses drugs, disobeys orders, and betrays his friends. toll road (played by randy couture) is traumatized by his cauliflower ear and routinely sees a therapist. yin yang (played by jet li) constantly complains how he should receive more money since he’s shorter than everyone else and, thus, works harder to complete the same assignments. even jason statham’s character lee christmas has problems with his girlfriend and is fixated on vitols & lynch | back in the saddle again anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 15 15 discussing romantic relationships with the male group. only ross is entirely rational, calm, mature, and moral, ultimately leading the gang to victory over the aging villains played by eric roberts (age 54) and former wrestler steve austin (a youthful 46). indeed, all the older adults in these two hollywood films have only improved with age, since they are at the peaks of their lives. aside from a few bald heads and some grey hair, no other outward markers identify the r.e.d. squad or stallone’s ross as having any signs of the degeneration that accompanies growing older. morgan freeman’s character joe has stage 4 cancer throughout the film, but appears as spry and fit as ever, emerging from a getaway car to tell moses’ younger girlfriend that he’s “not dead. just retired.” he is also sexually frisky, teasing the nursing home attendant about her shapely bottom. in fact, joe chooses to die as a sacrifice to save the other members of the team, asserting his agency in the face of illness (in other words, he doesn’t allow cancer to beat him he controls his own death on his terms). at the same time, in the expendables, ross uses every opportunity to show off his bulging muscular physique, his face described by one film critic as “tumefied to resemble a fleshy balloon” (huber 78). time and experience may have made these adults wiser, but they certainly have minimally touched their bodies. in other words, the bodily process of aging is rendered invisible. this mainstream representation of aging adults unsurprisingly mirrors the “successful aging” movement in the united states. in her critique of the discourse of successful aging, lamb explains: no one uniform definition of successful aging emerges from this discourse, which spans thousands of articles, books, policy documents and websites; yet several common cultural themes underlying the varying definitions stand out, including: an emphasis on individual agency and control (you can be the drafter of your own successful aging); the value of independence and the importance of avoiding dependence; the value of activity and productivity; and a vision of not aging at all, while pursuing the goals of agelessness and what could be termed a permanent personhood. (lamb 2014:4) lamb’s analysis of successful aging is reflected in the way r.e.d. and the expendables depict the aging process: all of the older adults in these films defy a youth-oriented culture’s limitations and achieve individual agency and control by the end of the stories. they all demonstrate the importance of being independent and able to take care of oneself, while also showing how much they value their activity, productivity, and contributions to society (whether bringing the vice president of the united states to justice or saving a mythical caribbean island from a dictatorship and c.i.a. exploitation). most of all, these characters embody this “vision of not aging at all,” maintaining their permanent personhood by insisting verbally and physically that the passing of time has not altered them in any negative way. moses still performs crunches and boxes with agility during his morning exercise routine. when asked how she has adjusted to retirement, victoria (played by helen mirren) tells moses: “well, i do get a bit restless sometimes. i take the odd contract on the side… i just can’t stop. you can’t just flip a switch and become someone else!” in other words, echoing the notion of “permanent personhood” identified by lamb, victoria is the same person now as she was thirty years ago when she actively hunted soviet agents. her “permanent personhood” is further emphasized later in the film when she resumes her torrid affair with former russian spy ivan simanov as if no time had passed. in one memorable scene in the expendables, vitols & lynch | back in the saddle anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 16 christmas and ross flee from the dictator’s troops on the island, with christmas preparing their small plane for takeoff while ross throws explosives at the pursuing soldiers. as the plane’s engines roar and the machine starts to take off, ross sprints down a pier, jumps up in the air, and catches the side of the plane’s open door. ross proceeds to hang acrobatically from the plane as it splashes through water, receives bullets from the angry troops, and finally escapes into a higher altitude. within the logic of the film, it seems perfectly plausible that a man who qualifies for membership in the aarp can achieve such a feat. by all indications, these mature bodies are ageless, or perhaps even improved with age (like a fine wine). audiences embraced this cinematic envisioning of successful aging in droves, earning r.e.d. over $90 million dollars in the united states alone (almost $22 million worldwide), while the expendables grossed over $103 million at home (and almost $35 million worldwide), clearly marking both films as blockbusters. why would a youth-driven culture endorse two films starring actors arguably ‘past their prime’? one answer may be the changing demographics of moviegoers. journalists pamela mcclintock and tatiana siegel explain: not even the youth-obsessed studios can ignore the numbers. there are 78 million baby boomers, defined as those born between 1946 and 1964. in 2010 thanks in great part to advances in medicine 40.3 million were over the age of 65, making them the fastestgrowing segment of the population, according to the u.s. census. that compares with 30.7 million people between 18 and 24. it’s also the segment that most likes to go to the cinema. the mpaa reports that movie attendance across all age groups dipped in 2011 save for those 60 and older (mcclintock and siegel 2012:64). if lamb’s theories regarding the u.s. population embracing the concepts of “successful aging” are accurate, these movie-going baby boomers flock to the cinema to see images of their own desired ‘ageless aging’—and so far, hollywood obliges. one example of this ‘ageless aging’ appears in a sequence from r.e.d., where moses meets his younger nemesis for the first time. after trading brief barbs, moses and cooper enter into hand-to-hand combat, destroying office furniture and glass in the process. though both men suffer serious injuries, moses ultimately overpowers cooper and manages to elude capture. this sequence is particularly revealing, since the fight is accompanied on the non-diegetic soundtrack by aerosmith’s 1977 song “back in the saddle.” as moses brawls with the agent, spectators hear the following lyrics: “i’m back in the saddle again, i’m back, i’m back in the saddle again. i’m riding, i’m loading up my pistol; i’m riding i really got a fistful, i’m riding, i’m shining up my saddle, i’m riding, this snake is gonna rattle.” setting this song against images of moses defeating cooper encourages audiences to view the retired agent as experiencing a second youth. having metaphorically returned to his former saddle, he displays the potency and prowess of older adults. propitiously, the phrase “back in the saddle” also appears in stephen walker’s documentary young@heart, yet its use denotes a different meaning. in the non-fiction film that follows several months in the lives of a chorus group comprised of older adults, during one rehearsal chorus member bob salvini (age 76), discusses his passion for singing. though still recovering from an almost lethal bout with spinal meningitis, he insisted on singing a solo with his beloved choral group because this activity makes him feel like himself again. asserting that singing makes him feel “like being back in the saddle again,” he quickly refuses to entertain any vitols & lynch | back in the saddle again anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 17 17 possibility of leaving the group for health reasons. in this situation, the phrase isn’t employed as a display of physical and mental domination, as it is in r.e.d. for salvini, being ‘back in the saddle’ signifies returning to his life and his community. he views singing with the chorus as a valuable activity and contribution to society (in this case, the town of northampton, massachusetts, the chorus headquarters). this moment in young@heart reveals how the documentary presents aging in a more productive and ethical light than its hollywood counterparts (a term we use intentionally considering that young@heart received relatively wide distribution and financial success). while walker certainly shows “successful aging” in this work (the chorus members are, as a whole, energetic, lively, productive, and active), he also includes passages that illustrate what lamb refers to as “meaningful decline.” lamb (10) asserts that the united states’ anti-aging culture reveals a “broad discomfort with situations of bodily and cognitive impairment, dependence, and human transience.” instead of denying or rendering invisible “the realities of change, decline and mortality” (lamb 2014:9), u.s. society would benefit from acknowledging, discussing, and making visible the limitations and transformations that time brings. describing counter-narratives among some of her u.s. research subjects who contest the successful aging discourse, lamb maintains, “adapting to and accepting change and limitations are thus, for these persons, an important part of aging well” (2014:9). by featuring scenes where choral members struggle with illness, are hospitalized, and require help from others to get to and from rehearsals due to vision loss and impaired mobility, young@heart offers more compelling counter-narratives to support lamb’s critique of the dominant u.s. paradigm. when the narrator notes that stan is “suffering from an extremely painful spinal condition,” viewers almost feel his agony as he stands and practices the james brown song “i feel good.” spectators watch the older adults read their sheet music with magnifying glasses, even though the lettering already looks enormous, and they hear the rhythms of a singer’s oxygen machine keeping time along with the instruments during coldplay’s song “fix you.” walker even includes in the film the deaths of two prominent members of the chorus, compassionately and poignantly chronicling the grief and mourning processes experienced by the group as they continue to rehearse and perform. in young@heart, mortality is an accepted part of everyday life, and aging is made very visible on screen. for example, the first shot of the documentary is an extreme close-up of a screaming mouth with yellowing and missing teeth. the camera will eventually track back to reveal the owner of the mouth, choral member eileen hall (age 93), singing the clash’s punk anthem “should i stay or should i go?” into a microphone on a concert-hall stage. moreover, the choices of songs included in the chorus’ repertoire humorously highlight the many issues that aging adults may face, such as experiencing intense boredom; feeling useless in society; missing lost loved ones; and anticipating and worrying about memory loss and, ominously, dementia. yet, these images are not enough. merely appearing on screen does not grant older adults the agency in society to be valued as human beings. public speech in the form of a filmic presence is not sufficient for concrete political and social change. some may even point to the appearance of older adults on screen as an excuse to go no further, maintaining older adults’ mar-ginalized status. moreover, the audience for nonfiction filmmaking is highly specialized. after all, the demographic for documentary consumption has traditionally been limited to academia, libraries, museums, and fringe movie houses. very few documentaries are widely released on a national scale. vitols & lynch | back in the saddle anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 18 while inclusion and presence on screen are not enough, they are an important beginning. seeing and hearing older adults on screen in young@heart is an improvement over past representations, and raises spectator consciousness, if only for a moment. this new awareness will, hopefully, lead to further, more concrete action towards solidifying the human rights of older adults. after all, acknowledging the issue is the first step towards remedying the problem. how would hollywood benefit from making visible the financial, social, and physical precarity that can characterize the aging process? rather than rendering invisible the signs of growing old in an effort to perpetuate the dominant paradigm of “successful aging,” what would more nuanced portrayals mean for the baby boomer viewers, and audiences of all ages, who make sense of media images in light of their unspoken assumptions—and for whom media images feed those very assumptions? the documentary young@heart offers one possible model for how to constructively and ethically represent aging on screen, embracing the positive and negative aspects of growing old. if the landscape of portrayals of aging experiences expands in this direction, perhaps, finally, new generations of filmgoers will be able to enjoy an improvement over gerontologist robert butler’s lament four decades ago and demonstrate the ability “to identify with their elders as human beings” (butler 1975:12). though media representations alone are not enough, their positive impacts influence lived realities, challenging us to rethink our beliefs about what it means to age. acknowledgements the authors would like to extend their sincere thanks to elizabeth dunn for raising provocative questions about this study when it was presented at the 2014 american ethnological society spring meeting in collaboration with the society for visual anthropology, and to casey golomski for organizing the panel at those meetings and for providing insightful comments on the draft. references basting, anne davis 2009 forget memory: creating better lives for people with dementia. baltimore: johns hopkins university press. 2010 interest group on aging and the life course, business meeting. annual meeting of the american anthropological association, new orleans, 19 november 2010. interlocutor interview comments. butler, robert n. 1969 age-ism: another form of bigotry. gerontologist 9:243-246. 1975 why survive? being old in america. new york: harper & row. dodds, klaus 2014 shaking and stirring james bond: age, gender, and resilience in skyfall (2012). the journal of popular film and television 42(3):116-130. vitols & lynch | back in the saddle again anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.85 http://anthro-age.pitt.edu 19 19 huber, christopher 2010 the expendables: sylvester stallone, us. cinema scope 44 (fall):78-79. lamb, sarah 2014 permanent personhood or meaningful decline? toward a critical anthropology of successful aging, journal of aging studies 29: 41–52. lynch, caitrin 2012 retirement on the line: age, work, and value in an american factory. ithaca, new york: cornell university press. mcclintock, pamela and tatiana siegel 2012 the great white-haired hope. hollywood reporter 23 august 2012:64-67. nichols, bill 2010 introduction to documentary. second edition. bloomington and indianapolis: in-diana university press, 2010. print. 29(2).indd anthropology & aging quarterly 2008: 29 (2) 47 features respecting the aging self: communication in the nursing home jean tinney, ph.d. research fellow national ageing research institute, parkville, victoria, australia j.tinney@bigpond.com abstract this article draws on findings of an ethnographic nursing home study that explores the role of communication in maintaining residents’ sense of self. these findings suggest that the nursing home can be a site for recovery for the aging self, despite loss and bereavement and the negative effects on self-esteem of pain, illness and loss of function. however, where care privileges the body over social and emotional needs, residents have inadequate opportunities for communication essential to make sense of being old and in care. the key to sustaining the aging self is empathetic communication that recognizes the individuality and value of each older person, no matter how reduced by present illness or incapacity, and at the same time respects residents’ rights of choice and personal control. harried staff, often well-intentioned but unsupported by management, carry an unfair burden. frequently called upon to do more with less, they find themselves faced with the competing pressures of work routines and residents’ emotional needs. in trying to balance these competing needs and provide opportunities for residents to exert personal control over their lives, they must protect both the residents and themselves from the results of “wrong” choices. introduction many nursing home residents suffer from loneliness and loss of self-esteem. contributing factors include bereavement and loss of previous social roles and relationships. attempts to form new relationships with other residents may be undermined by pain, illness, and loss of physical, cognitive, and communicative capacity. lack of emotional support and opportunities for relational communication can threaten residents’ sense of self and increase their levels of dependence. conversely, close relationships offer enjoyment, meaning, and purpose in life, enhancing health and wellbeing (o’hanlon and coleman 2004). in the absence of family or close friends, staff might appear to be the most readily available conversation partners, but the conflicting demands of their work routines can limit their capacity to explore and try to meet the emotional needs of residents. staff may also hold negative stereotypes of aging or lack the skills and awareness to recognize the impact of their own communication styles, attitudes, and behavior on residents’ self esteem and personal control. in optimal circumstances, staff will be supported by management with a philosophy of holistic care, and institutional routines that foster person-centered practice. such a model implicitly recognizes the whole person, and, in so doing, recognizes the history behind that person. it also entails concepts of respect, dignity and self-worth. ideally, a written code of ethics encapsulating such a philosophy will express the commitment of management and provide a blueprint for staff training. in such circumstances the nursing home is a potential site of growth and recovery of the diminished aging self (nussbaum et al. 2000). in this article i explore staff perceptions of their role in meeting residents’ communication needs, and their commitment to a code of ethics that “encourages personal independence in everyday life and respects every person’s right to privacy, dignity and individual decision making” (in-house code of ethics). i explored these perceptions as part of an ethnographic study, which investigated the role of communication in sustaining residents’ sense of self and personal control. in discussing my key findings, i argue that empathetic communication of respect is the key to providing care that recognizes and supports the self. i focus on communication as a means of demonstrating this respect, and with it reinforcing resident self-esteem and well-being. the maintenance of resident dignity and personal control, ethically derived, is deliverable via the practices and communication of respect. definition of terms respect is an assumption of competence and worth in another person or in oneself. dignity is a personal sense of worth or value. in the absence of reinforcement though demonstrable personal achievement, it may depend on the communication of respect from others. the aging self, or kaufman’s “ageless self” (1986) reflects the notion of continuity of self throughout the life span. the core self is strengthened by relational communication, and weakened by loss of relationships and communication partners. anthropology & aging quarterly 2008: 29 (2) 48 features the study this article is based on ethnographic fieldwork in two aged care facilities in melbourne, australia administered by the same not-for-profit provider. i chose this organization because of its good reputation for residentcentered care. this choice arose directly from my research goals. i sought to explore the role of communication in strengthening residents’ capacity to maintain sense of self and find meaning in being old and in care. my belief, based on the literature and my own observation of other institutions, was that i needed to observe “good” models of care in order to identify the qualities and characteristics that serve to strengthen resident sense of self. this bias means that i make no direct comparisons with sites offering less resident-centered models of care. in the absence of a body of australian literature on the subject, references are made principally to studies from the united states. my study fills a gap in the literature concerning older people’s experience of aging in residential care, the role of communication, and the staff experience of trying to deliver resident-centered care. the sites the first site had 50 beds for residents with high care needs. it was an old building in an inner suburb, close to the street and surrounded by other buildings. most rooms had four beds and no en suite bathrooms. these physical limitations made it difficult for staff to safeguard resident privacy. in contrast, the second site of 60 beds in an outer-suburban setting was a relatively new, purposebuilt structure set in spacious gardens. most rooms were single, and the few shared rooms were for two people only. all rooms had en suite bathrooms, and resident privacy, at least during personal care, was easier to respect. methodology the research design included prolonged participantobservation (for eight months, two days a week at each site) in the role of voluntary assistant to the allied health and activities staff. additionally, there were interviews and conversations with residents (initial recorded semi-structured interviews with twelve cognitively and communicatively competent residents), and many follow-up conversations with these and other residents, families and other visitors. the original research design did not include interviews with staff, although implicit in the principal research question were issues of power and control, dependence and autonomy. important questions about staff attitudes and practices emerged during the first six months of fieldwork, prompting me to request institutional approval to conduct staff interviews. as an active participant-observer, i had developed good relationships with both care and non-care staff. this partly explains why none of the 23 staff i asked for interviews declined, even though the recorded semistructured interviews of 30 to 60 minutes occurred before or after work shifts. staff informants included nursing staff (from managers to the most junior personal care assistants), allied health and diversionary therapists, and kitchen and housekeeping staff. the average age of nursing staff in residential care in australia is 47 years, and the workforce is predominantly female (only two of my 23 informants were male). the employer organization had formulated its own code of ethics, and made all regular staff aware of it through orientation procedures and on-going inservice workshops. i asked staff general questions about the rewards and challenges of working in aged care, the possibility of meeting residents’ communication needs, and the code of ethics. i asked for responses to the affirmation that the organization “encourages personal independence in everyday life and respects every person’s right to privacy, dignity and individual decision making” (in-house code of ethics). i also asked how staff balanced the tension between safeguarding resident autonomy and resident health and safety. background communication and the maintenance of the self to explain how empathetic and respectful communication reinforces the sense of self, i examine more closely what is entailed in the process of communication. this is especially relevant in an environment where nonverbal communication, particularly through touch and silence becomes salient: “what doesn’t get said also has to be heard” (savishinsky 1991:159). communication involves recognition of the other person, and, ideally, that recognition involves the whole person. implicit in such recognition is the capacity to see beyond illness and disability and realize that a person does not need a body to function perfectly to maintain identity (kaufman 1988). communication also carries, beyond the affective message of recognition and acceptance, willingness to engage with the history and the ideas of a partner who is able to express these. the demonstration of interest conveys a positive valuation of the person as a worthwhile conversation partner, and confirms that the story is worth telling and worth hearing. in the warmth of relational communication, conversation partners form bonds that strengthen the relational self (cohen 1994). i argue that the aging self is reinforced through narration. in the process of making explicit the links between the past and present self is the possibility of making sense of the present, especially a present where losses have diminished self-esteem and sense of purpose (gubrium 2001, kaufman 1986). anthropology & aging quarterly 2008: 29 (2) 49 features patronizing communication: “aging talk” patronizing communication includes “verbal alterations such as simplified vocabulary and grammar, repetition, over-familiarity, disapproval, non-listening, and altered topic management” (ryan et al. 2006:130). other elements are the linguistic characteristics of “secondary baby talk” (caporael et al. 1981), altered speech pace, volume, stress and intonation. caporael and colleagues found the positive response of some care receivers to patronizing language was related to their degree of cognitive dependency. those less dependent preferred other kinds of talk. “aging talk” (giles et al. 1994) that highlights incapacity or powerlessness can reinforce dependent behavior, as can “talking down”, or using directive parental language (kayser-jones 1981, shield 1988). patronizing speech is a form of overaccommodation, described within communication accommodation theory (coupland and giles 1988). this is an adjusted communication style arising from negative expectations of recipients’ communicative capacity. it is likely to be perceived by competent older recipients as infantilizing, and indeed, many receivers are made feel less powerful, less competent and less worthy of respect. however, when genuine caring and nurturing inspire such patronizing communication, it may be less negatively perceived than communication that is controlling (barker et al. 2004). the communication enhancement model (cem) (ryan et al. 1995) offers an answer to some of the problems highlighted in the communication predicament of ageing (cpa) (ryan et al. 1986). in cpa, recognition of “old age cues” activates stereotypes (hummert 1994) that prompt negative expectations of communicative capacity. the cem instead includes recognition of cues on an individualized basis, and individual assessment of need. this leads to more effective communication with empowerment of both client and provider, and optimizes health, well-being, and competence of the older person. other perceived benefits are maximized communication skills and opportunities for the client and increased effectiveness and satisfaction for the provider. in their discussion of these models, barker and colleagues (2004) emphasize the importance of individual assessment, sensitivity, and active listening. in supporting this contention, i argue that respect for the individual conveyed by appropriate communication styles is fundamental to the empowerment and well-being of residents in aged care, but that genuine interest in the stories as well as the rights of residents confirms the value of the storyteller. balancing the ledger: obligation and reciprocity communication offers a means of reducing the imbalance in power and agency inherent in the nursing home context. if the resident’s conversation is seen to be valued, it is a gift to be offered in exchange for the care received. this is an extension of anthropological theories of exchange: the lack of relationship with strangers imposes a much greater burden of reciprocity on the receiver of care and services than that involved in family care, where the ideal of love produces a notionally balanced reciprocity (sahlins 1972). consequently, reciprocity and perceived obligation in the nursing home is a complex issue, connected to the desire of many residents to be liked. as savishinsky (1991:120) found, feeling productive and being able to reciprocate mattered: “things that people gave in return for what they got” were important to residents obliged to ask for and accept so much help. other researchers report that residents’ self-esteem and wellbeing are positively or adversely affected by whether they feel they have anything to offer staff, and in some of the worst cases, delivery of care is also affected (kayser-jones 1981). shield (1988:154) concludes that where old people have “little or nothing considered valuable to exchange, dependency increases, and the value of the old person declines”. while i found no evidence of loss of resident value in the eyes of staff, and none of differential treatment, there was, nonetheless, a marked desire on the part of the residents to find something to offer to staff and volunteers – even a joke or a story, and it is reasonable to believe that they felt less worthy when they had nothing to exchange. communication enhances resident agency. expressing personal choices is an act of agency and there is empowerment in having them heard and acted on. this recognition of personal control, or autonomy, as a key value in aged care is central to australian aged care legislation and government ethical guidelines. respect as policy: codes of ethics i maintain that respect provides a viable means for enhancing independence and personal control. this respect, although enacted through local care practices and communication, should also be emphasized at the higher level of government guidelines and codes of ethics. one of the stated purposes of the australian government ethical guidelines for residential aged care is to encourage providers to develop their own written protocols. key rights outlined are “the right of individuals to be treated with respect, the right of competent individuals to selfdetermination, and the right to privacy and confidentiality” (commonwealth department of health and aged care 2001). these goals are voluntary and self-regulatory, and the extent to which they are put into practice depends on anthropology & aging quarterly 2008: 29 (2) 50 features the level of awareness, the personal interpretation, and the good will of individual providers. adequate funding of residential aged care remains a contentious political issue in australia, unresolved by a number of government inquiries in recent years. while care costs make it increasingly difficult for service providers to meet their objectives, many will cut corners by reducing staff numbers and devoting a smaller proportion of their budget to meeting residents’ social needs. time-centered and task-centered care, rather than resident-centered care, is an attendant risk. resident rights, including personal independence, cannot be promoted if residents are rendered powerless, either by restrictive institutional structures and practices, or by denial of adult status as expressed through staff attitudes and behavior (williams and nussbaum 2001, nussbaum and coupland 2004). findings: overview key findings from staff interviews include confirmation of the value of a resident-centered management philosophy and a code of ethics communicated to staff at orientation and supported by regular staff development programs. other findings include staff willingness to commit to relationships with residents, and support for recognition of the individual personality, history and needs of the residents. staff identified limitations to their capacity to meet residents’ communication needs and provide optimal opportunities for respecting resident choices, and limitations to resident privacy. these limitations included time, staffing numbers, and continuity of staffing necessary to enhance opportunities to “know your resident” and be better able to recognize the preferences and choices of residents with impaired speech and cognition. limitations to autonomy the limitations in resident autonomy are apparent in all of the day-to-day routines of nursing homes. even the maintenance of clothing requires the assistance of others. charles, a 94 year-old male resident showed me how the belt-loops on his trousers no longer held his belt. with his trousers no longer held up securely, he was embarrassed and limited in his mobility. the staff i asked for needle and thread were unaware of his problem, and assured me they would have been happy to fix it. his need had not been noticed, and he lacked the assertiveness described by ryan et al. (2006) to express it. his capacity to have his wishes recognized and carried out failed him at a time when his dignity and self-esteem were threatened. limitations to privacy some aspects of the buildings and fittings limited resident privacy. these included shared bathrooms separate from residents’ own rooms, and shared bedrooms that made privacy of conversation with visitors or care staff impossible to maintain, even when curtains were drawn to maintain bodily privacy. shared rooms and open doors meant that personal space and possessions were not safe from intrusion by ambulant but cognitively impaired residents. many staff expressed a commitment to protecting privacy boundaries, but found this challenging, confirming the findings of petronio and kovach (1997). discussion of findings communicating respect: preserving dignity all twenty-three staff respondents were aware of their employer’s code of ethics and the affirmation i chose to discuss. when asked to comment, most expressed support for the goals, although their interpretation of what could or should be achieved varied widely. kay, a middleaged allied health staffer, felt that having a code of ethics increased her work satisfaction. she stated, “i think it’s crucial. i wouldn’t want to work for an organization that didn’t believe that”. she felt equally strongly about respecting residents’ choices: “i think we should all be striving harder to give as many choices as possible, because otherwise the person just doesn’t have any dignity left”. this commitment to preserving resident dignity was shared by many staff. some felt it should underpin every aspect of care delivery, and be the most important lesson for new staff and trainees. it was linked with recognizing resident individuality, getting to know residents well, and treating residents as equals. richard, a 40-year-old male nurse, condensed his philosophy of care into the word “dignity”, also seeing empathetic care as reflective of his own humanity. in some ways we do meet their communication needs by taking care of their basic needs...it is a communication need, which in actual fact is a reflection of maintaining their dignity. if we are human in the proper sense, everyone tries to maintain their sense of dignity. unlike those described by shield (1988), the residents at these two nursing homes were not viewed or treated alike, or spoken to as non-persons. although i saw occasional examples of “talking over”, a number of the staff vigorously rejected the practice as well as the use of patronizing or infantilizing language. i suggest that it is simplistic to condemn all terms of endearment as patronizing, because it is evident that some residents anthropology & aging quarterly 2008: 29 (2) 51 respond well to such language and do not feel diminished by it. for those who have long-term relationships with certain staff, who have always used terms like ‘love’ and ‘dear’ themselves, the use of such terms is seen as nurturing, and a mark of solidarity (see also barker et al. 2004). do as you would be done by many staff expressed their commitment to treating residents respectfully. alice, a 50 year-old nurse, advised new trainees: just look at these people as your mother or your father or your grandmother or yourself. what would you like? would you like people treating your parent or yourself like a little kid? just put yourself in their place. others echoed this sentiment. they felt that empathetic imagination was the solution to knowing what residents might like when other attempts to learn their wishes failed. if they could not understand speech, or read residents’ bodies or faces, they believed that imagining themselves in the other person’s shoes would enable them to deliver the best care. for some this was an emotional theme that reflected the degree of attachment they felt for the residents. for others it was a way of providing the best of professional care and of attempting to ensure that all staff consistently delivered this standard of care. recognition of the individual staff rejected the labeling of residents by their illness or disability, by not using terms such as a ‘parkinson’s’ or a ‘dementia’, a practice described in other studies (kayserjones 1981). this awareness of, and respect for, resident individuality was fostered by the institution and supported in training practices. as catherine, a middle-aged senior nurse described her approach to staff education: it’s around people actually asking the question of direct care staff: “do you realize that’s a person who has a name, who has a family and has a life, and who has probably contributed significantly to the world that we live in, and in their own world?” so, it’s about identifying the older person as somebody specific, and that holistic thing, rather than an old person. difficulties around communication: age, disability and the nursing home in maintaining that communication is the key to enhancing personal control, i nonetheless recognize very real limitations to communication that takes place in the nursing home context. first, there are institutional barriers, both social and physical. equally important are individual personal barriers to communication (including resident health, degree of disability, cognitive and communicative capacity, language and culture, and personality). in light of these barriers, staff cooperation is a vital factor, and the influence of staff workloads and routines on their capacity to know and meet residents’ communication needs should be carefully considered. “knowing” residents’ wishes all staff supported residents’ right to personal decision-making, but many expressed reservations about residents’ cognitive and communicative capacity to make and convey decisions. some felt it was impossible for staff to know or, in some cases, to value the decisions made. they nonetheless respected the need to see each person as an individual. others considered it worth making every effort to know and execute the wishes of all residents. they made conscious efforts to find ways of communicating which were not demeaning, no matter how impaired the resident. emily, a 30 year-old diversionary therapist, explained her approach: when i am communicating with people it is an effort, like i really, really think about the ways, especially people with dementia or alzheimer’s in the later stages…where i am constantly thinking about the best way to approach them in a way that is not going to demean them at all. some staff relied heavily on the information provided by families and others recorded in the resident profile upon entry into the nursing home. the institution saw this resident profile as an instrument for respecting resident decision-making. activities staff kept their own files on individual residents, constantly adding notes arising from casual conversation with the residents, families, other visitors, and other staff. staff who felt it was vital to continue to try to communicate even with the brain-injured assumed that non-responsive residents might hear and understand what was said to or about them. they were confident that, given enough time, they could determine what even a severely communication-impaired resident’s wishes might be. they concentrated on listening and watching, knowing features anthropology & aging quarterly 2008: 29 (2) 52 features that “sometimes movement alone could be eloquent” (savishinsky 1991:131). maria, a middle-aged nurse, expressed her certainty: it is one thing that i’ve learned in aged care…is to listen, and to communicate. it doesn’t matter what, because there’s always a sign, somewhere in their bodies, their eyes, their lips, their hands, their touch, that gives you the answer. “know your resident”: continuity of staffing most staff believed that knowing residents well was the key to understanding them and anticipating their needs, and this was an important care issue. by comparing their long-term knowledge of residents with other longterm partnerships, they highlighted the part that time and familiarity played in acquiring this knowledge. jill, a 51 year-old senior nurse, emphasised the importance of continuity of staffing: there’s lots of non-verbal communication that goes on too, so i guess it’s like living with a partner where you learn to…know what that person’s thinking. i believe, working in an aged care facility, we need familiar faces. we need people that do know what their needs are and get to know the residents, and that’s how they get quality care. this emphasis on staff continuity as a means of enhancing resident care was a recurring theme. knowing residents well was the key to respecting and empowering them. this included knowing how to address them in ways that engaged them, both in the relationship and in their own care. vicky, a 45 year-old allied health staffer, felt that listening was the most important part of knowing the residents and the means of establishing relationships, “the thing that really makes you click together”. respect in practice: supporting independence following kaufman (1988), i argue that loss of personal control is a threat to identity. on the other hand, self-esteem is boosted by validation and an increased sense of personal control. resident control is increased by encouragement and the opportunity to make autonomous choices, to find roles, routines and responsibilities, and to exert agency even in such actions as saying no to participating in activities (savishinsky 1991:119). many very ill and disabled residents cannot act independently or contribute to their own health care. their physical dependence is already established, and their selfesteem and any associated health benefits rest on recognition, not of their capacity to act independently, but of their adult status and their basic rights, including the right to have their decisions respected. i argue that the recognition of adult status and positive evaluation of the worth of individual residents and their lives is best conveyed by respectful communication. staff who communicate this respect, along with positive expectations of capacity and worth, are instrumental in sustaining resident self-esteem. their encouragement for residents to make decisions and trust carers to help execute them gives residents the confidence to believe that their wishes are worthy of consideration and reinforces resident identity. to sum up, the degree of personal control that an individual nursing home is able or willing to guarantee individual residents is dependent on a number of factors. these include the philosophy and communication practices of that organization, the structures and routines, the staffing mix and levels of staff training and experience, and the degree to which the home provides an environment in which staff are encouraged and assisted to consider residents’ dignity, privacy, and personal choices. staff need to know the residents well and these relationships have to be empathetic enough that respect for residents’ rights directs the execution of residents’ choices. staff–resident relationships staff-resident relationships are crucial to reducing the “autonomy-restricting aspects” of the nursing home (foldes 1990:34). my findings confirm the existence of meaningful staff–resident relationships, the willingness of staff to enter into these relationships, and staff belief in the beneficial effect on residents of care delivered with respect. indeed, as aroskar et al. (1990:278) suggest, “given the intimate nature of the care required, it is hard to believe that personal care could be rendered happily or received comfortably in the absence of some relationship of mutual respect”. emotional dependence staff, while willing to form relationships, also faced the question of how they could best respect and protect the residents in their care from emotional dependence. there is no easy answer to this question. the relationship between staff and residents is inherently unequal, given staff responsibility for resident health and safety and the dependence of residents on staff for all of their care needs. they live in a closed world, and residents are vulnerable and relatively powerless. thoughtful staff are aware of the risk of increasing resident dependency through building social relationships that are too close and absorbing. nina, a anthropology & aging quarterly 2008: 29 (2) 53 features middle-aged nurse manager, recognized that “you become people’s life” and try to handle that gift responsibly. staff felt they could help to reduce the power imbalance by not using patronizing language or doing so much for residents that they were discouraged from helping themselves (as described by baltes and wahl 1992). remembering to acknowledge and spend time with the more independent residents was also important. some of my informants saw residents almost as family and were proud to be part of their lives, suffering when residents died, but considering the investment worth the pain. others preferred to not become too close. with these variations, there was a general conviction that knowing individual residents well enough to establish effective communication was the key to furthering resident independence. this finding supports the communication enhancement model (ryan et al. 1995) the time factor even with the confidence that they could always communicate with residents they knew well enough, staff saw time as the most significant barrier. getting to know residents with physical or cognitive challenges takes time and great patience. staff needed time to be with residents; to learn their likes and dislikes; to gain their trust; to make contact with the hearing impaired; and above all, to listen to what the residents’ voices or bodies were trying to communicate, especially in cases of physical incapacity. barbara, a 52 year-old senior nurse, explained: “it is timeconsuming. you might have to wait for five minutes for a long blink to give an affirmative answer, so it is time consuming”. time was seen as the main obstacle to their being able to know and execute residents’ wishes. savishinsky (1991) reported similar findings, including staff regret that they lacked time to show compassion. alice described the pressure imposed by trying to balance conflicting imperatives: i think that’s probably one of the worst things about it, that you don’t have the time to actually understand, to stand there and…when you do make yourself stand there and listen to what they’re going to say, all the time i’m thinking, “oh, i’ve still got so many other medications to give out”. explicit in these words is the conflict felt between the sense of medical professional duty and that of recognizing social needs and the resident’s right to be heard. staff were willing to be patient, but the pressures of attending to medical needs limited the time available to build relationships. this highlights the basic dilemma of the conflicting roles of a nursing home (foldes 1990). if it is considered primarily a medical facility, then professional care goals will inevitably take precedence over social needs. if it is perceived as a residence, then social needs will take a higher priority, as will concern for resident autonomy. time is an important factor in communicating with the cognitively impaired, with thoughtful staff anxious not only to communicate effectively, but to communicate respectfully, as far as possible in meaningful ways. as kay explained it: we always seem to be rushing from one thing to the other. then because you can’t really rush when you have someone with a dementing illness, you have to sit down, be on their eye level, and make it meaningful. many staff felt the effort well worth making, even if they could not know what meaning the interaction held for such residents. emily confirmed her commitment: “once again i feel like sometimes they don’t have to be meaningful for me…but meaningful to them.” the balancing act: resident independence versus duty of care some staff interpreted the aspect of the code of ethics that “encourages personal independence in everyday life” literally, referring to activities of daily living. they encouraged residents to take part in their own daily hygiene routines and in eating and drinking. others encouraged residents to maintain strength and mobility and participate in social activity. most saw individual decision making as part of personal independence, and supported the ideal. however, the list of limitations to resident selfdetermination included safety issues, other people’s rights, residents’ own physical or intellectual capacities, lack of time for staff to determine residents’ wishes, and, above all, lack of resources to implement these wishes. some were very frank about recognizing that they were in control, and that autonomy in aged care was very much something to be granted, or “allowed to happen” rather than something residents could automatically claim. the word “give” in the context of “give them autonomy” and “give them choices” also highlights the power of the staff to control both the expression of resident choices and the execution of those choices. barbara summarized the staff dilemma: we’ve got a duty of care and to be responsible for people’s safety and security …and also if it impacts negatively on other people. and i think we all like to think: “yes, we give them a choice”, probably at the end of the day we’re still in control to a certain anthropology & aging quarterly 2008: 29 (2) 54 features extent. but yes, you can, and again, it’s not easy to give autonomy because again you’ve still got to be aware of their needs. staff have a duty, both legal and moral, to preserve resident health and safety, to protect residents from adverse effects of their own behavior, and residents from others’ behavior. they are required to be responsible for decisions about care, as opposed to residents who are not. this is epitomized in barbara’s conclusion that extra staff and extra time are probably the keys to furthering resident autonomy, still expressed in terms of staff control, “to be able to let them, allow them to do whatever it is that they need to do for their independence”. the balancing of resident independence against concerns for duty of care cannot be divorced from two key issues. one is the quality of resident–staff relationships and the other is the degree of reconciliation between medical and social understandings of the nature and role of the nursing home. when old people are stereotyped as pathetic, powerless, and mentally incompetent, risk factors may seem much greater and the need for protection consequently greater, justifying the denial of autonomy. residents are often angered and distressed by the denial of what they see as their right to make their own choices and this has a profound effect on their well-being and quality of life. staff were well aware of this. kay, explaining how she understood dignity of risk and duty of care, emphasized the importance of accepting that accidents happen to everybody, but of reducing foreseeable risk factors so that residents’ choices can be executed and their autonomy protected as safely as possible. her understanding of autonomy included assisting the resident “to live a full life as a human being”. “at the end of the day you can only do what you think’s best” in balancing risk factors against residents’ wishes, staff had to decide how important a perceived risk factor was. they tried to involve the resident in the decision, or at least to make clear their reasons for making the decision themselves. the words “let them do what they want” are a reminder of the custodial aspects of nursing home care and the control ultimately held by staff. different aspects of resident health and safety emerged in interviews. some staff felt that they needed to intervene if residents chose not to bath or shower, or to get out of bed. this was justified as acting for their own sake. others were concerned with perceived safety risks, particularly those involved in residents’ desire to leave the building unaccompanied. most of those who wanted to leave were cognitively impaired, and lacked the capacity to perceive or weigh up the magnitude of the risks involved. when staff believed that a resident was incapable of making a rational decision there was less weighing up, but more need for strategies which enabled them to distract or deflect the resident who wanted to act “dangerously”. all staff believed that they should not simply refuse residents’ requests, and had a range of strategies for dealing with denial of autonomy with as little conflict and as much respect as possible. kay noted: but you have to treat it with dignity as well, you have to know ways where you can coax a person away from a door situation where it’s not being closed in their face, where it’s being done with subtlety and gentleness as well. the time factor emerged as a reason for not spending too long making decisions, or debating decisions with residents. when staff felt that there was a safety risk they tended to act rather than deliberate. barbara felt that there’s all sorts of issues in this environment and you’ll never get the staffing. that would be just impossible to get the staffing mix that you need to cater for all of these things. at the end of the day you can only do what you think’s best. do your best, i mean, and make sure that everyone’s safe and warm and comfortable and as happy as they can be. the pessimism reflected in “you’ll never get the staffing” reflects some of the realities of the current australian situation, particularly the budget restrictions and staff shortages. my informants knew what they would like to do for residents, and that included assisting them in their independent decision-making and in carrying out their wishes where possible, but they did not feel they could meet resident needs as well as they wished. the lack of adequate staffing limited the time they had to devote to meeting residents’ communication needs. in the interim, they were obliged to make their own judgements and accept compromises. i argue that these compromises mean that our potential as a society to deliver care which best respects the aging self and gives meaning to being old is also compromised. acknowledgement this research was conducted through the centre for health and society in the faculty of medicine at the university of melbourne, victoria, australia. anthropology & aging quarterly 2008: 29 (2) 55 references cited aroskar, mila ann, ene kristi urv-wong, and rosalie a. kane 1990 building an effective caregiving staff: transforming the nursing service. in everyday ethics: resolving dilemmas in nursing home life, r. a., kane and a. l. caplan, ed. new york: springer publishing co. baltes, margret m., and hans-werner wahl 1992 the dependency-support script in institutions: generalization to community settings. psychology and aging 7: 409 418. barker, valerie, howard giles, and jake harwood 2004 interand intragroup perspectives on intergenerational communication. in handbook of communication and aging research, j.f. nussbaum and j. coupland.. marwah, n.j.: laurence erlbaum associates. caporael, l.r. 1981 the paralanguage of caregiving: baby talk to the institutionalized elderly. journal of personality and social psychology 40(5):876-884. commonwealth department of health and aged care, 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o’hanlon, ann, and peter coleman 2004 attitudes towards aging: adaptation, development and growth into later years. in nussbaum, jon f. and coupland, justine. handbook of communication and aging research. marwah, n.j.: laurence erlbaum associates. ryan, ellen b., ann p. anas, and daniela b. friedman 2006 evaluations of older adult assertiveness in problematic clinical encounters. journal of language and social psychology 25: 129 -144 ryan, ellen b., howard giles, g. bartolucci, and k. henwood 1986 psycholinguistic and social psychological components of communication by and with the elderly. language and communication 6: 1-24. ryan, ellen b., mary lee hummert, and l. h. boich 1995 communication predicaments of aging: patronizing behavior towards older adults. journal of language and social psychology 13: 144-166. sahlins, marshall 1972 on the sociology of primitive exchange. in sahlins, marshall. stone age economics. pp 185-275. chicago: aldine savishinsky, joel s. 1991 the ends of time: life and work in a nursing home. new york: bergin and garvey. features continued on page 55 aging in non-human primate society: what relevance for social gerontology? chris gilleard c.gilleard@ucl.ac.uk division of psychiatry, faculty of brain sciences university college london abstract wild animals were once thought not to age, as their deaths were viewed as the consequences of constant exposure to the perennial risks of nature. studies of non-human aging were largely confined to biological investigations, focusing upon short-lived species such as fruit flies, mice and nematodes. over recent decades, this has changed, and studies of non-human aging have begun to investigate aging taking place in social contexts. the present paper reviews such work on social aging in non-human primate societies. four themes were evident in seeking potential parallels between human and nonhuman social aging. these were social disengagement, social bonds or social capital, status rank and dominance, and kinship ties. no studies were found that had explored parent caregiving. the lack of clear evidence that agedness is perceived and recognised within non-human primate groups suggests that most age-associated behavioral changes are at best demi-regularities that map quite imprecisely upon social aging in human societies. however as non-human primate societies are becoming gradually confined to areas and environments established through human agency and human institutions, it is possible to speculate that non-human primate old age will become more common if less natural and as a result, perhaps more akin to social aging in human societies. keywords: non-human primates; kinship; social aging; social bonds; social disengagement; rank and status anthropology & aging, vol 44, no 1 (2023), pp. 37-56 issn 2374-2267 (online) doi 10.5195/aa.2023.417 this work is licensed under a creative commons attribution 4.0 international license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. gilleard | 37 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu aging in non-human primate society: what relevance for social gerontology? chris gilleard c.gilleard@ucl.ac.uk division of psychiatry, faculty of brain sciences university college london introduction for quite some time it was thought that aging was rarely observed ‘in the wild.’ death among wild animals was considered to be largely a random affair, arising from the ever-present dangers posed by the environment, with aging having little opportunity to impose itself as a distinct process on these ‘natural’ patterns of mortality (gaillard and lemaitre 2020, 8). aging was thus considered a phenomenon observed most clearly in human society, since only human societies were able to establish and sustain the kinds of environment securing their members reach old age (caspari and lee 2004). in recent decades, the presence and nature of aging ‘in the wild’ has become more evident. studies have begun to examine in more detail the nature of aging in non-human mammals, and the potential interaction between their aging and their social environment. traditionally, research on aging in nonhuman species has employed short-lived laboratory animals such as fruit flies, mice, and nematode worms to study biological variation in lifespan with scant attention to any social aspects of their environment. given the longer lives of most mammals, studies of their aging and longevity have been more limited, even among non-human mammals living in captivity (colman 2018). as research into later life in non-human societies has developed in recent decades, it has begun to offer some interesting insights into actuarial aging and – the focus of the present paper – on ‘social aging.’ while much of this focus on social aging can be dated back to the earlier work of jane goodall and sarah blaffer hrdy and their studies of apes (goodall 1986a, 1986b) and monkeys (hrdy 1981) it is only in the last quarter century that a non-human primate gerontology can be seen emerging. research into human aging has shown how the biological features of aging – notably patterns of morbidity and mortality over the life course – vary quite considerably from one period to another, from one society to another, and between social strata within a single society (sokolovsky 2009). while it is not clear exactly how society ‘gets under the skin’ to achieve such effects, it seems clear enough that it does (das 2013; ferraro and shippee 2009; green and darity 2010; hertzman and boyce 2010; taylor, repetti, and seeman 1997). given the powerful impact of social change in human society, exploration of social attributes contributing to human aging and longevity has assumed that it is the distinctive social, economic and cultural development of human society, and especially its progressive modernization, that has had the most powerful effect on shaping human aging. the increase in assets, capital, culture and technology, the strengthening of the social contract and the accumulation of resources evident in the world’s more advanced economies have clearly influenced both the trajectory and the rate of human aging – that is, the timing of its onset, the rate at which it proceeds and the degree of its associated decline (crimmins 2020). how far might it be possible to identify similar effects (i.e., social effects on the onset, degree and speed of aging) in non-human societies? in the absence of any direct equivalence between developments in human society and the relative stability of non-human social species, is there evidence of social aging in non-human societies? http://anthro-age.pitt.edu/ gilleard | 38 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu although the potential of cross-species comparisons for informing the study of social aging was noted some time ago (pavelka 1994) such endeavours have had only a very limited impact on either contemporary age studies, the sociology of aging or social gerontology. primate anthropologist, mary pavelka, was herself rather skeptical that age and aging were significant aspects of non-human society (pavelka 1990, 372). since then, there have been significant developments. this paper is intended to examine systematically whether social aging is a meaningful concept in non-human societies, and if so, whether any substantive benefit can be gained from integrating research into social aging in non-human societies with that in human society. in choosing to examine this question, my focus here is specifically upon primates as the genera to which human beings belong and which share our “long slow life histories” (jones 2011). unlike most other mammals, primates “grow more slowly, have later ages at first reproduction, live longer lifespans and lower fertility” (jones 2011, r708). given the common experience of a long adult life spent in the context of social groups, it seems reasonable to assume that the impact of such conditions might be more conducive to identifying potential commonalities in social aging. hence, rather than review aging across the large and diverse class of mammals, as some have done in relation to social aging (e.g., siracusa et al. 2022), this review is confined strictly to studies of apes and monkeys whose aging was first drawn attention to by the works of jane goodall and sara blaffer hrdy (goodall 1986a; hrdy 1981). even here, of course, considerable variability exists between species and between habitats.1 identifying common research themes in social aging animal models have been used frequently to explore commonalities and differences in behavioral and biological processes between human and non-human mammals. fewer attempts have been made to study how social behavior and social organization in non-human mammals might illuminate human social aging, whether through their commonalities or, equally importantly, by their differences. focusing upon the primate literature published over the last three decades, four distinct social aging themes can be identified.2 first are the several studies which focus upon what might be called ‘animal models’ of late life social disengagement (e.g., corr 2003; fischer 2017; machanda and rosati 2020). one recent review of this area, for example, concluded that, at least among female monkeys, there is evidence of their disengagement with age, in the form of reduced social interests, restricted social contacts, and less exploration of the environment (fischer 2017). the second theme concerns the value of social bonds in maintaining health and well-being in later life. here the emphasis has been on assessing the size and strength of social bonds and how far they increase fitness and survival among older non-human primates (ellis et al. 2019). such research reveals how much the particular species and the particular measures for assessing sociality vary in their contribution to survivor benefit in later life. the third theme concerns the relationship between age, rank, and status, and the patterns of dominance that can be observed between younger and older adult non-human primates (e.g., borries, sommer, and srivastava 1991; macmillan, 1989). in this context, status is typically measured by evidence of the relative dominance (versus yielding) of individual group members in their encounters with other members of the group (drews 1993).3 the fourth theme concerns the impact of kinship ties on members’ aging, health, and longevity. one frequently explored topic has been the so-called ‘grandmother hypothesis,’ namely the notion that by enacting family caregiving roles, older, post-reproductive adults promote both their own health and survivorship, as well as the well-being of the young of the species (kim, coxworth, and hawkes 2012; peccei 2001). the existence of a significant post-reproductive period in the life course, most sharply evidenced by the human menopause, but linked with the more gradual loss of fertility in many primate species is thought to increase the capacity of adult children to raise, look after, and sustain their own children, and thus promote the family gene pool, while also being of benefit to the grandparents themselves (kim, coxworth, and hawkes 2012; pavelka, fedigan and, zohar, 2002; peccei 2001). other themes have appeared in the literature, notably responses to death and http://anthro-age.pitt.edu/ gilleard | 39 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu dying within primate society, which though linked, can be considered a distinct topic in themselves, and which have been quite fully reviewed elsewhere (gonçalves and carvalho 2019). some themes are notable by their absence, not least studies examining patterns of care shown toward the oldest old in primate society. anecdotal observations however suggest that “[u]nlike humans, non-human primates do not receive substantial support from group-mates if their physical condition compromises foraging” (thompson gonzález et al. 2020, 2). in the main part of this paper, each of these four social themes – social disengagement, social capital, social status, and inter-generational kinship – will be elaborated, citing research primarily as illustration of how these kinds of themes might be linked with human social aging. as noted, this review does not aim to offer an exhaustive account of all published studies on non-human primates. the intent is to illustrate the potential – and limitations – of these research findings on aging in non-human primate societies, as well as highlighting the pitfalls in their ‘translation’ to aging in human society. before addressing these four themes a preliminary, but important consideration needs to be made, namely how far ‘age’ and ‘agedness’ are recognized in non-human primate societies, and whether, once adulthood/sexual maturity has been reached, further age or life stages can be distinguished as meaningful social realities for such groups. since this question is critical in assessing how aging in these settings might best be realized as a social phenomenon, it will be addressed first. age recognition in non-human primate society how far does agedness serve as a stimulus for social behavior in non-human societies? while there exists a considerable literature in aging studies and social gerontology on the perception of and judgements about age and agedness, such studies are presaged upon a widespread recognition of agedness, both as a social status and as a (perceptible) physical identity. hence the study of age discrimination, attitudes toward old people and ageism constitute major topics in these fields (north and fiske 2015). how distinct is the physical appearance of age among non-human primates and how evident are observable aged behaviors among such primate groups? if, for example, there is little evidence that non-human primates can and do distinguish between old and mature conspecifics, one might expect that social behavior and social bonds directed toward older adult conspecifics by other adults would not be evident. if indeed there are age changes in sociability however, arising from intrinsic aging processes, might such behavioral changes (rather than any other markers of age) serve instead as the stimulus affecting others’ behavior? if such is the case, might ‘aging’ behaviors be rather less aligned to both chronology and the appearance of age, contrary to reactions to the appearance of age evident in human society. while facial recognition is well developed in primates, and most primates can distinguish between familiar and unfamiliar conspecifics, the development of individual recognition might occur independently of any higher order recognition of classes or categories beyond, say, familiar versus unfamiliar or kin versus non-kin (tibbetts and dale 2007). to address this question of age-recognition, i will focus first upon what evidence there is of age-embodied physical changes in the appearance of non-human primates, before turning to evidence of behavioral changes associated with older age. the physical signs of age in non-human mammals have rarely been commented on by human researchers, in part, it would seem, because few reliable ways of ascertaining agedness have been established (dagg 2009). while most mammals do show visible signs of agedness, like loss of fur, hair, and muscle mass as well as evident slowness of movement, these are by no means reliable indicators of chronological age (lowenstine, mcmanamon, and terio 2016). no system has yet been developed that categorizes observable post-adult changes in appearance and correlated them with animals’ known chronological ages. while classificatory systems do exist, they either emphasize early developmental stages, which http://anthro-age.pitt.edu/ gilleard | 40 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu stop once mature adulthood is reached (e.g., garber et al. 2020; turner, anapol, and jolly 1997) or they constitute post-hoc categorisations based entirely upon either known chronological age or post-mortem cranial and dental analyses (cf. schultz 2004, 85). in general, the use of either behavioral or observational methods of age classification beyond adulthood “can lead to contradictory conclusions” (balcells and baro 2009, 7). it is perhaps no surprise then that initial attempts to categorize the later stages of life and to provide estimates of primate longevity have had to be consistently revised upwards (washburn 1982, 15-17). put succinctly, it seems difficult for us as human beings to readily distinguish between non-human primate stages of maturity and late adulthood. research employing age as a key variable, therefore, has typically been conducted on captive populations where apes have been raised and maintained as lab animals from a reasonably early age, with fairly accurate knowledge of their ages arising from the detailed records of their time at the research center (tarou et al. 2002, 212). whether their conspecifics share with their human researchers this problem of not being able to differentiate post-adult life stages is a question largely unresearched but it is clear that chronological age per se has little if any social meaning within non-human primate societies. still, there is some evidence that age group distinctions can be and are made – at least in terms of patterns of age-differentiated social behavior. albon lemasson and colleagues (2010) found that older monkeys elicited more responses from their younger conspecifics despite emitting fewer calls themselves. similar findings were reported in a community of marmosets (chen, kaplan, and rogers 2009). other studies have indicated that there are characteristic changes in the vocalization of some primates, such that older adult japanese monkeys elicit more harsh syllables in their food calls than do younger adults (inoue 1988). whether perceptual discrimination of age by conspecifics – by sight, sound, or other senses – is demonstrable, however, is not clear. evidence of visual discrimination of agedness among non-human primates is limited, with most studies focusing upon distinctions made between infants and adults, rather than between mature and old adults (sato et al. 2012). in sum, given the difficulty in identifying reliable physical markers of agedness in most primates, there remains considerable doubt whether non-human primates show evidence of adult age discrimination – and hence any non-human equivalence to ageism or age prejudice. while there is evidence that some behaviors of older adult primates can be distinguished – by researchers – from those of younger adults, and that some differential behaviors can be discerned that are directed toward older adults by younger adults, this shows only that behavioral changes associated with age are socially realized within nonhuman primate social groups, not that this constitutes some form of prejudice, special affection for, or deliberate avoidance of older conspecifics. whether this represents anything more significant than changing response behavior to changing stimulus behavior, however, is difficult to ascertain. more deliberate experimentation, such as that intended to demonstrate differential responses to infants, has not been carried out and arguably even if it were it would still provide little evidence of preference for or against older adult primates. age discrimination as a perceptual frame among non-human primates however has not been shown and seems somewhat unlikely and certainly less pervasive than is found in human society. aging and social disengagement studies of aging in human societies have provided consistent evidence of changes in social behavior and network size with age such that most people’s social networks decline during adulthood, except for family (kin) networks (wrzus et al. 2013). from such observations, two important theoretical propositions have been developed. the first is disengagement theory (cumming et al. 1960); the second http://anthro-age.pitt.edu/ gilleard | 41 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu is socioemotional selectivity theory (carstensen, isaacowitz, and charles 1999). while the former assumes that, with age, individuals withdraw from the wider society, the latter postulates that this withdrawal affects mostly non-intimate social connections, while emotionally close relations are maintained into and through later life. these theoretical formulations have guided several studies of non-human primates designed to see whether these human patterns of social interaction fit age-associated changes in sociality among non-human primates. mary pavelka has argued against drawing too close comparisons between age related changes in sociality among human and non-human primates (pavelka 1991). she argues that at least three distinctly human features of later life set human social aging apart from that of non-human primates, namely the universality of menopause in human beings, the age-associated division of labor whereby younger adults engage more in production and older adults in consumption, and the significant human awareness of aging and mortality. given these considerations, pavelka argues that there is little reason to “expect there to be a social category for the elderly” for monkeys (1991, 396). she further argues that “frailty to the point of dependence is not a characteristic of old monkeys or old apes because animals in this position would simply die” (ibid, 396). other studies, however, have found evidence of age-associated social disengagement both in monkeys and in apes. primatologists gabriele schino and marta pinzaglia (2019), for example, studied the social behavior of a colony of capuchin monkeys and found that, with age, affiliative interactions decreased, with older monkeys engaging in less mutual grooming and spent less time in proximity with other adult conspecifics. they observed what they described as an increased tendency to select preferred partners to engage in grooming. they posited this reflected one of the tenets of socioemotional selectivity, as outlined by laura carstensen and her colleagues (1999), namely that with age, social contacts became both narrower and more exclusive (schino and pinzaglia 2019, 5). their conclusion supports pavelka’s contention that the phenomena of increasing socioemotional selectivity with increasing age may be “taxonomically widespread” and not dependent upon the advanced cognitive abilities by which humans are aware of their own future lifetime (schino and pinzaglia 2018, 6). these effects seem if anything more pronounced in apes. nicole thompson gonzález and colleagues (2021) observed declines in social engagement with age among both male and female chimpanzees, but with what these authors called increasing “cliquishness” among the older males. despite a reduction in their overall social contacts (reflected for example by the amount of grooming), these authors observed that among those who continued to groom and be groomed, there was a tendency for this to be increasingly confined to a small group (“clique”) (thompson gonzález et al. 2021). this social selectivity was evident in siracusa and colleagues’ (2022) longitudinal study of female rhesus monkeys when they observed a narrowing of the monkeys’ social networks with age over an eight-year period. these results were not the consequence of any absolute reduction in the total amount of social behavior with age nor were they the consequence of the deaths of social partners. such studies imply that across most non-human primate groups there is a narrowing of social relations and, particularly among the great apes, a degree of intensification of those relations despite an overall decline in social activities. rather than complete social disengagement, there is evidence of selective disengagement compared with earlier social relations – with older males being less gregarious but maintaining their close friendships well into later life (rosati et al. 2020). since such effects have been observed in both genders and in wild and captive populations, there seems strong support for some form of social aging across the primates, albeit one characterized less by signs of disengagement but rather increasing social selectivity. what this suggests is that social embeddedness retains its http://anthro-age.pitt.edu/ gilleard | 42 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu importance for primates in later life every bit as much as earlier in life even if the form of that embeddedness changes with age. aging and social capital using the term ‘social capital’ to refer to the size and strength of social ties, research in non-human primates has generally concluded that primates with greater amounts of social capital more often thrive than those lacking in social capital (silk et al. 2010). in recording levels of social capital in female baboons, silk and colleagues used two composite measures: one reflecting social dominance (based on the ratio of approach to versus retreat from other females in the group) and the other reflecting relationship quality (a composite of the stability of the social ties and their strength, as measured by the frequency and duration of grooming). the authors found that both indices contributed to greater longevity and reinforced the value of social capital as a source of variation in adult fitness and survival in non-human primates. it may however be worth distinguishing between these two forms – namely sociability and dominance/status. for the purposes of this section of the paper, the review of social capital will be confined to studies of social contacts, defined by the degree of their engagement and valence, to use zarin machanda and alexandra rosati’s terms (2020, 2). this means that questions of dominance, rank, and status will be ignored until the next section. some researchers have argued that despite a decline in the size of social networks with age, the ‘healthy aging’ benefit of sociality applies less to older adults than it does to early or mid-age adult primates (brent, ruiz-lambides, and platt 2017). these authors suggested that the potentially deleterious effects of aging on social network size was compensated for, at least among females, by their effective management navigating the social landscape thus avoiding the health-damaging effects of interpersonal conflicts. of course, one could also argue that the declining effect of social capital on later life longevity in non-human primates reflects some of the age-as-leveller effects noted in human aging, whereby social inequalities exercise a lesser influence on later life compared with earlier adulthood and mid-life when social relations matter more (house et al. 1994; nagel 2016). other studies have proposed the existence of a trade-off between reproductive activity and sociality, such that as the former declines (with age) so the latter increases. this serves as compensation, at least in the way that sociality is directed toward kin whose reproductive success might in turn be enhanced. however, as noted in the previous section, most research points to a reduction in primates’ general sociality with age. generally, for non-human as for human societies, social capital seems to contribute to healthy aging even if the effect is less marked than that observed at earlier adult ages (holt-lunstad, smith, and layton 2010; pradana 2022; silk et al. 2010; sueur et al. 2021; thompson 2019). this effect seems to operate through several pathways, as nicole thompson (2019) suggests, contributing to both health and survival over the life course and across the generations as they continue into later life, even if the effects are to some degree muted by age. studies in human populations suggest that women retain (or acquire) more social capital than men, and generally live longer (moon, park, and cho 2010: warr 2006). in many non-human primate studies, gender differences in levels of sociality also emerge with age, such that the dominant gender retains or even increases their social capital with age, while the subordinate gender shows a steady decline (machanda and rosati 2020). such gender effects may be even more marked in non-human primates, but they do not consistently favor one sex over the other as machanda and rosati note. one study reported a marked decline in sociality with age among females, but this arose, in large part, because sociality was present at a higher level initially in females, irrespective of age, making the decline more noticeable (schino and pinzaglia 2018). http://anthro-age.pitt.edu/ gilleard | 43 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu other studies of wild baboons have suggested that social affiliation has a positive effect on survival throughout adulthood and into old age (archie et al. 2014; silk et al. 2010). this effect applied to both same sex and opposite sex connectedness with each type of affiliation adding survival value independently (archie et al. 2014). what is noteworthy however is the distinction between ‘social capital’ expressed as affiliation and connectedness and ‘social status’ reflected as dominance or rank. while it is found that the former shows consistent benefits to most non-human primate groups studied, and to both males and females, the impact of the latter is less clearcut with high social status having survival value for some groups but not others (campos et al. 2020, 6). fernando campos and colleagues (2020) observed that while status or dominance rank had no effects on adult survival among female baboons, it had a deleterious effect on males. this suggests there is a “tradeoff” between reproductive success and life expectancy, with high-status male baboons having shorter adult lives – and hence less old age – compared with lower status males. age, rank, and status in non-human primate groups one of the classical theories concerning patterns of change in human social aging is that of donald cowgilland his modernization thesis (cowgill and holmes 1972, cowgill, 1974). cowgill and holmes suggested that the status or rank assigned to older people varied over time and across societies and was crucially dependent upon the dominant mode of production within a society at any one point in time. as societies moved from an economy based on hunting, gathering and nomadic pastoralism to settled arable farming, they suggested, the status of the older men grew as they retained ownership of farmland and farm animals, and thus ensured the transfer and succession of the family’s wealth. with industrialization and urbanization, income from wage labor, rather than wealth located in land ownership, dominated economic relations: old age lost much of its status as the earning power of younger adults outweighed considerations of land ownership. migration to urban centers, reliance upon a wage economy and the educational and occupational skills associated with earning a living in the city favored younger adults and the status of old men declined. this thesis, however much it has been disputed, reflects a position that holds old age has no intrinsic or essential status in human societies; rather its rank or standing depends largely upon other aspects of social organization than on agedness per se. much of the literature on dominance and age in primate social groups reinforces this point – that there is no universal relationship between the two. in many non-human primate groups, in contrast to human social groups, status determination applies more to female members than to male members, because the latter often disperse to form their own troop, rarely remaining within their natal group. among the great apes, where there is generally less dispersal, there is evidence that male dominance drops with increasing age, while females retain their position and social influence (baker 2000, 113). older chimpanzees and gorillas generally show less aggressive behavior irrespective of their gender or status, while some studies of japanese monkeys have found that older high-ranking females maintain their social attraction and position with age while low ranking older females do not (nakamichi 2003). some of the earliest studies of monkeys assumed that status declined with age, on account of the limited value to the troop of monkeys displaying senescent reproductive aging (borries, sommer, and srivastava 1991). these authors suggested that with age, female monkeys (hanuman langurs) lost status within their troop in terms of their limited reproductive value, only retaining status when it came to defending their troop from others. older female monkeys “frequently sat and watched at the troop's periphery” (borries, sommer, and srivastava 1991, 252). interestingly, they observed that the effect of reproduction in late life was somewhat to boost the status of older monkeys,in contrast to monkeys http://anthro-age.pitt.edu/ gilleard | 44 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu demonstrating a quasi-menopause who fell into the lowest rank (borries, sommer, and srivastava 1991, 253). this model – of declining status with increasing age – has not proved so robust, however, and other longitudinal studies have found rank more closely related to dynastic status with daughters inheriting the rank of their mothers, whatever their ages (hausfater, altmann, and altmann 1982). it has been argued that dominance relations vary according to the resourcefulness of the environment, such that populations in “permissive” environments are “characterized by a degree of nepotism in female rank relations comparable to that of provisioned macaques, but in harsh environments an agegraded rank order of females” applies (hausfater, altmann, and altmann 1982, 754). a more complex version of these options has been proposed, distinguishing between increasing dominance with age, decreasing dominance with age and ‘nepotistic’ hierarchies where matrilineal descent matters more than age (e.g., broom, koenig, and barries 2009). other studies have found that older female macaques are less often the recipients of aggressive behaviors but more often engaged in low-level aggression effectively deterring becoming victims of others’ attacks in a pattern of selective dominance (almeling et al. 2017). like the macaques studied by laura almeling and her colleagues, chimpanzees display a more positive relationship, with older adult female chimpanzees exhibiting greater dominance than younger ones (e.g., wittig and borsch 2003). some writers have gone so far as to describe female chimpanzee troops as a "gerontocracy" with individual adult females moving up the status hierarchy as older adult chimpanzees die off (nishida 1989, 86). others have questioned whether any clear or stable hierarchy can be discerned among adult female chimpanzees, and it seems unlikely that a gerontocracy model is a universal feature of chimpanzee communities. as for male chimpanzees, while several studies have observed a more stable dominance hierarchy in multi-male troops, challenges to the dominant (alpha) male occur with increasing age, and previous alpha males may accede to a drop in status whilst remaining part of the group. indeed, some regain their status while others may simply leave the group and remain solitary, depending at least in part on the strength of their established social bonds (uehara et al. 1994). studies of female gorillas have observed an inverted u-relationship, with mature/middle aged female gorillas exhibiting greater dominance ranking than either young or old adults (robbins et al. 2005, 792). most studies suggest that multi-male gorilla groups are rarer, as male gorillas tend to disperse leaving behind the senior male of their troop, to then form troops of their own. hence patterns of dominance among female gorilla troops are easier to elucidate and observe over time. male gorillas, as they age, retain their dominance because of the serial dispersal of younger males. while reports of aged males being displaced by their juniors do occur, this seems to be restricted to only a minority of cases – with the majority of alpha males dying or disappearing. the fate of elderly displaced males seems generally poor. one study reported that older displaced males “became solitary after losing their alpha status [and] subsequently died within 3 months of being usurped” (robbins et al. 2019, 138). while such a fate is observed among other great apes, it seems clear that though age poses a greater risk from loss of status among males than females, there is no inevitability that age constitutes a decline either in activity, fitness, or indeed in dominance among the apes, nor that it constitutes a source of changing rank and resourcefulness (thompson gonzález et al. 2020). equally, as jane goodall (1986b) observed, precious little attention or care is directed toward older frail chimpanzees by their conspecifics. if it arises, it might be said that old age plays little part in the society of the great apes. kinship, social ties, and the grandparent hypothesis bernard thierry (1990) has argued that it is possible to identify a core dimension representing the degree of hierarchy within the social group. some non-human primate groups exhibit strong hierarchical http://anthro-age.pitt.edu/ gilleard | 45 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu status-systems, use more injurious forms of aggression in defending status positions, and show a marked preference for aggressively asserting status in non-kin interactions (effectively favoring relations with kin). other groups, thierry suggested, were at the other extreme, maintaining fewer and less stable patterns of dominance ranking, showing less aggression in expressing dominance, and behaving less differentially when interacting with kin and non-kin. this offers straightforward evidence that ‘nepotism’ exists in hierarchical groups, whereby intraand inter-generational status is effectively reproduced over time (cf. hausfater, altman, and altman, 1982). in hierarchical social groups, kinship matters, and is especially evident along matrilineal relations, where cooperation rather than confrontation characterizes relations between siblings, mothers and daughters, and grandchildren and grandmothers (kapsalis 2004; kapsalis and berman 1996). one of the earliest studies of grandparenting was carried out in india by carola borries (1988) through observations of a troop of langur monkeys which included two grandmothers who were no longer reproducing. she found that there was a conspicuous difference in the attention invested by maternal grandparents who favored female over male grandchildren. borries suggested that grandparenting could be understood as a biologically evolved trait that favored the reproduction of the matrilineage. the ‘grandparenting hypothesis’ was first proposed by peter mayer (1982) in relation to the evolutionary benefits deriving from an extended period of post-reproductive life. this idea was developed further by kristen hawkes and her colleagues (1998), who proposed that, by extending women’s post-reproductive life, menopause enabled “senior females [to] increase the reproductive success of childbearers more than enough to offset the reduced expenditure of the childbearers themselves” (hawkes et al. 1998, 1336). these researchers were however working with a model of menopause as a uniquely human phenomenon, of benefit to the species, rather than a more general characteristic of the primate taxa, implying that grandparenting was a specifically human, not a generic primate trait. although there are few clear-cut examples of discrete menopause in other primates, if applied more generally, as mayer himself suggested, to primates demonstrating minimal or no reproduction in later life, the grandmother hypothesis can be re-framed such that “old individuals may forego the production of new offspring and instead care for their existing descendants including help for their breeding age offspring” (peron et al. 2019, 360). in their review of mammalian grandparenting behaviors, peron and colleagues concluded that there does seem to be evidence of some tradeoff between a longer postreproductive lifespan and what has been termed greater “allo-nursing” or allo-parenting, that is helping care for offspring not one’s own (peron et al. 2019, 361). linked to this perspective of the benefits arising from preferential intraand inter-generational relationships with kin has been speculation over the general adaptive value of grandparenting. living long enough, it has been suggested, helps ensure that one’s adult female children have access to improved childrearing resources via grandparenting (chiefly grandmothering) and thus increases the reproductive success of the troop (kim, coxworth, and hawkes 2012). others however have argued that extended post-reproductive life is more a reflection of general longevity than it is of some special allo-parenting investment (fedigan and pavelka 2001). peron and colleagues have suggested that there exists a spectrum of parental-grandparental investment, such that some species disinvest completely in reproduction and invest completely in grandparenting (humans showing the most extreme form), while others continue investing in reproduction and show no grandparenting investment (peron et al. 2019, 365). this evolutionary approach to grandparenting has been taken up in family studies, to form part of what has been termed ‘evolutionary family sociology’ (rotkirch 2018). in a recent finnish family study into human grandparent-grandchildren relationships, for example, antti tanskanen and mirkka http://anthro-age.pitt.edu/ gilleard | 46 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu danielsbacka (2018) observed that differing degrees of biological relatedness were associated with both the closeness and intensity of support offered across the generations. they found that closer kin relationships predicted greater investments in grandparenting. as with much human and non-human primate research, there are many surprising parallels in social aspects of aging, despite the huge imbalance in behavioral, cognitive, cultural, and social complexity between the two species. the parallels may however lead to researchers overlooking key differences between human and non-human primates, leading in turn to a degree of unjustified anthropomorphism. cautions, caveats, and complexities non-human primates form and maintain social groups that take many forms, and it is no longer the case that variations in social behavior and social organization arise merely from intra-species specificity (strier 2018a). the demography of the group, the ecological conditions they find themselves in and the particular history and lineage of the group (its mixture of incomers, leavers and hierarchical history) play a large part in how members of the group behave, how much affiliation or antagonism they show to each other, and the extent of stability experienced by their infants (strier 2018a, 808). as research has become more attuned “to the high level of behavioral flexibility that many species exhibit” (strier 2018b, 5), it becomes clear that non-human primate social behavior reflects a level of complexity that was scarcely grasped even a couple of decades ago. as far as social aging is concerned, though the research base continues to be limited, there seems every reason to believe that a similar level of complexity exists between and within species of primates. as colonies and settings where basic provisions are ensured come to dominate much primatological research, it seems likely that such anthropogenic influences will introduce further unexplored sources of variability, such as the number of older animals surviving and the variety of their behavioral, physical, and social agedness. if the demographic aging of human society is becoming ever more salient in understanding contemporary society, an equivalent demographic change may well be underway, ‘in the wild’, as primate societies are increasingly managed as a series of sustainable communities (see catherine hill [2002] for a useful debate about the ethics of sustainable communities). given the consistent evidence that mammals raised in captivity live considerably longer than do their conspecifics in the wild, that reproductive senescence occurs earlier and more completely in the wild than in captivity, and that dominance hierarchies adopted to ensure reliable food supplies and safety from predators are much less necessary in sustained communities, it is not improbable that primates’ social behavior and organization will continue to change, and this will most likely include changes in forms of social aging (atsalis and videan 2009). social scientists were once fiercely critical towards the sociobiology promoted during the 1960s and 1970s (caplan 1976; gove 1987). consider how the situation has changed in the twenty first century, with the increasing human influence on non-human primate society: on the one hand the destruction of the natural habitat and on the other the increase in protected and provisioned areas suggests that it no longer makes sense to presage an understanding of human society upon its precursors. rather, it seems necessary to consider the endless entanglement of nature and society as a persistent and pervasive feature of primate life, with an accompanying interand intra-species diversity and diffusion taking place in the context of the shrinking habitat that previously sustained non-human primate societies. a future ‘unwilding’ seems probable, as life outside conserved areas becomes, for most nonhuman primates, increasingly precarious (carvalho et al. 2021; iucn 2020; junker et al. 2020). the global dominance of one species (homo sapiens) over all other species of primate seems likely to fulfil alison jolly’s prediction that “we will more and more be studying non-human primates as affected by human primates…[as] looking at primate social behavior in the face of human-induced change will http://anthro-age.pitt.edu/ gilleard | 47 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu soon be respectable” (jolly, as cited in pollock 2015, 213). this will no doubt include the study of human interventions that modify patterns of demographic and social aging in non-human primate society in ways that may be surprisingly difficult to predict, let alone adjudicate (nelson 2017). aging, both social and biological, is changing more rapidly now than at any previous time; that is perhaps the most important common denominator for all human and non-human primates. conclusions the aim of this paper has been to consider whether and how far the study of social aging in non-human mammals (mainly other primate species) might aid understanding social aging in human societies. while animal models are widely used to study the biological processes of aging and their relevance to human aging, aging in non-human social groups has rarely been used to illuminate human social aging. this paper suggests that, based on its literature review of studies of social aging in non-human primate societies, at least four themes can be identified which have potential relevance for aging studies, social gerontology, and the anthropology of old age. these are (a) evidence of social disengagement with age; (b) the returns of social capital in aging well; (c) the relationship between age and rank or status within the social group’ and (d) the role of post-reproductive ‘grandparenting’ in enhancing health and survival across the generations. given that primates constitute some of the longest living mammalian species on earth, and hence are most likely to reach and live through a period akin to old age, it seems plausible to consider this sort of evidence for illuminating old age as a conserved status within social groups in human as well as nonhuman primate society. critical to such consideration is the conceptual status of aging and old age in non-human primates’ social groups. do primates other than humans recognize agedness as a salient characteristic of their conspecifics and if so, is there evidence that such recognition alters their behavior? the evidence for the recognition of old age – as distinct from adulthood or maturity – in non-human primates is in fact not very strong. yet, as mary pavelka noted some decades ago, “there is little evidence that the behavior of the aged [monkey] females differs significantly from that of other adult females, and it does not appear that the fact of biological aging creates any radically different social situation” (pavelka 1990, 363). it is remarkable how rarely, at least until recently, non-human primates’ agedness or old age has even been commented upon, let alone enabled a stage of life termed ‘old age’ to be defined or described by primatologists on grounds other than known chronology or post-mortem examination. this problem of recognition poses a major challenge in studies of social aging in non-human primates and constrains the relevance of such studies to contemporary aging studies, social gerontology, and the anthropology of later life. concepts such as age discrimination and ageism seem to have little relevance outside of human societies, suggesting there is no inherent dislike, disregard, or hostility toward the aged in non-human societies. at the same time, there are numerous examples of human-like processes – from age-associated change in social status to the value of sociality on primate longevity, and from evidence of grandparenting to signs of social disengagement. most importantly there is growing evidence that patterns of social aging in both non-human and human social groups are more open and flexible than has perhaps been acknowledged, including the often quite marked impact that human behavior and culture can have in shaping non-human primate aging. while the grandparenting hypothesis implies a degree of evolutionary reductionism that should certainly be treated cautiously, the complex interplay between age, gender lineage, and ecological resources illustrates just how variable the links are between rank or status, social relations, and older age. differential effects on social behavior between juvenile, mature, and older primates repudiate any simple evolutionary reductionism. however, this also suggests that independent of social cognition (or collective representations), behavioral change may arise, in part at http://anthro-age.pitt.edu/ gilleard | 48 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu least, from the ecology of the group, its gendered constitution, the extent of post-reproductive senescence alongside more general patterns of affiliation, and antagonism evident within the group. human interpretations of age rank and status have long been written about, including the notion that once upon a time and/or in some other society, those deemed ‘aged’ were treated with great respect, usually by older men lamenting their loss of power. such collective and uniquely human representations (or social imaginaries) may in fact be post-hoc explanations for patterns of behavior shared by us all. while it has become abundantly clear that there is indeed aging in the wild, what has also become clear is that ‘the wild’ is itself a more complex entity, reflecting a mixture of ecological factors – the scarcity or plenitude of resources, the degree of predation and level of intra-species competition as well as interspecies variability in the rate of living and of aging – alongside increasing human impact on that ecology. as non-human primates living outside protected areas face increasing risks of extinction, in large part because of human behavior, so the demographic and behavioral aspects of non-human primate aging are likely to change, perhaps, and somewhat paradoxically, contributing to the aging both of human and non-human primate societies. bearing this duality in mind, it is possible that a comparative social gerontology of human and non-human primates can be envisioned, not so much by basing models of human aging on the non-human world but by recognizing that both monkeys and apes (including ourselves) “are indeed unified by behavioral and demographic social flexibility” (malone, fuentes, and white 2012, 1253). there is a growing two-way interchange between the human and non-human world that is based less on mechanisms of evolutionary selection than on a shared heritage of social complexity and flexibility, a point that is as applicable to the ordering and organization of the life course as it is to the social world more generally (bronikowski et al. 2011). how far old age in non-human primate societies can be seen as the internal product of those societies and how far both it and the ‘aging societies’ in which old age appears are being realised principally as the co-products of human society remains to be seen. this is of course speculation but the more the wild becomes a series of conserved and protected spaces engineered and ensured by human agency, the more one wonders whether or not all primate old age may be becoming a kind of human old age, after all. notes 1. among primates, a broad division can be made between apes (bonobos, chimpanzees, gibbons, gorillas, humans, and orangutans) and monkeys (baboons, capuchins, colobus, macaques and marmosets. the apes have a later onset of fertility (10-30 years) greater longevity (50 years +) and a longer period of senescence (35-50 years) than monkeys (5-20 years, 25 years + and 20-35 years respectively) as outlined in washburn (1982, 13). for further classificatory details see the appendix. 2. the empirical literature reviewed here draws upon the major primatology and physical anthropology journals – the american journal of primatology, the american journal of physical anthropology, folia primatologica, the international journal of primatology, neotropical primates and primates – from 1990 to 2022. the intention was to cover relevant empirical research on primate societies, but not to conduct a systematic review of all the empirical research in this emerging field. rather the aim was to derive the main themes relating to social aging – and link these to themes in social gerontology. the overall goal was to critically examine how closely aging in non-human primate society can be aligned with, or distinguished from, aging in human society. 3. drews distinguished between dominance as “an attribute of the pattern of repeated, agonistic interactions between two individuals, characterized by a consistent outcome in favour of the same dyad http://anthro-age.pitt.edu/ gilleard | 49 anthropology & aging vol 44 no 1 (2023) issn 2374-2267 (online) doi 10.5195/aa.2023.417 http://anthro-age.pitt.edu member and a default yielding response of its opponent” and dominance as rank (or status) namely, “the position of one individual in a dominance hierarchy” (drews 1993, 308). appendix taxonomy of major primate groups the major division of the order of primates is between the family of apes and that of monkeys (the latter are smaller, have tails and live a largely tree bound existence). both old and new world monkeys have smaller bodies, brains and shorter lifespans compared with apes. among the lesser apes, the only major species are the gibbons. among the family of great apes, orangutans are considered a distinct subfamily, while chimpanzees, gorillas and humans together form the main species making up the subfamily of homininae (groves 2018). references almeling, laura, holger sennhenn‐reulen, kurt hammerschmidt, alexandra m. freund, and julia fischer. 2017. “social interactions and activity patterns of old barbary macaques: further insights into the foundations of social selectivity.” american journal of primatology 79 (11). http://doi.org/10.1002/ajp.22711 atsalis, sylvia, and elaine videan. 2009. 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2374-2267 (online) doi 10.5195/aa.2015.99 this work is licensed under a creative commons attribution 4.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. conceptual frameworks and practical applications to connect generations in the technoscape matthew kaplan1 mariano sánchez2 & leah bradley3 1 department of agricultural economics, sociology, and education, the pennsylvania state university (u.s.) 2 department of sociology, university of granada (spain) 3 heyman interages center, jewish council for the aging (u.s.) abstract there are many ways to frame and use technology so it functions as a pathway to intergenerational engagement. the ever-evolving technoscape is filled with powerful technological tools and resources that help people connect, communicate, build relationships, and take collective action across generations. this technology can be life-altering, especially for isolated seniors and families navigating long distance relationships. however, at the center of the intervention equation is not the technology itself, but the quest for tapping into the relationship-enhancing potential of the technology. to explore this potential, an international survey was conducted with 46 intergenerational programs that reflect innovation and intensive uses of technology. results demonstrate that important strides are being made in utilizing new technology for effectively connecting generations and positively affecting aging adults’ lives. keywords: technology, intergenerational programs, intergenerational relationships, intergenerational communication http://creativecommons.org/licenses/by/4.0/ http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu conceptual frameworks and practical applications to connect generations in the technoscape matthew kaplan1, mariano sánchez2 & leah bradley3 1 department of agricultural economics, sociology, and education, the pennsylvania state university (u.s.) 2 department of sociology, university of granada (spain) 3 heyman interages center, jewish council for the aging (u.s.) introduction what are the dimensions of today’s technoscape that pervade the aging process and have an impact on intergenerational relationships? this is the overall framing question at stake in this paper. since the term intergenerational focuses on interactions happening between different generations, and human aging and longevity develops through an array of intraand intergenerational age-linked trajectories and transitions embedded in institutional contexts (i.e., throughout a life course), the capacity of technologies in the technoscape to mediate and potentially transform intergenerational relationships becomes a relevant issue to consider. this is particularly true in a time when the global relevance of both phenomena (population aging and technology pervasiveness) has become so evident (hampton 2015; plouffe and voelcker 2015). interest around digital technology and intergenerational relationships has been gaining momentum in the era of technoscape. for instance, we have learned that cell phone usage by subsharan african young people is a shifter of the generational power balance, particularly within the family context, as youngsters are becoming repositioned as family information hubs (porter et al. 2015). there is growing international evidence of older adults’ use of information and communication technologies (ict) to maintain or strengthen communication among family members, especially grandchildren (chesley and johnson 2014; yuan et al. 2015). attention has been paid to social media use as well as web-based communicative practices for family-based kin-keeping and intergenerational relationship building (dare 2008; napoli 2014; siibak, andrak and tamme 2013). a subset of this attention addresses the dual potential of new technologies to exacerbate (mesch 2006) as well as reduce intergenerational tensions in families (gerschenfeld and levine 2012; horst 2010). it is also relevant to consider breakthroughs in the development of digital products such as augmented reality integrated games to construct “barrier-free” digital environments for older adults, thus promoting their social interaction with children (lin, fe and chang 2013). improvements in software and hardware platforms for game playing and game-based communication have implications for enriching family communication (chen, wen and xie 2012). in fact, specialists in access in the information society have concluded that “the intergenerational context is important for designers and researchers to accommodate as an explicit focus for design efforts” (harley et al. 2012:2). kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 183 183 we use the term intergenerational technology programs (itp) to refer to programs with a strong technological component that aim to establish relationships between any two generations (kaplan and sánchez 2014; sánchez, kaplan and bradley 2015). it is our belief that itp “provide some useful clues as to strategies for tapping into the positive potential of technology for creating and supporting intergenerational relationships and contributing to participants’ health and wellbeing, support for families, and stronger communities” (kaplan, sánchez, shelton, and bradley 2013:46). in this paper, our focus is not just finding ways in which a particular technology may be helpful for intergenerational interactions in the framework of specific programs. instead, and following licoppe’s (2004) stance, we contend that to understand intergenerational relationships within itp we need to take into account the ways in which the management of these relationships rely on the whole available technoscape, hence the importance of blended processes such as the combination of face-to-face and asynchronous technology-centered intergenerational learning. technology is ambivalent: depending on the circumstances, it can cut both ways, as a social connector and isolator, a friend or foe (jarvenpaa, lang and tuunainen 2005). the main focus of this article is the ways technology is being used to “connect” people from different generations. our focus, however, goes beyond sheer contact. we look at how new and emerging technologies are being utilized to promote understanding, build relationships, and facilitate cooperation throughout the life course between generations that are aging together in a range of community settings and family contexts pervaded by the technoscape. theoretical framework central to our theoretical perspective is the concept of life course, “which relates to aging as a general process of intergenerational interactions in changing historical circumstances” (lowenstein 2010:57). the life course principle of linked lives underlines the interconnectedness of lives as we move through the life course (bengtson, elder and putney 2005), and technology as utilized in itp may have an impact on such interconnectedness between lives and social structures. compellingly enough, it has been argued that a life course approach can be useful in terms of deepening our understanding of social implications of technological innovations (chesley and johnson 2014). we concur. issues regarding the balance of power between generations interacting in the technoscape (gora 2009), the consequences of role changing as so-called digital natives meet digital migrants (prensky 2001), and the web of complex and fluid patterns of technology use and competencies across and within non-homogeneous generational groups (bertel 2013) are but some examples of relevant questions to consider once a life course lens is implemented at the crossroad of intergenerational programs and the technoscape. since a life course perspective is dynamic by definition, our exploratory approach to international itp confronts the static view according to which young people are always the most skilled and innovative users of digital technologies as well as the ones who are able to take more advantage of ict. itp can be perceived by individuals and generational groups as opportunities to maintain intergenerational ties with significant others (relatives, neighbors, organizational members, and so on) with whom they feel interdependent. the technoscape in general and the particular involvement in itp may influence the way key life transitions, crisis, risks, and changes at different life stages are approached. overall, “the life-course perspective is a tale of kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 184 path dependency, gravity, and shocks” (mcdaniel and bernard 2011:1-2). to what extent might our own life course tales be altered as a function of how we immerse ourselves in the technoscape and engage in itp initiatives? empowerment is a central feature in intergenerational programs (gamliel and gabay 2014). itp are not an exception to this regard. given the intra-generational variation in terms of technology literacy and its changing nature throughout the life course, as well as the importance of being technology wise in the technoscape, itp may provide a viable context of empowerment for traditionally disempowered groups (i.e., children and elderly people). therefore, special attention will be paid to the empowering effect of itp on participants. in this paper, life course analysis and empowerment will be considered with a strong relational orientation in mind. to this regard, we follow donati (1999) in considering the underlying essence of generations as being inseparable from social relationships, actual and implied. consequently, in our exploration of itp we will emphasize the being with and being together in the technoscape (sánchez, sáez and pinazo 2010). procedure in line with our review of the literature and our emergent theoretical framework, we have reflected on three broad questions related to the infusion of technology into intergenerational practice: 1) how might the technoscape provide intergenerational specialists with new tools and strategies for building intergenerational relationships and achieving itp goals? 2) how might intergenerational programs with a heavy technology component contribute to health and well-being, family cohesion, and livable communities throughout the life course? 3) how might the technology component be configured to provide the best conditions for participants’ empowerment? in the literature, examples of itp do not abound (gamlier and gabay 2014; han 2013; lanaspa gatnau 2012; wu 2005). furthermore, to the best of our knowledge, at the moment of launching our research effort there was no available exploratory study on international itp. therefore, the primary data source for this article is a recent survey of itp (i.e., intergenerational programs that have a heavy technology component) (sánchez, kaplan and bradley 2015). to identify a diverse group of programs, the project team, which consisted of the article authors and a graduate student assistant, pursued a three-part outreach strategy. the team scanned the research literature across several disciplines, reviewed the “gray literature” (including web-based materials highlighting relevant programs and practices), and reached out to intergenerational specialists and practitioners affiliated with prominent national and international networks in this field. a series of questions was sent to professionals affiliated with programs that met the study criteria. with the goal of creating a content-rich resource for those who are interested in learning more about intergenerational technology-based programs, in what follows we draw heavily on respondents’ quotes and use them to paint a composite picture of program innovation, success kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 185 185 and challenge. as for how quotes presented below have been selected, after second cycle coding and prolific analytic memo writing, researchers in the team independently selected the most vivid and representational quotes in the sample in line with focusing strategies in qualitative analysis (saldaña 2009). through several debriefing sessions, selection decisions as to representative quotes to be included in the final narrative were made. in order to present a broader range of ideas and to connect as many threads as possible, in the narrative below, analysis of responses to the survey is interwoven with text that highlights ideas from the literature from relevant fields, practical recommendations for action, and reflections on upcoming challenges and opportunities towards a more powerful combination of intergenerational approaches and technology. methods constructing and conducting the survey the survey designed by the project team counted on one questionnaire structured in two sections: organization and primary contact information (including questions on primary program objectives, program description, time of program in existence, age distribution of program participants, and frequency of intergenerational interaction, among others) and technology specific questions (such as type of technology being used, how it is used, and the level of importance attributed to the technology in terms of its capacity to facilitate intergenerational relationships). to identify intergenerational technology programs to be included in the survey, project team members employed a threefold strategy during the first half of 2013: outreach through intergenerational list-servs (managed by local, national, and international membership organizations) and personal contact with intergenerational practitioners, a structured web search (via google search), and literature review (via google scholar, scopus, and web of knowledge) for the period january 1, 2009 to december 31, 2012. in both the web search and the literature review, the following combinations of terms were used: “intergenerational program” and “technology,” “intergenerational project” and “technology,” “intergenerational activity” and “technology,” and “intergenerational technology program.” 72 surveys filled-out by program coordinators were received, 46 of which were deemed non-redundant, complete and within the scope of the study and those programs constitute the study sample. the 46 programs in the sample are quite diverse in terms of geography (they span 11 countries), type of technology used, and the ways in which technology is being used to intentionally support and enrich the lives of people of all ages. information about the names of these programs as well as the organizations and countries in which they are based is posted online.1 most programs (74 percent of the sample) were designed to have a positive impact on the lives of the participants, whether through helping older individuals in developing ict skills or through raising awareness of and reducing digital exclusion amongst older people (sánchez, kaplan and bradley 2015:99). while a majority of these programs were primarily focused on enhancing individual participants’ technology-related knowledge and skills, 24 percent of the kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 186 programs in the sample also targeted non-technology related capabilities such as how to maintain a healthy lifestyle and improve second language skills (sánchez, kaplan and bradley 2015:99). some other program objective themes that were only touched upon briefly in the sánchez, kaplan and bradley (2015) article, such as reducing the sense of isolation or exclusion among older people, impact on family life and community connectedness, are explored in this article in more depth. the primary focus here is on objectives and outcomes associated with the ways in which digital technologies are allowing older adults to establish deeper intergenerational connections in their families and communities in the framework of the technoscape. analysis the project team employed a mixed-methods analytic strategy. we implemented thematic inductive and deductive analysis of responses to open questions (braun and clark 2006) through coding (saldaña 2009). two members of the research team generated an initial draft codebook by independently reviewing approximately 25 percent of the raw data. afterwards, research team members compared proposed themes and produced an initial master list of codes fitting into four major categories: 1) program objectives, 2) program description, 3) technology use, and 4) (perceived) technology importance. examples of themes are “relational level,” “generational differences with regard to technology,” “inclusion,” and “technology as (dis)connector.” some excerpts were assigned multiple codes, though such multiple coding determinations rarely crossed the four categories noted above. after several joint coding sessions a final codebook with 113 codes was reached. during the coding process two members of the research team worked independently to review and code the entire database (consisting of 431 excerpts which are classified in this article as distinct responses). differences in coding were reconciled through discussion (graneheim and lundman 2004). inter-rater reliability rate achieved was .93 (cohen kappa), a highly reliable value (miles and huberman 1994). coding of qualitative data and sample demographics were used to feed descriptive quantitative analysis: “information from codes could be used in the quantitative follow-up or for specific, significant statements or quotes from participants” (creswell and plano clark 2007:145). dedoose mixed methods web-based application was used to this regard. in choosing the excerpts to display in this article, the project team looked for quotes that best illustrated prevalent themes and patterns found in the data which provided detail about programs functioning with a concentration on intergenerational communication and relationship formation. following porter et al. (2015), in the remainder of the paper we draw attention to itp’s specific features insofar as they are considered vital for discussion. results and discussion valuing and using technology to build meaningful intergenerational relationships the program objectives data illustrates some of the distinctive ways in which the surveyed programs aim to use technology to influence intergenerational relations. table 1, below, kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 187 187 provides examples of respondents’ comments indicating intended program impact on the following dimensions of intergenerational contact: communication [better/enhanced/expanded communication; record and share life experiences/ stories across geographic distances] understanding [better/worse understanding of one another. for example, learning to challenge or see past stereotypes] relationships [forming or improving relationships with one another; includes comments about increased respect] service [serving one another as volunteers, role models, mentors, or technology tutors] learning together cooperation table 1: program objectives aimed at influencing intergenerational relations main categories (intergenerational relations) # of responses/ percentage of programs [56/82.6%] example quotes intergenerational communication 18/32.6%  “increase communication and connectedness for students and elders”  “help younger and older people in their network to share information about their own abilities and competences” understanding 15/32.6%  “identify prejudices, discover differences/ identify common ground”  “evoke critical analysis for debunking ageist myths” relationships formation / change 14/28.3%  “encourage intergenerational bonding”  “foster social relationships in the way of network development the development of a virtual place of exchange between the generations” serving one another 12/23.9%  “improve students' ability on digital teaching material and software” kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 188 learning together 12/23.9%  “co-productive approach to learning with older people as opposed to learning about them” cooperation 3/6.5%  “create collaboratively and share purposeful projects developed by participants for the larger community (e.g. intergenerational photography exhibit, and intergenerational blog)” according to the language presented in table 1, a majority of itp practitioners believed that diverse relationships could be encouraged through joint intergenerational activities mediated by digital technology. to what extent is technology crucial to the latter in the context of itp? survey respondents were asked the question: “in your program, how important is using technology to facilitate intergenerational relationships among the participants?” as can be seen from table 2, below, most respondents provided a very high rating of the importance of technology for facilitating intergenerational relationships. table 2: level of importance attributed to technology for facilitating intergenerational relationships when asked to explain their ratings, 17 respondents (32.6 percent of all programs surveyed) noted how technology serves as either a primary pathway for promoting intergenerational contact or they commented on the relationship-building properties of technology. here are some examples of these responses: on a scale of 1-7 scale, 1=unimportant, and 7= very important number of programs percentage of programs 7 23 50 6 7 15.2 5 9 19.6 4 4 8.7 3 3 6.5 2 1 kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 189 189 “the didactical intergenerational approach is based on the active role of young students, who act as ict teachers or tutors of elders. within the project, the intergenerational exchange occurs while elders and youth practice together the use of technologies.” “the technology becomes the tool for building their bond with each other. when the children help the adults connect via social media with new friends there is an immediate and tangible outcome.” “the technology is important in particular for communication. the older generation wants to communicate, to be in touch, to have the possibility to talk to the younger generation. and for this, even if the argument was not the one foreseen at the beginning of the project, we realize that this is really important.” “creative working with media brings people together.” we were able to explore the relationship between the choice of technology, how the technology is used, and participants’ intergenerational relationships. we delved into the responses from participants who emphasized “building meaningful relationships” when asked about how their programs are using technology. some of these responses are provided in table 3, below. this broad diversity of technology being used in our sample of programs indicates that the promotion of meaningful intergenerational relationships is not so much a matter of the specific types of technology being used as it is with the way in which technology is actually applied. therefore, the observation by licoppe (2004) above applies in the sense that the whole available technoscape may provide tools and strategies (e.g., new mentor-mentee relationships) for intergenerational interaction. maintaining the interest, keeping participants involved, stimulating conversation and exchange, documenting interactions, and providing care are examples of how technology can connect to relationship building. in the sections below, and connecting to the theoretical framework previously presented, we share some themes with regard to program approaches being used to strengthen intergenerational relationships in families, study and work to improve communities, and promote social and digital inclusion throughout the life course. table 3: some ways in which technology is used to promote meaningful intergenerational relationships the technology (tools, resources and services) example quotes (describing how the technology is used to promote meaningful intergenerational relationships) gaming platforms (designed) to teach collaboration and systems thinking; broad band connectivity used to allow people to exercise together but separated in space using ms kinnect technology “(these applications of technology serve to) improve multiage relationships and health” kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 190 smart board “we are using a smart board to maintain the interest of the children and older adults during activities. it keeps the participants involved in the activity as well as stimulates more conversation about a picture presented on the smart board.” technology such as ipads, digital cameras, computers, and lcd projectors “(used to) support interaction and relationship development among child and elder participants and to document these developing relationships.” provide use of video and remix equipment as educational tools (to teach youth/seniors to become more aware of age-related bias in the media) “(used to) foster mentor-mentee relationships between seniors and teens.” computing devices, mobile communication devices “stimulate conversation, establish rapport, transfer of knowledge and wisdom.” e-mail, texting, skype “students and residents interact over the teaching and learning of skype and the personal computing devices.” individualized computer tutoring. includes exchanging e-mails, learning about graphic software, expanding the use of facebook pages, video chatting; smartphones, and ipads. each program is documented by a teen using a digital camera. “since the program began last year, more residents (85-93 years old) are using smartphones, ipads, and skyping with family and friends.” digital media projects around themes of digital photography, producing a newsletter/ booklet/dvd developing social media/internet/website “provide opportunities for conversation, discussion, building of friendships and creating better understanding between generations.” free technology (training) programs that extend to smartphones, ipads, digital cameras, skype, wifi, web searching, and online platforms for sharing video-based content “this series facilitates communication, learning and interaction between generations.” a web-based platform with a knowledge sharing component where mentors and young people in transitions can tell their stories and share/ receive advice on job related questions “(used to) stimulate the exchange of experiences between young peoples and their mentors.” e-mail correspondence platform designed to support english as a second language instruction across geographical distance “(used to) provide care and support” (in addition to stimulating written language improvement). kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 191 191 strengthening intergenerational relationships in families throughout the survey, across questions, and in line with some of the literature noted above, respondents alluded to positive ways in which technology and technological competence can have an impact on family relationships. here are a few examples of such comments: [program participants use e-mail and texts to] “see and hear their family and friends overseas and communicating with them in daily bases.” [the program helps families] “create lasting memories and have fun together.” “older adults have testified that technology builds bridges to the outside world leading to greater respect from their families.” interestingly, “the outside world” is where the technoscape becomes fully meaningful. itp in families can help pave the way for older adults to keep connected with a changing outside world. there is as well an empowerment component in the process of being technologically skilled: the status of older adults within the family improves because of their capacity to use technology. to place responses into a broader context, we have looked to the literature to provide some complementary perspectives on how older adults and professionals view the role of technology in influencing intergenerational relationships in families. the following quote is from a 65-year-old grandfather living in england who is dissatisfied with the communication (or lack thereof) with his grandchildren living in the u.s.: it’s interesting, very, very, very rarely do we contact them, and that’s not because we don’t want to it’s because, our son will say “do you want to talk to granddad?” and they’ll say “no,” because they’re doing something else, but i think it’s as much to do with … they don’t know us, they don’t know us. (tarrant 2015:294-295) this grandfather is not alone. many grandparents, particularly those living long distance from their grandchildren, are looking for ways to have more frequent and more satisfying communication with their grandchildren. even with ict advances that provide family members with additional options for communicating across great distances, it is not always clear how to get the conversation started, nor place priority on the connection. itp can be instrumental to this regard since respondents in our sample referred to “stimulate conversation” as one strength associated with use of technology in intergenerational programs. harley et al. (2012) emphasize the important role that many grandchildren play with regard to motivating their grandparents to learn about and use new technology: when considering older people’s engagement with new information and communication technologies, it is inevitable that intergenerational contact will play some part in framing these interactions. this is particularly true for familial interactions between grandchildren and grandparents. grandchildren are often a significant source of expertise for their kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 192 grandparents when it comes to learning about computer-based technologies. intergenerational contact also provides an important motivator for older people to engage with new technologies in the first place. (harley et al. 2012:1) fortunately, in many instances, new and updated technology is being utilized, and applications are being developed, to help family members to stay in contact and maintain lines of social support across geographic distance. this is consistent with other research reported in the literature which notes that families seeking to extend communication and relationships over great distances is one of the major incentives for using new computer-based communication technologies (e.g., aarp 2012). as noted by harley et al., despite the dramatic changes to everyday family life in developed societies, intergenerational bonds remain very important within families continuing to operate over great distances and provide an incentive for using new computer-based communication technologies. (2012:2) community study, community organizing, and cultural/ historical preservation in several of the surveyed programs, intergenerational teams use mobile technology to explore community quality of life issues of common interest or to solve a community challenge. this often entails concentrated learning and selective projects focused on issues related to local history, natural resources, recreational outlets, educational opportunities, and opportunities for civic engagement and social action. consistent with the emphasis on participatory program development that is found in the literature on intergenerational approaches to community study/improvement (e.g., henkin, brown and liederman 2012; lawrence-jacobson and kaplan 2011), many of these programs have adopted an empowerment perspective. digital storytelling programs, for example, are designed to help participants articulate how the local community affects their individual and collective experiences. participants choose the personal and collective stories they will record and the photographic images and artwork they will use to illustrate their experience. below, we draw from several of the programs in our study to provide narrative detail as to how such programs engage participants: the methodological approach [which involves providing older adult participants with access to an “easy-to-handle weblog learning environment with the potential of including audio and video files”] is a narrative one and combines the approaches of oral history, biographical research and storytelling. senior citizens tell about their individual experiences within the european history in the 20th and beginning 21st century. the learning process can be both the telling itself, because it means reflecting on and working through personal experiences, and listening to/reading tales of others. [excerpt from survey. program: llp grundtvig. organization: innovation in learning institute, university of erlangen-nuremberg (germany)] kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 193 193 people of all ages and backgrounds have a story to tell. that is the fundamental principle behind our use of intergenerational digital storytelling to build community. we merge the age-old art of storytelling with new multimedia technologies, bringing people together in a collaborative environment where they can exchange dreams, memories, thoughts and family histories, while learning how to use the tools of success in the rapidly evolving digital age. in this way we can appeal to the interests of a 92-year old grandmother, as well as the tech savvy preteen who would otherwise spend most of his or her time buried in a video game or instant messaging their sibling in the next room. [this statement is posted on the digital clubhouse network’s website (http://www.digiclub.org/progproj/index.html).] the following excerpt conveys the value of merging traditional knowledge with modern communication tools for generating new solutions to community development challenges: mountain regions in europe are centers of traditional cultural and natural diversity. at the same time, far away from the urban centers and marginalized, they are facing many challenges, including the lack of economic opportunities, and as a result — migration of the younger population towards urban centers. this process exacerbates the challenges of the rural mountainous areas — because the ageing population is not properly integrated in the development process and leads to the loss of traditional knowledge by breaking the connection between the older and younger generations. the idea of the big foot project is to bridge this gap by establishing intergenerational learning and dialogue and by enabling and valuating the skills and knowledge of the older generation of locals, combining traditional knowledge with modern communication tools and expertise in order to enable innovative, creative and productive joint solutions for local sustainable development. [excerpt from survey. program: big foot. organization: menon network eeig (belgium)] historypin, another one of the programs in our survey of intergenerational technology programs, has received a fair amount of attention in the intergenerational studies literature with regard to its effective use of technology for stimulating intergenerational conversations about local history as well as participation in community activities. historypin.com, which functions as an online, global archive to which people can add photos, audio, video, stories, and memories by pinning them to a particular place and time on a communal map, serves as “a catalyst for numerous online and offline collaborations between older and younger people” (armstrong 2012:294). knight (2012) writes about the historypin program in reading, england as follows: the [historypin] project worked in reading to build a living, collective history of the city and its people over the last 150 years through the use of an online google-map tool. based at reading museum, the main project partner, an intergenerational volunteer group reached out to members of the community to encourage them to participate in intergenerational activities and events including weekly historypin drop-ins, one to one history sharing sessions, historypin guided walks, and heritage events. (2012:312) […] nearly four out of ten (38 per cent) of survey respondents stated that since taking part in historypin activities, they had become more involved in activities in their community. kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 194 one younger participant commented: ‘i learnt a lot about history and older residents lives. i learnt a lot from a particular resident about huntley and palmers where she had been a worker. i now feel i know so much more about reading – it makes me proud to be a reading resident’ (2012:312)” we have all learnt things we would never have known about reading’s history and even our own families, as we would have never had the reason to ask. it has given us the chance to spend our afterschool time doing something fun as well as educational, rather than going home just to sit on the sofa. ( 2012:309). it is also important to consider the multi-directional intergenerational communication dynamic in such projects. some projects begin with an emphasis on how tech savvy youth can help older adult participants enter and navigate in the world of “digital inclusion.” however, in turn and over time, the older participants tend to be counted on for making other types of contributions to the intergenerational exchange and to other program objectives such as teaching youth about local history and working together on community improvement projects. such a dynamic is reflected in the following description of the respective roles taken by participants of a novel community studies and participatory design program in a rural community in scotland: “young and old would work together; the elders have a vast local knowledge, the young have an intuitive understanding of contemporary technology and practitioners would bring insights from the design sector” (cld standards for scotland report n.d.: 6). infusing a historical perspective in itp emphasizes the temporal component linked to every human being and generation. therefore, the crossing of young and old around history and technology amalgamates for the life course linked lives principle to become self-evident. in this sense, digital technology can facilitate new ways for life course tales to keep being lived and told. “the my story project aims to record interesting stories from older people’s lives. the sorts of things that may be lost if not recorded in some way. and who better to record the stories than younger people, eager to learn first-hand about their own social history.” [excerpt from survey. program: my story. organization: euroed foundation (romania)] social and digital inclusion for aging well throughout the life course in looking at the multiple roles that technology plays in the programs that we surveyed, we gained a more complete picture of many of the ways in which technology contributes to the overall health and well-being of program participants as they age. one important theme noted by several respondents is how reducing digital exclusion can contribute to a reduction in social exclusion. age action ireland’s “getting started” program, one of the programs in our survey, runs computer and mobile phone classes across ireland for people over age 55. at a surface level, the program is simply about teaching older adults basic it skills. however, in looking more closely at benefits associated with the program, there is a much deeper significance to the technology training. as noted in the following excerpt, the program has implications for reducing the social kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 195 195 exclusion experienced by older adults and promoting youth as well as older adult community involvement: “confidence in using the internet tackles the social exclusion that many older people may feel, helping them to stay active, healthy and less isolated. an aim of getting started is to create a more inclusive community and older learners meet volunteer tutors from their local area and subsequently both learner and volunteer become more engaged within their local area.” [excerpt from survey. program: getting started. organization: age action ireland] other respondents also alluded to the relationship between digital inclusion and social inclusion. we see how increased technological skills, knowledge and use contribute to augmented interest, emphasis, and capacity to engage in new or improved relationships in family and community contexts: “resident a is unable to be part of a bridal shower for a family member in another state. with the skype up and running, she was able to actually participate in the joyful event.” “most have the desire to learn how to compose email, keep in contact with family/friends, scan the internet, etc.” “[the program aims to] improve by little steps the digital literacy of elderly people to foster their full citizenship in the digital society.” as evident in the following quote, empowerment, which emerged as a key theme in the previous section on community study and intervention, is also a useful concept for helping to explain how gaining digital skills can have positive psycho-social effects: “empowerment of residents closes the digital divide, tackles social exclusion, and improves access to services with intergenerational element; technology provides opportunities for conversation, discussion, building of friendships and creating better understanding between generations.” [excerpt from survey. program: digital age project. organizations: linking generations northern ireland (in partnership with workers educational association)] breaking the digital exclusion – social exclusion link recognition of the link between digital exclusion and social exclusion in older adults’ lives is one point of confluence in the gerontological and computer science literatures. on an optimistic note, joseph coughlin, director of the agelab at mit, asserts the following: “the new future of old age is about staying in society, staying in the workplace and staying very connected. and technology is going to be a very big part of that, because the new reality is, increasingly, a virtual reality. it provides a way to make new connections, new friends and new senses of purpose.” (from clifford june 2 2009:d5). however, it is also becoming evident that many people with limited technology skills, support and access do not readily reap such social benefits associated with the advancements in kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 196 technology. research focused on how older adults use information and communications technology concludes that older adults’ adoption of new technologies is neither quick, simple, nor universally accepted (feist, parker and hugo 2012; selwyn et al. 2003). harley and fitzpatrick (2009) suggest that the digital exclusion experienced by many older adults is more a matter of social exclusion than age: “being older does not preclude the opportunity to learn about new technology but social isolation does” (p. 19). itp surveyed can assist older adults in their transition into the technoscape given some of the objectives that these programs adopt, for example, “to raise awareness of and reduce digital exclusion amongst older people,” “social inclusion (and einclusion) of seniors,” and “break down social isolation for older people.” based on survey results as well as our review of the broader literature, we developed the following emergent conceptual framework for understanding and working to break the “’digital exclusion’–‘social exclusion’” link: a. the framework begins with an effort to increase digital literacy. this is done through technology training and support systems (formal and informal educational processes) and creating an accessible and user friendly virtual environment. it is assumed that people want and need friendly, simple, noncompetitive, free (or affordable) ways to learn about and access technology: “technology is used to create very simple experiences … for new and nervous users as well as those in low tech environments.” [survey excerpt, program: historypin. organization: we are what we do (united kingdom)]. b. enhanced digital literacy is likely to yield increased motivation and less fear and hesitancy to use new technology. older adults more frequently than youth consider computers and technology with apprehension, making assumptions that they are complicated and difficult. c. as our data show, increased motivation is likely to yield new opportunities for social engagement (including intergenerational engagement). the intergenerational exchange should not only focus on the technology (and topics related to digital exclusion). it is also important that opportunities are present for dialogue through which participants learn about each other’s lives and gain new insights into ways to expand their social circles and civic engagement pursuits: “some of the youth and seniors do not even use the computers, they talk about a variety of matters and conversation topics that are interesting to them at the time,” [survey excerpt, program: silver surfers intergenerational program. organization: linkages society of alberta (canada)]. broader access to new services (including human services and job training and career development opportunities). d. such opportunities and increased access are likely to yield greater capacity to further develop and practice their technological skills and use technological kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 197 197 resources in ways that reflect evolving interests, changing needs, and expanded social networks: “age soon became irrelevant. the older people gained a whole new set of skills and the younger people gained so much confidence from the project.” [survey excerpt, program. technology for all organization: volunteer centre east ayrshire (united kingdom)]. a positive c-d loop develops. this increase in technological competence and practice contributes to increased opportunities for social engagement and vice versa. this “loop” has implications for reducing social as well as digital exclusion. there is a caveat, however. while we agree that it is problematic that low technology skills and confidence on the part of many older adults can contribute to social exclusion (real and imagined), it is important to avoid creating or feeding a negative stereotype that equates technological competence with relevance and importance. final remarks technology: an integrating or dividing force? technology is most definitely a powerful medium for intergenerational exchange. however, technology is no panacea. the main question is how we decide to apply technology while staying true to underlying goals and corresponding values for promoting satisfactory and meaningful intergenerational interactions and relationships. on a positive note, we know that whether it is through e-mail, social media, video games, or other technological tools, additional opportunities can be created to stimulate, extend, and deepen intergenerational conversations. our survey respondents confirmed this possibility in diverse family and community contexts. however, there is no simple formula. as touched on briefly in the introduction, there are accounts of how advances in technology can have a negative as well as a positive influence on the ways people communicate and form relationships across generations. in family contexts for instance, young people’s expertise using electronic media and peer-oriented participation in social networks can introduce a divisive influence on family relations (figuer, malo and bertran 2010; mesch 2006). considering the many ways in which technology touches our lives, including the nature of our relationships with others, we recommend that our survey data be approached with a more nuanced understanding of how substantial use of technology can function as an intergenerational connector or isolator, a communication barrier or barrier remover. considering the preliminary nature of our study, we recommend viewing conclusions drawn from the study as speculative, requiring further research utilizing multiple methods. kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 198 limitations of study our intergenerational technology programs survey represents a preliminary effort to explore how new technological developments are being applied in a range of settings and contexts with a robust intergenerational engagement component. the data gathered describes some innovative strategies for utilizing technology to connect generations in areas focused on enhancing health and wellbeing, strengthening relationships in families, and organizing and improving communities. however, perhaps as an artifact of how the survey was constructed and distributed (e.g., it is a very short and general survey, and the emphasis is on identifying formal intergenerational programs), we had limited access to experts at the forefront of technological innovation, in areas such as robotics and the construction of new types of technological devices for recording, organizing, and sharing information. whereas it can be argued that many such devices are beginning to have applications in the intergenerational field, at this point, for those at the forefront of technological innovation, responding to a survey on technological applications in intergenerational programming might not have been their priority. accordingly, such work is beyond the purview of this preliminary study and hence not examined in any detail for this particular publication. another limitation of this study is that it does not allow for cross-cultural comparison of intergenerational technology programs. although the data set included programs from 11 countries, it is too small a sample to draw meaningful comparisons and conclusions. considering the global dimensions of technological innovation and concerns about social and demographic changes that influence intergenerational relations (kaplan and sánchez 2014), one line of future inquiry that we feel would be particularly useful is to explore potential cross-cultural variations in terms of how technology is conceived, perceived, and utilized for the purpose of strengthening intergenerational relationships. there are also limitations associated with the self-reporting nature of the dataset. this method does not assess the degree to which those filling out the surveys on behalf of their programs and organizations are describing actual practices. one way to address this limitation, as well as to provide more nuanced data with regard to itp operations and program challenges as well as successes, is to infuse an ethnographic component to complement survey data. however, this could not be done in the current study due to time and resource constraints. recommendations taking what our survey participants have shared with us into account, we would recommend considering the following questions when engaging in the complex task of designing itp aimed at enhancing intergenerational relationships. • how might the technology component be configured to prolong the intergenerational engagement along with deepening interpersonal intimacy? kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 199 199 • does the technology component add new domains of content to discuss, reflect upon, and act upon, together? [if not, and adding no interpersonal enhancement or enrichment value, consider not going high tech.] • what are some ways to create virtual environments that stimulate desired modes of intergenerational dialogue, relationship building, and joint problem solving? • what are some “active distracters?” in other words, what should we try to skip or avoid when trying to plan and implement technology-oriented intergenerational programs/ practices? • what are some effective strategies for addressing concerns related to cybersafety, invasions of privacy, etc.? • by embodying human experience/knowledge/histories into technological devices and services, how can this help strengthen intergenerational relationships in the technoscape? • are the new modes of human interaction between generations made possible by technology in any way inferior to person-to-person contact without the aid of technology? in other words, does technology-mediated interaction alter human relationships in somehow undesirable (less satisfying?) ways? keeping such a long list of questions and considerations in mind is indeed a tall order for those looking for ways in which technological innovation could be used to stimulate and support human interaction. the following quote from one of the survey respondents acknowledges the multidimensional nature of technology, yet articulates a simple idea for moving forward: “the technology we provide has opened a door that can often times be a barrier; we have made it a pathway.” [excerpt from survey. program: ipad-ican. organization: lutheran home at kane (united states)]. as it has been frequently said, the solution to opening this pathway is figuring out how “high tech” can lead to “high touch.” however, in the specific framework of this special issue of the journal, this other way to put that challenge becomes more appropriate: what is it that “technoscapes” have to say regarding the promotion of aging well in our increasing “multigenerational scapes”? our research indicates that promoting intergenerational bonding through technology-based programs is an interesting option. it is our hope that this preliminary effort to scan and contextualize the terrain of intergenerational programs that heavily utilize new technologies will be useful in generating additional interest, research and program innovation in this arena. acknowledgements: the authors gratefully acknowledge cecil shelton, for his assistance in conducting the survey, and the 46 survey participants who provided key information about their intergenerational technology programs. we also acknowledge support from generations united, kaplan, sánchez, bradley | conceptual frameworks and practical applications to connect generations in the technoscape anthropology & aging vol 36, no 2 (2015) issn 2374-2267 (online) doi 10.5195/ aa.2015.99 http://anthro-age.pitt.edu 200 the leading intergenerational membership organization in the united states, in terms of helping to disseminate the 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anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 20-21 issn 2374-2267 (online) doi 10.5195/aa.2015.87 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. response to “back in the saddle again” philip y. kao university of pittsburgh contact: pyk2@pitt.edu abstract response to commentary, “back in the saddle: ethics, visibility, and aging on screen,” but maruta z. vitols and caitrin lynch in this issue of anthropology & aging vol36, no.1 pp. 11-21. . http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.87 http://anthro-age.pitt.edu response to “back in the saddle again” philip y. kao university of pittsburgh the premise of this piece is important, mainly that filmic portrayals of aging and old age are not just whimsical tongue-in-cheek, back-patting celebrations of hollywood by (and for) its “senior” stars. rather, attention to representations of old age and aging in films exposes stereotypes regarding the elderly and unrealistic attitudes towards the aging process more generally. even though showcasing action heroes/heroines, boxers and ex-cia agents (they’re always coming out of retirement!) in roles whereby wisdom and experience are used to outwit their younger counterparts bodes well for revising caricatures of the feeble and doting old person, the authors of “back in the saddle again” point to a more subtle affront. in their words, they are “[…] concerned with the politics of the erasure of multi-dimensional portrayals of older adults as human beings” and—well to put it matter-of-factly—normal aging and all its “invisible” challenges. while it’s good (and entertaining) to be reminded that some of the dinosaurs can still dance, films and more specifically blockbusters which reach a large audience do more harm than good. the authors argue that films, as instruments of mass media, often deny, invalidate and depoliticize the experience of aging, dignity in the human condition, and subjectivities in the making. i would like to begin by calling attention to two main topics that should appeal to academic readers, namely the politics of aging and critical gerontology. the authors mention that filmic representations occupy a space (whether public, private, or post-post-neoliberal is up for debate) where arendt’s political theories regarding the visual take shape. the myths and narratives about aging are often reinforced by particular images and the technologies that enable them. if the authors are right, then there is no banality; rather, visualizing youth and vigor banishes the atrocity and reality of conventional biological aging from the realm of the “visual.” the second topic worthy of more research is the possible return to critical gerontology. the philosophy and praxis of the frankfurt school (e.g., adorno and his critique of the culture industry) helped to shape the field of critical gerontology in the early-mid 1990s. during this period, gerontologists were scratching their heads and wondering why earlier theorists had not written more about aging and the vulnerability of the elderly in light of the structures and logic of capitalism. in anticipation of the baby-boomers and an evolving political economy of aging, the critique of capitalism could potentially benefit from a recasting told from the point of view of the elderly and vice versa. perhaps film and the film industry is a good starting point from the perspective of a critical gerontology by way of mass media, consumption, and communication theory. in the spirit of dialogue, i would like to offer the authors a few questions: 1) recognizing the limitations of an article (for its length and scope), and given that there are so many film genres and types, what is the analytical value in kao | response to “back in the saddle again” anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.87 http://anthro-age.pitt.edu 21 21 comparing two “blow’em up” movies and a documentary? is this a case of apples and oranges? what makes documentaries more or less the products of mass media, and what does this say about the documentaries’ agency on rendering aging (in)visible? 2) what are the real motivations for making movies like r.e.d., the expendables, danny collins, last vegas, etc.? is it merely profits or is there something symbolic and cultural worth uncovering systematically? maybe, there is something beyond the power relations in hollywood (cf. hortense powdermaker’s “the factory of dreams”), i.e. something mythic about the human journey and our representational tropes. 3) if action heroes already defy what is possible for the body to achieve (film watching requires suspension of disbelief), then doesn’t it make sense that we still want our gun-toting heroes (no matter how old they are)? why do we need them, and furthermore, why can’t we allow these film characters to act upon their nostalgic reminiscing in the ways they have always known and done (once a fighter always a fighter)? 4) there seems to be a dichotomy between visible/invisible and the body/mind. to play the role of the contrarian why is it not possible for us to view these films benignly as metaphors rather than as products of mass media/societal deception and conspiracy? 5) the authors that “public speech in the form of a filmic presence is not sufficient for concrete political and social change” (17). was this ever in doubt (i’m thinking of the movie selma and the ongoing crisis of racism in america)? to come full circle again, and to be fair to the authors, they mention the political agency and distribution of socially meaningful documentaries, which brings me back to the question: do people really think that they (and others) are supposed to age like rambo? some but not all filmic representations, however ambivalent and pernicious, will inevitably do more than just reflect society’s norms. the authors argue convincingly that untenable fictions and expectations of our aging loved ones and future selves are at stake. there is one silver-lining, however, stemming from the effects of the aging baby-boomers and their consumerism, and that lesson was aptly captured in the “classic” 1980s movie cocoon. the aging protagonists stumble upon an indoor swimming pool with regenerative powers. when a new owner purchases the clubhouse and closes down the pool as a result, the following exchange takes place between two of the older men: joseph finley: maybe they could give us permission to use the pool. we could pay them something. art selwyn: it wouldn't be fun if we had permission. there is something to be said for breaking the rules, and not going gently into that good night. anthropology & aging quarterly 2013: 34 (3) 61 introduction anyone seeking to learn more about the subject of menopause1 will find standard clinical and public health policy interpretations readily and prominently available. a simple internet search for the word “menopause” returns numerous websites from reputable online medical resources2, all of which provide roughly the same, narrow definition: menopause is the complete cessation of menstruation, and occurs twelve months after the final menstrual period, usually between 45-55 years of age. along with these definitions, much of the accompanying health information addresses symptoms, risk for associated diseases, and treatment options. this information fits the overall medical paradigm that menopause is not simply a r t i c l e s postmenopausal health and disease from the perspective of evolutionary medicine andrew w. froehle department of community health boonshoft school of medicine wright state university a transition between physiologically distinct life history periods, but is instead a deficiency disease that calls for allopathic treatment (marnocha et al. 2011; meyer 2001; meyer 2003)  epidemiological evidence indeed shows that the period surrounding and following menopause is associated with an increased prevalence of disease and disease risk factors, particularly those relating to the metabolic syndrome including weight gain, body composition change, obesity, hyperlipidemia, hypertension, and insulin resistance, all of which increase risk for heart attack, stroke, and type 2 diabetes (torrens et al. 2009; enns and tiidus 2010). in the abstract menopause normally occurs between 45-55 years of age, marks the end of a woman’s reproductive lifespan, and is accompanied by a reduction in estrogen that has substantial physiological effects. the standard medical view is that these changes underlie high postmenopausal disease rates, defining menopause as an estrogen deficiency condition needing treatment. this view stems from the idea that extended postmenopausal longevity is a consequence of recent technological developments, such that women now outlive their evolutionarily-programmed physiological functional lifespan. increasingly, however, researchers employing an evolutionary medicine framework have used data from comparative demography, comparative biology, and human behavioral ecology to challenge the mainstream medical view. instead, these data suggest that a two-decade human postmenopausal lifespan is an evolved, species-typical trait that distinguishes humans from other primates, and has deep roots in our evolutionary past. this view rejects the inevitability of high rates of postmenopausal disease and the concept of menopause as pathology. rather, high postmenopausal disease risk likely stems from specific lifestyle differences between industrialized societies and foraging societies of the type that dominated human evolutionary history. women in industrialized societies tend to have higher estrogen levels during premenopausal life, and experience a greater reduction in estrogen across menopause than do women living in foraging societies, with potentially important physiological consequences. the anthropological approach to understanding postmenopausal disease risk reframes the postmenopausal lifespan as an integral period in the human lifecycle, and offers alternative avenues for disease prevention by highlighting the importance of lifestyle effects on health. keywords: ** anthropology & aging quarterly 2013: 34 (3) 62 andrew froehle postmenopausal health and disease united states, 39.8% of women aged 45-64 years are obese, 39.7% are hypertensive, and 11.3% are diabetic, whereas rates for the same conditions among women aged 20-44 years are 33.2%, 6.9% and 3.2%, respectively(3) 3. of all new type 2 diabetes diagnoses in u.s. adults over age 20 years, 55% occur in the 45-64 year age range, with an additional 20% occurring after age 65 years (centers for disease control and prevention (cdc) 2011).  the medical deficiency disease model attributes elevated disease prevalence to the substantial and permanent reduction in circulating levels of the reproductive steroid hormone 17β-estradiol (henceforth referred to as simply estrogen) that occurs within the four years surrounding the final menstrual period (randolph et al. 2011; sowers et al. 2008). estrogen has multiple non-reproductive physiological functions including fat metabolism for energy, and is involved in numerous metabolic signaling pathways (campbell and febbraio 2001; campbell et al. 2003; spangenburg, geiger et al. 2012; sugiyama and agellon 2012). thus, increased rates of metabolic diseases in menopausal and postmenopausal women are thought to result in large part from the menopausal reduction in circulating estrogen and the ensuing hyposteroidal physiological environment (carr 2003). in the medical model, the female body is poorly equipped to maintain normal metabolic function under reducedestrogen conditions, and the postmenopausal period represents a state of “…uncontrolled degenerative loss of homeostasis…” (austad 1997).  the idea that the female body is ill-prepared to function in the low-estrogen postmenopausal physiological environment derives from a specific view of the human lifespan, which holds that developments in hygiene, sanitation, and medical technology have only recently extended the normal human lifespan into the 6th and 7th decades of life, beyond the evolutionarily programmed physiological lifespan. in other words, these technological developments have resulted in humans “living too long”, and outlasting our intrinsic capacity for physiological self-maintenance. this perspective relies on the concept that somatic longevity, the lifespan of non-reproductive physiological systems, mirrors reproductive longevity, or the lifespan of germline cells that allow one to reproduce. menopause represents the termination of reproductive longevity, which, implicit in the medical view, means that evolution has programmed the maintenance of somatic longevity to cease at this same point. in other words, somatic systems are expected not to have evolved to function past menopause, and are thus incapable of adapting to the hyposteroidal postmenopausal environment. this view lends a character of inevitability to the medical conception of postmenopausal disease, and suggests that women simply live longer than their bodies are built to handle.  the main consequence of the medical deficiency disease model of menopause has been the extensive prescription of hormone replacement therapy (ht), with the intention of replacing lost estrogen to reduce symptoms and prevent development of disease. the promotion of ht as treatment serves as a thorough illustration of the medicalization of menopause, as demonstrated by a recent survey of ht-related pharmaceutical literature. websites for ht generally cast menopause as having unnatural, negative effects and leading to suffering, not only physically, but also psychologically and socially, and present the physician’s perspective as privileged, versus women’s own experiences (charbonneau 2010). widespread prescription of ht as the solution to the medical problem of menopause in and of itself provides ample reason to seek alternative conceptions of the relationship between menopause and women’s health. this is because over the past decade, a series of papers reporting the results of the women’s health initiative (whi) and the million women study have demonstrated an association between taking ht and increased risk of developing cardiovascular disease and breast cancer (narod 2011; rossouw et al. 2002). although these results have been debated since their publication (tanko and christiansen 2006; utian 2012; shapiro 2004), the rate of women taking ht has since declined (ettinger et al. 2012).  while decreased ht use represents a modest shift away from the emphasis on pharmaceutical responses to menopause, it appears mainly to be due to women’s choices rather than a change in the medical model (marnocha et al. 2011). instead, the medical model appears to remain intact, as evidenced by the ht advertising discussed above (charbonneau 2010), by the reflexive readiness of physicians to prescribe ht (marnocha et al. 2011), and by efforts in the scientific community to promote ht by citing criticism of the whi’s results (nedergaard et al. 2013). whereas women can reduce the physical consequences of the medical model by choosing not to fill ht prescriptions, the continued medicalization of menopause still has important and often negative social and psychological effects on women (cimons 2008; charbonneau 2010; marnocha et al. 2011).  this paper presents an alternative approach to understanding menopause and postmenopausal health, that of evolutionary medicine, which follows from the principle that modern human health and disease are at least partially products of the evolutionary forces that have shaped modern human biology and variation (nesse and anthropology & aging quarterly 2013: 34 (3) 63 andrew froehle postmenopausal health and disease williams 1994; williams and nesse 1991; gammelgaard 2000). as such, the following evidence serves as a critique of the medical model of menopause as a deficiency disease, supporting a different, evolutionary view that situates human menopause and the postmenopausal lifespan in its broader ecological and life history contexts. the evolutionary view derives from a wealth of comparative anthropological and biological evidence, incorporating cross-cultural and cross-species comparisons to more holistically understand the process of menopause and health expectations for the postmenopausal lifespan. adopting the evolutionary perspective has the potential to change clinical practice in two key ways. the first is to further obviate the routine prescription of ht by establishing that extended maintenance of sound physiological function under low-estrogen postmenopausal conditions is the human norm. in other words, somatic and reproductive longevity are divorced, so that the human female body has evolved to function and remain healthy for a substantial period of time after menopause, despite the accompanying reduction in circulating estrogen.  second, comparisons of menopausal physiology, postmenopausal survival, and health across species and between human cultures allows for the identification of lifestyle and behavioral factors that may play a role in the etiology of metabolic diseases among women living in industrialized societies, presenting non-pharmacological and non-hormonal avenues for disease prevention. although there is a vast literature on the physiology of metabolic disease, detailing the relevant physiochemical pathways and mechanisms of preventive strategies is beyond the scope of this paper. instead, the following sections review the evidence for evolutionary medicine’s interpretation of menopause, which can point to promising areas of research into the specific physiological mechanisms that promote postmenopausal health. overall, this paper contends that the medical paradigm of deficiency disease is out of step with the biological reality of human menopause, and that an evolutionary medicine approach has the potential to enhance medical, cultural, and individual understandings of menopause and the postmenopausal lifespan. the process of menopause and its relationship to postmenopausal health an important aspect of the evolutionary medicine approach is the recognition that menopause is the culmination of a long-term, highly-variable process, rather than a brief transition or event, as sometimes characterized in the medical model. the length of the menopausal process contributes to its variability and also to variability in postmenopausal physiology, providing the raw material upon which natural selection acts. also important to recognize is that menopause, defined as the end of menstruation, is better seen as the culmination of a larger and longer process wherein ovulation ceases and reduces fecundity, or reproductive potential, to zero. this larger process of the cessation of ovulation, in which menopause is the most readily observable outcome, places a limit on lifetime reproductive success, which is the key variable in natural selection. evolutionary interpretations of menopause must therefore incorporate an understanding of variation in the process of menopause and its relationship to reproductive potential.  the capacity to experience menopause is dependent on the property of semelgametogenesis, where all reproductive cells (in this case oocytes, or egg cells) are overwhelmingly produced only early in life, and are not replenished at any point later in the lifespan (finch 1990; peccei 2001b; ellison 2010). human females are semelgametogenic, a trait they share with all other female mammals and birds (bribiescas 2006), and human oocyte production occurs largely prior to birth (but see (white et al. 2012) with the number of egg cells peaking during the fifth month of gestation. thereafter, due to atresia (a form of apoptosis, or programmed cell death) the population of oocytes decreases to roughly two million at birth, and 400,000 at puberty. after puberty, ovulation and continued atresia cooperate to deplete the remaining store (faddy et al. 1992; hansen et al. 2008), eventually reaching a threshold of ~1000 surviving ova in the years leading up to menopause. below this threshold, the remaining oocytes produce very little estrogen, which is required to stimulate uterine wall preparation in anticipation of implantation of the mature egg (clancy 2009).  among other hormonal changes, the menopausal reduction in estrogen is thought to disrupt endocrine pathways responsible for ovulation and thus fecundity, leading to an average age at menopause between ~45-55 years across human populations (o’connor et al. 1998; thomas et al. 2001; greenspan and gardner 2004; johnson et al. 2004; walker et al. 1984). the age at menopause does, however, vary on population and individual scales, owing to a combination of genetic, environmental and behavioral factors. on the whole, data from diverse human populations consistently fall within the aforementioned age range (see figure 1). the three lowest population average ages at menopause (≤47 years), however, all come from subsistence farming or herding populations practicing natural fertility (i.e. non-contracepting), suggesting that nutritional and reproductive factors influence menopausal timing. anthropology & aging quarterly 2013: 34 (3) 64 andrew froehle postmenopausal health and disease whereas the medical model would tend to view such variation and deviations from the norm as pathological (meyer 2001), the evolutionary perspective sees this variation as potentially adaptive (gluckman and beedle 2007; ellison 2010). given that the process of oocyte depletion occurs over decades and across several very distinct life history periods, it is possible that variation in age at menopause and postmenopausal physiology may be optimized for an individual in the mode of a predictive adaptive response (gluckman and beedle 2007; gluckman et al. 2005). the “predictive adaptive response” concept suggests that individual and population-level phenotypic variation reflects an evolved flexibility that responds to cues during development, influencing subsequent life history and geared towards maximizing lifetime fertility in the face of an unstable, yet to some extent predictable, environment. this approach has been used extensively to explain variation in menstrual cycle characteristics (vitzthum 2008; vitzthum 2009), and in a similar manner may be applicable to menopause and the postmenopausal lifespan (ellison 2010). in this view, variation in the process of menopause and postmenopausal physiology represents the normal range of phenotypic expression, within constraints set by the specific evolutionary history of the human species.  on top of population-level variation, there is also substantial inter-individual variation within populations in terms of the slowing of reproductive function and age at menopause (treloar 1981; te velde and pearson 2002). some of this variation is inherited, with heritability estimates ranging from 30-85% (torgerson, thomas, campbell et al. 1997; torgerson, thomas, and reid 1997; peccei 1999; de bruin et al. 2001; van asselt et al. 2004; murabito et al. 2005; snieder et al. 1998), but such estimates should be interpreted conservatively (vitzthum figure 1: number of populations (total n=53) with average (mean and median) ages at natural menopause within each age range (adekunle et al. 2000; ayatollahi et al. 2003; beall 1983; castelo-branco et al. 2005; chim et al. 2002; garrido-latorre et al. 1996; gonzales et al. 1997; ku et al. 2004; mohammad et al. 2004; balan 1995; okonofua et al. 1990; reynolds and obermeyer 2003; walker et al. 1984; castelo-branco et al. 2006; burch and gunz 1967; chow et al. 1997; fuchs and paskarbeit 1976; greer et al. 2003; hunt, jr. and newcomer 1984; ismael 1994; kapoor and kapoor 1986; karim et al. 1985; kato et al. 1998; kriplani and banerjee 2005; kono et al. 1990; kwawukume et al. 1993; luoto et al. 1994; magursky et al. 1975; mckinlay et al. 1985; morabia et al. 1996; ramoso-jalbuena 1994; reynolds and obermeyer 2001; rizk et al. 1998; samil and wishnuwardhani 1994; tungphaisal et al. 1991; walsh 1978; carda et al. 1998; hagstad 1988; scragg 1973). anthropology & aging quarterly 2013: 34 (3) 65 andrew froehle postmenopausal health and disease 2003; voorhuis et al. 2010). thus, the genetic basis for menopause remains incompletely understood (voorhuis et al. 2010) despite extensive research on the genetics of aging more generally (finch 1990; finch and kirkwood 2000). still, the inconsistency between samples can be taken to mean that age at menopause is a complex (nonmendelian) trait, under the influence of multiple genetic and environmental factors.  the effects of environmental, behavioral, and developmental influences on the age at menopause are somewhat better-known. cigarette smoking is associated with an earlier age at menopause (zenzes 2000; mishra et al. 2010), whereas women who experience fewer menstrual cycles throughout life due to greater parity or more irregular cycles tend to have a later age at menopause (soberon et al. 1966; kaufert et al. 1987; stanford et al. 1987; whelan et al. 1990; dahlgren et al. 1992; torgerson et al. 1994; cramer et al. 1995; vannoord et al. 1997). socioeconomic indicators including level of education and income may affect age at menopause, but results are highly inconsistent, likely owing to a large number of uncontrolled confounding variables (mohammad et al. 2004; flint 1974; beall 1983; kaufert et al. 1987; weinberg et al. 1989; torgerson et al. 1994; garrido-latorre et al. 1996; gonzales et al. 1997; vannoord et al. 1997; chim et al. 2002; ku et al. 2004; castelo-branco et al. 2005; walker et al. 1984; okonofua et al. 1990; gonzales et al. 1997; reynolds and obermeyer 2003; mohammad et al. 2004; kriplani and banerjee 2005). studies of birth weight and early postnatal growth suggest that developmental conditions can also affect age at menopause, but again, the aggregate results fail to point to a consistent relationship (mishra et al. 2007; cresswell et al. 1997; hardy and kuh 2002; hardy and kuh 2005; tom et al. 2010; sloboda et al. 2011; elias et al. 2003).  although continued research is needed to precisely define the major factors that influence menopause, it is clear that the timing and process of menopause are quite variable, and receive inputs from both external and internal environmental factors. the variability and heritability of the timing of menopause provide the raw material from which adaptations evolve, and part of the menopausal adaptation in humans appears to have been the retention of flexibility as part of an overall ovulatory predictive adaptive response mechanism, aimed at maximizing reproductive success. this flexibility may predispose different women to varying metabolic profiles after menopause, differentiating between levels of function and disease risk in the low-estrogen postmenopausal environment. as seen below, however, the evolutionary evidence also points to selection for extended somatic maintenance well-into the postmenopausal period, which may have also evolved as a method of increasing lifetime reproductive success. evolutionary views of the postmenopausal lifespan: paradox or adaptation? before discussing the postmenopausal lifespan specifically, it is important to understand how biologists conceptualize the more general issue of aging, defined not simply as the accrual of time spent living, but as the loss of function in physiological systems with increasing age (gavrilov and gavrilova 2006). aging in and of itself has long been a problematic concept for evolutionary biology (weismann 1889; medawar 1952), since theoretically the most reproductively successful organisms should be those that live forever and never cease to reproduce. why should selection allow for functional deterioration and the regular occurrence of intrinsic causes of mortality (i.e. death due to failure of internal physiological systems rather than succumbing to extrinsic sources of mortality such as predation), rather than favoring self-maintenance in perpetuity, so long as organisms can avoid extrinsic mortality factors? reproductive decline, in particular, requires explanation from the standpoint of natural selection (williams 1957), since reducing fecundity to zero curtails reproductive success and is of no apparent selective value.  the prevailing theory of aging posits that the rate of intrinsic senescence in physiological systems results from the interaction between the population-specific rate of extrinsic-cause mortality (e.g., predation) and age-specific fertility potential (medawar 1952; williams 1957; hamilton 1966; charlesworth 1994). for any age cohort, the number of individuals left alive at a particular age to pass on genes, and the offspring those remaining individuals will potentially produce as a fraction of total offspring production for that cohort, will determine the force of selection of any gene acting at that particular age. at ages where most individuals are still alive and only a small proportion of potential offspring have been produced (such as shortly after puberty), selection to minimize intrinsic mortality is very high. in contrast, at ages where many individuals from a cohort have fallen to accidental death, predation, disease, or other extrinsic factors, and when most of the likely offspring for that cohort have already been produced, then the strength of selection to maintain somatic integrity against intrinsic sources of mortality is much lower, since it has little effect on subsequent generations’ ability to reproduce (williams 1957; hamilton 1966; kirkwood 1977; kirkwood 1980; kirkwood and holliday 1979). anthropology & aging quarterly 2013: 34 (3) 66 andrew froehle postmenopausal health and disease  intrinsic challenges to somatic integrity arise as inborn biochemical byproducts of multiple physiological processes. for example, errors in cellular division, dna replication, and protein synthesis (kirkwood 1977; kirkwood and holliday 1979; kirkwood 1980) can occur easily and challenge somatic viability, so that organisms invest considerable energy in mechanisms that increase accuracy in these processes. such mechanisms are, however, only maintained as long as required to ensure that genes are successfully passed on to offspring at a population-specific rate. with increasing age, higher error rates in these processes lead to accumulation of dysfunction, disruption of physiological systems, and ultimately death (kirkwood and shanley 2010). challenges to somatic integrity can also arise as a result of antagonistic pleiotropy, where individual genes have positive effects early in life prior to and during the peak reproductive period, but have detrimental effects later in life (williams 1957). this occurs because genes that promote viability and reproductive success early in life, when much reproductive potential remains, will be strongly selected for, but will be only weakly selected against if they exert negative effects later in life, when fewer individuals remain alive and little if any reproductive potential remains. in fact, menopause itself and the resultant low estrogen environment may be products of antagonistic pleiotropy (crews 2003). genes that promote higher circulating estrogen levels during the reproductive years have likely been selected for, since they play a major role in stimulating ovulation and thus raise fecundity. this same process, however, leads to more rapid depletion of oocyte stores, and therefore menopause, after which the ovary drastically reduces estrogen production and poses significant challenges to maintaining the somatic integrity of metabolic and cardiovascular systems.  this sharp increase in disease risk after menopause is in agreement with the overarching biological perspective on aging. maintaining somatic viability after menopause is anathema to the evolutionary process, so much so that hamilton (hamilton 1966) predicted a so-called “wall of death”, where intrinsic mortality would increase sharply upon the loss of reproductive capacity. in the same paper, however, hamilton also noted that humans fail to meet the “wall of death” prediction, with much more gradual mortality rates past the age of menopause than expected from theory. thus, the human postmenopausal lifespan and its relative rarity in the living world present a theoretical paradox for evolutionary biology. the problem lies in the apparent disconnect between the reproductive lifespan and somatic longevity: if differential reproductive success is the key functional outcome of evolution, then why would human females have evolved to maintain non-reproductive physiological function for decades past the termination of ovulation? the assumption that somatic and reproductive longevity are closely linked is at least implicit in the medical model of menopause and postmenopausal health.  evolutionary biologists, on the other hand, have addressed several key questions in attempting to explain this paradox, the evidence for which is summarized below. first, are aging patterns in human somatic and reproductive systems disjointed only under conditions like those of industrialized societies, or is the pattern shared across diverse socioeconomic environments? second, do humans differ from other animals, especially closely-related primate species, in the process of menopause and the postmenopausal lifespan? if the pattern of postmenopausal survival seen among women in industrialized society is in fact shared by women in other types of societies, and if this differs from other primates, how and why might the unique human pattern have arisen? most importantly, what are the consequences of the answers the evidence provides for health expectations among postmenopausal women living today and in the future, and what do these data mean for the current prevailing medical model? comparative demography demographic data show clearly that a high rate of multi-decade postmenopausal survival occurs in human populations living under non-industrialized conditions, and lacking access to medico-technological developments, thus challenging the medical model’s notion that a long postmenopausal lifespan is only a recent, technological development. changes in mortality and survivorship from 1850 to 2000 among females in the united states illustrate this point well. whereas major changes in sanitation, hygiene and medical technology that occurred from the late 19th century to the present (cutler and miller 2005) have dramatically increased infant and childhood survivorship (gray 1976), they have had much more modest effects on the postmenopausal lifespan. survivorship rates from birth to age 15 years (a proxy for sexual maturity) and from birth to age 45 years (a proxy for age at menopause) have risen from ~ 65% to ~100% and from ~50% to ~95%, respectively, over the past 150 years (figure 2). the proportion of women living to age 15 that then also survived to age 45, meanwhile, increased from ~70% to ~95%. whereas life expectancy at birth has doubled over that same time period, the average amount of life remaining at age 45 has only increased from ~25 years to ~35 years, with most of the increase occurring after 1940 (figure 3). thus, despite modest gains in the past 150 anthropology & aging quarterly 2013: 34 (3) 67 andrew froehle postmenopausal health and disease figure 2: survivorship from birth to age 15 years (solid gray line) and birth to age 45 years (dashed gray line); conditional survivorship from 15-45 years (black line: rate at which individuals who survived to age 15 also survived to age 45). life table data for 1850-1890 (haines 1994) and for 19002000 (bell and miller 2005). figure 3: l.e. = life expectancy, or average years of life remaining at a specific age. life table data for 1850-1890 (haines 1994) and for 19002000 (bell and miller 2005). anthropology & aging quarterly 2013: 34 (3) 68 andrew froehle postmenopausal health and disease years, even in 1850 prior to greater sanitation, hygiene and medical technology, over two-thirds of women fortunate enough to live to age 15 could expect to live to age 45, and to then survive an average of another 25 years, or 35% of the total lifespan. demographic data from five hunter-gatherer groups (gurven and kaplan 2007) support the idea that this pattern of postmenopausal survival is a widely-shared human trait. despite immense diversity (kelly 1995; panter-brick et al. 2001), hunter-gatherer societies share general characteristics that make them good models for mortality and survivorship in non-industrial, nonagricultural people. although hunter-gathers are modern humans living in the modern world, and are thus not our “ancestors”, the manner in which they live approximates in some critical ways the activity patterns and nutritional and reproductive conditions that may have prevailed over the vast majority of human evolutionary history. huntergatherers obtain food from seasonally fluctuating wild plant and animal supplies, practice natural fertility, and lack reliable access to antibiotics, immunizations, water treatment, and other developments that increase life expectancy at birth in industrialized societies (wood 1994; panter-brick 2002; blurton jones et al. 2002; gurven and kaplan 2007). as such, hunter-gatherers are expected to differ in terms of mortality and survivorship rates from populations living under agricultural and industrialized conditions. nonetheless, hunter-gatherer survivorship and life expectancy patterns are remarkably similar to the pre-industrial united states (figure 4). in both cases, high rates of infant and juvenile mortality result in life expectancy at birth of less than 40 years and 57-65% survivorship from birth to age 15. for those who live to sexual maturity, however, ~65% will also reach age 45 and on average survive for another two decades. the data therefore strongly suggest that even under divergent socioeconomic conditions, a substantial proportion of all females born, and an even greater proportion of those who live to reproductive adulthood, share the expectation of multi-decade postmenopausal survival, amounting to on average a third of the total lifespan. figure 4: survivorship from birth to age 15 years (black bars) and birth to age 45 years (dark gray bars); conditional survivorship from 15-45 years (light gray bars); and pm/ls ratio, the average postmenopausal lifespan (pm) remaining at age 45 years as a percentage of total lifespan (ls), calculated as e45/(e45+45), where e45 is the life expectancy at age 45 years. united states (us) data for 1850 (haines 1994) and for 2000 (bell and miller 2005); hunter-gatherer (h-g) and chimpanzee data (gurven and kaplan 2007). anthropology & aging quarterly 2013: 34 (3) 69 andrew froehle postmenopausal health and disease comparative biology whereas comparative demography points to biological similarities between all humans, regardless of socioeconomic environment, comparative biology can place the human pattern of postmenopausal survival in its proper evolutionary context. note that figure 4 also includes survivorship data from wild and captive chimpanzees (addressed in detail below). as our closest living relatives (goodman et al. 1998), the panins (common chimpanzees: pan troglodytes spp.; bonobos: pan paniscus spp.) provide critical information as to which traits humans share with other primates, and which traits likely evolved since the split with our last common ancestor. comparative biological data can address whether the human pattern of postmenopausal survival is unique or common among some larger taxonomic grouping. as shown below, although a few individual animals in many species may briefly outlive menopause (cohen 2004) and some whale species exhibit a postmenopausal lifespan similar to humans (kasuya and marsh 1984; marsh and kasuya 1984; marsh and kasuya 1986; olesiuk et al. 1990; bloch et al. 1993; martin and rothery 1993; mcauliffe and whitehead 2005; foote 2008), overall humans are unique among mammals, including primates, and are evolutionarily derived relative to panins in having specieswide, common, multi-decade survival past menopause (caro et al. 1995; packer et al. 1998; bronikowski et al. 2002; pavelka and fedigan 1999; bellino and wise 2003; cohen 2004; fedigan and pavelka 2006).  the first question is whether human postmenopausal longevity has been achieved by foreshortening the reproductive lifespan, or by extension of the somatic lifespan relative to our last common ancestor. overwhelmingly, the evidence supports the latter conclusion: modern humans share an average age at menopause with panins, but have the capacity to live well beyond menopause due to an extension of somatic longevity. evidence for a shared human/panin menopausal process, and an age range for the cessation of ovulation of 45-55 years (walker and herndon 2008), comes from studies of both wild and captive chimpanzees and bonobos, with data on ovarian histology and reproductive hormones, menstruation and sexual swellings (swellings of the anogenital region that signify ovulation and are a proxy for estrogen activity), and age-specific fertility. first, from examinations of ovarian histology, humans and panins share a similar trajectory of oocyte reduction (gould et al. 1981; leidy et al. 1998; hansen et al. 2008; videan et al. 2008; jones et al. 2007) that proceeds at essentially the same rate in both taxa (jones et al. 2007). as in humans, the reduced oocyte population is related to hormonal changes in panins, and reproductive hormone profiles of panins from their late 30s to age 50 resemble those of preand perimenopausal women of the same age (gould et al. 1981; jurke et al. 2000; videan et al. 2006). in terms of the effects of oocyte depletion on estrogenic stimulation of ovulation and fecundity, panin menstrual bleeding and sexual swellings, which reach peak frequency, regularity, and duration of maximal tumescence in the 20s, gradually become less frequent, more irregular, and shorter until eventually ceasing altogether in the 40s and 50s (graham 1979; gould et al. 1981; jurke et al. 2000; videan et al. 2006; lacreuse et al. 2008). thus, it appears that humans and panins share an ancestral pattern of oocyte reduction and a similar ovulatory “dose-response” to the small remaining population of sex cells during the fifth and sixth decades of life (hawkes and smith 2010).  observations of panin age-specific fertility are consistent with the data on oocyte counts, hormone profiles, and ovulatory cycling, also suggesting an end to reproductive capacity occurring between the mid-40s and mid-50s. past age 35, fertility declines substantially, and the proportion of pregnancies terminating in stillbirth or spontaneous abortion increases among captive chimpanzees (graham 1979; roof et al. 2005; atsalis and videan 2009b; atsalis and videan 2009a). across a large sample from multiple wild chimpanzee study sites, there is a sharp drop-off in number of births per female per year between 40-44 years old, with a tiny fraction of females reproducing up to age 55 (emery et al. 2007).  as in humans (den tonkelaar et al. 1998; vitzthum 2009), there is substantial individual and population-level variation among panins in the process of reproductive aging, the age at which ovulation ceases, and the termination of fertility (boesch and boesch-achermann 2000; videan et al. 2006; emery et al. 2007; lacreuse et al. 2008). for example, there are isolated reports of live captive births in the late 40s (puschmann and federer 2008). whether this site-based variation is physiological or due to social differences in age-related mating behavior remains undetermined, but it is entirely possible that ecological factors affect reproductive parameters similarly in both panins and humans (atsalis and videan 2009b; atsalis and videan 2009a). although this hypothesis has not been extensively explored (herndon and lacreuse 2009), it points to the possibility of a shared capacity for predictive adaptive responses in the reproductive systems of the human-panin clade, and thus the variability necessary for evolutionary differentiation by natural selection.  overall, however, due to mortality patterns, menopause occurs in a very small proportion of all female panins anthropology & aging quarterly 2013: 34 (3) 70 andrew froehle postmenopausal health and disease born, and then usually only very late in life (herndon and lacreuse 2009; lacreuse et al. 2008), but there is also variation in the rate at which panins survive past menopause (hill et al. 2001; videan et al. 2006; emery et al. 2007; atsalis and videan 2009b; atsalis and videan 2009a; herndon and lacreuse 2009). to some extent, mortality differences between captive and wild chimpanzees mirror differences between human populations living under different socioeconomic circumstances (i.e. reduced infant mortality and greater survivorship due to nutritional security and decreased risk of extrinsic mortality). even in captivity, however, most benefits of reduced extrinsiccause mortality accrue as increased survivorship to age 15 (a good proxy for sexual maturity in chimpanzees as in humans: (hill et al. 2001), with a relatively small proportion of females born survive past menopause, and then only briefly (see figure 4). at wild sites, only 5% of all females born survive to age 45-50, with adult mortality rates rising between 25-30 years and spiking at and beyond age 40 (hill et al. 2001). of those surviving to sexual maturity, less than 10% survive to age 45, at which point they have only 10% of their total lifespan remaining (gurven and kaplan 2007)2007).  although extrinsic mortality risk likely differs between wild panins and human hunter-gatherers, much of the inter-species difference in survivorship and longevity past menopause may result from differences in the rate of aging in somatic physiological systems. critically, although overall mortality rates are lower in captive chimpanzees, they too experience a major increase in adult mortality at roughly the same age as wild populations, implicating intrinsic rather than extrinsic causes of death (hill et al. 2001). while adult mortality rates increase exponentially and at roughly the same rate in both chimpanzees and hunter-gatherers, the increase in mortality due to intrinsic senescence begins ≥10 years earlier in chimpanzees (gurven and kaplan 2007). wild chimpanzees begin to show signs of somatic aging beginning in their mid-30s, and though these outward signs of deterioration do not always correlate with incapacitation (tarou et al. 2002; finch and stanford 2004), it seems plausible that they tend to succumb to intrinsic somatic senescence at earlier average ages than do humans. possible mechanisms that explain these apparent species-level differences in intrinsic mortality and somatic longevity are discussed below. mechanisms for extension of the somatic lifespan in seeking explanations for the extension of somatic maintenance past menopause in humans, is it important to consider both the proximate physiological mechanisms by which cellular viability and functional integrity is maintained, as well as the ultimate evolutionary pressures most likely to have driven selection for an extended lifespan. the two main proximate causes of aging are the metabolic production of free radicals, which can oxidize and damage tissues and dna (harman 1956), and the accumulation of errors in dna and its macromolecular end-products due to poor replicative control, leading to malfunctioning cells and the eventual interruption of physiological pathways (orgel 1963; orgel 1970; kirkwood 1977; kirkwood and holliday 1979; kirkwood 1980). extending somatic longevity can be achieved by investing energy in mechanisms that reduce free radical production or activity, and that enhance the accuracy of protein synthesis and cellular replication.  although somewhat limited, existing data on differences between humans and other primates in the expression of such mechanisms tends to point to greater maintenance of somatic integrity among humans. on a large scale, a reduced metabolic rate may limit free radical production and thus reduce oxidative damage (ku and sohal 1993; barja et al. 1994), and humans have slightly lower than expected mass-specific metabolic rates compared to chimpanzees (froehle and schoeninger 2006). on a more molecular scale, blood levels of the free radical scavenger uric acid (ames et al. 1981) tend to be higher in primates than in most mammals (friedman et al. 1995), and are especially high in apes and humans (wu et al. 1992; oda et al. 2002). humans and apes, to the exclusion of monkeys, also share mutations in the genes responsible for another group of free radical scavengers, the superoxide dismutases (fukuhara et al. 2002), which are more active in longer-lived primate species and are most active in human organ tissues (tolmasoff et al. 1980). in terms of dna and fidelity in macromolecular synthesis and cellular replication, humans have higher rates of dna repair than apes (cortopassi and wang 1996). overall, then, in keeping with a longer lifespan, humans appear to have a greater physiological capacity for somatic maintenance via free-radical management and accuracy in macromolecule transcription and translation compared to other primates.  recent research has expanded beyond the above domains to include comparative studies of other biomarkers of aging in primates. perhaps the most extensive body of work has focused on dehydroepiandrosterone sulfate (dheas), an important androgen hormone with a wide variety of physiological roles, and protective effects against several metabolic and cardiovascular diseases (lane et al. 1997). multiple studies in rhesus monkeys (macaca mulatta) and humans have demonstrated a decline in serum anthropology & aging quarterly 2013: 34 (3) 71 andrew froehle postmenopausal health and disease concentrations of dheas with age (kemnitz et al. 2000; roth et al. 2002), and an association between higher levels of circulating dheas and slower rates of aging (roth et al. 2002; lane et al. 1997). compared to chimpanzees, human serum levels of dheas decline more rapidly with age, but overall concentrations are two-to-three times higher in humans at any age, and only begin to drop into the high end of the chimpanzee range at ages older than 65 years (blevins et al. 2013). other great ape species exhibit even lower dheas concentrations (bernstein et al. 2012), consistent with the idea that higher human levels have evolved since our split with the apes and promote a unique, extended period of somatic viability. additional research in these areas should help to clarify additional proximate physiological mechanisms by which the human lifespan is extended compared to our close primate relatives.  in terms of ultimate evolutionary mechanisms for the extension of the somatic lifespan past menopause in humans, multiple theorists (williams 1957; hamilton 1966) have proposed the existence of a critical breach in the so-called “wall of death”. in species with relatively low lifetime fertility and high levels of long-term parental care, infant and childhood survivorship can be enhanced by traits that increase the delivery of energy to offspring. this reproductive strategy is common to most primates, and mother-child food sharing is not uncommon among panins (ueno and matsuzawa 2004). humans, however, represent an extreme version of the primate pattern, with offspring that are slow-developing, energy-needy, and highly nutritionally-dependent for a much longer period of time than panins. thus, successfully raising human offspring to sexual maturity is an exceptionally energyexpensive endeavor (gurven and walker 2006). to address this challenge, humans also diverge from other primates in the frequency of food sharing, the quantity of calories shared, and the breadth of regular, dyadic food sharing relationships (kaplan and gurven 2005).  this pattern of food sharing greatly expands the range and frequency of opportunities to indirectly boost reproductive success (i.e., through means other than producing more of one’s own children), since a proportion of one’s genes are shared with even distant kin. because of these potential inclusive fitness benefits via broad-based food sharing, the human lifespan is socially selected rather than individually selected. in other words, the human lifespan serves not only to facilitate one’s own direct reproductive success, but also facilitates the reproductive success of close relatives, opening up the possibility of lifespan extension via kin selection and inclusive fitness effects (carey and judge 2001).  this is the crack evolution requires to pry open a hole in the “wall of death”: in humans, long-term parental care as well as “…altruistic contributions due to postreproductives…” (hamilton 1966) serve as methods by which infant and childhood survivorship are increased (williams 1957; hamilton 1966; lee 2008; lee 2003). the importance of food sharing to human reproduction has thus likely added reproductive value to older adults, driving the evolution of extended somatic longevity and generating a self-reinforcing feedback loop with adult mortality. increased fitness via food sharing at older ages would promote lower age-specific intrinsic mortality, which would in turn increase age-specific reproductive value as more individuals of older age would survive to obtain inclusive fitness benefits. this feedback would further increase the force of selection to maintain physiological function into later life (carey and judge 2001).  providing for the reproductive success of offspring via food sharing plays a prominent role in hypotheses for the evolution of human longevity through effects on selective fitness. the “mother hypothesis” (williams 1957; hamilton 1966; peccei 1995a; peccei 1995b; peccei 2001a; peccei 2001b; peccei 2005) and “grandmother hypothesis” (blurton jones et al. 2005; hawkes et al. 1989; hawkes et al. 1997; hawkes et al. 1998; hawkes 2003; o’connell et al. 1999) both propose that the postmenopausal lifespan evolved because it allowed women to boost lifetime reproductive success. in the former, postmenopausal mothers benefit directly by eschewing risky new pregnancies that could jeopardize the survival of existing dependent offspring. in the latter, postmenopausal women indirectly increase fitness by sharing food to promote grandchild production and survival.  several lines of evidence support the positive effect of postmenopausal women on the reproductive success, growth, development, and survival of their children and grandchildren. in pre-industrial and modern nonindustrial agricultural societies, a maternal grandmother’s presence promotes weight gain in grandchildren and increases lifetime fertility in daughters (mayer 1981; mayer 1982; turke 1988; sear et al. 2000; sear et al. 2002; voland and beise 2002; lahdenpera et al. 2004; fox et al. 2010). hadza hunter-gatherer grandmothers target hardto-obtain, valuable resources that their reproductivelyactive daughters are not as able to procure due to the constraints of pregnancy, nursing, and childcare (hawkes et al. 1989; hawkes et al. 1997; hawkes et al. 1995; crittenden et al. 2009). as such, childhood weight gain is positively correlated with the amount of time maternal grandmothers living in the same camp spend foraging anthropology & aging quarterly 2013: 34 (3) 72 andrew froehle postmenopausal health and disease (hawkes et al. 1989; hawkes et al. 1997).  mathematical models also tend to find both the mother and grandmother hypotheses evolutionarily plausible. maternal mortality has a strong enough effect on the survivorship of unweaned children, for example, to drive the extension of the lifespan past the end of fertility (shanley and kirkwood 2001; sousa 2003). the mother hypothesis is, however, weakened when other potential offspring providers (e.g., fathers, aunts, uncles) are present to feed weaned children (shanley and kirkwood 2001; shanley et al. 2007; lahdenpera et al. 2011). inclusive fitness effects accruing to grandmothers who participate in intergenerational foodsharing could also have driven lifespan extension (shanley and kirkwood 2001; lee 2008; lee 2003), with the greatest contributions to grandchild survival occurring during the critical period of 1-2 years old when infants are still nursing and on the cusp of being weaned (shanley et al. 2007). this suggests that provisioning of adult daughters to subsidize nursing energy needs may have served as the primary role for postmenopausal women that initially selected for a longer lifespan.  though many of the specific tenets of these two hypotheses differ, they share one crucial argument: active foraging and food sharing in support of offspring production and viability have imbued humans with the potential for reproductive value at much older ages than expected from theory, or from comparative data on panins. by extension, these hypotheses predict that selection has favored human phenotypes that retain the capacity for somatic maintenance at those older ages. as such, the human postmenopausal period is interpreted as an evolved, species-typical life history stage, as integral to the human life course as adolescence or childhood, and characterized by low rates of intrinsic senescence in physiological systems, at least into the seventh decade of life (gurven and kaplan 2007). this life-history interpretation informs the study of menopause and the postmenopausal lifespan from the perspective of evolutionary medicine. following these evolutionary hypotheses, it seems reasonable to expect that the evolutionary extension of somatic maintenance should foster low rates of chronic and degenerative diseases, and overall good health during the postmenopausal life history period, at least into the seventh decade of life. given this expectation, it becomes critical to evaluate the potential lifestyle and behavioral patterns among women in industrial society that may predispose them to postmenopausal disease by diverging sharply from conditions under the natural fertility foraging regime that has likely dominated human evolutionary history. evolutionary expectations for postmenopausal health in seeking lifestyle factors that might underlie postmenopausal disease risk in industrialized societies, it is important to first examine the prevalence of the same diseases among older women in hunter-gatherer societies. overwhelmingly, hunter-gatherers without access to medical care appear not to experience the high rate of decline in early postmenopausal somatic maintenance seen in industrialized populations. degenerative diseases in foraging populations (as far as they can be diagnosed) are extremely rare, accounting for less than 3% of deaths before age 60 (howell 1979; hill and hurtado 1996; gurven and kaplan 2007). although degenerative diseases become more common as causes of death after age 60, obesity, hypertension, heart attack and stroke are still very much the exception (eaton et al. 1988; gurven and kaplan 2007). anthropometric work among the hadza demonstrates that average body fat percentage remains constant at about 19% in women from age 18-75 (sherry and marlowe 2007), in stark contrast to the increase in body fat with age in postmenopausal women from industrialized societies (heymsfield et al. 1994). anecdotal and empirical evidence also points to the maintenance of physical vigor in old age in foragers (blurton jones et al. 2002; hawkes et al. 1989; walker and hill 2003), including the observation that older hadza women tend to work longer and perform difficult foraging tasks more frequently than women of reproductive age (hawkes et al. 1989; hawkes et al. 1997). these data show that the metabolic syndrome is rare among huntergatherers, likely related to an absence of age-related body composition change and continued physical activity. maintenance of somatic physiological systems well past menopause appears to be the hunter-gatherer norm, with an absence of the related high mortality rates that would be present in industrialized society without advanced medical treatment (e.g., insulin for diabetes).  the potential cause(s) of postmenopausal health differences between women living in industrialized vs. hunter-gatherer societies must be understood from a biocultural and evolutionary perspective as a consequence of the divergent conditions under which they live. as stated previously, probably the most important physiological change with menopause is the reduction in estrogen levels. this “hyposteroidal” physiological environment is thought to cause disease by undermining the proper functioning of various somatic physiological systems, especially those related to metabolic health. this hypothesis, however, is contrary to expectations if the postmenopausal lifespan indeed represents an evolved life history period. according to austad (austad 1997), “… if menopause is anthropology & aging quarterly 2013: 34 (3) 73 andrew froehle postmenopausal health and disease an adaptive physiological state molded by evolution… then natural selection would presumably have tailored postreproductive physiology to the hyposteroidal state…” [emphasis in the original]. in other words, if selection has promoted the extension of somatic maintenance past menopause, then one would expect postmenopausal physiology to retain functional capacity despite reduced estrogen levels.  rather than see this necessarily as a contradiction, it is possible that factors other than just a reduction in steroid hormone levels affect the ability of metabolic systems to maintain their operations after menopause. alternatively, if lifestyle factors elevate estrogen levels during the premenopausal period in women living under industrialized conditions, the magnitude of hormonal change across the menopausal transition may be greater than in women living in subsistence-level societies, with possibly important physiological consequences (pollard 2008). given that physiological systems act not in isolation, but interact and affect one another, it seems reasonable that the physiological effects of behavior and experiences during pre-menopausal life could extend into the postmenopausal period. in the same way that it is reasonable to suspect that selection would have molded human postmenopausal physiology to operate under hypersteroidal conditions, it is also reasonable to predict that the environment (both internal and external) under which individual metabolic physiological systems develop and operate across the reproductive lifespan might predispose those systems to function better or worse in the postmenopausal environment. if this is the case, we might then expect the prevailing conditions of hunter-gatherer life to be integral in preparing metabolic physiological systems for operation in the low-estrogen postmenopausal milieu. from this perspective, cultural variation in subsistence practices and reproduction may be particularly important.  the experience of women in industrialized countries differs in a variety of ways from women’s lives in modern hunter-gatherer societies, and many of these same differences likely distinguish industrialized life from conditions during the initial evolution of the postmenopausal life history period. for one, decreased infant and childhood mortality may remove biological filters on survival, thereby promoting higher adult disease risk if phenotypes prone to pre-adult mortality also tend to be prone to chronic disease (hawkes 2010; forbes 1997). reproductive history also diverges between women in low-fertility industrialized populations vs. women practicing natural fertility. in the latter, higher birthrates, longer nursing, and more frequent lactational amenorrhea (wood 1994) mean fewer lifetime ovulatory cycles and lower exposure to estrogens, possibly related to decreased risk for reproductive cancers (henderson et al. 1985; eaton et al. 1994; bernstein 2002; yang and wu 2005; yang and jacobsen 2008). the same factors, given their relationship to estrogen levels, could also relate to metabolic function in the low-estrogen, postmenopausal physiological environment (xue and michels 2007).  diets in industrialized societies, too, differ greatly from the seasonally-variable wild plants and animals that constitute hunter-gatherer diets, which generally tend to be higher in fiber and low in fat (cordain et al. 2000; cordain et al. 2002; eaton and konner 1985; eaton et al. 1997; konner and eaton 2010). disparities in consumption of fiber, simple carbohydrates, and fat likely relate to higher metabolic disease risk in industrialized populations, partly through effects on estrogen levels and related metabolic processes. contrary to the estrogendeficiency model of postmenopausal metabolic disease, however, characteristics of the typical hunter-gatherer diet actually tend to decrease estrogen levels. greater dietary fiber intake, for example, is correlated with lower concentrations of estrogen and estrogen metabolites in the blood (sowers et al. 2006; wayne et al. 2008; gaskins et al. 2012), as are low fat diets (gencel et al. 2012; nagata et al. 2005; turner 2011). in addition to greater estrogen from lowfiber/high-fat diets, women in industrialized societies may add more estrogen to the circulation from consumption of dairy products, in particular from dairy cattle bred to lactate year-round (davoodi et al. 2013). according to the model of low estrogen as a deficiency disease, a typical low-fat, high-fiber, and dairy-free hunter-gatherer diet should increase risk for metabolic disease vs. a high-fat, low-fiber western diet. this is, however, demonstrably not the case, and the evolutionary perspective suggests that dietary elevation of circulating estrogen during the premenopausal period may in fact have a carry-over effect on postmenopausal metabolic physiology that increases disease risk.  a fourth factor is the substantial difference in physical activity between hunter-gatherer women, who engage in regular, vigorous physical activity to obtain food, vs. the generally more sedentary women of industrialized societies (hayes et al. 2005). low exercise levels result in generalized health problems (cordain et al. 1997; eaton and eaton 2003; chakravarthy and booth 2004), but the particular relationship between exercise, estrogen, and metabolic physiology may put inactive postmenopausal women at even greater risk for metabolic and cardiovascular diseases (major et al. 2005; torrens et al. 2009). in premenopausal women, higher levels of anthropology & aging quarterly 2013: 34 (3) 74 andrew froehle postmenopausal health and disease exercise correlate with suppression of estrogen levels (jasienska et al. 2006), and in extreme cases lead to athletic amenorrhea and interruption of ovulation (mcardle et al. 2001). higher overall levels of estrogen compared to men, however, mean that women tend to burn more fat for energy both at rest and during exercise (tarnopolsky 2008). this metabolic difference fades with menopausal hormone changes (isacco et al. 2012), possibly making postmenopausal women prone to fat gain. low activity combined with low estrogen levels after menopause may also limit the body’s ability to build cardiovascular and muscular adaptations to exercise (grounds 1998; grounds 2002; harris 2005), potentially blunting the health benefits of exercise interventions in sedentary postmenopausal women. these factors suggest that postmenopausal women are more susceptible to metabolic diseases regardless of exercise levels. recent work shows, however, that resting energy expenditure, a fundamental indicator of metabolic function, has a dose-response relationship with exercise in postmenopausal women (froehle et al. 2013). thus, exercise after menopause appears to have metabolic effects that can compensate for the consequences of lowered estrogen (spangenburg et al. 2012).  researchers have only recently begun to focus on how these lifestyle and behavioral factors affect metabolic disease risk and prevalence specifically in the low-estrogen postmenopausal physiological context. the combined evidence provides some interesting leads, though, and points to potentially promising avenues for continued research. a common feature of the reproductive, dietary, and activity differences between women in industrialized societies and women in subsistence-level, natural fertility societies, is their effects on premenopausal estrogen levels. high lifetime fertility and breastfeeding, a diet high in fiber and low in fat, and greater levels of activity all characterize the hunter-gatherer lifestyle, and all have the common effect of suppressing estrogen levels during the reproductive years. the opposite is true of the typical lifestyle in industrialized societies, where women are subject to much higher estrogen exposure over the premenopausal lifespan. the difference may be critical to postmenopausal physiological functioning given the key role of estrogen in metabolism. it is possible that low estrogen levels during the premenopausal period “prime” metabolic systems to function under that hormonal regime, so that after the menopausal reduction in estrogen the body maintains greater capacity to function normally, even in the presence of low circulating estrogen.  in contrast, if the body adapts to high estrogen levels prior to menopause, the magnitude of the menopausal drop in estrogen and subsequent low-estrogen postmenopausal environment may more greatly disrupt metabolic pathways, resulting in higher disease risk without substantial intervention. this hypothesis has already been presented with regard to bone disease (pollard 2008; galloway 1997), and may very well also extend to metabolic disease. additionally, if the degree of hormonal change around the time of menopause is important to postmenopausal metabolic function, then lifestyle interventions that seek to lower estrogen levels need to begin as far before menopause as possible (spangenburg, wohlers et al. 2012; appt and ethun 2010; dipietro 2010). some speculations as to possible areas of non-pharmacological, behavioral modes of prevention are discussed below. conclusion overwhelmingly, the evidence from comparative demography and comparative biology contradict the tenets of the medical model of menopause and the postmenopausal lifespan. rather than being a recent technological development in industrialized societies that extends the lifespan past its evolutionarily intended endpoint, the postmenopausal period is shared broadly across a wide range of human societies living under widely varying nutritional and medical conditions. the shared age at menopause between humans and panins, coupled with greatly reduced mid-life adult mortality rates in the former vs. the latter, also suggest strongly that the postmenopausal lifespan has evolved not by early termination of the reproductive period, but instead by lengthening the lifespan of somatic physiological systems beyond a retained ancestral age range for menopause. in short, multi-decade postmenopausal survival that accounts for roughly one-third of the total lifespan is an evolved, species-defining trait in humans, and should be considered a normal life history phase akin to childhood, adolescence, or reproductive adulthood.  whereas the postmenopausal lifespan is universally experienced across societies, however, it does not universally represent the initiation of a period of metabolic disease risk and decline. given evidence that the lifespan has been selected to last past menopause, the low-estrogen deficiency disease model that prevails in western medicine is flawed. rather than a period of uncontrolled disruption to metabolic homeostasis, the evolutionary approach proposes that metabolic physiological systems have evolved to maintain sound function after menopause, despite decreased circulating estrogen. instead of focusing on prescribing estrogen to cure a perceived deficiency, more effective strategies to minimize postmenopausal metabolic disease among women in industrialized anthropology & aging quarterly 2013: 34 (3) 75 andrew froehle postmenopausal health and disease countries should follow from a better understanding of the conditions under which human physiology largely evolved. four key areas of continued research can potentially contribute to developing preventive strategies by addressing the effects of lifestyle and behavioral factors on estrogen levels during premenopausal life, their effect on the magnitude of the menopausal reduction in circulating estrogen, and the consequences for metabolic function after menopause. these areas are: 1) the effects of decreased infant and child mortality on adult disease risk; 2) the effects of reproductive patterns on estrogen levels; 3) the effects of diet on body composition and metabolic function in relation to estrogen; and 4) the effects of physical activity on metabolic function, again with regard to estrogen physiology.  first, there are clearly ethical concerns with advocating greater childhood mortality or interfering with individual women’s choices about reproduction, contraception, or family planning, and so preventive strategies deriving from the first two areas above are unlikely to be developed (nor should they be, in this author’s opinion). studying the effects of early life experiences on later life physiology, however, as well as genetic predisposition to certain conditions, may be fruitful in identifying women who may be at greater risk of developing metabolic diseases after menopause. such information would be useful in tailoring preventive exercise and dietary programs early in life so as to maximize postmenopausal health.  certainly, advocating diets higher in fiber and lower in many kinds of fat, along with greater levels of physical activity is important not only to general health, but also specifically for metabolic health after menopause. initiating these habits as early as possible in the lifespan may be critical to developing a metabolic adaptation to lower levels of estrogen, which may then prime these physiological systems to maintain function after menopause. there is already some interesting thought in this direction (pollard 2008; spangenburg et al. 2012), and continued work in this vein has great promise in reducing the prevalence of midlife metabolic disease among women in industrialized societies. overall, it is critical to understand menopause in its broader evolutionary and biological context so as to recognize that life past menopause is not a disease, but has likely been an integral part of the lifespan of most women for millennia (blurton jones et al. 2002; caspari and lee 2004). using the framework of evolutionary medicine to study menopause offers the opportunity to develop lifelong preventive strategies that ensure postmenopausal health, and that have the potential to change societal, and perhaps more importantly for health, medical perceptions of menopause. notes 1 this paper focuses on “natural menopause,” the result of innate physiological processes, as opposed to surgical menopause, which is a consequence of various surgical procedures, including hysterectomy and oophorectomy. 2 national library of medicine: http://www.nlm.nih.gov/ medlineplus/menopause.html (may 21, 2013); national institute on aging: http://www.nia.nih.gov/health/ publication/menopause (may 21, 2013); mayo clinic: http://www.mayoclinic.com/health/menopause/ds00119 (may 21, 2013). 3 national health and nutrition examination survey, obtained from national center for health statistics, health data interactive, http://www.cdc.gov/nchs/hdi.htm, accessed may 21, 2013. acknowledgements the author thanks margaret schoeninger, jim moore, sue hopkins, loki natarajan, katerina semendeferi, and two anonymous reviewers for their helpful comments on various incarnations of 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jacobsen 2008 a systematic review of the association between breastfeeding and breast cancer. journal of womens health 17(10):1635-1645. 263. zenzes, m. t. 2000 smoking and reproduction: gene damage to human gametes and embryos. human reproduction update 6(2):122-131. anthropology & aging quarterly 2009: 30 (2) 27 features giving meaning to health: daily occupations among elderly south africans enid schatz,phd university of missouri and university of the witwatersrand elderly south africans experience health burdens due to non-communicable disease, the responsibilities of caring for ailing children infected with aids, and raising fostered and orphaned grandchildren. the aim of this paper is to explore connections between daily occupations, health and well-being among older persons living in rural south africa. although a significant amount of research highlights meaningful activity as a factor for maintaining health and wellbeing in developed countries, very little empirical work has explored this issue in developing country settings. daily occupations, what makes them meaningful, and the meaning of health are all context specific; without empirical studies it is difficult to know how older persons see their lives, and what assistance they may need, or in what ways they are resilient. this paper builds on other work from the gogo (grandmother) project—repeated semi-structured interviews with 90 women over age 50 living in the south african medical council/university of the witwatersrand rural public health and health transitions research site. this paper describes the ways in which these rural south african women talk about their own health, the daily activities in which they take part, and possible connections between these and their sense of well-being. south africa’s high hiv-prevalence, emergent epidemic of non-communicable disease, and statefunded non-contributory pension system, which make older household members an important economic asset to their households and social networks, both help form and complicate the roles and responsibilities older people feel they can or must accomplish to support their families and themselves. i am a social demographer (who uses a lot of anthropological techniques) with a position as an assistant professor in the university of missouri (mu) department of occupational therapy & occupational science. research in the field of demography focuses on the statistical study of human populations, notably topics related to fertility, mortality and migration. the data for this basic research is usually collected in the form of surveys and censuses. as a social demographer, i draw on the tools of a range of disciplines in order to provide insights into the meanings and processes behind such statistics. my own work draws on sociology and demography, the disciplines in which i completed my doctoral training, as well as anthropology, occupational science, gender studies, and public health. using this interdisciplinary lens, i examine and elucidate the lived experiences of older women in rural south africa. despite my interdisciplinary research agenda, when i tell people that i am a demographer in an ot department, the response is often a blank stare—people are not sure how i fit in, what i do or what i teach. but i believe that my work and teaching exemplifies the connections and overlap between fields. in each of the disciplines from which i draw, particularly anthropology and occupational science, there is an evident desire to document individuals’ daily lives in a way that will uncover meanings and contextual specificities that provide insight into family and community dynamics. my presentation at the american anthropological association meeting in november, 2007, used older rural south african women’s narratives to focus on their “access [to] and participation in] activities that are meaningful, purposeful, and relevant to their lives, roles, and sense of well-being.” while enabling individuals and communities to engage in meaningful occupations is outlined as an explicit aim of the american occupational therapy association as a profession, my research examines what these occupations might be in contexts beyond our borders. i explore how those occupations might positively or negatively impact older women’s health and how their health impacts their ability to engage in these occupations. without this empirical evidence, it would be impossible to understand how individuals make meaning out of their daily lives, how social and cultural factors impact these meanings, or how the lived daily experiences impact and are impacted by their health and well-being. this evidence is important for understanding individuals, family and community dynamics, but also for shaping evidence-based practice. the ot department at mu has a three semester research series; i teach the first two of these research courses. in the first semester, students learn about the nitty-gritty details of what goes into doing research. during this semester they often see research as something someone else might do—an anthropologist, sociologist, public health specialist—but not an ot. they often do not connect research to something they could or would ever want to do. in the second semester they form research teams and write a proposal for research they will conduct with that group and a faculty mentor in the following semester. although the faculty mentor usually determines the research direction and topic, by the end of the second semester, the students have taken ownership of the idea of being researchers. their projects usually focus on occupation and function, but are largely interdisciplinary explorations of ways to improve continued on page 41 anthropology & aging quarterly 2009: 30 (2) 41 perkinson and briller, continued from p. 26 of a new house, to convey the experience of venturing into a new place (either physical or intellectual) and thoroughly exploring it, room-by room. this orienting metaphor enabled him to discuss quite eloquently how he viewed the “fun” (aka intellectual excitement) of throwing open the doors and seeing what one finds in these rooms. upon entering each new room, one can see what is already there and the overall dimensions and characteristics of these spaces. sometimes one knows about key aspects of what one will find there, and sometimes one is surprised as well. opening these doors also presents opportunities to think about how the various “rooms” in the house fit together and can be coordinated over time. he captured the excitement that comes at the beginning of such an exploration and recommended paying close attention to all aspects of this discovery process, keeping the “big picture” in mind and never forgetting the fundamentals of each field—e.g., what makes the framing of a particular issue anthropological, and likewise for ot. the “good bones” of the anthro-ot house, with its strong foundation and supporting structures, should provide an appropriate environment that will foster the continued growth of our cross-disciplinary dialogue. in spite of its time slot (i.e., the last morning of the conference), it was clear that the session had an impact. there was much post-session discussion in the hallway about individual papers, the discussants’ comments, and where to go from here; so much so that several people expressed concern about making it to the airport in time to catch their flights. we, as the session organizers, took it as a good sign that this conversation continued, that there was enthusiasm for ongoing exploration of this linkage, and it fortified us for taking this work forward. we hope that you will enjoy reading about these issues, learning about what has been discussed so far, and adding your own voices and perspectives to extending this conversation. references: american occupational therapy association (aota). 2008. occupational therapy practice framework: domain & process. 2nd edition. bethesda, md: the american occupational therapy association, inc. block, p., frank, g. & zemke, r. 2008. practicing anthropology (special issue on anthropology and occupational therapy), 30(3). frank, g. 2007. occupational therapy & occupational science interdisciplinary interest group: a proposal to the national association for the practice of anthropology. inhorn, m. 2007. medical anthropology at the intersections. medical anthropology quarterly, 21(3): 249-55. kronenberg, f., algado, s. & pollard, n. 2005. occupational therapy without borders. edinburgh: elsevier/churchill livingstone. law, m., polatajko, h. baptiste, w. & townsend, e. 1997. core concepts of occupational therapy. in e. townsend (ed.), enabling occupation: an occupational therapy perspective (pp. 29-56). ottawa, on: canadian association of occupational therapists. pollard, n., sakellariou, d. & kronenberg, f. 2009. a political practice of occupational therapy. edinburgh: elsevier/ churchill livingstone. the individuals’ “life opportunities.” in all likelihood, most of them will become practitioners, not researchers, but this experience allows them to see why evidence-based practice is important and how an interdisciplinary lens enhances both their field and others. schatz, continued from page 27 adults’ interest in not only “doing something” but also “being someone”, and for these participants, that meant being recognized as active, engaged, independent and therefore, vital contributing members within american society. going forward in extending this research program, i look forward to drawing upon and integrating a variety of disciplinary perspectives that can inform this work from anthropology, gerontology, occupational science/occupational therapy, and technology studies, to list some relevant areas here. harrod, continued from page 29 p27 schatz (2)may2009-5 p41_30 (2)may2009-2 anthropology & aging anthropology & aging, vol 36, no 1 (2015), pp. 62-81 issn 2374-2267 (online) doi 10.5195/aa.2015.83 this work is licensed under a creative commons attribution-noncommercial-no derivative works 3.0 united states license. this journal is published by the university library system of the university of pittsburgh as part of its d-scribe digital publishing program, and is cosponsored by the university of pittsburgh press. frail, independent, involved? care and the category of the elderly in japan iza kavedžija sainsbury institute for the study of japanese arts an cultures, norwich, uk contact: iza.kavedzija@gmail.com abstract this article examines how the category of the elderly in japan is constructed through diverse forms of care, understood as moral practices intrinsic to peoples’ senses of self. it offers an analysis of a range of informal as well as institutional configurations of care in the japanese urban context, highlighting the complexity as well as the overlapping nature of these diverse arrangements. it also explores ethnographically how older people experience these arrangements as they move through different sites of care, and how they negotiate the conflicting demands on their sense of self. the various types of care at work in these settings all contribute to different understandings of older persons, and different constructions of the category of the elderly: as clients; as visitors or guests; as fragile ‘struggling persons’; as ‘grannies’ in familial relations; as (caring) neighbours. more than a handful of labels, these variable configurations of personal identity affect care practices and social relationships in direct and tangible ways. keywords: category of the elderly, care, japan, personhood http://www.library.pitt.edu/ http://www.pitt.edu/ http://www.library.pitt.edu/articles/digpubtype/index.html http://www.upress.pitt.edu/upressindex.aspx http://creativecommons.org/licenses/by-nc-nd/3.0/us/ anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu frail, independent, involved? care and the category of the elderly in japan iza kavedžija sainsbury institute for the study of japanese arts an cultures, norwich, uk contact: iza.kavedzija@gmail.com the concept of care has recently gained prominence as a “defining moral practice” that shapes both caregivers’ and care-receivers’ senses of self (kleinman 2009:239). in the anthropology of aging, care practices have been shown to have profound consequences for making, sustaining or eroding the person. buch (2013), for example, shows how older adults in chicago are able to maintain a sense of independent selfhood with the support of their home workers, who, in provision of care to their clients, made an effort to embody their client’s values and sensory histories (buch 2013:639, 647). when taken to refer to a particular mode of relating to others in settings beyond the medical context, care and personhood can be so inextricably entwined as to reveal fundamental presuppositions about the nature of being in particular cultural contexts (e.g. borneman 1997; see also walker 2013). writing about healthcare and diabetes patients, annemarie mol (2008) has drawn a useful contrast between what she terms the “logic of care” and the “logic of choice.” the latter hinges on a conception of individuals as citizens or consumers in charge of making choices. if these are made poorly, something must be wrong with either the information they were provided or with their capacities to choose. as citizens, such individuals can form collectives to further their cause, and as consumers they are seen as parts of collectives, to whom goods and services (including treatments and support) can be marketed and sold. the logic of care, by contrast, moves away from an understanding of treatment as a series of moments of choice, and refers instead to a continuous, fluid and collaborative effort with uncertain outcomes. this ties specialists and other health providers into a network with patients, to make decisions jointly and to revise and amend them in a continuous iterative process. in the logic of care, collectives precede persons, and one always already belongs to a number of collectives, though these are not unchanging. indeed, mol argues that good care depends on the categories that designate the collectives one belongs to, which must continually be adjusted and crafted, time and again. these categories, are not based on characteristics that are given – as they are in the logic of choice, where one is grouped together with those seen to be similar – but selected as relevant in the process: “the category and the individual that belongs to it, are shaped together… [categories] are not taken to be fixed reflections of a given reality, but tools to work with” (mol 2008:73, 74). building on this recent work within the emerging anthropology of care, this article outlines the construction of the category of the elderly in japan in the context of community care.1 while a number of scholars of japan have made valuable contributions to the study of care, especially the care of older people, much of the research on older people has focused on the kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 63 63 institutionalized elderly living in nursing facilities (e.g., kinoshita and kiefer 1992, bethel 1992, thang 2001, wu 2004), or on occasion with their families and in the community (e.g. hashimoto 1992, long 2000, brown 2003, jenike 2004). as recent figures show, however, growing numbers of elderly live on their own or with their spouse2, and not in an institution or within a threegeneration household. this article therefore offers an analysis of a range of informal as well as institutional configurations of care in the japanese urban context, highlighting the complexity as well as the overlapping nature of these diverse arrangements. it also explores ethnographically how older people experience these arrangements as they move through different sites of care, and how they negotiate the conflicting demands on their sense of self. focusing on a particular neighborhood in the city of osaka, which i will call shimoichi, i describe community welfare3 as a continuum in which spheres of local government, private businesses, voluntary organizations, and informal networks of support are all in fact connected. actors involved in these various sites of care move seamlessly between such spheres, over the course of a day, a week or a lifetime (kavedžija 2013). in tracing movements along these paths, moreover, i further show how these actors may change their role from one cared for to one involved in the provision of care for others. when care is understood more broadly than formal medical care, or than strictly defined welfare provision systems such as the long–term care insurance in japan to include a variety of forms of support and expressions of concerns for others, the extent of involvement of those who are otherwise seen as merely receivers of care becomes even more prominent. some of the oldest residents provided forms of support and care for others by checking up on them, passing on information about them to others, or providing advice and connections in the neighborhood, all of which are vital roles for the effective functioning of a community network of support. my analysis begins with the local authorities and the long-established role of the volunteer welfare commissioners (minseiin); the more recent community network promotional officers; a monthly food service for the elderly; and a number of workshops and seminars organized by the ward. i then examine the not-for-profit organizations and private businesses enabled by the long-term care insurance (ltci) law of 1999 to provide welfare services. many of the actors involved in providing certain welfare services, such as volunteer welfare commissioners (minseiiin), helpers or volunteers, are themselves over the age of 65, and so could be considered elderly. the category of the elderly (kōreisha), outlined briefly in the following section, is thus considerably more variable and complex than it might at first appear. it certainly cannot be reduced to an image of frail dependents, as many older japanese are actively involved in the provision of care to others. the various forms of care at work in these settings all contribute to different understandings of older persons, and different constructions of the category of the “elderly”: as clients; as visitors or guests; as fragile “struggling persons”; as “grannies” in familial relations; as (caring) neighbors. more than just a handful of labels, these variable configurations of personal identity affect care practices and social relationships in direct and tangible ways. discursive frames such as these affect senses of moral personhood profoundly, shaping “our very ideas about what it to be normal, valued and successful human being” (lamb 2014: 51). kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 64 the category of the elderly in japan when simone de beauvoir wrote the coming of age in 1970, she hoped to break the “conspiracy of silence” surrounding the topic of aging. she voiced her indignation about what she perceived to be the current state of affairs: in practice the aged are not looked upon as a class apart (…). there are books, periodicals, entertainment, radio and television programmes for children and young people: for the old there are none (1970:3). the times have changed, it seems, for the elderly are increasingly perceived as a distinct social category, and targeted as consumers, patients, voters, and so forth. in japan, the descriptive labels used by the media vary widely and dramatically: from “elderly nobility” (rōjin kizoku) to “rampaging old folks” (bōsō rōjin4) or even “older criminals”5 – the latter a response to the increase in older people committing crimes, in proportion to an overall increase in the over-65 population. this is perhaps comparable to what anthropologists have shown to be the relatively recent emergence of a view of “children” as in some way fundamentally different to “adults,” as compared to medieval times, when children were not given a distinct social status, and “childhood did not exist” (aries 1962). in japan, where age is considered an important factor for classifying different members of society, where life stages were clearly marked by transitions that are remarkably consistently timed, and where practices of age-grading still persist in rural areas (traphagan 2000:9), one might expect that old age would be clearly defined. instead, we find that it is contested and challenged by some; quietly resisted by others; and– perhaps most importantly – takes different forms in different contexts. the older people i knew in shimoichi, especially those over the age of around seventy, rarely mentioned their age in the course of their everyday conversations. these took place in a local community salon where i often volunteered, an open, café-like space for members of the local community. by contrast, some of my younger interlocutors those in their late fifties and sixties– often joked about their age, remarking that they were “grannies” (obāchan tachi), for example. for many japanese, especially those lucky enough to be in good health in their seventies and eighties, i suspect that “being old” may be much less of an issue than “becoming old.” one afternoon in early january, for example, okada san a lively woman in her sixties with a strong presence who also volunteered in the salon every week arrived to make zenzai for the next day. in the middle of preparing a large amount of this very sweet winter favorite for everyone to enjoy together, she glanced up at the lively group of older ladies chatting loudly in the salon and smiled warmly at me: “i hope i won’t become like them when i get old! though, some people already tell me that i’m exactly like them: stubborn and loud!” she laughed, and in a more serious manner added: “i sometimes think how hard the job of a home helper is, physically and emotionally. old people just become selfish (wagamama). i guess we all become like that…i just hope that i won’t become a burden, i don’t want to get bedridden....”. okada san’s concerns about aging, in other words, were very closely related to the challenges of dependency and becoming a burden on others. despite the legal designation of elderly [kōreisha] as those above the age of 65, the precise age at which one is considered to be “elderly” or “old” is a contested issue. according to the kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 65 65 white paper on the aging society (cabinet office 2009: 17-8), of a sample of japanese asked at what age is one to be considered “elderly” (kōreisha), only 14 percent answered “65 and above.” almost 47 percent answered “70 and above,” almost 20 percent answered “75 and above,” and 10 percent answered “80 and above”. when older japanese were asked to compare the age at which one is considered to be elderly with their own age, three out of four people in the 65-69 age group answered “above my age.”6 moreover, when asked to compare their own age to the age at which one should be regarded as an elderly person who should be supported (sasaerubeki kōreisha), 83.6 percent of those aged 65-69 responded “above my age,” as well as more than half the 70-74 age group. it appears respondents in their sixties, especially those just over the age of 65, contest the official designation, and particularly the way it relates to an expectation of support and dependency. okada san’s offhand remark to me reflected much the same sentiment. the association of old age with the “right” to be dependent on others lies at the core of anxieties over “growing old.” according to traphagan (2000:9-10), this is related to a tension between two distinct cultural norms, both of which are highly valued in japanese society: filial piety and the right of older people to rely on their children for support, or to legitimately depend on others; and the imperative not to inconvenience or burden others. traphagan stresses that the tension between these two norms, in practice, means that many older people resist their designation as elderly in order to avoid the possibility of burdening others, thus foregoing the support to which they are legitimately entitled. while good care in most western contexts is associated with support allowing older subjects a form of independence (buch 2013), japanese conceptualizations of personhood is often said not to focus on independence so much as on relationships with others, constituted as “a nexus in a series of human interrelationships” (becker 1999:70). nonetheless, a degree of autonomy was highly valued by most of my healthy older interlocutors, who cultivated numerous relationships of support as a way of maintaining a form of independence “i’m like an information desk for everything”: faces of local government support when i met her, takano san was a sixty-three year old lady with a broad smile and a direct manner who had been working as a community network promotion officer for five years out of the fifteen the position had existed in her neighborhood. meanwhile, noguchi san, a talkative but soft-spoken lady in her late sixties, had held the position in her neighborhood for last seven years, after having previously served as a community welfare commissioner (minseiiin). i asked them both about their work, and takano san explained as follows, while noguchi san nodded quietly with approval: we work with the elderly (kōreisha san). our job is to look out for people in the neighborhood, supporting health and positive participation in society, so that people wouldn’t get isolated or withdrawn, encouraging them to get out but also visiting their places. we need to encourage conversation and the creation of a community in the neighborhood, which makes it easier to locate and discover those in need of help, due to physical difficulties or mental problems such as dementia. we provide advice about connections to various services such as home-helpers, check the conditions for care kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 66 insurance the creation of such connections is the main part of our job. (…) we need to discover the elderly who need help and watch over (mimamori) them. takano san then added that she felt that their job with the network council (netowāku iinkai) was created because the local administration didn’t know much about the actual living conditions of those residing in the neighborhood, so they transfer responsibility for looking out for the inhabitants to the welfare network promotion officers in each neighborhood or subsection of the ward. the position was created by the city out of concern for the growing number of elderly causing pressure on local communities, at the same time as communication and links within them were perceived to be weakening. before the introduction of this new full-time and paid position, the municipal government7 relied mostly on the services of the appointed volunteers, or so called “community welfare commissioners” (minseiiin), and still relies heavily on their service (goodman 2008:98). community welfare commissioners need not be certified social welfare specialists, but their role requires that they know the area and its inhabitants well, and they are usually local citizens. at the time of my fieldwork in shimoichi, it seemed that the visibility of minseiiin was rather low, and few of my interlocutors knew who the commissioner in their area was. as the local welfare commissioners council has relative organizational freedom, not all councils operate in the same way or with the same efficiency. the head of the local welfare commissioners council was himself aged 73 and had a fairly laissez-faire approach, according to one minseiiin in the area. there is little guidance or structure, which has led to a minimalist approach among the commissioners. another problem faced by welfare commissioners is the increasing numbers of elderly in the area (22 percent of the population of this ward is above the age of 65, and over 50 percent of people are above the age of 60). as a consequence, according to the head of the welfare commissioners council, the welfare commissioners (minseiiin) face difficulties in tracking detailed information for all the elderly in their area. in order to extend their services to the local population and to alleviate the burden on the commissioners, the new position of the community network promotion officer (chiiki netowaku suishinin), described by takano san and noguchi san, was created. certain aspects of the work of community welfare commissioners and community network promotion officers were very similar, involving visiting the elderly and others in need of support, such as single parents. noguchi san had experience in both positions, and emphasized that the responsibility she felt came from undertaking her role as a paid official: the main task is the same, looking for those who seem to be struggling [komatteharu mitai), but before [in the role of the minseiin] it finished on giving out the information. now i have to see it through, to the end. if i recommend the day-care service i will come and ask how they like it, and if it seems that they don’t like the atmosphere or are uncomfortable with something, i might accompany them to another place, or look for a different solution. when their circumstances change, if they need more care, i advise again and keep checking on them. to the very end… if i see taking a bath is becoming too difficult i may recommend a day-center they can drop in once a week for a bath. but i then come back and check if they like the place, and if they think the atmosphere is a bit off, i try to introduce them to another place, and so on (…) this can be difficult and it is a responsibility. one also has to beware of getting too close. you get asked to do this and that, helping with the rubbish or taking a letter to the post office, watering the plants… kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 67 67 our job is to provide a link to the services, to find them a home helper to do that, that’s their job… but grannies (obāchan tachi) don’t get it. (…) “why not have a cuppa [ocha nondeitte chōdai),” and then as soon as you get a bit closer – “it’s on your way, take this to the bank,” “drop this at my doctor’s office.” and we are not allowed, not even once, which is tough. as noguchi san spoke, i noticed that she switched from a formal register to the relative familiarity of the osakan dialect when trying to make me understand the problems of their job. she thereby placed me in the position of a familiar, and in fact, it could be suggested that she thus used precisely the same technique that “the grannies” used on her: namely including someone in one’s inner social circle, which of course makes it difficult for that person not to consider their perspective, and very hard to refuse their requests. the workers find it difficult to resist helping the elderly directly, but explain that the home helpers must be the ones performing these tasks, and so restrict themselves to putting the elderly in contact with the relevant services. some of these involve local volunteers, such as a local group of retired men who help with small tasks around the home, such as fixing taps or changing light bulbs; others involve calling in specialists, funded by the local authorities, to refurbish the homes of the elderly in order to make them more accessible. in all these cases, the promotion officers are supposed to be present, so that elderly people can interact with someone they already know, and need not feel unsafe about allowing strangers into their homes. the range of such tasks seemed vast, and indeed the network promotion officers worked overtime most days. their commitment to stay involved until “the end,” to see it through, very much resembles the “logic of care” described by mol (2008), in which care is not conceptualized a comprised of moments of choice, but as a continuous process, in which earlier decisions have to be continuously re-evaluated by all of those in the care nexus, including those cared for. the welfare commissioners and community network promotion officers are supposed to “look out for” those “in need of help,” those who “need support,” those who “seem to be struggling.” they are to make sure that no one gets isolated or is left to their own devices, not least the “elderly people” (kōreisha san), the suffix –san both adding respectfulness and softening the administrative sound of the formal designation of the “elderly.” in their role they are supposed to watch over the elderly as vulnerable, potentially at risk of loneliness and frailty at least as seen by their employers at the local authority. network promotion officers themselves also see these older people as neighbors, “grannies” (obāchan tachi) who do not understand their official role, who instead seek to befriend them and include them in their networks of favours, obligations, gifts and reciprocity. their role as carers has them balancing the formality of interacting with “elderly people” and the familiar neighborly relations of spending time with “grannies.” “has anyone seen harada-san this week?”: the community salon and a neighborhood network of support a sudden rain on a bright day in early june interrupted a stroll 5-year old kenji was having with his mother in the shopping arcade in their neighborhood. as soon as they noticed the confused pair through the window, 93-year old ishida san and her friend jumped to their feet and invited them into the community salon. this café-like space, offering local residents warm kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 68 drinks served by volunteers, was only half full, but the newcomers were nevertheless immediately greeted by a lively chorus of “welcome! welcome!” [irrashai! irrashai!]. four women and two men, mostly in their late seventies and early eighties, were enjoying a conversation and a cup of green tea after their lunch. two middle-age ladies were having a quiet coffee in the corner of the room, exchanging news about their families. one of them was a home helper who worked for the non-profit organization (npo) running the salon and which had its office upstairs. kenji was soon seated amidst the older salon visitors and being shown how to fold a paper bird, while his mother ordered a black coffee from ueda-san, the volunteer on duty. this tall, sturdy lady with a warm smile, now in her late sixties, swiftly brought it over and joined the group at the large table in the middle of the room. the conversation soon turned to the absence of harada-san who came in most afternoons. “has anyone seen her lately?” one lady confirmed that haradasan had stopped by yesterday morning, but suggested she wouldn’t be around for another day or two, as she has a friend visiting from another prefecture and was intending to show her osaka castle. other information about people from the neighborhood was exchanged: “what about that man who comes once or twice a week, that kinjo no kata [neighbor], you know, that one who lives across the road from the pharmacy?” someone asked. after a brief discussion, one of the ladies said she would knock on his door on her way home to check if he was all right. “that is what neighbors [kinjo no hito] do!” most people in shimoichi would know of the salon where these conversations took place, and where weekly events are organised and open to the public for free or for a small sum. the salon is located in an old two-storey townhouse in a shōtengai, or shopping arcade, and was a popular destination among the older residents who like doing daily grocery shopping in the small stores, where they can exchange news with the sellers and other customers. the arcade, now experiencing some loss of customers due to the proliferation of supermarkets, used to be a quite an attraction of this downtown (shitamachi) neighborhood, with some families having lived in the area for several generations. in the salon on e can have a tea or coffee every day between 10 am and 5 pm, or attend an event such as a concert, rakugo (traditional comedy performance), a singing or origami class, a children’s book reading session, or a film screening, all of which are held on a regular monthly or weekly basis. most visitors to the salon live in the neighborhood and arrive on foot from the little streets branching out from the shōtengai. many of these relatively healthy older people live on their own, some with their children and their families and not infrequently, they decide to pop back home for lunch, or an afternoon nap, and return again in a couple of hours. while the majority of the visitors are older, above the age of 65, and the oldest three ladies are in their nineties, some young women would come for a cup of tea while shopping in the arcade with their children, and a few middle aged women would meet regularly in the afternoons for coffee, once or twice a week. the salon is valued highly by the visitors, who create new informal networks of support for each other and exchange information on other services and events available in the neighborhood. it is also a place where other services can be booked, as the npo running it has engaged in a wide variety of activities: starting with a volunteer project (tasukeai – mutual help), later developing a home-helper service supporting people in their own homes; collaborating with other institutions in the field and supporting some of their projects; up to opening a community salon in 2007, run by volunteers and funded by these other activities. the care offered here extended beyond the home helper’s services, funded by the ltci, to include a range of everyday forms of support, including the provision of information on daily kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 69 69 matters and keeping track of one’s acquaintances in the area and thus minimising risks of accidents or feelings of isolation. the warm social atmosphere extended beyond the walls of the salon itself, and much of the care-work was performed by older people: some of the home helpers were above the age of 65, as were almost all volunteers in the salon (except one who was a daughter of a home helper, and the anthropologist). people were careful to be friendly with each other, but avoided being overly close, so as not to impose a burden on other visitors to the salon. in other words, they behaved like good neighbors – an expression one could often hear when people were asking after someone, that “kinjo no kata” [neighbour] who has glasses and a stick, or the “kinjo no kata” who lives opposite the pharmacy. some current volunteers, like ueda san, felt that helping out in the salon and in various other ways in the neighborhood was not only a normal and pleasant thing to do, as it gave one opportunities to chat and not feel lonely, but also felt a sense of gratitude: “i feel grateful [arigatai]. people from the area always looked in on my mother so i felt i did not have to stay at home and was able to continue working, even after my father passed away and she lived alone. that is probably why i felt like helping more.” this kind of neighborly behaviour tied older and younger members of the community in a large network of support. the care here often takes the simple form of presence and checking how other people are doing, or whether they need more help in obtaining information or support. my older interlocutors and they often stated that this kind of support really made it possible for them to keep living on their own and not have to move into an institution. while the support was then on the whole seen as invaluable, the particular acts of care and specific practices of support were circumscribed and limited to small favours, in order to avoid feelings of indebtedness to a particular person. older people were just as active in extending this kind of support to others as younger ones, if not more so, and people of different ages, of different levels of health and in different circumstances, all engaged in it on a fairly equal footing, without one group clearly demarcated as carers and others as care receivers. they were all simply neighbors, looking out for each other. figure 1. preparations for the food service for the elderly—doing things “properly.” photo by author kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 70 “put the kettle on, they’re coming!”: the food service for the elderly every other tuesday, a food service for the elderly (kōreisha shokuji sabisu) was organized by local volunteers in the meeting hall in shimoichi with support from the ward office. on the day i joined to help, the bright and spacious hall was unlocked by the first volunteers around ten thirty in the morning and the preparations began soon thereafter. all the volunteers change into identical aprons and caps and their belongings were stored out of sight in a storage cupboard. thus dressed for the task they wiped and arranged the tables and chairs for groups of eight, while others prepared the stock for soup and cut up the seasonal fruit for dessert. all the volunteers were female and middle-aged, their ages ranging from forties until well into the sixties. the atmosphere among the women was pleasant, cheerful but efficient. finally, the elderly started arriving, all above the age of 70 (the minimum age is defined differently in every neighborhood and varies between 70 and 75), but all of them unassisted. these “okyakusan” --the guests, or customers, as they were referred to, included around 35 people (over the age of 70) out of some 1200 elderly living in the area. information about the number of people was sent to the kitchen and steaming green tea was brought out as soon as they chose a place to sit. groups assembled and some of the visitors were soon greeting their acquaintances. very few did not seem to know anyone and they sat down wherever there was a free space. at figure 2.the food service for the elderly. photo by the author. kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 71 71 some tables, especially mixed ones, the conversation was lively. after a few words of official greetings the food was brought out, followed by dessert and hot drinks green tea, black tea or coffee. the volunteers commented on the speed with which the food disappeared, but did not make an effort to encourage people to stay longer to socialize, and, in fact, started cleaning up before most people seemed to have finished. promptly, the empty cups were collected and washed, and within half an hour the room was empty and swept, tables and chairs neatly arranged in the corner. with an air of mild relief volunteers sat down to have their lunch, for which they were expected to pay. in the course of the conversation it transpired that most of them were housewives who lived in the area, or were recently retired, but some worked part-time (for instance one worked as a care-worker in a day-care facility, and another was a home helper who obtained an official certificate after initially looking after her frail mother). the volunteers explained that they get involved only once in a while, in most cases once a year, since the rotation includes many of the women living in the area. as a consequence, the volunteers did not know the guests and were mostly unable to engage with them in a personal manner. of the many questions that emerge from this description, i wish now to address the following: what kind of image of the “elderly” is under construction, and what do the elderly themselves think of events of this kind? recall that the elderly here are defined as those over 70, and at times considerably older. as one of the employees of the social welfare council implied, the reason for this was essentially practical: to set the lower age limit in such a way that the group of people invited would not be too large. but she also suggested it was because the older people whose peers were now either immobile or deceased needed an opportunity to socialize. the kind of older person targeted was thus older though still mobile and in need of company. the treatment of the elderly was always respectful, efforts were made to prepare everything in the right way, such that everyone would be greeted properly and served tea at arrival, and the interaction was restricted to this formalized level, largely due to the large scale of the event, limited time and infrequent meetings. in some areas the lunch service was followed by some form of entertainment programme, presumably with the idea of engaging the elderly more actively. both the lack of engagement and the structured involvement caused mixed reactions among the elderly i knew well, who in some cases complained about the formality and strictness of the proceedings. for instance, nakano-san frowned with disapproval while explaining to me that at every one of these events one’s attendance is recorded at the beginning. she found it inappropriate and “strict,” so she decided to stop attending. others welcomed the opportunity to socialize and fill their time with various activities, and had quite a busy schedule. the elderly who knew many other people seemed to have a good time socializing and kept ordering additional cups of tea for their acquaintances and chatting vigorously. the ladies made sure that all the men, of whom there were far fewer, were comfortable and in lively company. on the other hand, several elderly ladies who didn’t seem to know anyone shared a few tables around the edges and did not socialize much among each other, leaving promptly after they finished their meal. it is likely that this event provided a welcome space for many elderly to socialize, and yet those who might have been most in need of company remained quite isolated. the older “okyakusan” – guests or customers were treated as such, with due formality and distance, with politeness and reserve, with appropriate polite language and with attention to detail. they were expected to respond and interact in the same manner, dressing for the occasion and no reference kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 72 was made to their age in any way throughout the event. excessive familiarity and diminutives in addressing the okyakusan were discouraged and on the whole they were treated not only as full adults, but as ladies and gentlemen who need to be respected: otoshiyori rather than kōreisha – “seniors” (those older in age than us, warranting respect), rather than “elderly,” the official and somewhat dispassionate designation of older age. “why don’t you try and paint her ribbon blue?”: a day in a day-care center for the elderly sato-san, a calm and quiet lady of 78, who lived with her daughter at the time of my fieldwork, attended a day-care center twice a week, mostly for the company and to get help with a bath. this is how a typical day in the pleasant day center, a private day-care center, began for her, much as it begins for all the others. first thing in the morning, around 9 am, sato-san was picked up from her house by one of the small vehicles owned by the pleasant day company. others chose to come on their own, either on foot if they live nearby, or by bus, but they are in a small minority. as soon as sato-san arrived, she put on her white canvas shoes, remarkably similar to school slippers. soon thereafter she was seated in her usual place, marked discreetly on a layout on a little magnetic board in the far corner of the room for the benefit of the carers. soon everyone would be led one by one to have a bath and have their hair washed and dried, first women and then men, of whom there are significantly fewer just four out of twenty. that particular wednesday, everyone was invited to colour an illustration for this month’s calendar, which depicts a young girl in a kimono. the drawing resembled children’s colouring books. sato-san was sitting quietly and not painting, so a young female staff member encourages her to participate by asking if she needs a particular colouring pencil, perhaps blue for the girl’s ribbon, if she agreed. two ladies in good health tried to avoid participating in the task and conducted a quiet but animated conversation, but were soon interrupted by a male staff member asking if their unfinished work should be included in the folders to be taken home to their families, along with notes on their health and food. unperturbed, two ladies smiled and continue with their conversation, not making any explicit statement about lack of interest in this infantilizing task. at around this time the nurse begun taking people one by one for a simple health check, enquiring into how they felt, measuring blood pressure and offering a simple massage of the upper back, neck, shoulders, and hands. on the days when i visited, no health complaints were registered. every time someone had to get up to the toilet, to wash their hands or to talk to the nurse, they were led and supported by one of the staff members, regardless of the state of their health and feeling of stability. this seemed to have two main consequences – everyone felt equal and as their health deteriorated they did not feel a notable change in how they were treated, but it also meant that everyone was much less mobile, having to wait for a staff member to wash their hands and approach them in order to lead them to their destination. kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 73 73 after everyone had their bath a young man led a series of light seated exercises b, followed by lunch, carefully customized for each person, bearing in mind preferences and health conditions. as the trays were collected, the quantities of food eaten and any other comments are duly noted in a special form. the note taking was extensive, with reports written up for the center and for the family and the staff spend most of the following coffee break to keep up with the documentation. a good acquaintance of mine, murata san, who used to work in the pleasant day care center, told me that even though the work was rewarding, it was extremely exhausting emotionally. one had always to be focused and careful, and the responsibility was high. furthermore, one always had to be attentive and in good spirits. he found it too difficult after a while and resigned from the job several months before i visited the center to focus on volunteering in his own neighborhood. murata-san believed it was a difficult job in the long term, being demanding but not very well paid, and it would be difficult to support a family with a carer salary. many members of staff were therefore new and very young, and the young female professional in charge of the organization within the center was also new to the job, with less than a year’s experience, though very warm and enthusiastic. after the coffee break the elderly were once again invited for an afternoon exercise and games before leaving for home. the staff, most of whom were energetic and cheerful, and seemed patient and gentle, addressed the elderly by their name, using a chart with the seating plan pinned next to sink as a reminder. compared to other settings, including the salon at the npo fureai, the elderly here were slightly frailer, and a couple had mental health problems and could not be left on their own. though the ages varied between 70 and 90, over half were in good health, and seemed alert and cheerful. while warm and generally pleasant, the atmosphere at times resembled a kindergarten. because the time was so carefully structured, the elderly were often being told what to do; the tasks designed to be inclusive were at times very simple and perhaps slightly demeaning for the healthier ones, yet everyone was encouraged to participate to the best of their abilities. i was struck by the contrast to the atmosphere in the salon, where the elderly were treated with full adult respect and as active, independent agents. while the care and protection seemed necessary for some of the frailer elderly in the center, the focus on inclusion and participation regardless of difficulties, physical or mental, seemed to create a more patronizing attitude. the fact that some of the most independent elderly were frequenting the center only once a week seemed to figure 3. water cups at the day-care center photo by the author. kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 74 indicate that they were perhaps at least as interested in the assistance with bathing and the health check-up, as in the socializing aspect of it. “even elderly can help”: the council of social welfare i entered a brightly lit, well-heated meeting room, with tables and chairs in three neat rows. my eyes met several rows of smiling and lively women in their late 60s, and a stately silverhaired lady in her 80s stood out in the first row. three men, all of whom seemed recently retired, sporting smart outfits, were sitting scattered around the room. the meeting was for people hoping to start community volunteering, who – as they put it –would like to give a little help, “chotto tasukeai,” in the neighborhood. the meeting was opened by one of the employees of the council of social welfare (shakai fukushi kyogikai or shakyo), who explained that the topic of the first seminar in the series was “the necessity of (mutual) help among the members of the community.” whereas contacts in the community were taken for granted in the past, this was no longer the case; and while there were various services available for the elderly in the neighborhood, one could not live using those services alone. furthermore, she explained, the reforms in ltci will make it more difficult to use, so we should be thinking about how people can help each other a bit. she concluded by introducing a guest speaker. the speaker, a professor from one of the universities in kansai region, herself in her sixties, spoke a warm and friendly-sounding osakan dialect and, smiling encouragingly, began her lecture. she asked how many of the members of the audience lived in a three generation household (consisting of children, parents and grand-parents) or even a two-generation household, and only a handful raised their hands. the show of hands confirmed that a majority lived on their own or with their partner, as is increasingly the case in osaka in general, the professor continued, as statistical data shows. she argued firmly that for most people over the age of, say, 85, even if they are healthy, daily tasks start becoming more difficult, and when thinking about that stage, elderly have basically just three options. the first is to move in with one's children, even if it isn't in the same area, but that should be done much earlier so one can make new friends and find new places to which one wants to go, and when one becomes frail, it is too late. the second is to move into a facility for the elderly, preferably in the neighborhood in which one already lives, but that can involve a number of problems, not least of which is the financial burden. the third way of thinking is something like this: “well, i have been involved in community support and have volunteered, so perhaps someone will help me and i can continue living in the neighborhood i am familiar with.” building on this view, the professor argued that support within the neighborhood is not just some distant general problem, but an immediate concern for everyone. even before one needs medical care, while healthy, one can start feeling uneasy and isolated, the world of an elderly person can shrink. many elderly do not want to live with their children, but instead want to live on their own terms, to do what they feel like, especially while in good health in their sixties and seventies. it is therefore important to be proactive, to do something oneself, to increase the numbers of the people one knows and to get involved. “even elderly can help [kōreisha demo tasukeai dekiru],” the professor argued encouragingly and compellingly. many nodded their heads in approval. this seminar was my first encounter with the activities of shakyo, or the council of social welfare, in the south osakan ward. the promotion of social welfare is one of its activities kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 75 75 in the area, which taken together aim at making a “lively community.” the activities of the council could be divided into three main categories cooperation with various welfare actors, promotion of social welfare, and aid and support for members of the community. cooperation with other community welfare actors includes professional support for the welfare institutions in the ward, support for the neighborhood councils of social welfare, administration of the volunteer bureau and the welfare goodwill-bank, as well as the “loving visit campaign,” a programme sponsored by yakult, a probiotic producer (volunteer based free deliveries of yakult products to people living alone above the age of 85 three times a week), and the management of the activities related to the respect for the aged day. the promotion of social welfare is achieved through the distribution of community newsletters, the organization of workshops and the promotion of welfare education in schools. finally, the aid and support of the members of the community ranges from providing advice and information about the social services and support available in the community (including a long-time insurance advisor and care manager for the elderly), to wheelchair lending, wheelchair-adapted car lending, a futon cleaning service for the residents of the ward over the age of 65, to the “anshin” [peace of mind] support service mentioned above. it is interesting to note that even though the leaflet advertising the seminar, with the titles of all the lectures in the series, did not mention the elderly at all, issues related to the elderly entirely dominated the lecture and the discussion, and all the subsequent seminars in the series. the japanese term in the title tasukeai, however, referred not just to helping, but also to mutual aid or cooperation. while i can imagine that in different circumstances the focus of such a workshop on mutual support in the community could have been on working women, education or children, aging and support for the elderly seemed to be such an obvious concern that it did not even need to be emphasized in the leaflet or singled out in the introductory speeches. in a neighborhood where almost one quarter of all inhabitants were elderly, it seemed that everyone was concerned with aging in one way or another. in the context of community welfare, it is perhaps even more interesting to note that the majority of the people in the room, interested in the first instance in helping out in the neighborhood, could themselves be described as elderly. the local officials have recognized the potential of involving the older people themselves in the networks of support, just like the organizers of this seminar. the call on the elderly to become more involved in care for others has important consequences in at least two ways: in creating and supporting an image of the elderly as providers as well as receivers of care; and in raising an important issue concerning the responsibility of the state for the welfare of the elderly. this latter issue seems increasingly important as changes in the availability of the lcti services8 have recently been announced by the government and will undoubtedly lead to interesting developments, with some of the local welfare organization leaders fearing increased pressure on volunteers to replace those services formerly provided through lcti. this caused much anguish and worry, as they see their services as complementary rather than a replacement to an effective large-scale national system of care and support. grannies, guests, neighbors: personhood and “the elderly” the illustrations from these various settings provide a background for understanding care and support institutions for the elderly in a south osakan ward. the elderly might seek support from one or more of these. furthermore, they may themselves in various ways be kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 76 engaged in providing care for others, as many care-related activities are carried out by people who can themselves be described as elderly. the members of the workshop on help in the neighborhood were mostly in their sixties and seventies. it is therefore important to note that the elderly are not just receivers of support in the community, but also increasingly participate in providing it, not only within the bounds of their own family. in some cases it is even more complicated, as they might be simultaneously receiving support in some way and providing it in another. for instance, the silver haired lady, sitting in the front row in the workshop for community volunteers, lives in a facility for the elderly, with long-term-insurance partly covering the cost. these cases presented, therefore, undermine the homogeneity of the category of the elderly as simply those who are in need of care and support. not only with respect to the reliance on support and care of others, but more generally with regard to differing life circumstances and lived experiences, the elderly cannot be treated as a homogeneous category, with similar lives and needs (c.f. matsumoto 2011:6-7). how then do people become defined as old or elderly? vera-sanso (2006) argues that these definitions need to be understood with respect to control of resources, as “being defined as old not only implies particular capacities, needs and rights, but also confers duties of care and support on sons [in the context of south india] and these are deeply contested and context dependent... in terms of class, gender and the localized labour market...” (2006:87). thus the issues of dependence, autonomy and interdependence, as well as the meaning of care, are at the very heart of the construction of the category of the elderly. it comes as no surprise then, that the category of the elderly is shaped by the welfare and care provision institutions including the local administration, and that the form this definition takes is itself fluid and in constant negotiation and change. the older people are thus variously envisaged as “the elderly,” “seniors,” “guests” or “customers,” “neighbors,” or “grannies.” the “elderly” are a category of citizens above the age of 65, who have certain rights and obligations: they have a right to care and support through the ltci, under the stipulated conditions and through approved channels, institutions and organizations. these citizens may also “be struggling,” or in “need of support.” in turn, they need to make an effort to maintain their good health, mental agility and their social relationships, which the local authorities support by offering lifelong learning programmes: what is required is discipline and effort directed towards self-maintenance (traphagan 2006). to the extent they are defined as citizens, older people are required to maintain a degree of health, and control over their bodies, which is presupposed in the definition of a citizen (mol 2008). citizens can make claims, but these must be within well-defined boundaries: they may request help with taking out their rubbish or posting a letter, but not just from anyone; these actions should be performed by appropriate service providers. thus in order to make requests to community network officers, they seek to befriend them, to make them their neighbors, to be their “grannies.” this more familiar relationship relies on an exchange of favours as well as expressions of concern. a tired community officer is offered refreshments before she is asked for a favour; asked about her children before she is requested to go to deposit a check; and offered gifts of fruit as tokens of gratitude. sometimes, she is just a “granny,” who “does not understand” things, and is not treated with much reverence or respect. often she is forgetful, getting frail, sometimes she forgets the niceties of social interaction. “seniors,” on the other hand, are polite ladies and gentlemen, treated as respected members of the community, people from whom one can learn a lot, but with whom one would not be overly familiar, especially if they are “guests” or “customers.” a “neighbor” is concerned with other members of the community; she looks in on them and makes kavedžija | frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 77 77 sure that they are all right, and if she tries to help in other ways: she asks after people and conveys the information to those who might be passing by the house of so and so; he offers advice about who might be able to change your lightbulb or where the next foodservice is held; she asks about your health and offers her sympathy. as they move through these different sites of care, all of which are available to them on daily basis, the older residents of shimoichi are interpellated in these various ways. they negotiate conflicting demands on their self-identity – what sometimes seems like quiet acceptance can in fact be form of avoidance, as in the case of ishida-san who likes coming to the salon but avoids the food service for the elderly, because she dislikes the formality of the arrangement. similarly, avoiding a confrontation, two older ladies in the day-center quietly carried on their conversation despite the continued encouragement from the staff to colour in the drawing of a girl in a kimono, a task that could easily be seen as infantilizing. others tried to present themselves as vulnerable and in need of care, switching the tone of the conversation to a more informal register, like the “grannies” described by takano-san and noguchi-san. but most prominently, rather than merely expecting others to care for them, almost all of my informants admittedly all healthy older people living in their own homes engaged in various forms of care for others. in this way, they challenged the deeply ingrained image of the elderly as frail and primarily in need of care and support. recently, government officials have noted the capacity of the elderly to be involved in support and care activities for others, as many of my interlocutors involved in community welfare pointed out, making it a part of their agenda to engage the elderly, especially in light of the growing costs of care. the official policy change is yet to take place and it will be interesting to observe in which ways the official category of the elderly will change as a consequence in the coming years, as funding for state support is thinned out and reliance on volunteer services (often ran by those who are themselves over the age of 65) increases. what light, then, might we finally suggest is shed on japanese personhood more generally by these differing images of the category of the elderly and its modes of construction? older japanese can certainly not be expected to be unchanging, “ageless selves,” coherent continuations of the self of their earlier years now persisting in a changing and increasingly frail body; they are instead unfolding temporally with others, enmeshed in human relationships as “aging selves” (danely 2014:189), continuously changing alongside their consociates (plath 1980). in order to avoid becoming a burden on others, they are expected to make disciplined efforts to maintain their self, thus demonstrating their commitment to the community (traphagan 2006). from the descriptions in this paper, a third imperative for the “good older person” emerges, alongside interconnectedness and disciplined self-improvement: the imperative to care. the ability to care and to express concern, through gestures no matter how small, lies at the heart of social personhood in japan. notes 1. this article is based on extensive fieldwork conducted over the course of 14 months from 2009 to 2010, with follow-up visits in 2013. research was made possible through the generous support of the japan foundation and the japanese society for the promotion of science. the writing up was supported by a robert and lisa sainsbury fellowship, for which i am very grateful. i would like to thank the kavedžija| frail, independent, involved? anthropology & aging vol 36, no 1 (2015) issn 2374-2267 (online) doi 10.5195/aa.2015.83 http://anthro-age.pitt.edu 78 anonymous reviewer on their comments and suggestions. i am particularly indebted to harry walker for his comments, help and support. 2. according to data from 2007, the largest proportion of all households with people aged 65 or over (which comprise over 40% of the overall number of households) comprised ‘couple only households’ (29,8%), followed by ‘one-person households’ (22.5%). ‘three generation family households’ comprised 18.3% and ‘parents and unmarried children only households’ accounted for 17.7% (cabinet office 2009: 6) 3. while acknowledging that community welfare (chiiki fukushi) is not easily distinguished from social welfare in general, it has been argued that the former is not merely a sub-field of the latter (e.g. tsuneji et al. 1996: 2). according to kaneko (1993) community welfare is characterized as a special kind of exchange of social resources in the community, delivered and developed in four ways: through public services; through cooperative services; through commercial services; and self-help and cooperation between citizens. while public services are sponsored by the state or municipal bodies, cooperative services are sponsored directly by people in the community (kaneko 1993: 7). tsuneji and colleagues (1996: 179-187) mention two kinds of actors involved in community welfare: officials or staff (including home helpers and officials of the council of social welfare); and citizens (including volunteers, people taking part in the in-home services and volunteer social workers or minseiiin). all of these groups are in various ways linked to local authorities, informal networks and npos in the area and all form a complex network of actors participating broadly in “community welfare” and services for the elderly. according to furukawa, providers of social welfare can be divided into the “public welfare sector, the voluntary welfare sector, the informal sector and the market welfare organization” (2008:186). 4. a phrase used in the title of a famous book by tomomi fujiwara, an akutagawa prize winner. 5. “the number of those over 65 who committed criminal offences increased almost fourfold from 1998 to 2007, up from 13,739 to 48,597 cases annually, according to national police agency statistics.” (martin 2008; matusyama 2015) 6. the most common term in official use for an elderly person is kōreisha (literally a person of high, advanced age), and it has replaced the earlier term rōjin in official use, as a consequence of an effort by the administration to use more neutral terms (traphagan 1998:346). when speaking of particular people and in direct communication my interlocutors preferred to use the surname of the person followed by –san, or in more informal situations ojiichan/obāchan (granddad/granny). 7. the local government office with which every adult inhabitant of shimoichi is probably most familiar is the kuyakusho, or ward office, a branch of the municipal government (osaka city hall or osaka shiyakusho). it offers some support services directly, particularly financial support for medical equipment and the installation of emergency and fire alarms, as well as the provision of advice to citizens. 8. the reforms announced by the government will affect social welfare and taxation system in an allencompassing way, and aim to increase the overall funds for healthcare and social security in order to accommodate the rising costs of an aging population (mhlw 2015). some of the changes related to the lcti, which is allocated in six categories depending on their assessed needs, would only affect the lower levels (viz. support levels 1 and 2 and care levels 1 and 2), and would lead to increased costsharing (abe 2013). at the same time, the government’s calls for more ‘mutual aid’ and assistance kavedžija | frail, independent, involved? 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